Levels of depression and self-esteem in women with cancer of the endometrium and cervix receiving chemotherapy treatment in Türkiye.

OBJECTIVE: Endometrium and cervical cancer is a common and important health problem that affects women in many physical, emotional and psychological aspects. This study aimed to determine the levels of depression and self-esteem in women with endometrial and cervical cancer receiving chemotherapy, determine the factors affecting them, and examine the relationship between the levels of depression and self-esteem. METHODS: This descriptive and cross-sectional study was conducted with 158 women who came to the gynecology-oncology policlinic and chemotherapy unit of a training and research hospital in Izmir, western Türkiye, between April 2022 and April 2023. Data were collected with the "Descriptive Information Form", "Beck Depression Inventory" and "Rosenberg Self-Esteem Scale". Descriptive and inferential statistics were performed to analyse the association between the study variables. RESULTS: In this study, 52.5% of women were diagnosed with endometrial cancer and 47.5% with cervical cancer. Beck Depression Inventory mean total score was 11.28 ±â€¯6.35, and 20.3% of them were at risk of depression (BDI ≥ 17). Rosenberg Self-Esteem Scale mean total score was 21.06 ±â€¯3.85, and 97.5% of them had high self-esteem. There was a statistically significant and strong negative correlation between the mean total scores of the Beck Depression Inventory and Rosenberg Self-Esteem Scale (r = 0.723; p < 0.05). It was determined that an increase in the Rosenberg Self-Esteem Scale mean total score by 1 unit decreased the Beck Depression Inventory mean total score by 1.2 units and was responsible for 52% of the variance (B = -1.192; R2 = 0.523). CONCLUSION: It was determined that one-fifth of women experienced moderate/severe depression and the majority of them had high self-esteem. The increase in women's depression levels decreased their self-esteem. Health professionals and oncology nurses should perform screenings to determine the depression and self-esteem levels of women with endometrial and cervical cancer and provide necessary education, counseling, and care to women.

Clinical Characteristics and Outcomes of a High-grade Endometrial Cancer Cohort Treated at Instituto Nacional de Câncer, Brazil / Características clínicas e desfechos de uma coorte de câncer endometrial de alto grau tratada no Instituto Nacional de Câncer, Brasil

Abstract Objective To analyze the outcomes of a cohort of patients with high-risk histologies of endometrial cancer (EC) treated at Instituto Nacional de Câncer (National Cancer Institute, INCA, in Portuguese), in Brazil. Materials and Methods We reviewed the medical records of patients with high-risk histologies of EC in any stage registered at INCA between 2010 and 2016 to perform a clinical and demographic descriptive analysis and to evaluate the outcomes in terms of recurrence and survival. Results From 2010 to 2016, 2,145 EC patients were registered and treated at INCA, and 466 had high-grade histologies that met the inclusion criteria. The mean age of the patients was 65 years, 44.6% were Caucasian, and 90% had a performance status of 0 or 1. The most common histology was high-grade endometrioid (31.1%), followed by serous carcinoma (25.3%), mixed (20.0%), carcinosarcoma (13.5%), and clear cell carcinoma (9.4%). Considering the 2018 Fédération Internationale de Gynécologie et d'Obstétrique (International Federation of Gynecology and Obstetrics, FIGO, in French) staging system, 44.8%, 12.4%, 29.8%, and 12.9% of the patient were in stages I, II, III or IV respectively. Age (> 60 years), more than 50% of myoinvasion, higher stage, poor performance status, serous and carcinosarcoma histologies, and adjuvant treatment were independent factors associated with recurrence-free survival (RFS) and overall survival (OS) in the multivariate analysis. Conclusion The current findings reinforced the international data showing poor outcomes of these tumors, especially for serous and carcinosarcomas and tumors with advanced stages, with shorter survival and high recurrence rates in distant sites, independently of the FIGO stage. Adjuvant therapy was associated with better survival.

Resumo Objetivo Analisar os desfechos de uma coorte de pacientes com câncer de endométrio (CE) e histologias de alto risco atendida no Instituto Nacional do Câncer (INCA) entre 2010 e 2016. Materiais e Métodos Foram revisados prontuários de pacientes com histologias de alto risco de CE em qualquer estágio cadastradas no INCA entre 2010 e 2016 para realizar uma análise descritiva clínica e demográfica e avaliar os resultados em termos de recorrência e sobrevida. Resultados De 2010 a 2016, 2.145 pacientes com CE foram cadastradas e atendidas no INCA, e 466 tinham histologias de alto grau e atendiam aos critérios de inclusão. A média de idade das pacientes foi de 65 anos, 44,6% eram brancas, e 90% tinham performance status de 0 ou 1. A histologia mais comum foi endometrioide de alto grau (31,1%), seguida de carcinoma seroso (25,3%), misto (20,0%), carcinossarcoma (13,5%) e carcinoma de células claras (9,4%). Considerando o estadiamento da Fédération Internationale de Gynécologie et d'Obstétrique (Federação Internacional de Ginecologia e Obstetrícia, FIGO, em francês) de 2018, 44,8%, 12,4%, 29,8% e 12,9% apresentaram estágios I, II, III ou IV, respectivamente. Idade (> 60 anos), mais de 50% de mioinvasão, estágio avançado, performance status ruim, histologias serosas e carcinossarcoma, e tratamento adjuvante foram fatores independentes associados à sobrevida livre de recorrência e sobrevida global na análise multivariada. Conclusão Os achados atuais reforçam os dados internacionais que demonstram o prognóstico ruim desses tumores, principalmente para as histologias serosas e carcinossarcomas e para estágios avançados, com menor sobrevida e altas taxas de recorrência à distância, independentemente do estágio da FIGO. A terapia adjuvante foi associada a melhor sobrevida.

