Skip to main content
SpringerLink
Log in

Endometrioid endometrial adenocarcinoma: an increase of G3 cancers?

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Endometrial cancer can be divided into two types: endometrioid Type 1 (G1, G2) has a hormonal driven etiology, while Type 2 is more aggressive (G3 endometrioid, clear cell and serous cancer type) and estrogen independent. We noticed an increase of more aggressive G3 endometrioid endometrial adenocarcinomas. This observation is of relevance for daily clinical practice because therapy depends on the histopathological grading and myometrial invasion. G3 cancers or myometrial invasion of more than 50% should be hysterectomized including bilateral adnexectomy with pelvine and paraaortal lymphadenectomy. In G1/G2 and lower infiltration levels, hysterectomy with adnexectomy without lymphadenectomy is sufficient.

Methods

Data of the ASF Statistic were used to analyze the changes in the incidences of patients with endometrioid cancer, grading groups and their first diagnosed stages between 2006 and 2014.

Results

2611 patients, with 243–341 women per year, were analyzed. The number of diagnosed G1 tumors increased from 25 to 37% and the G3 tumors from 18 to 32%, whereas the G2 cancers decreased from 58 to 31%. Despite the rise of G3 tumors, an increase in age at diagnosis was not observed. The proportions of initial diagnosed stages (FIGO I–IV) in each grading remained constant over time.

Conclusion

Potential consequences in treatment recommendations and prognosis urge attention to the detected increase of G3 endometrioid cancers.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Johann S, Santi A, Günthert A, Lössl K, Aebi S, Müller MD (2010) Das Endometriumkarzinom, Diagnostik, Therapie und Nachsorge. Schweiz Med Forum 10(7):129–133

  2. SGO Clinical Practice Endometrial Cancer Working Group, Burke WM, Orr J, Leitao M, Salom E, Gehrig P et al (2014) Endometrial cancer: a review and current management strategies: part I. Gynecol Oncol 134(2):385–392

    Article  Google Scholar 

  3. Bokhman JV (1983) Two pathogenetic types of endometrial carcinoma. Gynecol Oncol 15(1):10–17

    Article  CAS  PubMed  Google Scholar 

  4. Brinton LA, Felix AS, McMeekin DS, Creasman WT, Sherman ME, Mutch D et al (2013) Etiologic heterogeneity in endometrial cancer: evidence from a Gynecologic Oncology Group trial. Gynecol Oncol 129(2):277–284

    Article  PubMed  PubMed Central  Google Scholar 

  5. Sheikh MA, Althouse AD, Freese KE, Soisson S, Edwards RP, Welburn S et al (2014) USA endometrial cancer projections to 2030: should we be concerned? Future Oncol Lond Engl 10(16):2561–2568

    Article  CAS  Google Scholar 

  6. Morice P, Leary A, Creutzberg C, Abu-Rustum N, Darai E (2016) Endometrial cancer. Lancet 387(10023):1094–1108

    Article  PubMed  Google Scholar 

  7. Shepherd JH (1989) Revised FIGO staging for gynaecological cancer. Br J Obstet Gynaecol 96(8):889–892

    Article  CAS  PubMed  Google Scholar 

  8. Zaino RJ, Kurman RJ, Diana KL, Paul Morrow C (1995) The utility of the revised International Federation of Gynecology and Obstetrics histologic grading of endometrial adenocarcinoma using a defined nuclear grading system. A gynecologic oncology group study. Cancer 75(1):81–86

    Article  CAS  PubMed  Google Scholar 

  9. Conlon N, Leitao MM, Abu-Rustum NR, Soslow RA (2014) Grading uterine endometrioid carcinoma: a proposal that binary is best. Am J Surg Pathol 38(12):1583–1587

    Article  PubMed  Google Scholar 

  10. Creasman WT (1989) Announcement, FIGO stages: 1988 revision. Gynecol Oncol 35:125–127

    Article  Google Scholar 

  11. Mariani A, Dowdy SC, Cliby WA, Gostout BS, Jones MB, Wilson TO et al (2008) Prospective assessment of lymphatic dissemination in endometrial cancer: a paradigm shift in surgical staging. Gynecol Oncol 109(1):11–18

