Thirty-four patients with primary endometrial
papillary adenocarcinoma diagnosed in our institution from 1970 to 1982 were studied.
Papillary adenocarcinomas represented 10% of all endometrial
adenocarcinomas seen during this period. Papillary
neoplasms were morphologically subclassified as either papillary serous
adenocarcinoma or well-differentiated
papillary adenocarcinoma, following review of the histological sections obtained prior to
radiotherapy or
chemotherapy. Twenty-five patients were found to have papillary serous
adenocarcinoma, and nine had well-differentiated
papillary adenocarcinoma. A control group of 305 patients with endometrial
adenocarcinoma of nonpapillary type was compared with respect to age, race, and survival. Fifty percent of the patients with papillary serous
adenocarcinoma were black and they were significantly older (p = 0.001) than the control group, with a mean age of 71 years. Thirty percent of the papillary serous
adenocarcinoma group had deep myometrial invasion and peritoneal surface involvement by
tumor. In 20% of these patients there was a discrepancy between the clinical stage and the surgical stage at
laparotomy. Survival was markedly worse (p = 0.01) than that of the control group. Patients with well-differentiated
papillary adenocarcinomas were similar to control patients with respect to age and racial status and had similar clinical survival outcome. We conclude that well-differentiated
papillary adenocarcinoma of the endometrium is a distinct form of
papillary adenocarcinoma, and must be morphologically and clinically distinguished from papillary serous
adenocarcinomas because of its better prognosis. Morphological differentiation of these two papillary variants of endometrial
adenocarcinoma is presented.