Endometrial carcinoma: Clinical-pathologic comparison of cases in postmenopausal women receiving and not receiving exogenous estrogens

Abstract

Clinical and pathologic findings were compared in 43 postmenopausal endometrial carcinoma patients who had received exogenous estrogens prior to diagnosis and 79 similar patients unexposed to estrogens. Estrogen non-users were more likely to manifest lower parity, later menopause, obesity, hypertension, and diabetes, all of which have been considered to be constitutional risk factors for the development of endometrial carcinoma. Although estrogen users and non-users had similar extent of disease as judged by clinical stage, there was a tendency to more myometrial invasion in hysterectomy specimens from non-users, as well as greater frequency of unfavorable histologic types and grades of tumor. At short-term follow-up, more recurrences occurred in non-users, and this tendency appeared to be independent of clinical stage, histologic type, histologic grade, or modality of treatment. The significance of these and other observation to the determination of the risk-benefit ratio for estrogen administration is discussed.

Steroid Sulfatase and Estrogen Sulfotransferase in Human Endometrial Carcinoma

“…In addition, in situ estrogen metabolism, including its synthesis and degradation, has been considered recently to play a very important role in the development and progression of various human estrogen-dependent neoplasms including endometrial carcinoma especially in the postmenopausal subjects (2).…”

“…In situ estrogen metabolism, including its synthesis and degradation, has been considered to play a very important role in the development and/or progression of various human estrogen-dependent neoplasms including endometrial carcinoma (2). In endometrial carcinoma, in situ 17␤-estradiol availability has been demonstrated to be closely related to the pathogenesis and development of endometrial proliferative disorders including endometrial hyperplasia and carcinoma, especially of the endometrioid type (3).…”

Orphan nuclear receptor DAX‐1 in human endometrium and its disorders

“…Forty-six normal cycling human endometria (26 proliferative phase, 20 secretory phase), 36 endometrial hyperplasias 3 To whom correspondence should be addressed. E-mail: s221t@mail.tains.tohoku.ac.jp (16 simple hyperplasia, nine complex hyperplasia, and 11 atypical complex hyperplasia), and 103 endometrial endometrioid adenocarcinomas (49 well differentiated, 32 moderately differentiated, 22 poorly differentiated; 67 stage I, 12 stage II, 21 stage III, four stage IV) were retrieved from the surgical pathology files of Tohoku University Hospital, Sendai, Japan.…”

“…(3,4) In endometrial carcinoma, in situ 17β-estradiol (E2) availability has been reported to be closely associated with the pathogenesis and development of endometrial proliferative disorders including endometrial hyperplasia and carcinoma, especially the endometrioid type.…”

“…(1,2) In situ estrogen metabolism, including synthesis and degradation, has been recently recognized as a very important factor in the development and progression of various human estrogen-dependent neoplasms, including endometrial carcinoma, especially the endometrioid type. (3,4) In endometrial carcinoma, in situ 17β-estradiol (E2) availability has been reported to be closely associated with the pathogenesis and development of endometrial proliferative disorders including endometrial hyperplasia and carcinoma, especially the endometrioid type. (5) DAX-1 (dosage-sensitive sex reversal adrenal hypoplasia congenita critical region on the X chromosome gene 1) is a recently characterized member of the orphan nuclear receptor family.…”