Common malignancy, usually an adenocarcinoma.
Overweight and obesity are associated with an increased incidence and poorer outcome.
Patients typically present with postmenopausal vaginal bleeding and often have surgically curable disease.
Diagnosis is confirmed by biopsy, or dilation and curettage; staging and histology is confirmed at surgery.
The most important prognostic information relates to stage, histologic subtype, tumor grade, patient age, presence of lymphovascular space invasion, and extent of cervical and myometrial invasion.
Adjuvant vaginal brachytherapy or pelvic external beam radiation therapy can reduce local recurrence and improve progression-free survival, but does not improve survival in stages I and II disease.
Chemotherapy is an option for patients with stages III and IV disease, nonendometrioid carcinomas (e.g., serous, clear-cell, undifferentiated carcinoma, carcinosarcoma), or recurrent disease, but its optimal role in these patients is unclear and controversial.
An epithelial malignancy of the uterine corpus mucosa, usually an adenocarcinoma.
History and exam
- overweight and obesity
- age >50 years
- endometrial hyperplasia
- unopposed endogenous estrogen
- unopposed exogenous estrogen
- tamoxifen use (postmenopausal women)
- insulin resistance
- family history of endometrial cancer
- family history of breast cancer or ovarian cancer
- family history of hereditary nonpolyposis colon cancer (Lynch syndrome)
- family history of PTEN syndromes
- nulliparity and infertility
- polycystic ovary syndrome
- radiation therapy
- white ethnicity
Division of Gynecologic Oncology
Department of Obstetrics, Gynecology, and Reproductive Sciences
Magee-Womens Hospital of UPMC
University of Pittsburgh School of Medicine
ABO declares that he has no competing interests.
Medical Gynecologic Oncology
Division of Hematology Oncology
Massachusetts General Hospital
RTP declares that he is on the scientific advisory boards of: Genentech, Inc., AstraZeneca, Endocyte, Inc., Eisai Inc., Vascular Biogenics Ltd, Baxalta Oncology, AbbVie, Clovis Oncology, Roche, and Merck. RTP receives research funding from: Genentech, Inc., ImClone Systems, Inc., Endocyte, Inc., AstraZeneca., Eisai Inc., Amgen Inc., and Vascular Biogenics Ltd. RTP was an expert witness for Aventis Pharma S.A. Vs. Apotex Inc in 2009. RTP has received royalties from: BMJ, Blackwell Publishing Medicine at a glance, and UpToDate Advance Medical: Second Medical Opinion.
Department of Radiation Oncology
Brigham and Women’s Hospital/Dana-Farber Cancer Institute
LJL receives research funding from the Koch Institute at the Massachusetts Institute of Technology and Dana-Farber Cancer Institute. LJL is also the Principal Investigator of an immunotherapy and radiation trial sponsored by AstraZeneca.
Dr Alexander B. Olawaiye, Dr Richard T. Penson, and Dr Larissa J. Lee would like to gratefully acknowledge Dr Neil S. Horowitz and Dr Anthony H. Russell, previous contributors to this topic.
S/M Obstetrics & Gynecology (UCD)
University of Colorado Health Sciences Center
SAD declares that she has no competing interests.
Assistant Professor of Radiology
Memorial Sloan-Kettering Cancer Center
SM declares that she has no competing interests.
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