Do uterine fibroids which are left to postmenopausa have any negative effects on the developing endometrial cancer?

Yıl 2018, , 9 - 14, 18.05.2018

Hamdullah Pekkolay Önder Sakin , Zehra Meltem Pirimoğlu Gülhan Bayraktar

https://doi.org/10.5505/deutfd.2018.88700

Öz

Objective: Endometrial cancer and uterine
leiomyoma are the most common malignant and benign tumors in developed
countries. In women operated for endometrial cancer, accompanying uterine myome
is observed in high rates. The treatment of the premenopausal myomas is delayed
after the menopause conservatively.

Yet it is unclear whether this approach has any
negative effect on possible endometrial cancer. The goal of this study is to
investigate the relationship between premenopausal myomas and the prognostic
factors of endometrial cancer.

Material and Method: The files of 127 patients who were operated between
January 2005 and February 2011 in our hospital fulfilling the criteria were
investigated retrospectively. Sociodemographic characteristics, obstetric
traits, myoma presence, endometrial tumor presence, tumor grade, myometrial
invasion grade were evaluated and significance was investigated.

Results: Factors affecting the prognosis of endometrial
carcinoma; age, histological type, histological grade and myometrial invasion were
found to be not significantly related to myoma uteri.

Conclusion: Endometrial cancer, the most common gynecologic cancer
in women, and uterine myoma, the most common benign tumor, were investigated
together. The histopathological prognostic findings of endometrial cancer are
unchanged by the presence uterine myoma. Therefore we reached the conclusion
that there is no negative impact on prognosis.

Anahtar Kelimeler

Endometrial neoplasms, myoma uteri, risk factors, postmenopause

Menopoz sonrasına bırakılan uterin myomların gelişen endometrium kanseri üzerine olumsuz etkileri var mıdır?

Öz

Amaç: Endometrium
kanseri ve myoma uteri, gelişmiş ülkelerde en sık görülen malign ve benign
tümörlerdir. Endometrium kanseri nedeniyle opere olan kadınlarda myoma uterinin
de yüksek oranlarda eşlik ettiği görülmektedir. Premenopozal dönemde
konservatif bir yaklaşım ile, medikal tedavilerle menopoz sonrasına ertelenen
premenopozal myomların olası endometrium kanseri üzerine herhangi bir olumsuz
etkisinin bulunup bulunmadığı araştırıldı.

Gereç ve Yöntem:
Çalışmada Ocak 2005 - Şubat 2011 yılları arasında hastanemizde opere edilmiş ve
araştırma kriterlerine uyan 127 hasta dosyası retrospektif olarak incelendi.
Sosyodemografik özellikleri, obstetrik öyküleri, myom varlığı, endometrial
tümör varlığı, tümör derecesi, myometriuma invazyon derecesi değerlendirildi ve
anlamlılığı araştırıldı.

Bulgular: Endometrial
karsinom prognozuna etkili faktörlerden yaş, histolojik tip, histolojik derece
ve myometrial invazyon durumlarının myoma uteri ile ilişkisi bulunmadığı
belirlendi.

Sonuç: Kadınlarda en
sık görülen jinekolojik kanser olan endometrium kanseri ile en sık görülen
benign tümörü olan myoma uterinin beraberlikleri araştırılmış ve endometrium
kanserinin histopatolojik prognostik bulgularının myoma uteri varlığıyla
değişmediği, dolayısıyla prognoza olumsuz etkisinin olmadığı sonucuna
ulaşılmıştır.

