Endometrial cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

Colombo, Nicoletta; Preti, Eleonora Petra; Landoni, Fabio; Carinelli, Silvestro; Colombo, Alessandro; Marini, Carolina; Sessa, C.

doi:10.1093/annonc/mdr374

Cited by 371 publications

(226 citation statements)

References 24 publications

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“…3 Women can be classified with early-stage EC at low-, intermediate-, or high-risk for recurrence by a combination of histologic criteria (ie depth of myometrial invasion and histologic type and grade). 4 Standard treatments for early-stage EC consist of primary hysterectomy and bilateral salpingooophorectomy. In this specific setting, many centers in the United States perform lymph node sampling, 5,6 rates that can be higher in the case of lymphovascular space involvement (LVSI) on the primary tumor.…”

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confidence: 99%

Identification of microRNA expression profile related to lymph node status in women with early-stage grade 1–2 endometrial cancer

et al. 2016

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Conventional methods used for histologic classification and grading of endometrial cancer (EC) are not sufficient to predict lymph node metastases. microRNA signatures have recently been related to EC pathologic characteristics or prognosis. The aim of this study was to evaluate whether microRNA profiles of grade 1-2 endometrioid adenocarcinomas can be related to nodal status and used as a tool to adapt surgical staging in early-stage EC. microRNA expression was assessed in nine formalin-fixed paraffin-embedded (FFPE) EC primary tumors with positive lymph node and in 27 FFPE EC primary tumors with negative lymph node, matched for grade, stage, and lymphovascular space involvement status. A microarray analysis showed that there was more than a twofold significant difference in the expression of 12 microRNAs between the two groups. A quantitative reverse transcriptase-PCR assay was used to confirm these results: the expression levels of five microRNAs (microRNA-34c-5p, -375, -184, -34c-3p, and -34b-5p) were significantly lower in the EC primary tumor with positive lymph node compared with those with negative lymph node. A minimal P-value approach revealed that women with a microRNA-375-fold change o 0.30 were more likely to have positive lymph node (n = 8; 53.3%) compared with those with a microRNA-375-fold change 40.30 (n = 1; 4.8%), P = 0.001. Furthermore, women with a microRNA 184-fold change o0.30 were more likely to have positive lymph node (n = 6; 60.0%) compared with those with a microRNA 184-fold change 40.30 (n = 3; 11.5%), P = 0.006. This is the first study investigating the relative expression of mature microRNA genes in early-stage grade 1-2 EC primary tumors according to the nodal status. This microRNA expression profile provides a potential basis for further study of the microRNA function in EC and could be used as a diagnostic tool for nodal status.

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confidence: 99%

Identification of microRNA expression profile related to lymph node status in women with early-stage grade 1–2 endometrial cancer

et al. 2016

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“…The diagnosis requires histopathological confirmation, while surgical staging depends on acquisition of peritoneal fluid or washings, exploration of the abdominal cavity and pelvic and para-aortic nodal areas, and total hysterectomy with bilateral salpingo-oophorectomy. 2 About 75% of endometrial tumors are limited to the uterus by the time of diagnosis, which corresponds to stage I according to FIGO classification. 1 This was not the case of this patient, since peritoneal carcinomatosis and diffuse nodular hepatic metastases were documented.…”

Section: Discussionmentioning

confidence: 99%

Chylaskos as a presentation of serous papillary adenocarcinoma of the endometrium: a case report

Sequeira¹,

Borges²,

Camões³

2017

Gal. Clin.

