Endometrial Cancer
•Download as PPTX, PDF•
1 like•829 views
This clinical pathway document summarizes the evaluation and treatment of endometrial cancer. It outlines pre-operative testing including office endometrial biopsy and imaging for staging. It discusses surgical techniques for laparotomy and minimally invasive surgery (MIGS). It also covers staging criteria, adjuvant therapy based on surgical staging, prognosis, genetic screening for Lynch syndrome, post-treatment surveillance, and future directions for robotic surgery. The goal is to provide optimized and cost-effective care for patients with endometrial cancer.
Report
Share
Report
Share
Recommended
Endometrial Cancer; Evidence Based Approach
Endometrial cancer is the most common gynecologic cancer. It has a lifetime risk of 2.4% in white women. Risk factors include obesity, late menopause, diabetes, and unopposed estrogen exposure. Diagnosis is usually made with endometrial biopsy. Treatment involves hysterectomy, bilateral salpingo-oophorectomy, and lymph node dissection. Adjuvant radiation and/or chemotherapy may be used in high risk cases. With early stage diagnosis, endometrial cancer has a good prognosis.
Endometrial carcinoma by dr syed usman shah
1) Endometrial carcinoma arises from the epithelial lining of the endometrium and is the most common female pelvic malignancy.
2) Risk factors include increasing age, nulliparity, obesity, diabetes, hormone replacement therapy using estrogen alone, and endometrial hyperplasia.
3) Diagnosis involves investigation of postmenopausal bleeding with ultrasound and biopsy showing adenocarcinoma in 90% of cases. Treatment is usually hysterectomy with radiation or chemotherapy for advanced stages.
Endometrial Cancer
Endometrial cancer develops from normal endometrial tissue through increasing abnormal cell changes and progresses to cancer. Key risk factors include estrogen stimulation that is unopposed or inadequately opposed, nulliparity, infertility, PCOS, irregular menses, elevated BMI, early menarche, and late menopause. Symptoms can include postmenopausal or abnormal perimenopausal bleeding. Diagnosis involves endometrial biopsy or D&C to obtain tissue samples, while ultrasound can image the endometrium. Treatment depends on cancer stage and cell type, and can involve progestational agents, surgery, radiation, or a combination of therapies. Prognosis is generally good for common cell types if diagnosed
Carcinoma endometrium
Endometrial carcinoma arises from the epithelial lining of the endometrium. It is the most common gynecologic cancer in developed countries. Risk factors include increased age, nulliparity, obesity, diabetes, and exposure to unopposed estrogen. Symptoms include abnormal uterine bleeding. Diagnosis is made through endometrial biopsy. Treatment depends on stage and includes surgery, radiation, chemotherapy, or hormone therapy. Prognosis is best for early stage disease and overall 5-year survival is 70%.
Ca endometrium
carcinoma edometrium by Dr.Saeed Ur Rehman Wazir PG trainee radiation and medical oncology NORI cancer hospital
Carcinoma Endometrium ( uterine cancer)
This document discusses endometrial carcinoma. It defines endometrial carcinoma as cancer of the uterine lining and notes it is the third most common gynecologic malignancy. Risk factors include increasing age, obesity, prolonged estrogen exposure without progesterone, late menarche and early menopause. The document outlines the pathology, staging, clinical evaluation, treatment including surgery and adjuvant therapies, and prognosis of endometrial carcinoma. Prevention focuses on weight control and restricting unnecessary estrogen use.
Endometrial cancer
Endometrial cancer is the most common female pelvic genital cancer. It has a higher incidence in postmenopausal women and obesity is a major risk factor. Treatment involves total hysterectomy, bilateral salpingo-oophorectomy, and pelvic and para-aortic lymphadenectomy for early stage disease. Adjuvant radiation or vaginal brachytherapy may be used for intermediate risk disease. Advanced stage disease is treated with chemotherapy using cisplatin and doxorubicin or carboplatin and paclitaxel. Five year survival is 72% for stage I disease but only 3% for stage IV disease.
Ca endometrium
Endometrial cancer most commonly presents with postmenopausal vaginal bleeding. Histopathology shows endometrioid adenocarcinoma in 75-80% of cases. There are two types - type I is estrogen-dependent and has a better prognosis, while type II is more aggressive and has a poorer prognosis. Diagnosis involves endometrial biopsy or dilation and curettage. Staging involves surgical procedures like total abdominal hysterectomy and lymph node sampling or dissection. Prognosis depends on factors like age, grade, histology, lymph node involvement and stage.
Recommended
Endometrial Cancer; Evidence Based Approach
Endometrial cancer is the most common gynecologic cancer. It has a lifetime risk of 2.4% in white women. Risk factors include obesity, late menopause, diabetes, and unopposed estrogen exposure. Diagnosis is usually made with endometrial biopsy. Treatment involves hysterectomy, bilateral salpingo-oophorectomy, and lymph node dissection. Adjuvant radiation and/or chemotherapy may be used in high risk cases. With early stage diagnosis, endometrial cancer has a good prognosis.
Endometrial carcinoma by dr syed usman shah
1) Endometrial carcinoma arises from the epithelial lining of the endometrium and is the most common female pelvic malignancy.
2) Risk factors include increasing age, nulliparity, obesity, diabetes, hormone replacement therapy using estrogen alone, and endometrial hyperplasia.
3) Diagnosis involves investigation of postmenopausal bleeding with ultrasound and biopsy showing adenocarcinoma in 90% of cases. Treatment is usually hysterectomy with radiation or chemotherapy for advanced stages.
