Mesonephric (clear cell) endometrial cancer

Abstract

Clear Cell Endometrial Cancer is a rare nonendometrioid endometrial carcinoma detected in 1–6 %. The aim of the study was to determine clinical and morphologic features of Clear Cell Endometrial Cancer. Materials: All the cases with Clear Cell Endometrial Cancer treated in the N. N. Petrov Research Institute of Oncology (Saint-Petersburg) were identified from surgical pathology files from 1985 to 2010 years. Saint-Petersburg Population Cancer Registry data (2000–2005 years period) and N. N. Petrov Research Institute of Oncology Hospital Cancer Registry data (1985–2010 years period) were analyzed. The population based study included 3 224 cases of endometrial cancer patients, the hospital study — 3 345 patients. Results: A review of 3 345 cases of endometrial cancer revealed 73 cases (2.2 %) of Clear Cell Endometrial Cancer. Clear Cell Endometrial Cancer registered in elder women with late menopause and atrophic endometrium. The tumor is a highly malignant variant of endometrial carcinoma with deep myometrial invasion (42.5 %), high rate of metastasis (39.1 %) even in cases with superficial invasion (23.0 %) versus endometrioid endometrial cancer: 6.0 %, 14.2 % and 9.0 % respectively. Clear Cell Endometrial Cancer has a poor prognosis with 3-year observed survival 62.7 %, 5-year observed survival — 52.2 % (Saint-Petersburg Population Cancer Registry), 70.9 % (3-year survival) and 61.8 % (5-year survival) according to the N. N. Petrov Research Institute of Oncology Hospital Cancer Registry data. Whereas prognosis in patients with endometrioid endometrial carcinoma is much more favorable: 3-year observed survival 79.4 %, 5-year observed survival — 75.5 %

Keywords

mesonephric cancer / clear cell adenocarcinoma / endometrial cancer / histopathology / treatment / forecast

References

[1] Ульрих Е. А., Нейштадт Э. Л. Редкие формы рака тела матки // Практическая онкология. — 2004. — Т. 5, № 1. — С. 68–76.

[2] Урманчеева А. Ф. Лекарственная терапия рака эндометрия // Практическая онкология: избранные лекции. — СПб., 2008. — С. 400.

[3] Чиссов В. И., Старинский В. В., Петрова Г. В. Злокачественные новообразования в России в 2010 году (заболеваемость и смертность) . — М., 2012. — 260 с.

[4] Bokhman J. V. Two pathogenetic types of endometrial carcinoma // Gynecol. Oncol. — 1983. — Vol. 15. — P. 10–17.

[5] Clear cell carcinoma of the endometrium. Prognosis and metastatic pattern / Abeler V. M., Vergote I. B. [et al.] // Cancer. — 1996. — Vol. 78. — Р. 1740–1747.

[6] Global cancer statistics, 2002 / Parkin D. M. [et al.] // C A. Cancer. J. Clin. — 2005. — Vol. 55. — P. 74–108.

[7] Is adjuvant therapy necessary for Stage IA and IB uterine papillary serous carcinoma and clear cell carcinoma after surgical staging? / Kwon J. S. [et al.] // Int. J. of Gynecol. Cancer. — 2008. — Vol. 18. — P. 820–824.

[8] Kurman R. J., Norris S. J. Evaluation of criteria for distinguishing atypical endometrial hyperplasia from well-differentiated carcinoma // Cancer. — 1986. — Vol. 49. — P. 2547–2549.

[9] P53 in endometrial cancer and its putative precursors: evidence for diverse pathways of tumorigenesis / Sherman M. E. [et al.] // Hum. Pathol. — 1995. — Vol. 26. — P. 1268–1274.

[10] Pattern of recurrence in endometrial cancer: a retrospective CTF studi / Sartori E. [et al.] // Endometrial Cancer. — 1999. — Vol. 12. — P. 80.

[11] Saia di P. J., Creasman W.T. Clinical Gynecologic Oncology. — St. Louis, 1992.

[12] Schiller W. Mesonephroma ovarii // Am. J. Cancer. — 1939. — P. 351.

[13] Scully R. E., Barlow J. F. «Mesonefroma» of ovary. Tumor of Mullerian nature related to the endometrioid carcinoma // Cancer. — 1967. — Vol. 20. — P. 1405.

[14] Silverberg S., Kurman R. Tumours of the uterine corpus and gestational trophoblastic disease // Atlas of tumor pathology / Armed forces institute of pathology. — Third Series. — Washington D. C. ,1992. — P. 240–288.

[15] Stewart K., Martinez A., Weiner S. Ten-year outcome including pattern of failure and toxicity for adjuvant whole abdominopelvic irradiation in high-risk and poor histologic feature patients with endometrial carcinoma // Int. J. Radiat. Oncol. Biol. Phys. — 2002. — Vol. 54. — P. 527.

[16] Surgery and postoperative radiotherapy versus surgery alone for patients with stage — 1 endometrial carcinoma: multicentre randomised trial. PORTEC Study Group. Post operative radiation therapy in endometrial carcinoma / Creutzberg C. L. [et al.] // Lancet. — 2000. — Vol. 355. — P. 1404–1411.

[17] Tavassoli F., Devilee P. Tumours of the breast and female genital organs / World Health Organization. — Lion, 2003.

[18] Trope C., Kristensen G. B., Abeler V. M. Clear cell and papillary serous cancer: treatment options // Baillieres Best. Pract. Res. Clin. Obstet. Gynecol. — 2001. — Vol. 15, N 3. — P. 433–446.

RIGHTS & PERMISSIONS

Ulrikh E.A., Khalimbekova D.I., Urmancheyeva A.F., Matsko D.Y., Merabishvili V.M.