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European Journal of Gynaecological Oncology  2020, Vol. 41 Issue (3): 361-363    DOI: 10.31083/j.ejgo.2020.03.5376
Original Research Previous articles | Next articles
Ten-year survival in patients with endometrial adenoacanthoma and endometrial adenocarcinoma with malignant squamous cell differentiation
U. Indraccolo1(), R. Martinello1, G. Scutiero1, G. Bernardi1, 2, C. Borghi1, O. Brasile1, 2, P. Greco1, 2
1Department of Reproduction and Growth, Obstetric and Gynaecology Unit, Azienda Ospedaliero-Universitaria Arcispedale Sant'Anna of Cona, Italy
2Department of Morphology, Surgery and Experimental Medicine, Section of Obstetric and Gynaecology, University of Ferrara, Ferrara 06024, Italy
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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.

Key words:  Endometrial adenocarcinoma      Adenoacanthoma      Squamous cells differentiation     
Submitted:  30 September 2019      Accepted:  24 October 2019      Published:  15 June 2020     
*Corresponding Author(s):  U. Indraccolo     E-mail:

Cite this article: 

U. Indraccolo, R. Martinello, G. Scutiero, G. Bernardi, C. Borghi, O. Brasile, P. Greco. Ten-year survival in patients with endometrial adenoacanthoma and endometrial adenocarcinoma with malignant squamous cell differentiation. European Journal of Gynaecological Oncology, 2020, 41(3): 361-363.

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Figure 1.  - Survival curves with 95% confidence intervals. Time variable (on x-axis) is expressed in semesters.

Table 1  - Descriptive statistics and univariate comparisons.
Adenoacanthoma Adenocarcinoma with malignant squamous cells differentiation p
Age 61.4 64.5 0.424
FIGO 2009 Stage
-II+ 1 (2.9%) 7 (38.9%) 0.003
-Ia 9 (26.5%) 2 (11.1%) 0.351
-Ib 24 (70.6%) 9 (50.0%) 0.244
-Grade 1 12 (35.3%) 4 (22.2%) 0.512
-Grade 2 17 (50.0%) 11 (61.1%) 0.637
-Grade 3 5 (14.7%) 3 (16.7%) 0.768
Radicality on parametria
-Yes 0 1 (5.6%) 0.272
-Yes 4 (11.85) 5 (27.8%) 0.143
Adjuvant chemotherapy
-Yes 15 (44.1%) 8 (44.4%) 0.625
Adjuvant radiotherapy
-Yes 12 (35.3%) 4 (22.2%) 0.259
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