Villoglandular adenocarcinoma of the endometrium

A clinicopathologic study of 61 cases: A gynecologic oncology group study

Richard J. Zaino, Robert J Kurman, Virginia L. Brunetto, C. Paul Morrow, Rex C. Bentley, James O. Cappellari, Pincas Bitterman

Research output: Contribution to journalArticle

Abstract

Papillary endometrioid or villoglandular adenocarcinoma (VGA) is a relatively common type of endometrial adenocarcinoma, but studies describing its behavior have yielded conflicting results. Patients with a component of VGA were identified in a review of 819 women entered in a Gynecology Oncology Group Study (Protocol 33) of clinical stages I and II 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 villoglandular differentiation and 37 who were admixed with typical endometrioid adenocarcinoma (EA). The general clinicopathologic features of patients 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 versus 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-specific 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 villoglandular and endometrioid carcinoma. In view of the frequent admixture of VGA and EA and their generally similar biological characteristics, with a prognosis similar to that of typical EA, we conclude that VGA should be considered a variant of EA.

Original languageEnglish (US)
Pages (from-to)1379-1385
Number of pages7
JournalAmerican Journal of Surgical Pathology
Volume22
Issue number11
DOIs
StatePublished - Nov 1998

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Endometrioid Carcinoma
Endometrium
Adenocarcinoma
Clinical Protocols
Gynecology
Neoplasms
Survival Rate
Confidence Intervals
Carcinoma

Keywords

  • Clear cell
  • Endometrium carcinoma
  • Mucinous adenocarcinoma
  • Serous adenocarcinoma
  • Villoglandular adenocarcinoma

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine

Cite this

Villoglandular adenocarcinoma of the endometrium : A clinicopathologic study of 61 cases: A gynecologic oncology group study. / Zaino, Richard J.; Kurman, Robert J; Brunetto, Virginia L.; Morrow, C. Paul; Bentley, Rex C.; Cappellari, James O.; Bitterman, Pincas.

In: American Journal of Surgical Pathology, Vol. 22, No. 11, 11.1998, p. 1379-1385.

Research output: Contribution to journalArticle

Zaino, Richard J. ; Kurman, Robert J ; Brunetto, Virginia L. ; Morrow, C. Paul ; Bentley, Rex C. ; Cappellari, James O. ; Bitterman, Pincas. / Villoglandular adenocarcinoma of the endometrium : A clinicopathologic study of 61 cases: A gynecologic oncology group study. In: American Journal of Surgical Pathology. 1998 ; Vol. 22, No. 11. pp. 1379-1385.
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abstract = "Papillary endometrioid or villoglandular adenocarcinoma (VGA) is a relatively common type of endometrial adenocarcinoma, but studies describing its behavior have yielded conflicting results. Patients with a component of VGA were identified in a review of 819 women entered in a Gynecology Oncology Group Study (Protocol 33) of clinical stages I and II 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 villoglandular differentiation and 37 who were admixed with typical endometrioid adenocarcinoma (EA). The general clinicopathologic features of patients 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 versus 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-specific 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 villoglandular and endometrioid carcinoma. In view of the frequent admixture of VGA and EA and their generally similar biological characteristics, with a prognosis similar to that of typical EA, we conclude that VGA should be considered a variant of EA.",
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