Endometrial Cancer
Endometrial cancer develops from normal endometrial tissue through increasing abnormal cell changes and progresses to cancer. Key risk factors include estrogen stimulation that is unopposed or inadequately opposed, nulliparity, infertility, PCOS, irregular menses, elevated BMI, early menarche, and late menopause. Symptoms can include postmenopausal or abnormal perimenopausal bleeding. Diagnosis involves endometrial biopsy or D&C to obtain tissue samples, while ultrasound can image the endometrium. Treatment depends on cancer stage and cell type, and can involve progestational agents, surgery, radiation, or a combination of therapies. Prognosis is generally good for common cell types if diagnosed
Carcinoma endometrium
Endometrial carcinoma arises from the epithelial lining of the endometrium. It is the most common gynecologic cancer in developed countries. Risk factors include increased age, nulliparity, obesity, diabetes, and exposure to unopposed estrogen. Symptoms include abnormal uterine bleeding. Diagnosis is made through endometrial biopsy. Treatment depends on stage and includes surgery, radiation, chemotherapy, or hormone therapy. Prognosis is best for early stage disease and overall 5-year survival is 70%.
Ca endometrium
carcinoma edometrium by Dr.Saeed Ur Rehman Wazir PG trainee radiation and medical oncology NORI cancer hospital
Carcinoma Endometrium ( uterine cancer)
This document discusses endometrial carcinoma. It defines endometrial carcinoma as cancer of the uterine lining and notes it is the third most common gynecologic malignancy. Risk factors include increasing age, obesity, prolonged estrogen exposure without progesterone, late menarche and early menopause. The document outlines the pathology, staging, clinical evaluation, treatment including surgery and adjuvant therapies, and prognosis of endometrial carcinoma. Prevention focuses on weight control and restricting unnecessary estrogen use.
Endometrial cancer
Endometrial cancer is the most common female pelvic genital cancer. It has a higher incidence in postmenopausal women and obesity is a major risk factor. Treatment involves total hysterectomy, bilateral salpingo-oophorectomy, and pelvic and para-aortic lymphadenectomy for early stage disease. Adjuvant radiation or vaginal brachytherapy may be used for intermediate risk disease. Advanced stage disease is treated with chemotherapy using cisplatin and doxorubicin or carboplatin and paclitaxel. Five year survival is 72% for stage I disease but only 3% for stage IV disease.
Ca endometrium
Endometrial cancer most commonly presents with postmenopausal vaginal bleeding. Histopathology shows endometrioid adenocarcinoma in 75-80% of cases. There are two types - type I is estrogen-dependent and has a better prognosis, while type II is more aggressive and has a poorer prognosis. Diagnosis involves endometrial biopsy or dilation and curettage. Staging involves surgical procedures like total abdominal hysterectomy and lymph node sampling or dissection. Prognosis depends on factors like age, grade, histology, lymph node involvement and stage.
Ovarian cancer
Based on the clinical findings and investigations, the differential diagnoses in this case include:
1. Advanced ovarian malignancy
2. Tubo-ovarian abscess
3. Advanced uterine malignancy
4. Advanced gastrointestinal malignancy
The investigations that should be advised include:
1. Tumor markers (CA 125, CEA, CA 19-9)
2. Abdominal and pelvic ultrasound/ CT scan to look for primary site and metastases
3. Chest X ray
4. Colonoscopy
Considering the age of the patient, elevated tumor markers, splenomegaly on USG and restricted mobility of mass on examination, advanced ovarian malignancy seems to be the likely diagnosis
Endometrial cancer
Endometrial Cancer is a malignancy that arises from the lining of the uterus, endometrium.
It is the most common gynaelogical cancer in developing countries, while in developed countries it is the second most common cancer, behind cervical cancer.
• In year 2012 a total of 320,000 new cases were recorded.
• Globally, it is the sixth most common cancer in women, fourteenth most common overall.
• In Peninsular Malaysia, it is the seventh most common cancer in women, according to Malaysian cancer Registry 2006.
• It is rare among women younger than 40 years.
• Peak incidence occurring at age 60-69.
• Majority are of Chinese ethnicity (47.5%), followed by Malays (41.6%) and Indian (10.9%).
Endometrial Cancer
Cancer that
forms in the tissue lining the uterus (the small, hollow, pear-shaped
organ in a woman's pelvis in which a fetus develops). Most endometrial
cancers are adenocarcinomas (cancers that begin in cells that make and
release mucus and other fluids).
NCI
Endometrial cancer
The uterus is a pear-shaped organ divided into the fundus, body, and cervix. Lymph drainage from the fundus goes to para-aortic nodes at L1, while the body and cervix drain to internal and external iliac nodes. Endometrial cancer is the most common gynecologic malignancy in the US, with risk factors including age, estrogen exposure, genetics, and medical history. Treatment depends on staging and includes surgery, radiation, chemotherapy, and hormonal therapy.
Uterine sarcoma
Uterine sarcomas are a heterogeneous group of rare uterine cancers comprising 3% of uterine neoplasms. This document discusses the classification, management, and role of radiation therapy for various uterine sarcoma subtypes based on the 2014 WHO classification. It summarizes evidence from retrospective studies and phase III trials that adjuvant radiation improves local control for leiomyosarcoma and carcinosarcoma but does not provide a survival benefit. Ongoing research aims to determine optimal chemotherapy regimens and targeted therapies to improve survival by controlling metastasis.
Carcinoma of endometrium
Carcinoma of the endometrium is one of the most common gynecological cancers, especially in postmenopausal white women. There is no effective screening program. Risk factors include estrogen exposure, obesity, and nulliparity. Symptoms include postmenopausal bleeding. Diagnosis involves endometrial biopsy. Treatment depends on staging and includes surgery with radiation or chemotherapy for advanced cases. Prognosis depends on staging, histology, and treatment received.
Endo ca
This document summarizes information about endometrial cancer, including that it is the most common malignancy of the female genital tract, with most cases occurring in post-menopausal women aged 60-70 years. Risk factors include nulliparity, late menopause, obesity, diabetes, and use of unopposed estrogen therapy. Endometrial hyperplasia, especially when atypical, increases the risk. Prognosis depends on factors like histologic type, grade, depth of myometrial invasion, and whether the cancer has spread. Treatment may involve surgery, with radiation and chemotherapy also used in more advanced cases.
