Reproductive and Oncologic Outcomes in Young Women with Stage IA and Grade 2 Endometrial Carcinoma Undergoing Fertility-Sparing Treatment: A Systematic Review

Biomolecules, Journal Year: 2024, Volume and Issue: 14(3), P. 306 - 306

Published: March 5, 2024

Background: Endometrial cancer (EC) is the most common gynecological malignancy in both Europe and USA. Approximately 3–5% of cases occur women reproductive age. Fertility-sparing treatment (FST) options are available, but very limited evidence regarding grade 2 (G2) ECs exists current literature. This systematic review aimed to comprehensively evaluate oncologic outcomes among young diagnosed with stage IA or G2EC disease who underwent FST. Methods: A comprehensive search literature was carried out on following databases: MEDLINE, EMBASE, Global Health, The Cochrane Library (Cochrane Database Systematic Reviews, Central Register Controlled Trials, Methodology Register), Health Technology Assessment Database, Web Science. Only original studies that reported patients tumors FST were considered eligible for inclusion this (CRD42023484892). Studies describing only endometrial hyperplasia G1 EC excluded. Results: Twenty-two papers met abovementioned criteria included present review. Preliminary analysis suggested encouraging after Conclusions: approach may represent a feasible safe option childbearing age G2EC. Despite these promising findings, cautious interpretation warranted due inherent limitations, including heterogeneity study designs potential biases. Further research standardized methodologies larger sample sizes imperative obtaining more robust conclusions.

Language: Английский

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Molecular classification of endometrial carcinoma on endometrial biopsy: an early prognostic value to guide personalized treatment

International Journal of Gynecological Cancer, Journal Year: 2024, Volume and Issue: 34(8), P. 1211 - 1216

Published: July 1, 2024

Molecular features are essential for estimating the risk of recurrence and impacting overall survival in patients with endometrial cancer. Additionally, surgical procedure itself could be personalized based on molecular characteristics tumor. This study aims to assess feasibility obtaining reliable classification status from biopsy specimens collected during hysteroscopy better modulate appropriate treatment.

Language: Английский

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The Exciting Journey of Progress: Exploring FIGO 2023 Staging for Endometrial Cancer at a Leading ESGO Institution

European Journal of Surgical Oncology, Journal Year: 2025, Volume and Issue: 51(6), P. 109695 - 109695

Published: Feb. 12, 2025

INTRODUCTIONThe 2023 FIGO staging of endometrial cancer integrates tumor grade and histology along with molecular features that recognize the prognostic significance p53 POLE mutations, accounting for potential conflicts such as lymphovascular space invasion subserosal invasion.MATERIALS AND METHODSIn this single-institution retrospective study, data were collected on 229 patients from January 2020 to September 2024 re-stage them according criteria.RESULTSFrom stage 2009 IA, 70 do not cross (21 are IA1 49 IA2), 8 upgraded IC because aggressive histotype; 1 is upstaged substantial LVSI, 12 myoinfiltrating tumors (23% upstaging). From IB 34 remain in IB, while 5 become IIB (LVSI) 27 IIC (aggressive myoinfiltrating), a total 32 upstages (48% Within II, no proper upstage was possible. We observed statistical correlation between stages BMI, well age, both (p=0.009 p<0.001 respectively) (p=0.002 p=0.003 classifications. Additionally, found BMI (p=0.02).CONCLUSIONSThe system gaining importance recent studies highlight role classification prognosis personalized therapy. Updating our study's follow-up will clarify its impact clinical practice.

Language: Английский

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The Histomorphology to Molecular Transition: Exploring the Genomic Landscape of Poorly Differentiated Epithelial Endometrial Cancers

Cells, Journal Year: 2025, Volume and Issue: 14(5), P. 382 - 382

Published: March 5, 2025

The peremptory need to circumvent challenges associated with poorly differentiated epithelial endometrial cancers (PDEECs), also known as Type II (ECs), has prompted therapeutic interrogation of the prototypically intractable and most prevalent gynecological malignancy. PDEECs account for cancer-related mortalities due their aggressive nature, late-stage detection, poor response standard therapies. are characterized by heterogeneous histopathological features distinct molecular profiles, they pose significant clinical propensity rapid progression. Regardless complexities around PDEECs, still being administered inefficiently in same manner clinically indolent readily curable type-I ECs. Currently, there no targeted therapies treatment PDEECs. realization new options transformed our understanding enabling more precise classification based on genomic profiling. transition from a provided critical insights into underlying genetic epigenetic alterations these malignancies. This review explores landscape focus identifying key subtypes mutations that variants. Here, we discuss how correlates outcomes can refine diagnostic accuracy, predict patient prognosis, inform strategies. Deciphering underpinnings led advances precision oncology protracted remissions patients untamable

Language: Английский

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Landscape of Endometrial Cancer: Molecular Mechanisms, Biomarkers, and Target Therapy

Cancers, Journal Year: 2024, Volume and Issue: 16(11), P. 2027 - 2027

Published: May 27, 2024

Endometrial cancer is one the most prevalent gynecological cancers and, unfortunately, has a poor prognosis due to low response rates traditional treatments. However, progress in molecular biology and understanding genetic mechanisms involved tumor processes offers valuable information that led current classification describes four subtypes of endometrial cancer. This review focuses on pathogenesis cancers, such as mutations, defects DNA mismatch repair pathway, epigenetic changes, or dysregulation angiogenic hormonal signaling pathways. The preclinical genomic investigations presented allowed for identification some molecules could be used biomarkers diagnose, predict, monitor progression Besides therapies known clinical practice, targeted therapy described new treatment involves identifying specific targets cells. By selectively inhibiting these targets, key pathways can disrupted while normal cells are protected. connection between vital fight against Ongoing research trials exploring use standard agents combination with other strategies like immunotherapy anti-angiogenesis improve outcomes personalize patients approach potential transform management patients. In conclusion, enhancing tools essential stratifying risk guiding surgery, adjuvant therapy, women addition, from this may have an value personalized patient’s life.

