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Changing Concepts in Endometrial Carcinoma

Introduction

No conclusive, prospective randomized trials Gat clearly offer definitive guidelines for

Many questions remain

When is lymph node sampling helpful?

What is the value of postoperative radiation? endometrial carcinoma, uterine cancer, cancer of the uterus, endometrial cancer, endometreal cancer

 What is the value of adjunctlye chemotherapy? endometrial carcinoma, uterine cancer, cancer of the uterus, endometrial cancer

What is the role of hormone therapy?

Which chemotherapeutic agents are active?

Epidemiology And Risk

Incidence: 2002 American Cancer Society projections endometrial carcinoma, uterine cancer, cancer of the uterus, endometrial cancer

Most common gynecologic cancer (after breast)

Third: colorectal (66,000) endometrial carcinoma, uterine cancer, cancer of the uterus, endometrial cancer, endometreal cancer

Fourth: endometrial 04,000) endometrial carcinoma, uterine cancer, cancer of the uterus, endometrial cancer, endometreal cancer

B. Distribution by stage: International Federation of Gynecology and endometrial carcinoma, uterine cancer, cancer of the uterus, endometrial cancer Obstetrics

FIGO Staging

Stage I: 75%

Stage II: 15%

Stage III: 7%

Stage IV: 3%

Estimate of risk

Geographic: the white population in the United States has the endometrial carcinoma, uterine cancer, cancer of the uterus, endometrial cancer highest age-adjusted incidence in the world

Race: United States

White peak: 87% in 100,000 at 65-70 years endometrial carcinoma, uterine cancer, cancer of the uterus, endometrial cancer

Black peak: 78 % in 100,000 at 75-80 years

3. Age

Postmenopausal: 75-80%

Mean age at diagnosis: 61 years

<5 % below age 40

4. Obesity

From 20-50 lbs overweight: 3X

Over 50 lbs overweight: 9X

Diabetes: up to 3X increased risk

Hypertension

Parity

One-third nulliparous

Risk decreases with