Revisión sistemática sobre el papel de la 18F-FDG PET/TC preoperatoria para el pronóstico y la estratificación de riesgo en pacientes con cáncer de endometrio / A systematic review about the role of preoperative 18F-FDG PET/CT for prognosis and risk stratification in patients with endometrial cancer

objetivo Analizar la literatura disponible sobre el valor pronóstico de los parámetros metabólicos de la 18F-FDG PET/TC preoperatoria y su utilidad en la estratificación de riesgo en pacientes con cáncer de endometrio (CE). Material y métodos En búsquedas de Pubmed se utilizó «(endometr* OR uter*) AND (PET OR FDG)» como palabras clave desde enero-2000 hasta junio-2020. Se revisaron referencias en los artículos incluidos buscando posibles publicaciones no incluidas en la primera búsqueda. Se incluyeron los estudios que evaluaron el valor pronóstico de la 18F-FDG PET/TC preoperatoria y su papel para la estratificación del riesgo en pacientes con CE. Los artículos no originales (revisiones, editoriales, cartas, casos legales, entrevistas, informes de casos, etc.) no fueron incluidos. Resultados Veintiséis estudios (1.918 pacientes) fueron elegidos según los criterios de inclusión en esta revisión. Se incluyeron 13 estudios (939 pacientes) relacionados con el papel pronóstico de la 18F-FDG PET/TC preoperatoria y 14 estudios (1.036 pacientes) relacionados con su papel en la estratificación de riesgo. Parámetros como SUVmáx, volumen tumoral metabólico (VTM) y glicólisis total de lesión (GTL) del tumor primario fueron analizados. Conclusiones El SUVmáx preoperatorio es útil para realizar diagnósticos no invasivos y decidir la estrategia terapéutica adecuada, ya que podría utilizarse como marcador pronóstico independiente de recurrencia y supervivencia en el CE. Además, tanto VTM como GTL preoperatorios podrían ser factores pronósticos independientes para predecir recurrencia y supervivencia, pero, aun no existe suficiente evidencia científica. La utilidad del SUVmáx para la estratificación del riesgo es limitada (no existe literatura suficiente acerca de que la 18F-FDG PET/TC pueda sustituir la estadificación quirúrgica), aunque el VTM y la GTL sí que son más precisos y tienen un valioso papel en la estratificación del riesgo del CE (AU)

Objective To analyse the available literature on the prognostic value of preoperative 18F-FDG PET/CT metabolic parameters and their usefulness in risk stratification in patients with endometrial cancer (EC). Material and methods Pubmed searches used «(endometr* OR uter*) AND (PET OR FDG)» as keywords from January-2000 to June-2020. References in included articles were checked for possible publications not included in the first search. Studies evaluating the prognostic value of preoperative 18F-FDG PET/CT and its role for risk stratification in patients with EC were included. Non-original articles (reviews, editorials, letters, legal cases, interviews, case reports, etc.) were not included. Results Twenty-six studies (1918 patients) were selected according to the inclusion criteria in this review. Thirteen studies (939 patients) related to the prognostic role of preoperative 18F-FDG PET/CT and 14 studies (1036 patients) related to its role in risk stratification were included. Parameters such as SUVmax, metabolic tumour volume (MTV) and total lesion glycolysis (TLG) of the primary tumour were analysed. Conclusions Preoperative SUVmax is useful for non-invasive diagnosis and for deciding the appropriate therapeutic strategy, as it could be used as an independent prognostic marker for recurrence and survival in EC. In addition, both preoperative VTM and GTL could be independent prognostic factors for predicting recurrence and survival, but there is still insufficient scientific evidence. The usefulness of SUVmax for risk stratification is limited (there is insufficient literature that 18F-FDG PET/CT can replace surgical staging), although VTM and GTL are more accurate and have a valuable role in risk stratification of EC. However, larger multicentre studies with adequate follow-up time are needed to confirm these findings (AU)

A systematic review about the role of preoperative 18F-FDG PET/CT for prognosis and risk stratification in patients with endometrial cancer.

OBJECTIVE: To analyse the available literature on the prognostic value of preoperative 18F-FDG PET/CT metabolic parameters and their usefulness in risk stratification in patients with endometrial cancer (EC). MATERIAL AND METHODS: Pubmed searches used "(endometr* OR uter*) AND (PET OR FDG)" as keywords from January-2000 to June-2020. References in included articles were checked for possible publications not included in the first search. Studies evaluating the prognostic value of preoperative 18F-FDG PET/CT and its role for risk stratification in patients with EC were included. Non-original articles (reviews, editorials, letters, legal cases, interviews, case reports, etc.) were not included. RESULTS: Twenty-six studies (1918 patients) were selected according to the inclusion criteria in this review. Thirteen studies (939 patients) related to the prognostic role of preoperative 18F-FDG PET/CT and 14 studies (1036 patients) related to its role in risk stratification were included. Parameters such as SUVmax, metabolic tumour volume (MTV) and total lesion glycolysis (TLG) of the primary tumour were analysed. CONCLUSIONS: Preoperative SUVmax is useful for non-invasive diagnosis and for deciding the appropriate therapeutic strategy, as it could be used as an independent prognostic marker for recurrence and survival in EC. In addition, both preoperative VTM and GTL could be independent prognostic factors for predicting recurrence and survival, but there is still insufficient scientific evidence. The usefulness of SUVmax for risk stratification is limited (there is insufficient literature that 18F-FDG PET/CT can replace surgical staging), although VTM and GTL are more accurate and have a valuable role in risk stratification of EC. However, larger multicentre studies with adequate follow-up time are needed to confirm these findings.

Qualidade de vida e mapeamento de complicações: avaliação do linfonodo sentinela no câncer de endométrio / Quality of life and complications: evaluation of the sentinel lymph node in endometrial cancer

Objetivo: Avaliar a incidência das complicações pós-operatórias do estadiamento cirúrgico e qualidade de vida relacionada ao protocolo do linfonodo sentinela associado ou não à linfadenectomia sistemática no tratamento do câncer do endométrio. Métodos: Foi conduzida uma coorte prospectiva entre dezembro de 2017 e abril de 2022, incluindo mulheres com carcinoma de endométrio em estágio inicial presumido (doença restrita ao útero) e com estadiamento linfonodal, agrupadas em: Grupo LNS (somente pesquisa do linfonodo sentinela) e Grupo LNS+LND (linfonodo sentinela com adição de linfadenectomia sistemática). Foram incluídas pacientes com baixo e alto risco para metástase linfonodal. As pacientes de alto risco fazem parte do estudo ALICE (NCT03366051), um estudo prospectivo randomizado de não inferioridade. As pacientes foram avaliadas no pré-operatório, 1 mês, 6 e 12 meses, com aplicação de questionário de qualidade de vida (QQV) pelo EORTC QLQ-C30 e Cx24, avaliação clínica e perimetria para avaliar linfedema. Resultados: Foram incluídas 152 mulheres, sendo 113 (74,3%) no grupo LNS e 39 (25,7%) no grupo LNS+LND. Complicações cirúrgicas intraoperatórias ocorreram em 2 (1,3%) casos todas pertencentes ao grupo LNS+LND. Complicações cirúrgicas até 30 dias foram encontradas em 29 (19,1%) casos. As pacientes submetidas a LNS+LND apresentaram taxas gerais de complicações cirúrgicas mais altas em comparação com aquelas submetidas apenas a LNS (33,3% vs. 14,2%; p=0,011). O grupo LNS+LND apresentou maior tempo de cirurgia (p=0,001) e necessidade de UTI (p=0,001). A incidência de linfocele foi encontrada em 8 casos, apenas no grupo LNS+LND (0 vs. 20,5%; p<0,001). Para o linfedema de membros inferiores, não foi encontrada diferença entre os grupos pela avaliação perimétrica do grupo LNS comparado ao LNS+LND (23,2% vs. 13,3%; p= 0,25). O mesmo ocorreu para a avaliação clínica do linfedema, encontrado em 21,2% do grupo LNS e 33,3% do grupo LNS+LND (p=0,14). Entretanto, na avaliação de presença de linfedema pelo score de sintomas do EORTC, houve maior relato de linfedema no grupo LNS+LND (score 23,52) comparado ao grupo LNS (score 12,45) na avaliação de 12 meses (p=0,02). Além disso, encontramos associação entre avaliação clínica e linfedema relatado pelo paciente. O score médio de linfedema foi maior quando este foi detectado por exame clínico em 6 meses (30,10 vs. 7,8; p<0,001) e 12 meses (36,4 vs. 6,0; p<0,001), no entanto sem associação entre perimetria e avaliações clínicas (p=0,76). Em relação à avaliação global de qualidade de vida, não houve diferença entre os grupos aos 12 meses (p=0,21). Conclusões: Houve maior taxa geral de complicações para o grupo submetido a linfadenectomia sistemática, assim como maiores taxas de linfocele e linfedema pelo score de sintomas. Nenhuma diferença foi encontrada em relação à qualidade de vida entre os grupos LNS e LNS+LND

