Clinical characteristics of prognostic factors in uterine endometrioid adenocarcinoma of various grade.

The aim of this study was to compare clinical characteristics of prognostic factors in uterine endometrioid adenocarcinoma of various grades. We have studied 104 postmenopausal women with a histological diagnosis of uterine endometrioid adenocarcinoma. Staging and grading of primary tumor were done according to FIGO system. The following factors were examined: family history of cancer, presence of obesity and vaginal bleeding, recurrence rate within the two years of the study (disease-free periods), vessel permeation, muscle invasion (<1/3, 2/3, >2/3), cervical involvement, lymph node metastasis, ascites cell analysis, parametrium invasion, adnexal metastasis, CA125 pre-surgery values. Histological examination has showed grade 1 endometrioid adenocarcinoma in 35 cases (33,7%, group 1), grade 2 adenocarcinoma in 44 cases (42,3%, group 2), and grade 3 adenocarcinoma in 25 cases (24%, group 3). Most of the factors we have examined seem to be associated with histological grade of uterine endometrioid carcinoma. The analysis of clinicopathological prognostic factors in G1 endometrioid adenocarcinoma cases has showed that about half of these patients are obese, vaginal bleeding is not common, no cervical involvement, parametrium invasion, adnexal metastasis and vessel permeation at the time of diagnosis, no recurrence within two years, pre-surgery value of CA125 is normal, and myometrial invasion is less than 1/3. G3 endometrioid adenocarcinoma cases have showed family history of endometrial cancer, more than half of the patients were obese, with uncommon vaginal bleeding and positive peritoneal cytology, but cervical involvement, parametrium invasion, adnexal metastasis and vessel permeation are present at the time of diagnosis, pre-surgery value of CA125 is high, and myometrial invasion is 2/3 or more than 2/3 in majority of cases, furthermore, in some cases recurrent tumors were developed within two years. G2 endometrioid adenocarcinoma can be considered as an intermediary form which should be managed according to the clinical stage. The results lead to conclude that the histological grade of uterine endometrioid adeno carcinoma seems to be an important independent prognostic indicetor as it is strongly associated with other clinical pathological prognostic factors.