Advances In Prognosis And Treatment Of Endometrial Cancers

This book discusses in detail the recent advances in the management of endometrial cancer, including the latest therapies and diagnostic methods. The book focuses on treatment-oriented topics such as the role of lymphadenectomy and sentinel node dissection, surgical complications, radiation techniques, and chemotherapy in endometrial cancer, and also explores treatment options in advanced disease stages, including hormonal therapy and targeted therapy. Providing insights into the evidence-based management guidelines for endometrial cancer, this book is a valuable resource for students, trainees and practitioners in the field of gynecology and gyne-oncology.

This practical reference book provides up-to-date, evidence-based multidisciplinary guidelines on the epidemiology, biology, diagnosis, and treatment of endometrial cancer. Individual chapters focus on topics such as hormonal interactions, cancer prevention, genetic classification and its clinical applications. Recent advances in diagnostic methods are described. The treatment-oriented chapters include coverage of the roles of lymphadenectomy and sentinel node dissection, surgical complications, radiation techniques, and chemotherapy in early-stage disease. Treatment options in advanced disease, including hormonal therapy and targeted therapy, are considered separately, as is the management of rare tumor types. The authors are international key opinion leaders. Summaries of the ESMO/ESGO/ESTRO guidelines on management are included. Each clinical chapter ends with a summary of recommendations with the level of evidence.

Part of the popular Advances in Surgical Pathology Series, this volume is a concise, updated review of the pathological characteristics of endometrial cancer. It emphasizes the histologic correlation, clinical management, and treatment of endometrial cancer, and features current and emerging concepts in the field. The book provides a resource for the timely updates in knowledge that are necessary for daily practice, for current credentialing, and for the self-assessment modules for recertification (MOC). A free companion web site features fully searchable text as well as over 130 full-color images.

During the past 20 years, endometrial carcinoma has continued to increase in frequency and it is quite possible that this carcinoma will become the major gynecologic malignancy in the future. For many years, endometrial carcinoma was considered less malignant than other gynecologic malignancies, simple hysterectomy and bil ateral salpingo-oophorectomy or surgery combined with radiation being effective in certain circumstances. It is unfortunate to note that the global 5-year survival rate for patients with advanced or recurrent endometrial carcinoma has improved only slightly. Therefore any complacency regarding this 'benign malignancy' should be reconsidered. There is a growing awareness of the nature of end ometrial carcinoma, with advances in our knowledge ranging from its etiology through its epidemiology to its clinical findings. This volume has been designed to fill a hiatus in the literature in China. To achieve this aim, we have attempted to review the world-wide advances on endometrial carcinoma and summarize systematically and comprehensively this common gynecologic malig nancy, including the clinical experiences gathered at the Cancer Institute (Hospital) of the Chinese Academy of Medical Sciences since 1958 as well as a brief description of the psychological problems in patients with gyneco logic cancers.

For the Editors, the task of writing a Preface is most satisfying. It represents the completion of the book and a moment of reflection on whether the whole is more than the sum of all the parts. And also, one must reflect on how this book is likely to be utilized in this era of rapid communications. The Editors first met in May 2003 at a stimulating Italian symposium on endometrial cancer (organizers Drs. Luigi Frigerio, Roberto Grassi and Andrea Lissoni, with participation of the deans of Italian Gynecologic Oncology, Ugo Bianchi and Constantino Mangioni) that took place at Bergamo and Caravaggio. The impressive gains in biology and clinical trials were further discussed by the two editors and others that are co-authors in this venture on this side of the Atlantic at a 2004 Educational Session at the American Society of Clinical Oncology (ASCO). The pace of progress in various aspects of management of uterine cancer was no- worthy, not only was tumor biology fueling novel hypotheses such as questioning the mesenchymal origin of carcinosarcomas, but knowledge of molecular pathways was beginning to be applied as prognostic and as predictive factors portending benefit from systemic therapies. Surgical staging and sensitive imaging provided the underpinning for refining our treatment algorithms. Finally, a role for che- therapy had finally become established, principally through phase III studies c- paring chemotherapy to radiation in mostly locally advanced stages III and IV that had undergone resection.

The incidence of endometrial cancer rose sharply in the United States in the early 1970s, paralleling changes in the use of postmenopausal estrogens by American women. A sizeable body of evidence supports the role of both excessive endogenous estrogen and exogenous estrogen in the etiology of endometrial cancer. There is growing evidence that inadequate progesterone has the opposite effect, in that progesterone supplementation of postmeno pausal estrogen therapy reduces the incidence of endometrial cancer. Despite this new awareness of the hormonal role that is played in carcino ma of the endometrium, the disease still plagues the oncologist. The general approach to carcinoma of the endometrium in the United States is that of primary surgical staging. This provides the maximum amount of information to best plan postoperative radiation therapy and/or chemotherapy for these patients. In general, patients who are considered candidates for surgical staging are those with advanced disease or high-risk stage I endometrial carcinoma. High-risk endometrial carcinoma is defined as those patients with moderately differentiated lesions with deep myometrial invasion, poor ly differentiated carcinoma of the endometrium, and the high-risk histolo gies such as papillary carcinoma and clear-cell carcinomas. The surgical staging has extended in most institutions to patients with occult stage II carcinoma of the endometrium, i. e.

Endometrial cancer (EC) is the most common cancer of the uterus and the only gynecologic malignancy that is increasing in incidence and mortality. Early-stage EC generally has a good prognosis but 5-year survival is poor for those with advanced-stage disease or recurrent disease. This resource provides the latest information on epidemiology, risk factors and diagnosis, including the implications of Lynch syndrome in younger women, and the latest thinking on classification, grading, staging and prognostic risk groups, made possible by major advances in the molecular characterization of EC. The therapeutic implications of these advances are still being discovered and here we outline the latest evidence-based therapies and management of the disease. Table of Contents: • Epidemiology and risk factors • Diagnosis • Grading, staging and prognosis • Molecular characterization • Treatment of early-stage disease • Management of advanced and recurrent disease • Research directions