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Endometrial Cancer in Reproductive Age: Fertility-Sparing Approach and Obstetric Outcomes
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Endometrial Cancer in Reproductive Age: Fertility-Sparing Approach and Obstetric Outcomes

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Oncology".

Deadline for manuscript submissions: closed (30 June 2022) | Viewed by 23138

Special Issue Editors

Dr. Giuseppe Gullo

E-Mail Website
Guest Editor
Obstetrics and Gynecology, Villa Sofia Cervello Hospital, I.V.F. Public Center, University of Palermo, Palermo, Italy
Interests: endometrial cancer; obstetric and gynecological cancers; reproductive medicine; fertility preservation
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Gaspare Cucinella

E-Mail Website
Guest Editor
Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, IVF UNIT, University of Palermo, 90146 Palermo, Italy
Interests: laparoscopy; surgery; robotic surgery; urogynaecological disease; reproductive endocrinology; molecular science; infertility; sterility; stem cells
Special Issues, Collections and Topics in MDPI journals
Dr. Antonio Simone Laganà

E-Mail Website
Guest Editor
Department of Obstetrics and Gynecology, “Filippo Del Ponte” Hospital, University of Insubria, 21100 Varese, VA, Italy
Interests: women’s health; minimally invasive procedures; up-to-date management; gynecology; reproductive health; surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Although the incidence of endometrial cancer is predominant especially after menopause, to date a significant proportion of cases are diagnoses during reproductive age. In this scenario, tailored treatments are mandatory to preserve fertility and to allow the best chances for reproduction in early-stage endometrial cancer. Indeed, both surgery and adjuvant treatments can play a detrimental role on fertility potential, so the targeted fertility-sparing approach should be accurately planned, even considering gamete preservation. Considering these recent paradigm shift in the diagnosis and management of endometrial cancer during reproductive age, this Special Issue aims for a significant step forward in our knowledge about the topic and stimulate further discussion among the readers, providing an update about the current cutting edge of diagnosis, management, treatment and outcomes, from basic science to translation, clinical and surgical approach.

This focused issue aims to provide an update about the current cutting of diagnosis management, treatment and outcomes of Endometrial cancer in reproductive age: fertility, from basic science to translation approach.

Topics in the focused issue：

  1. Etiology and pathogenesis of endometrial cancer in fertile women
  2. Molecular and cellular pathways of endometrial malignancies in reproductive age.
  3. Diagnostic work-up for endometrial in young women
  4. Conservative management and fertility outcomes of endometrial cancer
  5. Fertility-sparing approach for endometrial premalignant and malignant lesions.
  6. Prognostic factors for endometrial cancer management in fertile patients
  7. Fertility-preservation approach in in women affected by endometrial
  8. Sexuality and psychological wellbeing in reproductive aged women affected by endometrial cancer

Dr. Giuseppe Gullo
Prof. Dr. Gaspare Cucinella
Dr. Antonio Simone Laganà
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Molecular Sciences is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. There is an Article Processing Charge (APC) for publication in this open access journal. For details about the APC please see here. Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • endometrial cancer

Published Papers (7 papers)

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Editorial

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5 pages, 240 KiB  
Editorial
Fertility-Sparing Strategies for Early-Stage Endometrial Cancer: Stepping towards Precision Medicine Based on the Molecular Fingerprint
by Giuseppe Gullo, Gaspare Cucinella, Vito Chiantera, Miriam Dellino, Eliano Cascardi, Péter Török, Tünde Herman, Simone Garzon, Stefano Uccella and Antonio Simone Laganà
Int. J. Mol. Sci. 2023, 24(1), 811; https://doi.org/10.3390/ijms24010811 - 03 Jan 2023
Cited by 15 | Viewed by 2088
Abstract
Endometrial cancer represents the fifth most common cancer in women, and the most common gynecological malignancy in developed countries [...] Full article
(This article belongs to the Special Issue Endometrial Cancer in Reproductive Age: Fertility-Sparing Approach and Obstetric Outcomes)

