Tarinee Manchana1, Nipon Khemapech. 1. Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand. T_manchana@hotmail.com
Abstract
OBJECTIVE: To evaluate the clinicopathological characteristics and survival analysis in endometrial adenocarcinoma women younger than the age of 40 years compare to older women. METHODS: Medical records of 423 endometrial adenocarcinoma patients who received primary surgical treatment at King Chulalongkorn Memorial Hospital during 1996-2005 were reviewed. The patients were divided into two groups; 40 years of age or younger (group A, 42 patients) and older than 40 years (group B, 381 patients). RESULTS: Up to 10% (42/423) of endometrial adenocarcinoma patients were younger than the age of 40 years. The higher incidence of nulliparous and obesity (BMI > 30 kg/m2) was significantly demonstrated in group A (81%/34.1% and 52.4%/25.2%, respectively). However, obesity was an only independent factor in multivariate analysis. No significant difference in surgical stage distribution and the other pathologic characteristics was demonstrated between both groups. However, poor histologic grade (grade 3) and deep myometrial invasion (myometrial invasion more than 50%) tended to be found more frequent in the patients older than the age of 40 years, although there was no statistical significance (16% versus 4.7% and 31% versus 14.3%, respectively). Moreover, synchronous ovarian cancer seemed to be higher in young patients (7.1% and 2.9%, p > .05). Median time to follow was 63 months (range 0-145 months). Five years disease free survival and 5 years overall survival were 87.3% and 92.4% in group A versus 83.8% and 88.0% in group B without statistical significance between both groups. CONCLUSIONS: Obesity was the only independent factor associated with endometrial adenocarcinoma in young patients. Distribution of the surgical stage and the other pathologic characteristics were similar between both groups without survival benefit in young patients.
OBJECTIVE: To evaluate the clinicopathological characteristics and survival analysis in endometrial adenocarcinomawomen younger than the age of 40 years compare to older women. METHODS: Medical records of 423 endometrial adenocarcinomapatients who received primary surgical treatment at King Chulalongkorn Memorial Hospital during 1996-2005 were reviewed. The patients were divided into two groups; 40 years of age or younger (group A, 42 patients) and older than 40 years (group B, 381 patients). RESULTS: Up to 10% (42/423) of endometrial adenocarcinomapatients were younger than the age of 40 years. The higher incidence of nulliparous and obesity (BMI > 30 kg/m2) was significantly demonstrated in group A (81%/34.1% and 52.4%/25.2%, respectively). However, obesity was an only independent factor in multivariate analysis. No significant difference in surgical stage distribution and the other pathologic characteristics was demonstrated between both groups. However, poor histologic grade (grade 3) and deep myometrial invasion (myometrial invasion more than 50%) tended to be found more frequent in the patients older than the age of 40 years, although there was no statistical significance (16% versus 4.7% and 31% versus 14.3%, respectively). Moreover, synchronous ovarian cancer seemed to be higher in young patients (7.1% and 2.9%, p > .05). Median time to follow was 63 months (range 0-145 months). Five years disease free survival and 5 years overall survival were 87.3% and 92.4% in group A versus 83.8% and 88.0% in group B without statistical significance between both groups. CONCLUSIONS:Obesity was the only independent factor associated with endometrial adenocarcinoma in young patients. Distribution of the surgical stage and the other pathologic characteristics were similar between both groups without survival benefit in young patients.