Morphologic prognostic criteria in endometrial cancer with special reference to nuclear grading

Abstract

The prerequisite for the implementation and later assessment of new concepts of therapy is a description of the tumor that is as exact and objective as possible, that corresponds to the actual extent of the tumor and its morphological appearance, and is thus reproducible. Only if results are based on precise postoperative staging can they be compared. Between 1963 and 1981, the average unadjusted 5-year survival probability for patients in Erlangen, a total of 719 endometrial carcinomas, was 69.3%. The 5-year survival probability with primary surgery for endometrial carcinoma in all tumor stages is 81.9%, 81.5% for simple adenocarcinoma, 87.5% for adenoacanthoma, and 40% for clear cell carcinoma. With primarily irradiated endometrial carcinomas the 5-year survival probability is 45.4%; it is 44.2% for adenocarcinoma, and 52.2% for adenoacanthoma. The prognosis for patients with slight myometrium infiltration is better than that for women deep carcinoma infiltration. While 70% of grade I endometrial carcinoma consists of very highly differentiated tumor cells, 30% consists of tumor cells with less differentiation. Two-thirds of grade III carcinoma consist of undifferentiated tumor cells, one-third of very highly differentiated tumor cells.