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Romanian Journal of Morphology and... 2014Endometrial carcinoma is the most common malignancy in the female genital system and has increased in incidence during the past years. Our study was retrospective and...
Endometrial carcinoma is the most common malignancy in the female genital system and has increased in incidence during the past years. Our study was retrospective and included 79 patients with diagnosed endometrial adenocarcinoma. The parameters investigated in the study included clinical status, menopause, history of estrogen intake, obesity, histological results, transvaginal ultrasonography. We evaluated the status of the common clinicopathological features and immunohistochemical biomarkers of endometrial carcinoma. The main type of carcinoma was endometrial endometrioid carcinoma (68 cases), followed by serous carcinoma (seven cases). Immunohistochemical study performed included the following antibodies: cytokeratin, vimentin, ER, PR, PTEN, p53, β-catenin, bcl-2, WT1 and Ki67. The immunohistochemical profile showed significant differences between the two subtypes. The majority of cases showed positivity for steroid hormones and the positivity correlated with the endometrioid subtype. We observed a correlation between p53 overexpression and specific histological alterations. A high percentage of Ki67 positivity tumors correlated with grade 3 tumors, as well as with a high percentage of p53 positivity. The study shows the importance of the use of biomarkers in the positive diagnosis and the guiding of therapeutic approach.
Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Biomarkers, Tumor; Biopsy; Endometrial Neoplasms; Female; Humans; Immunohistochemistry; Middle Aged; Neoplasm Proteins; Prognosis; Ultrasonography
PubMed: 25611264
DOI: No ID Found -
The Oncologist 2010Adenocarcinoma of the endometrium represents the most common gynecologic malignancy in developed countries. Although early-stage cancers are effectively treated... (Review)
Review
Adenocarcinoma of the endometrium represents the most common gynecologic malignancy in developed countries. Although early-stage cancers are effectively treated surgically, commonly without adjuvant therapy, the treatment of high-risk and advanced disease is more complex. Chemotherapy has evolved into an important modality in high-risk early-stage and advanced-stage disease, and in recurrent endometrial cancer. Taxane-based therapy consistently demonstrates the highest response rates in the first-line and salvage settings of endometrial cancer. Unfortunately, response to chemotherapy is modest and strategies are needed to predict chemotherapy-responsive and chemotherapy-resistant populations. Chemotherapy resistance mediated by overexpression of drug efflux pump proteins and mutations in β-tubulin isoforms in both primary and recurrent disease represent unique treatment challenges and highlight the need for new agents that are less susceptible to these known resistance pathways. Epothilone B analogs are novel cytotoxic agents with activity in solid tumors, including advanced/recurrent endometrial carcinoma, and may have unique properties that can overcome resistance in some settings. These agents alone and in combination represent a new therapeutic opportunity in endometrial carcinoma.
Topics: Adenocarcinoma; Antineoplastic Agents; Combined Modality Therapy; Drug Resistance, Neoplasm; Endometrial Neoplasms; Female; Humans
PubMed: 20930101
DOI: 10.1634/theoncologist.2010-0087 -
Fertility and Sterility Mar 2014To evaluate the various possible prognostic factors on the fertility-sparing management of atypical hyperplasia and endometrial cancer; to generate survival curves to... (Meta-Analysis)
Meta-Analysis Review
Prognostic factors of oncologic and reproductive outcomes in fertility-sparing management of endometrial atypical hyperplasia and adenocarcinoma: systematic review and meta-analysis.
OBJECTIVE
To evaluate the various possible prognostic factors on the fertility-sparing management of atypical hyperplasia and endometrial cancer; to generate survival curves to estimate remission and recurrence rates according to time.
DESIGN
Systematic review and meta-analysis.
REGISTRATION NUMBER
CRD42013004557.
SETTING
University hospital.
PATIENT(S)
Patients who underwent fertility-sparing management for atypical hyperplasia and endometrial cancer.
INTERVENTION(S)
All published studies were identified through MEDLINE and reported according to PRISMA guidelines.
