OVARIAN METASTASIS IN ENDOMETRIAL CARCINOMA
Magdi Mohammed El-Shahawy;
Abstract
SUMMARY
A
s of 2014, approximately 320, 000 women are diagnosed with endometrial cancer worldwide each year and 76, 000 die, making it the sixth most common cancer in women .
Ovarian metastasis occurs at rates of 2.4% to 14.1% in endometrial carcinoma. Parametrial metastasis, positive peritoneal lavage and deep muscular invasion account for three major risk factors, and this finding appears to support that the main rout of ovarian metastasis in endometrial carcinoma might be through muscular invasion that subsequently causes parametrial metastasis and consequently, ovarian metastasis .
The aim of this study was to assess the prevalence of ovarian metastasis in women treated for endometrial cancer and the impact on survival and recurrence rates.
This is a retrospective study that was carried out at the gynecological oncology unit of the Ain Shams university maternity hospital. Case files of women treated for endometrial carcinoma at period between 2003-2009 were retrieved.
Data concerning patient characteristics (age- parity- past medical history- past surgical history- radiation therapy) were extracted.
Data concerning the diagnosis (as regard presentation- initial pathology- tumor type- grade and stage) was extracted.
Data concerning the treatment: either surgical treatment with or without lymphadenectomy - irradiation therapy - chemotherapy was extracted.
Data concerning performance status of life:( ability of self care - need special care – bedridden) and data concerning death:( cause – time - place) were extracted.
Archived pathological specimens and slides were reviewed for histological cell type, histological grade, depth of myometrial invasion, cervical invasion, vascular space invasion, uterine serosa extension, fallopian tube involvement, metastasis to retroperitoneal lymph node and peritoneal cytology. Site and size of involved ovary and nature of the tumor whether metastatic or synchronous also were reviewed in each patient.
Patients themselves or their families were contacted by mail or by phone to asses their status, recurrences or deaths from endometrial cancer and their exact time and dates. All data were recorded in a specially designed sheet for every patient.
Seventy five women with the diagnosis of endometrial cancer were enrolled in the study. All patients underwent abdominal hysterectomy and bilateral salpingoopherectomy, peritoneal cytology and omental biopsy. Eight patients had ovarian metastasis and the remaining sixty seven patients were without ovarian metastasis.
There was no statistical significant difference regarding the incidence of metastasis and personal data (The age, marital status, occupation and the parity) of studied patients.
There was statistical significant difference regarding the incidence of metastasis associated with D.M. and hypertension while there was no statistical significant difference regarding the incidence of metastasis with Asthma, AF and previous stroke.
Non-endometrioid endometrial carcinoma has higher incidence of ovarian metastasis , also incidence increase in poorly differentiated and higher stages endometrioid carcinoma.
Myometrial invasion more than 50%, endocervical canal invasion, Vascular space invasion, Uterine serosa extension, positive Peritoneal cytology and fallopian tube involvement have significant statistical difference between both groups, as these patients were more liable to ovarian metastasis.
A
s of 2014, approximately 320, 000 women are diagnosed with endometrial cancer worldwide each year and 76, 000 die, making it the sixth most common cancer in women .
Ovarian metastasis occurs at rates of 2.4% to 14.1% in endometrial carcinoma. Parametrial metastasis, positive peritoneal lavage and deep muscular invasion account for three major risk factors, and this finding appears to support that the main rout of ovarian metastasis in endometrial carcinoma might be through muscular invasion that subsequently causes parametrial metastasis and consequently, ovarian metastasis .
The aim of this study was to assess the prevalence of ovarian metastasis in women treated for endometrial cancer and the impact on survival and recurrence rates.
This is a retrospective study that was carried out at the gynecological oncology unit of the Ain Shams university maternity hospital. Case files of women treated for endometrial carcinoma at period between 2003-2009 were retrieved.
Data concerning patient characteristics (age- parity- past medical history- past surgical history- radiation therapy) were extracted.
Data concerning the diagnosis (as regard presentation- initial pathology- tumor type- grade and stage) was extracted.
Data concerning the treatment: either surgical treatment with or without lymphadenectomy - irradiation therapy - chemotherapy was extracted.
Data concerning performance status of life:( ability of self care - need special care – bedridden) and data concerning death:( cause – time - place) were extracted.
Archived pathological specimens and slides were reviewed for histological cell type, histological grade, depth of myometrial invasion, cervical invasion, vascular space invasion, uterine serosa extension, fallopian tube involvement, metastasis to retroperitoneal lymph node and peritoneal cytology. Site and size of involved ovary and nature of the tumor whether metastatic or synchronous also were reviewed in each patient.
Patients themselves or their families were contacted by mail or by phone to asses their status, recurrences or deaths from endometrial cancer and their exact time and dates. All data were recorded in a specially designed sheet for every patient.
Seventy five women with the diagnosis of endometrial cancer were enrolled in the study. All patients underwent abdominal hysterectomy and bilateral salpingoopherectomy, peritoneal cytology and omental biopsy. Eight patients had ovarian metastasis and the remaining sixty seven patients were without ovarian metastasis.
There was no statistical significant difference regarding the incidence of metastasis and personal data (The age, marital status, occupation and the parity) of studied patients.
There was statistical significant difference regarding the incidence of metastasis associated with D.M. and hypertension while there was no statistical significant difference regarding the incidence of metastasis with Asthma, AF and previous stroke.
Non-endometrioid endometrial carcinoma has higher incidence of ovarian metastasis , also incidence increase in poorly differentiated and higher stages endometrioid carcinoma.
Myometrial invasion more than 50%, endocervical canal invasion, Vascular space invasion, Uterine serosa extension, positive Peritoneal cytology and fallopian tube involvement have significant statistical difference between both groups, as these patients were more liable to ovarian metastasis.
Other data
| Title | OVARIAN METASTASIS IN ENDOMETRIAL CARCINOMA | Other Titles | ثانويـــات المبيـض مــن سرطــان بطانــة الرحــم | Authors | Magdi Mohammed El-Shahawy | Issue Date | 2014 |
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