ABSTRACT
BACKGROUND: When endometrial carcinoma invades the cervical stroma, overall survival and disease-free survival decrease. However, it is still controversial whether patients in suspected stage II should be treated with radical hysterectomy. The goal of this study is to describe the role of radical hysterectomy in patients with endometrial carcinoma and cervical involvement. METHODS: This was a retrospective cohort study were a total of 239 patients with endometrial carcinoma with cervical involvement from Mexico City's National Cancer Institute were divided according to the type of hysterectomy, and the outcomes were compared using statistical analysis. RESULTS: The 5-year overall survival was 75.76% for the simple hysterectomy group and 89.19% for the radical hysterectomy group, without achieving statistical significance. The 5-year disease-free survival was 72.95% for the simple hysterectomy group and 64.31% for the radical hysterectomy group, without achieving statistical significance. Radicality was associated with longer surgical times, intraoperative complications, and bleeding over 500 ml. CONCLUSIONS: In patients with endometrial carcinoma with cervical involvement, radical hysterectomy does not improve prognosis or alter adjuvant therapy.
Subject(s)
Carcinoma, Endometrioid/therapy , Endometrial Neoplasms/therapy , Hysterectomy/methods , Uterine Cervical Neoplasms/therapy , Blood Loss, Surgical/statistics & numerical data , Carcinoma, Endometrioid/mortality , Carcinoma, Endometrioid/pathology , Cervix Uteri/pathology , Cervix Uteri/surgery , Chemoradiotherapy, Adjuvant/methods , Disease-Free Survival , Endometrial Neoplasms/mortality , Endometrial Neoplasms/pathology , Female , Humans , Hysterectomy/adverse effects , Kaplan-Meier Estimate , Middle Aged , Operative Time , Prognosis , Retrospective Studies , Uterine Cervical Neoplasms/mortality , Uterine Cervical Neoplasms/pathologySubject(s)
Laryngeal Neoplasms/surgery , Sarcoma/surgery , Adult , Aged , Aged, 80 and over , Cohort Studies , Disease-Free Survival , Female , Humans , Laryngeal Neoplasms/mortality , Laryngeal Neoplasms/pathology , Male , Mexico , Middle Aged , Sarcoma/mortality , Sarcoma/pathology , Survival Rate , Treatment Outcome , Young AdultABSTRACT
AIM: Micropapillary carcinoma (MPC) is regarded as an aggressive variant of adenocarcinoma in any location. The reported proportion of a micropapillary carcinoma component in an entire tumour ranges from 5 to 95% and only one case of pure MPC has been reported. To date, approximately 130 cases of MPC in the colorectum have been reported, but it is likely that this small number is to some extent due to under-reporting because this pattern is not well recognized by the general pathologist. All previous studies have combined colonic and rectal primary tumours and most have only analysed patients with clinical Stages I or II. METHOD: We analysed 15 cases of MPC of the colon alone, diagnosed in our institution, and compared them with 105 conventional carcinomas of the colon. RESULTS: An MPC component was present in 10% of all colonic carcinomas. These tumours presented at a median age of 56 years, and all were of American Joint Committee on Cancer Stages III and IV. Subserosal tissue invasion was present in every case, 60% had more than four positive lymph nodes, 60% were accompanied by poorly differentiated conventional carcinoma, 40% had had an incomplete resection and a third demonstrated lymphovascular invasion. Despite these adverse prognostic factors, tumours containing MPC showed the same survival, stage by stage, as conventional adenocarcinoma in multivariate analysis, although 3-year survival (81.7%vs 87.3%, P=0.035) was worse on univariate analysis. CONCLUSION: The histopathologist should be aware of the possibility of MPC. Three-year survival is worse than in patients with conventional colonic carcinomas in Stage III.
