Prognostic factors in young women with endometrial carcinoma: a report of 20 cases and review of literature.

We retrospectively reviewed the pathologic features of patients with endometrial carcinoma (EC) treated in our facility between 1989 and 1998. First, we identified the clincopathologic features of young women with EC and compared them with similar patients from the literature. Second, 148 EC patients were divided into two groups: group A (age</=45 years, n = 20) and B (age>45, n = 128). The mean follow-up periods were 65 months and 50 months in groups A and B, respectively. Group A patients had better disease-free survival (Kaplan-Meier method, P = 0.0283) compared to group B patients. The independent variables related to disease-free survival (Cox regression analysis) were age (P = 0.0001), stage (P = 0.0183), histology (P = 0.0011), and lymph node metastasis (P = 0.0007). The distribution of stage was significantly different between the two groups (Chi-square test, P = 0.0089). More group A patients (18 of 20; 90%) had early stage disease. There were no significant differences (Fisher's exact test) between the two groups in histology, grade, cervical involvement, vascular invasion, tumor size, ovarian malignancy, and lymph node metastasis. However, group A patients had a significant higher incidence of disease confined to the inner half of the myometrium than group B patients (P = 0.0004). We statistically confirmed that young women with EC had better outcome due to a significantly higher proportion of early stage disease and less myometrial invasion than older patients.