Objectives: To evaluate the incidence of postoperative complications of surgical lymph node staging procedures and quality of life related to the sentinel lymph node protocol associated or not with systemic lymphadenectomy in the treatment of endometrial cancer. Methods: A prospective cohort was conducted between December 2017 and April 2022. Women with presumed early-stage endometrial carcinoma (disease restricted to the uterus) and with lymph node staging were included, grouped as follows: SLN group (sentinel lymph node only) and SLN+LND Group (sentinel lymph node with addition of systematic lymphadenectomy). Patients with low and high risk for lymph node metastasis were included, and high-risk patients were part of the ALICE study (NCT03366051), a prospective randomized non-inferiority study. The patients were assessed preoperatively, 1 month, 6 and 12 months with the application of a quality-of-life questionnaire (QQL) using the EORTC QLQ-C30 and Cx24, clinical evaluation and perimetry to assess lymphedema. Results: 152 women were included, 113 (74.3%) women in the SLN group and 39 (25.7%) in the SLN+LND group. Intraoperative surgical complications occurred in 2 (1.3%) cases, all of them in the SLN+LND group. Surgical complications within 30 days were found in 29 (19.1%) cases. Patients undergoing SLN+LND had higher overall rates of surgical complications compared to women undergoing SLN alone (33.3% vs. 14.2%; p=0.011). The SLN+LND group had longer surgery time (p=0.001) and need for ICU (p=0.001). The incidence of lymphocele was found in 8 cases and only in the SLN+LND group (0 vs. 20.5%; p<0.001). For lower limbs lymphedema, no difference was found between the groups by the perimetric evaluation of the SLN group compared to the SLN+LND (23.2% vs. 13.3%; p=0.25). The same occurred for the clinical evaluation of lymphedema, being found in 21.2% for the SLN group and 33.3% for the SLN+LND group (p=0.14). However, when evaluating the presence of lymphedema using the EORTC symptom score, there was a higher number of lymphedema reports in the SLN+LND group (score 23.52) compared to the SLN group (score 12.45) at the 12-month evaluation (p=0.02). In addition, we found an association between clinical evaluation and lymphedema reported by the patient. The lymphedema score had a higher mean score when lymphedema was detected by clinical examination at 6 months (30.10 vs. 7.8; p<0.001) and 12 months (36.4 vs. 6.0; p<0.001), however with no association between perimetry and clinical evaluations (p=0.76). Regarding the overall assessment of quality of life, there was no difference between the groups at 12 months (p=0.21). Conclusions: There was a higher overall rate of complications for the group undergoing systematic lymphadenectomy, as well as higher rates of lymphocele and lymphedema according to the symptom score. No difference was found regarding quality of life between the LNS and LNS+LND groups

Controversias en la técnica de detección del ganglio centinela en cáncer de endometrio / Controversy over sentinel lymph node detection in endometrial cancer

En la última década se ha introducido la biopsia selectiva del ganglio centinela en cáncer de endometrio de bajo riesgo, siendo opcional en el de riesgo intermedio y alto. Sin embargo, hasta hace un año no se existía consenso respecto al grupo de población indicado, el trazador de elección o el lugar de administración del trazador. En este trabajo, presentamos de forma multidisciplinar los aspectos más controvertidos sobre la técnica de detección del ganglio centinela en cáncer de endometrio, con mayor énfasis en las ventajas y desventajas de los tipos de trazadores disponibles: radiotrazadores, trazadores híbridos y verde de indocianina (AU)

In the last decade, the procedure of sentinel lymph node biopsy has been introduced in low-risk endometrial cancer, being optional in intermediate- and high-risk cancer. However, until the last year, there was no consensus regarding the group of patients to whom to apply it, the best tracer to use or the site of injection. In this paper, we present in a multidisciplinary view the most controversial issues about the sentinel lymph node procedure in endometrial cancer, emphasizing the pros and cons of the different tracers available: radiotracers, hybrid tracers and indocyanine green (AU)

Controversy over sentinel lymph node detection in endometrial cancer.

In the last decade, the procedure of sentinel lymph node biopsy has been introduced in low-risk endometrial cancer, being optional in intermediate- and high-risk cancer. However, until the last year, there was no consensus regarding the group of patients to whom to apply it, the best tracer to use or the site of injection. In this paper, we present in a multidisciplinary view the most controversial issues about the sentinel lymph node procedure in endometrial cancer, emphasizing the pros and cons of the different tracers available: radiotracers, hybrid tracers and indocyanine green.

