Cancer of the endometrium: current aspects of diagnostics and treatment

Münstedt, Karsten; Grant, Phillip; Woenckhaus, J. W.; Roth, G.P.; Tinneberg, Hans‐Rudolf

doi:10.1186/1477-7819-2-24

Cited by 40 publications

(13 citation statements)

References 129 publications

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“…Nowadays, more than 1 in 20 female cancers in Europe are of the endometrium. [1][2][3][4][5][6][7][8][9][10] Contrary to cervical carcinoma, no screening programs have been organized for the early detection of endometrial adenocarcinoma. The lack of screening programs may be related to the precocious presenting symptoms and to the relative good prognosis of the majority of endometrial adenocarcinomas.…”

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confidence: 99%

Liquid‐based endometrial cytology in the management of sonographically thickened endometrium

Buccoliero

Gheri

Castiglione

et al. 2007

Diagnostic Cytopathology

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Liquid-based cytology represents an opportunity to re-evaluate endometrial cytology. We evaluated the accuracy of liquid-based endometrial cytology as compared to biopsy in 670 women scheduled for histeroscopy because of thickened endometrium (>4 mm), as evaluated by transvaginal sonography. Endometrial biopsy detected pathology in 41 (6%) of cases (21 of which were adenocarcinomas). Cytologic study found pathology in 62 (9%) cases (19 of which were adenocarcinomas). Two hundred ninety-one biopsies (43%) and 28 (4%) cytologies were inadequate. The sensitivity and the specificity were estimated, respectively, at 95% and 98%; the positive and negative predictive values were estimated, respectively, at 83% and 99%. Cytology provided sufficient material more often than biopsy (P < 0.01). We consider endometrial cytology an efficacious diagnostic opportunity. It could be usefully applied in association with transvaginal sonography. The combination of these procedures might reduce more invasive and expensive diagnostic procedures. Diagn. Cytopathol. 2007;35:398-402. ' 2007 Wiley-Liss, Inc.Key Words: thin-layer; liquid-based; endometrial cytology; endometrial adenocarcinoma; endometrial hyperplasia Endometrial adenocarcinoma is the most common malignancy of the female genital tract. A significant increase in its frequency, both absolute and relative, has been observed during the last decades. This increase is considered the consequence of the extended life expectancy of women, the increase in the incidence of risk factors, and of the reduction of invasive cervical carcinomas. Nowadays, more than 1 in 20 female cancers in Europe are of the endometrium. [1][2][3][4][5][6][7][8][9][10] Contrary to cervical carcinoma, no screening programs have been organized for the early detection of endometrial adenocarcinoma. The lack of screening programs may be related to the precocious presenting symptoms and to the relative good prognosis of the majority of endometrial adenocarcinomas. Early abnormal uterine bleeding, the commonest presenting symptom for the 95% of women, allows diagnosis at stage I in 73% of cases. 11 Moreover, there has not been an endometrial test comparable to cervicovaginal cytology for diagnostic reliability, tolerability, and low cost.Several diagnostic procedures are used for investigating the endometrium, but there is no common agreement for the optimum approach in each circumstance (i.e. symptomatic vs. asymptomatic; with risk factors vs. without risk factors).Endometrial cytology has been hampered in its dissemination by the difficulty in its interpretation due to the common presence of excess blood and overlapping cells. Liquid-based cytology represents an opportunity to reexamine endometrial cytology. We conducted the current study to correlate the results of liquid-based endometrial cytology with the results of endometrial biopsy in a group of 670 women scheduled for hysteroscopy because of thick endometrium (>4 mm), as evaluated by transvaginal sonography (TVS). Our purpose was preliminarily to asce...

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confidence: 99%

Liquid‐based endometrial cytology in the management of sonographically thickened endometrium

Buccoliero

Gheri

Castiglione

et al. 2007

Diagnostic Cytopathology

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“…Finally, the long-term use of tamoxifen, with its paradoxical estrogen agonist effect in the uterus, can also lead to type I endometrial cancer. 58 …”

Section: Endometrial Cancermentioning

confidence: 99%

Chapter 2 Progesterone Receptor Action in Leiomyoma and Endometrial Cancer

Kim¹,

Sefton²,

Bulun³

2009

Progress in Molecular Biology and Translational Science

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Progesterone is a key hormone in the regulation of uterine function. In the normal physiological context, progesterone is primarily involved in remodeling of the endometrium and maintaining a quiescent myometrium. When pathologies of the uterus develop, specifically, endometrial cancer and uterine leiomyoma, response to progesterone is usually altered. Progesterone acts through mainly two isoforms of the progesterone receptor (PR), PRA and PRB which have been reported to exhibit different transcriptional activities. Studies examining the expression and function of the PRs in the normal endometrium and myometrium as well as in endometrial cancer and uterine leiomyoma are summarized here. The clinical use of progestins and the transcriptional activity of the PR on genes specific to endometrial cancer and leiomyoma are described. An increased understanding of the differential expression of PRs and response to progesterone in these two diseases is critical in order to develop more efficient and targeted therapies.

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“…For example, the highest incidence is observed in Western Europe, United States, and Canada, while in comparison, Africa and Asia are shown to have the lowest rates of incidence. [5] The overall increase in the incidence of this disease during the last decades is mainly related to higher life expectancy within the developed world. [5] Endometrial cancer is often described as principally a menopausal state disease, since the majority of the cases occur in advanced age.…”

Section: Introductionmentioning

confidence: 99%

“…[5] The overall increase in the incidence of this disease during the last decades is mainly related to higher life expectancy within the developed world. [5] Endometrial cancer is often described as principally a menopausal state disease, since the majority of the cases occur in advanced age. [4,5,6,8] The risk of endometrial cancer increases with the age of the woman.…”

Section: Introductionmentioning

confidence: 99%

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Robotic Surgery in the Management of Endometrial Cancer

Williams¹,

Villeneuve²,

Robinson-Bennett³

2016

Gynecologic Cancers - Basic Sciences, Clinical and Therapeutic Perspectives

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Endometrial cancer remains the most common gynecologic malignancy in the Unites States and Western Europe. It has been estimated that in 2014, about 52, 630 new cases of endometrial cancer was diagnosed and about 8,590 died from the disease. Prior to 1988, endometrial cancer was staged clinically. Since that time surgical staging has been adopted. With the advancement in technology, the vast majority of cases are being staged and treated surgically via minimally invasive approaches. Conventional laparoscopy has been a major advancement in staging and treatment of uterine cancers. However, technical challenges such as 2-D imaging, rigid instruments, and lack of precision and surgeon fatigue did not translate into widespread adoption of this technique. With the advent of computer-enhanced robotic telesurgery, this has dramatically changed the surgical management and staging of endometrial cancer.

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Cancer of the endometrium: current aspects of diagnostics and treatment

Cited by 40 publications

References 129 publications

Liquid‐based endometrial cytology in the management of sonographically thickened endometrium

Liquid‐based endometrial cytology in the management of sonographically thickened endometrium

Chapter 2 Progesterone Receptor Action in Leiomyoma and Endometrial Cancer

Robotic Surgery in the Management of Endometrial Cancer

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