Endometrial cancer

Crosbie, Emma; Kitson, Sarah; McAlpine, Jessica N.; Mukhopadhyay, Asima; Powell, Melanie; Singh, Naveena

doi:10.1016/s0140-6736(22)00323-3

Cited by 608 publications

(508 citation statements)

References 155 publications

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“…The incidence of endometrial cancer is rising year on year, in line with the obesity epidemic ( 2 ). Deaths from endometrial cancer are also rising, albeit at a slower rate, despite improvements in overall survival ( 3 , 4 ). Although most women with endometrial cancer are diagnosed with highly curable disease and have a favourable prognosis, a significant minority present with adverse clinico-pathological characteristics that portend poor outcomes ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

Impact of Type 2 Diabetes Mellitus on Endometrial Cancer Survival: A Prospective Database Analysis

Njoku

Agnew²,

Crosbie³

2022

Front. Oncol.

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PurposeType 2 diabetes mellitus (T2DM) is an established risk factor for endometrial cancer but its impact on endometrial cancer survival outcomes is unclear. The aim of this study was to investigate whether pre-existing T2DM impacts survival outcomes in endometrial cancer.Patients and MethodsWomen diagnosed with endometrial cancer were recruited to a single centre prospective cohort study. Relevant sociodemographic and clinico-pathological data were recorded at baseline. T2DM status was based on clinical and biochemical assessment, verified by general practitioner records and analysed in relation to overall, cancer-specific and recurrence-free survival using Kaplan-Meier estimation and multivariable Cox-regression.ResultsIn total, 533 women with median age and BMI of 66 years (Interquartile range (IQR), 56, 73) and 32kg/m2 (IQR 26, 39) respectively, were included in the analysis. The majority had low-grade (67.3%), early-stage (85.1% stage I/II), endometrial cancer of endometrioid histological phenotype (74.7%). A total of 107 (20.1%) had pre-existing T2DM. Women with T2DM had a two-fold increase in overall mortality (adjusted HR 2.07, 95%CI 1.21-3.55, p=0.008), cancer-specific mortality (adjusted HR 2.15, 95% CI 1.05-4.39, p=0.035) and recurrence rates (adjusted HR 2.22, 95% CI 1.08-4.56, p=0.030), compared to those without, in multivariable analyses.ConclusionT2DM confers an increased risk of death in endometrial cancer patients. Well-designed longitudinal studies with large sample sizes are now needed to confirm these findings.

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Section: Introductionmentioning

confidence: 99%

Impact of Type 2 Diabetes Mellitus on Endometrial Cancer Survival: A Prospective Database Analysis

Njoku

Agnew²,

Crosbie³

2022

Front. Oncol.

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“…4 Nº variants also identified in the tumor/Nº variants in the tumor. 5 Nº variants also identified in the tumor/Nº variants in the corresponding sample. Nº = Number of.…”

Section: Pilot Study To Detect Somatic Variants In Minimally Invasive...mentioning

confidence: 85%

“…4 Nº variants also identified in the tumor/Nº variants in the tumor. 5 Nº variants also identified in the tumor/Nº variants in the corresponding sample. Minimally invasive samples: No variants were detected in one pap brush sample (endometrioid histology) and two vaginal self-samples (endometrioid and serous histologies) from the cases (Table 3, Supplementary Figure S1).…”

Section: Pilot Study To Detect Somatic Variants In Minimally Invasive...mentioning

confidence: 85%

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An Integrated Approach for the Early Detection of Endometrial and Ovarian Cancers (Screenwide Study): Rationale, Study Design and Pilot Study

