BACKGROUND: Understanding the etiology, presentation, evaluation, and management of selected non-endometrioid endometrial adenocarcinomas of the uterine corpus is needed to define optimal treatment regimens. METHODS: The pathology and treatment of selected non-endometrioid endometrial adenocarcinomas of the uterus are reviewed and summarized. RESULTS: The most common non-endometrioid histology is papillary serous (10%), followed by clear cell (2% to 4%), mucinous (0.6% to 5%), and squamous cell (0.1% to 0.5%). Some non-endometrioid endometrial carcinomas behave more aggressively than the endometrioid cancers such that even women with clinical stage I disease often have extrauterine metastasis at the time of surgical evaluation. Therefore, when technically and medically feasible, comprehensive surgical staging is helpful for women with non-endometrioid endometrial cancer histology. Comprehensive surgical staging includes hysterectomy, bilateral salpingo-oophorectomy, pelvic and para-aortic lymphadenectomy, and cytological evaluation of the abdominal cavity. While whole abdominal radiotherapy has a limited role in early-stage uterine papillary serous carcinoma (UPSC) and clear cell carcinoma (CC), there may be a role for postoperative chemotherapy and volume-directed radiotherapy in both early-stage UPSC and CC. In the setting of optimally debulked advanced-stage disease, a combination of radiation and chemotherapy may be indicated. In the setting of recurrent disease or in women with residual disease after surgery, a platinum-based regimen or enrollment in a clinical trial is recommended. CONCLUSIONS: UPSC and CC are managed similarly since sufficient data to separate treatment recommendations are lacking. Because both histologies are associated with a high rate of recurrence, adjuvant therapy is recommended even in women with early-stage disease. The remaining cell types should be treated similar to endometrioid or other low-grade histologies.
BACKGROUND: Understanding the etiology, presentation, evaluation, and management of selected non-endometrioid endometrial adenocarcinomas of the uterine corpus is needed to define optimal treatment regimens. METHODS: The pathology and treatment of selected non-endometrioid endometrial adenocarcinomas of the uterus are reviewed and summarized. RESULTS: The most common non-endometrioid histology is papillary serous (10%), followed by clear cell (2% to 4%), mucinous (0.6% to 5%), and squamous cell (0.1% to 0.5%). Some non-endometrioid endometrial carcinomas behave more aggressively than the endometrioid cancers such that even women with clinical stage I disease often have extrauterine metastasis at the time of surgical evaluation. Therefore, when technically and medically feasible, comprehensive surgical staging is helpful for women with non-endometrioid endometrial cancer histology. Comprehensive surgical staging includes hysterectomy, bilateral salpingo-oophorectomy, pelvic and para-aortic lymphadenectomy, and cytological evaluation of the abdominal cavity. While whole abdominal radiotherapy has a limited role in early-stage uterine papillary serous carcinoma (UPSC) and clear cell carcinoma (CC), there may be a role for postoperative chemotherapy and volume-directed radiotherapy in both early-stage UPSC and CC. In the setting of optimally debulked advanced-stage disease, a combination of radiation and chemotherapy may be indicated. In the setting of recurrent disease or in women with residual disease after surgery, a platinum-based regimen or enrollment in a clinical trial is recommended. CONCLUSIONS: UPSC and CC are managed similarly since sufficient data to separate treatment recommendations are lacking. Because both histologies are associated with a high rate of recurrence, adjuvant therapy is recommended even in women with early-stage disease. The remaining cell types should be treated similar to endometrioid or other low-grade histologies.
Authors: Ashley S Felix; Joel L Weissfeld; Roslyn A Stone; Robert Bowser; Mamatha Chivukula; Robert P Edwards; Faina Linkov Journal: Cancer Causes Control Date: 2010-07-14 Impact factor: 2.506
Authors: Summer B Dewdney; Nora T Kizer; Abegail A Andaya; Sheri A Babb; Jingqin Luo; David G Mutch; Amy P Schmidt; Louise A Brinton; Russell R Broaddus; Nilsa C Ramirez; Phyllis C Huettner; Donald Scott McMeekin; Kathleen Darcy; Shamshad Ali; Patricia L Judson; Robert S Mannel; Shashikant B Lele; David M O'Malley; Paul J Goodfellow Journal: Cancer Prev Res (Phila) Date: 2012-01-13
Authors: Heather L Franco; Daisy Dai; Kevin Y Lee; Cory A Rubel; Dennis Roop; Derek Boerboom; Jae-Wook Jeong; John P Lydon; Indrani C Bagchi; Milan K Bagchi; Francesco J DeMayo Journal: FASEB J Date: 2010-12-16 Impact factor: 5.191
Authors: Louise A Brinton; Ashley S Felix; D Scott McMeekin; William T Creasman; Mark E Sherman; David Mutch; David E Cohn; Joan L Walker; Richard G Moore; Levi S Downs; Robert A Soslow; Richard Zaino Journal: Gynecol Oncol Date: 2013-02-26 Impact factor: 5.482