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methylation patterns may provide a useful signature for tumour diagnosis and may be used to assess prognosis. In the Western world, endometrial cancer is the most common malignant tumour of the female genital tract. The American Cancer Society estimates that
Departments of, Medical Technology, Obstetrics and Gynecology, Pathology, Research Institute for Clinical Oncology, Division of Breast Surgery, Tohoku University School of Medicine, 2-1, Seiryo-machi, Aoba-ku, Sendai 981-0872, Japan
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absent in disease-free endometrium ( Bulun et al . 1994 , Watanabe et al . 1995 ). Furthermore, the endometrial cancer patients with aromatase-positive stromal cells have poor survival prognosis compared with patients with aromatase-negative stromal
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Introduction Endometrial cancer is the most common invasive gynecologic malignancy and the fourth most common cancer in women in the United States. In 2005, it was estimated that there would be over 40 000 new cases and more than
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Cancer Research UK Epidemiology Unit, Nutrition and Hormones Group, University of Sydney, Julius Center for Health Sciences and Primary Care, Medical Research Council Human Nutrition Research, Epidemiology Unit, Department of Clinical and Experimental Medicine, Public Health Department of Gipuzkoa, Department of Epidemiology, Consejería de Sanidad y Política Social, Andalusian School of Public Health, Public Health & Health Planning Directorate, Instituto de Salud Pública de Navarra, Institute of Cancer Epidemiology, Division of Cancer Epidemiology, German Institute of Human Nutrition, Department of Nutritional Research, Molecular and Nutritional Epidemiology Unit, Department of Clinical Epidemiology, Inserm E3N-EPIC, MRC Dunn Human Nutrition Unit, Clinical Gerontology Unit, National Institute of Public Health and the Environment, Department of Hygiene and Epidemiology, Cancer Registry, Cancer Epidemiology and Prevention, University of Oxford, Oxford, UK
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Introduction Endometrial cancer comprises about 4% of all cancers in women worldwide ( Parkin et al . 2002 ) and is the fourth most common cancer in women in westernized countries ( Parkin et al . 2002 , Bray et al . 2005 ). Obesity is an
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SOCS-3 inhibits leptin-mediated tyrosine phosphorylation of JAK2 ( Bjorbaek et al. 1998 , 1999 , Emilsson et al. 1999 ). Whether activation of the above pathways by leptin occurs in endometrial cancer cells remains unknown. Endometrial
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endometrial cancer can be inhibited by progesterone treatment, but generally this does not cure the patient (Creaseman et al. 2001, Southcott 2001 ). Progesterone exerts its effect through the progesterone receptors (PR) A and B (PRA and PRB), which
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Endometrial cancer (EC) is the most frequent malignant tumor of the female genital tract. Increasing evidence suggests that at least two different types of EC exist. Type I is associated with an endocrine milieu of estrogen predominance. These tumors are of endometrioid histology and develop from endometrial hyperplasia. They have a good prognosis and are sensitive to endocrine manipulation. Type II EC is not associated with a history of unopposed estrogens and develops from the atrophic endometrium of elderly women. They are of serous histology, have a poor prognosis, and do not react to endocrine manipulation. Both types of EC probably differ markedly with regard to the molecular mechanisms of malignant transformation. This article reviews reproductive and lifestyle factors modifying the risk of developing type I EC, including the use of hormonal contraceptives, hormone replacement therapy and tamoxifen. The roles of established and novel therapies for precancerous lesions and for invasive EC in the adjuvant and palliative settings are discussed.
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Endometrial carcinoma is listed under the absolute contraindications to hormone therapy (HT). According to current opinion, HT after stage I or II is still considered an option, and continuous combined oestrogen/progestogen replacement therapy (CCEPT) would be recommended. However, up to now, only observational studies have been put forward. Although none of these studies have established an increased rate of recurrence or mortality, alternatives such as phytopreparations and tibolone, or particular psychotherapeutic drugs, such as venlafaxine, should be considered for the relief of climacteric complaints. Progestogen-only therapy (PT) particularly has been considered. However, the currently discussed possible progestogen effects regarding an increased risk of breast cancer have to be taken into account. Indeed, the wider discussion about the gestagen effects regarding the risk of breast cancer is to be considered. Generally, after hysterectomy, at least for patients with cardiovascular risk factors, the preference today is to use low-dose oestrogen therapy (patches or gels) instead of CCEPT, and this is also now recommended for patients after endometrial cancer. This is to be noted because of the risk factors for endometrial carcinoma, such as hypertension, obesity, polycystic ovary syndrome (PCO) and diabetes mellitus. However, each form of HT should be only exceptionally recommended, and the patients must be informed about the risks that exist and the use of alternatives.
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Cancer Biology and Therapeutics Laboratory, UCD Conway Institute of Biomolecular and Biomedical Science, University College Dublin, Belfield, Dublin, Ireland
Systems Biology Ireland, University College Dublin, Belfield, Dublin, Ireland
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transcription ( Frasor et al. 2003 , Laganière et al. 2005 , Carroll et al. 2006 ). Although anti-oestrogens are a key component of systemic breast cancer treatment, they are not routinely used in endometrial cancer due to lack of proven efficacy
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Introduction Endometrial cancer development is strongly linked to lifestyle factors ( Kaaks et al. 2002 ). Excess weight is a major risk factor ( Kaaks et al. 2002 ) that is estimated to cause up to half of all endometrial cancer