Cancers of the Uterine Corpus. SUNY Downstate Medical Center Division of Gynecologic Oncology Mark Borowsky, MD. American Cancer Society Female Cancers: 2000 Statistics. Cancers of the uterine corpus are the 4 th most common cancer in American women Lifetime incidence ~2-3%. Lifetime risk.
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SUNY Downstate Medical Center
Division of Gynecologic Oncology
Mark Borowsky, MD
*poor prognosis histology
Lanciano et al: Radiother Oncol 28:189,1993
Lynch II Syndrome
Matthews RP, Hutchinson-Colas J, Maiman M, et al.: Papillary Serous and Clear Cell Type Lead to Poor Prognosis of Endometrial Carcinoma in Black Women. Gynecol Oncol. 65: 206-212, 1997.
Fleischer AC, Wheeler JE, Lindsay I, et al.: An assessment of the value of ultrasonographic screening for endometrial disease in postmenopausal women without symptoms. American Journal of Obstetrics and Gynecology 184(2): 70-75, 2001.
Langer RD, Pierce JJ, O'Hanlan KA, et al.: Transvaginal ultrasonography compared with endometrial biopsy for the detection of endometrial disease. New England Journal of Medicine 337(25): 1792-1798, 1997.
Rebecca Smith-Bindman, MD; Karla Kerlikowske, MD; Vickie A. Feldstein, MD, etal: Endovaginal Ultrasound to Exclude Endometrial Cancer and Other Endometrial Abnormalities. JAMA. 1998;280:1510-1517
Bradley WH, Boente MP, Brooker, D, et al.: Hysteroscopy and Cytology in Endometrial Cancer. Obstet Gynecol 2004;104:1030-3
Zerbe M, Zhang J, Bristow RE, et al.: Retrograde seeding of malignant cells during hysteroscopy in presumed early endometrial cancer. Gynecol Oncol 2000;79:55-8
Obermair A, Geramou M, Gucer F, et al.: Does hysteroscopy facilitate tumor cell dissemination. Cancer 2000;88:139-43
Increase in positive cytology from ~2-3% to ~10%
Gu M, Shi W, Huang J, et al.: Association between initial diagnostic procedure and hysteroscopy and abnormal peritoneal wahisngs in patients with endometrial carcinoma. Cancer 2000;90:3:143-7
Selvaggi L Cormio G, Ceci O, et al.: Hysteroscopy does not increase the risk of microscopic extrauterine spread in endometrial carcinoma. Int J Gynecol Cancer 2003;13:223-7
Combined No Atypia (n=122) 1.6%
Combined with Atypia (n=48) 23% (P=0.001)
Mean age at study entry= 40y/o Mean study F/U=13.4yrs
Randall TC, Kurman RJ. Progestin treatment of atypical hyperplasia and well-differentiated carcinoma of the endometrium in women under age 40. Obstet Gynecol. 1997 Sep;90(3):434-40.
16/17 (94%) w/ AH regressed
9/12 (75%) w/ ECA regressed
Obstet Gynecol 1997;90:434-440
Obstet Gynecol 1997;90:434-440
Kim YB, Holschneider CH, Ghosh K, Nieberg RK, Montz FJ. Progestin alone as primary treatment of endometrial carcinoma in premenopausal women. Report of seven cases and review of the literature. Cancer. 1997 Jan 15;79(2):320-7.
Gotlieb WH, Beiner ME, Shalmon B, Korach Y, Segal Y, Zmira N, Koupolovic J, Ben-Baruch G. Outcome of fertility-sparing treatment with progestins in young patients with endometrial cancer. Obstet Gynecol. 2003 Oct;102(4):718-25.
- Gr 2 - 6 % - 50% solid
- Gr 3 - > 50% solid tumor
Poor Prognosis Cell Types - Papillary Serous
*Verified via frozen section
*TAH-BSO, washings, lymphadenectomy **omental/peritoneal biopsy
Magrina JF, Weaver AL. Laparoscopic treatment of endometrial cancer: five-year recurrence and survival rates. Eur J Gynaecol Oncol. 2004;25(4):439-41.
Holub Z, Jabor A, Bartos P, Eim J, Urbanek S, Pivovarnikova R. Laparoscopic surgery for endometrial cancer: long-term results of a multicentric study. Eur J Gynaecol Oncol. 2002;23(4):305-10.
GOG LAP2 Protocol: Randomized study of Total Hysterectomy, BSO and Staging via Laparotomy vs. Laparoscopy- study still open
Vergote et al: Cancer 64:1011, 1989