Prognostic factors in endometrial carcinoma

Abstract

Endometrial carcinoma is the most common malignancy of the female genital tract in industrialized countries, and occurs predominantly after the menopause. Although most endometrial carcinomas are detected at low stage, there is still a significant mortality from the disease. In postmenopausal women, prolonged life expectancy, changes in reproductive behavior and prevalence of overweight and obesity, as well as hormone replacement therapy use, may partially account for the observed increases of incidence rates in some countries. In order to improve treatment and follow-up of endometrial carcinoma patients, the importance of various prognostic factors has been extensively studied. The identification of high-risk groups would make it possible to avoid unnecessary adjuvant treatment among patients with a good prognosis. Over the past few decades, several studies have demonstrated the prognostic importance of different parameters including lymph node status, histological type of carcinoma (serous carcinoma and clear cell carcinomas are poor prognostic types), histological grade, stage of disease, depth of myometrial invasion, lymphovascular space involvement and cervical involvement. Other factors currently being investigated are estrogen and progesterone receptor status, p53 status, flow cytometric analysis for ploidy and S-phase fraction, and oncogenes such as HER-2/neu (c-erbB-2).

p21-activated kinase 4 regulation of endometrial cancer cell migration and invasion involves the ERK1/2 pathway mediated MMP-2 secretion

“…Both are even higher in lymph node metastases. More importantly, we found a significantly positive correlation between Pak4 and p-Pak4 expression with depth of myometrial invasion, vascular space invasion, lymph nodes metastasis, disease stage, and poor histological differentiation of endometrial cancer, all of which are important prognostic factors [29][30][31]. These data indicate that overexpression and/or activation of Pak4 contribute to accelerated progression of human endometrial cancer.…”

High-Risk Endometrial Carcinoma Profiling Identifies TGF-β1 as a Key Factor in the Initiation of Tumor Invasion

“…1), we found molecules already associated with an aggressive phenotype like HIF1A (24) or NR3C1 (25). Hormones have also been associated with high risk of recurrence, especially related to postmenopausal women with prolonged life expectancy, changes in reproductive behavior, and the prevalence of overweight and obesity (26). Interestingly, the majority of the genes at the core of the molecular network related to high risk of recurrence in endometrial carcinoma refer to the process of trophoblast invasion.…”

Expression of ER, PR, C-erbB-2 and Ki-67 in Endometrial Carcinoma and their Relationships with the Clinicopathological Features

“…EC pertains to hormone-dependent tumors, and both ER and PR in its tumor tissue are of great importance for the prognosis and clinical selection of endocrine therapy. C-erbB-2 that can inhibit tyrosinase activity plays a pivotal role in the cell growth, proliferation and differentiation, and its overexpression is positively correlated with the malignant degrees of the tumor (Uharcek, 2008). As one of the extensively-applied cell proliferation markers, Ki-67 can reflect the proliferation degree of malignant cells and is associated with the progression, metastasis and prognosis of various malignancies.…”