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Endometrial Cancer

• thought to have good prognosis
• mature women 50-65
• surgical treatment +/- lymph nodes
• grade as important as stage in prognosis
• Stage 1b Grade 2+ managed in cancer centres

Aetiology

• unopposed oestrogens
  • HRT
  • PCO
  • obesity

Symptoms

• post-menopausal bleeding
• irregular bleeding on HRT
• menorrhagia and intermenstrual bleeding
• vaginal discharge

Signs

• pelvic mass
• DVT

Investigations

• Pipelle biopsy
• hysteroscopy
• FBC / U&E / LFTs
• CXR
• MRI
• Examination under anaesthetic - , cystoscopy, sigmoidoscopy

Staging

• Stage 1 confined to uterus
• Stage 2 spread to cervix
• Stage 3 spread to pelvic side wall
• Stage 4 distant metastasis

Treatment

• TAH + BSO
• +/- pelvic lymph nodes if grade 3+ or > 1/2 wall thickness
• +/- radiotherapy
• +/- progesterones