Department of Obstetrics and Gynecology, Çukurova University, School of Medicine, Adana, Turkey.
Department of Medical Oncology, Faculty of Medicine, Çukurova University, Adana, Turkey.
Ginekol Pol. 2021;92(4):278-283. doi: 10.5603/GP.2020.0184. Epub 2021 Mar 10.
Grade 3 endometrioid adenocarcinomas (G3 EAC), type two endometrial carcinomas (Type 2 EC), and also uterine carcinosarcomas (UCS) are considered as high-grade endometrial adenocarcinomas. The aim of this study was to compare the clinicopathologic features and survival of patients with UCS, G3 EAC, Type2 EC.
We included two hundred and thirty-five patients in this study. Patients were divided into three groups according to the type of tumor as uterine G3 EAC (group 1, n = 62), Type 2 EC (serous, clear and mixed types; group 2, n = 93), and UCS (group 3, n = 80). We compared the groups according to age, initial symptom, surgical approach, stage, myometrial invasion (MI), lymph node invasion (LNI), lymphovascular space invasion (LVSI), adjuvant therapy, and survival. When comparing the survival outcomes the Kaplan-Meier analysis was performed.
The groups were similar according to age, menopausal status, nulliparity, initial symptoms, stage, LVSI, and LNI. Positive cytology was determined significantly more in group 3. There was a significant difference between the groups in terms of myometrial invasion degree. Optimal cytoreduction was similar among the groups. The primary adjuvant treatment was chemotherapy for UCS and Type2 EAC whereas radiotherapy was the main adjuvant treatment for G3 EAC. There were no significant differences among the groups according to overall survival (OS) (p = 0.290).
Although the survival difference among the groups can not be revealed, these patients have different clinical and pathological features and they should be considered as different groups.
3 级子宫内膜样腺癌(G3 EAC)、2 型子宫内膜癌(Type 2 EC)和子宫癌肉瘤(UCS)被认为是高级别子宫内膜腺癌。本研究旨在比较 UCS、G3 EAC、Type2 EC 患者的临床病理特征和生存情况。
本研究纳入了 235 例患者。根据肿瘤类型将患者分为三组:子宫 G3 EAC(第 1 组,n=62)、Type 2 EC(浆液性、透明性和混合性;第 2 组,n=93)和 UCS(第 3 组,n=80)。我们根据年龄、首发症状、手术方式、分期、肌层浸润(MI)、淋巴结浸润(LNI)、脉管间隙浸润(LVSI)、辅助治疗和生存情况对各组进行比较。比较生存结果时采用 Kaplan-Meier 分析。
三组患者在年龄、绝经状态、初潮、初诊症状、分期、LVSI 和 LNI 方面相似。第 3 组的细胞学阳性率显著更高。各组间 MI 程度存在显著差异。各组的最佳肿瘤减灭术相似。UCS 和 Type2 EAC 的主要辅助治疗是化疗,而 G3 EAC 的主要辅助治疗是放疗。三组患者的总生存率(OS)无显著差异(p=0.290)。
尽管各组之间的生存差异不明显,但这些患者具有不同的临床和病理特征,应视为不同的组别。