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2019 | OriginalPaper | Hoofdstuk

28. Uterine cancer and premalignant lesions

Auteurs : Dr Hanny J. M. A. Pijnenborg, Dr Koen K. van de Vijver, Professor Roy F. L. P. Kruitwagen

Gepubliceerd in: Textbook of Obstetrics and Gynaecology

Uitgeverij: Bohn Stafleu van Loghum

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Summary

Endometrial cancer is the most common malignancy of the female genital tract with rising incidence due to increased life expectancy and obesity. Most women presenting with postmenopausal bleeding are diagnosed at an early stage with a favourable outcome. Yet, a significant number of patients have advanced stage disease, or present with recurrent disease, and have limited treatment options. Primary treatment consists of hysterectomy and salpingo-oophorectomy, preferably by a minimal invasive approach. Lymph node dissection is recommended for patients with grade 3 endometrioid, serous and clear cell histology, since these patients are at significant risk of extended disease. Adjuvant radiotherapy can improve local control in a subgroup of patients. Chemotherapy is recommended for patients with metastatic disease. Alternatively, hormonal treatment can be effective with less side effects, but development of resistance to hormonal treatment limits the duration of effect. Prevention of endometrial cancer may be accomplished by a healthy lifestyle and improving the body weight.
Bijlagen
Alleen toegankelijk voor geautoriseerde gebruikers
Woordenlijst
Mesenchymal
Mesenchymal or stromal cells originate from the mesoderm and can develop into several types of tissues. Mesenchymal cells of the uterine corpus reflect the connective tissue that is surrounding the endometrial glands as well as the myometrium cells of the uterine wall
The Cancer Genome Atlas Network (TGCA)
A collaboration between the National Cancer Institute (NCI) and the National Human Genome Research Institute (NHGRI) that has generated comprehensive, multi-dimensional maps of the key genomic changes in 33 types of cancer
POLE
Encodes the enzyme DNA polymerase epsilon catalytic subunit. This enzyme is involved in DNA repair and chromosomal DNA replication. Mutations in POLE result in an ultra-mutated phenotype. In endometrial cancer, POLE mutations are associated with an excellent outcome, which is thought to be related to an activated immune system and a tumour-specific CD4+ T cell response
Microsatellite instability (MSI)
Refers to genetic hyper-mutability which is a result of impaired DNA mismatch repair (MMR) function. The MMR proteins are: MSH 1, MSH 2, MSH6, and PMS2
Lymphovascular space invasion (LVSI)
The spread of cancer into the blood vessels and/or lymph vessels
Epithelial-to-mesenchymal transition (EMT)
A process by which epithelial cells lose their cell polarity and cell-cell adhesion, and gain migratory and invasive properties such as mesenchymal stem cells. Although EMT is essential for numerous developmental and physiological processes, in cancer it can initiate progression and metastasis
Vaginal brachytherapy
Radiotherapy applied directly through the vagina with a sealed radiation source
Cytoreductive surgery
Debulking surgery, i.e. removal of all the macroscopic visible tumour
Literatuur
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Metagegevens
Titel
Uterine cancer and premalignant lesions
Auteurs
Dr Hanny J. M. A. Pijnenborg
Dr Koen K. van de Vijver
Professor Roy F. L. P. Kruitwagen
Copyright
2019
Uitgeverij
Bohn Stafleu van Loghum
DOI
https://doi.org/10.1007/978-90-368-2131-5_28