What are the prognostic factors for endometrial cancer?

Updated: Jun 19, 2018
  • Author: William T Creasman, MD; Chief Editor: Warner K Huh, MD  more...
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Answer

Multiple prognostic factors exist for endometrial cancer. These prognostic factors generally are related to surgical pathologic findings. As in all cancers, the stage of the disease is the most important prognostic factor. Obviously, the surgical procedure helps determine the stage. Listed below are prognostic factors that may relate specifically to the stage of the disease and, thereby, may affect overall survival.

Prognostic factors - histopathologic subtypes

Most endometrial carcinomas are endometrioid adenocarcinomas. Adenoacanthomas (benign squamous components) and adenosquamous carcinoma (malignant squamous components) make up the next largest category.

Clear cell and papillary serous adenocarcinomas represent approximately 10% of all endometrial cancers and are considered to be poor histopathologic subtypes. These latter subtypes tend to have deeply invasive myometrial involvement, and they have a propensity for extrauterine spread, even though the myometrium may be superficially involved.

Previously, a patient with an adenosquamous carcinoma was thought to have a poor prognostic histotype because of the malignant squamous component.

Contemporary data suggest that irrespective of whether a squamous component is present (either benign or malignant), prognosis is related directly to the grade of the adeno component and not the fact that a squamous malignancy is present. If a malignant squamous component is present, a greater tendency exists for a more poorly differentiated adeno component to be present.

More recently, considerable evidence suggests that carcinosarcomas (CS) are not true sarcomas, as it appears they are derived from an epithelial origin. As a result CSs are now considered as a subset of endometrial cancers (type 2). [6]


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