Lymph Node Metastases and Local Cancer Spread in Serous Endometrial Cancer and Endometrial Adenocarcinoma – A Retrospective Study

Serous endometrial carcinoma is characterized by its highly aggressive nature and represents about 10% of all endometrial carcinomas. It causes about 80% of deaths among women suffering from endometrial cancer.

The aim of our study was to determine the frequency, lymphatic and local spread of serous endometrial cancer compared with endometrial adenocarcinoma.

Materials and methods: This was a retrospective study conducted in a period of 4 years (from 2015 to 2019). One hundred and twenty-three women aged between 39 and 84 years suffering from endometrial carcinoma in various stages according to FIGO from stage I to IV were included in the study. Diagnosis was established clinically and by imaging studies and was histologically proven in all women. We performed radical hysterectomy type B or C (2017 Update on the Querleu-Morrow Classification of Radical Hysterectomy) and pelvic lymph node dissection (PN) with or without paraaortic (PAR) lymph node dissection in all patients.

Results: In 106 (86.2%) patients we found adenocarcinoma, in 9 (7.3%) of them – serous carcinoma, in 4 (3.3%) women – carcinosarcoma, in 4 (3.3%) women – clear cell carcinoma. The study compared the results only of 115 (100%) women with adenocarcinoma and serous carcinoma. In 17.8% of the patients with adenocarcinoma we found the presence of lymph node metastases, and in the group of patients with serous carcinoma we found lymph node metastases in 77.7% of them. There was a significant difference in the frequency of lymph node metastases according to the histological type EC (p < 0.00001). In 22.6% of patients with adenocarcinoma there was a local cancer spread, while such a spread was found in 66.7% of patients with serous cancer. After statistical processing of the results, we found a significant difference in the frequency of local tissue spread depending on the histological type of EC.

Conclusion: Patients with serous endometrial cancer have significant more frequent lymphatic metastases and local spread than those with endometrial adenocarcinoma.