MAIN OUTCOME MEASURE(S)
Remission, recurrence, progression, and pregnancy rates by age, obesity, infertility, previous pregnancy, histology, and medical treatment.
RESULT(S)
A total of 370 patients from 24 studies were included. The 12- and 24-month remission probabilities were 78.0% and 81.4%, respectively. In multivariate analysis, previous pregnancy (odds ratio [OR] 2.70, 95% confidence interval [CI] 1.23-5.89), infertility (OR 2.26, 95% CI 1.05-4.87), and treatment with megestrol acetate (OR 2.70, 95% CI 1.20-6.02) were associated with higher remission probability. The 12- and 24-month recurrence probabilities were 9.6% and 29.2%, respectively. In multivariate analysis, none of the factors studied was associated with higher recurrence probability. Twenty-two studies totaling 351 patients were used to assess pregnancy rate; 111 subjects (32%) had one pregnancy or more. In multivariate analysis, none of the factors were associated with pregnancy probability. Among the 263 patients used to assess progression rate, 39 (15%) had a tumor with at least myometrial invasion on the hysterectomy specimen. Endometrial cancer and the use of other medical therapies (in comparison with megestrol acetate) were associated with an increased probability of progression.
CONCLUSION(S)
Fertility-sparing management should not be contraindicated in older patients with previous infertility or obesity.
Topics: Adenocarcinoma; Endometrial Neoplasms; Female; Fertility Preservation; Humans; Hyperplasia; Pregnancy; Prognosis; Reproduction; Treatment Outcome
PubMed: 24388202
DOI: 10.1016/j.fertnstert.2013.11.028 -
BMC Cancer Mar 2023To investigate the application value of Ki67 and serum CA125 in diagnosing the deep myometrial invasion of endometrial adenocarcinoma.
OBJECTIVE
To investigate the application value of Ki67 and serum CA125 in diagnosing the deep myometrial invasion of endometrial adenocarcinoma.
METHODS
This study retrospectively analyzed 80 patients with endometrial adenocarcinoma, who underwent procedure from January 2018 to June 2021 at Senior Department of Obstetrics & Gynecology, the Seventh Medical Center of PLA General Hospital assigned to the Fourth Medical Center. The general clinical data, serum CA125 and Ki67 levels were compared between the superficial muscular infiltration group and the deep myometrial invasion group. We investigated the application value of Ki67 and serum CA125 in diagnosing the deep myometrial invasion of endometrial adenocarcinoma by the ROC curve.
RESULTS
80 patients were retrospectively analyzed, and 53 cases were superficial muscular infiltration, 27 cases were deep myometrial invasion. There was significant difference in age, tumor diameter, lymph node metastasis, Ki67, serum CA125, p53 status, serum CA125 and Ki67 levels between the two groups (p < 0.05). As high as 35% of Ki67 was the optimal cutoff value for predicting DMI in endometrial adenocarcinoma, and the area under ROC curve was 0.691, the sensitivity and specificity of diagnosis were 88.9% and 56.6%. As high as 43.645 U/ml of serum CA125 was the optimal cutoff value for predicting DMI in endometrial adenocarcinoma, and the area under ROC curve was 0.668, the sensitivity and specificity of diagnosis were 40.7% and 92.5%. After combined detection of both, the area under ROC curve was 0.719, and its sensitivity and specificity of diagnosis were 96.3% and 43.4%.
CONCLUSION
Serum CA125 and Ki67 may be used to evaluate DMI in patients with endometrial adenocarcinoma, and the diagnostic value of combination is higher, which provide reference for clinical treatment.
Topics: Female; Humans; Ki-67 Antigen; Endometrial Neoplasms; Retrospective Studies; Uterine Neoplasms; Adenocarcinoma; Neoplasm Staging; Neoplasm Invasiveness
PubMed: 36918859
DOI: 10.1186/s12885-023-10711-x -
Asian Pacific Journal of Cancer... 2014Endometrial adenocarcinoma is the most common gynecological cancer in the Western world and its incidence appears to be rising. However, population-based studies on...
