Differences in endometrial carcinoma presentations and characteristics in pre- and postmenopausal women

Sasa Andrijasevic, Jelena Dotlić, Nebojsa Neca Arsenovic, Milan Terzić

2019

Full text Open access: Gold Metadata (CSL-JSON)
DOI 10.2298/sarh181107055a
Data confidence 70 medium
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Abstract

Introduction/Objective. As of recently, an increasing number of premenopausal women is being diagnosed with endometrial carcinomas. The objective of our study was to determine if routinely collected clinical and imaging parameters, implying on tumor characteristics, are different in pre- and postmenopausal endometrial carcinoma patients, enabling their appropriate preoperative evaluation. Methods. The study included all patients (n = 209) operated on due to endometrial carcinoma over a period of three years. The diagnosis was based on histopathological findings of exploratory curettage. Medical history was taken for all the patients and they were divided regarding menopausal status. On preoperative ultrasound scan, the endometrial echo pattern was established. The existence of myomas, adnexal masses, free fluid in the abdomen or uterine cavity was noted. Magnetic resonance imaging detected the presence of pelvic metastases and tumor spreading into the uterine cavity, myometrium, cervix, and lymph nodes. Postoperatively, histopathological findings, the tumor stage and grade were established. Results. The majority of women were postmenopausal and secundiparous. Significantly more patients were obese, especially the postmenopausal ones (p = 0.001). Most tumors were endometrioid adenocarcinomas regardless of menopausal status. Irregular/abnormal bleeding (p = 0.037), presence of ascites (p = 0.010), obesity (p = 0.046), and lower parity (p = 0.016) correlated with postmenopausal status. Large exophytic endometrial carcinomas were predominant in younger patients (p = 0.026). Endometrial carcinomas were significantly more often diagnosed in the II FIGO stage in premenopausal patients. There were no other significant differences (endometrial thickness, uterine homogeneity, echogenicity, tumor infiltration and spreading, histopathological type and grade) between pre- and postmenopausal endometrial carcinoma patients. Conclusions. Few differences between pre- and postmenopausal endometrial carcinoma patients existed and the most prominent ones were obesity, parity, irregular/abnormal bleeding, and tumor growth into the cavity.