The Association between Lower Uterine Segment Involvement in Corpus Located Endometrioid Adenocarcinoma with the (International Federation of Gynecology and Obstetrics) Grade and Stage

Authors

  • Farah Hasan Department of Histopathology and Cytology, College of Medicine, University of Kerbala, Karbala, Iraq
  • Zina Hussein Department of Pathology, Baghdad Teaching Hospital, Medical City, Baghdad, Iraq

DOI:

https://doi.org/10.3889/oamjms.2022.7418

Keywords:

Endometrial carcinoma, Isthmus, Staging system, Grading system

Abstract

BACKGROUND: Although lower uterine segment (LUS) is regarded as an anatomically defined part that possess some histological differences, it is involvement by carcinoma have not been included in the criteria for definition in the staging system for endometrial carcinoma and there are few conflicting data focused on the effect of LUS involvement as a prognostic factor in endometrial cancer.

AIM: To find the association between LUS involvement in corpus located endometrioid carcinoma with the grading and staging system established by the international federation of gynecology and obstetrics (FIGO).

METHODS: This was a retrospective study involving data collected from achieves of histopathology departments of teaching laboratories within successive 4 years period in Medical City complex at Bagdad. Pathological analysis of 70 hysterectomy specimens of corpus located endometriod adenocarcinoma was done, histological sections from each case of endometrioid adenocarcinoma carcinoma were microscopically reviewed for appropriate grading and staging, in addition, meticulous search was applied for histological finding consistent with LUS involvement. The statistical comparison between the results was done using either independent sample t-test (for continuous data; mean ± SD) or Chi-square test at a significant p < 0.05.

RESULTS: The study enrolled 70 histological samples of endometrioid adenocarcinoma, the majority of the samples were of low grade and stage at presentation. Of total sample, 46 (65.71%) showed LUS involvement by tumor cells. There was a significant statistical relationship between LUS involvement and FIGO stage while a non-significant statistical association with FIGO grade was found.

CONCLUSION: LUS involvement by corpus located endometrioid adenocarcinoma is associated with an advanced FIGO stage at presentation while non-significant relationship was found between patient age and tumor grade.

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References

Ritterhouse LL, Howitt BE. Molecular pathology: Predictive, prognostic, and diagnostic markers in uterine tumors. Surg Pathol Clin. 2016;9(3):405-26. https://doi.org/10.1016/j.path.2016.04.006 PMid:27523969 DOI: https://doi.org/10.1016/j.path.2016.04.006

Lori A. Endometrial Adenocarcinoma, endometrioid type. Path Patient Image Quiz. 2018;93(7):963-64. DOI: https://doi.org/10.1016/j.mayocp.2018.03.017

Ali ZA, Hasan F, Yahya A. Immunohistochemical expression of HER2/NEU receptors in Iraqi patients with endometriod carcinoma. JCDR. 2018;12(11):EC05-8. DOI: https://doi.org/10.7860/JCDR/2018/37304.12215

Soslow RA, Tornos C, Park KJ, Malpica A, Matias-Guiu X, Oliva E, et al. Endometrial carcinoma diagnosis: Use of FIGO grading and genomic subcategories in clinical practice: Recommendations of the international society of gynecological pathologists. Int J Gynecol Pathol. 2019;38(1):64-74. https://doi.org/10.1097/PGP.0000000000000518 PMid:30550484 DOI: https://doi.org/10.1097/PGP.0000000000000518

Armstrong AJ, Hurd WW, Elguero S, Barker NM, Zanotti KM. Diagnosis and management of endometrial hyperplasia. J Minim Invasive Gynecol. 2012;19(5):562-71. https://doi.org/10.1016/j.jmig.2012.05.009 Mid:22863972 DOI: https://doi.org/10.1016/j.jmig.2012.05.009

Kadirogullari P, Atalay C, Ozdemir O, Sari M. Prevalence of co-existing endometrial carcinoma in patients with preoperative diagnosis of endometrial hyperplasia. J Clin Diagn Res. 2015;9(10):QC10-4. https://doi.org/10.7860/JCDR/2015/12484.6618 PMid:26557570 DOI: https://doi.org/10.7860/JCDR/2015/12484.6618

Hasan FF. The frequency of histopathological patterns in endometriam obtained from a sample of Iraqi women with abnormal Uterine Bleeding. Karbala J Med. 2017;10(3):3846-56.

Masuda K, Banno K, Yanokura M, Kobayashi Y, Kisu I, Ueki A, et al. Carcinoma of the lower uterine segment (LUS): Clinicopathological characteristics and association with lynch syndrome. Curr Genomics. 2011;12(1):25-9. https://doi.org/10.2174/138920211794520169 PMid:21886452 DOI: https://doi.org/10.2174/138920211794520169

McCluggage WG, Colgan T, Duggan M, Hacker NF, Mulvany N, Otis C, et al. Data set for reporting of endometrial carcinomas: Recommendations from the international collaboration on cancer reporting (ICCR) between United Kingdom, United States, Canada, and Australasia. Int J Gynecol Pathol. 2013;32(1):45-65. https://doi.org/10.1097/PGP.0b013e31825d808b PMid:23202790 DOI: https://doi.org/10.1097/PGP.0b013e31825d808b

Rungruang B, Olawaiye A. Comprehensive surgical staging for endometrial cancer. Rev Obstet Gynecol. 2012;5(1):28-34. PMid:22582124

