scholarly journals Fertility-Sparing Treatment of Patients with Endometrial Cancer: A Review of the Literature

2021 ◽  
Vol 10 (20) ◽  
pp. 4784
Author(s):  
Umberto Leone Roberti Maggiore ◽  
Rola Khamisy-Farah ◽  
Nicola Luigi Bragazzi ◽  
Giorgio Bogani ◽  
Fabio Martinelli ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Female Genital Tract ◽  
Young Patients ◽  
Developed Countries ◽  
Significant Shift ◽  
High Quality Evidence ◽  
Fertility Sparing ◽  
Rich Countries ◽  
Common Malignancy ◽  
Female Genital

Endometrial cancer (EC) is currently the most common malignancy of the female genital tract in developed countries. Although it is more common in postmenopausal women, it may affect up to 25% in the premenopausal age and 3–5% under the age of 40 years. Furthermore, in the last decades a significant shift to pregnancy at older maternal ages, particularly in resource-rich countries, has been observed. Therefore, in this scenario fertility-sparing alternatives should be discussed with patients affected by EC. This study summarizes available literature on fertility-sparing management of patients affected by EC, focusing on the oncologic and reproductive outcomes. A systematic computerized search of the literature was performed in two electronic databases (PubMed and MEDLINE) in order to identify relevant articles to be included for the purpose of this systematic review. On the basis of available evidence, fertility-sparing alternatives are oral progestins alone or in combination with other drugs, levonorgestrel intrauterine system and hysteroscopic resection in association with progestin therapies. These strategies seem feasible and safe for young patients with G1 endometrioid EC limited to the endometrium. However, there is a lack of high-quality evidence on the efficacy and safety of fertility-sparing treatments and future well-designed studies are required.

scholarly journals Controversies in the Management of Endometrial Carcinoma: An Update

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Mohamed K. Mehasseb ◽  
John A. Latimer
Keyword(s):  
Radiation Therapy ◽  
Endometrial Cancer ◽  
Early Detection ◽  
Endometrial Carcinoma ◽  
Genital Tract ◽  
Female Genital Tract ◽  
Developed Countries ◽  
Changing Roles ◽  
The Developed Countries ◽  
Female Genital

Endometrial carcinoma is the commonest type of female genital tract malignancy in the developed countries. Endometrial carcinoma is usually confined to the uterus at the time of diagnosis and as such usually carries an excellent prognosis with high curability. Our understanding and management of endometrial cancer have continuously developed. Current controversies focus on screening and early detection, the extent of nodal surgery, and the changing roles of radiation therapy and chemotherapy and will be discussed in this paper.

scholarly journals Fertility-Sparing Methods in Adolescents Affected by Endometrial Cancer: A Comprehensive Review

2021 ◽  
Vol 10 (5) ◽  
pp. 1020
Author(s):  
Krzysztof Gałczyński ◽  
Piotr Olcha ◽  
Katarzyna Romanek-Piva ◽  
Maciej Jóźwik ◽  
Andrzej Semczuk
Keyword(s):  
Endometrial Cancer ◽  
World Literature ◽  
Young Patients ◽  
Developed Countries ◽  
Type I ◽  
Genetic Syndromes ◽  
Patient Death ◽  
Future Fertility ◽  
Fertility Sparing

Although in developed countries endometrial cancer (EC) is the most common gynecological malignancy, its occurrence in adolescents is exceedingly rare. The increasing rate of obesity in children and adolescents is held responsible for the increasing prevalence of EC in younger cohorts of patients. The diagnosis of this malignancy can have devastating consequences for future fertility because standard treatment protocols for EC include hysterectomy. Here, we present the first detailed review of the world literature on EC in subjects aged 21 years or younger (n = 19). The mean age at diagnosis was 16.7 ± 0.6 years. One patient (5.3%) had a Type II (high-risk) disease. No communication retrieved from the search reported on patient death; however, two (10.5%) patients were lost to follow-up. There was also a high proportion (five subjects, or 26.3%) of cases with genetic background (Cowden syndrome and Turner syndrome), therefore genetic screening or a direct genetic study should be considered in very young patients with EC. The current fertility-sparing options, limited to Type I (low-risk) disease, are presented and discussed. Such information, obtained from studies on older women, translates well to adolescent girls and very young women. Careful anatomopathological monitoring at follow-up is essential for the safety of a conservative approach. Improved survival in very young EC patients makes the preservation of fertility a central survivorship issue, therefore both patients and caregivers should undergo counseling regarding available options. Moreover, our study suggests that genetic syndromes other than Lynch syndrome may be associated with EC more frequently than previously thought.