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A 77-year-old female was presented to the emergency department with intense anorexia, weight loss despite progressive abdominal distension, and dyspnea. Abdomen imaging studies revealed moderate-volume ascites and a hepatic space-occupying lesion. Diagnostic paracentesis allowed the drainage of a chylous effusion and cytology analysis identified adenocarcinoma cells. Hepatic metastasis of papillary serous adenocarcinoma of the endometrium was confirmed after tomography-guided biopsy. Endometrial carcinoma is the most common malignant gynecological neoplasm in developed countries and is often classified in type I with endometrioid histology (estrogen-dependent) and non endometrioid type II (non-estrogen-dependent). Chylous ascites or chylaskos is a rare presentation on hospital admission. Several etiologies have been described. In adults, solid malignancy is expected to be identified in less than 20% of the cases. Currently only one case of endometrial carcinoma presenting with chylous ascites was described in a systematic review. Keywords: Chylous ascites, endometrial neoplasms Clinical caseA 77-year-old female was admitted in the Internal Medicine ward for investigation after presenting to the emergency department with intense anorexia, weight loss despite progressive abdominal distension and dyspnea. As past medical history, the patient related chronic gastritis, chronic microcytic anemia, arterial hypertension, dyslipidemia and type 2 diabetes mellitus with no vascular events, besides chronic kidney disease (stage 3). She denied any alcohol or smoke habits. On gynecological reports she had one term labor with eutocic delivery, menarche at 12 and menopause at 40 years, with no further complaints or bleeding discharge since then. Laboratory evaluation showed microcytic anemia (hemoglobin 7.4 g/dL, mean corpuscular volume 75.7 fL) with normal white cells and platelet count, mild hypoalbuminemia (31.6 g/L), normal serum total protein (67.7 g/L), normal serum transaminases ( aspartate aminotranferease 17 U/L, alanine aminotranferease 8 U/L) normal gamma glutamyl transpeptidase (30 U/L), alkaline phosphatase (110 U/l) and lactate dehydrogenase (228 U/L) values; high erythrocyte sedimentation rate (71 mm in the first hour) and a high C-reactive protein (64.3 mg/L), not changed baseline renal function (serum creatinine of 1.60 mg/dL with an estimated glomerular filtration rate of 35 mL/min/1.73 m2). Diagnostic paracentesis allowed the drainage of an exudative effusion. The laboratory analysis revealed 574 total cells with lymphocytes predominance (total protein of 51.9 g/L, albumin of 25.8 g/L, with a serum-to-ascites albumin gradient (SAAG) of 0.58 g/dL, lactate dehydrogenase level of 175 IU/L, glucose level of 126 mg/dL and triglyceride level of 382 mg/dL. It wasn´t detected any microorganism from the effusion. These chemistry results were consistent with a chylous effusion. Cytological analysis identified adenocarcinoma cells of unknown origin. Abdominopelvic magnetic resonance imaging revealed several hyp...

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“…Recurrence of endometrial cancer is often symptomatic although reported to vary from 40-91% (23)(24)(25)27,28,(30)(31)(32). Most recurrences (70-95 %) occur within three years of initial treatment [31,33]. Symptomatic recurrences of endometrial cancer may have a worse prognosis than asymptomatic recurrences, as reported from recent studies carried out in Italy and Japan [34,35], although evidence is conflicting as other studies showed no such differences [23,36,37].…”

Section: Follow-up In Gynaecological Oncologymentioning

confidence: 99%

“…The Society for Gynecologic Oncology recommends a pelvic examination at each visit but suggests that routine CA125 testing, chest radiography and vaginal cytology is controversial and that there is no randomised data to guide practice [38]. The European Society for Medical Oncology recommends clinical examination only [33].…”

Section: Follow-up In Gynaecological Oncologymentioning

confidence: 99%

The future for follow-up of gynaecological cancer in Europe. Summary of available data and overview of ongoing trials

Leeson

Beaver

Ezendam

et al. 2017

European Journal of Obstetrics & Gynecology and Reproductiv

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After completing treatment, most patients follow a pre-determined schedule of regular hospital outpatient appointments, which includes clinical examinations, consultations and routine tests. More work is needed on alternative strategies for all gynaecological cancer types. New models will likely include risk stratification with early discharge from secondary care for early stage disease with fast track access to specialist services for suspected cancer recurrence or other problems.

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Endometrial cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

Cited by 371 publications

References 24 publications

Identification of microRNA expression profile related to lymph node status in women with early-stage grade 1–2 endometrial cancer

Identification of microRNA expression profile related to lymph node status in women with early-stage grade 1–2 endometrial cancer

Chylaskos as a presentation of serous papillary adenocarcinoma of the endometrium: a case report

The future for follow-up of gynaecological cancer in Europe. Summary of available data and overview of ongoing trials

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