Risk factors for recurrence and prognosis of low-grade endometrial adenocarcinoma; Vaginal versus other sites

Elizabeth J. Moschiano, Denise A. Barbuto, Christine Walsh, Kanwaljit Singh, Elizabeth D. Euscher, Andres A. Roma, Rouba Ali-Fehmi, Elizabeth Frauenhoffer, Delia P. Montiel, Insun Kim, Bojana Djordjevic, Anais Malpica, Sung Ran Hong, Elvio G. Silva

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Endometrial adenocarcinoma is the most common gynecologic cancer in the United States. The prognosis is generally favorable, however, a significant number of patients do develop local or distant recurrence. The most common site of recurrence is vaginal. Our aim was to better characterize patients with vaginal recurrence of low-grade endometrioid adenocarcinoma with respect to associated tumor parameters and clinical outcome. We compiled 255 cases of low-grade (FIGO Grade I or II) endometrioid adenocarcinoma on hysterectomy specimens with lymph node dissection. A total of 113 cases with positive lymph nodes or recurrent disease were included in our study group. Seventy-three cases (13 Grade 1, 60 Grade 2) developed extravaginal recurrence and 40 cases (7 Grade 1, 33 Grade 2) developed vaginal recurrence. We evaluated numerous tumor parameters including: percentage myoinvasion, presence of microcystic, elongated, and fragmented pattern of myoinvasion, lymphovascular space invasion, and cervical involvement. Clinical follow-up showed that 30% (34/113) of all patients with recurrent disease died as a result of their disease during our follow-up period, including 31 (42.5%) with extravaginal recurrence and 3 (7.5%) with primary vaginal recurrence (P=0.001). The 3 patients with vaginal recurrence developed subsequent extravaginal recurrence before death. Vaginal recurrence patients show increased cervical involvement by tumor, but lack other risk factors associated with recurrent disease at other sites. There were no deaths among patients with isolated vaginal recurrence, suggesting that vaginal recurrence is not a marker of aggressive tumor biology.

Original languageEnglish (US)
Pages (from-to)268-273
Number of pages6
JournalInternational Journal of Gynecological Pathology
Volume33
Issue number3
DOIs
StatePublished - Jan 1 2014

Fingerprint

Adenocarcinoma
Recurrence
Endometrioid Carcinoma
Neoplasms
Tumor Biomarkers
Lymph Node Excision
Hysterectomy
Lymph Nodes

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine
  • Obstetrics and Gynecology

Cite this

Moschiano, Elizabeth J. ; Barbuto, Denise A. ; Walsh, Christine ; Singh, Kanwaljit ; Euscher, Elizabeth D. ; Roma, Andres A. ; Ali-Fehmi, Rouba ; Frauenhoffer, Elizabeth ; Montiel, Delia P. ; Kim, Insun ; Djordjevic, Bojana ; Malpica, Anais ; Hong, Sung Ran ; Silva, Elvio G. / Risk factors for recurrence and prognosis of low-grade endometrial adenocarcinoma; Vaginal versus other sites. In: International Journal of Gynecological Pathology. 2014 ; Vol. 33, No. 3. pp. 268-273.
@article{68cf524abad542e4bf50fbb3b449616c,
title = "Risk factors for recurrence and prognosis of low-grade endometrial adenocarcinoma; Vaginal versus other sites",
abstract = "Endometrial adenocarcinoma is the most common gynecologic cancer in the United States. The prognosis is generally favorable, however, a significant number of patients do develop local or distant recurrence. The most common site of recurrence is vaginal. Our aim was to better characterize patients with vaginal recurrence of low-grade endometrioid adenocarcinoma with respect to associated tumor parameters and clinical outcome. We compiled 255 cases of low-grade (FIGO Grade I or II) endometrioid adenocarcinoma on hysterectomy specimens with lymph node dissection. A total of 113 cases with positive lymph nodes or recurrent disease were included in our study group. Seventy-three cases (13 Grade 1, 60 Grade 2) developed extravaginal recurrence and 40 cases (7 Grade 1, 33 Grade 2) developed vaginal recurrence. We evaluated numerous tumor parameters including: percentage myoinvasion, presence of microcystic, elongated, and fragmented pattern of myoinvasion, lymphovascular space invasion, and cervical involvement. Clinical follow-up showed that 30{\%} (34/113) of all patients with recurrent disease died as a result of their disease during our follow-up period, including 31 (42.5{\%}) with extravaginal recurrence and 3 (7.5{\%}) with primary vaginal recurrence (P=0.001). The 3 patients with vaginal recurrence developed subsequent extravaginal recurrence before death. Vaginal recurrence patients show increased cervical involvement by tumor, but lack other risk factors associated with recurrent disease at other sites. There were no deaths among patients with isolated vaginal recurrence, suggesting that vaginal recurrence is not a marker of aggressive tumor biology.",
author = "Moschiano, {Elizabeth J.} and Barbuto, {Denise A.} and Christine Walsh and Kanwaljit Singh and Euscher, {Elizabeth D.} and Roma, {Andres A.} and Rouba Ali-Fehmi and Elizabeth Frauenhoffer and Montiel, {Delia P.} and Insun Kim and Bojana Djordjevic and Anais Malpica and Hong, {Sung Ran} and Silva, {Elvio G.}",
year = "2014",
month = "1",
day = "1",
doi = "10.1097/PGP.0b013e31829c6757",
language = "English (US)",
volume = "33",
pages = "268--273",
journal = "International Journal of Gynecological Pathology",
issn = "0277-1691",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

