NUMBERS GAME
Endometrial Cancer is the ___ most common malignancy diagnosed in women in the United States of America.
What is the FOURTH
The classic presenting symptom of endometrial carcinoma.
What is vaginal bleeding.
Tumor limited to the uterus with no or less than half myometrial invasion.
What is Stage 1A.
Initial recommended treatment of endometrial cancer.
What is comprehensive surgical staging. hysterectomy, BSO, Pelvic and para-aortic LND (+washings)
Inherited mutations in these genes are associated with Lynch Syndrome.
What is MLH 1, MSH2, MSH6, PMS2
Stage I disease is is found in approximately ___ % of patients diagnosed with endometrial cancer.
What is ~70%
The initial workup of post menopausal bleeding.
What is endometrial biopsy and/or transvaginal ultrasound.
Tumor invades bladder and/or bowel mucosa.
What is stage IVA.
Name of trial that proved equal 5 year survival in patients undergoing laparotomy vs laparoscopy in treatment of endometrial cancer.
What is GOG LAP 2
The most commonly used progestins in patients who desire fertility-sparing treatment of their endometrial cancer.
What is medroxyprogesterone acetate, megestrol acetate and Mirena IUD.
(Must name 2 of the 3)
___ is the mean age of diagnosis of endometrial cancer.
What is 63 years old.
The two types of endometrial cancers and characteristics of each.
What is....
Type 1 - Unopposed Estrogen, well differentiated, endometrioid histology, favorable prognosis, PTEN mutations
Type 2 - Poorly differentiated, non-endometriod histology (Clear cell/serous), not favorable prognosis, p53 over expression
Metastases to vaginal and or parametrial tissue.
What is Stage IIIB.
What is the recommended chemotherapy regimen for patients with gross residual disease?
What is carboplatin and paclitaxel.
Population of patients who should be screened for endometrial cancer patients and how.
What is Lynch Syndrome patients age > 35 with annual EMBX.
Patients with LOCALIZED (Stage 1) disease have a 5 year survival rate of ___.
What is 90-95%
8 risk factors for Type 1 endometrial cancer.
What is....
Age, Nulliparity, Obesity, CHTN, DM, Lynch Syndrome, Citizen of North America, Tamoxifen use, History of infertility, Menstrual irregularities, PCOS, Early Menarche, Late Menopause, Unopposed Estrogen, Estrogen producing tumor
(Any 8 are acceptable)
Tumor invades the cervical stroma but does not extend beyond the uterus.
What is Stage II
Adjuvant therapy with ____ should be recommended in patients with early stage disease and high-intermediate risk of recurrence.
What is vaginal brachytherapy.
Type of endometrial cancer that accounts for only 10% of cases but 50% of treatment failures.
What is papillary serous.
The risk of underlying carcinoma when Endometrial Intraepithelia Neoplasia (EIN) is present on biopsy.
What is 30-50%.
The reason a postmenopausal patient with an endometrial stipe of 3mm on ultrasound and continued bleeding needs sampling.
What is possibility of underlying Type 2 endometrial cancer.
Metastasis to para-aortic LN (with or without pelvic lymph node involvement).
What is IIIC2.
Adjuvant treatment with highest Progression Free Survival and Overall survival in Stage III/IV patients?
What is "sandwich" therapy. Chemo-Radiation-Chemo.
Molecular features of Type I vs Type II endometrial cancers.
What is
Type 1- Diploid, +KRAS overexpression, +PTEN overexpression, +Micorsatellite instability
Type 2- aneuploid, +K-RAS overexpression, +p53 overexpression, +HER2 neu overexpression