STAGE IA UTERINE SEROUS CARCINOMA - A STUDY OF 13 CASES

Although in endometrioid type endometrial carcinoma depth of invasion is a powerful predictor of extrauterine disease and survival, in serou s carcinoma its importance is unclear. Recurrences and death in patien ts with serous tumors confined to the endometrium or an endometrial po lyp have been reported. In other studies, however, the absence of myom etrial invasion was correlated with a more favorable course. In an att empt to clarify this issue, we reviewed 13 completely staged, stage IA serous carcinomas with follow-up from 10 to 93 months (median 38), in which extensive histologic examination had been performed. Serous car cinoma was identified in an endometrial polyp in six cases, in an endo metrial polyp and associated endometrium in four, and solely in the en dometrium in three cases. No other histologic types of endometrial car cinoma were present, and there was no myometrial invasion. Multifocal serous intraepithelial carcinoma was also seen in 12 cases. Two of the patients died of disease with intraabdominal carcinomatosis at 10 and 14 months after presentation. The overall estimated survival was 83%, showing a relatively favorable prognosis. In conclusion, although the absence of histologically detected myometrial invasion may be associa ted with recurrences and death in serous carcinoma, an accurately asse ssed stage based on a careful histologic examination appears to be, at present, the most reliable predictor of survival.