Objective To report clinical and pathologic relationships with disease spread in endometrial cancer patients. Methods Surgical candidates with uterine cancer (adenocarcinoma or carcinosarcoma) who were eligible to participate in a surgical pathological study to create a clinically annotated tissue biorepository to support translational and clinical research studies. All patients were to undergo a hysterectomy, bilateral salpingo-oophorectomy, and bilateral pelvic and para-aortic lymphadenectomy. From 2003–2007, open eligibility enrollment was conducted, and from 2007–2011, eligibility was restricted to enrich underrepresented patients or those at high risk. Results This report details clinical pathological relationships associated with extra uterine disease spread of 5866 evaluable patients including those with endometrioid histology as well as papillary serous, clear cell and carcinosarcoma histologies. Review of unrestricted enrollment was constructed in an effort to capture a cross-section population representative of endometrial cancers seen by the GOG participating members. Evaluation of this group of patients suggested the more natural incidence of different surgical pathological findings as well as demographic information. The addition of 2151 patients enrolled during the restricted time interval allowed a total of 1630 poor histotype patients available for further analysis. As expected, endometrioid (E) cancers represented the largest enrollment and particularly E grade 1 and 2 (G1 and 2) were more frequently confined to the uterus. Grade 3 (G3) endometrioid cancers as well as the poor histotype (papillary serous, clear cell and carcinosarcoma) had a much greater propensity for extant disease. Conclusions This study confirms the previously reported surgical pathological findings for endometrioid cancers but in addition, using a large database of papillary serous, clear cell and carcinosarcoma, surgical pathological findings substantiate the categorization of poor histotypes for these cancers.
Bibliographical noteFunding Information:
This study was supported by National Cancer Institute grants to the Gynecologic Oncology Group Tissue Bank (U10 CA27469, U24 CA114793, U10 CA180868), NRG Oncology (1U10 CA180822), and NRG Operations (U10CA180868). The following Gynecologic Oncology Group member institutions participated in the primary treatment studies: Washington University School of Medicine, University of Oklahoma Health Sciences Center, Ohio State University Comprehensive Cancer Center, Women and Infants Hospital, University of Minnesota Medical Center-Fairview, Stony Brook University Medical Center, Roswell Park Cancer Institute, University of Colorado Cancer Center ? Anschutz Cancer Pavilion, Case Western Reserve University, Women's Cancer Center of Nevada, University of North Carolina at Chapel Hill, University of Pittsburgh Cancer Institute, Tacoma General Hospital, University of Massachusetts Memorial Health Care, University of Iowa Hospital and Clinics, University of California at Los Angeles Health System, Duke University Medical Center, Cooper Hospital University Medical Center, Penn State Milton S. Hershey Medical Center, Gynecologic Oncology Network/Brody School of Medicine, University of California Medical Center at Irvine-Orange Campus, Yale University, University of Illinois, University of Texas Southwestern Medical Center, Gynecologic Oncology of West Michigan PLLC, University of Wisconsin Hospital and Clinics, University of Virginia, Northwestern University, New York University Medical Center, Walter Reed National Military Medical Center, Fox Chase Cancer Center, University of Chicago, Mayo Clinic, University of Cincinnati, The Hospital of Central Connecticut, Abington Memorial Hospital, Aurora Women's Pavilion of Aurora West Allis Medical Center, Evanston CCOP-North Shore University Health System, University of New Mexico, Wayne State University/Karmanos Cancer Institute, University of Mississippi Medical Center, Cleveland Clinic Foundation, Fred Hutchinson Cancer Research Center, University of Arkansas Medical Center, University of Alabama at Birmingham, Indiana University Hospital/Melvin and Bren Simon Cancer Center, Tufts-New England Medical Center, Wake Forest University Health Sciences, Moffitt Cancer Center and Research Institute, Delaware/Christiana Care CCOP, Saint Vincent Hospital, Abramson Cancer Center of The University of Pennsylvania, North Shore University Hospital, Wisconsin NCI Community Oncology Research Program, Michigan Cancer Research Consortium Community Clinical Oncology Program, Memorial Sloan Kettering Cancer Center, Fletcher Allen Health Care, Mount Sinai School of Medicine, William Beaumont Hospital, Cancer Research for the Ozarks NCORP, UCSF-Mount Zion and Rush University Medical Center.
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- Poor histotypes