Moschiano, EJ, Barbuto, DA, Walsh, C, Singh, K, Euscher, ED, Roma, AA, Ali-Fehmi, R, Frauenhoffer, E, Montiel, DP, Kim, I, Djordjevic, B, Malpica, A, Hong, SR & Silva, EG 2014, 'Risk factors for recurrence and prognosis of low-grade endometrial adenocarcinoma; Vaginal versus other sites', International Journal of Gynecological Pathology, vol. 33, no. 3, pp. 268-273. https://doi.org/10.1097/PGP.0b013e31829c6757

Risk factors for recurrence and prognosis of low-grade endometrial adenocarcinoma; Vaginal versus other sites. / Moschiano, Elizabeth J.; Barbuto, Denise A.; Walsh, Christine; Singh, Kanwaljit; Euscher, Elizabeth D.; Roma, Andres A.; Ali-Fehmi, Rouba; Frauenhoffer, Elizabeth; Montiel, Delia P.; Kim, Insun; Djordjevic, Bojana; Malpica, Anais; Hong, Sung Ran; Silva, Elvio G.

In: International Journal of Gynecological Pathology, Vol. 33, No. 3, 01.01.2014, p. 268-273.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Risk factors for recurrence and prognosis of low-grade endometrial adenocarcinoma; Vaginal versus other sites

AU - Moschiano, Elizabeth J.

AU - Barbuto, Denise A.

AU - Walsh, Christine

AU - Singh, Kanwaljit

AU - Euscher, Elizabeth D.

AU - Roma, Andres A.

AU - Ali-Fehmi, Rouba

AU - Frauenhoffer, Elizabeth

AU - Montiel, Delia P.

AU - Kim, Insun

AU - Djordjevic, Bojana

AU - Malpica, Anais

AU - Hong, Sung Ran

AU - Silva, Elvio G.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Endometrial adenocarcinoma is the most common gynecologic cancer in the United States. The prognosis is generally favorable, however, a significant number of patients do develop local or distant recurrence. The most common site of recurrence is vaginal. Our aim was to better characterize patients with vaginal recurrence of low-grade endometrioid adenocarcinoma with respect to associated tumor parameters and clinical outcome. We compiled 255 cases of low-grade (FIGO Grade I or II) endometrioid adenocarcinoma on hysterectomy specimens with lymph node dissection. A total of 113 cases with positive lymph nodes or recurrent disease were included in our study group. Seventy-three cases (13 Grade 1, 60 Grade 2) developed extravaginal recurrence and 40 cases (7 Grade 1, 33 Grade 2) developed vaginal recurrence. We evaluated numerous tumor parameters including: percentage myoinvasion, presence of microcystic, elongated, and fragmented pattern of myoinvasion, lymphovascular space invasion, and cervical involvement. Clinical follow-up showed that 30% (34/113) of all patients with recurrent disease died as a result of their disease during our follow-up period, including 31 (42.5%) with extravaginal recurrence and 3 (7.5%) with primary vaginal recurrence (P=0.001). The 3 patients with vaginal recurrence developed subsequent extravaginal recurrence before death. Vaginal recurrence patients show increased cervical involvement by tumor, but lack other risk factors associated with recurrent disease at other sites. There were no deaths among patients with isolated vaginal recurrence, suggesting that vaginal recurrence is not a marker of aggressive tumor biology.

AB - Endometrial adenocarcinoma is the most common gynecologic cancer in the United States. The prognosis is generally favorable, however, a significant number of patients do develop local or distant recurrence. The most common site of recurrence is vaginal. Our aim was to better characterize patients with vaginal recurrence of low-grade endometrioid adenocarcinoma with respect to associated tumor parameters and clinical outcome. We compiled 255 cases of low-grade (FIGO Grade I or II) endometrioid adenocarcinoma on hysterectomy specimens with lymph node dissection. A total of 113 cases with positive lymph nodes or recurrent disease were included in our study group. Seventy-three cases (13 Grade 1, 60 Grade 2) developed extravaginal recurrence and 40 cases (7 Grade 1, 33 Grade 2) developed vaginal recurrence. We evaluated numerous tumor parameters including: percentage myoinvasion, presence of microcystic, elongated, and fragmented pattern of myoinvasion, lymphovascular space invasion, and cervical involvement. Clinical follow-up showed that 30% (34/113) of all patients with recurrent disease died as a result of their disease during our follow-up period, including 31 (42.5%) with extravaginal recurrence and 3 (7.5%) with primary vaginal recurrence (P=0.001). The 3 patients with vaginal recurrence developed subsequent extravaginal recurrence before death. Vaginal recurrence patients show increased cervical involvement by tumor, but lack other risk factors associated with recurrent disease at other sites. There were no deaths among patients with isolated vaginal recurrence, suggesting that vaginal recurrence is not a marker of aggressive tumor biology.

UR - http://www.scopus.com/inward/record.url?scp=84898597018&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84898597018&partnerID=8YFLogxK

U2 - 10.1097/PGP.0b013e31829c6757

DO - 10.1097/PGP.0b013e31829c6757

M3 - Article

C2 - 24681738

AN - SCOPUS:84898597018

VL - 33

SP - 268

EP - 273

JO - International Journal of Gynecological Pathology

JF - International Journal of Gynecological Pathology

SN - 0277-1691

IS - 3

ER -