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01-11-2021 | Endometrial Cancer | Review

Endometrial cancer from early to advanced-stage disease: an update for radiologists

Authors: Cibele Luna, Patricia Balcacer, Patricia Castillo, Marilyn Huang, Francesco Alessandrino

Published in: Abdominal Radiology | Issue 11/2021

Abstract

The purpose of this article is to review the current molecular classification of endometrial cancer, the imaging findings in early and advanced disease, and the current management strategies, focusing on the new systemic therapies for advanced EC. In recent years, the management of endometrial cancer has significantly changed. The molecular characterization of endometrial cancer has shed new light into the biologic behavior of this disease, the International Federation of Gynecology and Obstetrics staging system was recently revised, and imaging was formally incorporated in the management of endometrial cancer. Recent genomic analysis of endometrial cancer led to the approval of new molecular-targeted therapies and immune checkpoint inhibitors. Imaging allows assessment of myometrial invasion, cervical stromal extension, lymph node involvement and distant metastases, and has a crucial role for treatment planning. Treatment strategies, which include surgery, radiation and systemic therapies are based on accurate staging and risk stratification.

Graphic abstract

American Cancer Society. Key statistics for endometrial cancer. https://www.cancer.org/cancer/endometrial-cancer/about/key-statistics.html. Last revised: January 12, 2021. Visited December 5, 2020

Siegel RL, Miller KD, Jemal A (2020). Cancer statistics. CA: a cancer journal for clinicians; 70(1), 7–30. https://doi.org/10.3322/caac.21590

Clarke MA, Devesa SS, Harvey SV, Wentzensen N (2019). Hysterectomy-Corrected Uterine Corpus Cancer Incidence Trends and Differences in Relative Survival Reveal Racial Disparities and Rising Rates of Nonendometrioid Cancers. J Clin Oncol; 37(22):1895-1908. https://doi.org/10.1200/JCO.19.00151CrossRefPubMedPubMedCentral

US Surveillance, Epidemiology, and End Results (SEER). Cancer Stat Facts - Uterine Cancer: https://www.seer.cancer.gov/statfacts/html/corp.html. Accessed December 5, 2020

Brooks RA, Fleming GF, Lastra RR, et al (2019). Current recommendations and recent progress in endometrial cancer. CA Cancer J Clin; 69(4):258-279. https://doi.org/10.3322/caac.21561CrossRefPubMed

Connor EV, Rose PG (2018). Management Strategies for Recurrent Endometrial Cancer. Expert Rev Anticancer Ther; 18(9):873-885. https://doi.org/10.1080/14737140.2018.1491311CrossRefPubMed

Sorbe B, Juresta C, Ahlin C (2014). Natural history of recurrences in endometrial carcinoma. Oncol Lett; 8(4):1800-1806. https://doi.org/10.3892/ol.2014.2362CrossRefPubMedPubMedCentral

Jemal A, Siegel R, Ward E, et al (2008). Cancer statistics, 2008. CA Cancer J Clin; 58(2):71-96. https://doi.org/10.3322/CA.2007.0010CrossRefPubMed

Van Nyen T, Moiola CP, Colas E, Annibali D, Amant F (2018). Modeling Endometrial Cancer: Past, Present, and Future. Int J Mol Sci; 19(8):2348. https://doi.org/10.3390/ijms19082348

10.

Carlson J, McCluggage WG (2019). Reclassifying endometrial carcinomas with a combined morphological and molecular approach. Curr Opin Oncol; 31(5):411-419. https://doi.org/10.1097/CCO.0000000000000560CrossRefPubMed

11.

Arora S, Balasubramaniam S, Zhang W, et al (2020). FDA Approval Summary: Pembrolizumab plus Lenvatinib for Endometrial Carcinoma, a Collaborative International Review under Project Orbis. Clin Cancer Res; 26(19):5062-5067. https://doi.org/10.1158/1078-0432.CCR-19-3979CrossRefPubMed

12.

