scholarly journals Type II endometrial cancers: original research on a series

2017 ◽  
Vol 6 (6) ◽  
pp. 2306
Author(s):  
B. L. Nayak ◽  
Sujata Misra ◽  
Suryakant Jaysingh ◽  
S. K. Giri
Keyword(s):  
Clear Cell ◽  
Myometrial Invasion ◽  
Serous Carcinoma ◽  
Original Research ◽  
Clear Cell Adenocarcinoma ◽  
Type I ◽  
Type Ii ◽  
Clinicopathological Analysis ◽  
Hematoxylin And Eosin ◽  
Endometrial Carcinomas

Background: Endometrial carcinoma, which ranks 3rd in India amongst the gynecological malignancies, is of two histological types: I and II. These differ in molecular as well as in clinical and histopathological profiles. Type II is estrogen independent, nonendometrioid, with higher grade histologies, more aggressive and carries an adverse prognosis.Methods: Endometrial carcinomas diagnosed from endometrial biopsies and hysterectomy specimens in the Dept of Gynaec-oncology, AHRCC, Cuttack from November 2009 to January 2015 were included in the study. All specimens were fixed in 10% neutral buffered formalin and paraffin embedded for histological examination with hematoxylin and eosin staining. The clinicopathological analysis of the cases of EC was done with an emphasis on morphology.Results: Of a total of 150 cases of EC reported, 20 cases were classified as type II EC (13.33%) as per histology. The age of the patients ranged from 36 to 73 years, with mean age is 61 years. In 11 cases (55%), the myometrial invasion was more than half. the histological type was a clear cell adenocarcinoma in 50% of the cases. All were treated with hysterectomy and chemotherapy.Conclusions: Of the type II EC, serous carcinoma is the most common type. Clinical presentation and prognosis differs in comparison to type I EC, thus the recognition of this type of EC is pivotal.

Should All Cases of High-Grade Serous Ovarian, Tubal, and Primary Peritoneal Carcinomas Be Reclassified as Tubo-Ovarian Serous Carcinoma?

2015 ◽  
Vol 25 (7) ◽  
pp. 1201-1207 ◽  
Author(s):  
Esther Louise Moss ◽  
Tim Evans ◽  
Philippa Pearmain ◽  
Sarah Askew ◽  
Kavita Singh ◽  
...  
Keyword(s):  
Overall Survival ◽  
Clear Cell ◽  
Stage Iii ◽  
Serous Carcinoma ◽  
Low Grade ◽  
Type I ◽  
High Grade ◽  
Type Ii ◽  
Ovarian Serous Carcinoma ◽  
Significant Difference

IntroductionThe dualistic theory of ovarian carcinogenesis proposes that epithelial “ovarian” cancer is not one entity with several histological subtypes but a collection of different diseases arising from cells of different origin, some of which may not originate in the ovarian surface epithelium.MethodsAll cases referred to the Pan-Birmingham Gynaecological Cancer Centre with an ovarian, tubal, or primary peritoneal cancer between April 2006 and April 2012 were identified from the West Midlands Cancer Registry. Tumors were classified into type I (low-grade endometrioid, clear cell, mucinous, and low-grade serous) and type II (high-grade serous, high-grade endometrioid, carcinosarcoma, and undifferentiated) cancers.ResultsOvarian (83.5%), tubal (4.3%), or primary peritoneal carcinoma (12.2%) were diagnosed in a total of 583 woman. The ovarian tumors were type I in 134 cases (27.5%), type II in 325 cases (66.7%), and contained elements of both type I and type II tumors in 28 cases (5.7%). Most tubal and primary peritoneal cases, however, were type II tumors: 24 (96.0%) and 64 (90.1%), respectively. Only 16 (5.8%) of the ovarian high-grade serous carcinomas were stage I at diagnosis, whereas 240 (86.6%) were stage III+. Overall survival varied between the subtypes when matched for stage. Stage III low-grade serous and high-grade serous carcinomas had a significantly better survival compared to clear cell and mucinous cases,P= 0.0134. There was no significant difference in overall survival between the high-grade serous ovarian, tubal, or peritoneal carcinomas when matched for stage (stage III,P= 0.3758; stage IV,P= 0.4820).ConclusionsType II tumors are more common than type I and account for most tubal and peritoneal cancers. High-grade serous carcinomas, whether classified as ovarian/tubal/peritoneal, seem to behave as one disease entity with no significant difference in survival outcomes, therefore supporting the proposition of a separate classification of “tubo-ovarian serous carcinoma”.

