Significance of p27 as a predicting marker for medroxyprogesterone acetate therapy against endometrial endometrioid adenocarcinoma

2006 ◽  
Vol 16 (Suppl 1) ◽  
pp. 452-457 ◽  
Author(s):  
J. Watanabe ◽  
K. Watanabe ◽  
T. Jobo ◽  
Y. Kamata ◽  
M. Kawaguchi ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Medroxyprogesterone Acetate ◽  
Early Stage ◽  
Endometrial Adenocarcinoma ◽  
Endometrioid Adenocarcinoma ◽  
Nuclear Staining ◽  
Adenocarcinoma Cells ◽  
Clinical Responses ◽  
Effective Group ◽  
Endometrial Endometrioid Adenocarcinoma

Watanabe J, Watanabe K, Jobo T, Kamata Y, Kawaguchi M, Imai M, Okayasu I, Kuramoto H. Significance of p27 as a predicting marker for medroxyprogesterone acetate therapy against endometrial endometrioid adenocarcinoma. Int J Gynecol Cancer 2006;16(Suppl. 1): 452–457.We reported that p27 induced by medroxyprogesterone acetate (MPA) may be involved in the progestin-induced growth suppression of human endometrial adenocarcinoma cells. This study aimed at investigating whether p27 expression could be a predicting marker to evaluate the effectiveness of MPA therapy. The clinical responses of 15 patients with endometrial carcinoma treated with MPA were examined. p27 expression was evaluated by immunohistochemical staining. Percentage of positive nuclear staining was expressed as a strongly positive (SP) labeling index (LI). Before MPA treatment, SP LIs in the effective and noneffective groups were 22.6 ± 14.3% and 9.1 ± 9.2%. At 1–6 weeks in the MPA treatment, SP LIs increased in both groups and were significantly higher than those before the therapy. At 7–12 weeks, SP LIs in both groups decreased to the level of pretherapy. At 13–18 weeks, SP LIs in the effective group were 14.9 ± 5.7%, whereas in the noneffective group, 1.1 ± 2.0%. The former was significantly higher than the latter. p27 expression could predict the effectiveness of MPA treatment for endometrial carcinoma at an early stage of the 4-month period in MPA therapy and could be a useful predicting marker for MPA.

scholarly journals Undifferentiated Endometrial Carcinoma: A Diagnosis Frequently Overlooked

2013 ◽  
Vol 137 (3) ◽  
pp. 438-442 ◽  
Author(s):  
Shaymaa Al-Loh ◽  
Maysa Al-Hussaini
Keyword(s):  
Endometrial Carcinoma ◽  
Cancer Center ◽  
Endometrioid Adenocarcinoma ◽  
Diagnostic Challenge ◽  
Gynecology And Obstetrics ◽  
Proper Definition ◽  
Grade 3 ◽  
Md Anderson ◽  
Endometrial Endometrioid Adenocarcinoma ◽  
Uncommon Neoplasm

Undifferentiated endometrial carcinoma (UEC) is a relatively uncommon neoplasm with only few studies published thus far. It has always been a diagnostic challenge because of the lack of proper definition cited in most of the standard textbooks. Recently however, a few studies have highlighted the clinicopathologic features of UEC. The distinctive morphology of UEC was noted by the group from MD Anderson Cancer Center, which enabled them to establish the defining criteria. It appears to be more aggressive than endometrial endometrioid adenocarcinoma, FIGO (International Federation of Gynecology and Obstetrics) grade 3, its main differential diagnosis. Proper recognition of this entity is important owing to its aggressive behavior.

Peritoneal keratin granulomas complicating endometrial carcinoma: a report of two cases and review of the literature

2008 ◽  
Vol 18 (3) ◽  
pp. 549-553 ◽  
Author(s):  
C. VAN DER HORST ◽  
A. J. EVANS
Keyword(s):  
Endometrial Carcinoma ◽  
Endometrial Adenocarcinoma ◽  
Review Of The Literature ◽  
Squamous Differentiation ◽  
Adenocarcinoma Cells

Squamous differentiation in endometrial adenocarcinoma is common. Rarely, it may be complicated by peritoneal keratin granulomas. Keratin granulomas accompanied by viable adenocarcinoma cells are regarded as conventional metastatic foci. However, the significance of keratin granulomas without accompanying viable adenocarcinoma cells is difficult to ascertain. Only a small number of cases with significant follow up are documented in the literature. We present two cases of peritoneal keratin granulomas, review the literature and discuss the significance of these lesions

Feasibility of ovarian preservation in patients with early stage endometrial carcinoma: A retrospective study