Protein biomarkers in gynecological cancers: The need for translational research towards clinical applications / Biomarcadores proteicos en los cánceres ginecológicos: la necesidad de una investigación traslacional para las aplicaciones clínicas

Ovarian cancer is ranked highest among gynecological cancers, followed by cervical and endometrial cancer. Most women are asymptomatic and are eventually diagnosed with late-stage disease. Numerous recent studies have proposed promising protein tumour biomarkers for diagnosis, prognosis, treatment and disease recurrence. Cancer antigen 125 (CA-125) and human epididymis protein 4 (HE4) are biomarkers routinely used for monitoring recurrence in ovarian cancer patients. They are of limited diagnostic value in early-stage cancer. Application of sensitive advanced proteomics techniques reveals that a combined biomarker panel is superior in specificity and sensitivity compared to a single biomarker. The major limitation in translating potential tumour biomarkers from the research setting to clinical practice is a lack of validation in large patient cohorts. This review provides an overview of current and potential biomarkers for ovarian, endometrial and cervical cancers. In conclusion, we propose validation studies for multiple biomarker panels of apolipoprotein A-I (ApoA-I)+CA-125+transthyretin and vascular cell adhesion molecule-1 (VCAM-1)+CA-125+carcinoembryonic antigen (CEA)+HE4 for early diagnosis of ovarian cancer. We also suggest combination panels of prognostic value consisting of CA-125+HE4 for endometrial cancer and squamous cell carcinoma antigen (SCC-Ag)+CEA for cervical cancer.

El cáncer de ovario ocupa el primer lugar entre los cánceres ginecológicos, seguido del cáncer de cuello uterino y del cáncer de endometrio. La mayoría de las mujeres son asintomáticas, por lo que finalmente se les diagnostica la enfermedad en una fase avanzada. En numerosos estudios recientes se han propuesto prometedores biomarcadores tumorales proteicos para el diagnóstico, el pronóstico, el tratamiento y la recidiva de la enfermedad. El antígeno de cáncer 125 (CA-125) y la proteína 4 del epidídimo humano son biomarcadores que se utilizan de forma habitual para controlar la recidiva en pacientes con cáncer de ovario. Tienen un valor diagnóstico limitado en las fases iniciales del cáncer. La aplicación de técnicas sensibles de proteómica avanzada ha revelado que un grupo combinado de biomarcadores es superior en especificidad y sensibilidad en comparación con un único biomarcador. La principal limitación a la hora de trasladar los posibles biomarcadores tumorales del ámbito de la investigación a la práctica clínica es la falta de validación en grandes cohortes de pacientes. Esta revisión ofrece una visión general de los biomarcadores actuales y potenciales para el cáncer de ovario, de endometrio y de cuello uterino. En conclusión, proponemos estudios de validación para varios grupos de biomarcadores de apolipoproteína A-I+CA-125+transtiretina y molécula de adhesión celular vascular 1+CA-125+antígeno carcinoembrionario+proteína 4 del epidídimo humano para el diagnóstico precoz del cáncer de ovario. También sugerimos grupos combinados de valor pronóstico, compuestos por CA-125+proteína 4 del epidídimo humano para el cáncer de endometrio y antígeno de carcinoma de células escamosas+ antígeno carcinoembrionario para el cáncer de cuello uterino.

Manejo terapéutico del cáncer ginecológico durante la gestación / Therapeutic management of gynecological cancer during pregnancy

Antecedente: Aunque la asociación entre embarazo y cáncer es infrecuente, el retraso en la edad de gestación ha hecho que aumente la incidencia en las últimas décadas. El tratamiento del cáncer gine- cológico durante la gestación plantea un importante conflicto tanto a nivel ético como clínico. Objetivo: Material y métodos: Búsqueda bibliográfica de literatura a través de las bases de datos Pub- Med, MedLine, Embase, BioMed Central y SciELO.Conclusiones: La gestación no ha demostrado tener un impacto negativo en el pronóstico del cáncer de cérvix. La cirugía más o menos radical en función de la sospecha de malignidad es el manejo estándar del cáncer de ovario en el embarazo, aunque resultan prometedores los resultados de las pautas neoad- yuvantes con platino. El embarazo actúa como factor protector de cáncer de endometrio. (AU)

Background: Although the association between pregnancy and cancer is rare, the delay in gestation age has increased theincident in recent decades. The treatment of gynecological cancer during pregnancy involves an important conflict bothan ethical and clinical level.Objetive: To collect the current evidence regarding the diagnosis and management of gynecological cancer during preg-nancy.Material and methods: Bibliographic literature search through the Pubmed, MedLine, Embase, BioMed Central andSciELO databases.Conclusions: Pregnancy has not been shown to have a negative impact on the prognosis of cervical cancer. More or lessradical surgery based on suspected malignancy is the standard management of ovarian cancer in pregnancy, although theresults of neoadjuvant platinum regimens are promising. Pregnancy acts as a protective factor against endometrial cancer. (AU)

Análisis del cáncer de endometrio en un hospital universitario de Ourense, España / Analysis of endometrial cancer in a university hospital in Ourense, Spain

Resumen OBJETIVO: Describir, de forma retrospectiva, el comportamiento del cáncer de endometrio en pacientes diagnosticadas en el Complexo Hospitalario Universitario de Ourense MATERIALES Y MÉTODOS: Estudio descriptivo, observacional y retrospectivo efectuado en el Complexo Hospitalario Universitario de Ourense entre septiembre de 2014 y enero de 2018. Criterio de inclusión: diagnóstico, tratamiento y seguimiento en nuestro centro. Criterio de exclusión: historia incompleta y diagnóstico o tratamiento en otro centro. Variables de estudio: tipo de tumor y de tratamiento. Se realizó un análisis descriptivo. Las posibles asociaciones se comprobaron mediante χ2, Fisher, t de Student y prueba de Mann-Whitney. RESULTADOS: Se estudiaron 149 pacientes, con edad media al diagnóstico de 69.38 años ± 9.6 años. El 86.6% (n = 129) de las pacientes estaban en la posmenopausia. El 68% (n = 101) eran obesas y el 54.7% (n = 81) hipertensas. El 54.7% (n = 81) se diagnosticaron en estadio IA. El 68.4% de los tumores grado 3 tuvieron infiltración miometrial mayor al 50%, el 28.6% grado 1 (p < 0.001). De las pacientes que recibieron radioterapia o braquiterapia el 46% estaba en estadios avanzados; 76% en estadio IB, 26% en estadio IA (p < 0.001). El 91.3% de los tumores estadio I fueron tipo I, en los estadios avanzados hubo 48.6% de tumores tipo I (p < 0.001). El 87.4% de los tumores grados 1 o 2 se encontraron en estadio I, un 45.2% de los tumores grado 3 en estadio I (p < 0.001). CONCLUSIONES: La mayoría de las pacientes tenía más de 60 años y eran diabéticas, hipertensas y obesas. El cáncer de endometrio suele diagnosticarse en estadios tempranos. La braquiterapia es la coadyuvancia más indicada.

