scholarly journals Characteristics of endometrial carcinoma in obese women

2010 ◽  
Vol 63 (9-10) ◽  
pp. 709-714 ◽  
Author(s):  
Predrag Vukomanovic ◽  
Ranko Kutlesic ◽  
Milan Stefanovic ◽  
Mileva Milosavljevic ◽  
Jasmina Popovic ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Myometrial Invasion ◽  
Figo Stage ◽  
Stage I ◽  
Nuclear Grade ◽  
Obese Group ◽  
Type I ◽  
Cancer Type ◽  
Obese Women ◽  
Grade Ii

Introduction. In most developed countries, endometrial cancer appears as most frequent invasive neoplasm of genital tract. Obesity is one of most important risk factors. Aim of study was to establish characteristics endometrial cancer in obese women. Material and methods. The study included 50 surgically treated women with endometrial cancer. According body mass index they were divided into two groups - group A (30 obese women), group B (20 non-obese women). Results and Discussion. Non-obese women with endometrial cancer are statistically significantly older than obese. Menopausal status, parity are not statistically significant. The obese group most frequently includes endometrioid type of tumor, while non-obese group most frequently includes non-endometrioid types of endometrial cancer. Over 50% thick myometrial invasion is statistically more frequent in non-obese group than in obese group. In obese group, less than 50% thick myometrial invasion, is statistically significant in comparison to non-obese group. High-differentiated endometrial cancer(G1) is statistically significantly more present in obese women than non-obese. Low-diferentiated endometrial cancer is statistically more frequent in non-obese women than in obese. Most frequent in both groups is NG2. According to FIGO stage I, disease is statistically significantly more frequent in obese group than in non-obese. In non-obese group, total number of deseased in higher stages (II and III) is statistically significantly higher than in stage I. Conclusion. Endometrial cancer present in obese women is mostly endometroid type I, with slow myometrial invasion, with hystological grade I, nuclear grade II in FIGO stage I of disease. In non-obese women, non-endometrioid cancer - type II is more frequent, with faster myometrial invasion, hystological grade II and III, nuclear grade II, in FIGO stage II of disease.

scholarly journals Clinical value of selected markers of angiogenesis, inflammation, insulin resistance and obesity in type 1 endometrial cancer

2020 ◽  
Author(s):  
Katarzyna M. Terlikowska ◽  
Bozena Dobrzycka ◽  
Robert Terlikowski ◽  
Anna Sienkiewicz ◽  
Maciej Kinalski ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Endometrial Cancer ◽  
Growth Factor ◽  
Myometrial Invasion ◽  
Serum Levels ◽  
Figo Stage ◽  
Cancer Type ◽  
Cox Regression Analysis ◽  
Angiopoietin 2

Abstract Background: It is a well-known fact show that the risk of developing endometrial cancer (type 1 EC) is strongly associated with obesity. In this study, selected markers, such as obesity, insulin resistance, angiogenesis and inflammation markers related to EC type 1 progression and patients’ survival data were analyzed.Methods: To measure levels of adiponectin, C-reactive protein (CRP), vascular endothelial growth factor-A (VEGF-A), angiopoietin-2 (Ang-2), insulin-like growth factor-1 (IGF-1), insulin and C-peptide in 176 preoperative serum samples, the immunoassay technique (EMIT) has been applied.Results: Angiopoietin-2 levels increase with age (P=0.005), FIGO stage (p=0.042), myometrial invasion (P=0.009) and LVSI (P<0.001). The CRP levels increase with age (P=0.01), as well as the advancement of the FIGO stage (P<0.001), higher tumor grade (P=0.012), and myometrial invasion (P<0.001). A positive correlation between serum Ang-2 and CRP levels was demonstrated (r=0.44; p<0.001). Kaplan-Meier survival analysis showed that patients with high CRP levels in serum and Ang-2 presented a worse outcome (P=0.03 and P=0.015, respectively). Cox regression analysis of individual predictors revealed that high serum levels of Ang-2, CRP, advanced clinical FIGO stage (P<0.001, respectively), old age (P=0.013) were all significant overall survival predictors. By means of multivariate analysis, their predictive significance was confirmed.Conclusion: Our study provides evidence that serum levels of Ang-2 and CRP may serve as predictors for assessment of the clinical stage of type 1 EC and are significantly associated with poor prognosis. It is likely that angiogenesis and inflammation associated with obesity have a significant impact on EC type 1 progression and survival rate of patients.

