An Overview of Endometrial Cancer with Novel Therapeutic Strategies
Endometrial cancer (EC) stands as the most prevalent gynecologic malignancy. In the past, it was classified based on its hormone sensitivity. However, The Cancer Genome Atlas has categorized EC into four groups, which offers a more objective and reproducible classification and has been shown to have...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-08-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/30/9/574 |
| _version_ | 1797580702329339904 |
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| author | Theresa M. Kuhn Saeeda Dhanani Sarfraz Ahmad |
| author_facet | Theresa M. Kuhn Saeeda Dhanani Sarfraz Ahmad |
| author_sort | Theresa M. Kuhn |
| collection | DOAJ |
| description | Endometrial cancer (EC) stands as the most prevalent gynecologic malignancy. In the past, it was classified based on its hormone sensitivity. However, The Cancer Genome Atlas has categorized EC into four groups, which offers a more objective and reproducible classification and has been shown to have prognostic and therapeutic implications. Hormonally driven EC arises from a precursor lesion known as endometrial hyperplasia, resulting from unopposed estrogen. EC is usually diagnosed through biopsy, followed by surgical staging unless advanced disease is expected. The typical staging consists of a hysterectomy with bilateral salpingo-oophorectomy and sentinel lymph node biopsies, with a preference placed on a minimally invasive approach. The stage of the disease is the most significant prognostic marker. However, factors such as age, histology, grade, myometrial invasion, lymphovascular space invasion, tumor size, peritoneal cytology, hormone receptor status, ploidy and markers, body mass index, and the therapy received all contribute to the prognosis. Treatment is tailored based on the stage and the risk of recurrence. Radiotherapy is primarily used in the early stages, and chemotherapy can be added if high-grade histology or advanced-stage disease is present. The risk of EC recurrence increases with advances in stage. Among the recurrences, vaginal cases exhibit the most favorable response to treatment, typically for radiotherapy. Conversely, the treatment of widespread recurrence is currently palliative and is best managed with chemotherapy or hormonal agents. Most recently, immunotherapy has emerged as a promising treatment for advanced and recurrent EC. |
| first_indexed | 2024-03-10T22:53:40Z |
| format | Article |
| id | doaj.art-d6a0dcc0a67b422c900735a143784f8c |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-10T22:53:40Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-d6a0dcc0a67b422c900735a143784f8c2023-11-19T10:10:42ZengMDPI AGCurrent Oncology1198-00521718-77292023-08-013097904791910.3390/curroncol30090574An Overview of Endometrial Cancer with Novel Therapeutic StrategiesTheresa M. Kuhn0Saeeda Dhanani1Sarfraz Ahmad2Gynecologic Oncology Program, AdventHealth Cancer Institute, Orlando, FL 32804, USAGynecologic Oncology Program, AdventHealth Cancer Institute, Orlando, FL 32804, USAGynecologic Oncology Program, AdventHealth Cancer Institute, Orlando, FL 32804, USAEndometrial cancer (EC) stands as the most prevalent gynecologic malignancy. In the past, it was classified based on its hormone sensitivity. However, The Cancer Genome Atlas has categorized EC into four groups, which offers a more objective and reproducible classification and has been shown to have prognostic and therapeutic implications. Hormonally driven EC arises from a precursor lesion known as endometrial hyperplasia, resulting from unopposed estrogen. EC is usually diagnosed through biopsy, followed by surgical staging unless advanced disease is expected. The typical staging consists of a hysterectomy with bilateral salpingo-oophorectomy and sentinel lymph node biopsies, with a preference placed on a minimally invasive approach. The stage of the disease is the most significant prognostic marker. However, factors such as age, histology, grade, myometrial invasion, lymphovascular space invasion, tumor size, peritoneal cytology, hormone receptor status, ploidy and markers, body mass index, and the therapy received all contribute to the prognosis. Treatment is tailored based on the stage and the risk of recurrence. Radiotherapy is primarily used in the early stages, and chemotherapy can be added if high-grade histology or advanced-stage disease is present. The risk of EC recurrence increases with advances in stage. Among the recurrences, vaginal cases exhibit the most favorable response to treatment, typically for radiotherapy. Conversely, the treatment of widespread recurrence is currently palliative and is best managed with chemotherapy or hormonal agents. Most recently, immunotherapy has emerged as a promising treatment for advanced and recurrent EC.https://www.mdpi.com/1718-7729/30/9/574endometrial cancerhyperplasiadiagnosisprognosistreatment |
| spellingShingle | Theresa M. Kuhn Saeeda Dhanani Sarfraz Ahmad An Overview of Endometrial Cancer with Novel Therapeutic Strategies Current Oncology endometrial cancer hyperplasia diagnosis prognosis treatment |
| title | An Overview of Endometrial Cancer with Novel Therapeutic Strategies |
| title_full | An Overview of Endometrial Cancer with Novel Therapeutic Strategies |
| title_fullStr | An Overview of Endometrial Cancer with Novel Therapeutic Strategies |
| title_full_unstemmed | An Overview of Endometrial Cancer with Novel Therapeutic Strategies |
| title_short | An Overview of Endometrial Cancer with Novel Therapeutic Strategies |
| title_sort | overview of endometrial cancer with novel therapeutic strategies |
| topic | endometrial cancer hyperplasia diagnosis prognosis treatment |
| url | https://www.mdpi.com/1718-7729/30/9/574 |
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