Endometrial Cancer; Clinical Aspects and Prognosis

Review Article

Austin J Womens Health. 2015; 2(2): 1016.

Endometrial Cancer; Clinical Aspects and Prognosis

Victor Manuel Vargas Hernandez1* and Victor Manuel Vargas Aguilar2

¹Department of Gynecology, Hospital Juarez of Mexico, USA

²Oncology Hospital, CMN XXI century, Mexican Social Security Institute, USA

*Corresponding author: Victor Manuel Vargas Hernandez, Department of Gynecology, Hospital Juarez of Mexico, Insurgentes Sur 605-1403, Col. Napoles, 03810 DF Mexico, USA

Received: July 11, 2015; Accepted: November 11, 2015; Published: November 13, 2015

Abstract

In developed countries, endometrial cancer is common and is the second most common cancer in women; the lifetime risk of developing endometrial cancer is 2.6% and the average age at diagnosis is 61 years; 68% are diagnosed at an early stage; It manifests with abnormal uterine bleeding, especially in postmenopausal women; Risk factors are related to the effects of estrogen; reducing the risk with oral contraceptives, there are no screening tests; The treatment is surgical and minimally invasive surgery improves morbidity and mortality.

Keywords: Epidemiology; Symptoms; Risk Factors; Prognostic Indicators; Types of Endometrial Cancer

Epidemiology

Worldwide 288,000 women are diagnosed with cervical cancer [1,2], it is the most common gynecologic cancer in developed countries, with an incidence of 5.9 to 12.9 per 100,000 women and mortality rate [3] of 2.4 per 100,000. The mortality rate was 1.7 to 2.4 per 100,000 women; United States (US), is the most common gynecologic cancer; with 50,000 new cases and 8,600 deaths each year [1,2]; with incidence of 23.9 per 100,000 women [4-7], is presented at a mean age at diagnosis of 61 years and age is (20-34yrs); 1.5%, (35- 44yrs); 6% (45-54yrs ); 19% of (55-64yrs); 32.6% of (65-74yrs); 22.6%; (75 to 84yrs); 13.5% 85 years of age or older; 4.8%; from the (50-70 yrs) women have a 1.4% risk of being diagnosed with uterine cancer and risk for life in US is 2.6%; 68% are diagnosed at an early stage, the uterus located [8,9]; advanced stage with spread to regional lymph nodes and organs (20%); and distant metastases (8%). Survival rates for localized [5], and loco regional and metastatic spread are 96 %, 67%, and 17%, respectively [8,9].

Classification

Based on clinical features, pathological features, molecular genetics, incidence, response to estrogen and prognosis, the endometrial cancer could be classified as the following; there are two types of endometrial cancer [8-10 ]:

Women with endometrial cancer are obese associated with chronic diseases and have higher surgical risk; robotic surgery compared with classic and laparoscopic surgery have better prognosis for surgical staging; no differences in rates of recurrence and death, but with better postoperative quality of life. The survival rate is 86% for classical radical surgery and 90% for laparoscopic and robotic surgery in patients of the same age, body mass index, associated chronic diseases, number of previous surgeries. Classical surgery has more complications compared with robotic surgery (26 vs 6.4%, p <0.001) [11].

Clinical Presentation

Abnormal uterine bleeding is the main symptom of endometrial cancer 65-90%, occasionally detected in cervical cytology screening [1- 3,12]. It is most common in postmenopausal women. The suspected presence of endometrial neoplasia (endometrial hyperplasia or carcinoma neoplastic) depends on the symptoms, age and presence of risk factors [1-3,12]. The amount of bleeding is not correlated with the risk of cancer.

Risk Factors

The main risk factor for type I endometrial cancer is prolonged exposure to excessive endogenous or exogenous estrogen without progestin right opposition [8]. Other risk factors include obesity, nulliparity, diabetes mellitus and hypertension, see Table 1; exogenous estrogen exposure includes estrogen replacement therapy after menopause and tamoxifen, whereas the endogenous exposure results from obesity, chronic anovulation, and estrogen-secreting tumors [8].

Citation: Hernandez VMV and Aguilar VMV. Endometrial Cancer; Clinical Aspects and Prognosis. Austin J Womens Health. 2015; 2(2): 1016.