Malpica ovarian cancer, Venezuela 2016
Conferencia de la Dra. Ana Malpica (MD Anderson) XVII Congreso Venezolano de Oncología , Valencia, Estado Carabobo. 2016.
cervical carcinoma, endometrial carcinoma and vulval disease
Cervical cancer is the second most common gynecological cancer. It peaks between ages 45-55 and is often caused by HPV infection. Symptoms may include abnormal bleeding or discharge. Diagnosis involves colposcopy, biopsy, and imaging. Treatment depends on stage - early stage may involve cone biopsy or hysterectomy while advanced stages are treated with radiation or chemotherapy. 5-year survival ranges from 100% for stage 0 to 14% for stage 4 disease.
Gynecology 5th year, 7th lecture/part two (Dr. Sindus)
The document discusses premalignant and malignant disorders of the uterine corpus, specifically endometrial carcinoma. It covers the epidemiology, risk factors, classification, clinical presentation, diagnosis, staging, prognosis, differential diagnosis, and treatment of endometrial carcinoma. The highest incidence is in white North Americans over age 60. Risk factors include obesity, diabetes, nulliparity, late menopause, and unopposed estrogen use. Diagnosis involves endometrial biopsy and ultrasound. Prognosis depends on stage - stage I has an 85% 5-year survival rate. Treatment involves hysterectomy, with radiation for higher stages or risk factors.
Endometril carcinoma
This document discusses endometrial carcinoma (cancer of the uterus). It provides information on:
- Risk factors including prolonged estrogen exposure, nulliparity, obesity, and tamoxifen use.
- Types include endometrioid adenocarcinoma (most common), adenocarcinoma with squamous differentiation, clear cell carcinoma, and uterine papillary serous carcinoma.
- Staging from Stage I (limited to uterus) to Stage IV (distant metastases). Prognosis is generally good due to late invasion and spread but worsens with higher stage, grade, and certain histological types.
- Investigations include ultrasound, endometrial biopsy/sampling, and MRI or
Endometrial Carcinoma
This document discusses endometrial carcinoma (cancer of the uterus). It begins with an anatomy of the uterus and defines endometrial cancer as beginning in the endometrial lining of the uterus. Some risk factors include obesity, hormonal imbalances, and nulliparity. Diagnosis involves ultrasound, biopsy and imaging. Treatment depends on cancer stage and grade, and may include surgery, radiation, chemotherapy. Prognosis is generally good, though older age and advanced stage indicate poorer outcomes.
Epidemiology of uterine cancer
Endometrial cancer is the most common gynecologic cancer in the United States, with over 54,000 new cases and 10,000 deaths estimated in 2015. Risk factors include nulliparity, late menopause, obesity, diabetes, and use of unopposed estrogen therapy. The majority of cases are endometrioid adenocarcinomas associated with estrogen stimulation of the endometrium. About 3-5% of cases are caused by Lynch syndrome which is associated with mutations in mismatch repair genes. Prognosis is best for early stage localized disease, with an overall 5-year survival rate of 81.5%.
Treatment of CA Ovary
This document discusses the treatment of ovarian carcinoma. It begins with an overview of the epidemiology, patterns of spread, symptoms, diagnostic workup and surgical staging of the disease. It then describes the histopathological classification and various chemotherapy regimens used as adjuvant treatment, including platinum-based drugs like cisplatin and carboplatin, and taxanes like paclitaxel. The standard first-line regimen for early-stage high-risk ovarian cancer is 6 cycles of paclitaxel and carboplatin given every 3 weeks.
Endometrial carcinoma
Endometrial carcinoma is the most common gynecologic malignancy, predominantly affecting postmenopausal women. It is twice as common as ovarian cancer and three times more common than cervical cancer. The main risk factors are obesity, a high intake of animal fats, and use of unopposed estrogen therapy. Abnormal vaginal bleeding is the most common symptom and prompts diagnosis, usually at an early stage. Screening is not routinely recommended but may be considered for high risk groups like tamoxifen users. Pathologic examination determines histologic type and grade, which predict clinical behavior.
Uterine Corpus Tumors
This document summarizes information about uterine corpus tumors, specifically endometrial cancer. It discusses the epidemiology, etiology, risk factors, signs and symptoms, screening and diagnosis, pathology, staging and prognosis, and treatment of endometrial cancer. It notes that endometrial cancer is the most common female pelvic malignancy, with risk factors including obesity, unopposed estrogen exposure, and lack of parity. Diagnosis involves endometrial biopsy or dilation and curettage. Prognosis depends on staging which incorporates factors like tumor grade, myometrial invasion, and lymph node involvement. Treatment typically involves surgery including hysterectomy, with radiation therapy sometimes used as adjuvant treatment.
Ovarian cancer
This document discusses ovarian cancer, including its presentation, types, staging, and management. It notes that ovarian cancer is the second most common gynecological cancer and a major cause of death. Epithelial ovarian cancer accounts for about 90% of cases and often presents at an advanced stage with vague symptoms. Treatment typically involves surgery to remove as much of the tumor as possible followed by chemotherapy. The document reviews the different histological types of ovarian cancer and sex cord-stromal tumors and germ cell tumors, which each have distinct characteristics and management approaches focused on fertility preservation when possible.
Saving uterus saving ovary
This document discusses various management options for uterine bleeding and prolapse in women. It describes conservative treatments that can help avoid hysterectomy such as medical management using hormones, the Mirena IUD, and minimally invasive procedures. It also discusses the importance of considering conservative therapies and not assuming the uterus is vestigial after childbearing. Surgical options for fibroids like myomectomy and embolization are presented. Conservative surgeries for prolapse in young patients like cervicopexy and sling procedures are also mentioned.
Uterine body tumors.
This document discusses endometrial carcinoma. Some key points:
- It is the most common gynecological cancer in developed countries and affects postmenopausal women primarily. Risk factors include excess estrogen exposure, obesity, diabetes, and tamoxifen use.
- It is classified based on histopathology, with the most common type being endometrioid adenocarcinoma. It spreads locally through the uterus and lymphatically, with advanced cases spreading hematogenously.