Preoperative Serum Human Epididymis Protein 4 Levels in Early Stage Endometrial Cancer: A Prospective Study

2017 ◽  
Vol 27 (6) ◽  
pp. 1200-1205 ◽  
Author(s):  
Francesco Fanfani ◽  
Stefano Restaino ◽  
Stefania Cicogna ◽  
Marco Petrillo ◽  
Marcella Montico ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
High Risk ◽  
Gynecologic Oncology ◽  
Menopausal Status ◽  
Myometrial Invasion ◽  
Type I ◽  
Cancer Type ◽  
Type Ii ◽  
Human Epididymis Protein 4 ◽  
Human Epididymis

ObjectiveThe aim of the study was to evaluate the prognostic value of human epididymis protein 4 (HE4) and cancer antigen 125 markers with pathological prognostic factor to complete the preoperative clinical panel and help the treatment planning.MethodsThis prospective multicenter study was conducted in 2 gynecologic oncology centers between 2012 and 2014 (Institute for Maternal and Child Health IRCCS Burlo Garofolo in Trieste and Catholic University of the Sacred Heart in Rome, Italy). We enrolled 153 patients diagnosed with clinical early (International Federation of Gynecology and Obstetrics stages I–II) type I endometrial cancer.ResultsHuman epididymis protein 4 levels seemed to be strictly related to age (P < 0.001) and menopausal status (P < 0.002). Compared with myometrial invasion (MI), the HE4 values were significantly higher in case of invasion of greater than 50% of the thickness: MI of greater than 50%, median of 94.85 pmol/L (38.3–820.8 pmol/L), versus MI of less than 50%, median of 65.65 pmol/L (25.1–360.2 pmol/L), (P < 0.001). The HE4 levels increase significantly with increasing tumor size: diameter of larger than 2 cm, median of 86.9 pmol/L (35.8–820.8 pmol/L), versus diameter of smaller than 2 cm, median of 52.2 pmol/L (33.3–146.8 pmol/L), (P < 0.001). In our population, HE4 did not correlate with the histological grade, endometrial cancer type I versus type II (P = 0.86), the lymphovascular infiltration (P = 0.12), and the cervical invasion (P = 0.6). We established a new variable, considering 3 high-risk tumor features: MI of greater than 50% and/or histological G3 and/or type II. Human epididymis protein 4 levels significantly increase in high-risk tumors (high risk HE4, 93.6 pmol/L vs low-medium risk, 65.5 pmol/L; P < 0.001).ConclusionsA preoperative HE4 evaluation could help stratify patients with deep invasion and/or metastatic disease and is correlated with other relevant prognostic factors to be considered to tailor an adequate surgical strategy.

scholarly journals Clinical value of selected markers of angiogenesis, inflammation, insulin resistance and obesity in type 1 endometrial cancer

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Katarzyna M. Terlikowska ◽  
Bozena Dobrzycka ◽  
Robert Terlikowski ◽  
Anna Sienkiewicz ◽  
Maciej Kinalski ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Endometrial Cancer ◽  
Growth Factor ◽  
Myometrial Invasion ◽  
Serum Levels ◽  
Figo Stage ◽  
Cancer Type ◽  
Cox Regression Analysis ◽  
Angiopoietin 2

