WELL-DIFFERENTIATED VERSUS LESS-DIFFERENTIATED ENDOMETRIAL CARCINOMA

The aim of this study was to compare well-differentiated (grade 1) and less-differentiated (grades 2 and 3) endometrial carcinoma, concernin g clinical risk factors, presenting symptoms and operative findings. S eventy-one surgically staged endometrial carcinoma cases were reviewed and retrospectively divided according to tumor differentiation into t wo groups: grade 1 cases (Group I; n=40) and grade 2 and 3 cases (Grou p II; n=31). No difference was found between the two groups when compa ring patient age, gravidity and parity, history of hypertension, diabe tes or other malignancies, duration of menopause, number of patients r eceiving hormonal replacement therapy and histological type of tumor. There was also no difference in presenting symptoms or in duration of uterine bleeding up to the diagnosis of endometrial carcinoma. On the other hand, patients with well-differentiated tumors, as compared to p atients with less-differentiated endometrial carcinoma, were significa ntly more obese (p<0.02), had a smaller uterus (p<0.01) and presented with less advanced stage disease (p<0.0005). The fact that the age of the patients, as well as the duration of uterine bleeding before diagn osis, was similar in both groups may indicate that more advanced cases , as in group II, represent originally a more aggressive tumor rather than progression from a well-differentiated disease. This hypothesis n eeds further research.