Uterine Carcinosarcoma and High-Risk Endometrial Carcinomas: A Clinicopathological Comparison

2015 ◽  
Vol 25 (4) ◽  
pp. 629-636 ◽  
Author(s):  
Chuyao Zhang ◽  
Weiguo Hu ◽  
Nan Jia ◽  
Qing Li ◽  
Keqin Hua ◽  
...  
Keyword(s):  
High Risk ◽  
Myometrial Invasion ◽  
Cox Proportional Hazards ◽  
The Other ◽  
Serous Carcinoma ◽  
Clear Cell Adenocarcinoma ◽  
Disease Specific Survival ◽  
P53 Expression ◽  
Endometrial Carcinomas ◽  
Disease Specific

ObjectiveThis retrospective study aimed to evaluate the clinicopathological characteristics of carcinosarcoma, grade 3 endometrial endometrioid carcinoma (G3EEC), uterine serous carcinoma (USC), and uterine clear cell adenocarcinoma (CC) to determine whether carcinosarcoma exhibited the same characteristics and outcomes as the other 3 high-risk endometrial cancers.MethodsA total of 358 patients recruited from the Obstetrics and Gynecology Hospital of Fudan University were included in this study; the cases included 44 carcinosarcomas, 118 G3EECs, 118 USCs, and 78 CCs. Kaplan-Meier and Cox proportional hazards models were used to analyze outcomes and prognostic factors.ResultsUterine carcinosarcomas had significantly worse outcomes (overall survival, disease-specific survival, and recurrence-free survival) compared with G3EEC, USC, and CC (P< 0.001), whereas the other 3 shared similar outcomes. Carcinosarcoma type was an independent factor, even stratified by stage. Eighty-three percent of recurred carcinosarcoma patients occurred within 1 year. Compared with USC and CC, patients with carcinosarcoma had a greater incidence of deep myometrial invasion (55.8%,P <0.05) and cervical stromal involvement (P= 0.046). The carcinomatous regions of carcinosarcomas demonstrated a similar ER/P53 expression pattern as did USC and CC. However, all features were similar in carcinosarcoma and G3EEC patients, although the P53-positive rate was higher in carcinosarcoma patients compared with G3EEC patients (59.0% vs 38.5%,P= 0.037). For carcinosarcomas, a multivariate analysis showed that advanced stage (P= 0.006) was an independent prognostic factor for disease-specific survival. With regard to endometrioid-or-not epithelial and heterologous-or-homologous sarcomatous components, none of these components demonstrated apparent relationship with prognosis.ConclusionsCarcinosarcomas exhibited significantly poorer outcomes than did G3EECs, USCs, and CCs. Therefore, it seems reasonable to regard carcinosarcomas as a particular type among high-risk epithelial endometrial carcinomas.

scholarly journals Hypermethylation ofSOX2Promoter in Endometrial Carcinogenesis

2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
Oscar Gee-Wan Wong ◽  
Zhen Huo ◽  
Michelle Kwan-Yee Siu ◽  
HuiJuan Zhang ◽  
LiLi Jiang ◽  
...  
Keyword(s):  
Clear Cell ◽  
Mrna Level ◽  
Methylation Status ◽  
Clear Cell Adenocarcinoma ◽  
Type Ii ◽  
Chain Reaction ◽  
Gene Coding ◽  
Related Transcription Factor ◽  
Polymerase Chain ◽  
Endometrial Carcinomas

This paper aimed at investigating the expression and methylation profiles ofSOX2, a gene coding for the stem cell-related transcription factorSOX2, in endometrial carcinomas. By methylation-specific polymerase chain reaction (MS-PCR), the methylation status ofSOX2promoter region in 72 endometrial carcinomas and 12 normal endometrial samples was examined. Methylated allele was found in 37.5% (27/72) of endometrial carcinomas but only in 8.3% (1/12) of normal endometrial, significantly more frequent in cancers ().SOX2mRNA level was significantly reduced in endometrial carcinoma compared with nonneoplastic endometrium (). A significant correlation betweenSOX2mRNA expression and hypermethylation ofSOX2was found (). Hypermethylation ofSOX2tended to be more frequently found in type II serous or clear cell adenocarcinoma.SOX2methylation was also significantly correlated with shorter survival of patients (). In conclusion, epigenetic mechanisms may play a crucial role on the transcriptional regulation ofSOX2and loss ofSOX2expression may be related to endometrial carcinogenesis.