- Staging is done using the FIGO system, with stage I being confined to the uterus and stage IV being distant metastases. Prognosis depends on stage, grade, histological type, and degree of
Ovarian cancer
a nice presentation about the Ovarian Cancer its include an introduction with brief notes about the epidemiology and risk factors then shift to pathology and pathogenesis and diagnosis with signs , symptoms and lab tests with imaging modules , screening , management
Lines of ttt of p ca
This document summarizes risk stratification and treatment options for prostate cancer. It discusses using risk prediction models to stratify patients into low, intermediate, and high risk groups to help determine appropriate initial treatment. Options include active surveillance, radical prostatectomy, radiotherapy, and hormone therapy depending on risk level. Treatment selection involves weighing factors like life expectancy, disease control, and side effects.
Treatment of urological conditions in the era of covid
COVID-19 has put tremendous pressure on the existing healthcare system. While , all resources are being diverted for COVID-19 treatment, Urology should put in effort for the same, meanwhile treating patients for their emergent urological problems. This presentation discusses the Dos and Donts of urological practice in the hero of COVID-19
More Related Content
What's hot
Ovarian cancer
Based on the clinical findings and investigations, the differential diagnoses in this case include:
1. Advanced ovarian malignancy
2. Tubo-ovarian abscess
3. Advanced uterine malignancy
4. Advanced gastrointestinal malignancy
The investigations that should be advised include:
1. Tumor markers (CA 125, CEA, CA 19-9)
2. Abdominal and pelvic ultrasound/ CT scan to look for primary site and metastases
3. Chest X ray
4. Colonoscopy
Considering the age of the patient, elevated tumor markers, splenomegaly on USG and restricted mobility of mass on examination, advanced ovarian malignancy seems to be the likely diagnosis
Endometrial cancer
Endometrial Cancer is a malignancy that arises from the lining of the uterus, endometrium.
It is the most common gynaelogical cancer in developing countries, while in developed countries it is the second most common cancer, behind cervical cancer.
• In year 2012 a total of 320,000 new cases were recorded.
• Globally, it is the sixth most common cancer in women, fourteenth most common overall.
• In Peninsular Malaysia, it is the seventh most common cancer in women, according to Malaysian cancer Registry 2006.
• It is rare among women younger than 40 years.
• Peak incidence occurring at age 60-69.
• Majority are of Chinese ethnicity (47.5%), followed by Malays (41.6%) and Indian (10.9%).
Endometrial Cancer
Cancer that
forms in the tissue lining the uterus (the small, hollow, pear-shaped
organ in a woman's pelvis in which a fetus develops). Most endometrial
cancers are adenocarcinomas (cancers that begin in cells that make and
release mucus and other fluids).
NCI
Endometrial cancer
The uterus is a pear-shaped organ divided into the fundus, body, and cervix. Lymph drainage from the fundus goes to para-aortic nodes at L1, while the body and cervix drain to internal and external iliac nodes. Endometrial cancer is the most common gynecologic malignancy in the US, with risk factors including age, estrogen exposure, genetics, and medical history. Treatment depends on staging and includes surgery, radiation, chemotherapy, and hormonal therapy.
Uterine sarcoma
Uterine sarcomas are a heterogeneous group of rare uterine cancers comprising 3% of uterine neoplasms. This document discusses the classification, management, and role of radiation therapy for various uterine sarcoma subtypes based on the 2014 WHO classification. It summarizes evidence from retrospective studies and phase III trials that adjuvant radiation improves local control for leiomyosarcoma and carcinosarcoma but does not provide a survival benefit. Ongoing research aims to determine optimal chemotherapy regimens and targeted therapies to improve survival by controlling metastasis.
Carcinoma of endometrium
Carcinoma of the endometrium is one of the most common gynecological cancers, especially in postmenopausal white women. There is no effective screening program. Risk factors include estrogen exposure, obesity, and nulliparity. Symptoms include postmenopausal bleeding. Diagnosis involves endometrial biopsy. Treatment depends on staging and includes surgery with radiation or chemotherapy for advanced cases. Prognosis depends on staging, histology, and treatment received.
Endo ca
This document summarizes information about endometrial cancer, including that it is the most common malignancy of the female genital tract, with most cases occurring in post-menopausal women aged 60-70 years. Risk factors include nulliparity, late menopause, obesity, diabetes, and use of unopposed estrogen therapy. Endometrial hyperplasia, especially when atypical, increases the risk. Prognosis depends on factors like histologic type, grade, depth of myometrial invasion, and whether the cancer has spread. Treatment may involve surgery, with radiation and chemotherapy also used in more advanced cases.
Malpica ovarian cancer, Venezuela 2016
Conferencia de la Dra. Ana Malpica (MD Anderson) XVII Congreso Venezolano de Oncología , Valencia, Estado Carabobo. 2016.
cervical carcinoma, endometrial carcinoma and vulval disease
Cervical cancer is the second most common gynecological cancer. It peaks between ages 45-55 and is often caused by HPV infection. Symptoms may include abnormal bleeding or discharge. Diagnosis involves colposcopy, biopsy, and imaging. Treatment depends on stage - early stage may involve cone biopsy or hysterectomy while advanced stages are treated with radiation or chemotherapy. 5-year survival ranges from 100% for stage 0 to 14% for stage 4 disease.
Gynecology 5th year, 7th lecture/part two (Dr. Sindus)
The document discusses premalignant and malignant disorders of the uterine corpus, specifically endometrial carcinoma. It covers the epidemiology, risk factors, classification, clinical presentation, diagnosis, staging, prognosis, differential diagnosis, and treatment of endometrial carcinoma. The highest incidence is in white North Americans over age 60. Risk factors include obesity, diabetes, nulliparity, late menopause, and unopposed estrogen use. Diagnosis involves endometrial biopsy and ultrasound. Prognosis depends on stage - stage I has an 85% 5-year survival rate. Treatment involves hysterectomy, with radiation for higher stages or risk factors.
