Early recurrence of early stage endometrioid endometrial carcinoma: Possible etiologic pathways and management options.
AffiliationGynaecological Oncology Department, Christie Hospital, Manchester, United Kingdom.
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AbstractThe majority of endometrial cancers is early stage and of the endometrioid histological type, as the symptoms (mainly vaginal bleeding) of the disease lead to an early diagnosis. Close follow-up is nevertheless essential in such cancers staged early on, in which the rate of recurrence is relatively low. We retrieved the studies included in our narrative review after performing a systematic electronic search in the PubMed, Scopus and Cochrane databases. The incidence or recurrence of disease in such patients could be up to 2.6%, with the main sites of recurrence being the vaginal vault or metastases in distant parts of the body. Genetic factors such as p53 overexpression, inactivation of 14-3-3-sigma, KRAS amplification and KRAS mRNA expression, microsatellite instability and Lynch syndrome genes could be associated with such a recurrence. Black race is also correlated, as well as lymphovascular space involvement, lower uterine segment involvement and DNA aneuploidy. Longer hysteroscopy duration was not found to be associated. Close follow-up is suggested for early detection of recurrences, while surgical excision of isolated disease or exenteration of local disease as well as radiotherapy and chemotherapy are the main treatment options. This narrative review investigated the possible mechanisms of early recurrence in patients with endometrioid endometrial cancer as well as the further management of them.
CitationEarly recurrence of early stage endometrioid endometrial carcinoma: Possible etiologic pathways and management options. 2014: Maturitas
- Vaginal and pelvic recurrences in stage I and II endometrial carcinoma--survival and prognostic factors.
- Authors: Blecharz P, Brandys P, Urbański K, Reinfuss M, Patla A
- Issue date: 2011
- [Synchronous primary cancers of the endometrium and ovary: review of 43 cases].
- Authors: Ma SK, Zhang HT, Sun YC, Wu LY
- Issue date: 2008 Sep
- Local recurrence in high-risk node-negative stage I endometrial carcinoma treated with postoperative vaginal vault brachytherapy.
- Authors: Ng TY, Perrin LC, Nicklin JL, Cheuk R, Crandon AJ
- Issue date: 2000 Dec
- Patterns of recurrence in 1988 FIGO stage IC endometrioid endometrial cancer.
- Authors: Long KC, Zhou Q, Hensley ML, Alektiar KM, Gomez J, Gardner GJ, Chi DS, Barakat RR, Abu-Rustum NR
- Issue date: 2012 Apr
- Lymphovascular invasion is a significant predictor for distant recurrence in patients with early-stage endometrial endometrioid adenocarcinoma.
- Authors: Nofech-Mozes S, Ackerman I, Ghorab Z, Ismiil N, Thomas G, Covens A, Khalifa MA
- Issue date: 2008 Jun