title: Surgical treatment of high stage endometrial cancer: current perspectives.
abstract: Endometrial cancer is now the most common gynecologic malignancy. We investigate on new scientific evidences in endometrial cancer, particularly underlined updates in advanced endometrial cancer. Early stage endometrial cancer is the most frequent presentation; however, advanced endometrial cancer that occurs in 3-13 % of cases has bad prognosis. There are two types of endometrial cancer different in molecular pattern, therapeutic strategy and prognosis. Type I endometrial cancers develop in an environment of unopposed estrogen and often arise out of endometrial hyperplasia, characterized by mutations in the PTEN gene, K-ras, and microsatellite instability inception. Type II cancer is not an estrogen-related cancer, occurs predominantly in postmenopausal women, shows typical mutations in p53 and HER2/neu and has a poor prognosis. Preoperative characterization of the type's disease is an essential step for a right diagnosis and treatment. All patients should undergo to surgical staging, except those who are inoperable, according to FIGO recommendation. Surgical debulking, neoadjuvant chemotherapy and interval debulking can be strategy options.
authors.affiliation: Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Via Consolare Valeria 1, 98125, Messina, ME, Italy. vitalesalvatore@hotmail.com.
authors.forename: Salvatore Giovanni
authors.initials: SG
authors.lastname: Vitale
authors.affiliation: Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Valenti
authors.affiliation: Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy.
authors.forename: Ferdinando Antonio
authors.initials: FA
authors.lastname: Gulino
authors.affiliation: Department of Gynecologic Ultrasound Imaging, Altamedica Fetal Maternal Medical Centre, Rome, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Cignini
authors.affiliation: Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Biondi
mesh_terms: D065426:Cytoreduction Surgical Procedures / Q000379:methods*; D016889:Endometrial Neoplasms / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D009367:Neoplasm Staging
keywords: Advanced endometrial cancer; Diagnostic evaluation; Histology; Molecular pattern; Staging; Surgical debulking; Treatment strategies
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