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 15064-15064
Author(s):  
T. Lee ◽  
J. Jung ◽  
J. Kim ◽  
J. Kim ◽  
N. Park ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Carcinoma ◽  
Early Stage ◽  
Bowel Perforation ◽  
Ovarian Tissue ◽  
Endometrial Adenocarcinoma ◽  
Ovarian Metastasis ◽  
Surgical Removal ◽  
Ovarian Preservation ◽  
Synchronous Malignancy

15064 Background: The treatment of endometrial cancer involves surgical removal of the ovary; this elimination induces an abrupt menopause and may deteriorate the qualities of life. Therefore, ovarian preservation may be a consideration for premenopausal women. Our main objectives are to examine the occurrence of ovarian metastasis or synchronous malignancy and to evaluate the feasibility of ovarian preservation in patients with early stage endometrial carcinoma. Methods: We reviewed the medical records of 259 patients undergoing surgical treatment for endometrial cancer at a single institute from 1992 to 2004. Results: Among the 224 patients with endometrial adenocarcinoma who had undergone ovarian removal, cancer in ovarian tissue was detected in 21 cases (9.4%, 14 ovarian metastasis, 7 synchronous cancer). Synchronous ovarian cancer showed abnormal gross finding in all 7 cases. Thirteen cases of ovarian metastasis were high grade lesion in preoperative evaluation, or showed intraoperative peritoneal seeding or abnormal gross lesion around adnexa. In 35 patients, grossly normal ovary was saved selectively in compliance with patients’ need (19 bilateral, 16 unilateral). Thirty-one of 35 (89%) were under 45 years and mostly showed early stage (Ia, 24; Ib, 7; Ic, 1; IIa, 1; IIb, 2). Pre-operative MRI was available in 30 cases, and none of them showed findings suggesting tumor extension outside of uterus. In 2 cases of IIb, postoperative radiation therapy was done. There was no recurrence or death in all cases of ovarian preservation except one in which a patient died of sepsis caused by postoperative bowel perforation (median duration of follow-up, 76 mon.; range 3∼121). Conclusions: Ovarian preservation can be cautiously performed, preceded by a thorough preoperative and intraoperative assessment of the adnexa in young women with endometrial carcinoma. The patients who desire ovarian preservation should be counseled regarding the rate of ovarian metastasis or synchronous malignancy. No significant financial relationships to disclose.

Prolonged Conservative Treatment of Endometrial Cancer Patients: More Than 1 Pregnancy Can Be Achieved

2011 ◽  
Vol 21 (1) ◽  
pp. 72-78 ◽  
Author(s):  
Tamar Perri ◽  
Jacob Korach ◽  
Walter H. Gotlieb ◽  
Mario Beiner ◽  
Dror Meirow ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Conservative Treatment ◽  
Early Stage ◽  
Intrauterine Device ◽  
Endometrial Adenocarcinoma ◽  
Tertiary Care ◽  
Young Patients ◽  
High Recurrence Rate ◽  
High Dose ◽  
Endometrioid Adenocarcinoma

Background:Preserving reproductive function in young patients with early endometrial cancer is an accepted concept today. The safety and feasibility of long-term conservative treatment, allowing more than 1 pregnancy, remain to be ascertained.Methods:This study was a retrospective chart review of a 27 women with endometrioid adenocarcinoma of the endometrium, who were treated conservatively at 2 tertiary-care institutions. Treatment comprised oral high-dose progestins with or without a levonorgestrel-releasing intrauterine device. Endometrial biopsy was repeated every 2 to 3 months.Results:Over 7.8 to 412 months (median, 57.4 months), tumors regressed completely in 24 (89%) of 27 patients and partially in 2 patients, with 79% responding within 1 to 17 months. Of the complete responders, 15 (62%) of 24 had a recurrence; 4 underwent hysterectomy, and 11 underwent subsequent progestational treatment. All 11 responded, and 3 subsequently conceived. After 2 to 4 years, 5 patients again had a recurrence, of whom 3 underwent hysterectomy. Overall, 2 patients developed ovarian adenocarcinoma. All patients are currently disease-free. Conception occurred in 14 (51.8%) of 27 patients, in 5 more than once. There were 17 live births, and 2 patients are pregnant.Conclusions:According to our data, prolonged progestational therapy for early-stage endometrial adenocarcinoma, allowing women to conceive, is feasible and apparently does not alter clinical outcome. Patients should be advised of the high recurrence rate and possible concomitant ovarian malignancy.