Review

Jump to: Editorial

30 pages, 2378 KiB  
Review
Antioxidative, Anti-Inflammatory, Anti-Obesogenic, and Antidiabetic Properties of Tea Polyphenols—The Positive Impact of Regular Tea Consumption as an Element of Prophylaxis and Pharmacotherapy Support in Endometrial Cancer
by Piotr Olcha, Anna Winiarska-Mieczan, Małgorzata Kwiecień, Łukasz Nowakowski, Andrzej Miturski, Andrzej Semczuk, Bożena Kiczorowska and Krzysztof Gałczyński
Int. J. Mol. Sci. 2022, 23(12), 6703; https://doi.org/10.3390/ijms23126703 - 16 Jun 2022
Cited by 17 | Viewed by 2788
Abstract
Endometrial cancer (EC) is second only to cervical carcinoma among the most commonly diagnosed malignant tumours of the female reproductive system. The available literature provides evidence for the involvement of 32 genes in the hereditary incidence of EC. The physiological markers of EC [...] Read more.
Endometrial cancer (EC) is second only to cervical carcinoma among the most commonly diagnosed malignant tumours of the female reproductive system. The available literature provides evidence for the involvement of 32 genes in the hereditary incidence of EC. The physiological markers of EC and coexisting diet-dependent maladies include antioxidative system disorders but also progressing inflammation; hence, the main forms of prophylaxis and pharmacotherapy ought to include a diet rich in substances aiding the organism’s response to this type of disorder, with a particular focus on ones suitable for lifelong consumption. Tea polyphenols satisfy those requirements due to their proven antioxidative, anti-inflammatory, anti-obesogenic, and antidiabetic properties. Practitioners ought to consider promoting tea consumption among individuals genetically predisposed for EC, particularly given its low cost, accessibility, confirmed health benefits, and above all, suitability for long-term consumption regardless of the patient’s age. The aim of this paper is to analyse the potential usability of tea as an element of prophylaxis and pharmacotherapy support in EC patients. The analysis is based on information available from worldwide literature published in the last 15 years. Full article
(This article belongs to the Special Issue Endometrial Cancer in Reproductive Age: Fertility-Sparing Approach and Obstetric Outcomes)
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13 pages, 1189 KiB  
Review
Role of Leptin and Adiponectin in Endometrial Cancer
by Aneta Słabuszewska-Jóźwiak, Aron Lukaszuk, Marta Janicka-Kośnik, Artur Wdowiak and Grzegorz Jakiel
Int. J. Mol. Sci. 2022, 23(10), 5307; https://doi.org/10.3390/ijms23105307 - 10 May 2022
Cited by 16 | Viewed by 2536
Abstract
Endometrial cancer is the most common malignancy of the female genital tract. Obesity is a strong risk factor for endometrial cancer. Adipose tissue is an active endocrine organ that synthesizes biologically active cytokine peptides, called adipokines. Adiponectin and leptin are the main cytokines [...] Read more.
Endometrial cancer is the most common malignancy of the female genital tract. Obesity is a strong risk factor for endometrial cancer. Adipose tissue is an active endocrine organ that synthesizes biologically active cytokine peptides, called adipokines. Adiponectin and leptin are the main cytokines of adipose tissue, which may influence the development of metabolic diseases and carcinogenesis. In this scenario, we describe the role of leptin and adiponectin in the development of endometrial cancer. A better understanding of the signalling pathway of these cytokines in endometrial cancerogenesis will provide an opportunity for effective target therapy and may be usable in fertility-sparing treatment. In the future, clinical trials focusing on adipokines, molecular biology, and genetics of the tumour will be needed. Full article
(This article belongs to the Special Issue Endometrial Cancer in Reproductive Age: Fertility-Sparing Approach and Obstetric Outcomes)
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20 pages, 1878 KiB  
Review
Biomolecular and Genetic Prognostic Factors That Can Facilitate Fertility-Sparing Treatment (FST) Decision Making in Early Stage Endometrial Cancer (ES-EC): A Systematic Review
