The endometrial cancer risk scoring / Philippine Journal of Obstetrics and Gynecology

Our objectives were to determine the most significant prognostic factors affecting node metastasis in endometrial cancer and to devise and validate a scoring system for endometrial cancer. The study design consisted of retrospective chart review (operative record and histopathology report) of all endometrial cancer patients who underwent total hysterectomy/radical hysterectomy, bilateral salpingooophorectomy, bilateral pelvic lymph node dissection and peritoneal fluid cytology from September 21, 1989 to February 19, 1999. The analysis included 262 women, 21.4% of whom had pelvic lymph node metastasis.The mean ages for those with metastasis and without metastasis were similar positive lymph node (LN) =53.18 years old; negative LN=51.89 years old; range: positive LN=31-84 years old, negative LN=23-76 years old. Most patients were of low gravidity, with mean=G3, median=G4, mode = GO. The most significant factors affecting pelvic lymph node metastasis were peritoneal fluid cytology, myometrial invasion, cervix involvement and histologic grade as determined by logistic regression and Odds ratio. A prognostic scoring system was devised. All subjects were scored according to a proposed scoring system to determine the latter's clinical utility. A cut-off score of 5 was shown to be significant for pelvic lymph node metastasis. The proposed scoring system may be used to determine the likelihood of pelvic lymph node metastasis for patients who did not have lymphadenectomy and may have an important role in determining the need for adjuvant treatment.

Malignancies associated with endometriosis

The frequency of malignant transformation of endometriosis is presently unknown. Studies have mainly been retrospective; mostly on ovarian epithelial malignancies that have been found to be associated with endometriosis, either as a preexisting or as a coexisting lesion. Prospective studies on endometriosis itself, observing for malignant transformation, are wanting. Because of the strictness of the criteria for considering malignancy as having arisen from endometriosis, there is reason to believe that the transformation occurs much more frequently than reportedFour illustrative cases are presented. Two of the cases showed transition lesions with the demonstration of endometrioid carcinoma. One showed epithelial atypia in the original endometriosis. One, a primary mixed mesodermal tumor of the ovary, showed extensive endometriosis in the opposite ovaryThe following were discussed: 1) Clinical and histopathologic characteristics of the tumors; 2) Clinical indicators of possible malignant change in previously diagnosed endometriosis and 3) Clinical and histopathologic predictors of this malignant change