Is there a difference in outcome between stage I-II XXXX of papillary serous/clear cell and endometrioid FIGO Grade 3 @entity5 ?

@entity1 @entity1204 @entity5 @entity4348 @entity1349
PURPOSE: Several reports in the literature have shown that, compared with @entity4348 , @entity1 with papillary serous (PS) and clear cell (CC) histologic features do worse. However, it is unclear whether the outcome of PS/CC @entity5 is different from that of poorly differentiated @entity5 . The purpose of this study was to compare the outcome between PS/CC and endometrioid International Federation of Gynecology and Obstetrics (FIGO) Grade 3 @entity5 and was limited to @entity1 with @entity5 . METHODS AND MATERIALS: Between November 1987 and September 1999, 83 @entity1 with @entity1204 and @entity1204 were treated with simple hysterectomy and high-dose-rate intravaginal brachytherapy. Forty-one @entity1 (49%) had FIGO Grade 3 @entity5 (Group 1) and 42 (51%) had PS/CC histologic features (Group 2). The mean age was 63 years (range 30-89). Comprehensive surgical staging was done in 23 (28%) of 83 @entity1 . Capillary space-like invasion (CSLI) was seen in 24 (29%) of 83 @entity1 . The median dose of intravaginal brachytherapy when used alone was 21 Gy in 3 fractions. Additional external beam radiotherapy was given to 42 (51%) of 83 @entity1 to 45 Gy. The two groups were balanced with regard to age, race, comprehensive surgical staging, amount of myometrial involvement, CSLI, lower uterine segment involvement, cervical involvement, and use of external beam radiotherapy. The median follow-up was 46 months (range 4-147). RESULTS: The pattern of relapse was as follows: vagina/pelvis in 5 of 14 @entity1 , lungs in 8 of 15, intra-abdominal in 4 of 12, and supraclavicular lymph nodes in 1 of 14. One of the four intra-abdominal disseminations was in Group 1 and the other three in Group 2 (p = 0.6). The 5-year vaginal/pelvic control, disease-free survival (DFS), and @entity1349 ( @entity1349 ) rate was 93% (95% confidence interval [CI] 87-99%), 79% (95% CI 69-89%), and 74% (95% CI 64-85%), respectively. No significant difference in outcome was found between Groups 1 and 2. The 5-year vaginal/pelvic control rate was 97% (95% CI 91-100%) in Group 1 compared with 90% (95% CI 81-99%) in Group 2 (p = 0.2). The 5-year DFS rate was 79% (95% CI 64-95%) in Group 1 vs. 78% (95% CI 65-92%) in Group 2 (p = 0.6), and the 5-year @entity1349 rate was 71% (95% CI 55-87%) in Group 1 vs. 79% (95% CI 66-92%) in Group 2 (p = 0.3). The influence on outcome of age, race, comprehensive surgical staging, CSLI, amount of myometrial invasion, cervical involvement, lower uterine segment involvement, and presence of pure PS or CC histologic features was evaluated. On multivariate analysis, only CSLI correlated with poor DFS (p = 0.04; relative risk 3, 95% CI 1-9) and @entity1349 (p = 0.02; relative risk 3, 95% CI 1-6). CONCLUSION: On the basis of the results of this study, no significant difference in outcome exists between @entity1 with Stage I-II @entity1204 with PS/CC histologic features and those with similar stage disease, but with FIGO Grade 3 endometrioid histologic features. CSLI was the only independent predictor of poor DFS and @entity1349 .