Abstract Background It is a well-known fact show that the risk of developing endometrial cancer (type 1 EC) is strongly associated with obesity. In this study, selected markers, such as obesity, insulin resistance, angiogenesis and inflammation markers related to EC type 1 progression and patients’ survival data were analyzed. Methods To measure levels of adiponectin, C-reactive protein (CRP), vascular endothelial growth factor-A (VEGF-A), angiopoietin-2 (Ang-2), insulin-like growth factor-1 (IGF-1), insulin and C-peptide in 176 preoperative serum samples, the immunoassay technique (EMIT) has been applied. Results Angiopoietin-2 levels increase with age (P = 0.005), FIGO stage (p = 0.042), myometrial invasion (P = 0.009) and LVSI (P < 0.001). The CRP levels increase with age (P = 0.01), as well as the advancement of the FIGO stage (P < 0.001), higher tumor grade (P = 0.012), and myometrial invasion (P < 0.001). A positive correlation between serum Ang-2 and CRP levels was demonstrated (r = 0.44; p < 0.001). Kaplan-Meier survival analysis showed that patients with high CRP levels in serum and Ang-2 presented a worse outcome (P = 0.03 and P = 0.015, respectively). Cox regression analysis of individual predictors revealed that high serum levels of Ang-2, CRP, advanced clinical FIGO stage (P < 0.001, respectively), old age (P = 0.013) were all significant overall survival predictors. By means of multivariate analysis, their predictive significance was confirmed. Conclusion Our study provides evidence that serum levels of Ang-2 and CRP may serve as predictors for assessment of the clinical stage of type 1 EC and are significantly associated with poor prognosis. It is likely that angiogenesis and inflammation associated with obesity have a significant impact on EC type 1 progression and survival rate of patients.

scholarly journals Clinical value of selected markers of angiogenesis, inflammation, insulin resistance and obesity in type 1 endometrial cancer

2019 ◽  
Author(s):  
Katarzyna M. Terlikowska ◽  
Bozena Dobrzycka ◽  
Robert Terlikowski ◽  
Anna Sienkiewicz ◽  
Maciej Kinalski ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Endometrial Cancer ◽  
Growth Factor ◽  
Myometrial Invasion ◽  
Serum Levels ◽  
Figo Stage ◽  
Cancer Type ◽  
Cox Regression Analysis ◽  
Angiopoietin 2

Abstract Background It is a well-known fact show that the risk of developing endometrial cancer (type 1 EC) is strongly associated with obesity. In this study, selected markers, such as obesity, insulin resistance, angiogenesis and inflammation markers related to EC type 1 progression and patients’ survival data were analyzed.Methods To measure levels of adiponectin, C-reactive protein (CRP), vascular endothelial growth factor-A (VEGF-A), angiopoietin-2 (Ang-2), insulin-like growth factor-1 (IGF-1), insulin and C-peptide in 176 preoperative serum samples, the immunoassay technique (EMIT) has been applied.Results Angiopoietin-2 levels increase with age (P=0.005), FIGO stage (p=0.042), myometrial invasion (P=0.009) and LVSI (P<0.001). The CRP levels increase with age (P=0.01), as well as the advancement of the FIGO stage (P<0.001), higher tumor grade (P=0.012), and myometrial invasion (P<0.001). A positive correlation between serum Ang-2 and CRP levels was demonstrated (r=0.44; p<0.001). Kaplan-Meier survival analysis showed that patients with high CRP levels in serum and Ang-2 presented a worse outcome (P=0.03 and P=0.015, respectively). Cox regression analysis of individual predictors revealed that high serum levels of Ang-2, CRP, advanced clinical FIGO stage (P<0.001, respectively), old age (P=0.013) were all significant overall survival predictors. By means of multivariate analysis, their predictive significance was confirmed.Conclusion Our study provides evidence that serum levels of Ang-2 and CRP may serve as predictors for assessment of the clinical stage of type 1 EC and are significantly associated with poor prognosis. It is likely that angiogenesis and inflammation associated with obesity, not only obesity itself, have a significant impact on EC type 1 progression and survival rate of patients.

