Overall survival is 81.7 percent and varies from 20 to 91 percent depending on the tumour’s histology and stage at presentation. In reporting endometrial cancer, radiologists are required to incorporate histopathological subtypes I or II based on the tumour’s histology, clinical features, and risk of dissemination.
Patients with advanced endometrial cancer may benefit from chemotherapy and targeted therapies. The most common initial therapy for endometrial cancer is hysterectomy, which involves removing the entire uterus, ovaries, and lymph nodes located near the tumor. This treatment is highly effective, but it can be invasive and has significant risks. While this surgery is a common initial therapy for endometrial cancer, it is not the only available option.
In women, the risk for developing endometrial cancer is increased by genetic factors such as obesity, diabetes, and irregular ovulation. Women who are estrogen-only after menopause also increase their risk. Interestingly, women who start menstruating later or delay their menopause are also at an increased risk of developing endometrial cancer. This cancer is particularly common in women with a family history of this condition.
Early detection is crucial for the treatment of endometrial cancer. MRI can be used to identify whether the disease has spread to lymph nodes or is endometrium-confined. It can also be used to select patients for treatment who may be candidates for fertility-sparing treatments. This technology is highly recommended by the European Society of Urogenital Radiology for women with type I endometrial cancer. You should also consider MRI before any surgery to confirm a diagnosis.
A diagnostic imaging sequence that identifies endometrial cancer in two planes is called T2WI. It can help define tumour size, location, extent, and morphology. The three planes of T2WI are sagittal, axial, and transverse. For small tumours, the sagittal T2WI allows for early definition of the endometrial cavity and two additional planes are performed parallel to the uterine cavity. In this procedure, the stroma of the cervical cavity is assessed, and the extent and allocation of suspicious lymph nodes is assessed.
In addition to estrogen, progesterone regulates the expression of certain genes, such as p21 and p27, and folate receptor type a. These hormones can increase the risk of endometrial cancer, but they also have many side effects. It is best to discuss these with your doctor before starting any type of hormone therapy. Another treatment option is birth control pills. Birth control pills have side effects, and should not be used by women who are pregnant or have had prior endometrial ablation.
In addition to progesterone, other agents have been discovered to increase progestin sensitivity and extend survival. A study published in the BMJ recently demonstrated that progestin treatment can reverse endometrial cancer, even when the disease has spread to other parts of the body. In addition to progestin, new agents such as DNMT inhibitors can target these pathways and improve overall survival in some patients.