Abstract OBJECTIVE: To retrospectively describe the behavior of endometrial cancer in patients diagnosed at the Complexo Hospitalario Universitario de Ourense. MATERIALS AND METHODS: Descriptive, observational and retrospective study in the Complexo Hospitalario Universitario de Ourense between September 2014 and January 2018. Inclusion criteria: diagnosis, treatment and follow-up in our center. Exclusion criteria: incomplete history and diagnosis or management in another center. Patient, tumor and treatment variables were collected. A descriptive analysis was performed. Possible associations were tested by Chi-square, Fisher, Student's t-test and Mann-Whitney test. RESULTS: 149 patients were studied, with mean age at diagnosis of 69.38 years ± 9.6 years. 86.6% (n = 129) of the patients were postmenopausal. 68% (n = 101) were obese and 54.7% (n = 81) hypertensive. 54.7% (n = 81) were diagnosed at stage IA. 68.4% of grade 3 tumors had myometrial infiltration greater than 50%, 28.6% grade 1 (p < 0.001). Of the patients who received radiotherapy or brachytherapy 46% were advanced stage; 76% stage IB, 26% stage IA (p < 0.001). 91.3% of stage I tumors were type I, in advanced stages there were 48.6% of type I tumors (p < 0.001). 87.4% of grade 1 or 2 tumors were stage I, 45.2% of grade 3 tumors were stage I (p < 0.001). CONCLUSIONS: Most patients were older than 60 years and were diabetic, hypertensive and obese. Endometrial cancer is usually diagnosed at early stages. Brachytherapy is the most indicated adjuvant.

Factores predictores de recurrencia del cáncer de endometrio / Predictors of the endometrium cancer recurrence

Resumen OBJETIVO: Determinar qué factores favorecen la predicción de recurrencia de cáncer de endometrio en diferentes estadios de la enfermedad. MATERIALES Y MÉTODOS: Estudio retrospectivo efectuado en un grupo de pacientes con cáncer de endometrio atendidas entre el 2017 y 2020 en el Hospital Juan Ramón Jiménez de Huelva, España. Variables de análisis: edad, grado de diferenciación tumoral, invasión miometrial, estadio posquirúrgico e infiltración al espacio linfovascular, en todas las pacientes con recidiva. El análisis estadístico se procesó en el programa SPSS v23. Habiéndose realizado un análisis de Kolmogorov- Smirnov y tras haber obtenido un resultado no normal, se utilizó la prueba de χ2 para los datos categóricos paramétricos, e independientemente se aplicó la prueba U de Mann Whitney para los datos no paramétricos. Los valores de p < 0.01 se consideraron estadísticamente significativos. RESULTADOS: Se reunieron 9 pacientes con recidiva tumoral y seguimiento de 5 años luego del diagnóstico primario. Conforme al análisis estadístico no se encontró una relación de dependencia entre las variables recidiva e invasión miometrial (χ2 = 4.780; p = 0.092), recidiva y grado tumoral (χ2 = 7.765; p = 0.051) y recidiva y el estadio posquirúrgico (χ2 = 10.200, p = 0.070). Por el contrario, se observó relación de dependencia entre las variables afectación ganglionar e infiltración al espacio linfovascular positiva (χ2 = 9.954, Cc = 0.235, p < 0.01). En todas las pacientes se evaluó la infiltración al espacio linfovascular. Ésta fue negativa en 141 casos y 4 de estos casos tuvieron recurrencia de la enfermedad. 5 de 9 pacientes con recurrencia de la enfermedad tenían infiltración al espacio linfovascular positiva. CONCLUSIONES: Lo aquí encontrado muestra que más de la mitad de las pacientes con recurrencia de la enfermedad tuvieron infiltración al espacio linfovascular. Cuando ésta fue negativa hubo una reducción del riesgo de 2.8% de padecer una recurrencia.

Abstract OBJECTIVE: To determine which factors favor the prediction of endometrial cancer recurrence at different stages of the disease. MATERIALS AND METHODS: Retrospective study performed in a group of patients with endometrial cancer attended between 2017 and 2020 at the Juan Ramón Jiménez Hospital in Huelva, Spain. Analysis variables: age, degree of tumor differentiation, myometrial invasion, post-surgical stage and infiltration to the lymphovascular space, in all patients with recurrence. The statistical analysis was processed in SPSS v23. Having performed a Kolmogorov-Smirnov analysis and having obtained a non-normal result, a 2 test was used for parametric categorical data, and independently the Mann Whitney U test was used for non-parametric data. Values of p < 0.01 were considered statistically significant. RESULTS: Nine patients with tumor recurrence and 5-year follow-up after primary diagnosis were collected. According to the statistical analysis, no dependency relationship was found between the variables recurrence and myometrial invasion (χ2 = 4.780; p = 0.092), recurrence and tumor grade (χ2 = 7.765; p = 0.051) and recurrence and post-surgical stage (χ2 = 10.200, p = 0.070). In contrast, a dependency relationship was observed between the variables nodal involvement and positive lymphovascular space infiltration (χ2 = 9.954, Cc = 0.235, p < 0.01). The existence of infiltration of the lymphovascular space was evaluated in all patients. This was negative in 141 cases and 4 of these cases had disease recurrence. 5 of 9 patients with disease recurrence had positive lymphovascular space infiltration. CONCLUSIONS: The findings here show that more than half of the patients with disease recurrence have infiltration to the lymphovascular space and, in addition, if the infiltration to the lymphovascular space is negative, there is a 2.8% reduced risk of recurrence.

Abordaje laparoscópico mediante puerto único versus técnica convencional en el tratamiento quirúrgico del cáncer de endometrio / Single port laparoscopic approach versus conventional technique in the surgical treatment of endometrial cancer

Objetivo: El objetivo de este estudio es comparar el abordaje laparoscópico convencional con el acceso por puerto único en el tratamiento quirúrgico del cáncer de endometrio. Materiales y métodos: Estudio retrospectivo sobre 36 pacientes, 18 operadas con técnica convencional y 18 con acceso por puerto único mediante una única incisión en la piel y 3 en la fascia, para la inserción de un trócar de 10mm y 2 de 5mm. Resultados: Se obtiene menor dolor postoperatorio (22,3% vs. 83,3%, p<0,001) y un mejor resultado estético (10 vs. 8, p=0,001) en el grupo de pacientes intervenidas por puerto único. El tiempo quirúrgico fue mayor en el grupo con técnica convencional (120 vs. 180min; p=0,027). En cuanto a estancia hospitalaria (2,5 vs. 2,5 días, p=0,69), pérdida sanguínea (1,15 vs. 1,25g/dl, p=1), número de ganglios extirpados (16,5 vs. 18; p=0,78) y complicaciones intra (0% vs. 5%, p=0,19) y posquirúrgicas (16,6% vs. 11,1%, p=0,63) no hubo diferencias significativas. Conclusión: El abordaje por puerto único es una técnica factible, segura y efectiva en el tratamiento del cáncer ginecológico, presentando una menor tasa de dolor postoperatorio y un mejor resultado estético.(AU)

