الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Endometrial carcinoma is the most common cancer of the female reproductive system. Risk factors are related to excessive unopposed exposure of the endometrium to estrogen, including unopposed estrogen therapy, early menarche, late menopause, tamoxifen therapy, nulliparity, failure to ovulate, and polycystic ovary syndrome. Additional risk factors are increasing age, obesity, hypertension, diabetes mellitus, and Lynch syndrome.
Traditional classification of endometrial carcinomas is based either on clinical and endocrine features (Type I and Type II), or histopathological characteristics (endometrioid, serous, and clear-cell). Endometrioid adenocarcinoma is the most common type of endometrial cancer (type I).
The most common presentation for endometrial cancer is postmenopausal bleeding therefor most cases presented at early stage (I/II). Transvaginal ultrasonography and endometrial biopsy are recommended as the initial study. Further imaging methods like CT and MRI plays an important role for advanced and local stages.
The mainstay of treatment for endometrial cancer is total hysterectomy with bilateral salpingo-oophorectomy with/without lymphadenectomy. Radiation and chemotherapy also play an important role in adjuvant treatment.
In our study we retrospectively reviewed records on 134 patients presented in Alexandria university gyneoncology high specialized centre from January 2016 to December 2018 as regard demographic data (age ,risk factors ,comorbidities) ,diagnostic modalities ,surgery ,clinicopathological aspect and postoperative recurrence risk group stratification.
Our population under study had age ranged from 37- 87 with mean value 61.40 ± 8.60 with peak incidence 60-70 years. 88.1% of cases were post-menopause. Majority of cases were above average weight with Mean BMI 38.01 ± 8.37.
The most frequent medical history of the cases were hypertension (60.4 %) and diabetes mellitus (56%). Most common presentation was postmenopausal bleeding. As regard the clinic-pathological aspects of the operated cases 72.2 % of cases were type I. Majority of cases presented as stage I (53%) and low grade differentiation I and II (67.8%).
CT staging scan showed moderate agreement 0.574 (0.41-0.60) and showed statistically significance (p ≤ 0.05) in preoperative staging and associated with overall accuracy 71.7%. MRI showed accuracy ranged 83.3% to 86.8 % in local-regional staging of endometrial cancer.
Lymph node metastasis and Multivariate analysis revealed that risk of lymph node metastasis significantly increase (significant relation) in patients with deep myometrial invasion (p=0.024), lymphovascular space invasion (p=0.023) and high pathological grade (G3) p=0.009. But not significantly in patients large tumor size (>2cm in maximal tumor diameter) p=0.172.
According to ESGO guidelines criteria classification for risk of recurrence 27% had low risk recurrence and no further treatment was required and were only scheduled for follow up according to NCCN guidelines. 47.8% were high risk and 20% were intermediate/high intermediate risk that were referred to clinical oncology for postoperative adjuvant treatment.