Endometrial cancer in elderly patients: histological features.

Objective: To evaluate the pathologic features of endometrial cancer in elderly patients and to compare the results with those of a cohort of younger patients.Methods: Pathologic findings of patients with endometrial cancer,surgically managed, were reviewed. The study population wasdivided in two groups according to patients age: Group 175years (n¼54) and Group 270 years (n¼108). All patients underwent radical abdominal hysterectomy-Piver I, bilateral adnexectomy systematic lymphadenectomy and peritoneal washing. The Mann-Whitney U test, the Fisher exact test and the Wilcoxon generalized test were utilized.Results: The median age was 77.5 years (75—89) and 52.5 years(39—70) in Group 1 and Group 2, respectively. Median follow-upwas 49 months (7—161). The proportion of cases with histologicalStage I tumors was similar in the two groups (63% vs. 63.9%). The incidence of Stage IC (50% vs 10.2%, P<0.0001) and the absence of hyperplasia in the adjacent endometrium (77.8% vs 36.1%, P<0.0001) were significantly higher in group 1. The proportion of non-endometrioid tumors was 27.8% and 12% in Group 1 and Group 2 (P¼0.01), respectively. Grade 2 or 3 tumors were detected in 75.9% in group 1 compared with 42.6% in group 2 (P<0.0001). In older women with Stage I tumor overall survival was significantly lower in non-endometrioid compared to endometrioid hystotype (P¼0.0009). The survival rate was lower in Group 1 compared to Group 2 (P<0.0001).Conclusion: In elderly women, endometrial cancer is more frequently a non-endometrioid histotype, hystologically poorly differentiated and with a deeper myometrial invasion.