Article Text

Download PDFPDF
Undifferentiated Endometrial Carcinomas: Clinicopathologic Characteristics and Treatment Outcomes
  1. Rohit Gunan Ganju, MD*,
  2. Ossama Tawfik, MD, PhD,
  3. Laura Brown, MD,
  4. Allen M. Chen, MD*,
  5. Andrea Jewell, MD,
  6. Mindi TenNapel, PhD, MBA* and
  7. Andrew Hoover, MD*
  1. *Departments of Radiation Oncology,
  2. Pathology and Laboratory Medicine, and
  3. Obstetrics and Gynecology, University of Kansas Medical Center, Kansas City, KS.
  1. Address correspondence and reprint requests to Andrew Hoover, MD, Department of Radiation Oncology, University of Kansas Medical Center, 3901 Rainbow Blvd, Mail Stop 4033, Kansas City, KS 66160. E-mail: ahoover2{at}kumc.edu.

Abstract

Objective Undifferentiated endometrial carcinoma (UEC) represents a recently recognized and rare diagnosis that is commonly misclassified on histopathologic evaluation. These cancers account for less than 10% of carefully reviewed series of endometrial cancers from academic medical centers. We reviewed a single-institutional experience with the management of UEC focusing on clinicopathologic characteristics and treatment outcomes.

Methods The medical records of all patients treated for histologically proven endometrial carcinoma between 2007 through 2016 were reviewed. Analysis was limited to 24 consecutive patients with histologically proven endometrial carcinomas that had at least a component of undifferentiated carcinoma on central pathology review. All patients were initially treated by definitive surgical resection. Grade 3 endometrioid carcinomas treated over the same period were used as a control group. The Kaplan-Meier method was used to estimate survival outcomes.

Results The median age at diagnosis was 66 years (range, 37–74 years). Ten patients presented with locally advanced or metastatic disease (42%). Fifteen patients (63%) received adjuvant chemotherapy with carboplatin and paclitaxel, 12 patients (50%) received adjuvant pelvic external beam radiation, and 10 patients (42%) received adjuvant vaginal cuff brachytherapy. With a median follow-up of 14 months (range, 0.5–115 months), 4 patients (21%) had developed disease recurrence and/or progression, 2 patients (11%) had died of disease, and 1 patient died of treatment complications. Twelve patients (63%) were alive with no evidence of disease at last contact. Outcomes were comparable to those with grade 3 endometrioid carcinoma.

Conclusions Our data are consistent with prior studies demonstrating that UEC represents a rare clinical entity characterized by high rates of locally advanced disease at presentation. However, survival outcomes appear to be comparable to other high-grade endometrial cancers. Further studies investigating optimal adjuvant therapy in these patients are warranted.

  • Chemotherapy
  • Radiation therapy
  • Treatment outcome
  • Undifferentiated endometrial cancer

Statistics from Altmetric.com

Footnotes

  • The authors declare no conflicts of interest.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.