Pathologic Prognostic Factors in Endometrial Carcinoma (Other Than Tumor Type and Grade)

Naveena Singh, Lynn Hirschowitz, Richard Zaino, Isabel Alvarado-Cabrero, Maire A. Duggan, Rouba Ali-Fehmi, Elizabeth Euscher, Jonathan L. Hecht, Lars Christian Horn, Olga Ioffe, Xavier Matias-Guiu, W. Glenn McCluggage, Yoshiki Mikami, Jaume Ordi, Vinita Parkash, M. Ruhul Quddus, Charles M. Quick, Annette Staebler, Charles Zaloudek, Marisa NucciAnais Malpica, Esther Oliva

Research output: Contribution to journalArticlepeer-review

101 Scopus citations

Abstract

Although endometrial carcinoma (EC) is generally considered to have a good prognosis, over 20% of women with EC die of their disease, with a projected increase in both incidence and mortality over the next few decades. The aim of accurate prognostication is to ensure that patients receive optimal treatment and are neither overtreated nor undertreated, thereby improving patient outcomes overall. Patients with EC can be categorized into prognostic risk groups based on clinicopathologic findings. Other than tumor type and grade, groupings and recommended management algorithms may take into account age, body mass index, stage, and presence of lymphovascular space invasion. The molecular classification of EC that has emerged from the Cancer Genome Atlas (TCGA) study provides additional, potentially superior, prognostic information to traditional histologic typing and grading. This classifier does not, however, replace clinicopathologic risk assessment based on parameters other than histotype and grade. It is envisaged that molecular and clinicopathologic prognostic grouping systems will work better together than either alone. Thus, while tumor typing and grading may be superseded by a classification based on underlying genomic abnormalities, accurate assessment of other pathologic parameters will continue to be key to patient management. These include those factors related to staging, such as depth of myometrial invasion, cervical, vaginal, serosal surface, adnexal and parametrial invasion, and those independent of stage such as lymphovascular space invasion. Other prognostic parameters will also be discussed. These recommendations were developed from the International Society of Gynecological Pathologists Endometrial Carcinoma project.

Original languageEnglish (US)
Pages (from-to)S93-S113
JournalInternational Journal of Gynecological Pathology
Volume38
Issue number1
DOIs
StatePublished - Jan 1 2019

Keywords

  • Adnexal involvement
  • Cervical stromal invasion
  • Endometrial carcinoma
  • Lymphovascular space invasion
  • MELF
  • Myometrium invasion
  • Pathology
  • Prognosis
  • Staging

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Obstetrics and Gynecology

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