Insights in Gynecologic Oncology
Open Access

Uterine cancer, a leading cause of morbidity and mortality among women, represents a diverse group of malignancies primarily affecting the uterus. Endometrial cancer is the most common subtype, constituting nearly 90% of cases, followed by uterine sarcomas, which are relatively rare but highly aggressive. The global burden of uterine cancer has risen in recent decades, reflecting shifts in risk factors such as obesity, hormonal imbalances, and an aging population. Despite its prevalence, significant disparities exist in disease outcomes due to variations in early detection, access to healthcare, and treatment strategies. Understanding the complex biology of uterine cancer and its clinical manifestations is crucial for improving diagnosis, management, and patient survival [1-3].

Description

Uterine cancer is characterized by uncontrolled cellular proliferation within the uterus, often resulting from genetic and hormonal alterations. Endometrial cancer typically arises from the glandular epithelium of the endometrium and is further classified into Type I (estrogen-dependent) and Type II (non-estrogen-dependent) cancers. Type I cancers are associated with conditions such as obesity, polycystic ovary syndrome (PCOS), and unopposed estrogen exposure, whereas Type II cancers are often linked to genetic mutations, such as TP53. Uterine sarcomas, on the other hand, arise from the myometrium or connective tissue and include subtypes such as leiomyosarcoma and endometrial stromal sarcoma [4-6].

Clinical presentation varies depending on the cancer subtype and stage at diagnosis. Abnormal uterine bleeding is the most common symptom of endometrial cancer, particularly in postmenopausal women. Other symptoms may include pelvic pain, pressure symptoms, and systemic manifestations such as fatigue and weight loss in advanced stages. Uterine sarcomas often present with rapid tumor growth, pain, and atypical vaginal bleeding, necessitating prompt evaluation [7].

Diagnosis involves a combination of clinical, imaging, and histopathological methods. Transvaginal ultrasound and endometrial biopsy are commonly used initial tools to evaluate abnormal uterine bleeding. Advanced imaging modalities such as magnetic resonance imaging (MRI) and computed tomography (CT) scans are employed for staging and detecting metastatic spread. Immunohistochemical and molecular testing have become integral in characterizing tumor subtypes and identifying therapeutic targets.

Results

Advancements in diagnostic techniques and treatment approaches have significantly improved outcomes for uterine cancer patients. Surgical intervention, including total hysterectomy with bilateral salpingo-oophorectomy, remains the cornerstone of management for early-stage disease. Minimally invasive techniques, such as laparoscopic and robotic surgeries, have reduced recovery times and improved postoperative outcomes. Adjuvant therapies, including radiotherapy and chemotherapy, are employed based on risk stratification and disease stage.

Emerging therapies, such as immune checkpoint inhibitors and molecular-targeted agents, have shown promise in managing advanced and recurrent uterine cancers. Pembrolizumab, an anti-PD-1 antibody, and lenvatinib, a multi-targeted tyrosine kinase inhibitor, have demonstrated efficacy in improving progression-free survival in patients with advanced disease. Ongoing clinical trials are evaluating the role of combination therapies to overcome resistance and enhance therapeutic responses.

Discussion

Despite these advances, challenges persist in the management of uterine cancer. Late-stage diagnosis, particularly in underserved populations, continues to hinder optimal outcomes. Additionally, therapeutic resistance to conventional treatments remains a significant barrier. Research efforts are increasingly focused on elucidating the molecular mechanisms underlying tumor progression and resistance to develop more effective therapies. The integration of genomic and proteomic analyses has paved the way for personalized medicine, enabling tailored treatment strategies based on individual tumor profiles.

The role of preventive measures, such as weight management and hormonal modulation, is gaining recognition in reducing uterine cancer risk. Public health initiatives aimed at increasing awareness and promoting early detection through routine gynecological evaluations can further mitigate disease burden.

Conclusion

Uterine cancer poses a significant challenge to women's health, underscoring the need for continued research and innovation in diagnosis and management. While advances in surgical techniques and systemic therapies have improved survival rates, personalized medicine offers a promising avenue for addressing unmet clinical needs. Collaborative efforts among researchers, clinicians, and policymakers are essential to bridge existing gaps in care and ensure equitable access to effective treatments. As the understanding of uterine cancer biology evolves, so too will the strategies to combat this disease, ultimately improving outcomes and quality of life for affected individuals.

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