Endometril carcinoma
This document discusses endometrial carcinoma (cancer of the uterus). It provides information on:
- Risk factors including prolonged estrogen exposure, nulliparity, obesity, and tamoxifen use.
- Types include endometrioid adenocarcinoma (most common), adenocarcinoma with squamous differentiation, clear cell carcinoma, and uterine papillary serous carcinoma.
- Staging from Stage I (limited to uterus) to Stage IV (distant metastases). Prognosis is generally good due to late invasion and spread but worsens with higher stage, grade, and certain histological types.
- Investigations include ultrasound, endometrial biopsy/sampling, and MRI or
Endometrial Carcinoma
This document discusses endometrial carcinoma (cancer of the uterus). It begins with an anatomy of the uterus and defines endometrial cancer as beginning in the endometrial lining of the uterus. Some risk factors include obesity, hormonal imbalances, and nulliparity. Diagnosis involves ultrasound, biopsy and imaging. Treatment depends on cancer stage and grade, and may include surgery, radiation, chemotherapy. Prognosis is generally good, though older age and advanced stage indicate poorer outcomes.
Epidemiology of uterine cancer
Endometrial cancer is the most common gynecologic cancer in the United States, with over 54,000 new cases and 10,000 deaths estimated in 2015. Risk factors include nulliparity, late menopause, obesity, diabetes, and use of unopposed estrogen therapy. The majority of cases are endometrioid adenocarcinomas associated with estrogen stimulation of the endometrium. About 3-5% of cases are caused by Lynch syndrome which is associated with mutations in mismatch repair genes. Prognosis is best for early stage localized disease, with an overall 5-year survival rate of 81.5%.
Treatment of CA Ovary
This document discusses the treatment of ovarian carcinoma. It begins with an overview of the epidemiology, patterns of spread, symptoms, diagnostic workup and surgical staging of the disease. It then describes the histopathological classification and various chemotherapy regimens used as adjuvant treatment, including platinum-based drugs like cisplatin and carboplatin, and taxanes like paclitaxel. The standard first-line regimen for early-stage high-risk ovarian cancer is 6 cycles of paclitaxel and carboplatin given every 3 weeks.
Endometrial carcinoma
Endometrial carcinoma is the most common gynecologic malignancy, predominantly affecting postmenopausal women. It is twice as common as ovarian cancer and three times more common than cervical cancer. The main risk factors are obesity, a high intake of animal fats, and use of unopposed estrogen therapy. Abnormal vaginal bleeding is the most common symptom and prompts diagnosis, usually at an early stage. Screening is not routinely recommended but may be considered for high risk groups like tamoxifen users. Pathologic examination determines histologic type and grade, which predict clinical behavior.
Uterine Corpus Tumors
This document summarizes information about uterine corpus tumors, specifically endometrial cancer. It discusses the epidemiology, etiology, risk factors, signs and symptoms, screening and diagnosis, pathology, staging and prognosis, and treatment of endometrial cancer. It notes that endometrial cancer is the most common female pelvic malignancy, with risk factors including obesity, unopposed estrogen exposure, and lack of parity. Diagnosis involves endometrial biopsy or dilation and curettage. Prognosis depends on staging which incorporates factors like tumor grade, myometrial invasion, and lymph node involvement. Treatment typically involves surgery including hysterectomy, with radiation therapy sometimes used as adjuvant treatment.
Ovarian cancer
This document discusses ovarian cancer, including its presentation, types, staging, and management. It notes that ovarian cancer is the second most common gynecological cancer and a major cause of death. Epithelial ovarian cancer accounts for about 90% of cases and often presents at an advanced stage with vague symptoms. Treatment typically involves surgery to remove as much of the tumor as possible followed by chemotherapy. The document reviews the different histological types of ovarian cancer and sex cord-stromal tumors and germ cell tumors, which each have distinct characteristics and management approaches focused on fertility preservation when possible.
Saving uterus saving ovary
This document discusses various management options for uterine bleeding and prolapse in women. It describes conservative treatments that can help avoid hysterectomy such as medical management using hormones, the Mirena IUD, and minimally invasive procedures. It also discusses the importance of considering conservative therapies and not assuming the uterus is vestigial after childbearing. Surgical options for fibroids like myomectomy and embolization are presented. Conservative surgeries for prolapse in young patients like cervicopexy and sling procedures are also mentioned.
Uterine body tumors.
This document discusses endometrial carcinoma. Some key points:
- It is the most common gynecological cancer in developed countries and affects postmenopausal women primarily. Risk factors include excess estrogen exposure, obesity, diabetes, and tamoxifen use.
- It is classified based on histopathology, with the most common type being endometrioid adenocarcinoma. It spreads locally through the uterus and lymphatically, with advanced cases spreading hematogenously.
- Staging is done using the FIGO system, with stage I being confined to the uterus and stage IV being distant metastases. Prognosis depends on stage, grade, histological type, and degree of
Ovarian cancer
a nice presentation about the Ovarian Cancer its include an introduction with brief notes about the epidemiology and risk factors then shift to pathology and pathogenesis and diagnosis with signs , symptoms and lab tests with imaging modules , screening , management
What's hot (20)
cervical carcinoma, endometrial carcinoma and vulval disease
cervical carcinoma, endometrial carcinoma and vulval disease
Gynecology 5th year, 7th lecture/part two (Dr. Sindus)
Gynecology 5th year, 7th lecture/part two (Dr. Sindus)
Similar to Endometrial Cancer
Lines of ttt of p ca
This document summarizes risk stratification and treatment options for prostate cancer. It discusses using risk prediction models to stratify patients into low, intermediate, and high risk groups to help determine appropriate initial treatment. Options include active surveillance, radical prostatectomy, radiotherapy, and hormone therapy depending on risk level. Treatment selection involves weighing factors like life expectancy, disease control, and side effects.
