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3 results

  • Chapter 16 - Endometrial Cancer

  • Edited by Laurie J. Mckenzie, University of Texas MD Anderson Cancer Center, Houston, Denise R. Nebgen, University of Texas MD Anderson Cancer Center, Houston
  • Book:
    Caring for the Female Cancer Patient
    Published online:
    23 October 2024
    Print publication:
    17 October 2024, pp 271-283

  • Summary

    Endometrial cancer is the most common gynecologic malignancy in the United States, and is rising in both incidence and associated mortality. In 2023 an estimated 66,000 new cases of uterine cancer will be diagnosed in the United States and over 400,000 women will be affected globally. Risk factors for the development of endometrial cancer include advancing age, obesity and and conditions associated with metabolic syndrome, such as diabetes. Obesity is the most important risk factor for endometrial cancer, and as rates of obesity rise, so does the incidence of endometrial cancer. Surgery is the mainstay of initial management of endometrial cancer, and staging now includes sentinel lymph-node mapping, along with a minimally invasive surgical approach for removal of the uterus, fallopian tubes, and ovaries. Fortunately, 75% of patients with endometrial cancer have International Federation of Gynecologic and Obstetrics (FIGO) stage I disease, and 5-year overall survival rates exceed 90%. High-risk stage I patients are often recommended to receive adjuvant therapy and women with locally advanced disease and/or distant disease typically require multimodality treatment that can include some combination of surgery, chemotherapy, and radiotherapy. Endometrial cancer is more often being detected in young obese women. In women of childbearing age in whom endometrial cancer is diagnosed and wish to retain their ability to have children, a conservative alternative to hysterectomy for these women is the use of oral progestin or a levonorgestrel intrauterine system (LNG-IUS).

  • Glycaemic index, glycaemic load and risk of endometrial cancer: a prospective cohort study

  • Stephanie AN Silvera, Thomas E Rohan, Meera Jain, Paul D Terry, Geoffrey R Howe, Anthony B Miller
  • Journal:
    Public Health Nutrition / Volume 8 / Issue 7 / October 2005
    Published online by Cambridge University Press:
    02 January 2007, pp. 912-919
    • Article
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  • Objective

    High-glycaemic-load diets may increase endometrial cancer risk by increasing circulating insulin levels and, as a consequence, circulating oestrogen levels. Given the paucity of epidemiological data regarding the relationship between dietary glycaemic index and glycaemic load and endometrial cancer risk, we sought to examine these associations using data from a prospective cohort study.

    Design, setting and subjects

    We examined the association between dietary glycaemic load and endometrial cancer risk in a cohort of 49 613 Canadian women aged between 40 and 59 years at baseline who completed self-administered food-frequency questionnaires between 1982 and 1985. Linkages to national mortality and cancer databases yielded data on deaths and cancer incidence, with follow-up ending between 1998 and 2000.

    Results

    During a mean of 16.4 years of follow-up, we observed 426 incident cases of endometrial cancer. Hazard ratios for the highest versus the lowest quartile level of overall glycaemic index and glycaemic load were 1.47 (95% confidence interval (CI) = 0.90–2.41; P for trend = 0.14) and 1.36 (95% CI = 1.01–1.84; P for trend = 0.21), respectively. No association was observed between total carbohydrate or total sugar consumption and endometrial cancer risk. Among obese women (body mass index > 30 kg m−2) the hazard ratio for the highest versus the lowest quartile level of glycaemic load was 1.88 (95% CI = 1.08–3.29; P for trend = 0.54) and there was a 55% increased risk for the highest versus the lowest quartile level of glycaemic load among premenopausal women. There was also evidence to support a positive association between glycaemic load and endometrial cancer risk among postmenopausal women who had used hormone replacement therapy.

    Conclusions

    Our data suggest that diets with high glycaemic index or high glycaemic load may be associated with endometrial cancer risk overall, and particularly among obese women, premenopausal women and postmenopausal women who use hormone replacement therapy.

  • Metastatic endometrial carcinoma of the neck

  • M. A. Siddiq, S. K. Bhudia, P. Gana, J. Patel
  • Journal:
    The Journal of Laryngology & Otology / Volume 114 / Issue 3 / March 2000
    Published online by Cambridge University Press:
    08 March 2006, pp. 229-230
    Print publication:
    March 2000

  • We report a case of metastatic endometrial carcinoma of the neck. A patient with a past medical history of squamous cell carcinoma of the larynx, breast carcinoma and endometrial carcinoma presented with a neck mass. Fine needle aspiration cytology (FNAC) showed this to be a poorly differentiated carcinoma with squamoid features and thus a potentially curative neck dissection was performed. Histology of the mass showed a clear cell endometrial carcinoma. Metastatic gynacecological malignancies to the head and neck are rare and this is the first reported case of metastatic endometrial carcinoma in the neck.