Freeman SJ, Aly AM, Kataoka MY, Addley HC, Reinhold C, Sala E (2012). The revised FIGO staging system for uterine malignancies: implications for MR imaging. Radiographics; 32(6):1805-1827. https://doi.org/10.1148/rg.326125519CrossRefPubMed

13.

Amant F, Mirza MR, Koskas M, Creutzberg CL (2018). Cancer of the corpus uteri. Int J Gynaecol Obstet; 143 Suppl 2:37–50. https://doi.org/10.1002/ijgo.12612

14.

Lin MY, Dobrotwir A, McNally O, Abu-Rustum NR, Narayan K (2018). Role of imaging in the routine management of endometrial cancer. Int J Gynaecol Obstet; 143 Suppl 2(Suppl 2):109–117. https://doi.org/10.1002/ijgo.12618

15.

Bell DW, Ellenson LH (2019). Molecular Genetics of Endometrial Carcinoma. Annu Rev Pathol; 14:339-367. https://doi.org/10.1146/annurev-pathol-020117-043609CrossRefPubMed

16.

Piulats JM, Guerra E, Gil-Martín M, et al (2017). Molecular approaches for classifying endometrial carcinoma. Gynecol Oncol; 145(1):200-207. https://doi.org/10.1016/j.ygyno.2016.12.015CrossRefPubMed

17.

Talhouk A, McConechy MK, Leung S, et al (2015). A clinically applicable molecular-based classification for endometrial cancers. Br J Cancer; 113(2):299-310. https://doi.org/10.1038/bjc.2015.190CrossRefPubMedPubMedCentral

18.

Levine, D., The Cancer Genome Atlas Research Network., Genome sequencing centres: Broad Institute, et al (2013). Integrated genomic characterization of endometrial carcinoma. Nature; 497:67–73. https://doi.org/10.1038/nature12113

19.

Shinbrot E, Henninger EE, Weinhold N, et al (2014). Exonuclease mutations in DNA polymerase epsilon reveal replication strand specific mutation patterns and human origins of replication. Genome Res; 24(11):1740-1750. https://doi.org/10.1101/gr.174789.114CrossRefPubMedPubMedCentral

20.

Bellone S, Centritto F, Black J, et al (2015). Polymerase ε (POLE) ultra-mutated tumors induce robust tumor-specific CD4+ T cell responses in endometrial cancer patients. Gynecol Oncol; 138(1):11-17. https://doi.org/10.1016/j.ygyno.2015.04.027CrossRefPubMedPubMedCentral

21.

Chang Z, Talukdar S, Mullany SA, Winterhoff B (2019). Molecular characterization of endometrial cancer and therapeutic implications. Curr Opin Obstet Gynecol; 31(1):24-30. https://doi.org/10.1097/GCO.0000000000000508CrossRefPubMed

22.

Zighelboim I, Goodfellow PJ, Gao F, et al (2007). Microsatellite instability and epigenetic inactivation of MLH1 and outcome of patients with endometrial carcinomas of the endometrioid type. J Clin Oncol; 25(15):2042-2048. https://doi.org/10.1200/JCO.2006.08.2107CrossRefPubMed

23.

Liccardo R, De Rosa M, Izzo P, Duraturo F (2017). Novel Implications in Molecular Diagnosis of Lynch Syndrome. Gastroenterol Res Pract; 2017:2595098. https://doi.org/10.1155/2017/2595098CrossRefPubMedPubMedCentral

24.

Drakes ML, Czerlanis CM, Stiff PJ (2020). Immune Checkpoint Blockade in Gynecologic Cancers: State of Affairs. Cancers (Basel); 12(11):3301. https://doi.org/10.3390/cancers12113301CrossRef

25.

Howitt BE, Shukla SA, Sholl LM, et al (2015). Association of Polymerase e-Mutated and Microsatellite-Instable Endometrial Cancers With Neoantigen Load, Number of Tumor-Infiltrating Lymphocytes, and Expression of PD-1 and PD-L1. JAMA Oncol; 1(9):1319-1323. https://doi.org/10.1001/jamaoncol.2015.2151CrossRefPubMed

26.

