Abstract
Carcinoma Endometrium is the most common gynecological malignancy in the west. It ranks third in India after cervix and ovary. Women with endometrial cancer are usually diagnosed at an early stage, as most present with irregular bleeding or abnormal vaginal discharge and surgery is curative. A few subset of women may present with high risk histological factors or are in an advanced stage of disease. These women will need multimodality treatment to achieve a cure. The overall 5-year survival is 80–90 % in stage 1 tumors. With the advent of molecular and genetic factors, preoperative predictors of poor prognosis are needed to select women for adjuvant treatment to improve the disease free survival.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Morrow CP, Bundy BN, Kurman RJ, et al. Relationship between surgical-pathological risk factors and outcome in clinical stage 1 and 11 carcinoma of the endometrium. A gynecologic oncology group study. Gynecol Oncol. 1991;40:55.
Christopherson WM, Connelly PJ, Alberhasky RC. Carcinoma of the endometrium. An analysis of prognosticators in patients with favourable subtypes and stage 1 disease. Cancer. 1983;51:1705.
NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) Uterine Neoplasm. 2014; Version 1.
Hendrickson M, Ross J, Eifel PJ, et al. Adenocarcinoma of the endometrium: analysis of 256 cases with carcinoma limited to the uterine carpus. Pathol review and analysis of prognostic variables. Gynecol Oncol. 1982;13(3):373–92.
Nori D, Hilaris BS, Tame M, et al. Combined surgery and radiation in endometrial carcinoma; an analysis prognostic factors. Int J Radiat Oncol Biol Phys. 1987;13(4):489–97.
De Góis NM, Martins NV, Abrão FS. Peritumorous lymph-vascular invasion, grade of histologic differentiation, and myometrial infiltration as prognostic factors of endometrial carcinoma. Rev Paul Med. 1993;111(3):385–90.
Trimble EWL, Jones HW. Management of stage 11 endometrial carcinoma. Obstet Gynecol. 1988;71:323–6.
Doll KM, Denslow S, Tseng J, et al. Clinical study predictive and prognostic factors in definition of risk groups in endometrial carcinoma. J Clin Oncol. 2013;31 Suppl; abstr 5589.
Mariani A, Webb MJ, Keeney GL, et al. Surgical stage I endometrial cancer: predictors of distant failure and death. Gynecol Oncol. 2002;87:274–80.
Shah C, Johnson EB, Everett E, et al. Does size matter? Tumor size and morphology as predictors of nodal status and recurrence in endometrial cancer. Gynecol Oncol. 2005;99:564–70.
Chitrathara K, Khan A, Neetha S, et al. Discrepancy between clinicoradiological and surgicopathological staging in stage 1 carcinoma endometrium: identification of risk factors. Indian J Cancer 2014; (accepted for publication in 2014).
Creaseman WT, Morrow CP, Bundy L, et al. Surgical pathological spread patterns of endometrial cancer. Cancer. 1987;60:2035.
Turner DA, Gershenson DM, Atkinson N, Sneige N, Wharton AT. The prognostic significance of peritoneal cytology for stage I endometrial cancer. Obstet Gynecol. 1989;74:775–80.
Kadar N, Homesly HD, Malfenato JH. Positive peritoneal cytology is an adverse factor in endometrial carcinoma only if there is other evidence of extrauterine disease. Gynecol Oncol. 1992;46(2):145–9.
McLellan R, Dillon MB, Currie JL, Rosenshein NB. Peritoneal cytology in endometrial cancer: a review. Obstet Gynecol Surv. 1989;44:711–9.
Lurain JR. The significance of positive peritoneal cytology in endometrial cancer. Gynecol Oncol. 1992;46:143–4.
Hirai Y, Takeshima N, Kato T, Hasumi K. Malignant potential of positive peritoneal cytology in endometrial cancer. Obstet Gynecol. 2001;97:725–8.
Kasamatsu T, Onda T, Katsumata N. Prognostic significance of positive peritoneal cytology in endometrial carcinoma confined to the uterus. Br J Cancer. 2003;88(2):147–50.
