Prognostic factors in women 45 years of age or younger with endometrial cancer

Abstract

The purpose of this study was to conduct a clinical and pathologic review of endometrial cancers diagnosed in women aged younger than 45 years to better identify the prognostic factors for this subgroup of women. We retrospectively evaluated the clinical history, treatment, and follow-up of patients with histologically confirmed endometrial cancer treated in Faculty Hospital Nitra, Slovakia from 1993 to 2003. Data were abstracted regarding tumor histology, grade, age, parity, stage, diabetes, use of oral contraceptives, body mass index (BMI), and survival. One hundred seventy-three patients with endometrioid histology were divided into two groups: younger group (age ≤45 years, n= 20) and older group (age >45, n= 153). Patients with high-risk histology (clear cell or serous papillary) were excluded from the study. Twenty patients less than or equal to 45 years of age received treatment for endometrial cancer: stage I, 16 (80%); stage II, 2 (10%); stage III, 1 (5%); and stage IV, 1 (5%). Tumors were well differentiated in 12 (60%), moderately differentiated in 6 (30%), and poorly differentiated in 2 (10%). Age ranged from 28 to 45 years (mean 37), with mean BMI 35.8 ± 9.4. At the end of study period, 17 (85%) were alive with no evidence of disease and 3 (15%) had died of recurrent disease. We conclude that patients less than or equal to 45 years of age have better survival compared to older patients. Deeper myometrial invasion was significantly associated with age greater than 45 years. Majority of young patients with endometrial cancer were obese and nulliparous.