Carcinoma of the Lower Uterine Segment: A Newly Described Association With Lynch Syndrome

Westin, Shannon N.; Lacour, Robin A.; Urbauer, Diana L.; Luthra, Rajyalakshmi; Bodurka, Diane C.; Lu, Karen H.; Broaddus, Russell R.

doi:10.1200/jco.2008.18.6296

Cited by 181 publications

(167 citation statements)

References 23 publications

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“…Westin et al (3) suggested that tumors arising in the LUS were a subtype of endometrial cancer. In fact, several studies reported that tumors involving the LUS were equivalent to UC tumors in regards to survival and did not imply a worse prognosis (8,12).…”

Section: Discussionmentioning

confidence: 99%

“…EC arises from the uterine corpus (UC), but in 3%-6% of EC cases, the localization of the tumor is the lower uterine segment (LUS) (2)(3)(4). LUS-originated tumors are located between the UC and the uterine cervix and show histological characteristics of both parts, which sometimes complicates the differential diagnosis of EC and cervical adenocarcinomas when determination of the primary tumor is essential for further treatment and prognosis (2).…”

Section: Introductionmentioning

confidence: 99%

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Is lower uterine segment involvement a prognostic factor in endometrial cancer?

Erkaya¹,

Öz²,

Topçu³

et al. 2017

Turk J Med Sci

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compare the clinical and pathological characteristics and overall survival of endometrial carcinoma cases involving the LUS with UC tumors without LUS involvement. Materials and methodsThis study was conducted at Zekai Tahir Burak Women's Health Training and Research Hospital, Ankara, Turkey, after obtaining the approval of the institutional ethics board. The clinical records and pathology reports of the patients who were operated on with the diagnosis of endometrial carcinoma in the Gynecologic Oncology Department of our hospital between July 2007 and March 2015 were reviewed retrospectively.Inpatient and outpatient records, operation and pathology reports, and clinical and demographic data of the patients were reviewed. The pathological records of patients included in this study were reviewed and tumor localizations were identified. Tumor localizations were grouped as UC tumors with LUS involvement and UC without LUS involvement.Background/aim: The purpose of this study is to investigate the prognostic significance of lower uterine segment (LUS) involvement in endometrial cancer (EC). Materials and methods:We reviewed the patients who were operated at our institution between July 2007 and March 2015 with the diagnosis of EC. Tumors localized in the corpus and involving the LUS or localized entirely in the LUS formed Group A, while tumors in the uterine corpus without LUS involvement formed Group B. Clinicopathological characteristics and survival of the patients were compared in both groups.Results: A total of 500 patients were included in the study. There were 139 patients who had tumors involving the LUS and formed Group A, while 361 patients with endometrial tumors in the uterine corpus without LUS involvement formed Group B. We did not detect a significant difference between survival of the patients in group A and group B (78 months vs. 87 months, respectively; P > 0.05). Conclusion:We found that LUS involvement was not an independent prognostic factor for poor survival, but it is associated with other poor prognostic factors such as deep myometrial invasion, uterine serosal involvement, lymphovascular space invasion, lymph node metastasis and higher FIGO grade.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Is lower uterine segment involvement a prognostic factor in endometrial cancer?

Erkaya¹,

Öz²,

Topçu³

et al. 2017

Turk J Med Sci

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“…Endometrial adenocarcinoma mainly develops in the uterine corpus en-dometrium and is exceptionally derived from the LUS (9). Due to vaginal bleeding and diagnosis in early stage, most patients can be treated just by surgery (5,10). The prognosis of this carcinoma is usually excellent with an approximately 5-year survival of 85% (11).…”

Section: Introductionmentioning

confidence: 99%

Investigating the Association of Lower Uterine Segment Involvement with Deep Myometrial Invasion in Endometrial Adenocarcinoma