    Article  PubMed  PubMed Central  Google Scholar 

  12. Gao H, Zhang Z (2015) Laparoscopy versus laparotomy in the treatment of high-risk endometrial cancer: a propensity score matching analysis. Med (Baltimore) 94(30):e1245

    Article  Google Scholar 

  13. Mariani A, Webb MJ, Galli L, Podratz KC (2000) Potential therapeutic role of para-aortic lymphadenectomy in node-positive endometrial cancer. Gynecol Oncol 76(3):348–356

    Article  CAS  PubMed  Google Scholar 

  14. Eltabbakh GH, Piver MS, Hempling RE, Shin KH (1997) Excellent long-term survival and absence of vaginal recurrences in 332 patients with low-risk stage I endometrial adenocarcinoma treated with hysterectomy and vaginal brachytherapy without formal staging lymph node sampling: report of a prospective trial. Int J Radiat Oncol Biol Phys 38(2):373–380

    Article  CAS  PubMed  Google Scholar 

  15. Mariani A, Webb MJ, Keeney GL, Haddock MG, Calori G, Podratz KC (2000) Low-risk corpus cancer: is lymphadenectomy or radiotherapy necessary? Am J Obstet Gynecol 182(6):1506–1519

    Article  CAS  PubMed  Google Scholar 

  16. Pecorelli S (2009) Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet 105(2):103–104

    Article  Google Scholar 

  17. Boll D, Karim-Kos HE, Verhoeven RHA, Burger CW, Coebergh JW, van de Poll-Franse LV et al (2013) Increased incidence and improved survival in endometrioid endometrial cancer diagnosed since 1989 in The Netherlands: a population based study. Eur J Obstet Gynecol Reprod Biol 166(2):209–214

    Article  CAS  PubMed  Google Scholar 

  18. Creasman WT, Odicino F, Maisonneuve P, Quinn MA, Beller U, Benedet JL et al (2006) Carcinoma of the corpus uteri. FIGO 26th annual report on the results of treatment in gynecological cancer. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet 95(1):S105–S143

    Article  Google Scholar 

  19. Silverberg SG et al (2003) In: Tavassoli FA, Devilee P (eds) Pathology and genetics of tumours of the breast and female genital organs. IARC Press, p 222–224

  20. Scully RE, Bonfiglio TA, Kurman RJ, Silverberg SG, Wilkinson EJ (1994) Histological typing of female genital tract tumours

  21. Gallup DG, Stock RJ (1984) Adenocarcinoma of the endometrium in women 40 years of age or younger. Obstet Gynecol 64(3):417–420

    CAS  PubMed  Google Scholar 

  22. Soliman PT, Oh JC, Schmeler KM, Sun CC, Slomovitz BM, Gershenson DM et al (2005) Risk factors for young premenopausal women with endometrial cancer. Obstet Gynecol 105(3):575–580

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Bethesda Spital Basel, Gellertstrasse 144, 4052, Basel, Switzerland

    C. Mang, A. Birkenmaier & J. Humburg

  2. Institute of Pathology, Cantonal Hospital Baselland, Mühlemattstrasse 11, 4410, Liestal, Switzerland

    G. Cathomas

Authors
  1. C. Mang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Birkenmaier
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. G. Cathomas
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. Humburg
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

CM Data management, data analysis, manuscript writing. AB Manuscript editing. GC Manuscript editing. JH Project development, manuscript editing.

Corresponding authors

Correspondence to C. Mang or J. Humburg.

Ethics declarations

Conflict of interest

We declare that we have no conflict of interest.

Ethical approval

We affirm that the study was conducted according to the ethical principles of the Declaration of Helsinki. The independent Swiss Ethics Committee EKNZ (Ethikkommission Nordwest- und Zentralschweiz) approved that this study meets the general ethical principles for research and issued the declaration of no objection.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mang, C., Birkenmaier, A., Cathomas, G. et al. Endometrioid endometrial adenocarcinoma: an increase of G3 cancers?. Arch Gynecol Obstet 295, 1435–1440 (2017). https://doi.org/10.1007/s00404-017-4370-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-017-4370-4

Keywords

Search

Navigation