Clinicopathological analysis of mixed endometrial carcinomas: clinical relevance of different neoplastic components

Francesco Fanfani, Giovanni Scambia, Gian Franco Zannoni, Tommaso Bizzarro, Giorgia Monterossi, Frediano Inzani

Risultato della ricerca: Contributo in rivistaArticolo in rivista

5 Citazioni (Scopus)

Abstract

Mixed endometrial carcinomas (MECs) refer to tumors characterized by 2 or more distinct histotypes mostly that comprised endometrioid (EC) and serous/clear cell carcinomas (SC/CC). The specific quantification of these distinct components represents a challenging and critical point for both prognosis and management. Herein, we analyze a large series of MEC and compare them with EC and SC/CC. We evaluated a series of 69 MECs between January 2002 and December 2015. We compared the MEC series with 186 ECs (including 117 endometrioid G3), 31 SCs, and 38 CCs. The prognostic implication of the percentage of each component was analyzed. Among the 69 MECs, those patients older than 45 years represent the significant population, with 52.2% of them with stage III-IV disease. A similar result was found among pure SC. The comparative analysis of some prognostic parameters (multifocality, vascular invasion, and lymph node metastasis) underlined that MECs with a type II component larger than 5% represent a more aggressive entity. However, relapse, disease-free survival, mortality, and overall survival are statistically significant (P < .05) in EC-SC (SC <5% or >5%) and in EC-CC (CC <5% or >5%), whereas they are not significant (P > .05) in SC-CC (SC/CC <% or >5%). MECs, including also cases with less than 5% of SC/CC, show features as aggressive as those of pure SC/CC. In this perspective, MEC should be followed by personalized and tailored managements. The presence of different components suggests different pathogenic and metastatic processes when compared with pure carcinomas.
Lingua originaleEnglish
pagine (da-a)99-107
Numero di pagine9
RivistaHuman Pathology
Volume62
DOI
Stato di pubblicazionePubblicato - 2017

Keywords

  • 2734
  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy
  • Carcinoma, Endometrioid
  • Clear cell carcinomas
  • Disease-Free Survival
  • Endometrial Neoplasms
  • Endometrial tumor
  • Female
  • Humans
  • Immunohistochemistry
  • Kaplan-Meier Estimate
  • Middle Aged
  • Mixed endometrial carcinomas
  • Molecular testing
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Neoplasms, Complex and Mixed
  • Neoplasms, Cystic, Mucinous, and Serous
  • Predictive Value of Tests
  • Serous carcinomas
  • Time Factors
  • Treatment Outcome
  • Type I carcinomas
  • Type II carcinomas

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