Y5 - Endometrial cancer Flashcards

1
Q

def

A

an epithelial malignancy of the uterine corpus mucosa (usually an adenocarcinoma)

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2
Q

what is the cause of endometrial cancer

A

endometrial hyperplasia

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3
Q

what characterises endometrial hyperplasia

A

proliferation of endometrial glands which results in a greater gland-to-stroma ratio than in normal endometrium

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4
Q

what causes endometrial hyperplasia

A

chronic oestrogen stimulation unopposed by progesterone

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5
Q

what are possible causes of increased oestrogen

A

chronic anovulation (PCOS)
obesity
post-menopausal women and HRT

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6
Q

what are pathophysiological factors associated with endometrial cancer

A

oestrogen
loss of PTEN tumour suppressor gene by mutation
k-ras mutations
microsatellite instability and mismatch repair genes
p53

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7
Q

what is the most common form of endometrial cancer

A

endometrioid carcinoma

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8
Q

epi

A

most common gynaecological tumour

more common in developed countries

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9
Q

why is endometrial cancer more common in developed countries

A

obesity

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10
Q

signs and symptoms

A

post-menopausal bleeding

uterine or adnexal mass, fixed uterus

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11
Q

RFs

A
obesity (androgen excess and progesterone deficiency)
>50yrs
endometrial hyperplasia
high oestrogen
tamoxifen use as in breast cancer
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12
Q

investigations

A

pelvic (transvaginal) ultrasound

endometrial biopsy and histopathology

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13
Q

what may be found on pelvic (transvaginal) ultrasound in endometrial cancer

A

endometrial thickening >5mm

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14
Q

what may be found on endometrial biopsy and histopathology

A

confirms diagnosis histologically, identifies tumour subtype and grade

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15
Q

what cancer antigen is related to endometrial cancer

A

ca 125

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16
Q

management for stages I-II

A

staging surgery

  • total hysterectomy
  • bilateral salpingo-oophorectomy
  • node dissection
17
Q

what is removed in a total hysterectomy

A

uterus and cervix

18
Q

what is removed in a total hysterectomy with sapingo-oophorectomy

A

uterus plus one or both ovaries and fallopian tubes

19
Q

management for stages III-IV

A
staging surgery and chemotherapy
-total hysterectomy
-bilateral salpingo-oophorectomy
-node dissection
radiotherapy
20
Q

what is used for chemotherapy in endometrial cancer

A

paclitaxel and carboplatin

21
Q

what is a stage I endometrial cancer

A

limited to corpus uteri
A <50% myometrial invasion
B >50% myometrial invasion

22
Q

what is stage II endometrial cancer

A

invades cervical stroma but does not extend beyond the uterus

23
Q

what is stage III endometrial cancer

A

local and regional spread of tumour

24
Q

what is stage IV endometrial cancer

A

tumour invades the bladder and/or bowel mucosa and/or distant metastases

25
Q

complications

A

bladder instability following surgery
vaginal stenosis, atrophy, and fibrosis following radiotherapy
sexual dysfunction

26
Q

prognosis at 5 yr survival rate

A

stage I - 90%
stage II - 70%
stage III - 50%
stage IV 10%