Preponderance of endometrial carcinoma in elderly patients

Ogane,Naoki; Hori,Shin-Ichi; Yano,Mitsutake; Katoh,Tomomi; Kamoshida,Shingo; Kato,Hisamori; Kameda,Yoichi; Yasuda,Masanori

doi:10.3892/mco.2018.1680

Preponderance of endometrial carcinoma in elderly patients

Authors:
- Naoki Ogane
- Shin-Ichi Hori
- Mitsutake Yano
- Tomomi Katoh
- Shingo Kamoshida
- Hisamori Kato
- Yoichi Kameda
- Masanori Yasuda
View Affiliations

Affiliations: Department of Pathology, Kanagawa Prefectural Ashigarakami Hospital, Matsuda, Kanagawa 258-0003, Japan, Department of Gynecology and Obstetrics, Seto Hospital, Tokorozawa, Saitama 359-1128, Japan, Department of Pathology, Saitama Medical University International Medical Center, Hidaka, Saitama 350-1298, Japan, Laboratory of Pathology, Department of Medical Biophysics, Kobe University Graduate School of Health Sciences, Kobe, Hyogo 654‑0142, Japan, Department of Gynecology, Kanagawa Cancer Center, Yokohama, Kanagawa 241-8515, Japan
Published online on: July 19, 2018 https://doi.org/10.3892/mco.2018.1680
Pages: 269-273

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Elderly patients with endometrial carcinoma (EMC) are considered to have a poor clinical outcome. The present study included 79 patients aged ≥70 years with EMC stage I or II according to the International Federation of Gynecology and Obstetrics classification, and it was conducted to analyse the clinicopathological significance of histological type (I or II), depth of myometrial invasion (<1/2 or ≥1/2), lymphovascular invasion (+ or -) and immunohistochemical profile. The aim of these analyses was to determine whether these factors may adversely affect the patient outcome and the underlying mechanisms. The immunohistochemical markers used were estrogen receptor (ER), Ki-67 and p53. The expression of these markers was evaluated as high (+) or low (-). Accordingly, the patients were divided into groups as follows: 54 cases type I vs. 25 cases type II; 48 cases with myometrial invasion <1/2 vs. 31 cases without myometrial invasion ≥1/2; 63 cases with lymphovascular invasion vs. 16 cases without lymphovascular invasion; 57 cases with ER (+) vs. 22 cases with ER (-); 24 cases with Ki-67 (+) vs. 55 cases with Ki-67 (-); and 29 cases with p53 (+) vs. 50 cases with p53 (-). In conclusion, close attention must be paid to elderly patients with EMC due to the tumor's intrinsic aggressiveness, which may include the ER (-) and p53 (+) pattern as an independent poor prognostic factor.

