Endometrial cancer Flashcards
Define endometrial cancer.
Cancer of the endometrium.
Explain the aetiology of endometrial cancer.
Endometrial hyperplasia is characterised by proliferation of endometrial glands resulting in a greater gland-to-stroma ratio than is observed in normal endometrium. It has been associated with progression to adenocarcinoma in some studies.
What are the risk factors for endometrial cancer?
Overweight and obesity
Age >50 years
Endometrial hyperplasia
Unopposed endogenous/exogenous oestrogen
Insulin resistance
Family history of endometrial/breast/ovarian cancer
PCOS
Summarise the epidemiology of endometrial cancer.
Endometrial cancer is the most common gynaecological tumour in the developed world. Endometrial cancer is the sixth most common cancer overall in women.
Recognise the presenting symptoms of endometrial cancer. Recognise the signs of endometrial cancer on physical examination.
Uterine mass, fixed uterus, or adnexal mass indicating extra-uterine disease
Bleeding from vagina
Identify appropriate investigations for endometrial cancer and interpret the results.
Pelvic (transvaginal) ultrasound
Outpatient endometrial biopsy and histopathology
Jysteroscopy, dilation and curettage (D&C), and histopathology
Pap smear
FBC
Generate a management plan for endometrial cancer.
SURGERY
Identify the possible complications of endometrial cancer and its management.
Menopausal symptoms
Bladder instability following surgery
Vaginal stenosis, atrophy, and fibrosis following radiotherapy
Long-term sexual dysfunction following treatment
Local or distant spread
Lymphoedema
Toxicity associated with chemotherapy
Summarise the prognosis for patients with endometrial cancer.
The 5-year survival rate for endometrial cancer by stage at diagnosis is:
- Localised (disease confined to the uterus): 95%
- Regional (disease spread regional lymph nodes): 69.4%
- Distant (metastatic disease): 17.3%
- Unknown (unstaged): 53.2%.
