Clear cell carcinoma of the endometrium

In a clinical-pathologic review of 825 cases of endometrial carcinoma diagnosed between 1955 and 1984, 735 cases were confirmed as endometrial carcinoma. From this group 29 cases of clear cell carcinoma of the endometrium were found representing a 4% frequency. Clear cell carcinoma of the endometrium was found in an older group of women, all postmenopausal. No relationship to the use of estrogen could be demonstrated. The frequency of clear cell carcinoma of the endometrium dropped from 6% in the group diagnosed between 1955 and 1969 to 3% in the group diagnosed between 1970 and 1984, although the numbers of cases of endometrial cancer rose from 194 to 525 in the comparative time span. Clear cell carcinoma of the endometrium has a poorer prognosis, with a 64% 5-year survival rate compared with an 80% 5-year survival rate for adenocarcinoma, not otherwise stated. Three patients died after 5 years of disease. Treatment is still not satisfactory, but the proved therapy remains total abdominal hysterectomy plus salpingo-oophorectomy. The role of adjunctive therapy has not been established.