View Figures

View References

1	Alektiar KM, Venkatraman E, Abu-Rustum N and Barakat RR: Is endometrial carcinoma intrinsically more aggressive in elderly patients? Cancer. 98:2368–2377. 2003. View Article : Google Scholar : PubMed/NCBI
2	Kosary CL: FIGO stage, histology, histologic grade, age and race as prognostic factors in determining survival for cancers of the female gynecological system: An analysis of 1973-87 SEER cases of cancers of the endometrium, cervix, ovary, vulva, and vagina. Semin Surg Oncol. 10:31–46. 1994. View Article : Google Scholar : PubMed/NCBI
3	Zaino RJ, Kurman RJ, Diana KL and Morrow CP: Pathologic models to predict outcome for women with endometrial adenocarcinoma: The importance of the distinction between surgical stage and clinical stage-a Gynecologic Oncology Group study. Cancer. 77:1115–1121. 1996. View Article : Google Scholar : PubMed/NCBI
4	Abeler VM and Kjørstad KE: Endometrial adenocarcinoma in Norway. A study of a total population. Cancer. 67:3093–3103. 1991. View Article : Google Scholar : PubMed/NCBI
5	Irwin C, Levin W, Fyles A, Pintilie M, Manchul L and Kirkbride P: The role of adjuvant radiotherapy in carcinoma of the endometrium-results in 550 patients with pathologic stage I disease. Gynecol Oncol. 70:247–254. 1998. View Article : Google Scholar : PubMed/NCBI
6	Saito T, Takahashi F and Katabuchi H: 2016 Committee on Gynecologic Oncology of the Japan Society of Obstetrics and Gynecology: Annual Report of the Committee on Gynecologic Oncology, Japan Society of Obstetrics and Gynecology: Patient Annual Report for 2014 and Treatment Annual Report for 2009. J Obstet Gynaecol Res. 43:1667–1677. 2017. View Article : Google Scholar : PubMed/NCBI
7	Carcangiu ML and Chambers JT: Early pathologic stage clear cell carcinoma and uterine papillary serous carcinoma of the endometrium: comparison of clinicopathologic features and survival. Int J Gynecol Pathol. 14:30–38. 1995. View Article : Google Scholar : PubMed/NCBI
8	Sakaki M, Yasuda M, Yano M, Goto Y, Nakamura M, Kayano H and Hasegawa K: The prognostic significance of tumor lymphangiogenesis and lymphatic vessel density in endometrioid carcinoma of the uterine corpus. Oncol Lett. 14:5313–5318. 2017.PubMed/NCBI
9	Ogane N, Yasuda M, Kato H, Kato T, Yano M, Kameda Y and Kamoshida S: Cleaved caspase-3 expression is a potential prognostic factor for endometrial cancer with positive peritoneal cytology. Cytopathology. 29:254–261. 2018. View Article : Google Scholar : PubMed/NCBI
10	Carcangiu ML and Chambers JT: Uterine papillary serous carcinoma: A study on 108 cases with emphasis on the prognostic significance of associated endometrioid carcinoma, absence of invasion, and concomitant ovarian carcinoma. Gynecol Oncol. 47:298–305. 1992. View Article : Google Scholar : PubMed/NCBI
11	Mutter GL and Prat J: Endometrial adenocarcinoma. Pathology of the Female Reproductive Tract. 3rd edition. Churchill Livingstone Elsevier; Boston, MA: pp. 3972014
12	Kounelis S, Kapranos N, Kouri E, Coppola D, Papadaki H and Jones MW: Immunohistochemical profile of endometrial adenocarcinoma: a study of 61 cases and review of the literature. Mod Pathol. 13:379–388. 2000. View Article : Google Scholar : PubMed/NCBI
13	Sherman ME, Bur ME and Kurman RJ: p53 in endometrial cancer and its putative precursors: Evidence for diverse pathways of tumorigenesis. Hum Pathol. 26:1268–1274. 1995. View Article : Google Scholar : PubMed/NCBI
14	Lax SF, Kendall B, Tashiro H, Slebos RJ and Hedrick L: The frequency of p53, K-ras mutations, and microsatellite instability differs in uterine endometrioid and serous carcinoma: Evidence of distinct molecular genetic pathways. Cancer. 88:814–824. 2000. View Article : Google Scholar : PubMed/NCBI
15	Scholzen T and Gerdes J: The Ki-67 protein: From the known and the unknown. J Cell Physiol. 182:311–322. 2000. View Article : Google Scholar : PubMed/NCBI
16	Kallakury BV, Ambros RA, Hayner-Buchan AM, Sheehan CE, Malfetano JH and Ross JS: Cell proliferation-associated proteins in endometrial carcinomas, including papillary serous and endometrioid subtypes. Int J Gynecol Pathol. 17:320–326. 1998. View Article : Google Scholar : PubMed/NCBI
17	Salvesen HB, Iversen OE and Akslen LA: Identification of high-risk patients by assessment of nuclear Ki-67 expression in a prospective study of endometrial carcinomas. Clin Cancer Res. 4:2779–2785. 1998.PubMed/NCBI
18	Geisler JP, Geisler HE, Miller GA, Wiemann MC, Zhou Z and Crabtree W: MIB-1 in endometrial carcinoma: Prognostic significance with 5-year follow-up. Gynecol Oncol. 75:432–436. 1999. View Article : Google Scholar : PubMed/NCBI
19	Semczuk A, Skomra D, Cybulski M and Jakowicki JA: Immunohistochemical analysis of MIB-1 proliferative activity in human endometrial cancer. Correlation with clinicopathological parameters, patient outcome, retinoblastoma immunoreactivity and K-ras codon 12 point mutations. Histochem J. 33:193–200. 2001. View Article : Google Scholar : PubMed/NCBI
