Traditional and nontraditional histopathologic predictors of recurrence in uterine endometrioid adenocarcinoma

Ninety-three consecutive operative cases of myometrial invasive endometrioid adenocarcinoma of the uterus without evidence of extrauterine spread at surgery were reviewed to determine whether any histopathologic features other than those traditionally reported might predict recurrence. Recurrence was associated with traditionally analyzed features of deep myometrial invasion, high FIGO grade, vascular space invasion, and cervical stromal invasion as well as patient age. In addition, a diffuse pattern of myometrial invasion was associated with an increased risk for recurrence. Contrary to results from previous studies, no increased risk was seen with high nuclear grade or the presence of perivascular lymphocytic infiltrates. When adjusted for traditional parameters, perivascular lymphocytes and a tumor-host inflammatory response were associated with prolonged time to recurrence. A desmoplastic host response or residual adenomyosis were unrelated to recurrence.