Endometrial Cancer Flashcards Preview

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Flashcards in Endometrial Cancer Deck (21):
1

What type of cancer is endometrial cancer usually?

Enometrioid adenocarcinoma

2

How does endometrial cancer usually present?

-Postmenopausal vaginal bleeding
-pre menopausal recurrent metrorrhagia

3

Who is mostly affected by endometrial cancer?

Post menopausal women

4

Average age of endometrial cancer diagnosis?

Mean age =61
92% cases >50y (Diagnosed mostly 50-60y)

5

What are the major risk factors for endometrial cancer?

-Obesity
-DM
-Hypertension

6

What are additional (non major) RFx for endometrial cancer?

-Unopposed oestrogen
-Tamoxifen use for >5y
-Previous pelvic radiation therapy
-PHx or FHx breat or ovarian Ca
-FHx HNPCRC

7

What is unopposed oestrogen associated with/ caused by?

-Obesity
-PCOS
-Nulliparity
-Late menopause
-Oestrogen producing tumours
-Anovulation
-Oestrogen therapy without progesterone

8

Involvement of heredity in endometrial cancer?

-up to 10% cases
-50% of these occur in families with Lynch (HNPCRC) syndrome

9

What usually precedes endometrial cancer?

Endometrial hyperplasia

10

What are the types of endometrial adenocarcinoma?

-Type I: more common; ER responsive, usually younger / obese / perimenopausal women. Usually low grade.
Type II: usually high grade; occur in older women. Up to 10% ECa.

11

What are the mutations associated with Type I endometrial cancer?

Microsatellite instability + mutations:
-PTEN
-PIK3CA
-KRAS
-CTNNBI

12

What are the mutations associated with Type II endometrial cancer?

-10-30% p53

13

Examples of high grade histology demonstrated in Type II eCa?

-Serous
-Clear cell histolgy

14

How many women with post menopausal bleeding have endometrial cancer?

1/3

15

how is endometrial cancer diagnosed?

-Endometrial Bx
-Surgical staging

16

What is suggestive of endometrial cancer?

-Post menopausal bleeding
-Abnormal bleeding in premenopausal women
-Pap showing endometrial cells in post menopausal woman
-Pap showing atypical endometrial cells in any woman

17

What is pre treatment evaluation for endometrial cancer?

-FBE / UEC / LFTs
-CXR
-ECG
-Pelvic and abdo CT (?extrauterine / mets)

18

When is pelvic / abdo CT conducted in endometrial cancer work up?

-Abdo mass or hepatomegaly on PEx
-Abnormal LFTs
-High risk histologic subtype (papillary serous carcinoma, clear cell carcinoma)

19

How is staging conducted in endometrial cancer?

Surgically
-based on histologic differentiation (i-III)
-extent of spread (invasion depth, cervical involvement, extrauterine mets)
-included peritoneal fluid cytology, exploration, Bx suspicious lesions

20

Prognosis endometrial cancer?

Prognosis is worse with higher-grade tumors, more extensive spread, and older patient age. Average 5-yr survival rates are
Stage I or II: 70 to 95%
Stage III or IV: 10 to 60%
Overall 63% 5y cancer free survival

21

Treatment endometrial cancer?

-Total hysterectomy and bilateral salpingo-oophorectomy
-Pelvic and para-aortic lymphadenectomy for deep G1/2 and G3
-Pelvic radiation therapy +/- chemo for stage II or III
-Mulitmodal invididualsied for IV