Clinicopathological significance and prognostic value of intratumoral and peritumoral lymphocytes in endometrial cancer patients.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e17116-e17116
Author(s):  
Martin Ore-Arce ◽  
Carmen Illueca Ballester ◽  
Raquel Lopez-Reig ◽  
Monica Parra-Grande ◽  
Ignacio Romero ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Prognostic Value ◽  
Cytotoxic T Cells ◽  
Myometrial Invasion ◽  
Tumor Infiltrating Lymphocytes ◽  
Tp53 Gene ◽  
Figo Stage ◽  
Tumor Stage ◽  
Stage I ◽  
Clinicopathological Parameters

e17116 Background: The characterization and prognostic relevance of immune cells in the tumor microenvironment of endometrial cancer (EC) remain unknown. Our aims are to analyze the presence of tumor infiltrating lymphocytes (TIL) and peritumoral lymphocytes (PTL) in tumoral tissue of patients with EC, and to identify the correlation between TILs and PTLs subsets with clinicopathologic features and its prognostic value Methods: CD3, CD4, CD8, CD20, and FOXP-3 was determined by immunohistochemestry (IHQ). A 4-point score was defined based on TIL counts per highpowered field: (negative, low, moderate, and high). We used 10% positive peritumoral lymphocytes as a low-high cutoff value. POLE mutation was identified by Sanger sequencing of the exonuclease domain (exons 9-14). Analysis of mismatch repair expression and TP53 gene mutation status were assessed. Results from IHQ and analysis mutation were correlated with clinicopathological parameters and survival. Results: We recovered tumor samples from 68 FIGO stage I–IV EC patients. POLE mutations were identified in 5 of 44 (11.4%) EC analyzed. Microsatellite instability (MSI) and TP53 mutation were found in 45% and 25 % of cases respectively. According PTL, MSI tumors were significantly associated with low CD4+ (p = 0.01). High CD8+ was significantly associated with endometrioid grade 1-2 tumors (p = 0.04). Low FOXP3+ was significantly associated with endometrioid grade 1-2 (p = 0.02), MSS tumors (p < 0.01), FIGO stage I-II (p < 0.01), POLE WT (p < 0.01), TP53 WT (p < 0.01), and negative lymphovascular space invasion (p < 0.01). Negative CD20+ TIL was associated with endometrioid grade 1-2 tumors (p < 0.01) and ≥50% myometrial invasion (p = 0.03). Moderate CD8+ TIL was associated with lower tumor stage (p = 0.01). High CD8+ TIL was associated with better 5-year overall survival (OS) rate (high: 100 % vs. low: 53%; p = 0.003). No significant association was observed between POLE status, TP53 status, MMR expression and survival. Conclusions: Regulatory and cytotoxic T cells subsets differs in EC patients. High CD8+ TILs was significantly associated with better 5-year OS.

scholarly journals Adjuvant brachytherapy for FIGO stage I serous or clear cell endometrial cancer

2021 ◽  
pp. ijgc-2020-002217
Author(s):  
Elizabeth B Jeans ◽  
William G Breen ◽  
Trey C Mullikin ◽  
Brittany A Looker ◽  
Andrea Mariani ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Clear Cell ◽  
Early Stage ◽  
Figo Stage ◽  
Stage I ◽  
High Dose ◽  
Vaginal Cuff ◽  
Locoregional Failure ◽  
Platinum Based Chemotherapy ◽  
Increased Risk

