Endometrial Carcinoma

Synonyms/Description

Uterine cancer

Etiology

Endometrial cancer is the most common cancer of the female genital tract. The overall 5-year survival rate is 85%, 75%, 45%, and 25% for stages I through IV, respectively.

Risk factors for endometrial cancer include obesity, diabetes, nulliparity, estrogen-producing ovarian tumors, polycystic ovarian syndrome, advanced age, unopposed estrogen therapy, tamoxifen, and a family history of nonpolypoid colorectal cancer.

The prognosis depends on the tumor type and stage. Type 1 endometrial cancer or endometrioid carcinoma accounts for 80% of uterine carcinomas and is associated with increased and unopposed estrogen exposure. It typically arises from a background of endometrial hyperplasia and is frequently low-grade and slow-growing.

Type 2 tumors are not estrogen driven and are generally far more aggressive than type 1. They often occur in the setting of atrophic endometrium and include serous, clear cell, and other cell types. These tumors tend to invade the myometrium earlier and spread rapidly.