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Srpski arhiv za celokupno lekarstvo 2019 Volume 147, Issue 11-12, Pages: 692-698
https://doi.org/10.2298/SARH181107055A
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Differences in endometrial carcinoma presentations and characteristics in pre- and postmenopausal women

Andrijašević Saša (Clinical Center of Serbia, Clinic of Obstetrics and Gynecology, Belgrade, Serbia)
Dotlić Jelena (Clinical Center of Serbia, Clinic of Obstetrics and Gynecology, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, Serbia)
Arsenović Nebojša (Lincoln County Hospital, PathLinks Pathology Services, Department of Cellular Pathology, Lincoln, UK)
Terzić Milan ORCID iD icon (Nazarbayev University, School of Medicine, Department of Medicine, Astana, Kazakhstan + University Medical Center, National Research Center of Mother and Child Health, Department of Obstetrics and Gynecology, Astana, Kazakhstan + University of Pittsburgh,)

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.

Keywords: endometrial carcinoma, menopausal status, BMI, irregular abnormal bleeding, preoperative evaluation, ultrasound scan and MRI