Clinical pathological characteristics and survival of high-grade endometrioid carcinoma.

Abstract

The molecular features of high-grade endometrioid carcinoma (HGEC) are more akin to nonendometrioid high-grade carcinoma (NEHC). This study aims to explore whether HGEC also has similar clinical pathology and prognosis similar to NEHC. Using the SEER database (Surveillance, Epidemiology, and End Results), a retrospective study of the clinical-pathological data and prognosis was carried out. (1) Compared with LGEC (low-grade endometrioid carcinoma), HGEC patients were older with larger tumor size and a higher proportion of stage III-IV disease. However, the young had a lower proportion of stage III-IV disease than NEHC. (2) Postoperative pathological examination revealed that the positive rate of peritoneal cytology, pelvic lymph nodes and para-aortic lymph nodes in HGEC were significantly higher than LGEC, but lower than NEHC. LGEC, HGEC, and NEHC, all showed distant organ metastases such as brain metastases, bone metastases, liver metastases, and lung metastases. Notably, the metastasis rates between HGEC and NEHC were not significantly different but were higher than LGEC. (3) The five-overall survival rates of LGEC, HGEC, and NEHC were 95.1%, 73.2%, and 54.8%, respectively. Notably, the survival rates decreased significantly in stage IV. There were no significant differences between HGEC and NEHC in stage IV (p=0.665) and both were associated with worsened survival. Also, HGEC survival prognosis was similar to NEHC. HGEC presents mixed or overlapping clinical-pathological features of NEHC. Therefore, based on the unique pathological and prognostic features, HGEC could be classified as an intermediate between LGEC and NEHC.