ArticleCancers2026
Clinical and Prognostic Significance of a Squamous Cell Carcinoma Component in Endometrioid Endometrial Carcinoma: A Multicenter Retrospective Cohort Study.
Article in Cancers, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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9 authors.
Funding
Abstract
BACKGROUND/
objectivesContemporary endometrial cancer pathology integrates histological and molecular features for risk classification. Endometrioid endometrial carcinoma (EEC) with a squamous cell carcinoma (SCC) component was historically termed adenosquamous carcinoma but later incorporated into the squamous-differentiation subtype of EEC. This reclassification left an evidence gap, and its prognostic significance remains insufficiently defined. We compared clinicopathological aggressiveness and evaluated associations of an SCC component with overall survival (OS) and lymph node (LN) involvement.
methodsWe retrospectively analyzed 7590 surgically staged patients from 24 institutions (2000-2019): 7495 pure EEC and 95 EEC with SCC components. Confounding was addressed using overlap weighting (OW), inverse probability of treatment weighting targeting the average treatment effect on the treated (IPTW-ATT), and 1:4 propensity score matching (PSM), each with doubly robust Cox regression. Survival machine-learning models with SHapley Additive exPlanations (SHAP) assessed histological subtype contribution. LN involvement was assessed by OW/IPTW-ATT-weighted logistic regression.
resultsEEC with SCC component had higher grade, deeper myometrial invasion, more advanced stage, and worse unadjusted OS (hazard ratio [HR] 7.04; 95% confidence interval [CI] 3.50-14.16;
conclusionsEEC with SCC component was associated with worse OS after adjustment, without an adjusted increase in LN involvement. These findings support explicit morphologic reporting and future validation incorporating systematically recorded molecular testing when available.
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