Y5 - Endometrial cancer Flashcards Preview

Year 5 Cancer > Y5 - Endometrial cancer > Flashcards

Flashcards in Y5 - Endometrial cancer Deck (26):
1

def

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

2

what is the cause of endometrial cancer

endometrial hyperplasia

3

what characterises endometrial hyperplasia

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

4

what causes endometrial hyperplasia

chronic oestrogen stimulation unopposed by progesterone

5

what are possible causes of increased oestrogen

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

6

what are pathophysiological factors associated with endometrial cancer

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

7

what is the most common form of endometrial cancer

endometrioid carcinoma

8

epi

most common gynaecological tumour
more common in developed countries

9

why is endometrial cancer more common in developed countries

obesity

10

signs and symptoms

post-menopausal bleeding
uterine or adnexal mass, fixed uterus

11

RFs

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

12

investigations

pelvic (transvaginal) ultrasound
endometrial biopsy and histopathology

13

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

endometrial thickening >5mm

14

what may be found on endometrial biopsy and histopathology

confirms diagnosis histologically, identifies tumour subtype and grade

15

what cancer antigen is related to endometrial cancer

ca 125

16

management for stages I-II

staging surgery
-total hysterectomy
-bilateral salpingo-oophorectomy
-node dissection

17

what is removed in a total hysterectomy

uterus and cervix

18

what is removed in a total hysterectomy with sapingo-oophorectomy

uterus plus one or both ovaries and fallopian tubes

19

management for stages III-IV

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

20

what is used for chemotherapy in endometrial cancer

paclitaxel and carboplatin

21

what is a stage I endometrial cancer

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

22

what is stage II endometrial cancer

invades cervical stroma but does not extend beyond the uterus

23

what is stage III endometrial cancer

local and regional spread of tumour

24

what is stage IV endometrial cancer

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

25

complications

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

26

prognosis at 5 yr survival rate

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