Treatment of urological conditions in the era of covid
COVID-19 has put tremendous pressure on the existing healthcare system. While , all resources are being diverted for COVID-19 treatment, Urology should put in effort for the same, meanwhile treating patients for their emergent urological problems. This presentation discusses the Dos and Donts of urological practice in the hero of COVID-19
Approach to breast disease (accad)
This document provides an overview of approaches to breast disease and summarizes several topics discussed, including:
1. Screening and management of breast cancer, mastalgia, nipple discharge, and breast masses. Biopsies are recommended for any breast masses regardless of patient age.
2. Lobular carcinoma in situ, ductal carcinoma in situ, and challenges around determining when a benign lesion becomes malignant.
3. Staging, multimodal treatment including surgery, radiation, chemotherapy, and reconstruction post-mastectomy.
4. Prevention strategies like surveillance, chemoprevention, and prophylactic mastectomy for high risk patients.
5. Issues around pregnancy-associated breast cancer diagnosis
Locally advanced breast cancer
This document discusses the management of locally advanced breast cancer (LABC). Key points:
1. LABC includes stages IIIA, IIIB, IIIC breast cancer with large tumors (>5cm), chest wall involvement, skin ulcers, or fixed lymph nodes. Inflammatory breast cancer is an aggressive subtype of LABC.
2. Diagnosis involves history, physical exam, imaging like mammography and MRI, and biopsy. Staging workup includes labs, imaging of chest, abdomen, pelvis and bone.
3. Treatment involves neoadjuvant chemotherapy to downstage the cancer and allow for surgery. Surgery may include mastectomy or breast conservation. Postoperative radiation and endocrine therapy
Gastrointestinal Stomal Tumours latest updates
1. Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors that originate in the gastrointestinal tract.
2. Diagnosis involves biopsy and immunohistochemistry testing for markers like CD117 and CD34. Tumor size and mitotic rate help determine prognosis.
3. Treatment is complete surgical excision of localized tumors. Targeted drug therapy with imatinib is standard for metastatic or high-risk GISTs.
CERVIX CANCER IN NUTSHELL
The document provides information on cervical cancer including:
1. Statistics on global cancer incidence and mortality with cervical cancer among the most common cancers.
2. Risk factors for cervical cancer including human papillomavirus infection, young age of first intercourse, multiple sexual partners, and smoking.
3. Screening guidelines recommend co-testing with cytology and HPV testing every 5 years for women aged 30-65 or cytology alone every 3 years.
Oncology: basic science for general surgical residents
The document discusses oncology and cancer biology. It defines neoplasia as uncontrolled proliferation of transformed cells. The primary goals of surgical and radiation therapy for cancer are local and regional control, while systemic therapy aims for systemic control to prevent distant recurrence. The most common cancers worldwide are lung cancer in men and breast cancer in women. Cancer diagnosis involves methods like biopsy to obtain a definitive diagnosis. Staging systems like TNM are used to determine cancer progression. A multidisciplinary approach utilizing surgery, radiation, chemotherapy, targeted therapy and other modalities can improve survival rates compared to surgery alone.
ca endometrium.pptx
The document discusses the anatomy and histology of the endometrium, the lining of the uterus. It then covers endometrial cancer, including risk factors, common presentations, workup involving endometrial biopsy and imaging, and staging. Treatment is discussed for each stage, with surgery being primary treatment and adjuvant therapy depending on grade, myometrial invasion, and other pathological factors. Sentinel lymph node biopsy and recent advances are also mentioned.
VTS-Cancer-Screening-slides-27.6.17.pptx
Early diagnosis and screening for cancer was discussed. The presentation covered background on early diagnosis, cancer screening programmes including bowel, breast and cervical screening, and safety netting practices. Barriers to bowel cancer screening uptake were reviewed, along with practical tips practices can implement to increase uptake such as providing staff training, displaying screening information, and using practice data to review uptake. Resources for practices from Cancer Research UK including audit tools, guidelines and patient information materials were also presented.
Basic sciences of breast cancer
basic sciences of breast cancer about molecular biology, staging, work up of breast cancer, investigations
Innovations in Pancreatic Cancer: A Reason to Hope
This document discusses innovations in pancreatic cancer treatment and research. It provides hope by highlighting advances that allow patients to live longer with the disease or be cured. These include early diagnosis, dedicated cancer specialists, clinical trials of new treatments, and laboratory research. The author advocates for a focus on both immediate patient care and long-term cures through a combination of new treatments and optimized patient selection for surgery.
Ovarian cancer surgery march 2012
This document discusses the optimal surgical management of ovarian cancer. It covers assessing pelvic masses, the epidemiology and etiology of ovarian cancer, recent trends in surgical approaches including primary debulking surgery or neoadjuvant chemotherapy followed by interval debulking surgery, management of recurrent cancer, and palliative surgery. Key points include the importance of comprehensive surgical staging for early disease, achieving optimal cytoreduction for advanced disease to improve survival outcomes, and considering secondary cytoreduction for recurrent platinum-sensitive disease.
Ovary 1
This document discusses the management of ovarian cancer. It covers risk-reducing salpingo-oophorectomy (RRSO) for high-risk patients, surgical staging techniques including open and minimally invasive approaches, management of early-stage disease including adjuvant chemotherapy and radiation, cytoreductive surgery and goals for advanced-stage disease, and the role of interval debulking surgery after neoadjuvant chemotherapy. Complete resection of all tumor is the optimal outcome for advanced ovarian cancer to improve survival outcomes.
Cervical Cancer.pptx
Cervical cancer occurs when abnormal cells grow uncontrolled on the cervix. It is caused by human papillomavirus (HPV) infection and other risk factors like early sexual activity and smoking. Most cases occur in low- and middle-income countries. Early stages may be asymptomatic but later stages can cause abnormal bleeding, discharge and metastasis. Screening tests like Pap smears and HPV tests can find pre-cancerous lesions for treatment to prevent invasive cancer. Treatment depends on stage but may include surgery, radiation, chemotherapy or a combination. With treatment, survival rates are over 50% on average but drop with more advanced stages. Prevention focuses on HPV vaccination, screening programs, and addressing risk factors.
