Endometrial Cancer Flashcards
What is the most common gynecologic malignancy?
Endometrial cancer
What is the fourth most common cancer in women in the US?
Uterine cancer
what is the most common histologic type of uterine cancer?
Adenocarcinoma of the endometrium
What are the two histologic categories of endometrial carcinomas?
type 1 tumors include tumors of endometrioid histology that are grade 1, 2; these comprise approx. 80% of endometrial Ca, good prognosis; type 2 account for 10-20% of endometrial carcinomas, they include grade 3, poor prognosis
What is the scheme of hyperplasia to cancer?
simple hyperplasia, complex hyperplasia w/out atypia, complex hyperplasia w/ atypia, endometrial CA
What percentage of endometrial CA are found to w/ atypical hyperplasia background?
30-40%
Presentation of CA?
abnormal uterine bleeding, commonly in postmenopausal women and w/ increasing age in premenopausal women
What can protect women from endometrial CA?
oral contraceptives (probably due to progesterone), exss, smoking
How is it detected?
abnormal bleeding patterns, cytologic findings on PAP smear, Imaging
Cervical cytology findings that need further evaluation with endocervical and endmetrial biopsy?
adenocarcinoma, atypical glandular cells
What is the work up?
PE: size, mobility, shape of uterus on bimanual exam, CBC, CMP, US, endometrial sampling
A biopsy should be done if…
endometrial thickness >4mm or if there’s continued bleeding and
how is staging done?
FIGO, if mets, regional lymph nodes, involves adnexa, vagina, or serosa, if invades bladder or bowel- stage 4,
What’s the treatment?
total extrafasical hysterectomy w/ bilateral salpingo-oophorectomy w/ pelvic and para-aortic lymph node dissection, cytoreduction preformed if mets are evident, adjunctive RT, chemo
What does a total hysterectomy include?
the uterus and cervix
