scholarly journals The Advance and Correlation of KRAS Mutation With the Fertility-Preservation Treatment of Endometrial Cancer in the Background of Molecular Classification Application

2021 ◽  
Vol 27 ◽  
Author(s):  
KeXuan Yu ◽  
Yiqin Wang
Keyword(s):  
Endometrial Cancer ◽  
Clinical Practice ◽  
Cancer Patients ◽  
Fertility Preservation ◽  
Tumor Grade ◽  
Molecular Classification ◽  
Molecular Characteristics ◽  
Histological Subtype ◽  
Younger Women

The annually increasing incidence of endometrial cancer in younger women has created a growing demand for fertility preservation. However, the diverse therapeutic efficacy among patients under the same histological subtype and the same tumor grade suggests the potential interference of the innate molecular characteristics. The molecular classification has now been applied in clinical practice and might help to stratify the endometrial cancer patients and individualize the therapy, but the candidates for the fertility-spared treatment are most likely to be subdivided in the subgroup lacking the specific signature. KRAS mutation has been linked to the malignant transition of the endometrium, while its role in molecular classification and fertility preservation is vague. Here, we mainly review the advance of molecular classification and the role of KRAS in endometrial cancer, as well as their correlation with fertility-preservation treatment.

scholarly journals Preoperative and intraoperative assesment of myometrial invasion and histological grade in endometrial cancer: Role of MRI and frozen section

2016 ◽  
Author(s):  
Rohit Raghunath Ranade
Keyword(s):  
Endometrial Cancer ◽  
Tumor Size ◽  
Early Stage ◽  
Frozen Section ◽  
Myometrial Invasion ◽  
Tumor Grade ◽  
Endometrial Biopsy ◽  
Intraoperative Frozen Section ◽  
Cervical Involvement

Introduction: The role of systematic lymphadenectomy in clinically early stage endometrial cancer is controversial. A number of factors can predict lymph node metastasis including myometrial invasion, tumor grade in endometrial cancers. The purpose of the present study is to evaluate the accuracy of preoperative MRI and intraoperative frozen section in determining the depth of myometrial invasion, cervical involvement, tumor size and lymph nodal status. We also studied the accuracy of preoperative endometrial biopsy and intraoperative frozen section in determining the grade of the tumor. Materials and Methods: Medical records of 235 consecutive cases of clinically early stage endometrial cancer were reviewed retrospectively. A record of depth of myometrial invasion, tumor size, cervical involvement and presence of enlarged lymph nodes was made on a preoperative MRI. Similarly depth of myometrial invasion, tumor size, cervical involvement and grade of the tumor were recorded on an intraoperative frozen section. The grade of the tumor was also recorded on a preoperative endometrial biopsy. Standard statistical calculations were used. Results: The sensitivity and specificity of MRI for myometrial invasion for the first 160 cases were 81.3 and 75%, respectively while that for frozen section were 80 and 96.2%, respectively. For tumor grade the sensitivity and specificity of preoperative endometrial biopsy were 60 and 95.6%, respectively while that of frozen section were 53.8 and 97.6%, respectively. For cervical involvement the sensitivity of MRI and frozen section was 62.5 and 98.4%, respectively. Updated results of the entire cohort of 235 cases will be presented at the conference if selected. Conclusion: Although the sensitivity of both frozen section and MRI for predicting deep myometrial invasion was similar (80 vs 81.3%) but the specificity (96.2 vs 75%) and negative predictive value (92.7 vs 88.2%) of frozen section were superior to MRI. Both preoperative biopsy and intraoperative frozen section had low sensitivity (60 vs 53.8%) for detecting a high grade lesion.

