TY - JOUR
T1 - The presence of an endometrioid component does not alter the clinicopathologic profile or survival of patients with uterine serous cancer
T2 - A gynecologic oncology group (GOG/NRG) study of 934 women
AU - Hagemann, Ian S.
AU - Deng, Wei
AU - Zaino, Richard J.
AU - Powell, Matthew A.
AU - Gunderson, Camille
AU - Cosgrove, Casey
AU - Mathews, Cara
AU - Pearl, Michael L.
AU - Waggoner, Steven
AU - Ghebre, Rahel
AU - Lele, Shashikant
AU - Guntupalli, Saketh
AU - Secord, Angeles Alvarez
AU - Ioffe, Olga
AU - Park, Kay
AU - Rasty, Golnar
AU - Singh, Meenakshi
AU - Soslow, Robert
AU - Creasman, William
AU - Mutch, David G.
N1 - Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2021/3
Y1 - 2021/3
N2 - Objective: While most cases of endometrial cancer can readily be classified as pure endometrioid, pure serous, or another type, others show an apparent mixture of serous and endometrioid components, or indeterminate serous versus endometrioid features. Since serous histology carries a worse prognosis than endometrioid, Gynecologic Oncology Group protocol GOG-8032 was established to examine whether the presence of a non-serous component is a favorable feature in an otherwise serous cancer. Methods: 934 women with serous cancer were prospectively identified among a larger group enrolled in GOG-0210. Six expert gynecologic pathologists classified each case as pure serous (SER, n=663), mixed serous and endometrioid (SER-EM-M, n=138), or indeterminate serous v. endometrioid (SER-EM-I, n=133) by H&E morphology. Follow-up data from GOG-0210 were analyzed. Results: The subgroups did not differ on BMI, race, ethnicity, lymphovascular invasion, cervical invasion, ovary involvement, peritoneal involvement, omental involvement, FIGO stage, or planned adjuvant treatment. SER-EM-M patients were younger (p=0.0001) and less likely to have nodal involvement (p=0.0287). SER patients were less likely to have myoinvasion (p=0.0002), and more likely to have adnexal involvement (p=0.0108). On univariate analysis, age, serous subtype, race, and components of FIGO staging predicted both progression-free and overall survival. On multiple regression, however, serous subtype (SER, SER-EM-M, or SER-EM-I) did not significantly predict survival. Conclusions: There were few clinicopathologic differences between cases classified as SER, SER-EM-M, and SER-EM-I. Cases with a mixture of serous and endometrioid morphology, as well as cases with morphology indeterminate for serous v. endometrioid type, had the same survival as pure serous cases.
AB - Objective: While most cases of endometrial cancer can readily be classified as pure endometrioid, pure serous, or another type, others show an apparent mixture of serous and endometrioid components, or indeterminate serous versus endometrioid features. Since serous histology carries a worse prognosis than endometrioid, Gynecologic Oncology Group protocol GOG-8032 was established to examine whether the presence of a non-serous component is a favorable feature in an otherwise serous cancer. Methods: 934 women with serous cancer were prospectively identified among a larger group enrolled in GOG-0210. Six expert gynecologic pathologists classified each case as pure serous (SER, n=663), mixed serous and endometrioid (SER-EM-M, n=138), or indeterminate serous v. endometrioid (SER-EM-I, n=133) by H&E morphology. Follow-up data from GOG-0210 were analyzed. Results: The subgroups did not differ on BMI, race, ethnicity, lymphovascular invasion, cervical invasion, ovary involvement, peritoneal involvement, omental involvement, FIGO stage, or planned adjuvant treatment. SER-EM-M patients were younger (p=0.0001) and less likely to have nodal involvement (p=0.0287). SER patients were less likely to have myoinvasion (p=0.0002), and more likely to have adnexal involvement (p=0.0108). On univariate analysis, age, serous subtype, race, and components of FIGO staging predicted both progression-free and overall survival. On multiple regression, however, serous subtype (SER, SER-EM-M, or SER-EM-I) did not significantly predict survival. Conclusions: There were few clinicopathologic differences between cases classified as SER, SER-EM-M, and SER-EM-I. Cases with a mixture of serous and endometrioid morphology, as well as cases with morphology indeterminate for serous v. endometrioid type, had the same survival as pure serous cases.
KW - Endometrial carcinoma
KW - Endometrioid carcinoma
KW - Malignant mixed tumors
KW - Pathology
KW - Serous carcinoma
KW - Survival analysis
UR - http://www.scopus.com/inward/record.url?scp=85099602917&partnerID=8YFLogxK
U2 - 10.1016/j.ygyno.2020.12.040
DO - 10.1016/j.ygyno.2020.12.040
M3 - Article
C2 - 33423806
AN - SCOPUS:85099602917
SN - 0090-8258
VL - 160
SP - 660
EP - 668
JO - Gynecologic oncology
JF - Gynecologic oncology
IS - 3
ER -