AN UNUSUAL CASE OF ISOLATED PULMONARY RECURRENCE IN EARLY STAGE ENDOMETRIOID ENDOMETRIAL CARCINOMA EIGHT YEARS AFTER INITIAL DIAGNOSIS AND TREATMENT

Endometrial cancer is the only gynecological cancer that is rising in incidence and associated mortality worldwide. Although most cases are diagnosed as early stage disease, with chances of cure after primary surgical treatment, those with advanced or metastatic disease have a poor prognosis because of the quality of treatment options that are currently available. Mismatch repair (MMR)-deficient cancers are susceptible to programmed cell death protein 1 (PD-1)/programmed cell death ligand 1 inhibitors. The US Food and Drug Administration granted accelerated approval to pembrolizumab for MMR-deficient tumors, the first tumor-agnostic approval for a drug. We present a case of stage IV endometrioid endometrial carcinoma with isolated PMS2 protein loss, in which treatment with first-line pembrolizumab therapy achieved a complete clinical and pathological response of tumor.

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Tumor progression, metastasis, and modulators of epithelial–mesenchymal transition in endometrioid endometrial carcinoma: an update

Endocrine Related Cancer ◽

10.1530/erc-15-0218 ◽

2015 ◽

Vol 23 (2) ◽

pp. R85-R111 ◽

Cited By ~ 32

Author(s):

Annu Makker ◽

Madhu Mati Goel

Keyword(s):

High Risk ◽

Tumor Progression ◽

Endometrial Carcinoma ◽

Molecular Mechanisms ◽

Epithelial Mesenchymal Transition ◽

Current Knowledge ◽

Early Stage ◽

Invasion And Metastasis ◽

Mesenchymal Transition ◽

Endometrioid Endometrial Carcinoma

Endometrioid endometrial carcinoma (EEC), also known as type 1 endometrial cancer (EC), accounts for over 70–80% of all cases that are usually associated with estrogen stimulation and often develops in a background of atypical endometrial hyperplasia. The increased incidence of EC is mainly confined to this type of cancer. Most EEC patients present at an early stage and generally have a favorable prognosis; however, up to 30% of EEC present as high risk tumors, which have invaded deep into the myometrium at diagnosis and progressively lead to local or extra pelvic metastasis. The poor survival of advanced EC is related to the lack of effective therapies, which can be attributed to poor understanding of the molecular mechanisms underlying the progression of disease toward invasion and metastasis. Multiple lines of evidence illustrate that epithelial–mesenchymal transition (EMT)-like events are central to tumor progression and malignant transformation, endowing the incipient cancer cell with invasive and metastatic properties. The aim of this review is to summarize the current knowledge on molecular events associated with EMT in progression, invasion, and metastasis of EEC. Further, the role of epigenetic modifications and microRNA regulation, tumor microenvironment, and microcystic elongated and fragmented glands like invasion pattern have been discussed. We believe this article may perhaps stimulate further research in this field that may aid in identifying high risk patients within this clinically challenging patient group and also lead to the recognition of novel targets for the prevention of metastasis – the most fatal consequence of endometrial carcinogenesis.

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Early recurrence of early stage endometrioid endometrial carcinoma: Possible etiologic pathways and management options

Maturitas ◽

10.1016/j.maturitas.2014.04.009 ◽

2014 ◽

Vol 78 (3) ◽

pp. 155-159 ◽

Cited By ~ 1

Author(s):

Christos Iavazzo ◽

Ioannis D. Gkegkes ◽

Nikolaos Vrachnis

Keyword(s):

Endometrial Carcinoma ◽

Early Stage ◽

Early Recurrence ◽

Management Options ◽

Endometrioid Endometrial Carcinoma

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48 A local study on survival outcome and prognostic significance of lower uterine segment involvement in early stage endometrioid endometrial carcinoma

10.1136/ijgc-2020-igcs.47 ◽

2020 ◽

Author(s):

J Abrenica ◽

J Madera

Keyword(s):

Endometrial Carcinoma ◽

Early Stage ◽

Prognostic Significance ◽

Survival Outcome ◽

Lower Uterine Segment ◽

Local Study ◽

Endometrioid Endometrial Carcinoma

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Myoinvasive Pattern as a Prognostic Marker in Low-Grade, Early-Stage Endometrioid Endometrial Carcinoma

Cancers ◽

10.3390/cancers11121845 ◽

2019 ◽

Vol 11 (12) ◽

pp. 1845 ◽

Cited By ~ 2

Author(s):

Ignacio Ruz-Caracuel ◽

Jorge L Ramón-Patino ◽

Álvaro López-Janeiro ◽

Laura Yébenes ◽

Alberto Berjón ◽

...

Keyword(s):

Prognostic Factor ◽

Microsatellite Instability ◽

Endometrial Carcinoma ◽

Early Stage ◽

Disease Free Survival ◽

Figo Stage ◽

Low Grade ◽

Gynecology And Obstetrics ◽

Endometrioid Endometrial Carcinoma ◽

Endometrial Carcinomas

Low-grade and early Federation for Gynecology and Obstetrics (FIGO) stage endometrioid endometrial carcinomas (EEC) have an excellent prognosis. However, approximately 10% of patients develop recurrence, which cannot be correctly predicted at diagnosis. We evaluated myoinvasive patterns as a prognostic factor of relapse in low-grade, early-stage EEC. Two-hundred and fifty-eight cases were selected according to the following inclusion criteria: (i) endometrioid endometrial carcinomas, (ii) grade 1 or 2 with (iii) FIGO stage I or II, and (iv) clinical follow-up. Slides were reviewed to annotate the myoinvasive pattern present in each case (infiltrative glands, microcystic, elongated and fragmented –MELF-, broad front, adenomyosis-like and adenoma malignum). Microsatellite instability was studied by immunoexpression of mismatch repair proteins (MLH1, PMS2, MSH2, and MSH6). There were 29 recurrences (11.2%) among the 258 cases analysed. A predominant broad front myoinvasive pattern was significantly associated with tumour relapse (p = 0.003). The presence of a pattern of infiltrative glands (p = 0.001) and microsatellite instability (p = 0.004) were associated with lower disease-free survival, without having an impact on overall survival. Our observations suggest the potential value of the pattern of myoinvasion as a prognostic factor in low-grade, early-stage endometrioid endometrial carcinoma.

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