Endometrial Cancer Flashcards
What are the pathological prognostic features for endometrial cancer?
- Histological type
- Histological grade
- Stage
- LVSI
How is endometrial cancer staged?
- Surgery/pathological
- MRI
What is looked at on MRI to stage endometrial cancer?
- Depth of myometrial involvement
- Cervical involvement
- Lymph node involvement
What staging system is used?
FIGO staging
What are the FIGO stages of endometrial cancer?
- 1A: Inner half of myometrium
- 1B: Outer half of myometrium
- 2: Invades cervix
- 3A: Serosa/adnexa
- 3B: Vagina/parametrium
- 3C: Pelvic or para-aortic nodes
- 4: Bladder/bowel/ intra-abdominal/inguinal nodes
What are the 2 distinct categories of endometrial cancer?
- Type 1= Endometrioid adenocarcinoma
- Type 2= Uterine serous and clear cell carcinoma
What are the features of endometrioid adenocarcinoma?
- By far the commonest
- Unopposed oestrogen
- Hyperplasia with atypia precursor
What are the features of uterine serous and clear cell carcinoma?
- High grade, more aggressive, worse prognosis
- Generally older ladies
- Serous intraepithelial carcinoma precursor
How is endometrial cancer treated?
Early Stage
-Surgery TAH/BSO/washings
High risk histology
-Chemotherapy
Advanced Stage
-Radiotherapy
Palliation
-Progesterone
- Radiotherapy: external beam
- Caesium insertion :intra cavity/vault
What are the cure rates of endometrial cancer relevant to their stage?
- 1B: 85%
- 2A: 75%
- 2B: 60%
- 3B: 30%
- 4: 21%
What are the risk factors for endometrial cancer?
- Post-menopausal women
- High circulating oestrogen levels
- Atypical endometrial hyperplasia
- HNPCC/Lynch type II familial cancer syndrome
Give reasons for high circulating oestrogen levels.
- Obesity
- Unopposed E2 therapy/Tamoxifen
- Polycystic ovarian syndrome (PCOS)
- Early menarche/late menopause
What are the symptoms of endometrial cancer?
- Abnormal vaginal bleeding
- Post-menopausal bleeidng
What stage do most women present with?
Stage 1
What is the epidemiology of endometrial cancer?
- 1.0 per 100,000 women aged 40
29. 8 per 100,000 women - Mortality 6.7 per 100,000 women
- 5YS for all stages 78%
- 5YS 95% for stage 1
- 5YS 14% for stage 4
