The Biology And Therapy Of Advanced Endometrial Adenocarcinoma

Based on histological or clinical variables from surgicopathological studies, several models have been created that predict the probability of spreading to regional lymph nodes, recurrence of tumor, or death from disease (20,83-90). Age, cell type, histological grade, lymphatic or capillary invasion, depth of myometrial invasion, help to predict advanced disease. Whereas surgical stage, age, depth of myometrial invasion, ploidy, and steroid receptor status assist in estimating the probability of recurrence and death from tumor. These prognostic variables reflect varying biological import. As the cell type and histological grade of a tumor are statistically significant prognosticators only before adjusting for International Federation of Gynecologists and Obstetricians FIGO stage, it is evident that they serve as markers of the inherent aggressiveness of a tumor and potential for spread. The depth of myometrial invasion and presence of lymphatic or capillary space involvement are related to the factor that a tumor has to gain access to regional nodes, whereas the surgical stage defines the observed spread of the tumor. Extrauterine spread of tumor generally precludes a surgical cure. Age is one of the most significant prognosticators of disease free survival even after adjustment for stage, but the mechanism remains speculative, perhaps reflecting the opportunity for a neoplasm to accumulate a higher number of deleterious mutations.

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