Vélez CAL, Hurtado EG

Language: Spanish
References: 22
Page: 95-101
PDF size: 162.06 Kb.

ABSTRACT

Background: Endometrial carcinoma (EC) is the most common tumors infiltrating the female genital tract in developed western countries with 36,000 new cases and 6,000 deaths per year. The risk factors include age, obesity, nulliparity, hormone therapy and other factors. The prognostic variables involved are age, histological type, histological grade and myometrial invasion, vascular invasion, peritoneal cytology results, the hormone receptor status, nuclear grade, tumor size, DNA ploidy and biological markers, methods of treatment and special circumstances. Objective: To determine risk factors and prognosis present in our population of women affected with endometrial cancer. Material and methods: This study is a series of cases. This is a retrospective, observational, cross sectional. We included all records of patients diagnosed with endometrial carcinoma histologically verified, analyzed the risk factors and prognosis in each during the period 2005 to 2009. Results: During the study period 21 patients were diagnosed with endometrial carcinoma, with a mean age of 52.2 ± 9.4 years. One patient (4.76%) were under 30 years of age, 2 (9.52%) were between 31 and 40, 5 (23.8%) between 41 and 50, 10 (47.61%) between 51 and 60, and 3 (14.28%) over 60 years. The histologic types were identified endometrioid adenocarcinoma in 16 patients (76.19%), mucinous adenocarcinoma in 2 (9.52%), adenoacanthoma in 1 (4.76%) and serous papillary adenocarcinoma in 2 (9.52%). The CA 125 was high in 6 (28.57%) patients and normal in 15 remaining (71.42%). Conclusions: Endometrial adenocarcinoma is becoming increasingly common in our country. The incidence of this neoplasm in young patients under 40 years is much higher than in other countries. As the average age of our population is nearly a decade lower than the USA.

REFERENCES

1. Surveillance, Epidemiology and End Results (SEER). Base de datos de SEER: Incidencia - SEER 9 Regs uso público. Instituto Nacional del Cáncer, DCCPS, Vigilancia del Programa de Investigación. Disponible en: http://seer.cancer.gov/.

2. Bernstein L, Deapen D, Cerhan JR et al. Tamoxifen therapy for breast cancer and endometrial cancer risk. J Natl Cancer Inst 1999; 91 (19): 1654-62.

3. Creasman WT. Endometrial cancer: incidence, prognostic factors, diagnosis, and treatment. Semin Oncol 1997; 24 (1 Suppl 1): S1-140.S141-S150.

4. Goff BA, Kato D, Schmidt RA et al. Uterine papillary serous carcinoma: patterns of metastatic spread. Gynecol Oncol 1994; 54 (3): 264-8.

5. American College of Obstetricians and Gynecologists. Estrogen replacement therapy and endometrial cancer. ACOG Committee Opinion: Committee on Gynecologic Practice Number 126-August 1993. Int J Gynaecol Obstet 1993; 43 (1): 89.

6. Morrow CP, Bundy BN, Kurman RJ et al. Relation between surgical-pathological risk factors and outcome in clinical stage Iand II carcinoma of the endometrium: a Gynecologic Oncology Group Study. Gynecol Oncol 1991; 40(1): 55-65.

7. Silverberg SG, Major FJ, Blessing JA, Fetter B, Askin FB, Liao SY et al. Carcinosarcoma (malignant mixed mesodermal tumor) of the uterus. A Gynecologic Oncology Group pathologic study of 203 cases. Int J Gynecol Pathol 1990; 9 (1): 1-19.

8. Kadar N, Malfetano JH, Homesley HD. Determinants of survival of surgically staged patients with endometrial carcinoma histologically confined to the uterus: implications for therapy. Obstet Gynecol 1992; 80 (4): 655-9.

9. Creasman WT, Morrow CP, Bundy BN et al. Surgical pathologic spread patterns of endometrial cancer. A Gynecologic Oncology Group Study. Cancer 1987; 60 (8 Suppl): 2035-41.

10. DiSaia PJ, Creasman WT. 7th ed. Clinical Gynecologic Oncology. St. Louis, Mo: Mosby; 2007.

11. Kilgore LC, Partridge EE, Alvarez RD. Adenocarcinoma of the endometrium: survival comparisons of patients with and without pelvic node sampling. Gynecol Oncol 1995; 56 (1): 29-33.

12. Kurman RJ, Kaminski PF, Norris HJ. The behavior of endometrial hyperplasia. A long-term study of «untreated» hyperplasia in 170 patients. Cancer 1985; 56 (2): 403-12.

13. Mariani A, Dowdy SC, Keeney GL et al. High-risk endometrial cancer subgroups: candidates for target-based adjuvant therapy. Gynecol Oncol 2004; 95 (1): 120-6.

14. Creasman WT. Revised FIGO staging for carcinoma of the vulva, cervix and endometrium. Inter J Gynecol and Obstet 2009; 105: 103-4.

15. Creasman WT, Kohler MF, Odicino F et al. Prognosis of papillary serous, clear cell, and grade 3 stage I carcinoma of the endometrium. Gynecol Oncol 2004; 95 (3): 593-6.

16. Creasman WT, Morrow CP, Bundy BN, Homesley HD, Graham JE, Heller PB. Surgical pathologic spread patterns of endometrial cancer. A Gynecologic Oncologic Group Study. Cancer 1987; 60: 2035-41.

17. Creasman WT, Odicino F, Maisonneuve O, Quinn MA, Belle U, Benedet JL, Heintz AMP, Ngan HYS, Pecorelli S. FIGO (International Federation of Gynecology and Obstetrics) 26th Annual Report on the Results of Treatment in Gynecological Cancer. Int J Gynaecol Obstet 2006; 95 (Suppl 1): S1-257.

18. Mariani A, Keeney GL, Aletti G, Webb MJ, Haddock MG, Podratz KC. Endometrial carcinoma: paraaortic dissemination. Gynecol Oncol 2004; 92: 833-838.

19. Orr JW Jr, Orr PF, Taylor PT. Surgical staging endometrial cancer. Clin Obstet Gynecol 1996; 39: 656-68.

20. Kinkel K, Kaki Y, Yu KK et al. Radiologic staging in patients with endometrial cancer: a meta-analysis. Radiology 1999; 212 (3): 711-718.

21. Chuang L, Burke TW, Tornos C, Marino BD, Mitchell MF, Tortolero-Luna G, Levenback C, Morris M, Gershenson DM. Staging laparotomy for endometrial carcinoma: assessment of retroperitoneal lymph nodes. Gynecol Oncol 1995; 58: 189-93.

22. Bristow RE, Zerbe MJ, Rosenshein NB, Grumbine FC, Montz FJ. Stage IVb endometrial carcinoma: the role of cytoreductive surgery and determinants of survival. Gynecol Oncol 2000; 78: 85-91.