scholarly journals Recent Concepts of Ovarian Carcinogenesis: Type I and Type II

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Masafumi Koshiyama ◽  
Noriomi Matsumura ◽  
Ikuo Konishi
Keyword(s):  
Clear Cell ◽  
Transitional Cell ◽  
Iron Concentration ◽  
Serous Carcinoma ◽  
Surface Epithelium ◽  
Low Grade ◽  
Borderline Tumor ◽  
Type I ◽  
High Grade ◽  
Type Ii

Type I ovarian tumors, where precursor lesions in the ovary have clearly been described, include endometrioid, clear cell, mucinous, low grade serous, and transitional cell carcinomas, while type II tumors, where such lesions have not been described clearly and tumors may developde novofrom the tubal and/or ovarian surface epithelium, comprise high grade serous carcinomas, undifferentiated carcinomas, and carcinosarcomas. The carcinogenesis of endometrioid and clear cell carcinoma (CCC) arising from endometriotic cysts is significantly influenced by the free iron concentration, which is associated with cancer development through the induction of persistent oxidative stress. A subset of mucinous carcinomas develop in association with ovarian teratomas; however, the majority of these tumors do not harbor any teratomatous component. Other theories of their origin include mucinous metaplasia of surface epithelial inclusions, endometriosis, and Brenner tumors. Low grade serous carcinomas are thought to evolve in a stepwise fashion from benign serous cystadenoma to a serous borderline tumor (SBT). With regard to high grade serous carcinoma, the serous tubal intraepithelial carcinomas (STICs) of the junction of the fallopian tube epithelium with the mesothelium of the tubal serosa, termed the “tubal peritoneal junction” (TPJ), undergo malignant transformation due to their location, and metastasize to the nearby ovary and surrounding pelvic peritoneum. Other theories of their origin include the ovarian hilum cells.

Histologic and Immunohistochemical Analyses of Endometrial Carcinomas: Experiences From Endometrial Biopsies in 358 Consultation Cases

2013 ◽  
Vol 137 (11) ◽  
pp. 1574-1583 ◽  
Author(s):  
Jian-Jun Wei ◽  
Ajit Paintal ◽  
Pacita Keh
Keyword(s):  
Endometrial Carcinoma ◽  
Endometrial Adenocarcinoma ◽  
Serous Carcinoma ◽  
Type I ◽  
Tumor Type ◽  
Type Ii ◽  
Endometrioid Carcinoma ◽  
Immunohistochemical Markers ◽  
Uterine Serous Carcinoma ◽  
Endometrial Carcinomas

Context.—Uterine serous carcinoma is biologically more aggressive than the endometrioid carcinoma. Because uterine serous carcinoma has a high propensity for lymphovascular invasion and intraperitoneal and extra-abdominal spread, accurate diagnosis of this tumor type in endometrial biopsies/curettings is critical for appropriate clinical management. Objective.—To share our experience in the evaluation of endometrial biopsy specimens in type I and type II endometrial adenocarcinoma. Design.—We retrospectively reviewed 358 biopsies containing endometrial carcinoma during a recent 3 year period of our consultation records. In cases in which our interpretation differed from the submitting diagnosis, a panel of immunostains was performed. The performance characteristics of each antibody in our panel was calculated in this group of challenging cases. Results.—Among the endometrial carcinomas we examined, a diagnosis of type I carcinoma accounted for 91% of cases (327 of 358) and type II carcinoma for 9% of cases (31 of 358); 41 cases (11.5%) were ambiguous or discordant (differing from submitted diagnoses and reviewed) based on histology alone. All 41 ambiguous and discordant cases were further evaluated with a battery of immunohistochemical markers. Of the 41 cases, 36 (88%) were ultimately classified (10 cases [24%] were endometrioid carcinoma; 18 cases [44%] were uterine serous carcinoma; 8 cases [20%] resulted in various other outcomes) and 5 cases (12%) remained indeterminate. Conclusions.—Making the distinction between type I and II endometrial carcinoma remains a common problem in general practice. Although no one biomarker provides excellent statistical performance, a panel of immunohistochemical markers is often useful in difficult cases.