scholarly journals Controversies in the Management of Endometrial Cancer

2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
V. Masciullo ◽  
G. Amadio ◽  
D. Lo Russo ◽  
I. Raimondo ◽  
A. Giordano ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Genital Tract ◽  
Female Genital Tract ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Curative Therapy ◽  
Sixth Decade ◽  
Common Malignancy ◽  
Female Genital

Endometrial cancer (EC) remains the most common malignancy of the female genital tract. The median age at diagnosis is the sixth decade, with abnormal uterine bleeding at the presentation in 90% of the patients. Surgical treatment, including complete hysterectomy, removal of remaining adnexal structures, and an appropriate surgical staging, represents the milestone of curative therapy for patients with EC. Adjuvant therapy is necessary in patients at high risk of recurrence. Conservative treatment approaches should be used in selected cases for women with a desire of fertility preservation. This review summarizes the management of EC and discusses current controversies regarding the role of lymphadenectomy and radiotherapy in patients with intermediate-risk tumors confined to the uterus.

scholarly journals A Pyrosequencing Assay for the Quantitative Methylation Analysis ofGALR1in Endometrial Samples: Preliminary Results

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Christine Kottaridi ◽  
Nikolaos Koureas ◽  
Niki Margari ◽  
Emmanouil Terzakis ◽  
Evripidis Bilirakis ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Genital Tract ◽  
Critical Role ◽  
Female Genital Tract ◽  
Methylation Analysis ◽  
Preliminary Results ◽  
Pyrosequencing Assay ◽  
Aberrant Dna Methylation ◽  
Common Malignancy ◽  
Female Genital

Endometrial cancer is the most common malignancy of the female genital tract while aberrant DNA methylation seems to play a critical role in endometrial carcinogenesis. Galanin’s expression has been involved in many cancers. We developed a new pyrosequencing assay that quantifies DNA methylation of galanin’s receptor-1 (GALR1). In this study, the preliminary results indicate that pyrosequencing methylation analysis ofGALR1promoter can be a useful ancillary marker to cytology as the histological status can successfully predict. This marker has the potential to lead towards better management of women with endometrial lesions and eventually reduce unnecessary interventions. In addition it can provide early warning for women with negative cytological result.

scholarly journals High Expression of Ecto-Nucleotidases CD39 and CD73 in Human Endometrial Tumors

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Elisabet Aliagas ◽  
August Vidal ◽  
Laura Texidó ◽  
Jordi Ponce ◽  
Enric Condom ◽  
...  
Keyword(s):  
Gene Expression ◽  
Endometrial Cancer ◽  
Genital Tract ◽  
Female Genital Tract ◽  
Tumor Grade ◽  
Type I ◽  
Type Ii ◽  
Extracellular Adenosine ◽  
Serous Tumors ◽  
Female Genital