Preoperative quantitative dynamic contrast-enhanced MRI and diffusion-weighted imaging predict aggressive disease in endometrial cancer

2017 ◽  
Vol 59 (8) ◽  
pp. 1010-1017 ◽  
Author(s):  
Kristine E Fasmer ◽  
Atle Bjørnerud ◽  
Sigmund Ytre-Hauge ◽  
Renate Grüner ◽  
Ingvild L Tangen ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Cancer Patients ◽  
Diffusion Weighted Imaging ◽  
Histological Subtype ◽  
Dce Mri ◽  
Aggressive Disease ◽  
Imaging Parameters ◽  
Dynamic Contrast Enhanced ◽  
Contrast Enhanced ◽  
And Diffusion

Background Quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) may yield preoperative tumor biomarkers relevant for prognosis and therapy in cancer. Purpose To explore the value of preoperative DCE-MRI and DWI for the prediction of aggressive disease in endometrial cancer patients. Material and Methods Preoperative MRI (1.5-T) from 177 patients were analyzed and imaging parameters reflecting tumor microvasculature (from DCE-MRI) and tumor microstructure (from DWI) were estimated. The derived imaging parameters were explored in relation to clinico-pathological stage, histological subtype and grade, molecular markers, and patient outcome. Results Low tumor blood flow (Fb) and low rate constant for contrast agent intravasation (kep) were associated with high-risk histological subtype ( P ≤ 0.04 for both) and tended to be associated with poor prognosis ( P ≤ 0.09). Low tumor apparent diffusion coefficient (ADC) value and large tumor volume were both significantly associated with deep myometrial invasion ( P < 0.001 for both) and were also unfavorable prognostic factors ( P = 0.05 and P < 0.001, respectively). Conclusion DCE-MRI and DWI represent valuable supplements to conventional MRI by providing preoperative imaging biomarkers that predict aggressive disease in endometrial cancer patients.

scholarly journals Improvements in Clinical Practice for Fertility Preservation Among Young Cancer Patients: Results from Bundled Interventions

2018 ◽  
Vol 7 (1) ◽  
pp. 37-45 ◽  
Author(s):  
Natalie K. Bradford ◽  
Roderick Walker ◽  
Roslyn Henney ◽  
Po Inglis ◽  
Raymond J. Chan
Keyword(s):  
Clinical Practice ◽  
Cancer Patients ◽  
Fertility Preservation

MRI of the endometrium - from normal appearances to rare pathology

2021 ◽  
pp. 20201347
Author(s):  
Roxana Pintican ◽  
Vlad Bura ◽  
Marta Zerunian ◽  
Janette Smith ◽  
Helen Addley ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Endometrial Cancer ◽  
Cancer Patients ◽  
Endometrial Hyperplasia ◽  
Surgical Planning ◽  
Disease Extent ◽  
Mri Protocol ◽  
Essential Knowledge ◽  
Post Menopausal

MRI was recently included as a standard pre-operative diagnostic tool for patients with endometrial cancer. MR findings allow a better risk assessment and ultimately guides the surgical planning. Therefore, it is vital that the radiological interpretation is as accurate as possible. This requires essential knowledge regarding the appropriate MRI protocol, as well as different appearances of the endometrium, ranging from normal peri- and post-menopausal changes, benign findings (e.g. endometrial hyperplasia, polyp, changes due to exogenous hormones) to common and rare endometrium-related malignancies. Furthermore, this review will emphasize the role of MRI in staging endometrial cancer patients and highlight pitfalls that could result in the underestimation or overestimation of the disease extent.

Gynecologic Cancer InterGroup (GCIG) Consensus Review for Uterine Serous Carcinoma

2014 ◽  
Vol 24 (Supp 3) ◽  
pp. S83-S89 ◽  
Author(s):  
Satoru Sagae ◽  
Nobuyuki Susumu ◽  
Akila N. Viswanathan ◽  
Daisuke Aoki ◽  
Floor J. Backes ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Gynecologic Cancer ◽  
Survival Rates ◽  
Serous Carcinoma ◽  
Molecular Characteristics ◽  
Histologic Subtype ◽  
High Propensity ◽  
Stage Disease ◽  
Uterine Serous Carcinoma

