Endometrial cancer

Question 1

Endometrial hyperplasia without atypia

Answer 1

5% malignancy risk
Spontaneous regression 80%
96% regression with Mirena
Address reversible causes
Mirena or oral progesterone (10-20mg provera)
Consider hysterectomy if progression to atypia, no regression, or relapse
resample every 6 months
annual surveillance if BMI >35

Question 2

EH w atypia

Answer 2

Progression to cancer risk 30%
40% have concomitant carcinoma at hysterectomy
standard: hysterectomy +/- BSO
Address reversible causes
Spontaneous resolution in 30%
weight loss to near normal BMI has been shown to be effective in reversing the process
regression with mirena 86%
Resample 3 monthly if high risk, otherwise at 6 and 12 months
annual sampling once resolution
hyst when family finished - 11% risk of EC longterm

Question 3

Endometrial cancer lifetime risk

Answer 3

1:60 (2%)

Question 4

EC 5 year survival by stage

Answer 4

1 - 80-95%
2- 65-75%
3- 30%
4-10%

Question 5

RT for EC

Answer 5

improves local control rate, but has no effect on overall survival