Clear cell carcinoma of the uterus

The aim of this study was to determine the characteristics and outcome of patients presenting with clear cell carcinoma (CCC) of the endometrium treated in a single institution.

We reviewed the records of patients treated in the Salah-Azaiz institute for CCC of the endometrium. A histopathological stage was retrospectively assigned to these patients according to the FIGO classification and was compared to the clinical stage. Pathological features were studied in order to determine predictif factors of extrauterine disease extention and failure patterns.

12 patients were included in the study. The mean age at diagnosis was 64 years (50 to 84 yers). Upstaging after surgery was found in 9 patients. 9 patients had extrauterine extension. Deap myometrial invasion was not correlated with extrauterine extension. After a median follw up of 32 months, 4 patients presented with recurrences: one vaginal recurrence, two cases of pelvic and abdominal recurrence and abdominal recurrence in one patient. All recurrences occurred during the first year after surgery. Tumor recurrence was located within the radiation field in one case. Two patients with abdomino-pelvic recurrences progressed despite the association of surgery, radiation therapy and chemotherapy.

Extrauterine extension is frequent at diagnosis and not correlated to classical risk factors observed in endometrioid carcinoma. A comptlete surgical staging is necessary for adjuvant treatment. Locoregional and distant recurrences are frequent and have a poor outcome.