Page 8 - WALS Journal

Mohammed Khairy Ali et al

induction of ovulation increases the risk of ovarian cancer. 6 Family history is also linked to endometrial cancer and
The menstrual pattern of the female should be put in to they are many genetic syndromes, such as Lynch syndrome
consideration because early menarche and late menopause which also known as nonpolyposis colorectal cancer
have been associated with an increased risk of ovarian (HNPCC), in which the endometrial cancer is considerd the
cancer. On the other side, breast feeding has a protective most common extracolonic manifestation of this
effect as it prevent, the ovarian cancer, may be due to syndrome. 14
amenorrhea and an ovulation associated usually with Oral contraceptive use for at least 1 year decreases the
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lactation. The combined oral contraceptive also reduces risk of endometrial cancer by about 30 to 50% and risk
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the risk of ovarian cancer by 50% by its effect in inhibition reduction extends for 10 to 20 years. The medical
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of ovulation. In contrast, hormone replacement therapy by conditions play an important role in development of
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estrogen after the menopause elevate the risk. The racial endometrial cancer. Cancer corpus triad include obesity,
and ethnic factors can give some explanation for diabetes mellitus and hypertension which are commonly
development of ovarian cancer. The incidence of ovarian associated with endometrial cancer. 16
cancer among white women is higher than black women.
Although exact reasons are unknown, but gynecologic ROLE OF MINIMALLY INVASIVE SURGERY IN
surgery may have a role. Tubal ligation and hysterectomy THE MANAGEMENT OF OVARIAN CANCER
have been associated with reduction in the risk of developing Minimally invasive surgery for patients with ovarian cancer
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ovarian cancer. The incidence of ovarian cancer rises with plays an important role in different ways depending on the
increasing age up to 70 years and then begins to decrease stage in which the diseasess is discovered and also the
among women above 80 years. 11
surgical aim of the procedure. 17
EPIDEMIOLOGY OF ENDOMETRIAL CANCER In early-stage of the disease, laparoscopy may be used
IN REPRODUCTIVE AGE in staging instead of surgical staging, and also the second-
look operation is one of its use to assess the progress of the
The incidence of endometrial cancer is about one in disease after the patient completes the course of adjuvant
38 American women (2.6%) during their lifetime. In 2007, chemotherapy.
39,080 new cases are estimated to be developed in the In advanced stage of ovarian malignancy the
United States, but only 7,400 deaths are expected. The laparoscopy in general can be used to confirm diagnosis by
endometrial cancer is considered less dangerous than visualization of internal organs and also give picture about
ovarian cancer because the early diagnosis is easy and so nature of the tumor and its respectability. Frozen section
the cure rate is high. All over the world, the endometrial biopsy can be taken during the operation for histological
cancer is the fourth leading cancer in incidence but only testing. However, when the ovarian cancer has been
the eighth leading cause of cancer deaths among women. confirmed through frozen section biopsies, the laparoscopy
Numerous risk factors have been described for
developing endometrial cancer but the most important risk procedure is usually converted into laparotomy that enables
factor is related to excessive estrogen state. Obesity is removing the tumor without contact with the abdominal wall
considered as the most common cause of overproduction as well as performing infracolic omentectomy for tumor
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of endogenous estrogen because the excessive adipose tissue staging.
increases peripheral conversion of androstenedione to The use of minimal invasive surgery to evaluate ovarian
estrone. The estrogen replacement therapy is the next most masses began approximately 10 years ago but it was only
important factor in development of endometrial cancer, so considered as a diagnostic method because laparoscopy
combined estrogen plus progesterone hormonal therapy could facilitate tumor spreading in the cavity. In addition,
should be prescribed for postmenopausal women to reduce the omentectomy, which needed to complete staging, is
their risk of endometrial cancer. difficult to be done by laparoscopy but nowadays the risk
The reproductive factors play an important role in of tumor dissemination during laparoscopy was reduced by
development of endometrial cancer whenever anovulation using of the endobag which consist of sheath placed around
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is present in women with polycystic ovarian syndrome and removed adnexal mass to eliminate tumor dissemination.
thus have an increased risk of developing endometrial ROLE OF MINIMALLY INVASIVE SURGERY IN
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cancer, and also menstrual pattern especially when the THE MANAGEMENT OF ENDOMETRIAL CANCER
duration of uninterrupted menstrual cycles is prolonged, so
early menarche and late menopause both increase the risk Endometrial cancer is the most common gynecologic
of endometrial cancer. 13 malignancy in the United States. Surgical staging plays an
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