Aminimoghaddam

Kamyabi

Yarandi

et al. 2017

J Obstet Gynecol Cancer Res

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Background: Endometrial carcinoma is the most common cancer of the female genitalia and its prevalence is 2% to 3% along the females' lifetime. This adenocarcinoma is diagnosed in the early stages because the patients become symptomatic early in the course of disease. The correlation of the lower uterine segment involvement (LUSI) with the recurrence, and the survival rates in patients with endometrial adenocarcinoma are always questionable. Confirming the prognostic significance of LUSI can fundamentally improve the current state of patients' surveillance. The current study aimed at investigating the association of lower uterine segment involvement with deep myometrial invasion in endometrial adenocarcinoma. Methods: In the current retrospective cohort study, 54 patients with stage I endometrial endometrioid adenocarcinoma who underwent surgery in Mirza-Koochak-Khan Hospital, Tehran, Iran, from 2004 to 2014 were divided into 2 groups according to the presence of LUSI. In the current cohort study, the data from the patients exposed to LUSI were obtained by questionnaires to measure deep myometrial invasion besides post-operative adjuvant radiotherapy. The median of follow-up period was 48 months for all of the patients, which started after their surgery, and the measurement period for variables were similar to those of the follow-up period, which was 48 months. They were compared regarding to age, tumor grade, depth of myometrial invasion, lymphovascular involvement, extra uterine diseases, the extent of lymphadenectomy, adjuvant therapy, recurrence rate, time, and location. The data analysis was conducted by the SPSS v.16 statistical software (Chicago, IL, USA) at the significance level of 5%. In the investigation, Chi-square, the Kolmogorov-Smirnov, t test, and the Mann-Whitney U tests were used. Results: Group 1 consisted of 13 patients with LUSI and group 2 had 41 patients without LUSI divided by a non-random sampling method. According to the results of the Mann-Whitney U test, there was a significant difference between the mean age of patients with LUSI and that of the ones without LUSI (P = 0.03). It showed that the mean age in the former group was significantly higher than that of the latter. A Chi-square test showed no significant association between the lymphovascular involvement and the presence of LUSI (P = 0.1). The Fisher exact test showed that patients with LUSI had significantly higher rate of radiotherapy after surgery rather than the ones without LUSI (P < 0.001). Conclusions: In conclusion, there was a significant association between the lower uterine segment involvements with deep myometrial invasion in the endometrial endometrioid adenocarcinoma. In other words, there was a significant difference in the depth of myometrial invasion between the groups, and the patients with LUSI had deeper myometrial invasion (the Mann-Whitney U test, P < 0.001).

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“…These investigators identified a correlation between the anatomic origin of the cancer and individuals with LS: Up to 29% of patients with ECs centered in the lower uterine segment had LS (26 ). In another study, the actual incidence of involvement of the lower uterine segment in LS patients was 5.3% (27 ). The study of Ryan et al found that 76% of the tumors were low-grade (grade 1 or 2) endometrioid carcinomas.…”

Section: Histopathology Of Ec In Lsmentioning

confidence: 92%

Lynch Syndrome Presenting as Endometrial Cancer

Tafe¹,

Riggs

Tsongalis³

2014

Clinical Chemistry

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BACKGROUND Lynch syndrome (LS) is the most common form of the hereditary colon cancer syndromes. Because of its high prevalence, a nationwide campaign has begun to screen all colorectal cancers for the genetic abnormalities associated with LS. CONTENT Next to colorectal cancer, endometrial cancer is the most common form of malignancy found in women with LS. Identifying individuals who harbor the well-characterized mismatch-repair gene mutations via immunohistochemistry, microsatellite instability analysis, or direct gene sequencing is critical to managing the LS patient and to surveillance for the development of other associated tumor types. SUMMARY Although many institutions have begun screening all colorectal tumors for LS, the evidence is sufficient to warrant the testing of all endometrial cancers for LS as well. Various testing algorithms, along with genetic-counseling efforts, can lead to a cost-efficient and beneficial screening program.

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Carcinoma of the Lower Uterine Segment: A Newly Described Association With Lynch Syndrome

Cited by 181 publications

References 23 publications

Is lower uterine segment involvement a prognostic factor in endometrial cancer?

Is lower uterine segment involvement a prognostic factor in endometrial cancer?

Investigating the Association of Lower Uterine Segment Involvement with Deep Myometrial Invasion in Endometrial Adenocarcinoma

Lynch Syndrome Presenting as Endometrial Cancer

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