ObjectivesUterine serous carcinoma (USC) represents a rare and aggressive histologic subtype of endometrial cancer, associated with a poor prognosis. This article critically reviews the literature pertinent to the epidemiology, pathology, molecular biology, diagnosis, management, and perspectives of patients with USC.MethodsAs one of a series of The Gynecologic Cancer InterGroup (GCIG) Rare Tumor Working Group in London, November 2013, we discussed about USC many times with various experts among international GCIG groups.ResultsBoth USC and approximately 25% of high-grade endometrioid tumors represent extensive copy number alterations, few DNA methylation changes, low estrogen and progesterone levels, and frequent P53mutations. Uterine serous carcinoma shares molecular characteristics with ovarian serous and basal-like breast carcinomas. In addition to optimal surgery, platinum- and taxane-based chemotherapy should be considered in the treatment of both early- and advanced-stage disease. The combination of radiation and chemotherapy appears to be associated with the highest survival rates. The role of radiation therapy in the management of this disease, with a high propensity for distant failures, remains elusive.ConclusionsUterine serous carcinoma is a unique and biologically aggressive subtype of endometrial cancer and should be studied as a distinct entity. Futures studies should identify the optimized chemotherapy and radiation regimens, sequence of therapy and schedule, and the role of targeted biologic therapy.

scholarly journals From guidelines to clinical practice: a roadmap for oncologists for nutrition therapy for cancer patients

2019 ◽  
Vol 11 ◽  
pp. 175883591988008 ◽  
Author(s):  
Maurizio Muscaritoli ◽  
Jann Arends ◽  
Matti Aapro
Keyword(s):  
Treatment Outcome ◽  
Clinical Practice ◽  
Nutritional Status ◽  
Cancer Patient ◽  
Cancer Patients ◽  
European Society ◽  
Nutrition Therapy ◽  
Challenging Tasks ◽  
Robust Evidence

Tackling malnutrition in cancer patients remains one of the most challenging tasks in clinical practice. Even though robust evidence exists stressing the role of nutritional status in relation to treatment outcome, its appropriate consideration in clinical practice is often lacking. In this review, we discuss the significance of nutritional status and of malnutrition for the cancer patient. Drawn from experience and from current recommendations of the European Society for Clinical Nutrition and Metabolism (ESPEN), we propose concrete and manageable steps to routinely incorporate nutritional aspects in today’s oncological clinical practice.

scholarly journals Role of Human Epididymis Protein 4 (HE4) in Determining Survival of Patients With Endometrial Cancer: A Meta-Analysis

2020 ◽  
Vol 19 ◽  
pp. 153303382097166
Author(s):  
Ying He ◽  
Jing Wang ◽  
Chun-Xing Ma ◽  
Yan-Hua Kang
Keyword(s):  
Endometrial Cancer ◽  
Cancer Patients ◽  
Science Studies ◽  
Meta Analysis ◽  
High Serum ◽  
Baseline Serum ◽  
Human Epididymis Protein 4 ◽  
Human Epididymis ◽  
Low Serum

Background: Human epididymis protein 4 (HE4) is a novel cancer biomarker. This study evaluates the prognostic role of HE4 in determining the survival of endometrial cancer patients. Methods: Literature search was conducted in electronic databases (Embase, Ovid, PubMed, Scopus, and Web of Science). Studies were selected if they reported the relationship between HE4 and the survival of endometrial cancer patients. Random-effects meta-analyses were performed to achieve estimates of baseline serum HE4 levels, the 5-year survival with high and low serum HE4 levels/expression, and the hazard ratios (HRs) of the survival between patients with high and low serum HE4 levels. Results: 9 studies (1404 patients; age 63.1 years [95% confidence interval (CI): 61.2, 64.9]; follow-up 35.9 months [95% CI: 32.2, 39.6]) were included. In these patients, serum HE4 levels were 83.36 picomole/liter (pM) [95% CI: 70.15, 96.56] overall but these were higher in patients with recurrence (108.13 pM [95% CI: 63.09, 153.18] and lower in patients with no recurrence (67.88 pM [95% CI: 65.09, 70.67]). The 5-year overall survival rate was higher in patients with low HE4 levels/expression (86% [95% CI: 79, 92] but lower in patients with high HE4 levels/expression (63% [95% CI: 58, 68]. A pooled HR of survival between patients with high and low serum HE4 levels of 2.25 [95% CI: 1.56, 2.94] indicated shorter survival in patients with high serum HE4 levels. Conclusion: High HE4 concentrations in patients with endometrial cancer are found to be associated with shorter survival.

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