Endometrial Thickness Measured by Ultrasonography in Postmenopausal Patients With Endometrial Carcinoma Has Significance, Irrespective of Histological Subtype

2013 ◽  
Vol 23 (7) ◽  
pp. 1266-1269 ◽  
Author(s):  
Ayako Hosoi ◽  
Yutaka Ueda ◽  
Mariko Shindo ◽  
Satoshi Nakagawa ◽  
Shinya Matsuzaki ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Postmenopausal Women ◽  
Clinical Data ◽  
Endometrial Thickness ◽  
Myometrial Invasion ◽  
University Hospital ◽  
Transvaginal Ultrasonography ◽  
Type I ◽  
Type Ii ◽  
Endometrial Carcinomas

ObjectiveThe criterion standard of practice for gynecologists is to measure the endometrial thickness with ultrasonography in women presenting with postmenopausal bleeding. A recent study reported that a thin endometrial stripe upon ultrasonography did not reliably exclude type II endometrial carcinoma. The aim of the present study was to reevaluate the reliability of ultrasonographic measurement of the endometrium for prediction of endometrial carcinomas of both types I and II in postmenopausal women.MethodsWe collected clinical data from patients with endometrial carcinoma who underwent surgical treatment at the Department of Obstetrics and Gynecology of the Osaka University Hospital, Osaka, Japan, during our study period from 2010 to 2012. Only the postmenopausal cases were included in our study. We excluded cases with insufficient clinical data.ResultsPreoperative measurement of the endometrium by transvaginal ultrasonography revealed that the endometrium was greater than 4 mm in 80 (89%) of the 90 type I cases and in 41 (93%) of the 44 type II cases. The median of the endometrial thickness measured with transvaginal ultrasonography preoperatively in type I cases, including both patients with myometrial invasion less than 1/2 and those with myometrial invasion greater than 1/2, was 13 mm (range, 1–78 mm). That of type II cases was 15 mm (range, 1–54 mm). This difference was not statistically significant (P= 0.46 by Mann-WhitneyUtest). These results implied that endometrial thickness was not significantly associated with the type of tumors.ConclusionsUltrasonographic measurements of the endometrium for prediction of endometrial carcinomas in postmenopausal women are reliable for both type I and type II tumors. These results encourage us to continue to use the “4-mm (5-mm) rule” to evaluate endometrial thickness in postmenopausal women, in opposition to a previous report.

scholarly journals Differential Expression of Androgen Receptor in Type I and Type II Endometrial Carcinomas: A Clinicopathological Analysis and Correlation with Outcome

2021 ◽  
Vol 36 (2) ◽  
pp. e245-e245
Author(s):  
Nisreen Abu Shahin1 *, ◽  
Tariq Aladily ◽  
Nezeen Abu Alhaj ◽  
Ali Al-Khader ◽  
Shefa’ Alqaqa ◽  
...  
Keyword(s):  
Androgen Receptor ◽  
Tumor Stage ◽  
Clinicopathological Parameters ◽  
Lower Grade ◽  
Type I ◽  
Type Ii ◽  
Node Status ◽  
Clinicopathological Analysis ◽  
Alive With Disease ◽  
Endometrial Carcinomas

Objectives: Endometrial carcinomas (EC) are the most common gynecological malignancies and are conventionally divided into type I and type II due to diagnostic and prognostic considerations. Female hormone expression in EC is extensively studied; however, data about androgen receptor (AR) expression in EC are sparse. We aimed to study AR expression in different types of EC at our institute and whether it had an impact on patient outcomes. Methods: A retrospective analysis of EC cases diagnosed and treated from 2010–2019. AR immunohistochemical expression was tested in 52 EC cases (type I = 40; type II = 12). Histological typing was verified according to conventional diagnostic criteria. Only primary EC were included without neoadjuvant therapy. Histologic score was calculated as: stain intensity (graded 0–3) × positive cells percentage (graded 0–4). Level of expression was scored from 0 to 12. Results: The mean age of the selected patients was 60.3 years (range = 31–88 ± 12.6). Recurrence was detected in 11 (21.2%) patients. The outcome was 40 patients were alive without disease, eight alive with disease, three dead of disease, and one dead of other causes. About 62.5% of type I-EC and 25.0% of type II-EC were AR positive. AR expression was analyzed against different clinicopathological parameters including: type (p = 0.005), histotype (p = 0.044); grade (p = 0.035); age group (p = 0.207); menopause (p = 0.086); estrogen receptor (ER) expression (p = 0.284); atypical complex hyperplasia (p = 0.594); tumor stage (p = 0.994); tumor recurrence (p = 0.530); node status (p = 0.110); and outcome (p = 0.202). Conclusiosn: AR expression was higher in type I EC, endometrial endometrioid carcinoma histotype, and with a lower grade. AR expression was not significantly correlated with age, stage, ER, atypical hyperplasia, recurrence, node status, or outcome. Results agree with recent literature that AR expression is associated with better-differentiated EC and may be a potential hormonal therapeutic tool.