BACKGROUND
Endometrial adenocarcinoma is the most common gynecological cancer in the Western world and its incidence appears to be rising. However, population-based studies on endometrial cancer providing survival estimates by age, histology, and stage in Asia have been sparse. The aim of this study was to evaluate the clinicopathological data and survival for patients with endometrial adenocarcinoma treated at three institutions in Yazd, Iran.
MATERIALS AND METHODS
Medical and anatomicopathological records at the Department of Pathology and Radiotherapy of the Shahid Sadoughi University of Medical Sciences and Madar private hospital, between 2005 and 2012 were reviewed. All cases of endometrial adenocarcinoma were included. The Kaplan-Maier method was used for survival analysis and Cox proportional hazards model for multiple regression analysis.
RESULTS
The study included 84 patients. Stages I, II, III, and IV were identified in 65.4%, 21.5%, 11.9% and 1.2%, respectively. Disease-free survival rate was 73.9 ± 3.77 months (95% confidence interval, 64.51-83.22 months) and relapse occurred in 12.3% of the patients. The overall survival rate was 78. 2 ± 3.65 months (95% confidence interval, 71.0-85.3 months). A multivariate analysis revealed that stage and grade were associated with overall survival.
CONCLUSIONS
In this survival analysis of patients with endometrial cancer, we found that the prognosis of endometrial cancer was fair but strongly varied by stage and grade, and moderately varied by histology and age.
Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Combined Modality Therapy; Endometrial Neoplasms; Female; Follow-Up Studies; Humans; Middle Aged; Neoplasm Grading; Neoplasm Staging; Prognosis; Retrospective Studies; Survival Rate
PubMed: 24761903
DOI: 10.7314/apjcp.2014.15.6.2797 -
Deutsches Arzteblatt International Aug 2010Endometrial carcinoma is the fourth most common type of cancer among women in Germany, with more than 11 000 newly diagnosed cases each year. The present lack of clarity... (Review)
Review
BACKGROUND
Endometrial carcinoma is the fourth most common type of cancer among women in Germany, with more than 11 000 newly diagnosed cases each year. The present lack of clarity about the optimal clinical management of these patients is due in part to inconsistencies in the scientific evidence and in part to recent modifications of the FIGO classification. In this article, the issues requiring clarification are presented and discussed.
METHODS
This article is based on a selective review of the pertinent literature, including evidence-based guidelines and recommendations.
RESULTS AND CONCLUSION
Current scientific evidence does not support the screening of asymptomatic women. On the other hand, women with postmenopausal and acyclic bleeding should undergo histopathological evaluation, particularly if they have risk factors for endometrial cancer. The current FIGO classification divides endometrial cancer into stages depending on the findings at surgery. On the basis of risk stratification (e.g., by tumor stage and histological differentiation grade), women who are judged to be at high risk (FIGO Stage IB and above, Grade 3) should undergo not just hysterectomy and adnexectomy, but also systematic pelvic and para-aortic lymphadenectomy. Risk stratification also determines whether adjuvant radiotherapy should be given. The additional or alternative administration of chemotherapy is a particular consideration for women at high risk, although the pertinent clinical trials to date have yielded conflicting evidence on this point.
Topics: Adenocarcinoma, Clear Cell; Adult; Aged; Aged, 80 and over; Carcinoma, Endometrioid; Chemoradiotherapy, Adjuvant; Combined Modality Therapy; Cystadenoma, Serous; Endometrial Neoplasms; Evidence-Based Medicine; Female; Humans; Hysterectomy; Lymph Node Excision; Middle Aged; Neoplasm Invasiveness; Neoplasm Staging; Neoplasms, Hormone-Dependent; Survival Rate
PubMed: 21904591
DOI: 10.3238/arztebl.2011.0571 -
International Journal of Medical... 2019Endometrial cancer is one of the most common cancers in women worldwide, affecting more than 300,000 women annually. Dysregulated gene expression, especially those...
