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  #1  
Old 11-24-2011
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Question Endometrial Cancer Prognosis

A 60-year-old nulliparous woman is seen by her gynecologist for a followup appointment to discuss the results of an endometrial biopsy performed after a routine Papanicolaou (PAP) smear showed high-grade atypia. Pathology reports the endometrial sample is positive for carcinoma. What is the single most important factor in establishing the patient's prognosis?
A) Depth of invasion
B) Histological Grade
C) Pelvic node metastasis
D) Positive peritoneal washings
E) Tumor volume
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Old 11-24-2011
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I m btw c and d
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Old 11-24-2011
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I might guess A , since the treatment for all stages of endometrial CA is TAH-BSO... depth of invasion being less can have significant impact on mortality??
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Old 11-24-2011
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prone to A
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Old 11-25-2011
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Quote:
Originally Posted by sonu.agarwall View Post
A 60-year-old nulliparous woman is seen by her gynecologist for a followup appointment to discuss the results of an endometrial biopsy performed after a routine Papanicolaou (PAP) smear showed high-grade atypia. Pathology reports the endometrial sample is positive for carcinoma. What is the single most important factor in establishing the patient's prognosis?
A) Depth of invasion
B) Histological Grade
C) Pelvic node metastasis
D) Positive peritoneal washings
E) Tumor volume
TNM...IŽll go w/ D
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  #6  
Old 11-27-2011
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I too was confused with this as the answer was given as B..
Hope someone can explain
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Old 11-27-2011
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Quote:
Originally Posted by sonu.agarwall View Post
I too was confused with this as the answer was given as B..
Hope someone can explain
this is what I found:
1.- http://emedicine.medscape.com/articl...overview#a0104
Endometrial cancers are divided into 2 classes, each with differing pathophysiology and prognosis. More than 80% of endometrial carcinomas are type I and are due to unopposed estrogen stimulation, resulting in a low-grade histology. Approximately 15-20% of endometrial cancers are type II cancers with papillary serous or clear cell histologies. Papillary serous histology represents 5-10% and clear cell histology represents less than 5% of endometrial cancers. They are considered high grade with poor prognosis. Even with surgical stage I cancer, the 5-year survival rate is 60%.

2.-
Outcome of Endometrial Cancer Stage IIIA with Adnexa or Serosal Involvement Only. Obstetrics and Gynecology International. Volume 2011:

"FIGO has recently updated the staging system with a significant change to the staging of endometrial carcinoma stage IIIA. The presence of abnormal cells in peritoneal washings no longer affects staging."
...so, D is not the answer

I guess the idea here is the same as in lung cancer (small vs non small)?

Correct answer should be B then...
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Old 11-27-2011
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ok thanks.i just thought staging was more important than grading.so was confused
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