Objective: The objective of this study is to compare conventional laparoscopy with transumbilical single-port access for the surgical treatment of endometrial cancer. Materials and methods: A retrospective study was performed with 36 patients, of whom 18 were operated using conventional laparoscopy, and 18 using a transumbilical single-port access (laparoendoscopic single-site surgery, or LESS) by making a single incision in the umbilical skin of 2-3cm, and 3 incisions in the fascia. One 10-mm trocar and two 5-mm trocars were inserted next to each other to access the abdominal cavity. Results: There were no statistical differences between groups in postoperative changes in haemoglobin concentration (1.15 vs. 1.25g/dL, P=1), hospital stay (2.5 vs. 2.5 days, P=.69), intraoperative complication rate (0% vs. 5%, P=.19), postoperative complications (16.6% vs. 11.1%, P=.63), number of pelvic lymph nodes (16.5 vs. 18, P=.78), and number of para-aortic lymph nodes (9 vs. 10, P=.64). Patients in the LESS group experienced less postoperative pain (22.3% vs. 83.3%, P<.001), and had a higher rate of satisfaction with the cosmetic results (10 vs. 8, P=.001). The median operating time was lower in the LESS group (120-180min, P=.027). Conclusion: Laparoendoscopic single-site surgery is a feasible, safety and effective technique for the treatment of endometrial cancer, with less postoperative pain and better cosmetic results.(AU)

Hemorragia de vías digestivas altas por presentación atípica de adenocarcinoma endometrial metastásico en el estómago. Tipificación diagnóstica con recursos endoscópicos / Upper gastrointestinal bleeding due to atypical presentation of metastatic endometrial adenocarcinoma in the stomach. Diagnostic typing with endoscopic resources

Resumen El cáncer de endometrio es la neoplasia ginecológica maligna más frecuente en el sexo femenino. Su presentación metastásica se limita principalmente a los órganos vecinos y ganglios cercanos, y es infrecuente la invasión al tubo digestivo superior. En el presente artículo se presenta una paciente que ingresó al servicio de urgencias con cuadro de hemorragia de vías digestivas altas, enfocado inicialmente como un tumor estromal gastrointestinal (GIST) de la pared gástrica, pero que luego de la realización de una adecuada historia clínica, complementada con imágenes diagnósticas y avances ecoendoscópicos, se logró el diagnóstico de metástasis de cáncer de endometrio.

Abstract Endometrial cancer is the most common gynecologic malignancy in women. Its metastatic presentation is mainly limited to neighboring organs and nearby lymph nodes, and infiltration of the upper digestive tract is uncommon. This case report depicts a patient admitted to the emergency department with upper gastrointestinal bleeding symptoms. Initially, a gastrointestinal stromal tumor (GIST) of the gastric wall was suspected, but endometrial cancer metastasis was discovered after a thorough medical examination, diagnostic imaging, and echoendoscopes.

Residual disease after operative hysteroscopy in patients with endometrioid endometrial cancer associated with polyps / Doença residual após histeroscopia cirúrgica em pacientes com câncer de endométrio endometrioide associado a pólipo endometrial

Abstract Objective To evaluate the presence of residual disease in the uterine specimen after hysteroscopic polypectomy or polyp biopsy in patients with endometrioid endometrial cancer (EC). Methods We analyzed a series of 104 patients (92 cases from the Hospital AC Camargo and 12 from the Hospital do Servidor Público Estadual de São Paulo) with polyps that were diagnosed by hysteroscopy, showing endometrioid EC associated with the polyp or in the final pathological specimen. Patients underwent a surgical approach for endometrial cancer from January 2002 to January 2017. Their clinical and pathological data were retrospectively retrieved from the medical records. Results In78cases (75%), thepolyphad EC, and in 40(38.5%), itwas restricted tothe polyp, without endometrial involvement. The pathologic stage was IA in 96 cases (92.3%) and 90 (86.5%) had histologic grade 1 or 2. In 18 cases (17.3%), there was no residual disease in the final uterine specimen, but only in 9 of them the hysteroscopy suggested that the tumor was restricted to the polyp. In 5 cases (4.8%) from the group without outside of the polyp during hysteroscopy, myometrial invasion was noted in the final uterine specimen. This finding suggests the possibility of disease extrapolation through the base of the polyp. Conclusion Patients with endometrioid EC associated with polyps may have the tumor completely removed during hysteroscopy, but the variables shown in the present study could not safely predict which patient would have no residual disease.

Resumo Objetivo Avaliar a presença de doença residual no exame anatomopatológico definitivo de pacientes com câncer de endométrio endometrioide após polipectomia ou biópsia de pólipo histeroscópica. Métodos Analisamos 104 pacientes (92 casos do Hospital AC Camargo e 12 casos do Hospital do Servidor Público Estadual de São Paulo) com pólipos diagnosticados durante histeroscopia e cuja biópsia histeroscópica ou exame patológico final do útero acusaram câncer de endométrio endometrioide. As pacientes foram submetidas a cirurgia para câncer de endométrio de janeiro de 2002 a janeiro de 2017. Os dados clínicos e anatomopatológicos de cada paciente foram retirados dos prontuários médicos Resultados Em 78 casos (75%), o pólipo continha a neoplasia, e em 40 (38.5%), ela estava restrita ao tecido do pólipo, sem envolvimento endometrial adjacente. O estadio final foi IA em 96 casos (92.3%) e em 90 (86.5%) tratava-se de grau 1 ou 2. Em 18 casos (17.3%), não havia doença residual no espécime uterino, mas emapenas 9 deles a histeroscopia sugeriu doença restrita ao pólipo. Em 5 casos (4.8%), não havia doença aparente extrapólipo na histeroscopia, mas havia invasão miometrial, sugerindo extravasamento do tumor pela base do pólipo. Conclusão Pacientes com câncer de endométrio associado a pólipos podem ter o tumor completamente removido durante a histeroscopia, mas, com as variáveis avaliadas, é difícil predizer com segurança qual paciente ficará sem tumor residual.