Endometrial cancer is one of the most common cancers in women worldwide, affecting more than 300,000 women annually. Dysregulated gene expression, especially those mediated by microRNAs, play important role in the development and progression of cancer. This study aimed to investigate differentially expressed genes in endometrial adenocarcinoma using next generation sequencing (NGS) and bioinformatics. The gene expression profiles and microRNA profiles of endometrial adenocarcinoma (cancer part) and normal endometrial tissue (non-cancer part) were assessed with NGS. We identified 56 significantly dysregulated genes, including 47 upregulated and 9 downregulated genes, in endometrial adenocarcinoma. Most of these genes were associated with defense response, response to stimulus, and immune system process, and further pathway analysis showed that human papillomavirus infection was the most significant pathway in endometrial adenocarcinoma. In addition, these genes were also associated with decreased cell death and survival as well as increased cellular movement. The analyses using Human Protein Atlas, identified 6 genes (, , , , , and ) significantly associated with poorer prognosis and 3 genes (, , and ) significantly associated with better prognosis. Combining with the data of microRNA profiles using microRNA target predicting tools, two significantly dysregulated microRNA-mediated gene expression changes in endometrial adenocarcinoma were identified: downregulated hsa-miR-127-5p with upregulated and upregulated hsa-miR-218-5p with downregulated . These findings may contribute important new insights into possible novel diagnostic or therapeutic strategies for endometrial adenocarcinoma.
Topics: Adenocarcinoma; Aged; Biomarkers, Tumor; Computational Biology; Cystatin B; Down-Regulation; Endometrial Neoplasms; Endometrium; Female; Follow-Up Studies; Gene Expression Profiling; Gene Expression Regulation, Neoplastic; High-Throughput Nucleotide Sequencing; Humans; Hydroxyprostaglandin Dehydrogenases; Kaplan-Meier Estimate; MicroRNAs; Middle Aged; Prognosis; Signal Transduction; Up-Regulation
PubMed: 31692912
DOI: 10.7150/ijms.38219 -
The Oncologist Mar 2015Endometrial cancer is the most common gynecologic cancer in developed countries. Approximately 3%-14% of endometrial cancers are diagnosed in young women under 40 who... (Review)
Review
Endometrial cancer is the most common gynecologic cancer in developed countries. Approximately 3%-14% of endometrial cancers are diagnosed in young women under 40 who want to preserve their fertility. The incidence of endometrial cancer in this age group is increasing, for which fertility-sparing therapy is increasingly used because it is one of the most important quality of life issues in these women. Progestin therapy is the most common type of fertility-sparing therapy. In this review, the most up-to-date findings regarding fertility-sparing progestin therapy for young women with primary and recurrent endometrial cancer is addressed in terms of diagnosis, treatment, follow-up, and oncologic and reproductive outcomes. Fertility-sparing progestin therapy is highly effective in selected young women with primary and recurrent endometrial cancer. The selection of appropriate patients through comprehensive pretreatment evaluation is of paramount importance to achieve the best outcomes without compromising survival. Because of the high rate of recurrence after successful fertility-sparing therapy, close surveillance is mandatory, and prophylactic hysterectomy is the best option for patients who have completed family planning. Pregnancy outcomes are very promising with the aid of assisted reproductive technologies. Continuous daily oral medroxyprogesterone acetate and megestrol acetate are the preferred progestins for fertility-sparing therapy, but future studies should be performed to determine the optimal dose and treatment duration of these agents.
Topics: Adenocarcinoma; Antineoplastic Agents, Hormonal; Endometrial Neoplasms; Female; Fertility Preservation; Humans; Neoplasm Recurrence, Local; Patient Selection; Progestins; Quality of Life; Retreatment
PubMed: 25673106
DOI: 10.1634/theoncologist.2013-0445 -
Gynecologic Oncology Sep 2013Because few cases of bone metastases of endometrial cancer have been reported, and information is scarce on their incidence, treatment, prognosis, and outcomes, we... (Review)
Review
OBJECTIVE
Because few cases of bone metastases of endometrial cancer have been reported, and information is scarce on their incidence, treatment, prognosis, and outcomes, we sought to compile a series of bone metastases of endometrial cancer and to systematically review the medical literature.