scholarly journals Unusual Presentation of Recurrent Early Stage Endometrial Carcinoma 28 Years after Primary Surgery

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Alessandro Franchello ◽  
Gianruggero Fronda ◽  
Giacomo Deiro ◽  
Alessia Fiore ◽  
Davide Cassine ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Early Stage ◽  
Rectal Wall ◽  
Endometrial Adenocarcinoma ◽  
Neoadjuvant Treatment ◽  
Female Genital Tract ◽  
Immunohistochemical Analysis ◽  
Early Stage Disease ◽  
Pelvic Mri ◽  
Primary Surgery

Endometrial carcinoma is the most common neoplasia of female genital tract. The prognosis of early stage disease (FIGO I and FIGO II) is excellent: recurrence after surgery is less than 15%, most of which are reported within 3 years after primary treatment. Herein we report a case of late rectal recurrence from FIGO Ib endometrial adenocarcinoma. Patient had also familiar and personal history of colonic adenocarcinoma and previous findings of microsatellite instability (MSI); molecular analysis evidenced heterozygotic somatic mutation in MLH1 gene. Twenty-eight years after hysterectomy and bilateral salpingoovariectomy, a rectal wall mass was detected during routine colonoscopy. Patients underwent CT scan, pelvic MRI, and rectal EUS with FNA: histopathological and immunohistochemical analysis revealed differentiated carcinoma cells of endometrial origin. No neoadjuvant treatment was planned and low rectal anterior resection with protective colostomy was performed; histology confirmed rectal lesion as metastasis from endometrial carcinoma. Recurrence of early stage endometrial carcinoma after a long period from primary surgery is possible. It is important to keep in mind this possibility in order to set a correct diagnostic and therapeutic algorithm, including preoperative immunohistochemical staining, and to plan a prolonged follow-up program.

Genomic biomarkers of recurrence in low-grade, early-stage endometrial adenocarcinoma.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 5588-5588
Author(s):  
Katie Lee Hwang ◽  
William L. Hwang ◽  
Brooke E. Howitt ◽  
Martin T. King ◽  
Elizabeth Stover ◽  
...  
Keyword(s):  
Adjuvant Therapy ◽  
Somatic Mutation ◽  
Somatic Mutations ◽  
Early Stage ◽  
Figo Stage ◽  
The United States ◽  
Low Risk ◽  
Endometrioid Adenocarcinoma ◽  
Risk Of Recurrence ◽  
Endometrial Endometrioid Adenocarcinoma

5588 Background: Endometrial cancer is the most common gynecologic malignancy in developed countries with over 60,000 new cases diagnosed in the United States each year. Adjuvant therapy is often omitted for low-risk, early-stage disease (FIGO stage IA, grade 1) but 1 in 20 women suffer recurrence after surgery alone. Hence, there is an important need for biomarkers of recurrence in this population to guide therapeutic management. Methods: We retrospectively analyzed 74 patients with FIGO stage 1A, grade 1 endometrial endometrioid adenocarcinoma treated at our institution with hysterectomy alone between 2009-2016. All patients had targeted genomic assessment of their tumors (OncoPanel; somatic mutations, copy number variations and structural variants across 300 cancer genes). The primary outcome of interest was freedom from recurrence (FFR). Outcomes were compared by the logrank test and survival estimates calculated by Kaplan-Meier method. Results: We identified 14 patients who recurred at a median time of 23.6 months after surgery and 60 patients without recurrence at a median follow-up of 38.9 months. Age (median 57 years; log-rank p = 0.91) and BMI (median 31 kg/m2; log-rank p = 0.21) were not associated with risk of recurrence. The median somatic mutation count in the cohort was 8. Patients with more than 8 somatic mutations had a significantly higher risk of recurrence (3-year FFR: 74% vs 90%; log-rank p = 0.004). At the level of individual genes, there were four genes that were significantly associated with recurrence: CTNNB1 (p = 0.046), RHPN2 (p = 0.020), SF1 (p = 0.044), SQSTM1 (p = 0.034). Patients with a mutation in one or more of these four genes had a significantly higher risk of recurrence (3-year FFR: 62% vs 93%; log-rank p = 0.0004). Conclusions: We have identified overall somatic mutation burden and mutations in a subset of four genes ( CTNNB1, RHPN2, SF1, SQSTM1) as determined by a validated 300-gene panel used in routine clinical practice as prognostic biomarkers for patients with low-risk, early-stage endometrial endometrioid adenocarcinoma. These patients may benefit from the addition of adjuvant therapy. Validation with larger cohorts and prospective studies is warranted.

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