by Panayiotis Tanos, Savvas Dimitriou, Giuseppe Gullo and Vasilios Tanos
Int. J. Mol. Sci. 2022, 23(5), 2653; https://doi.org/10.3390/ijms23052653 - 28 Feb 2022
Cited by 40 | Viewed by 3125
Abstract
Endometrial cancer occurs in up to 29% of women before 40 years of age. Seventy percent of these patients are nulliparous at the time. Decision making regarding fertility preservation in early stage endometrial cancer (ES-EC) is, therefore, a big challenge since the decision [...] Read more.
Endometrial cancer occurs in up to 29% of women before 40 years of age. Seventy percent of these patients are nulliparous at the time. Decision making regarding fertility preservation in early stage endometrial cancer (ES-EC) is, therefore, a big challenge since the decision between the risk of cancer progression and a chance to parenthood needs to be made. Sixty-two percent of women with complete remission of ES-EC after fertility-sparing treatment (FST) report to have a pregnancy wish which, if not for FST, they would not be able to fulfil. The aim of this review was to identify and summarise the currently established biomolecular and genetic prognostic factors that can facilitate decision making for FST in ES-EC. A comprehensive search strategy was carried out across four databases; Cochrane, Embase, MEDLINE, and PubMed; they were searched between March 1946 and 22nd December 2022. Thirty-four studies were included in this study which was conducted in line with the PRISMA criteria checklist. The final 34 articles encompassed 9165 patients. The studies were assessed using the Critical Appraisal Skills Program (CASP). PTEN and POLE alterations we found to be good prognostic factors of ES-EC, favouring FST. MSI, CTNNB1, and K-RAS alterations were found to be fair prognostic factors of ES-EC, favouring FST but carrying a risk of recurrence. PIK3CA, HER2, ARID1A, P53, L1CAM, and FGFR2 were found to be poor prognostic factors of ES-EC and therefore do not favour FST. Clinical trials with bigger cohorts are needed to further validate the fair genetic prognostic factors. Using the aforementioned good and poor genetic prognostic factors, we can make more confident decisions on FST in ES-EC. Full article
(This article belongs to the Special Issue Endometrial Cancer in Reproductive Age: Fertility-Sparing Approach and Obstetric Outcomes)
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19 pages, 345 KiB  
Review
Fertility-Sparing Approaches in Atypical Endometrial Hyperplasia and Endometrial Cancer Patients: Current Evidence and Future Directions
by Nayanar-Adela Contreras, Jordi Sabadell, Paula Verdaguer, Carla Julià and Maria-Eulalia Fernández-Montolí
Int. J. Mol. Sci. 2022, 23(5), 2531; https://doi.org/10.3390/ijms23052531 - 25 Feb 2022
Cited by 20 | Viewed by 4178
Abstract
Endometrial cancer (EC) is the fourth most common cancer in women in developed countries. Although it is usually diagnosed in postmenopausal women, its incidence has increased in young women, as well in recent decades, with an estimated rate of 4% in those under [...] Read more.
Endometrial cancer (EC) is the fourth most common cancer in women in developed countries. Although it is usually diagnosed in postmenopausal women, its incidence has increased in young women, as well in recent decades, with an estimated rate of 4% in those under 40 years of age. Factors involved in this increase, particularly in resource-rich countries, include delayed childbearing and the rise in obesity. The new molecular classification of EC should help to personalize treatment, through appropriate candidate selection. With the currently available evidence, the use of oral progestin either alone or in combination with other drugs such as metformin, levonorgestrel-releasing intrauterine devices and hysteroscopic resection, seems to be feasible and safe in women with early-stage EC limited to the endometrium. However, there is a lack of high-quality evidence of the efficacy and safety of conservative management in EC. Randomized clinical trials in younger women and obese patients are currently underway. Full article
