Clinicopathological Characterization of Endometrial Carcinomas Arising in Elderly Women Aged over 70 Years.
Masanori Yasuda, Shinichi Hori, Tomomi Katoh, Michio Shimizu, Keiichi Fujiwara, Naoki Ogane, Yoichi Kameda, Hiroki Nakayama. Saitama Medical University International Medical Center, Hidaka, Japan; Kanagawa Cancer Center, Yokohama, Japan
Background: The incidence of type II endometrial carcinomas (EMCs) increases with increasing age, and mixed type EMCs composed of type I and type II are also more often encountered. Thus, many EMCs in elderly women tend to harbor histologically variable combinations.
Design: This study was conducted to clarify the profiles of EMCs in elderly women aged over 70 years from the histological and clinical standpoint. The 161 examined EMCs were surgically resected during 1995 to 2005 and at FIGO stage I to III. Histologically, the cases were categorized into type I EMCs (G1 or G2 endometrioid, mucinous), type II EMCs (G3 endometrioid, serous, clear, undifferentiated) and mixed type EMCs (composed of more than 90% of type I and less than 10% of type II). Invasive pattern (infiltrative or expansile) and frequency of vessel infiltration (-, 1+, 2+, 3+) were evaluated. Immunohistochemically, expressions of estrogen receptor (ER) and p53 were analyzed using representative sections. Survival ratios were calculated by the Kaplan-Meier method and analyzed by log-rank test.
Results: The 161 cases were divided into 96 cases (59%) for type I, 54 cases (34%) for type II and 11 cases (7%) for mixed type. Type II included 22 cases (14%) with one histology and 32 cases (20%) with more than one histology. There was no significant difference in invasive pattern between type I and type II, but vessel infiltration was more frequently observed in type II than type I (p<0.05). ER and p53 expression manner of mixed type was found to be intermediate between type I and type II, but very closer to that of type II. Expression of p53 was evident in the serous components compared to the clear cell components, but expression of ER was stronger in clear cell components than serous components. The prognosis showed the tendency towards becoming less favorable in the order of type I, mixed type, type II with one histology and type II with more than one histology (p<0.05).
Conclusions: In the elderly women, one-third of total EMCs were type II. The mixed type was relatively few in number, but the clinicopathological profiles were nearly same as those of type II, in spite of the minority (5-10%) of type II components. It was suggested that the serous component was more significant in the determination of clinical outcome compared to other histological types.
Category: Gynecologic & Obstetrics
Wednesday, March 2, 2011 1:00 PM
Poster Session VI # 151, Wednesday Afternoon