Carcinoma of the lower uterine segment as a potential factor for the poor prognosis for the early stage of the endometrial cancer development may lead to the need for adjuvant radiation therapy after surgery. Literature review

«Radiation and Risk», 2024, vol. 33, No. 2, pp.126-144

DOI: 10.21870/0131-3878-2024-33-2-126-144

Authors

Tkachenko B.E. – Post-Graduate Student. Contacts: 4 Korolyov str., Obninsk, Kaluga region, Russia, 249035. Tel.: +7 918-654-1322; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. .
Mkrtchyan L.S. – Lead. Researcher, MD
Ushakova D.A. – Clinical Resident
Krikunova L.I. – Chief Researcher, MD, Prof.
Zamulaeva I.A. – Head of Dep., C. Sc., Biol., Prof.
Ivanov S.A. – Director, Corr. Member of RAS, MD, Prof. of RUDN University Dep. A. Tsyb MRRC.
Kaprin A.D. – General Director, Director of P. Hertsen MORI, Head of RUDN University Dep., Academician of RAS, MD, Prof. NMRRC.
¹ A. Tsyb MRRC, Obninsk
² Peoples' Friendship University of Russia named after Patrice Lumumba, Moscow
³ P. Hertsen MORI, Moscow
⁴ NMRRC, Obninsk

Abstract

The aim of research is to analyze available scientific data for the study of the relationship between carcinoma of the lower uterine segment and traditional prognostic factors for the stage 1 uterine corpus cancer, and to assess its prognostic significance related to the treatment outcomes and the feasibility of adjuvant radiotherapy in cases with the disease poor prognosis. Search for the data of concern in electronic databases with the use of keywords and analysis of Russian and English translated data published between 1987 and 2024. The tumor in the lower segment occurs in 3-27.8% of endometrial cancer of the uterus body and, due to the anatomical features of the structure, blood supply, and lymphatic drainage, can be considered as a potential prognostic factor. According to limited studies data, a tumor lesion in the lower segment has not been associated with other clinical and morphological prognostic factors, and it does not affect the relapse-free survival in patients. Other researchers demonstrate the relationship between a lesion in the lower segment and the myometrium deep invasion, lymphovascular space invasion, and metastatic involvement of lymph nodes, however, they have not found any they have not impacted on treatment outcomes. However, a wide range of studies has demonstrated that the lower segment lesions are independent and poor prognostic factors. The factors significantly correlate with traditional prognostic factors and reduce both overall and recurrence-free survival. Therefore, it may be justified to consider postoperative radiotherapy for patients with a low or intermediate risk of disease progression, despite the absence of evidence of lymph node involvement. Analysis of the found research data has revealed the potential for further research into the impact of tumors in the lower segment of the uterus on patients with stage I endometrioid cancer. This could help identify new prognostic.

Key words
endometrial adenocarcinoma, uterine corpus cancer, lower uterine segment, risk factor, radiation therapy, adjuvant treatment, radiology.

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