Serous endometrial intra-epithelial carcinoma: an observational study
Ciska Slaager1,2, Ward Hofhuis3, Klaas J Hoogduin4
1Department of Gynecology, Franciscus Gasthuis en Vlietland, Rotterdam, The Netherlands c.slaager@franciscus.nl.
Summary
Serous endometrial intra-epithelial carcinoma (SEIC) management via hysterectomy shows no recurrences or deaths. Surgical staging may be excessive for this condition, challenging current guidelines.
Area of Science:
- Gynecologic Oncology
- Pathology
- Surgical Management
Background:
- Serous endometrial intra-epithelial carcinoma (SEIC) is a superficial lesion with potential for extra-uterine spread and poor prognosis.
- Current guidelines recommend treating SEIC as high-grade endometrial carcinoma.
Purpose of the Study:
- To evaluate the surgical management of SEIC.
- To assess the impact of surgical management on oncologic outcomes and complications.
- To determine if current treatment guidelines for SEIC are appropriate.
Main Methods:
- Retrospective cohort study of 23 patients diagnosed with pure SEIC in the Netherlands (2012-2020).
- Pathological review by gynecological oncology experts.
- Analysis of progression-free survival, follow-up duration, adverse events, and overall survival.
Main Results:
- All 23 patients underwent hysterectomy; 12 (52.2%) had surgical staging, revealing no extra-uterine disease.
- No recurrences or disease-related deaths were observed with a median follow-up of 35.6 months.
- Two patients received adjuvant brachytherapy.
Conclusions:
- Hysterectomy for SEIC is associated with excellent oncologic outcomes, including nearly 3 years of progression-free survival and no reported recurrences.
- The findings challenge the World Health Organization's 2014 recommendation to treat SEIC as high-grade endometrial carcinoma.
- Full surgical staging may lead to overtreatment in patients with SEIC.
