Carcinoma of the endometrium. III. Analysis of 865 cases of adenocarcinoma and adenoacanthoma.

Eight hundred sixty-five patients with confirmed adenocarcinoma of the endometrium were studied. Eight hundred eleven were followed up for at least 5 years or until death, and 537 were followed up for 10 years. The survival rate was 77.1% at 5 years and 61.0% at 10 years. Age at diagnosis was the single most important clinical determinant of survival. Tumor grade was an important predictor of the course of disease, and nuclear grade was a significantly more accurate indicator than was histologic grade. Stage and depth of invasion were also important predictors of survival. The 5-year survival rate for black women was only 41.9%. Stage for stage and grade for grade, women undergoing hysterectomy alone and with radiation had similar survival rates. Adenoacanthoma had a better prognosis that did adenocarcinoma without squamous metaplasia; there were no deaths at 5 to 10 years in women diagnosed before age 50. The subtype of carcinoma was found to be a highly significant predictor of prognosis.