Low Stage Clear Cell Carcinoma of the Endometrium: A Review of Clinical Outcome and Survival
Aneta Bakula, Andrea Montgomery, Amy Brown, Aaron Shafer, Srini Mandavilli. Hartford Hospital, Hartford, CT
Background: The clinical behavior and prognosis of endometrial clear cell carcinoma (ECC) is thought to be in between that of endometrioid and serous carcinomas (ESC). ECC is considered a type II endometrial carcinoma and like ESC even at low stage has a risk of recurrence and metastatic disease. However, the behavior and management of Stage I ECC is unclear and there is only limited literature addressing this issue. The aim of this study was to evaluate the clinical outcome of Stage I ECC.
Design: All cases of ECC in which endometrial biopsy/currettings and hysterectomies were performed and slides available for pathologic review were retrieved from a 10-year time period of January 2002 to September 2012. All pathologic slides were reviewed by a gynecologic pathologist and only cases of Stage I pure ECC were included in this study. Clinical features were summarized including demographic information, treatment summary, and clinical follow-up.
Results: 13 cases of ECC that were Stage I (all cases IA) were identified. The depth of myometrial invasion was: 45%, 38%, 17%, <10% (2 cases), 0% (4 cases), no residual carcinoma (4 cases). None of the cases had lymphovascular invasion. In 11 patients the pelvic washings were negative, positive in one patient and not performed in one. The patient age range was 49-83 years of age with mean of 63 years. All thirteen patients were treated with total hysterectomy and bilateral salpingo-oophorectomy. Nine of these patients also got radiation and/or chemotherapy while three were under surveillance. The follow-up period ranged from one month to 8 years with a mean of approximately 36 months. Two patients developed ascites but cytology specimens were negative. To date, there are no local recurrences or distant metastases in this patient cohort.
Conclusions: In our study, Stage I ECC is uncommon with only 13 cases identified over a 10-year period. While this is a small data set and follow-up limited, the short term prognosis of ECC appears to be favorable. This also raises the question of utility of adjuvant therapy in Stage IA ECC. Larger prospective studies are recommended.
Category: Gynecologic & Obstetrics
Tuesday, March 5, 2013 9:30 AM
Poster Session III # 113, Tuesday Morning