Endometrial cancer natural history, complications and prognosis

Jump to navigation Jump to search

Endometrial cancer Microchapters

Home

Patient Information

Overview

Historical perspective

Classification

Pathophysiology

Causes

Differentiating Endometrial cancer from other Diseases

Epidemiology and Demographics

Risk factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Staging

History and Symptoms

Physical Examination

Laboratory Findings

Chest X Ray

CT

MRI

Ultrasound

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Future or Investigational Therapies

Case Studies

Case #1

Endometrial cancer natural history, complications and prognosis On the Web

Most recent articles

cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Endometrial cancer natural history, complications and prognosis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Endometrial cancer natural history, complications and prognosis

CDC on Endometrial cancer natural history, complications and prognosis

Endometrial cancer natural history, complications and prognosis in the news

Blogs on Endometrial cancer natural history, complications and prognosis

Directions to Hospitals Treating Endometrial cancer

Risk calculators and risk factors for Endometrial cancer natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

If left untreated, 8–30% of patients with atypical endometrial hyperplasia may progress to develop endometrial cancer. Common complications of endometrial cancer include vaginal bleeding and metastasis. Depending on the extent of the tumor at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as good.

Natural history

Complications

Complications of endometrial cancer include:

Prognosis

Another factor found to correlate with extrauterine and nodal spread of tumor is involvement of the capillary-lymphatic space on histopathologic examination. Three prognostic groupings of clinical stage I disease become possible by careful operative staging.
1. Patients with grade 1 tumors involving only endometrium and no evidence of intraperitoneal disease (i.e., adnexal spread) have a low risk (<5%) of nodal involvement.
2. Patients with grade 2 or 3 tumors and invasion of less than 50% of the myometrium and no intraperitoneal disease have a 5% to 9% incidence of pelvic node involvement and a 4% incidence of positive para-aortic nodes.
3. Patients with deep muscle invasion and high-grade tumors and/or intraperitoneal disease have a significant risk of nodal spread, 20% to 60% to pelvic nodes and 10% to 30% to para-aortic nodes.
The following four are statistically significant adverse prognostic factors:

  • Myometrial invasion
  • Vascular invasion
  • Eight or more mitoses per ten high-power fields
  • An absence of progesterone receptors
  • Based on Gynecologic Oncology Group (GOG) study following are the other prognostic indicators of clinical outcome
  • Oncogene expression
  • DNA ploidy
  • The fraction of cells in S-phase
  • The following subtypes of endometrial cancer are associated with the poor prognosis:
  • Clear cell endometrial carcinoma
  • Serous endometrial carcinoma
  • Squamous cell endometrial carcinoma
  • Undifferentiated endometrial carcinomas

5-Year Survival

  • Between 2004 and 2010, the 5-year relative survival of patients with endometrial cancer was 83.2%.[1]
  • When stratified by age, the 5-year relative survival of patients with endometrial cancer was 86.6% and 73.1% for patients <65 and ≥ 65 years of age respectively.[1]
  • The survival of patients with endometrial cancer varies with the stage of the disease. Shown below is a table depicting the 5-year relative survival by the stage of uterine cancer:[1]
Stage 5-year relative survival (%), (2004-2010)
All stages 81.5%
Localized 95.1%
Regional 67.7%
Distant 17,5%
Unstaged 47.9%
  • Shown below is an image depicting the 5-year conditional relative survival (probability of surviving in the next 5-years given the cohort has already survived 0, 1, 3 years) between 1998 and 2010 of endometrial cancerby stage at diagnosis according to SEER. These graphs are adapted from SEER: The Surveillance, Epidemiology, and End Results Program of the National Cancer Institute.[1]

5-year conditional relative survival (probability of surviving in the next 5-years given the cohort has already survived 0, 1, 3 years) between 1998 and 2010 of endometrial cancerby stage at diagnosis according to SEER

References

  1. 1.0 1.1 1.2 1.3 Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site, April 2014.


Template:WikiDoc Sources