Surgical treatment of clinically early-stage endometrial carcinoma                without systematic lymphadenectomy

Bezerra, Artur Lício Rocha; Batista, Thales Paulo; Martins, Mário Rino; Carneiro, Vandré Cabral Gomes

doi:10.1590/1806-9282.60.06.017

Cited by 5 publications

(8 citation statements)

References 18 publications

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“…Thus, there is a great need to investigate molecular mechanism of endometrial carcinoma and develop novel targeted therapies against endometrial carcinomas. 2 …”

Section: Introductionmentioning

confidence: 99%

A small compound spindlactone A sensitizes human endometrial cancer cells to TRAIL-induced apoptosis via the inhibition of NAD(P)H dehydrogenase quinone 1

Zhao¹,

Wu²

2018

OTT

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IntroductionSpindlactone A (SPL-A) is a novel small molecule inhibitor of TACC3 that selectively inhibits the nucleation of centrosome microtubules and induces mitotic arrest in ovarian cancer cells. SPL-A is derived from dicoumarol which inhibits the activity of NAD(P)H dehydrogenase quinone oxidoreductase 1 (NQO1). This study aimed to investigate the mechanism by which SPL-A enhances TRAIL-induced apoptosis in endometrial carcinoma cells.Materials and methodsEndometrial carcinoma cells were treated with SPL-A and/or TRAIL, and the apoptosis and protein expression in the treated cells were examined.ResultsCombined treatment with SPL-A and TRAIL significantly induced apoptosis in various human endometrial carcinoma cells, but not in normal human endometrial stromal cells and endometrial epithelial cells. Notably, both NQO1 inhibitor ES936 and NQO1 siRNA enhanced TRAIL-induced apoptosis of endometrial carcinoma cells. Furthermore, SPL-A downregulated the expression of c-FLIP, Bcl-2, Bcl-xl, and Mcl-1, while increasing p53 expression.ConclusionIn particular, luciferase assay showed that SPL-A inhibited Bcl-2 promoter activity, and p53 inhibitor PFT-α could reverse the effect of SPL-A on Bcl-2 expression. Moreover, Bcl-2 overexpression inhibited the apoptosis induced by SPL-A and TRAIL. Taken together, our results suggest that SPL-A sensitizes endometrial cancer cells to TRAIL-induced apoptosis via the regulation of apoptosis-related proteins and the inhibition of NQO1 activity.

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“…Thus, there is a great need to investigate molecular mechanism of endometrial carcinoma and develop novel targeted therapies against endometrial carcinomas. 2 …”

Section: Introductionmentioning

confidence: 99%

A small compound spindlactone A sensitizes human endometrial cancer cells to TRAIL-induced apoptosis via the inhibition of NAD(P)H dehydrogenase quinone 1

Zhao¹,

Wu²

2018

OTT

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“…Moreover, the discordance rates vary according to grades and other factors, such as the method of sample collection. [16][17][18][19][20][21][22][23][24] Thus, the study of preoperative endometrial sampling as a predictor of surgical specimen grading and its value on surgical decisions and patient prognosis is still debated.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Preoperative Endometrial Histopathological Sampling as a Predictor of Final Surgical Pathology in Endometrial Cancer

Piotto

Focchi

Marques

et al. 2020

Rev Bras Ginecol Obstet

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Objective To evaluate the agreement between the histopathological diagnoses of preoperative endometrial samples and surgical specimens and correlate the agreement between the diagnoses with the impact on surgical management and the survival of patients with endometrial adenocarcinomas. Methods Sixty-two patients treated for endometrial cancer at a university hospital from 2002 to 2011 were retrospectively evaluated. The histopathological findings of preoperative endometrial samples and of surgical specimens were analyzed. The patients were subjected to hysterectomy as well as adjuvant treatment, if necessary, and clinical follow-up, according to the institutional protocol. Lesions were classified as endometrioid tumor (type 1) grades 1, 2, or 3 or non-endometrioid carcinoma (type 2). Results The agreement between the histopathological diagnoses based on preoperative endometrial samples and surgical specimens was fair (Kappa: 0.40; p < 0.001). However, the agreement was very significant for tumor type and grade, in which a higher concordance occurred at a higher grade. The percentage of patients with lymph nodes affected was 19.2%. Although most patients presenting with disease remission or cure were in the early stages (90.5%), there were no significant differences between those patients who had a misdiagnosis (11/16; 68.8%) and those who had a correct diagnosis (25/33; 75.8%) based on preoperative endometrial sampling (p = 0.605). Conclusion Our findings corroborate the literature and confirm the under staging of preoperative endometrial samples based on histopathological assessment, especially for lower grade endometrial tumors. We suggest that the preoperative diagnosis should be complemented with other methods to better plan the surgical management strategy.

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“…In developed countries endometrial carcinoma is most frequently seen malignancy of female genital tract and is the second commonest in developing countries. 6 Vaginal bleeding being commonly associated with the presence of disease, fortunately majority of the patients are therefore diagnosed at an early stage which results in overall favourable prognosis with high cancer specific survival rates. 7,8 Pelvic lymph nodes is common site of extra-uterine disease in patients with clinical early stage disease and thus pelvic lymph node dissection is an integral part of standard surgical procedures.…”

Section: Discussionmentioning

confidence: 99%

“…7,8 Pelvic lymph nodes is common site of extra-uterine disease in patients with clinical early stage disease and thus pelvic lymph node dissection is an integral part of standard surgical procedures. 6 The 3 common spread patterns in endometrial carcinoma are through local invasion, lymphatic spread & hematogenous spread. The lymphatic drainage of the uterus normally occurs through the parametrium to the pelvic sidewalls including spread to the iliac and obturator nodes.…”

Section: Discussionmentioning

confidence: 99%

Supraclavicular lymph node involvement in endometrial carcinoma, rare site of metastasis: A case report

2020

IJOGR

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Endometrial carcinoma is one of the commonest gynecological cancers of female genital tract, usually occurring after menopause. Supraclavicular lymph node is one of the rare sites of metastasis in the endometrial carcinoma. The present article illustrates the typical and atypical metastasis, surgical staging and role of lymph node dissection in patients with endometrial carcinoma. Typical sites are pelvic, the para-aortic nodes, the peritoneum, and lungs. Atypical sites are extra-abdominal lymph nodes, brain, bones, liver, soft tissue and adrenals. It is therefore important for the radiologists to recognize typical & atypical sites of metastases seen in patients of endometrial carcinoma so as to facilitate early diagnosis and treatment.

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Surgical treatment of clinically early-stage endometrial carcinoma without systematic lymphadenectomy

Cited by 5 publications

References 18 publications

A small compound spindlactone A sensitizes human endometrial cancer cells to TRAIL-induced apoptosis via the inhibition of NAD(P)H dehydrogenase quinone 1

A small compound spindlactone A sensitizes human endometrial cancer cells to TRAIL-induced apoptosis via the inhibition of NAD(P)H dehydrogenase quinone 1

Assessment of Preoperative Endometrial Histopathological Sampling as a Predictor of Final Surgical Pathology in Endometrial Cancer

Supraclavicular lymph node involvement in endometrial carcinoma, rare site of metastasis: A case report

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