• Endometrial Cancer

    by  • 28/05/2013 • Gynecologic Cancer

     

    1. 95% of uterine cancers
    2. Median age = 60
    3. RFs: exposure to unopposed oestrogens, plus HPNCC mutations (MLH1, MSH2) give 40-60% chance of endometrial cancer
    4. Prevention: chemoprevention = oral contraceptives decrease risk
    5. P/c: abnormal bleeding, intermenstrual or menorrhagia, post-menopausal bleeding.
    6. Pathology:
      1. o 80% adenocarcinoma and most treatable.
      2. o Adenosquamous and clear cell adenocarcinoma are infrequent and more aggressive.
      3. o Many high risk tumours will have mixed cell types.
      4. o Spreads by lymphatic or haemotological dessemination, direct extension and transtubal passage.
    7. Surgically staged
    8. Tx:
      1. o Exploratory laparotomy, peritoneal washings, total abdominal hysterectomy and bilateral salpingo-oopherectomy.
      2. o Pelvic and para-aortic node dissection may be neccessary.
      3. o External beam RT or brachytherapy can reduce recurrence.
      4. o Combination CT.
      5. o Palliation with hormonal therapies (progestin, tamoxifen). 
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