[Prognostic significance of morphological parameters in endometrial carcinomas]

A retrospective analysis of 163 cases of operations for carcinoma of the endometrium performed at the 2nd Department of Gynecology and Obstetrics, University of Vienna, demonstrates that the clinical staging as recommended by FIGO is not conclusive, and that the subdivision according to the size of the uterus is of no prognostic significance. On the other hand, the morphological parameters listed below have a strong prognostic relevance as is shown by survival curves and survival rates: Grading parameters (histological and cytological degree of differentiation as well as the number of mitotic figures); parameters of the extent of the tumor (histologically proven involvement of the cervix; depth of invasion in relation to the thickness of the myometrium; invasion of lymphatics). In addition, patients with suspicious or positive cytological vaginal smears have less propitious survival chances, whereas the age and the menopausal status of the women as well as the type of carcinoma were only of subordinate significance within this sample. The grading parameters are closely correlated, the determination of several parameters, however, increases the weight of the prognosis. Furthermore, they show a close correlation to the parameters of the extent of the tumor. Since the grading parameters can be ascertained pre-operatively from the curetting they should be taken into consideration when planning further therapy. The post-operative staging of the carcinoma has to take into account above all the depth of the invasion. A classification to that point is proposed.