Singh N, Hirschowitz L, Zaino R, Alvarado-Cabrero I, Duggan M, Ali-Fehmi R. Pathologic prognostic factors in endometrial carcinoma (other than tumor type and grade). Int J Gynecol Pathol. 2019;38(1):93-113. https://doi.org/10.1097/PGP.0000000000000524 PMid:30550486 DOI: https://doi.org/10.1097/PGP.0000000000000524

Colombo N, Preti E, Landoni F, Carinelli S, Colombo A, Marini C, et al. Endometrial cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2011;22(6):35-9. DOI: https://doi.org/10.1093/annonc/mdr374

Colombo N, Creutzberg C, Querleu D, Barahona M, Sessa S. Endometrial cancer: EUpdate published online 8 June 2017. Ann Oncol. 2017;28(4):153-6. DOI: https://doi.org/10.1093/annonc/mdx243

Onsrud M, Cvancarova M, Hellebust TP, Tropé C, Kristensen G, Lindemann K. Long-term outcomes after pelvic radiation for early-stage endometrial cancer. J Clin Oncol. 2013;31(31):3951-6. https://doi.org/10.1200/JCO.2013.48.8023 PMid:24019546 DOI: https://doi.org/10.1200/JCO.2013.48.8023

Trovik J, Wik E, Werner HM, Krakstad C, Helland H, Vandenput I, et al. Hormone receptor loss in endometrial carcinoma curettage predicts lymph node metastasis and poor outcome in prospective multicentre trial. Eur J Cancer. 2013;49(16):3431-41. https://doi.org/10.1016/j.ejca.2013.06.016 PMid:23932335 DOI: https://doi.org/10.1016/j.ejca.2013.06.016

Mukonoweshuro P, Oriowolo A, Smith M. Audit of the histological definition of cervical transformation zone. J Clin Pathol. 2005;58(6):671. PMid:15917428

Erkaya S, Öz M, Topçu H, Şirvan A, Güngör T, Meydanli M. Is lower uterine segment involvement a prognostic factor in endometrial cancer? Turk J Med Sci. 2017;47(1):300-6. https://doi.org/10.3906/sag-1602-137 PMid:28263506 DOI: https://doi.org/10.3906/sag-1602-137

Freeman SJ, Aly AM, Kataoka MY, Addley HC, Reinhold C, Sala E. The revised FIGO staging system for uterine malignancies: Implications for MR imaging. Radiographics. 2012;32(6):1805-27. https://doi.org/10.1148/rg.326125519 PMid:23065170 DOI: https://doi.org/10.1148/rg.326125519

Aminimoghaddam S, Kamyabi G, Yarandi F, Zarei S. Investigating the association of lower uterine segment involvement with deep myometrial invasion in endometrial adenocarcinoma. JOGCR. 2017;2(2):e10991. DOI: https://doi.org/10.5812/jogcr.10991

Ogden L, Hakima L, Feuerman M, Bondoc CH, Villella J, Khullar P. The prognostic significance of lower uterine segment involvement in endometrioid endometrial adenocarcinoma. AJCP. 2012;138(1):A089. DOI: https://doi.org/10.1093/ajcp/138.suppl1.084

Clark L, Gehrig P, Bae-Jump V, Franasiak J, Ko E. Does lower uterine segment involvement in grade 3 endometrial cancer impact recurrence patterns and patient outcomes? J Clin Gynecol Obstet. 2014;3(3):85-92. DOI: https://doi.org/10.14740/jcgo264w

Kogan L, Octeau D, Amajoud Z, Abitbol J, Laskov I, Ferenczy A. Impact of lower uterine segment involvement in type II endometrial cancer and the unique mutational profile of serous tumors. Gynecol Oncol Case Rep. 2018;24:43-7. https://doi.org/10.1016/j.gore.2018.03.004 PMid:29915797 DOI: https://doi.org/10.1016/j.gore.2018.03.004

Kizer NT, Gao F, Guntupalli S, Thaker PH, Powell MA, Goodfellow PJ, Mutch DG, et al. Lower uterine segment involvement is associated with poor outcomes in early-stage endometrioid endometrial carcinoma. Ann Surg Oncol. 2011;18(5):1419-24. https://doi.org/10.1245/s10434-010-1454-9 PMid:21181281 DOI: https://doi.org/10.1245/s10434-010-1454-9

Gemer O, Gdalevich M, Voldarsky M, Barak F, Ben Arie A, Schneider D, et al. Lower uterine segment involvement is associated with adverse outcome in patients with stage I endometroid endometrial cancer: Results of a multicenter study. Eur J Surg Oncol. 2009;35(8):865-9. https://doi.org/10.1016/j.ejso.2008.10.007 PMid:19013746 DOI: https://doi.org/10.1016/j.ejso.2008.10.007

Lavie O, Uriev L, Gdalevich M, Barak F, Peer G, Auslender R, et al. The outcome of patients with stage I endometrial cancer involving the lower uterine segment. Int J Gynecol Cancer. 2008;18(5):1079-83. https://doi.org/10.1111/j.1525-1438.2007.01150.x PMid:18081795 DOI: https://doi.org/10.1111/j.1525-1438.2007.01150.x

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Published

2022-03-04

How to Cite

1.
Hasan F, Hussein Z. The Association between Lower Uterine Segment Involvement in Corpus Located Endometrioid Adenocarcinoma with the (International Federation of Gynecology and Obstetrics) Grade and Stage. Open Access Maced J Med Sci [Internet]. 2022 Mar. 4 [cited 2024 Apr. 26];10(A):1121-5. Available from: https://oamjms.eu/index.php/mjms/article/view/7418