CHSJ

Curr Health Sci J, vol. 39, no. 4, 2013

Diagnosis and Therapeutic Problems in Endometrial Cancer

[Original Paper]

B. VOINEA(1)


(1)Department of Obstetrics and Gynecology, University of Medicine of Craiova, Romania


Abstract:

Aim: to improve the immediate and late results in endometrial cancer. Materials and methods. 62 endometrial cancers (mean age=62.24 years) hospitalized between 2007-2012 were analyzed. Poor and nonspecific clinical picture dominated by abnormal pre-, peri- or postmenopausal uterine bleeding (100%), which impose specific investigations. Imaging tests (abdominal/vaginal 83.8%, CT 17.4%, MRI 56.45%) provided useful data for diagnosis and pre-therapeutic staging (TNM). Histopathology and immunohistochemistry (biopsy curettage and hysterectomy specimen) confirm the diagnosis, determine the tumor type (endometroid 82.25%, nonendometroid 17.75%) and grading (G1 =53.22%, G2 30.64%, G3 19.14%), established differential diagnosis between endometrial and cervical cancer, hormonal profile and aggressiveness markers of the tumor. 59 (95%) patients were operated on: 38 total hysterectomy+bilateral adnexectomy+pelvic lymphadenectomy (stage I and III C) and 21 lymphadenocolpohisterectomy Wertheim type (stage II and III A). Adjuvant therapy (21 cases) and neoadjuvant (24 cases) Ã?A¢Ã¯A¿A½Ã¯A¿A½ indicates depending on stage. Results: fair evolution - 48 cases (81.4%), postoperative morbidity rate of 18.6%, postoperative mortality rate 0. Survival rate: 82.78% stage I, 69.83% stage II and 54.54% stage III. Conclusions: 1. Endometrial cancer (second place in Romania) is becoming the most common genital cancer in women. 2. Complex diagnosis - clinical, imaging (ultrasound, CT, MRI), histological and immunohistochemistry (pre-therapeutic curettage biopsy and hysterectomy specimen). 3. Surgery - the main therapeutic means. 4. Adjuvant and neoadjuvant therapy according to stage. 5. Five years rate survival over 50% even for stage III B.


Keywords: endometrial cancer, imaging tests, pathological exam



Corresponding: Bogdan Voinea, Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, Romania, Blv 1 Mai, Craiova, Romania, e-mail:bogdan1977@hotmail.com


DOI 10.12865/CHSJ.39.04.09 - Download PDF
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