Mundt AJ, Waggoner S, Yamada D. Age as a prognostic factor for recurrence in patients with endometrial carcinoma. Gynecol Oncol. 2000;79:79–85.
Fleming ND, Lentz SE, Cass I. Is older age a poor prognostic factor in stage I and II endometrioid endometrial adenocarcinoma? Gynecol Oncol. 2011;120(2):189–92.
Kosary CL. FIGO stage, histology, histologic grade, age and race as prognostic factors in determining survival for cancers of the female gynecological system: an analysis of 1973–87 SEER cases of cancers of the endometrium, cervix, ovary, vulva, and vagina. Semin Surg Oncol. 1994;10(1):31–46.
Hicks ML, Kim W, Abrams J, Johnson CC. Racial differences in surgically staged patients with endometrial cancer. J Natl Med Assoc. 1997;89(2):134–40.
Allard JE, Maxwell GL. Race disparities between black and white women in the incidence, treatment, and prognosis of endometrial cancer. Cancer Control. 2009;16(1):53–6.
Sorbe B. Clinical study; Predictive and prognostic factors in definition of risk groups in endometrial carcinoma. ISRN Obstet Gynecol. 2012:Article ID 325790.
Gadducci A, Cavazzana A, Cosio S, et al. Lymph-vascular space involvement and outer one-third myometrial invasion are strong predictors of distant haematogeneous failures in patients with stage I–II endometrioid-type endometrial cancer. Anticancer Res. 2009;29(5):1715–20.
Narayan K, Khaw P, Bernshaw D, et al. Prognostic significance of lymphovascular space invasion and nodal involvement in intermediate- and high-risk endometrial cancer patients treated with curative intent using surgery and adjuvant radiotherapy. Int J Gynecol Cancer. 2012;22(2):260–6.
Loizzi V, Cormio G, Lorusso M, et al. The impact of lymph vascular space invasion on recurrence and survival in patients with early stage endometrial cancer. Eur J Cancer Care (Engl). 2014;23(3):380–4. doi:10.1111/ecc.12115. Epub 23 Sept 2013.
Hongberg T, Signorelli C, de Olivera CF, et al. Sequential adjuvant chemotherapy and radiotherapy in endometrial cancer-results of two randomized studies. Eur J Cancer. 2010;36(2):371–8.
Sorbe B, Nordestrom J, Maepaa J, et al. Intravaginal brachytherapy in FIGO stage1 low risk endometrial cancer; a controlled randomized study. Int J Gynecol Cancer. 2009;19(5):873–8.
Sorbe B, Horvath G, Anderson H, et al. External pelvic and vaginal irradiation versus vaginal irradiation alone as postoperative therapy in medium risk endometrial carcinoma- a prospective randomized study. Int J Radiat Oncol Biol Phys. 2012;82(3):1249–55.
Espino-strebel EE, Luna JTP. Correlation between pre-operative serum CA 125 and surgicopathologic prognostic factors. Gynecol Obstet. ISSN: 2161-0932.
Denschlag D, Tan L, Patel S, et al. Stage III endometrial cancer: preoperative predictability, prognostic factors, and treatment outcome. Am J Obstet Gynecol. 2007;196(6):546e1–7.
Lo SS, Cheng DK, Ng TY, et al. Prognostic significance of tumour markers in endometrial cancer. JCT. 2013:966–970.
Hetzel DJ, Wilson TO, Keeney GL, et al. HER-2/neu expression: a major prognostic factor in endometrial cancer. Gynecol Oncol. 1992;47(2):179–85.
Gurpride E. Endometrial cancer: biochemical and clinical correlates. J Natl Cancer Inst. 1991;83(6):406–16.
Salvesen HB, Iversen OE, Akslen LA. A population-based endometrial carcinoma study – prognostic significance of angiogenesis and Ki-67, p53, and p21 expression. J Clin Oncol. 1999;17(5):1382–90.
Creasman WT. Prognostic significance of hormone receptors in endometrial cancer. Cancer. 1993;71(4 Suppl):1467–70.
