Flashcards in Endometrial Cancer Deck (21)
What type of cancer is endometrial cancer usually?
How does endometrial cancer usually present?
-Postmenopausal vaginal bleeding
-pre menopausal recurrent metrorrhagia
Who is mostly affected by endometrial cancer?
Post menopausal women
Average age of endometrial cancer diagnosis?
Mean age =61
92% cases >50y (Diagnosed mostly 50-60y)
What are the major risk factors for endometrial cancer?
What are additional (non major) RFx for endometrial cancer?
-Tamoxifen use for >5y
-Previous pelvic radiation therapy
-PHx or FHx breat or ovarian Ca
What is unopposed oestrogen associated with/ caused by?
-Oestrogen producing tumours
-Oestrogen therapy without progesterone
Involvement of heredity in endometrial cancer?
-up to 10% cases
-50% of these occur in families with Lynch (HNPCRC) syndrome
What usually precedes endometrial cancer?
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.
What are the mutations associated with Type I endometrial cancer?
Microsatellite instability + mutations:
What are the mutations associated with Type II endometrial cancer?
Examples of high grade histology demonstrated in Type II eCa?
-Clear cell histolgy
How many women with post menopausal bleeding have endometrial cancer?
how is endometrial cancer diagnosed?
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
What is pre treatment evaluation for endometrial cancer?
-FBE / UEC / LFTs
-Pelvic and abdo CT (?extrauterine / mets)
When is pelvic / abdo CT conducted in endometrial cancer work up?
-Abdo mass or hepatomegaly on PEx
-High risk histologic subtype (papillary serous carcinoma, clear cell carcinoma)
How is staging conducted in endometrial cancer?
-based on histologic differentiation (i-III)
-extent of spread (invasion depth, cervical involvement, extrauterine mets)
-included peritoneal fluid cytology, exploration, Bx suspicious lesions
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