Comparison of the clinicopathological characteristics of premenopausal and postmenopausal endometrial carcinomas: analysis of endocrinologically evaluated cases.

A study was performed to clarify the clinicopathological differences between premenopausal endometrial carcinoma, which occurs during the reproductive period, and postmenopausal endometrial carcinoma. We analyzed 76 patients with endometrial carcinoma treated in our department between January 1984 and July 1994. Using classification criteria which included menstrual history and results of endocrinological tests (serum FSH, LH and estradiol), 50 (65.7%) patients were defined as postmenopausal, 16 (21.0%) as premenopausal, and 10 (13.1%) as unclassified. From an epidemiologic viewpoint, the incidence of nulliparity was higher in the premenopausal (37.5%) than in the postmenopausal (10%) patients. However, no significant differences were observed between the two groups with regard to the incidence of obesity, diabetes and hypertension. The results of our clinicopathological study revealed that premenopausal endometrial carcinoma had a significantly higher incidence of well differentiated (63.1%) and relatively less advanced (31.1% of cases at stages III and IV) cancers than postmenopausal carcinoma (38% and 46%, respectively). These features were positively correlated with prognosis, i.e., premenopausal patients in general had a much better prognosis than postmenopausal patients.