Controversies in the management of early endometrial carcinoma: an update

Author(s):  
P. Reddi Rani ◽  
Jasmina Begum ◽  
K. Sathyanarayana Reddy

Endometrial carcinoma (EC) is the commonest genital tract malignancy in developing countries and is usually confined to the uterus at the time of diagnosis with excellent prognosis and high cure rates. But the management is associated with lot of controversies like in staging, best surgical approach, extent of lymphadenectomy, adjuvant therapy, fertility sparing surgery in young women etc. A thorough surgical staging is important to determine uterine and extrauterine spread and also understanding of the pathophysiology and management strategies to identify women who are at high risk and tailoring the adjuvant treatment if necessary without increasing the morbidity. This evidence based narrative review conducted by searching Medline (1994- 2015) and other online articles from Pubmed, Google scholar. Articles were selected based on their currency and relevance to the discussion they summarize the current literature to provide an approach to best practice management of early endometrial carcinoma.

2013 ◽  
Vol 31 (3) ◽  
pp. 189-189 ◽  
Author(s):  
Salvatore Gizzo ◽  
Emanuele Ancona ◽  
Tito Silvio Patrelli ◽  
Carlo Saccardi ◽  
Omar Anis ◽  
...  

2016 ◽  
Vol 18 ◽  
pp. 4-7 ◽  
Author(s):  
Geneviève Bouchard-Fortier ◽  
Raymond H. Kim ◽  
Lisa Allen ◽  
Abha Gupta ◽  
Taymaa May

2018 ◽  
Vol 224 ◽  
pp. 38-43 ◽  
Author(s):  
Laura L. Stafman ◽  
Ilan I. Maizlin ◽  
Matthew Dellinger ◽  
Kenneth W. Gow ◽  
Melanie Goldfarb ◽  
...  

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Gry Johansen ◽  
Pernilla Dahm-Kähler ◽  
Christian Staf ◽  
Angelique Flöter Rådestad ◽  
Kenny A. Rodriguez-Wallberg

Abstract Background Epithelial ovarian cancer (EOC) is rare in women of reproductive age and fertility-sparing surgery (FSS) may be applied in early stages. The purpose of this study was to investigate the safety and efficacy of FSS for treatment of EOC. Methods The Swedish nationwide population-based Quality Register for Gynecological Cancer was used to identify all women 18–40 years of age diagnosed with stage I EOC between 2008 and 2015. Detailed data on surgery, staging, histopathology, and follow-up were extracted and reviewed. Cross-linking of individuals to population-based registries allowed retrieval of data on obstetrical and reproductive outcomes after FSS. Disease-free survival (DFS) and overall survival (OS) rates were compared (Kaplan-Meier method) between women who underwent FSS vs. radical surgery (RS). Results In total 83 women were identified; 36 who had FSS performed and 47 RS. The 5-year OS rate was 92% and no statistical differences between DFS or OS were found between women treated by FSS or RS. The recurrence rate after RS was 13% compared to 6% after FSS. Recurrences were more frequently found in women with stage IC tumor or with histologic subtypes with more aggressive behavior. In the FSS cohort, nine women gave birth to 12 healthy children, all delivered at fullterm. Only one women had received assisted reproductive technology treatment. Conclusion In this nationwide population-based cohort study natural fertility was maintained after FSS. Specific histologic subtypes showed greater prognostic impact on the oncological outcome than the use of FSS. Recurrences occurred after FSS, but none in the uterus, which questions the need of hysterectomy in young women with EOC. Trial registration This article reports the results of a healthcare intervention using the data prospectively registered in the Swedish population-based registries including the Quality Register for Gynecological Cancer, the National Death Register, the Swedish Medical Birth Register, and the National Quality Register for Assisted Reproduction.


2017 ◽  
Vol 69 (1) ◽  
pp. 29-34 ◽  
Author(s):  
Salvatore Giovanni Vitale ◽  
Diego Rossetti ◽  
Alessandro Tropea ◽  
Antonio Biondi ◽  
Antonio Simone Laganà

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