(This article belongs to the Special Issue Endometrial Cancer in Reproductive Age: Fertility-Sparing Approach and Obstetric Outcomes)
14 pages, 297 KiB  
Review
Fertility Sparing Treatments in Endometrial Cancer Patients: The Potential Role of the New Molecular Classification
by Anna Franca Cavaliere, Federica Perelli, Simona Zaami, Marco D’Indinosante, Irene Turrini, Marco Giusti, Giuseppe Gullo, Giuseppe Vizzielli, Alberto Mattei, Giovanni Scambia, Annalisa Vidiri and Fabrizio Signore
Int. J. Mol. Sci. 2021, 22(22), 12248; https://doi.org/10.3390/ijms222212248 - 12 Nov 2021
Cited by 52 | Viewed by 3477
Abstract
Endometrial cancer is the most frequent gynecological malignancy, and, although epidemiologically it mainly affects advanced age women, it can also affect young patients who want children and who have not yet completed their procreative project. Fertility sparing treatments are the subject of many [...] Read more.
Endometrial cancer is the most frequent gynecological malignancy, and, although epidemiologically it mainly affects advanced age women, it can also affect young patients who want children and who have not yet completed their procreative project. Fertility sparing treatments are the subject of many studies and research in continuous evolution, and represent a light of hope for young cancer patients who find themselves having to face an oncological path before fulfilling their desire for motherhood. The advances in molecular biology and the more precise clinical and prognostic classification of endometrial cancer based on the 2013 The Cancer Genome Atlas classification allow for the selection of patients who can be submitted to fertility sparing treatments with increasing oncological safety. It would also be possible to predict the response to hormonal treatment by investigating the state of the genes of the mismatch repair. Full article
(This article belongs to the Special Issue Endometrial Cancer in Reproductive Age: Fertility-Sparing Approach and Obstetric Outcomes)
12 pages, 530 KiB  
Review
Fertility-Sparing Approach in Women Affected by Stage I and Low-Grade Endometrial Carcinoma: An Updated Overview
by Giuseppe Gullo, Andrea Etrusco, Gaspare Cucinella, Antonino Perino, Vito Chiantera, Antonio Simone Laganà, Rossella Tomaiuolo, Amerigo Vitagliano, Pierluigi Giampaolino, Marco Noventa, Alessandra Andrisani and Giovanni Buzzaccarini
Int. J. Mol. Sci. 2021, 22(21), 11825; https://doi.org/10.3390/ijms222111825 - 31 Oct 2021
Cited by 48 | Viewed by 3224
Abstract
Endometrial cancer (EC) is a deleterious condition which strongly affects a woman’s quality of life. Although aggressive interventions should be considered to treat high-grade EC, a conservative approach should be taken into consideration for women wishing to conceive. In this scenario, we present [...] Read more.
Endometrial cancer (EC) is a deleterious condition which strongly affects a woman’s quality of life. Although aggressive interventions should be considered to treat high-grade EC, a conservative approach should be taken into consideration for women wishing to conceive. In this scenario, we present an overview about the EC fertility-sparing approach state of art. Type I EC at low stage is the only histological type which can be addressed with a fertility-sparing approach. Moreover, no myometrium and/or adnexal invasion should be seen, and lymph-vascular space should not be involved. Regarding the pharmaceutical target, progestins, in particular medroxyprogesterone acetate (MPA) or megestrol acetate (MA), are the most employed agent in conservative treatment of early-stage EC. The metformin usage and hysteroscopic assessment is still under debate, despite promising results. Particularly strict and imperious attention should be given to the follow-up and psychological wellbeing of women, especially because of the double detrimental impairment: both EC and EC-related infertility consequences. Full article
(This article belongs to the Special Issue Endometrial Cancer in Reproductive Age: Fertility-Sparing Approach and Obstetric Outcomes)
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