Abdulfatah E, et al. - This article was written with the objective to assess the clinicopathologic features of a multi-institutional cohort of endometrial clear cell carcinoma (CCC) in order to identify which, if any, have prognostic importance. It was concluded that the older age at diagnosis, advanced stage, deep myometrial invasion (MI), and adnexal involvement were independent poor prognostic factors in this series of endometrial CCC. Adjuvant radiotherapy had a significant positive effect on 5-year overall survival (OS).

Methods

• For this study, they performed a retrospective review of endometrial CCC diagnosed between 1995 and 2012.
• This study was conducted at 3 institutions to assess clinicopathologic parameters: age, race, tumor size, stage, myometrial invasion (MI), lymphovascular invasion, lymph node and adnexal involvement, adjuvant therapy, and outcomes.
• Data were examined using Fisher exact, Cox regression, and Kaplan-Meier analyses.

Results

• In this study, patients’ ages ranged from 36 to 90 years (median, 67 years).
• 3.6 cm was the median tumor size.
• Inner-half MI was present in 44%, lymphovascular invasion in 34%, adnexal involvement in 16%, and lymph node metastasis in 30% of cases.
• 58% of the patients presented with early-stage disease.
• The 5-year overall survival (OS) was 58%.
• Shorter disease-free interval (DFI) was significantly related to older age at diagnosis (>70 years), advanced-stage disease, adnexal involvement, and deep MI (P = 0.005, P = 0.001, P = 0.001, and P = 0.003, respectively).
• Patients who received adjuvant chemotherapy had a significantly worse DFI and 5-year OS (P = 0.001 and P = 0.001, respectively).
• A significantly shorter 5-year OS was noted with advanced stage (III-IV) and presence of adnexal involvement (P = 0.001 and P = 0.021, respectively).
• On Cox regression investigation, advanced-stage disease, older age, and adnexal involvement were significant independent predictors of worse DFI (P = 0.001, P = 0.005, and P = 0.019, respectively), whereas inner-half MI was a significant independent predictor of longer DFI (P = 0.004).
• Adjuvant radiotherapy alone was a significant independent predictor of better 5-year OS (P = 0.012).