Endometrial cancer

Endometrial cancers are the most common of the gynecologic malignancies, affecting an estimated 42,160 U.S. women in 2009 [1]. Both the incidence and the death rates associated with endometrial cancer have been gradually increasing. Carcinoma develops as a proliferation of epithelial cells lining the glands of the uterine cavity. Many endometrial tumors exhibit an indolent growth pattern and are contained within the uterus at the time of diagnosis. Spread to regional lymph nodes or distant metastatic sites such as the liver or lungs is less common. It is conceptually convenient to categorize endometrial tumors into two types: a hormonally driven well-differentiated lesion that is typically associated with a favorable prognosis, and an undifferentiated or variant group of histologic subtypes characterized by more aggressive clinical behavior and a poorer prognosis. Postmenopausal status, low parity, obesity, diabetes, and estrogen exposure have been epidemiologically associated with the well-differentiated lesions; the presence of identified oncogenes, overexpression of oncogenic proteins, or activation of aberrant signaling pathways have been more frequently associated with the aggressive variants of endometrial cancer.