[1226] Risk Factors in Patients with Low-Grade Endometrial Adenocarcinoma and Lung Recurrence Versus Recurrence at Other Sites. A Multi-Institutional Study

Andres A Roma, Denise A Barbuto, Elizabeth Euscher, Rouba Ali-Fehmi, Bojana Djordjevic, Jennifer A Bennett, Elizabeth E Frauenhoffer, Sun Rang Hong, Insun Kim, Delia Montiel, Elizabeth Moschiano, Anais Malpica, Elvio G Silva. Cleveland Clinic, Cleveland, OH; Cedar Sinai, Los Angeles, CA; MD Anderson, Houston, TX; Wayne State University, Detroit, MI; Ottawa Hospital, Ottawa, ON, Canada; Penn State University, Hershey, PA; Cheil General Hospital, Seoul, Korea; Instituto Nacional Cancerologia, Mexico, Mexico

Background: There is no significant data analyzing risk factors for low-grade endometrial tumors that recur in the lung vs other sites.
Design: In this multi-institutional study, we analyzed data from 79 patients with FIGO grade 1 and 2 endometrial adenocarcinomas with extrauterine recurrence (excluding vagina) and 187 age matched controls with negative lymph nodes and no treatment that did not recur; with similar follow-up time (44 and 59 months, respectively).
Results: Twenty patients had lung recurrence and 59 patients had recurrence in other sites at initial recurrence (Table 1). Tumors that recurred in lung showed a significantly greater depth of myometrial invasion, compared to other recurrences (p<0.05) and controls (p<0.0001), respectively. Cervical involvement was more frequent in cases with lung recurrence than in other sites (p< 0.05); moreover, cervical stromal involvement was a highly significant risk factor (p<0.003) for lung recurrence. All analyzed features, except necrosis, were significantly different in all recurrent tumors compared to controls (p<0.001).

 GrossSizeNecrosisMyoinvasionMELFDesmoplasiaCervical invasion
Lung (20)Flat 8/Exo 11/Unk 14.9961.2% (12 >50%;3>33%)10 (25.3%)1713 (10 stroma)
Other rec (59)Flat 20/Exo 36/Unk 35.13444.1% (24>50%;8>33%)31 (18.2%)3823 (13 stroma)
Controls (187)Flat 49/Exo 1383.37326.9% (41>50%;22>33%)61 (10.2%)8015 (11 stroma)
Exo: exophytic; Unk: unknown; Myoinvasion depth: average (number cases over 50%; cases 33- 50%); MELF: microcystic, elongated and/or fragmented myoinvasive pattern: number of cases with MELF (average of MELF % at invasive front of tumor)


Conclusions: 1. Low grade tumors that recur in the lung have significantly greater myometrial invasion, invade the cervical stroma and show desmoplasia more often than tumors that recur at other sites.
2. Differences in the site of recurrence might be related to the type (veins vs. lymphatics) or location of involved vessels; veins are usually deeper in the myometrium and the route of dissemination from cervical vascular invasion may be different.
Category: Gynecologic & Obstetrics

Tuesday, March 5, 2013 9:30 AM

Poster Session III # 111, Tuesday Morning

 

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