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reproductive system 2 > Endometrial Cancer > Flashcards

Endometrial Cancer Flashcards

1
Q

What are the pathological prognostic features for endometrial cancer?

A
  • histological type
  • histological grade
  • stage
  • lymphovascular space invasion (LVSI)
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2
Q

How is endometrial cancer staged?

A
  • surgical/pathological

- MRI

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3
Q

What is looked at on MRI to stage endometrial cancer?

A

involvement of:

  • myometrial
  • cervical
  • lymph node
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4
Q

What staging system is used?

A

FIGO staging

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5
Q

What are the FIGO stages of endometrial cancer?

A
  • 1A: Inner half of myometrium
  • 1B: Outer half of myometrium
  • 2: Invades cervix
  • 3A: Serosa/adnexa
  • 3B: Vagina/parametrium
  • 3C: Pelvic or para-aortic nodes
  • 4: Bladder/bowel/ intra-abdominal/inguinal nodes
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6
Q

What are the 2 distinct categories of endometrial cancer?

A
  • type 1 = endometrioid adenocarcinoma

- type 2 = uterine serous and clear cell carcinoma

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7
Q

What are the features of endometrioid adenocarcinoma?

A
  • commonest
  • unopposed oestrogen
  • hyperplasia with atypia precursor
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8
Q

What are the features of uterine serous and clear cell carcinoma?

A
  • high grade, more aggressive, worse prognosis
  • generally older ladies
  • serous intraepithelial carcinoma precursor
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9
Q

How is endometrial cancer treated?

A

Early Stage
-Surgery TAH/BSO/washings

High risk histology
-Chemotherapy

Advanced Stage
-Radiotherapy

Palliation
-Progesterone

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10
Q

What are the cure rates of endometrial cancer relevant to their stage?

A
  • 1B: 85%
  • 2A: 75%
  • 2B: 60%
  • 3B: 30%
  • 4: 21%
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11
Q

What are the risk factors for endometrial cancer?

A
  • post-menopausal women
  • high circulating oestrogen levels
  • atypical endometrial hyperplasia
  • HNPCC/Lynch type II familial cancer syndrome
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12
Q

Give reasons for high circulating oestrogen levels.

A
  • obesity
  • unopposed E2 therapy/Tamoxifen
  • polycystic ovarian syndrome (PCOS)
  • early menarche/late menopause
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13
Q

What are the symptoms of endometrial cancer?

A
  • abnormal vaginal bleeding

- post-menopausal bleeidng

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14
Q

What stage do most women present with?

A

Stage 1

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15
Q

What is the epidemiology of endometrial cancer?

A
  • 1.0 per 100,000 women aged 40
    29. 8 per 100,000 women
  • Mortality 6.7 per 100,000 women
  • 5YS for all stages 78%
  • 5YS 95% for stage 1
  • 5YS 14% for stage 4
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16
Q

How should PMB be investigated?

A
  • trans vaginal US: endometrial thickness and contour
  • biopsy if >4 mm thickness or irreglular
  • hysteroscopy
17
Q

What is the main treatment for endometrial cancer?

A

total abdominal hysterectomy with removal of tubes and ovaries with peritoneal washings

reproductive system 2 (35 decks)

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