Histological grading of endometrial carcinoma. Clinical and patomorphological analysis

Abstract

Objective: Retrospective clinical and pathomorphological analysis of patients undergoing surgery due to endometrial carcinoma; analysis of the correlation between histological grading of endometrial cancer and selected pathomorphological results. Material and methods: Statistical analysis was based on the pathomorphological results in a group of 353 patients operated because of endometrial carcinoma at the Clinical Department of Gynecologic Oncology, Medical University of Lodz, between 2003 and 2013. A possible correlation between histological grading, clinical staging, myometrial infiltration, parametrial invasion and nodal metastases to ilio-obturator lymph nodes was investigated. Results: Among poorly differentiated carcinomas G3, myometrial infiltration above half of its thickness was observed in 67.44% of the cases, whereas in the G2 and G1 groups it was detected in 60.82% and 39.33% of the affected individuals, respectively. Parametrial invasion was found in 24.39% of G3 cases, i.e. 4.23 times more often than in G2 (5.76%) and 10.65 times more often than in G1 (2.29%). Nodal metastases to ilio-obturator lymph nodes were present in 27.50% of poorly, 10.86% of moderately, and 8.11% of well-differentiated carcinomas. Uterine appendages were infiltrated in 23.25% of G3 cases – 3.45 times more than in G2 (6.73%) and 6.82 times more than in G1 (3.41%). Conclusions: Histologic grading for carcinoma at the time of diagnosis is significantly related to clinical staging. No correlation between patient age and carcinoma grading or its clinical staging was observed. Risk of lymph node invasion for well-differentiated carcinomas is similar to the risk for moderately differentiated carcinomas, and should also be an indication for lymphadenectomy in that group of patients.