endometrial cancer

Question 1

name 5 radical txs for endo cancer

Answer 1

Simple hysterectomy (GOLD STANDARD) - with removal of clinically enlarged lymph nodes
EBRT - alternative if pt unfit or postoperative to reduce recurrence or if recurrence
Brachytherapy - EBRT and BT most common 8Gy in 2 # or BT alone 21Gy in 3#
Chemorad- no benefit for t1/t2 but benefit for t3
Hormone therapy - better outcome for well-differentiated tumours

Question 2

role of EBRT for endo cancer

Answer 2

post op rt = 45Gy in 25# - reduce recurrence

Question 3

name 6 FIGO stages of endo cancer

Answer 3

1a=confined to endo
1b=confined to endo
2=invades cervical stroma
3= spread to pelvic tissue or pelvic LNs
4a= spread to bladder / rectum
4b= distant mets

Question 4

give 4 etiological risk factors for endo. cancer

Answer 4

diabetes
CV disease
late menopause
genetic history
obese nulliparous women
early menarche

Question 5

main cell type of endo. tumours

Answer 5

adenocarcinoma

Question 6

2 types of endo. tumours

Answer 6

type 1 endo cancer = moderately differentiated and sensitive to progesterone
type 2 endo cancer = often in elderly an related to the use of tamoxifen - deeply invasive and high metastatic potential

Question 7

spread endo. tumours

Answer 7

local - most common = myometrium or cervix, least common = fallopian tubes
lymph = submucosal LNs and pelvic LNs
Blood = lung/bones