Subsequent endometrial carcinoma with adjuvant tamoxifen treatment in Japanese breast cancer patients

2001 ◽  
Vol 11 (4) ◽  
pp. 272-276 ◽  
Author(s):  
N. Nishimura ◽  
T. Hachisuga ◽  
T. Saito ◽  
T. Kawarabayashi
Keyword(s):  
Breast Cancer ◽  
Endometrial Carcinoma ◽  
Cancer Patients ◽  
Myometrial Invasion ◽  
Tamoxifen Treatment ◽  
Adjuvant Tamoxifen ◽  
Serous Carcinoma ◽  
Breast Cancer Patients ◽  
Two Stage ◽  
Endometrial Carcinomas

Abstract.Nishimura N, Hachisuga T, Saito T, Kawarabayashi T. Subsequent endometrial carcinoma with adjuvant tamoxifen treatment in Japanese breast cancer patients.This study aimed to detail the clinicopathologic features of endometrial carcinomas that developed in Japanese patients receiving adjuvant tamoxifen treatment for breast cancer patients. Ten endometrial carcinomas in tamoxifen-treated breast cancer patients were collected from two medical centers. The endometrial carcinomas included two stage Ia, four stage Ib, two stage Ic and two stage IIIc. Three tumors were Grade 1, six were Grade 2, and one was Grade 3. The tumor was limited to the endometrium in two cases. Myometrial invasion was limited to the inner half of the myometrium in five cases and involved the outer half in three. A mild degree of lymphovascular space invasion was identified in five cases. Deep cervical invasion was recognized in one case. The cell types comprised nine endometrioid adenocarcinomas and one serous carcinoma. Five of eight postmenopausal endometrial carcinomas were associated with polypoid endometrial lesions composed of cystically dilated atrophic and proliferative glands widely separated by fibrotic stroma. Two patients with retroperitoneal lymph node metastases died of endometrial cancer. One patient developed a contralateral breast cancer during tamoxifen treatment. No patient died of breast cancer. We did not demonstrate a higher frequency of either high-grade tumors or unfavorable histologic subtypes in tamoxifen-treated Japanese breast cancer patients.

A randomized, phase II efficacy assessment of multiple MET kinase inhibitors in metastatic papillary renal carcinoma (PRCC): SWOG S1500.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. TPS4599-TPS4599 ◽  
Author(s):  
Sumanta K. Pal ◽  
Catherine M. Tangen ◽  
Ian Murchie Thompson ◽  
Brian M. Shuch ◽  
Naomi B. Haas ◽  
...  
Keyword(s):  
Phase Ii ◽  
Metastatic Disease ◽  
Kinase Inhibitors ◽  
Clear Cell ◽  
Performance Status ◽  
Progression Free Survival ◽  
Type I ◽  
Type Ii ◽  
Randomized Phase Ii ◽  
Clear Cell Rcc

TPS4599 Background: PRCC constitutes approximately 15% of RCC cases, and no standard of care exists for metastatic disease. Approved VEGF- and mTOR-directed therapies for clear cell RCC in metastatic PRCC (mPRCC) have generally been ineffective. Trials assessing sunitinib and everolimus in non-clear cell RCC show a numerical advantage in progression-free survival (PFS) with sunitinib therapy. Prospective studies evaluating sunitinib in mPRCC show a broad range of efficacy, with PFS ranging from 1.6-6.6 months. Another possible approach to treating mPRCC is to target the MET protooncogene, which is frequently altered across both type I and type II disease. SWOG 1500 is a randomized, phase II study which will compare sunitinib to three MET-directed therapies in pts with mPRCC. Methods: Eligible pts will have PRCC (type I, type II or NOS), Zubrod performance status 0-1, and measurable metastatic disease. Pts may have received up to 1 prior systemic therapy, with the exception of prior VEGF-directed treatments. Treated brain metastases are allowed. Tissue must be available for central pathologic review of papillary subtype. Pts will receive either oral sunitinib, cabozantinib, crizotinib or savolitinib in a 1:1:1:1 randomization, with stratification by (1) prior therapy (0 vs 1) and (2) PRCC subtype (type I vs type II vs NOS). The primary endpoint of the study is to compare PFS with sunitinib to PFS with MET-directed therapies. Secondary endpoints in the study include comparison of response rate, overall survival and safety profile. Translational aims of the study include correlation of clinical outcome with MET mutation, copy number and other markers of MET signaling. Radiographic assessment will be performed every 12 wks. Interim analyses are planned for each arm. A total of 275 pts will be enrolled, with 26 pts registered as of Jan 30, 2017. Clinical trial information: NCT02761057.

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