IDENTIFICATION OF SMALL AREAS OF SOLID GROWTH HAS A STRONG PROGNOSTICIMPACT IN DIFFERENTIATED ENDOMETRIAL CARCINOMAS - A HISTOPATHOLOGIC AND MORPHOMETRIC STUDY

A large, consecutive series of 562 patients with endometrial adenocarc inomas was investigated with respect to prognostic factors. In the his topathologic evaluation the World Health Organization (WHO) classifica tion system was used. In addition to that, in moderately differentiate d (MD) tumors small areas of solid growth were identified and the prop ortions of these out of the whole areas of tumor (in the predominant n umber of cases this being less than 5%) were later determined by morph ometry, showing a good accordance with the subjective estimations. Dif ferentiated tumors with small solid areas (MD + S tumors) implied a si gnificantly worse prognosis compared to tumors without a solid compone nt (P < 0.001), which was also confirmed in a multivariate analysis. I n the multivariate analysis MD + S differentiation had an independent prognostic impact, as strong as age, clinical stage and myometrial inv asion. It is suggested that the occurrence of even a very small solid component is an ominous sign, the presence (or absence) of which might be an important parameter to take into consideration in the discrimin ation between high- and low-risk endometrial carcinomas.