Endometrial Cancer Flashcards Preview

Systems: Reproduction AB > Endometrial Cancer > Flashcards

Flashcards in Endometrial Cancer Deck (17)
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1
Q

What are the pathological prognostic features for endometrial cancer?

A
  • Histological type
  • Histological grade
  • Stage
  • LVSI
2
Q

How is endometrial cancer staged?

A
  • Surgery/pathological

- MRI

3
Q

What is looked at on MRI to stage endometrial cancer?

A
  • Depth of myometrial involvement
  • Cervical involvement
  • Lymph node involvement
4
Q

What staging system is used?

A

FIGO staging

5
Q

What are the FIGO stages of endometrial cancer?

A
  • 1A: Inner half of myometrium
  • 1B: Outer half of myometrium
  • 2: Invades cervix
  • 3A: Serosa/adnexa
  • 3B: Vagina/parametrium
  • 3C: Pelvic or para-aortic nodes
  • 4: Bladder/bowel/ intra-abdominal/inguinal nodes
6
Q

What are the 2 distinct categories of endometrial cancer?

A
  • Type 1= Endometrioid adenocarcinoma

- Type 2= Uterine serous and clear cell carcinoma

7
Q

What are the features of endometrioid adenocarcinoma?

A
  • By far the commonest
  • Unopposed oestrogen
  • Hyperplasia with atypia precursor
8
Q

What are the features of uterine serous and clear cell carcinoma?

A
  • High grade, more aggressive, worse prognosis
  • Generally older ladies
  • Serous intraepithelial carcinoma precursor
9
Q

How is endometrial cancer treated?

A

Early Stage
-Surgery TAH/BSO/washings

High risk histology
-Chemotherapy

Advanced Stage
-Radiotherapy

Palliation
-Progesterone

  • Radiotherapy: external beam
  • Caesium insertion :intra cavity/vault
10
Q

What are the cure rates of endometrial cancer relevant to their stage?

A
  • 1B: 85%
  • 2A: 75%
  • 2B: 60%
  • 3B: 30%
  • 4: 21%
11
Q

What are the risk factors for endometrial cancer?

A
  • Post-menopausal women
  • High circulating oestrogen levels
  • Atypical endometrial hyperplasia
  • HNPCC/Lynch type II familial cancer syndrome
12
Q

Give reasons for high circulating oestrogen levels.

A
  • Obesity
  • Unopposed E2 therapy/Tamoxifen
  • Polycystic ovarian syndrome (PCOS)
  • Early menarche/late menopause
13
Q

What are the symptoms of endometrial cancer?

A
  • Abnormal vaginal bleeding

- Post-menopausal bleeidng

14
Q

What stage do most women present with?

A

Stage 1

15
Q

What is the epidemiology of endometrial cancer?

A
  • 1.0 per 100,000 women aged 40
    29. 8 per 100,000 women
  • Mortality 6.7 per 100,000 women
  • 5YS for all stages 78%
  • 5YS 95% for stage 1
  • 5YS 14% for stage 4
16
Q

How should PMB be investigated?

A
  • Trans vaginal US to look at endometrial thickness and contour
  • Biopsy if >4 mm thickness or irreglular
  • Hysteroscopy
17
Q

What is the main treatment for endometrial cancer?

A

Total abdominal hysterectomy with removal of tubes and ovaries with peritoneal washings