Carcinoma endometrioide sincrónico de ovario y endometrio / Ovarian and endometrial synchronous endometrioid carcinoma

ANTECEDENTES: existe una asociación demostrada entre endometriosis y algunas histologías del carcinoma epitelial de ovario. Por otra parte, se ha observado que hasta un 30% de las neoplasias de ovario se presentan de forma concomitante a neoplasias del endometrio. Para considerar la sincronicidad entre estos tumores, estos deben cumplir criterios anatomopatológicos estrictos como los descritos por scully. OBJETIVO: presentar un caso clínico de carcinoma endometrioide sincrónico de ovario y endometrio sobre focos de endometriosis, así como su diagnóstico y manejo. CASO CLÍNICO: paciente de 27 años que consulta por spotting intermenstrual. En la ecografía endocavitaria se observa un pólipo endometrial. Además, se describe un tumor anexial izquierdo de 42mm, trilobulado, con un polo sólido de 17×15mm. Se somete a una polipectomía histeroscópica y quistectomía ovárica laparoscópica. Asimismo, se reseca implante sospechoso en el fondo de saco posterior. El resultado anatomopatológico de las piezas quirúrgicas fue: pólipo endometrial con hiperplasia compleja con atipias y focos de adenocarcinoma endometrioide grado I; el tumor quístico ovárico izquierdo consistente con quiste endometriósico con focos de adenocarcinoma endometrioide. La lesión peritoneal corresponde a un implante de adenocarcinoma endometrioide grado I. El estudio de las características anatomopatológicas y la presencia del implante peritoneal sugieren el diagnóstico de un carcinoma endometrioide ovárico con origen en una lesión endometriósica sincrónico con un carcinoma endometrioide endometrial. CONCLUSIÓN: el diagnóstico diferencial entre la sincronicidad o diseminación de los tumores de ovario y endometrio de estirpe endometrioide supone un reto para el clínico y es fundamental para el correcto manejo de estas neoplasias.

BACKGROUND: there is a demonstrated association between endometriosis and some epithelial ovarian carcinoma histologies. On the other hand, it has been observed that up to 30% of ovarian neoplasms present concomitantly with endometrial neoplasms. To consider synchronicity between these neoplasms, they must meet strict pathological criteria such as those described by scully. OBJECTIVE: to introduce a case of an ovarian and endometrial synchronous endometrioid carcinoma implanted on endometriosis sites, as well as its diagnosis and management. CLINICAL CASE: a 27-year-old patient who consulted because of an intermenstrual spotting. The ultrasound image showed an endometrial polyp. Furthermore, a 42 mm left adnexal trilobal tumor with a 17×15mm solid pole was described. She underwent a hysteroscopic polypectomy and laparoscopic ovarian cystectomy. Likewise, resection of a suspicious implant in the posterior vaginal fornix was done. The pathological result of the surgical pieces was: endometrial polyp with complex hyperplasia with atypia and focal points of grade I endometrioid adenocarcinoma; the left ovarian cystectomy: endometriotic cyst with focal points of endometrioid adenocarcinoma. The peritoneal lesion corresponded to a grade I endometrioid adenocarcinoma implant. The study of the pathological characteristics and the presence of the peritoneal implant suggest the diagnosis of endometrioid ovarian carcinoma originated in a synchronous endometriotic lesion with endometrial endometrioid carcinoma. CONCLUSION: differential diagnosis between the synchronicity or spread of ovarian and endometrial endometrioid cell line carcinomas, is a great challenge and it is essential for the correct management of these neoplasms

Obesidad y cáncer de endometrio: las repercusiones de un problema de salud pública / Obesity and endometrial cancer: The impact of a public health problem

Resumen: OBJETIVO: Describir el incremento en la frecuencia del cáncer de endometrio en un hospital de tercer nivel en las últimas décadas y su asociación con el sobrepeso y la obesidad. MATERIALES Y MÉTODOS: Estudio retrospectivo, comparativo y observacional efectuado con base en la información de los expedientes de pacientes con diagnóstico de cáncer de endometrio atendidas en el servicio de Oncología del Hospital General de México (2000-2017). Los datos se compararon con un estudio previo de 1966-1993. RESULTADOS: Del 2000 al 2017 se registraron 785 pacientes y en el periodo global de 44 años, incluidos en el estudio, 1045 enfermas. En el lapso de 27 años se registraron 260 pacientes, y en el de 17 años: 785 enfermas; es decir, un incremento de 200% en la frecuencia de esta enfermedad. CONCLUSIONES: En esta serie los porcentajes de sobrepeso y obesidad se elevaron de 46 a 72.5%. El cáncer de endometrio en mujeres menores de 48 años aumentó de 19 a 28%. El 30.5% de las pacientes en etapas tempranas de cáncer de endometrio tuvieron factores de riesgo de recurrencia tumoral y 42% de la serie global cursó con neoplasias avanzadas, lo que está demostrado afecta su pronóstico.

Abstract: OBJECTIVE: To describe the increase shown in the frequency of endometrial cancer in a tertiary hospital in the last decades and its association with overweight and obesity. MATERIALS AND METHODS: Retrospective, comparative and observational study based on information from the files of patients with a diagnosis of endometrial cancer attended at the Oncology Service of the General Hospital of Mexico (2000-2017). Data were compared with a previous study from 1966-1993. RESULTS: From 2000 to 2017, 785 patients were registered and in the global period of 44 years, 1045 patients were included in the study. In the 27-year period, 260 patients were registered, and in the 17-year period, 785 patients were registered; that is, a 200% increase in the frequency of this disease. CONCLUSIONS: In this series the percentages of overweight and obesity rose from 46 to 72.5%. Endometrial cancer in women under 48 years of age increased from 19 to 28%. 30.5% of patients in early stages of endometrial cancer had risk factors for tumor recurrence and 42% of the overall series had advanced neoplasms, which is shown to affect their prognosis.

Resultados preliminares en la implementación de una técnica de detección de ganglio centinela en cáncer de cuello uterino y endometrio en un hospital público y centro formador en chile / Preliminary results in the implementation of a sentinel node detection technique in cervical and endometrial cancer in a public hospital and training center in Chile