20	Lundgren C, Auer G, Frankendal B, Moberger B, Nilsson B and Nordstrom B: Nuclear DNA content, proliferative activity, and p53 expression related to clinical and histopathologic features in endometrial carcinoma. Int J Gynecol Pathol. 12:110–118. 2002. View Article : Google Scholar
21	AlHilli MM, Bakkum-Gamez JN, Mariani A, Weaver AL, McGree ME, Keeney GL, Jatoi A, Dowdy SC and Podratz KC: Risk-adjusted outcomes in elderly endometrial cancer patients: Implications of the contrasting impact of age on progression-free and cause-specific survival. Gynecol Oncol. 138:133–140. 2015. View Article : Google Scholar : PubMed/NCBI
22	Fleming ND, Lentz SE, Cass I, Li AJ, Karlan BY and Walsh CS: Is older age a poor prognostic factor in stage I and II endometrioid endometrial adenocarcinoma? Gynecol Oncol. 120:189–192. 2011. View Article : Google Scholar : PubMed/NCBI
23	Farley JH, Nycum LR, Birrer MJ, Park RC and Taylor RR: Age-specific survival of women with endometrioid adenocarcinoma of the uterus. Gynecol Oncol. 79:86–89. 2000. View Article : Google Scholar : PubMed/NCBI
24	Jolly S, Vargas CE, Kumar T, Weiner SA, Brabbins DS, Chen PY, Floyd W and Martinez AA: The impact of age on long-term outcome in patients with endometrial cancer treated with postoperative radiation. Gynecol Oncol. 103:87–93. 2006. View Article : Google Scholar : PubMed/NCBI
25	Vance S, Yechieli R, Cogan C, Hanna R, Munkarah A and Elshaikh MA: The prognostic significance of age in surgically staged patients with Type II endometrial carcinoma. Gynecol Oncol. 126:16–19. 2012. View Article : Google Scholar : PubMed/NCBI
26	Connelly PJ, Alberhasky RC and Christopherson WM: Carcinoma of the endometrium. III. Analysis of 865 cases of adenocarcinoma and adenoacanthoma. Obstet Gynecol. 59:569–575. 1982.PubMed/NCBI
27	Goff BA, Kato D, Schmidt RA, Ek M, Ferry JA, Muntz HG, Cain JM, Tamimi HK, Figge DC and Greer BE: Uterine papillary serous carcinoma: Patterns of metastatic spread. Gynecol Oncol. 54:264–268. 1994. View Article : Google Scholar : PubMed/NCBI
28	Lax SF, Pizer ES, Ronnett BM and Kurman RJ: Clear cell carcinoma of the endometrium is characterized by a distinctive profile of p53, Ki-67, estrogen, and progesterone receptor expression. Hum Pathol. 29:551–558. 1998. View Article : Google Scholar : PubMed/NCBI
29	Jia L, Yuan Z, Wang Y, Cragun JM, Kong B and Zheng W: Primary sources of pelvic serous cancer in patients with endometrial intraepithelial carcinoma. Modern pathology : An official journal of the United States and Canadian Academy of Pathology. Inc. 28:118–127. 2015.
30	Creasman W: Revised FIGO staging for carcinoma of the endometrium. Int J Gynaecol Obstet. 105:1092009. View Article : Google Scholar : PubMed/NCBI
31	Zaino RJ, Kurman RJ, Diana KL and Morrow CP: The utility of the revised International Federation of Gynecology and Obstetrics histologic grading of endometrial adenocarcinoma using a defined nuclear grading system. A Gynecologic Oncology Group study. Cancer. 75:81–86. 1995. View Article : Google Scholar : PubMed/NCBI
32	Fukuda K, Mori M, Uchiyama M, Iwai K, Iwasaka T and Sugimori H: Prognostic significance of progesterone receptor immunohistochemistry in endometrial carcinoma. Gynecol Oncol. 69:220–225. 1998. View Article : Google Scholar : PubMed/NCBI
33	Matias-Guiu X, Catasus L, Bussaglia E, Lagarda H, Garcia A, Pons C, Muñoz J, Argüelles R, Machin P and Prat J: Molecular pathology of endometrial hyperplasia and carcinoma. Hum Pathol. 32:569–577. 2001. View Article : Google Scholar : PubMed/NCBI
34	Berchuck A and Boyd J: Molecular basis of endometrial cancer. Cancer. 76 Suppl:2034–2040. 1995. View Article : Google Scholar : PubMed/NCBI
35	An HJ, Logani S, Isacson C and Ellenson LH: Molecular characterization of uterine clear cell carcinoma. Modern pathology : An official journal of the United States and Canadian Academy of Pathology. Inc. 17:530–537. 2004.
36	Huvila J, Laajala TD, Edqvist PH, Mardinoglu A, Talve L, Pontén F, Grénman S, Carpén O, Aittokallio T and Auranen A: Combined ASRGL1 and p53 immunohistochemistry as an independent predictor of survival in endometrioid endometrial carcinoma. Gynecol Oncol. 149:173–180. 2018. View Article : Google Scholar : PubMed/NCBI
37	Obata T, Nakamura M, Mizumoto Y, Iizuka T, Ono M, Terakawa J, Daikoku T and Fujiwara H: Dual expression of immunoreactive estrogen receptor β and p53 is a potential predictor of regional lymph node metastasis and postoperative recurrence in endometrial endometrioid carcinoma. PLoS One. 12:e01886412017. View Article : Google Scholar : PubMed/NCBI
38	Geels YP, van der Putten LJ, van Tilborg AA, Lurkin I, Zwarthoff EC, Pijnenborg JM, van den Berg-van Erp SH, Snijders MP, Bulten J, Visscher DW, et al: Immunohistochemical and genetic profiles of endometrioid endometrial carcinoma arising from atrophic endometrium. Gynecol Oncol. 137:245–251. 2015. View Article : Google Scholar : PubMed/NCBI