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Published on: September 12, 2019
High-Grade Endometrial Cancer-Behaviour and Outcomes at a Tertiary Cancer Centre
Prerna Lakhwani1, Priya Agarwal1, Ashish Goel2
1Gynae Oncology, BL Kapur Super Specialty Hospital, Pusa Road, Delhi, India.
Abstract:
High-grade endometrial carcinomas are a heterogeneous group of clinically aggressive tumours. They include FIGO grade 3 endometrioid adenocarcinoma, uterine papillary serous carcinoma (UPSC), clear cell carcinoma, undifferentiated carcinoma and carcinosarcomas or malignant mixed Mullerian tumour (MMMT). The aim of this study is to look at clinicopathological features and survival outcomes of high-grade endometrial cancers of the uterus in our centre. A tertiary care centre in India. The study design is retrospective with survival analysis. We did a retrospective analysis of all patients admitted with a diagnosis of high-grade uterine carcinoma. Data regarding baseline characteristics, disease profiles, surgical outcomes, complications, extent of surgical staging, duration of surgery, blood loss, length of hospital stay, drain output, wound infection, surgico-pathological stage and grade, tumour size and location, myometrium and lymphovascular invasion, node positivity, adjuvant treatment, overall survival and recurrence-free survival. Survival analysis was done using the Kaplan-Meier method. We had 115 females diagnosed with endometrial cancer. Of these, 40 patients had high-grade endometrial cancer. Mean age at presentation was 64.7 years (range 33-80 years). Of this, endometrioid adenocarcinoma grade III was the commonest (37.5%), followed by UPSC in 32.5% and MMMT in 22.5% patients. Clear cell variant and mixed dedifferentiated variant were reported in 5% and 2.5%, respectively. Over 48 months of follow-up, recurrence was detected in eight patients (20%) and median time to recurrence was 11 months. Mean recurrence-free survival was 32.8 months and mean overall survival was 38.6 months High-grade endometrial cancers are aggressive tumours of postmenopausal women. Surgical staging and combination chemotherapy along with radiation therapy are the mainstay of treatment. In spite of adequate debulking followed by adjuvant therapy, survival remains poor.
