VILLOGLANDULAR ADENOCARCINOMA OF THE ENDOMETRIUM - A CLINICOPATHOLOGICAL STUDY OF 61 CASES - A GYNECOLOGIC-ONCOLOGY-GROUP STUDY

Papillary endometrioid or villoglandular adenocarcinoma (VGA) is a rel atively common type of endometrial adenocarcinoma, bur studies describ ing its behavior have yielded conflicting results. Patients with a com ponent of VGA were identified in a review of 819 women entered in a Gy necology Oncology Group Study (Protocol 33) of clinical stages I and I I endometrial adenocarcinoma. Cases with coexisting foci of serous or clear cell carcinoma were excluded from further consideration. Of the 61 cases that formed the study sample, there were 24 with pure villogl andular differentiation and 37 who were admired with typical endometri oid adenocarcinoma (EA). The general clinicopathologic features of pat ients with pure and mixed VGA are compared with 469 patients with pure EA. The VGAs were better differentiated (grade 1 or 2-97% of VGA vers us 74% EA, p = 0.001), but they were not significantly different with respect to median age, depth of invasion, or frequency of nodal spread . Six of the 61 patients with VGA died of their tumor, The disease-spe cific survival rate at 3 years for VGA is 94% (95% confidence interval : 0.88-0.99) compared with 88% (95% CI: 0.86-0.91) for EA. Two of the patients who died had pure villoglandular tumors and four had mixed vi lloglandular and endometrioid carcinoma. In view of the frequent admix ture of VGA and EA and their generally similar biological characterist ics, with a prognosis similar to that of typical EA, we conclude that VGA should be considered a variant of EA.