Anahtar Kelimeler

Endometrium kanseri, myoma uteri, risk faktörleri, postmenopoz

Kaynakça

• Siegel RL, Miller KD, Jemal A. Cancer Statistics, 2017. CA Cancer J Clin 2017;67:7-30.
• Torre LA, Bray F, Siegel RL, et al. Global cancer statistics, 2012. CA Cancer J Clin 2015;65:87–108.
• Martin JY, Schiff MA, Weiss NS, Urban RR. Racial disparities in the utilization of preventive health services among older women with early-stage endometrial cancer enrolled in Medicare. Cancer Med 2017;6:2153-2163.
• T.C. Sağlık Bakanlığı Türkiye Halk Sağlığı Kurumu. Türkiye Kanser İstatistikleri Ankara. 2017. Kanser.gov.tr/Dosya/ca.istatistik/2014-RAPOR_uzun.pdf
• Torre LA, Siegel RL, Ward EM, Jemal A. Global Cancer Incidence and Mortality Rates and Trends-An Update. Cancer Epidemiol Biomarkers Prev 2016;25:16-27.
• Wei J, Zhang W, Feng L, Gao W. Comparison of fertility-sparing treatments in patients with early endometrial cancer and atypical complex hyperplasia: A meta-analysis and systematic review. Medicine (Baltimore) 2017;96(37):e8034.
• Colombo N, Creutzberg C, Amant F, Bosse T, González-Martín A, Ledermann J, et al. ESMO-ESGO-ESTRO Consensus Conference on Endometrial Cancer. Diagnosis, Treatment and Follow-up Int J Gynecol Cancer 2016; 26:2–30.
• Smith DC, Prentice R, Thompson DJ, et al. Association of exogenous estrogen and endometrial carcinoma. N Engl J Med 1975;293:1164.
• American Society for Reproductive Medicine Practice Committee: Myomas and reproductive function. Fertil Steril 2004;82:111.
• Mashal RD, Fejzo ML, Friedman AJ, et al. Analysis of androgen receptor DNA reveals the independent clonal origins of uterine leiomyomata and the secondary nature of cytogenetic aberrations in the development of leiomyomata. Genes Chromosomes Cancer 1994;11:1.
• Brosens I, Deprest J, Dal Cin P, et al. Clinical significance of cytogenetic abnormalities in uterine myomas. Fertil steril 1998; 69: 232.
• Sato F, Mori M, Nishi M,et al. Familial aggregation of uterine myomas in Japanese women. J Epidemiol 2002;12: 249.
• Kim da H, Kim ML, Song T, Kim MK, Yoon BS, Seong SJ. Is myomectomy in women aged 45 years and older an effective option? Eur J Obstet Gynecol Reprod Biol 2014;177:57-60.
• Zaino RJ, Silverberg SG, Norris HJ, et al: The prognostic value of nuclear versus architectural grading in endometrial adenocarcinoma. A Gynecologic Oncology Group Study. Int J Gynecol Pathol 1994;13:29.
• Zaino RJ, Kurman RJ, Diana KL, et al. The utility of the revised International Federation of Gynecology and Obstetrics histologic grading of endometrial adenocarcinoma using a defined nuclear grading system A Gynecologic Oncology Group Study. Cancer 1995;75:81.
• Pecorelli S, Benedet JL, Creasman WT, et al. FİGO staging of gynecologic cancer, 1994-1997. FİGO Committee on Gynecologic Oncology, İnternational Federation of Gynecology and Obstetrics Int J Gynaecol Obstet 1999;64:5.
• Sholten AN, van Putten WL, Beerman H, et al. Postoperative radiotherapy for stage 1 endometrial carcinoma: long term outcome of the randomized PORTEC trial with central pathology review. Int J Radiat Oncol Biol Phys 2005;63:834.
• Schottenfeld D. Epidemiology of endometrial neoplasia. J Cell Biochem uppl23:151,1995.
• Hemminki K, Bermejo JL, Granstrom C. Endometrial cancer: Population attributable risks from reproductive, familial and socioeconomic factors. Eur J Cancer 2005;41:2155.
• Aarnio M, Sankila R, Pukkala E, et al. Cancer risk in mutation carriers of DNA mismatch-repair genes. Int J Cancer 1999;81:214.
• Hampel H, Frankel W, Panescu J, et al. Screening for Lynch syndrome among endometrial cancer. Gynecol Oncol 2005;99:689.
• Fabjani G, Kucera E, Schuster E, Minai-Pour M, Czenvenka K, Sliutz G,et al. Genetic alterations in endometrial hyperplasia and cancer. Cancer Letters 2002;175:205-211.
• Rutledge F. The role of radical hysterectomy in adeno-carcinoma of the endometrium. Gynecol Oncol 1974;2:331-47.
• Rubin SC, Hoskins WJ, Saigo PE, Nori D, Mychalczak B, Chapman D, et al. Management of endometrial adenocarcinoma with cervical involvement. Gynecol Oncol 1992;45:294.