Ten-year survival in patients with endometrial adenoacanthoma and endometrial adenocarcinoma with malignant squamous cell differentiation

Objectives: It is acknowledged that squamous differentiation in the endometrial adenocarcinoma does not affect the outcome of type I cancer. However, it has been recently reported that the so-called shadow cell differentiation is likely present in endometrial adenoacanthomas. As the shadow cells differentiation suggests a caspase-independent cell death, based on the previous reports it can be hypothesized that the endometrial adenoacanthoma would have a better prognosis than the endometrial adenocarcinoma with squamous differentiation. Methods: From a database of 829 endometrial cancer, 34 endometrial adenoacanthomas and 18 endometrial adenocarcinomas with malignant squamous differentiation were assessed. The Kaplan-Meier curves were generated and compared for endometrial adenoacanthomas and endometrial adenocarcinomas with malignant squamous differentiation. Results: the 10-year survival in patients with adenocarcinoma with malignant squamous differentiation is significantly lower than the survival in patients with adenoacanthoma. Advanced stage (2009 FIGO II or over) was more likely found in adenocarcinoma with malignant squamous differentiation at the surgery time. Matching groups for the FIGO stage, there were no difference in overall survival. Conclusion: patients with endometrial adenoacanthoma have a better prognosis than patients with endometrial adenocarcinoma with malignant squamous differentiation probably because of the earlier stage diagnosis.