Carcangiu ML, Chambers JT, Voynick IM, et al. Immunohistochemical evaluation of oestrogen and progesterone receptor content in 183 patients with endometrial carcinoma. Part 1: clinical and histological correlation. Am J Clin Pathol. 1990;94(3):247–54.
Chambers JT, Carcangiu ML, Voynick IM, et al. Immunohistochemical evaluation of oestrogen and progesterone receptor content in 183 patients with endometrial carcinoma. Part 11: correlation between biochemical and immunohistochemical methods and survival. Am J Clin Pathol. 1990;94(3):255–60.
Ingram SS, Rosenman J, Heath R, et al. The predictive value of progesterone receptor levels in endometrial cancer. Int J Radiat Oncol Biol Phys. 1989;17(1):21–7.
Huvila J, Talve L, Carpén O, et al. A progesterone receptor negativity is an independent risk factor for relapse in patients with early stage endometrioid endometrial adenocarcinoma. Gynecol Oncol. 2013;130(3):463–9.
Yao YY, Xu WZ, Wang Y, et al. Relationships between the molecular biomarkers and the clinicopathologic features and prognosis in endometrial carcinoma. Beijing Da Xue Xue Bao. 2011;43(5):743–8. English abstract.
Susini T, Baldi F, Howard CM, et al. Expression of the retinoblastoma-related gene Rb2/p130 correlates with clinical outcome in endometrial cancer. J Clin Oncol. 1998;16:1085–93.
Susini T, Massi D, Paglierani M, et al. Expression of the retinoblastoma-related gene Rb2/p130 is downregulated in atypical endometrial hyperplasia and adenocarcinoma. Hum Pathol. 2001;32(4):360–7.
Mhawech-Fauceglia P, Wang D, Kim G, et al. Expression of DNA repair proteins in endometrial cancer predicts disease outcome. Gynecol Oncol. 2014;132(3):593–8. doi:10.1016/j.ygyno.2014.02.002. Epub 6 Feb 2014.
Gao QL, Ye F, Li J, et al. PTEN coding product: a marker for tumorigenesis and progression of endometrial carcinoma. Ai Zheng. 2003;22(6):640–4.
Pallares J, Bussaglia E, Martínez-Guitarte JL, et al. Immunohistochemical analysis of PTEN in endometrial carcinoma: a tissue microarray study with a comparison of four commercial antibodies in correlation with molecular abnormalities. Mod Pathol. 2005;18(5):719–27.
Konstantinos K, Marios S, Anna M, et al. Expression of p53 in imprint smears of endometrial carcinoma. Diagn Cytopathol. 2014;42(5):416–22. doi:10.1002/dc.23056. Epub 25 Oct 2013.
Inaba F, Yamazaki T, Fukasawa I, et al. Endometrial adenosquamous carcinoma with osteoclast-like giant cells: immunohistochemistry and histogenesis. Oncol Rep. 2005;13(1):17–24.
Karaayvaz M, Zhang C, Liang S. Prognostic significance of miR-205 in endometrial cancer. 2012. doi:10.1371/journal.pone.0035158
Ugaki H, Yoshino K, Fujita M, et al. Endometrial carcinoma with extra-abdominal metastasis: improved prognosis following cytoreductive surgery. Ann Surg Oncol. 2010;17(4):1111–7. doi:10.1245/s10434-009-0892-8.
Ghassan A, Bernardini MQ, Ren-Chin Wu RC, et al. ARID1A loss correlates with mismatch repair deficiency and intact p53 expression in high-grade endometrial carcinomas. Mod Pathol. 2014;27:255–61. doi:10.1038/modpathol.2013.144.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer India
About this chapter
Cite this chapter
Chitrathara, K. (2015). Prognostic and Predictive Factors in the Management of Carcinoma Endometrium. In: Rajaram, S., K, C., Maheshwari, A. (eds) Uterine Cancer. Springer, New Delhi. https://doi.org/10.1007/978-81-322-1892-0_12
Download citation
DOI: https://doi.org/10.1007/978-81-322-1892-0_12
Publisher Name: Springer, New Delhi
Print ISBN: 978-81-322-1891-3
Online ISBN: 978-81-322-1892-0
eBook Packages: MedicineMedicine (R0)