Endometrial hyperplasia/cancer management (RCOG guidelines) Flashcards
What is the management of endometrial hyperplasia without atypia?
IUS
Oral progesterone if not wanting IUS
How often should women with endometrial hyperplasia without atypia be followed up and how?
Every 6 months
Outpatient biopsy
When would women with endometrial hyperplasia without atypia be discharged?
2 consecutive negative biopsies
UNLESS
BMI >35 or using oral progesterone
Then do biopsy yearly after 2 consecutive negative 6 month biopsies
What hormone drug increases the risk of endometrial hyperplasia?
Tamoxifen
NOT letrozole
(Probably more than one but feel this is a commoner question)
What is the management of atypical endometrial hyperplasia?
Total hysterectomy (and bilateral salpingoophrectomy if not wanting fertility sparing)
What is the surgical management of endometrial cancer?
Total hysterectomy, bilateral salpingo-oophorectomy and lymphadenectomy
What is stage 1A and 1B endometrial cancer?
1A: Cancer has invaded no more than 50% into myometrium
1B: Cancer has invaded more than 50% into myometrium
What is stage 2 endometrial cancer?
The cancer has spread through the body of the uterus and extends to the connective tissue of the cervix (the cervical stroma)
What is stage 3 endometrial cancer?
The cancer has spread beyond the uterus to other sites but is still confined to the pelvis (A,B and C but probs don’t need to learn them)
What is stage 4A and 4B endometrial cancer?
Stage 4A: Involvement of the bowel or bladder mucosa.
Stage 4B: Involvement of other organs such as the lungs, liver or bones. This also includes the development of malignant ascites and peritoneal involvement.
When is radiotherapy used in patients with endometrial cancer?
Adjunct to surgery in patients with grade 1b or above disease
Or palliative for mets
When is chemotherapy used in patients with endometrial cancer and what kind of chemo is used?
Less common than radiotherapy
Part of approach for stage III and above cancer
Usually platinum based chemo