METHODS
We retrospectively reviewed medical records of patients who had osseous metastases of endometrial cancer treated initially at Mayo Clinic (1984-2001), and of all patients who were referred for treatment of primary bone metastases after primary treatment for endometrial cancer elsewhere.
RESULTS
Of 1632 patients with endometrial cancer, 13 (0.8%) had primary bone dissemination and 6 (0.4%) were referred after initial treatment. Three (15.8%) of these 19 had bone metastases at presentation; in the rest, median time to recurrence was 19.5 months (range, 3-114). The most common sites were the spine and hip. Median survival after metastasis was 12 months (range, 2-267). Median survival after radiotherapy alone vs. multimodal treatment was 20 months (range, 12-119) vs. 33 months (range, 9-267), respectively (P > .99). Of the 87 cases we reviewed from the literature, all but 1 (98.9%) had diagnoses based on symptoms. Multiple bone involvement and extraosseous dissemination were associated with poor prognosis. Type II endometrial cancer (i.e., serous or clear-cell histology) was associated with shorter life expectancy after diagnosis of bone metastasis compared to Type I tumors.
CONCLUSIONS
The incidence of primary bone metastases of endometrial cancer is < 1%. Single bone metastases without extraosseous spread indicate less aggressive disease. Optimal treatment is unclear.
Topics: Adenocarcinoma; Aged; Aged, 80 and over; Bone Neoplasms; Endometrial Neoplasms; Female; Hip; Humans; Middle Aged; Retrospective Studies; Spine
PubMed: 23685013
DOI: 10.1016/j.ygyno.2013.05.010 -
Pathology Oncology Research : POR Jun 2011Focal Adhesion Kinase (FAK) is a protein tyrosine kinase, localised in the focal adhesions, which, upon activation interacts with Src, another tyrosine kinase,...
Focal Adhesion Kinase (FAK) is a protein tyrosine kinase, localised in the focal adhesions, which, upon activation interacts with Src, another tyrosine kinase, regulating several cellular signalling pathways. Both enzymes have been implicated in malignant transformation and disease progression. The aim of the present study was to evaluate the clinical significance of FAK and Src expression in cases of endometrial adenocarcinoma. The total (t) and the activated, phosphorylated (p) forms of FAK and Src proteins were assessed immunohistochemically in tumour specimens obtained from 43 endometrial adenocarcinoma patients and were statistically analyzed in relation to various clinicopathological parameters and tumour proliferative capacity, reflected by Ki-67 labelling index. t-FAK positivity was significantly correlated with FIGO disease stage (p = 0.031), and t-FAK overexpression with patients' age (p = 0.015). No statistically significant correlation was identified between t-FAK staining intensity, t-Src positivity, overexpression or staining intensity and any of the clinicopathological parameters tested. No significant correlation was found between neither the positivity nor the intensity of staining of either p-FAk or p-Src with any of the parameters under study. Nonetheless, important, but non-significant, trends were identified between t-FAK staining intensity, t-Src positivity and overexpression and patients' survival (log rank, p = 0.122, p = 0.090 and p = 0.057 respectively). Similarly, p-FAK and p-Src staining characteristics seemed to correlate, even though non-significantly, with patients' survival (log rank, p = 0.051 and p = 0.070 for p-FAK and p-Src expression, respectively; log rank, p = 0.134 and p = 0.110 for p-FAK and p-Src staining intensity, respectively). These results support an important potential role of FAK-Src signalling in endometrial malignant disease progress and render further research in this field a necessity.
Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Biomarkers, Tumor; CSK Tyrosine-Protein Kinase; Disease Progression; Endometrial Neoplasms; Female; Focal Adhesion Kinase 1; Humans; Immunohistochemistry; Middle Aged; Neoplasm Staging; Protein-Tyrosine Kinases; Proto-Oncogene Proteins; Signal Transduction; src-Family Kinases
PubMed: 21058027
DOI: 10.1007/s12253-010-9310-6