Histologic variants of cervical involvement by endometrial carcinoma

Examination of histologic material from 54 patients with endometrial carcinoma, in whom the pretreatment fractional curettage showed adenocarcinoma in the endocervical specimen, demonstrated 4 main patterns. These were designated as tumor separate from endocervical tissue (13 patients), true stage II (23 patients), tumor in stroma (12 patients), and tumor only (6 patients). Patients with tumor separate from endocervical tissue had a better survival rate (expressed as survival to first recurrence) than did patients in the other 3 groups, and this difference was statistically significant. No statistically significant difference between the survival of patients in the true stage II, tumor in stroma, and tumor only groups could be demonstrated. It is therefore suggested that the treatment protocol used for these 3 groups of patients be similar. Among the true stage II groups, only 3 patients had superficial endocervical involvement, whereas 15 had stromal involvement without surface tumor. Therefore, spread to the cervix in endometrial carcinoma appears to be more frequent by tissue spaces or lymphatic channels than by contiguous surface extension.