Ca endometrium-1.pptx
This document discusses endometrial carcinoma (cancer of the uterus). It covers the epidemiology, risk factors, types/classification, diagnosis, staging, treatment and prognosis. Some key points:
- It is the 3rd most common female cancer in India, occurring most often in post-menopausal women aged 60-70. The 5-year survival rate is approximately 75%.
- There are two main types - Type 1 is associated with estrogen exposure, is lower grade, and has a better prognosis. Type 2 occurs without estrogen stimulation, is higher grade and has a poorer prognosis.
- Risk factors include family history, nulliparity, early menarche/late menopause, obesity,
caendometrium-1-220817052735-f5d0c990.pdf
This document discusses endometrial carcinoma (cancer of the uterus). It covers the epidemiology, risk factors, types/classification, diagnosis, staging, treatment and prognosis. Some key points:
- It is the 3rd most common female cancer in India, occurring most often in post-menopausal women aged 60-70. The 5-year survival rate is approximately 75%.
- There are two main types - Type 1 is associated with estrogen exposure, is lower grade, and has a better prognosis. Type 2 occurs without estrogen stimulation, is higher grade and has a poorer prognosis.
- Risk factors include family history, nulliparity, early menarche/late menopause, obesity,
Basic principles of preoperative therapy in breast cancer.pptx
This document discusses the basic principles of preoperative therapy for breast cancer. It outlines the clinical evaluation process including history, examination, imaging and biopsy. It then discusses molecular testing, multidisciplinary team review, known benefits of preoperative therapy including increased breast conservation and prognostic information, and opportunities and cautions. Finally, it identifies candidate and non-candidate situations for preoperative systemic therapy.
Breast conservation surgery
Breast conservation surgery is an established way of treating Ca breast in early stages.
For details plz vist https://drnitinjha.com/
Breast ca during pregnancy the lect
Breast cancer diagnosed during pregnancy presents unique challenges as treatment must consider both the health of the mother and fetus. Diagnosis may be delayed due to changes in breast tissue during pregnancy. Imaging options are limited but ultrasound is useful. Treatment involves surgery, usually lumpectomy, and chemotherapy after the first trimester. Radiation is avoided due to risks to the fetus. Outcomes are similar when accounting for stage, though delay in diagnosis impacts prognosis. Pregnancy after treatment does not impact survival but is often deferred for 2 years. Management requires a multidisciplinary approach to balance aggressive maternal care and fetal protection.
Focussed therapy and imaging in prostate cancer
This document discusses focal therapy and imaging techniques for prostate cancer. It provides background on the increasing diagnosis of localized, low-risk prostate cancer and rationale for focal therapy alternatives to radical treatments. It describes improved biopsy strategies using MRI-ultrasound fusion to target small tumors. The document outlines different focal therapy techniques including thermal ablation methods like cryoablation and HIFU, as well as non-thermal methods. It discusses the advantages of focal therapy in preserving function while eliminating cancerous tissue and notes challenges in patient selection and defining clinically significant tumors.
Similar to Endometrial Cancer (20)
Treatment of urological conditions in the era of covid
Treatment of urological conditions in the era of covid
Oncology: basic science for general surgical residents
Oncology: basic science for general surgical residents
Innovations in Pancreatic Cancer: A Reason to Hope
Innovations in Pancreatic Cancer: A Reason to Hope
Basic principles of preoperative therapy in breast cancer.pptx
Basic principles of preoperative therapy in breast cancer.pptx
Recently uploaded
Dr. Tan's Balance Method.pdf (From Academy of Oriental Medicine at Austin)
Home
Organization
Academy of Oriental Medicine at Austin
Academy of Oriental Medicine at Austin
Academy of Oriental Medicine at Austin
About AOMA: The Academy of Oriental Medicine at Austin offers a masters-level graduate program in acupuncture and Oriental medicine, preparing its students for careers as skilled, professional practitioners. AOMA is known for its internationally recognized faculty, award-winning student clinical internship program, and herbal medicine program. Since its founding in 1993, AOMA has grown rapidly in size and reputation, drawing students from around the nation and faculty from around the world. AOMA also conducts more than 20,000 patient visits annually in its student and professional clinics. AOMA collaborates with Western healthcare institutions including the Seton Family of Hospitals, and gives back to the community through partnerships with nonprofit organizations and by providing free and reduced price treatments to people who cannot afford them. The Academy of Oriental Medicine at Austin is located at 2700 West Anderson Lane. AOMA also serves patients and retail customers at its south Austin location, 4701 West Gate Blvd. For more information see www.aoma.edu or call 512-492-303434.
Call Girls Lucknow 9024918724 Vip Call Girls Lucknow
Call Girls Lucknow 9024918724 Vip Call Girls Lucknow
Hemodialysis: Chapter 6, Hemodialysis Adequacy and Dose - Dr.Gawad
- Video recording of this lecture in English language: https://youtu.be/RvdYsTzgQq8
- Video recording of this lecture in Arabic language: https://youtu.be/ECILGWtgZko
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
June 2024 Oncology Cartoons By Dr Kanhu Charan Patro
une 2024 Oncology Cartoons By Dr Kanhu Charan Patro
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
Cervical Disc Arthroplasty ORSI 2024.pptx
Indication and installation of a mobile cervical disc prosthesis. Benefits of the PRODISC C VIVO mobile disc prosthesis (Centinel Spine)
Nano-gold for Cancer Therapy chemistry investigatory project
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
Pollen and Fungal allergy: aeroallergy.pdf
Pollen and Fungal allergy: aeroallergy.pdfChulalongkorn Allergy and Clinical Immunology Research Group
Pollen and Fungal allergy
Presented by Chaloemchai Chumsaengchotsakul, MD.
June 14, 2024TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14...
