ENDOMETRIAL CANCER IN WOMEN YOUNGER THAN 40 YEARS OF AGE: A CLINICOPATHOLOGIC REVIEW

Emery Salom,MD, Luis Mendez,MD, Namita Jhamb,MD, Nicholas Lambrou,MD, Zoyla Almeida,MD, Ramin Mirhashemi,MD, Giselle Ghurani,MD, Manuel Penalver,MD.

Division of Gynecologic Oncology, University of Miami School of Medicine

   Objective:  The aim of this study is to characterize endometrial cancer in women younger than 40 years of age.

   Methods:  A retrospective chart review of patients younger than 40 years of age with endometrial carcinoma was performed. A total of 51 patients were identified using a tumor registry and departmental database between 1985 – 1998. Data was abstracted with regards to age, Body Mass Index (BMI), parity, medical history, tumor grade, stage, and survival data.

   Results: A total of 51 patients were identified with ages ranging between 27 and 40 years of age (median 36), a BMI ranging of 14-73 (median 28) with 24 patients (47%) that were clinically obese (BMI > 30). Thirty patients (59%) were parous Nineteen (37%) patients had hypertension and 5 (10%) patients had diabetes mellitus. Twenty-four (45%) patients had a history of smoking. All patients underwent a hysterectomy and bilateral salpingoophorectomy, 36 patients (71%) underwent lymphadenectomy and 12 patients (24%) underwent appendectomy. Perioperative complications rates were: hemorrhage (4%), wound infection (2%), ileus/obstruction (0%) and thromboembolic disease (2%). The majority of patients were stage I (78%) and grade I (57%). Although a trend was seen, BMI was not statistically related to stage or grade. After a median follow up of 137 months, there was an overall survival of 83% for all stages.

   Conclusion:  The patients with endometrial carcinoma who are under 40 years of age are diagnosed at an early stage with excellent 5-year survival. In our evalutation BMI was not related to stage or grade of disease. Molecular and genetic studies are under way in our institution to evaluate this rare subset of patients with endometrial cancer.