Language: Английский

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Fertility Sparing in Endometrial Cancer: Where Are We Now?

Cancers, Journal Year: 2025, Volume and Issue: 17(1), P. 112 - 112

Published: Jan. 1, 2025

Endometrial cancer is the most common gynecological neoplasm with an increased incidence in premenopausal population recent decades. This raises problem of managing endometrial fertile women who have not yet achieved pregnancy. In these women, after careful selection, hysterectomy may be postponed favor conservative management if specific requirements are met. The latest evidence focused on early carcinoma, endometrioid histotype, Grading 1, no myometrial infiltration. Few clinical trials opened this possibility also for 2 diagnosis. There still questions about best medical therapy, dosage, route, and duration treatment. Oral progestins or levonorgestrel-releasing intrauterine devices appear to options associated outcome terms complete response lower recurrence rates. Other include use GnRH analogues, surgical hysteroscopy, metformin, a therapeutic approach that takes into account characteristics patient. pursuit pregnancy should start as soon two consecutive biopsies obtained 3 months apart from each other; it recommended refer patients ART centers maximize success rate. After having reached fulfillment reproductive desire, radical treatment recommended.

Language: Английский

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Comprehensive Review of Endometrial Cancer: New Molecular and FIGO Classification and Recent Treatment Changes

Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(4), P. 1385 - 1385

Published: Feb. 19, 2025

Endometrial cancer (EC) is the most common gynecologic malignancy in developed countries, with rising incidence due to aging populations and obesity-related factors. This review explores evolving molecular FIGO classifications of EC, highlighting their significance diagnosis, prognosis, personalized treatment strategies. Molecular subtyping based on The Cancer Genome Atlas (TCGA) classification offers a more precise understanding dividing it into POLE ultramutated, microsatellite instability-high (MSI-H), copy-number low (CNL), high (CNH) subtypes. Each subgroup has distinct genetic, histological, prognostic characteristics. Recent updates staging system incorporate features, allowing for tailored approaches. Advances immunotherapy, targeted therapies, novel therapeutic combinations have reshaped clinical management. emphasizes integration diagnostics routine practice, outlining challenges future perspectives managing EC improved patient outcomes.

Language: Английский

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Molecular Classification of Endometrial Carcinoma: Insights From a Teaching Hospital

International Journal of Gynecological Pathology, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 20, 2025

Abstract: Endometrial carcinoma is a heterogeneous disease with distinct molecular subtypes that have varied prognosis and therapeutic implications. Since the development of signatures malignancy prominent, we are trying to implement this in our cases previously diagnosed endometrial cancer. The aim was determine prevalence specific alterations correlate genetic profile pathologic features clinical characteristics. We identified 100 carcinoma, which were eventually classified using immunostains for mismatch repair (MMR) p53 proteins, addition Sanger analysis POLE gene (Ex, 9, 13, 14). Our findings showed high nonspecific (NSMP) 46 (46%), MMR deficiency 30 (30%). worst observed mutant pattern expressed tumors. No statistical difference characteristics when classification applied. Of note, mutual grouping assignment appears be present 5 (5%) carcinoma. This first study conducted Saudi Arabia investigated implications these percentage result similar what had been published globally.

Language: Английский

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Inoperable Endometrial Carcinoma Treated With External Beam Radiation and a Stereotactic Body Radiation Therapy Boost

Cureus, Journal Year: 2025, Volume and Issue: unknown

Published: March 28, 2025

A significant comorbidity of endometrial cancer is severe obesity with a Body Mass Index (BMI) greater than 40, which can dramatically limit treatment options such as surgery or brachytherapy. Alternative need to be investigated, and in this case report, we examine female significantly enlarged uterus who was ineligible for intracavitary brachytherapy (ICBT). She subsequently underwent external beam radiation therapy (EBRT) alone the pelvis, followed by stereotactic boost (SBRT) uterus. Following treatment, her uterine bleeding subsided, she currently without evidence disease.

Language: Английский

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Artificial Intelligence in Placental Pathology: New Diagnostic Imaging Tools in Evolution and in Perspective

Journal of Imaging, Journal Year: 2025, Volume and Issue: 11(4), P. 110 - 110

Published: April 3, 2025

Artificial intelligence (AI) has emerged as a transformative tool in placental pathology, offering novel diagnostic methods that promise to improve accuracy, reduce inter-observer variability, and positively impact pregnancy outcomes. The primary objective of this review is summarize recent developments AI applications tailored specifically histopathology. Current AI-driven approaches include advanced digital image analysis, three-dimensional reconstruction, deep learning models such GestAltNet for precise gestational age estimation automated identification histological lesions, including decidual vasculopathy maternal vascular malperfusion. Despite these advancements, significant challenges remain, notably dataset heterogeneity, interpretative limitations current algorithms, issues regarding model transparency. We critically address by proposing targeted solutions, augmenting training datasets with annotated artifacts, promoting explainable methods, enhancing cross-institutional collaborations. Finally, we outline future research directions, emphasizing the refinement algorithms routine clinical integration fostering interdisciplinary cooperation among pathologists, computational researchers, specialists.

Language: Английский

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