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition (Hinkle, 2017) Verified Chapter's 1 - 73 Complete.pdf
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition (Hinkle, 2017) Verified Chapter's 1 - 73 Complete.pdf
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition (Hinkle, 2017) Verified Chapter's 1 - 73 Complete.pdf
District Residency Programme (DRP) for PGs in India.pptx
District Residency Programme (DRP) for PG in India
Patellar Instability: Diagnosis Management
Pictorial and detailed description of patellar instability with sign and symptoms and how to diagnose , what investigations you should go with and how to approach with treatment options . I have presented this slide in my 2nd year junior residency in orthopedics at LLRM medical college Meerut and got good reviews for it
After getting it read you will definitely understand the topic.
RESPIRATORY DISEASES by bhavya kelavadiya
The Children are very vulnerable to get affected with respiratory disease.
In our country, the respiratory Disease conditions are consider as major cause for mortality and Morbidity in Child.
5 Effective Homeopathic Medicines for Irregular Periods
Discover the benefits of homeopathic medicine for irregular periods with our guide on 5 common remedies. Learn how these natural treatments can help regulate menstrual cycles and improve overall menstrual health.
Visit Us: https://drdeepikashomeopathy.com/service/irregular-periods-treatment/
Foundation of Yoga, YCB Level-3, Unit-1
Unit -1 of Yoga certification board, level 3, all topics covered. An exam conducted by ministry of Ayush for yoga enthusiastic students.
Microbiology & Parasitology Exercises Parts of the Microscope
Exercise 1 of Microbiology and Parasitology which is the parts of the microscope and their uses
Travel Clinic Cardiff: Health Advice for International Travelers
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
Breast cancer: Post menopausal endocrine therapy
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...Université de Montréal
“Psychiatry and the Humanities”: An Innovative Course at the University of Montreal Expanding the medical model to embrace the humanities. Link: https://www.psychiatrictimes.com/view/-psychiatry-and-the-humanities-an-innovative-course-at-the-university-of-montrealHelminthiasis or Worm infestation in Children for Nursing students
Brief description worm infestation/Helminthiasis for Basic B.Sc Nursing students
acne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticals
cosmetics and cosmeceuticals
Muskan
mpharm
2nd semester
Guru Gobind Singh college of pharmacy, yamunanagar, haryana
Recently uploaded (20)
Dr. Tan's Balance Method.pdf (From Academy of Oriental Medicine at Austin)
Dr. Tan's Balance Method.pdf (From Academy of Oriental Medicine at Austin)
Call Girls Lucknow 9024918724 Vip Call Girls Lucknow
Call Girls Lucknow 9024918724 Vip Call Girls Lucknow
Hemodialysis: Chapter 6, Hemodialysis Adequacy and Dose - Dr.Gawad
Hemodialysis: Chapter 6, Hemodialysis Adequacy and Dose - Dr.Gawad
June 2024 Oncology Cartoons By Dr Kanhu Charan Patro
June 2024 Oncology Cartoons By Dr Kanhu Charan Patro
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)
Nano-gold for Cancer Therapy chemistry investigatory project
Nano-gold for Cancer Therapy chemistry investigatory project
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14...
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14...
District Residency Programme (DRP) for PGs in India.pptx
District Residency Programme (DRP) for PGs in India.pptx
5 Effective Homeopathic Medicines for Irregular Periods
5 Effective Homeopathic Medicines for Irregular Periods
Microbiology & Parasitology Exercises Parts of the Microscope
Microbiology & Parasitology Exercises Parts of the Microscope
Travel Clinic Cardiff: Health Advice for International Travelers
Travel Clinic Cardiff: Health Advice for International Travelers
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...
Helminthiasis or Worm infestation in Children for Nursing students
Helminthiasis or Worm infestation in Children for Nursing students
acne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticals
acne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticals
Endometrial Cancer
- 1. Clinical Pathway for Endometrial Cancer Valena Wright, MD Lahey Hospital and Medical Center March 10, 2014
- 2. Objectives • Diagnosing Endometrial cancer • Pre-operative testing • Surgical technique – Application of new technology • Patient education
- 3. Who develops endometrial cancer?
- 4. Clinical Presentation • Asymptomatic • Abnormal bleeding • Genetic screening
- 5. Cost effective evaluation • Office endometrial biopsy • Morbidly obese BMI greater than 30 consider pelvic ultrasound for uterine size Chest XRAY PA and Lateral CA 125 in papillary serous, clear cell histology
- 6. Preoperative Teaching • Expect same day discharge • Patients with co morbidities scheduled as 3rd case for expected overnight stay • Talk to Fran
- 7. Multimodal Pain Therapy • Set expectations/ discuss with anesthesia • pregabalan • Tylenol • Celebrex • Avoid narcotics
- 9. Celebrex
- 10. Laparotomy • Enlarged uterus > 12 weeks • Adnexal pathology greater than 7 cm • Metastatic disease not amenable to surgical resection
- 11. MIGS • TLH BSO, staging • Robotic assisted TLH BSO staging
- 12. Who should be staged? • Mayo Clinic Protocol grade 1, 2 less than 1/3 myometrial invasion tumor size less than 2 cm
- 13. How accurate is intraoperative pathology? • Depends on who is looking • Depends on gross verses frozen section NCCN guidelines recommend expert GYN ONC pathology review on all new cancer cases.
- 14. How long does it take? • Depends on OR case load • Depends on gross verses frozen • Depends on time of day
- 15. Staging • Bilateral pelvic nodes – External – Obturators – Para-aortic
- 16. How long does it take? • Depends on surgeon • Depends on resident • Depends on patient BMI • Depends on surgical exposure
- 17. ICG and infrared imaging • IRB feasability study for high risk patients – Grade 3 – Clear cell – Serous
- 19. Adjuvant Therapy • Determined by surgical staging • Chemotherapy • Radiation IMRT • Vaginal brachytherapy
- 20. GOG
- 22. Lynch Syndrome • Immunohistochemistry for MSM • Genetic counseling referral if screen positive
- 24. Are Pap smears helpful?
- 25. Future directions • Remote console surgeon
- 27. Patient Education • Document and counsel BMI • Medical indications for barietric evaluation • More likely to die from co-morbidites than cancer