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Gepubliceerd in:
hoofdstuk lezen eerste hoofdstuk lezen

2024 | OriginalPaper | Hoofdstuk

40. Uterine cancer and premalignant lesions

Auteurs : Dr. Hanny J. M. A. Pijnenborg, Dr. Nicole C. M. Visser, Dr. Erica H. M. J. Werner

Gepubliceerd in: Textbook of Obstetrics and Gynaecology

Uitgeverij: Bohn Stafleu van Loghum

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Summary

Endometrial cancer is the most common malignancy of the female genital tract with rising incidence due to increased life expectancy and obesity. Most women presenting with postmenopausal bleeding are diagnosed at an early stage with a favourable outcome. Yet, a significant number of patients have advanced stage disease, or present with recurrent disease, and have limited treatment options. Primary treatment consists of hysterectomy and salpingo-oophorectomy, preferably by a minimal invasive approach. Lymph node dissection is recommended for patients with grade 3 endometrioid, serous and clear cell histology since these patients are at significant risk of extended disease. Adjuvant radiotherapy can improve local control in a subgroup of patients. Chemotherapy is recommended for patients with metastatic disease. Alternatively, hormonal treatment can be effective with less side effects, but development of resistance to hormonal treatment limits the duration of effect. Prevention of (high risk of) endometrial cancer may be accomplished by a healthy lifestyle and improving body weight.
vorige hoofdstuk The menopause, the perimenopause and the postmenopause
volgende hoofdstuk Ovarian cancer
Bijlagen
Alleen toegankelijk voor geautoriseerde gebruikers
Woordenlijst
Cytoreductive surgery
Debulking surgery, i.e. removal of all the macroscopic visible tumour.
Epithelial-to-mesenchymal transition (EMT)
A process by which epithelial cells lose their cell polarity and cell-cell adhesion, and they gain migratory and invasive properties such as mesenchymal stem cells. Although EMT is essential for numerous developmental and physiological processes, in cancer it can initiate progression and metastasis.
Lymphovascular space invasion (LVSI)
The spread of cancer into the blood vessels and/or lymph vessels.
Mesenchymal
Mesenchymal or stromal cells originate from the mesoderm and can develop into several types of tissues. Mesenchymal cells of the uterine corpus reflect the connective tissue that is surrounding the endometrial glands as well as the myometrium cells of the uterine wall.
Microsatellite instability (MSI)
Refers to genetic hyper-mutability which is a result of impaired DNA mismatch repair (MMR) function. The MMR proteins are: MSH 1, MSH 2, MSH6 and PMS2.
POLE
Encodes the enzyme DNA polymerase epsilon catalytic subunit. This enzyme is involved in DNA repair and chromosomal DNA replication. Mutations in POLE result in an ultra-mutated phenotype. In endometrial cancer, POLE mutations are associated with an excellent outcome, which is thought to be related to an activated immune system and a tumour specific CD4+ T cell response.
The Cancer Genome Atlas Network (TCGA)
A collaboration between the National Cancer Institute (NCI) and the National Human Genome Research Institute (NHGRI) that has generated comprehensive, multi-dimensional maps of the key genomic changes in 33 types of cancer.
Vaginal brachytherapy
Radiotherapy applied directly through the vagina with a sealed radiation source.
Literatuur
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Cancer Genome Atlas Research Network; Kandoth C, Schultz N, Cherniack AD, et al. Integrated genomic characterization of endometrial cancer. Nature 2013 May 2;497(7447):67–73.
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Kong A, Johnson N, Kitchener HC, Lawrie TA. Adjuvant radiotherapy for stage I endometrial cancer: an updated Cochrane systematic review and meta-analysis. J Natl Cancer Inst. 2012;104(21):1625–34.CrossRefPubMed
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Murali R, Soslow RA, Weigelt B. Classification of endometrial cancer: more than two types. Lancet Oncol. 2014;15(7):e268-78.CrossRefPubMed
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Onstad MA, Schmandt RE, Lu KH. Addressing the role of obesity in endometrial cancer risk, prevention, and treatment. J Clin Oncol. 2016;34(35):4225–30.CrossRefPubMedPubMedCentral
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McAlpine J, Leon-Castillo A, Bosse T. The rise of a novel classification system for endometrial carcinoma; integration of molecular subclasses. J Pathol. 2018;244(5):538–49.CrossRefPubMed
Metagegevens
Titel
Uterine cancer and premalignant lesions
Auteurs
Dr. Hanny J. M. A. Pijnenborg
Dr. Nicole C. M. Visser
Dr. Erica H. M. J. Werner
Copyright
2024
Uitgeverij
Bohn Stafleu van Loghum
Boek
Textbook of Obstetrics and Gynaecology

Print ISBN: 978-90-368-2993-9

Elektronisch ISBN: 978-90-368-2994-6

Copyright: 2024

DOI
https://doi.org/10.1007/978-90-368-2994-6_40