Resumen Objetivo Evaluar el rendimiento diagnóstico de la técnica de azul patente (disponible en todo el territorio nacional) en el ganglio centinela para la estadificación del cáncer cérvico uterino y en-dometrial. Método Estudio prospectivo realizado entre enero de 2014 y diciembre de 2018. Se evaluó la técnica de azul patente para la detección de ganglio centinela en la estadificación del cáncer cérvico uterino y endometrial, antes de la linfadenectomía pélvica estándar. La inyección del azul patente se aplicó en el cuello uterino (1 cc 1 cm de profundidad y 1 cc superficial) a las 3 y 9 horas, 20 minutos antes del inicio de la cirugía (laparotomía o laparoscópica). La identifica-ción y extracción del ganglio centinela fue realizado por un ginecólogo oncólogo certificado y evaluado mediante histología tradicional con hematoxilina y eosina (H&E). Resultado Se realiza-ron un total de 80 cirugías. El ganglio centinela se identificó en 75 (94%) pacientes, 60 (75%) bilateralmente; Con una detección media de 1,9 nodos por paciente. El sitio de identificación más frecuente fue la fosa obturatriz (43,9%), seguida de los vasos ilíacos externos. Otro 2,6% de los nodos fueron encontrados en sitios poco comunes. Entre los ganglios linfáticos seleccio-nados, 10 casos fueron positivos para el cáncer. No hubo ganglio centinela falso negativo. La tasa de detección fue del 83%, con una especificidad del 95%. Conclusiones Los datos aquí expuestos nos permiten estandarizar e implementar el uso de gan-glio centinela con azul patente. El uso de GC adecua la cirugía a la necesidad de la paciente, con una clara disminución en la incidencia de complicaciones asociadas a la linfadenectomía. Este trabajo forma parte de un estudio inicial el cual se debe complementar con el uso de la tin-ción de verde de indocianina y el estudio anatomo patológico con ultraestadiaje para obtener una validación e implementación adecuada del GC en la etapificación en cáncer de cérvix y endo-metrio.

SUMMARY Objective To assess the diagnostic performance of patent blue dye technique (available in the whole country) in sentinel lymph node for cervical and endometrial cancer staging. Methods A prospective cohort study was conducted between January 2014 to December 2018. Patent blue dye technique was assessed for the detection of sentinel lymph node in cervical and endometrial cancer staging, before standard pelvic lymphadenectomy. Blue dye injection was applied in the cervix (1cc 1cm deep and 1cc superficial) at 3 and 9 hour, 20 minutes prior start-ing a surgery (laparotomy or laparoscopic). The sentinel lymph node was collected by a certified surgeon and assessed by traditional histologic hematoxylin and eosin stain. Results A total of 80 surgeries were performed. The sentinel lymph node was identified in 75 (94%) patients, 60 (75%) bilaterally; with an average detection of 1,9 nodes per patient. The most common site of identifi-cation was the obturator fossa, followed by the external iliac vessels (43,9%). 2,6% of the nodes were found in uncommon sites. 10 lymph nodes were cancer-positive. There were no false neg-ative sentinel node.Overall in our cohort the detection rate was 83% for specificity 95%. Conclusions Our data presented in this publication allow us to safely standardize and implement a sentinel lymph node technique with patent blue. This technique will allow us to adapt the sur-gery for the patient's needs, diminishing the incidence of complications associated with lym-phadenectomy. This is the first stage of our work which we must complement with indocyanine green and pathological study with ultrastaging to obtain an adequate validation and implementa-tion of sentinel node in cervical and endometrial cancer staging.

A unique case of aggressive uterine cancer in a 45-year-old man with persistent Müllerian duct syndrome.

OBJECTIVE: Persistent Müllerian Duct Syndrome (PMDS), one of the causes of male pseudohermaphroditism, is a rare syndrome characterized by the presence of internal female genitalia (uterus, fallopian, tubes, cervix and upper vagina) in otherwise phenotypically and normally virilized men. METHODS: We present the 4th documented case of uterine malignancy in a 45-year-old man with PMDS presenting with lower abdominal protuberance and hematuria. RESULTS: Although testicular malignancies are common in undescended testis associated with PMDS, very few cases of müllerian duct malignancies have been reported. CONCLUSIONS: Persistent mullerian duct syndrome can be associated with aggressive non-testicular malignancies, especially uterine cancer, in normally virilized males.

OBJETIVOS: El síndrome de persistencia del Conducto de Müller (SPCM), una de las causas de pseudohermafroditismo masculino, es un síndrome raro caracterizado por la presencia de genitales internos femeninos (útero, trompas de falopio, cervix y fondo vaginal) en pacientes varones fenotipicamente y con virilización normal. MÉTODOS: Presentamos el 4º caso documentado de tumor maligno uterino en un hombre de 45 años con SPCM que presenta protuberancia abdominal inferior y hematuria. RESULTADOS: Aunque los tumores malignos testiculares son frecuentes en testículos no descendidos asociados con SPCM, se han comunicado muy pocos casos de tumores malignos del conducto de Müller. CONCLUSIONES: El síndrome de persistencia del Conducto de Müller se puede asociar con tumores malignos no testiculares agresivos, especialmente cáncer uterino en hombres normalmente virilizados.

Prognostic role of FDG PET-derived parameters in preoperative staging of endometrial cancer. / Función pronóstica de los parámetros derivados de FDG PET en la estadificación preoperatoria del cáncer de endometrio.

PURPOSE: To investigate the preoperative prognostic role of 18F-FDG PET/CT in patients with endometrial carcinoma (EC). METHODS: 18F-FDG PET/CT was performed in 57 patients for EC preoperative staging. Maximum and mean standardized uptake values (SUVmax, mean), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) of primary tumors, at different thresholds of 40%, 50%, 60% (40-50-60), were evaluated and compared with anatomopathological features. The diagnostic performance of PET-parameters (categorized by ROC analysis) in discriminating low-intermediate and high-risk disease and the prognostic role on survival (overall survival -OS; disease free survival - DFS) was evaluated. RESULTS: The categorized TLG40-50-60 were the only parameters related to FIGO stage I versus II-III-IV (p = 0.0035 for all). The cut-off values for risk stratification were 83.69, 61.81 and 41.32, respectively (sensitivity: 60.00%; specificity; 71.43% for all parameters). Pathological stage 1 (pT1) of the primary tumor was predicted by MTV60 and TLG40-50 (p = 0.0328, 0.0240, 0.0147, respectively). The optimal thresholds were 7.795, 99.55 and 77.58, respectively (sensitivity: 38.46%, 53.85% and 53.85%, respectively; specificity: 88.64%, 79.55% and 81.82%, respectively). SUVmax and SUVmean40-50-60 were the only parameters discriminating endometrioid from non-endometrioid subtype. The corresponding sensitivity was 64.86% and 62.16% for SUVmax and SUVmean 50-60 and 62.16% for SUVmean40; specificity was 70.00% for all parameters. The mean (SD) OS was 79.77% (3.34%) and the mean DFS was 77.89% (3.73%). The tumor type was the only variable significantly associated with OS (p = 0.0486). TLG50 > 77.58 cm3 was the only variable associated with a higher risk of relapse (p = 0.0472). CONCLUSION: TLG40-50-60 and MTV60 of primary EC have prognostic value in discriminating FIGO and pathological staging. These results suggest a possible role of these parameters in predicting EC aggressiveness, thus improving the preoperative characterization of endometrial cancer.