Updates on Endometrial Cancer Screening and Treatment

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Obstetrics and Gynecology".

Deadline for manuscript submissions: 30 July 2024 | Viewed by 513

Special Issue Editors


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Guest Editor
1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, 10679 Athens, Greece
Interests: minimally invasive gynecology; gynecology; endometriosis; gynecologic malignancies; HIPEC; obstetrics; high risk pregnancies

E-Mail Website
Guest Editor
1st Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Alexandra Hospital, National and Kapodistrian University of Athens, 10679 Athens, Greece
Interests: gynecology; endometrial cancer

Special Issue Information

Dear Colleagues,

Endometrial cancer is a type of cancer that originates in the inner lining of the uterus, known as the endometrium. It is the most common gynecologic cancer in developed countries and primarily affects postmenopausal women, although it can occur in premenopausal women as well. In 2020, 417,367 new cases of endometrial cancer were registered, with up to 14% of them were in patients of reproductive age. Endometrial cancer often presents with noticeable symptoms, prompting women to seek medical attention. The most common symptom is abnormal vaginal bleeding, particularly postmenopausal bleeding. Other symptoms may include pelvic pain, pain during intercourse and unexplained weight loss.

Endometrial cancer is a heterogeneous disease with multiple etiological factors contributing to its development. The most prominent risk factor is a hormonal imbalance, specifically an increased exposure to estrogen unopposed by progesterone. This hormonal imbalance can result from various conditions, including obesity, metabolic syndrome and hormone replacement therapy. Nulliparity, early menarche, late menopause, tamoxifen use, older age and Lynch syndrome are also among the risk factors. Understanding the molecular mechanisms underlying endometrial cancer development, such as alterations in the PTEN/PI3K/Akt pathway and DNA mismatch repair genes, is essential for targeted therapeutic interventions and estimating the risk of recurrence and survival.

In this Special Issue, we present an update regarding the diagnosis and screening of endometrial cancer, the role of molecular features of endometrial carcinoma in overall survival and the latest data concerning treatment options.

We are pleased to invite authors to submit manuscripts focusing on the screening, diagnosis, management and treatment of endometrial cancer, and we are soliciting original studies, meta-analysis, reviews and case report investigating new advances in endometrial cancer treatment.

Dr. Dimitrios Papageorgiou
Dr. Dimitrios-Efthymios Vlachos
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • endometrial cancer
  • endometrial intraepithelial neoplasia
  • microsatellite instability
  • mismatch repair
  • hysterectomy
  • chemotherapy
  • radiation therapy
  • hormonal therapy

Published Papers (1 paper)

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17 pages, 774 KiB  
Systematic Review
The Impact of Positive Peritoneal Cytology on the Survival Rates of Early-Stage-Disease Endometrial Cancer Patients: Systematic Review and Meta-Analysis
by Vasilios Pergialiotis, Michail Panagiotopoulos, Antonios Koutras, Andreas Daras, Thomas Ntounis, Michalis Liontos, Georgios Daskalakis and Nikolaos Thomakos
Medicina 2024, 60(5), 733; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina60050733 - 28 Apr 2024
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Abstract
Background and Objectives: The impact of positive peritoneal cytology has been a matter of controversy in early-stage endometrial cancer for several years. The latest staging systems do not take into consideration its presence; however, emerging evidence about its potential harmful effect on patient [...] Read more.
Background and Objectives: The impact of positive peritoneal cytology has been a matter of controversy in early-stage endometrial cancer for several years. The latest staging systems do not take into consideration its presence; however, emerging evidence about its potential harmful effect on patient survival outcomes suggests otherwise. In the present systematic review and meta-analysis, we sought to accumulate current evidence. Materials and Methods: Medline, Scopus, the Cochrane Central Register of Controlled Trials CENTRAL, Google Scholar and Clinicaltrials.gov databases were searched for relevant articles. Effect sizes were calculated in Rstudio using the meta function. A sensitivity analysis was carried out to evaluate the possibility of small-study effects and p-hacking. Trial sequential analysis was used to evaluate the adequacy of the sample size. The methodological quality of the included studies was assessed using the Newcastle–Ottawa scale. Results: Fifteen articles were finally included in the present systematic review that involved 19,255 women with early-stage endometrial cancer. The Newcastle–Ottawa scale indicated that the majority of included studies had a moderate risk of bias in their selection of participants, a moderate risk of bias in terms of the comparability of groups (positive peritoneal cytology vs. negative peritoneal cytology) and a low risk of bias concerning the assessment of the outcome. The results of the meta-analysis indicated that women with early-stage endometrial cancer and positive peritoneal cytology had significantly lower 5-year recurrence-free survival (RFS) (hazards ratio (HR) 0.26, 95% CI 0.09, 0.71). As a result of the decreased recurrence-free survival, patients with positive peritoneal cytology also exhibited reduced 5-year overall survival outcomes (HR 0.50, 95% CI 0.27, 0.92). The overall survival of the included patients was considerably higher among those that did not have positive peritoneal cytology (HR 12.76, 95% CI 2.78, 58.51). Conclusions: Positive peritoneal cytology seems to be a negative prognostic indicator of survival outcomes of patients with endometrial cancer. Considering the absence of data related to the molecular profile of patients, further research is needed to evaluate if this factor should be reinstituted in future staging systems. Full article
(This article belongs to the Special Issue Updates on Endometrial Cancer Screening and Treatment)
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