Endometrial Carcinoma

1 Epidemiology and Etiology.- 1.1 Epidemiology.- 1.2 Etiology.- 1.2.1 Age.- 1.2.2 Obesity.- 1.2.3 Nulliparity.- 1.2.4 Late Menopause.- 1.2.5 Diabetes Mellitus, Hypertension, and Associated Internal Medical Diseases.- 1.2.6 Ovarian Tumors and Ovarian Diseases.- 1.2.7 Oral Contraceptives.- 1.2.8 Exogenous Estrogen.- 1.2.9 Previous Pelvic Irradiation.- 1.2.10 Summary.- References.- 2 Pathology.- 2.1 Pathologic Manifestation of Endometrial Carcinoma.- 2.1.1 Gross Characteristics.- 2.1.2 Microscopic Appearances.- 2.1.3 Histologic Grade.- 2.1.4 Pattern of Spread.- 2.2 Ultrastructural, Chromosomal Karyotyping, and Nuclear DNA Studies.- 2.2.1 Ultrastructural Studies.- 2.2.2 Chromosomal Karyotyping and Nuclear DNA Studies.- 2.3 Rare Types of Endometrial Carcinoma.- 2.3.1 Argyrophil Cell Carcinoma of Small Cell Carcinoma.- 2.3.2 Primary Pure Squamous Cell Carcinoma of the Endometrium.- 2.4 Endometrial Hyperplasia and Adenocarcinoma in Situ.- 2.4.1 Classification of Endometrial Hyperplasia.- 2.4.2 Pathology of Endometrial Hyperplasia.- 2.4.3 Relationships of Various Forms of Endometrial Hyperplasia.- 2.4.4 Etiology and Pathogenesis of Endometrial Hyperplasia.- 2.4.5 Carcinoma in Situ of the Endometrium.- 2.4.6 Distinction Between Hyperplasia and Adenocarcinoma.- References.- 3 Diagnosis of Endometrial Carcinoma.- 3.1 Clinical Manifestation.- 3.1.1 Age.- 3.1.2 Symptoms.- 3.1.3 Pelvic Examination.- 3.2 Diagnosis.- 3.2.1 Endometrial Sampling of the Uterine Cavity.- 3.2.2 Cytologic Examination.- 3.2.3 Hysteroscopy.- 3.2.4 Computerized Tomography.- 3.2.5 Magnetic Resonance Imaging.- 3.2.6 Ultrasonographic Assessment of Endometrial Carcinoma.- 3.2.7 Pelvic Lymphography.- 3.3 Differential Diagnosis.- 3.3.1 Differential Diagnosis of Endometrial Carcinoma.- 3.3.2 Association of Endometrial Carcinoma with Other Malignancies or Pregnancy.- 3.3.3 Rare Cases of Endometrial Carcinoma.- 3.4 Clinical Staging.- References.- 4 Treatment of Endometrial Carcinoma.- 4.1 Historical Review.- 4.2 Surgical Treatment.- 4.2.1 Value of Surgical Treatment.- 4.2.2 Common Surgical Approaches for Endometrial Carcinoma.- 4.2.3 Problems of Surgery.- 4.3 Radiotherapy.- 4.3.1 Indication and Value.- 4.3.2 Intracavitary Irradiation.- 4.3.3 External Beam Therapy.- 4.4 Hormonal Treatment.- 4.4.1 Progestogens.- 4.4.2 Antiestrogens.- 4.4.3 Combination of Progestogens with Antiestrogens.- 4.4.4 Use of Estrogen After Surgery and Irradiation for Endometrial Carcinoma.- 4.5 Chemotherapy.- 4.5.1 Single-Agent Chemotherapy.- 4.5.2 Combination Chemotherapy.- 4.6 Suggested Therapy in Each Stage of Endometrial Carcinoma.- 4.6.1 Stage I.- 4.6.2 Stage II.- 4.6.3 Stages III and IV.- 4.6.4 Recurrent Disease.- References.- 5 Prognosis of Endometrial Carcinoma.- 5.1 Treatment Result.- 5.2 Recurrence.- 5.2.1 Recurrence Rate.- 5.2.2 Interval Between Primary Treatment and Recurrence.- 5.2.3 Recurrence Location.- 5.2.4 Treatment and Prognosis of Recurrence.- 5.3 Prognostic Factors.- 5.3.1 Age.- 5.3.2 Clinical Stages.- 5.3.3 Lymph Node Involvement.- 5.3.4 Myometrial Invasion.- 5.3.5 Cervical Involvement.- 5.3.6 Uterine Size.- 5.3.7 Histologic Differentiation.- 5.3.8 Histologic Type.- 5.3.9 Tumor Volume.- 5.3.10 Distance of the Lesion from the Internal Cervical Os.- 5.3.11 Pathology of Pericancerous Endometrium.- 5.3.12 Peritoneal Cytology.- 5.3.13 Hormone Receptor.- 5.3.14 Treatment Modalities.- References.- 6 Laboratory Research.- 6.1 Steroid Hormone Receptors of Endometrial Carcinoma.- 6.1.1 Discovery of Sex Steroid Hormone Receptors.- 6.1.2 Definition and Characteristics of Steroid Hormone Receptors.- 6.1.3 Intracellular Mechanism of Action of Steroid Receptors.- 6.1.4 Methodology of Steroid Hormone Receptor Detection.- 6.1.5 Physiology of Steroid Receptors in Normal Tissues.- 6.1.6 Estrogen Receptors and Progesterone Receptors in Endometrial Carcinoma.- 6.1.7 Estrogen Receptors and Progesterone Receptprs in Ovarian Carcinoma and Cervical Carcinoma.- 6.2 Monoclonal Antibody in Cancer.- 6.2.1 Basic Principles.- 6.2.2 Procedures for Generating Monoclonal Antibodies.- 6.2.3 Application of Monoclonal Antibodies.- References.- 7 Medicopsychologic Problems in Patients with Gynecologic Cancers.- 7.1 Psychologic Problems in Patients with Gynecologic Cancers.- 7.1.1 Concept of Psychologic Stress.- 7.1.2 Psychologic Stress in Each Stage of Medical Course.- 7.1.3 Psychologic Components in Patients with Gynecologic Cancers.- 7.2 Medical Intervention and Nursing Care of Patients with Gynecologic Cancers.- 7.2.1 Psychophysiologic Care.- 7.2.2 Physical Care.- 7.2.3 Social Care.- 7.3 Euthanasia.- 7.3.1 Basic Concepts.- 7.3.2 Quality of Life, Human Suffering, and Euthanasia.- References.