Aggressive stage I grade 1 endometrial carcinoma

Cancer. 1992 Aug 15;70(4):790-8. doi: 10.1002/1097-0142(19920815)70:4<790::aid-cncr2820700413>;2-8.


Background: Patients with Stage I Grade 1 endometrial carcinoma have an excellent prognosis and a 10-year survival rate of more than 90%. In every clinical series, however, a few patients in this group have recurrence and die of their disease.

Methods: The authors reviewed 80 patients with Stage I Grade 1 endometrial carcinoma treated at their institution from 1955-1980. Eight patients died of recurrent disease within 4 years of diagnosis. The authors studied multiple clinical and histopathologic features, estrogen receptor (ER) and progesterone receptor (PR) status, DNA flow cytometric characteristics, and the expression of c-myb, H-ras, and neu oncogenes. Results were compared with those for a control group of 11 patients who survived more than 10 years free of disease.

Results: The authors identified the following four statistically significant adverse prognostic factors: myometrial invasion, vascular invasion, 8 or more mitoses per 10 high-power fields, and an absence of PR. Residual tumor, aneuploidy, and high proliferative activity were associated with a more aggressive behavior, although the relationship did not reach statistical significance.

Conclusions: All patients who died of disease within 4 years had tumors with two or more of the significant adverse prognostic factors.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aneuploidy
  • Endometrial Neoplasms / genetics
  • Endometrial Neoplasms / pathology*
  • Endometrial Neoplasms / surgery
  • Female
  • Humans
  • Hysterectomy
  • Lymph Nodes / pathology
  • Middle Aged
  • Neoplasm Invasiveness / genetics
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Oncogenes / genetics
  • Paraffin Embedding
  • Prognosis
  • Risk Factors