ObjectivesOptimal adjuvant treatment for early-stage clear cell and serous endometrial cancer remains unclear. We report outcomes for women with surgically staged International Federation of Gynecology and Obstetrics (FIGO) stage I clear cell, serous, and mixed endometrial cancers following adjuvant vaginal cuff brachytherapy with or without chemotherapy.MethodsFrom April 1998 to January 2020, women with FIGO stage IA–IB clear cell, serous, and mixed endometrial cancer underwent surgery and adjuvant vaginal cuff brachytherapy. Seventy-six patients received chemotherapy. High-dose rate vaginal cuff brachytherapy was planned to a total dose of 21 gray in three fractions using a multichannel vaginal cylinder. The primary objective was to determine the effectiveness of adjuvant vaginal cuff brachytherapy and to identify surgicopathological risk factors that could portend towards worse oncological outcomes.ResultsA total of 182 patients were included in the analysis. Median follow-up was 5.3 years (2.3–12.2). Ten-year survival was 73.3%. Five-year cumulative incidence (CI) of vaginal, pelvic, and para-aortic relapse was 1.4%, 2.1%, and 0.9%, respectively. Five-year locoregional failure, any recurrence, peritoneal relapse, and other distant recurrence was 4.4%, 11.6%, 5.3%, and 6.7%, respectively. On univariate analysis, locoregional failure was worse for larger tumors (per 1 cm) (HR 1.9, 95% CI 1.2 to 3.0, p≤0.01). Any recurrence was worse for tumors of at least 3.5 cm (HR 3.8, 95% CI 1.3 to 11.7, p=0.02) and patients with positive/suspicious cytology (HR 4.4, 95% CI 1.5 to 12.4, p≤0.01). Ten-year survival for tumors of at least 3.5 cm was 56.9% versus 86.6% for those with smaller tumors (HR 2.9, 95% CI 1.4 to 5.8, p≤0.01). Ten-year survival for positive/suspicious cytology was 50.9% versus 77.4% (HR 2.2, 95% CI 0.9 to 5.4, p=0.09). Multivariate modeling demonstrated worse locoregional failure, any recurrence, and survival with larger tumors, as well as any recurrence with positive/suspicious cytology. Subgroup analysis demonstrated improved outcomes with the use of adjuvant chemotherapy in patients with large tumors or positive/suspicious cytology.ConclusionAdjuvant vaginal cuff brachytherapy alone without chemotherapy is an appropriate treatment for women with negative peritoneal cytology and small, early-stage clear cell, serous, and mixed endometrial cancer. Larger tumors or positive/suspicious cytology are at increased risk for relapse and worse survival, and should be considered for additional upfront adjuvant treatments, such as platinum-based chemotherapy.

scholarly journals Prognostic parameters in FIGO stage I endometrial carcinoma of endometrioid type

2006 ◽  
Vol 63 (12) ◽  
pp. 1006-1010 ◽  
Author(s):  
Zorica Stanojevic ◽  
Biljana Djordjevic
Keyword(s):  
Endometrial Carcinoma ◽  
Myometrial Invasion ◽  
Figo Stage ◽  
Histologic Grade ◽  
Stage I ◽  
Prognostic Parameters ◽  
Vascular Space ◽  
Vascular Space Invasion ◽  
Pathologic Parameters

Background/Aim. Endometrial carcinoma is the most common malignant neoplasm of the female genital tract in developed countries. Endometrioid carcinoma represents about three-fourths of all endometrial carcinoma. The aim of this study was to examine pathologic parameters, age, and the 5-year survival of the patients with FIGO stage I endometrial carcinoma of endometrioid type and to assess the prognostic utility of age, depth of myometrial invasion, hystologic type (endometrioid or variant), histologic grade, nuclear grade, and lymph-vascular space invasion. Methods. Age, pathologic parameters, and survival data were retrospectively collected on 236 patients with FIGO stage I endometrial carcinoma of endometrioid type. All the patients underwent hysterectomy between 1996 and 2000 and follow-up until December 2005. Results. A total of 236 patients (mean age 58.0, range 40?79) were analyzed. During the 5-year period of follow-up, 59 (25.0%) patents died from the disease. An univariate analysis revealed that age, depth of myometrial invasion, histologic grade, nuclear grade, and lymph-vascular space invasion were associated significantly with the 5-year survival of the patients. A multivariate analysis revealed that age, lymph-vascular space invasion, and depth of myometrial invasion were associated significantly with the 5-year survival. Conclusion. Age, lymph-vascular space invasion, and depth of myometrial invasion are independent prognostic parameters for the 5-year survival of the patients with FIGO stage I endometrial carcinoma of endometrioid type.

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