Peremiquel-Trillas

Paytubi

Pelegrina

et al. 2022

JPM

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Screenwide is a case-control study (2017–2021) including women with incident endometrial and ovarian cancers (EC and OC), BRCA1/2 and MMR pathogenic variant carriers, and age-matched controls from three centers in Spain. Participants completed a personal interview on their sociodemographic factors, occupational exposure, medication, lifestyle, and medical history. We collected biological specimens, including blood samples, self-collected vaginal specimens, cervical pap-brush samples, uterine specimens, and, when available, tumor samples. The planned analyses included evaluation of the potential risk factors for EC/OC; evaluation of molecular biomarkers in minimally invasive samples; evaluation of the cost-effectiveness of molecular tests; and the generation of predictive scores to integrate different epidemiologic, clinical, and molecular factors. Overall, 182 EC, 69 OC, 98 BRCA pathogenic variant carriers, 104 MMR pathogenic variant carriers, and 385 controls were enrolled. The overall participation rate was 85.7%. The pilot study using 61 samples from nine EC cases and four controls showed that genetic variants at the variant allele fraction > 5% found in tumors (n = 61 variants across the nine tumors) were detected in paired endometrial aspirates, clinician-collected cervical samples, and vaginal self-samples with detection rates of 90% (55/61), 79% (48/61), and 72% (44/61) by duplex sequencing, respectively. Among the controls, only one somatic mutation was detected in a cervical sample. We enrolled more than 800 women to evaluate new early detection strategies. The preliminary data suggest that our methodological approach could be useful for the early detection of gynecological cancers.

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“…Postmenopausal bleeding is a symptom of endometrial cancer that prompts urgent investigation by a sequentially invasive diagnostic strategy, which includes transvaginal ultrasound scan, hysteroscopy, and endometrial biopsy [ 7 , 8 ]. This diagnostic approach exposes healthy women to unpleasant, painful, and anxiety-provoking tests that are avoidable in over 90% of cases, with huge financial implications for health service providers [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Urine CA125 and HE4 for the Triage of Symptomatic Women with Suspected Endometrial Cancer

Njoku

Barr

Sutton

et al. 2022

Cancers

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A simple, noninvasive and accurate detection tool that can triage women with suspected endometrial cancer for definitive testing will transform patient care. The aim of this study was to evaluate urine CA125 and HE4 levels for the detection of endometrial cancer in symptomatic women. This was a cross-sectional diagnostic accuracy study of 153 symptomatic women who underwent urgent diagnostic investigations for suspected endometrial cancer at a large gynecological cancer center. Urine samples were collected prior to routine clinical procedures. Urine CA125 and HE4 levels were determined using automated chemiluminescent enzyme immunoassays. Univariate and multivariable receiver operating characteristic (ROC) curve analyses were performed. Urine CA125 and HE4 were discovered to be significantly elevated in women with endometrial cancer, compared to controls (p < 0.001 and p = 0.01, respectively). Urine CA125 and HE4 detected endometrial cancer with an area under the ROC curve (AUC) of 0.89 (0.81, 0.98) and 0.69 (0.55, 0.83), respectively. CA125 exhibited good discriminatory potential for Type I and early-stage tumors (AUC 0.93 and 0.90, respectively). A diagnostic model that combined urine CA125 and transvaginal ultrasound-measured endometrial thickness predicted endometrial cancer with an AUC of 0.96 (0.91, 1.00). Urine CA125 displays potential as a diagnostic tool for symptomatic women with suspected endometrial cancer. When combined with transvaginal ultrasound-measured endometrial thickness, this patient-friendly, urine-based test could help triage women for invasive diagnostics or safe reassurance, reducing costs and improving patient experience.

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Endometrial cancer

Cited by 608 publications

References 155 publications

Impact of Type 2 Diabetes Mellitus on Endometrial Cancer Survival: A Prospective Database Analysis

Impact of Type 2 Diabetes Mellitus on Endometrial Cancer Survival: A Prospective Database Analysis

An Integrated Approach for the Early Detection of Endometrial and Ovarian Cancers (Screenwide Study): Rationale, Study Design and Pilot Study

Urine CA125 and HE4 for the Triage of Symptomatic Women with Suspected Endometrial Cancer

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