One of the strategies used by tumors to evade immunosurveillance is the accumulation of extracellular adenosine, which has immunosupressive and tumor promoting effects. The study of the mechanisms leading to adenosine formation at the tumor interstitium are therefore of great interest in oncology. The dominant pathway generating extracellular adenosine in tumors is the dephosphorylation of ATP by ecto-nucleotidases. Two of these enzymes acting sequentially, CD39 and CD73, efficiently hydrolyze extracellular ATP to adenosine. They have been found to play a crucial role in a variety of tumors, but there were no data concerning endometrial cancer, the most frequent of the invasive tumors of the female genital tract. The aim of the present work is to study the expression of CD39 and CD73 in human endometrial cancer. We have analyzed protein and gene expression, as well as enzyme activity, in type I endometrioid adenocarcinomas and type II serous adenocarcinomas and their nonpathological endometrial counterparts. High levels of both enzymes were found in tumor samples, with significantly increased expression of CD39 in type II serous tumors, which also coincided with the higher tumor grade. Our results reinforce the involvement of the adenosinergic system in cancer, emphasizing the relevance of ecto-nucleotidases as emerging therapeutic targets in oncology.

scholarly journals Patterns of Myometrial Invasion in Endometrial Adenocarcinoma with Emphasizing on Microcystic, Elongated and Fragmented (MELF) Glands Pattern: A Narrative Review of the Literature

Diagnostics ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 1707
Author(s):  
Svetlana Mateva ◽  
Margarita Nikolova ◽  
Angel Yordanov
Keyword(s):  
Scientific Literature ◽  
Endometrial Adenocarcinoma ◽  
Female Genital Tract ◽  
Myometrial Invasion ◽  
Staging System ◽  
Tumor Spread ◽  
Precise Assessment ◽  
Common Malignancy ◽  
Female Genital ◽  
Morphological Patterns

Endometrioid endometrial adenocarcinoma (EEC) is the most common malignancy of the female genital tract. According to the 2009 FIGO staging system, the depth of myometrial invasion (MI), and tumor spread to adjacent organs or tissues are the staging criteria for endometrial carcinoma (EC). Therefore, assessment of the depth of MI is of great importance. There is a spectrum of morphological patterns of MI. Still, their number and features vary according to the scientific literature, with a certain overlap that creates difficulties and controversies in the precise assessment of MI depth. The purpose of this review is to present and discuss the most important and recent information about patterns of MI, focusing on the more aggressive and the elongated and fragmented glands (MELF) pattern in particular. Assessment of MI depth and correct staging of EC is possible only after the precise recognition of each MI pattern.

scholarly journals Malignant Tumors of the Female Genital Tract – a Hospital Based Analysis

2016 ◽  
Vol 10 (2) ◽  
pp. 24-28
Author(s):  
R Joshi ◽  
G Baral ◽  
K Malla
Keyword(s):  
Ovarian Cancer ◽  
Cervical Cancer ◽  
Endometrial Cancer ◽  
Genital Tract ◽  
Malignant Tumors ◽  
Female Genital Tract ◽  
Limited Data ◽  
Corpus Uteri ◽  
Female Genital

Aims: The incidence of cancer and the cancer related deaths are increasing worldwide. There is limited data regarding  gynecological cancers in Nepal. This study is conducted to analyze the trends of female genital tract malignancies in Paropakar Maternity and Women’s Hospital (PMWH) and compare it with the national/international data.Methods: This was a retrospective study conducted in Department of Obstetrics/Gynecology and Pathology in PMWH.  All female diagnosed with the genital tract malignancies from July 2013 to July 2015 were included in the study.Results: Among 62 cases, cervical cancer was the commonest (71%) followed by ovarian cancer (14%), endometrial cancer (8%) and choriocarcinoma (3%). Majority of women belonged to 50-59 years for each type of tumors. Four-fifth of endometrial, half of the cervical and one-third of ovarian cancers were among grand-multipara. Sixty nine percent of women received treatment with 22 (9 cervical, 9 ovarian, 3 endometrial and one of corpus uteri)  surgical and 21 primary chemo/radiotherapy but 19 (31%) were lost for follow-up. Squamous type of cervical cancer was the commonest (93%).Conclusions: Cervical cancer was the commonest genital tract malignancy followed by ovarian cancer, endometrial cancer and choriocarcinoma. For each type of tumors, 50-59 years was the common age group and grand multiparity was seen in half of the women with the cervical cancer. Squamous type of cervical cancer was the commonest variety.  

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