Endometrial cancer Flashcards
Risk of endometrial cancer?
10%
Risk of malignancy in endometrial polyp in pre-menopausal and post-menopausal woman?
Pre-menopausal 2%
Post-menopausal 6%
Is risk of malignancy higher or lower in an asymptomatic polyp?
Lower
Risk factors endometrial ca?
early menrche, late menopause
nulliparity
PCOS
unopposed oestrogen
DM
Obesity
HTN
Tamoxifen
Hx breast cancer
Endometrial thickness cut off for investigation in post-menopausal women?
4mm
Types of uterine tumours?
Endometrial ca
Uterine sarcomas - highly malignant, more common in women with previous pelvic irradiation
Leiomyosarcomas - 10% arise from fibroids
Endometrial stromal sarcomas
Malignant mixed mullerian tumours
Stage 1A1 endometrial cancer is…
non-aggressive histological type
confined to a polyp or the endometrium
1A2 endometrial cancer?
Treatment?
non-aggressive
<50% of the myometrium
TAH+BSO
1B endometrial cancer?
Treatment?
non-aggressive
>50% myometrium
TAH + BSO + pelvis and para-aortic LN sampling
After surgery, sometimes brachytherapy (internal beam radiation)
1C endometrial cancer
Aggressive histological type
e.g. serous high grade endometrioid, clear cell, carcinosarcomas
Limited to polyp or endometrium
Stage 2A endometrial cancer?
Treatment?
invades cervical stroma
non-aggressive
Stage 3A endometrial cancer
Spread to ovary or fallopian tube
Stage 3B endometrial cance
metastatic spread to vagina/parametra or pelvic peritoneum
Stage 4A endometrial cancer
Locally advanced disease infiltrating bladder/rectal mucosa
Stage 4C endometrial cancer
Distant metastasis