Akhtar M, Al Hyassat S, Elaiwy O, Rashid S, Al-Nabet ADMH (2019). Classification of Endometrial Carcinoma: New Perspectives Beyond Morphology. Adv Anat Pathol; 26(6):421-427. https://doi.org/10.1097/PAP.0000000000000251CrossRefPubMed

27.

Le Gallo M, Bell DW (2014). The emerging genomic landscape of endometrial cancer. Clin Chem; 60(1):98-110. https://doi.org/10.1373/clinchem.2013.205740CrossRefPubMed

28.

Expert Panel on GYN and OB Imaging, Reinhold C, Ueno Y, et al (2020). ACR Appropriateness Criteria® Pretreatment Evaluation and Follow-Up of Endometrial Cancer. J Am Coll Radiol; 17(11S):S472-S486. https://doi.org/10.1016/j.jacr.2020.09.001

29.

Nougaret S, Horta M, Sala E, et al (2019). Endometrial Cancer MRI staging: Updated Guidelines of the European Society of Urogenital Radiology. Eur Radiol; 29(2):792-805. https://doi.org/10.1007/s00330-018-5515-yCrossRefPubMed

30.

Saleh M, Virarkar M, Bhosale P, El Sherif S, Javadi S, Faria SC (2020). Endometrial Cancer, the Current International Federation of Gynecology and Obstetrics Staging System, and the Role of Imaging. J Comput Assist Tomogr; 44(5):714-729. https://doi.org/10.1097/RCT.0000000000001025CrossRefPubMed

31.

Sala E, Wakely S, Senior E, Lomas D (2007). MRI of malignant neoplasms of the uterine corpus and cervix. AJR Am J Roentgenol; 188(6):1577-1587. https://doi.org/10.2214/AJR.06.1196CrossRefPubMed

32.

National Comprehensive Cancer Network. NCCN Guidelines Version 1.2021 Endometrial Carcinoma. https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1473. Visited January 24, 2021

33.

Rizzo S, Femia M, Buscarino V, et al (2018). Endometrial cancer: an overview of novelties in treatment and related imaging keypoints for local staging. Cancer Imaging; 18(1):45. https://doi.org/10.1186/s40644-018-0180-6CrossRefPubMedPubMedCentral

34.

ACOG Committee Opinion No. 734: The Role of Transvaginal Ultrasonography in Evaluating the Endometrium of Women With Postmenopausal Bleeding. Obstet Gynecol. 2018;131(5):e124-e129. https://doi.org/10.1097/AOG.0000000000002631CrossRef

35.

Leone FP, Timmerman D, Bourne T, et al (2010). Terms, definitions and measurements to describe the sonographic features of the endometrium and intrauterine lesions: a consensus opinion from the International Endometrial Tumor Analysis (IETA) group. Ultrasound Obstet Gynecol; 35(1):103-12. https://doi.org/10.1002/uog.7487CrossRefPubMed

36.

Andreano A, Rechichi G, Rebora P, Sironi S, Valsecchi MG, Galimberti S (2014). MR diffusion imaging for preoperative staging of myometrial invasion in patients with endometrial cancer: a systematic review and meta-analysis. Eur Radiol; 24(6):1327-1338. https://doi.org/10.1007/s00330-014-3139-4CrossRefPubMed

37.

Frei KA, Kinkel K, Bonél HM, Lu Y, Zaloudek C, Hricak H (2000). Prediction of deep myometrial invasion in patients with endometrial cancer: clinical utility of contrast-enhanced MR imaging-a meta-analysis and Bayesian analysis. Radiology; 216(2):444-449. https://doi.org/10.1148/radiology.216.2.r00au17444CrossRefPubMed

38.

Lee JH, Dubinsky T, Andreotti RF, et al (2011). ACR appropriateness Criteria® pretreatment evaluation and follow-up of endometrial cancer of the uterus. Ultrasound Q; 27(2):139-145. https://doi.org/10.1097/RUQ.0b013e31821b6f73CrossRefPubMed

39.

Chi DS, Barakat RR, Palayekar MJ, et al (2008). The incidence of pelvic lymph node metastasis by FIGO staging for patients with adequately surgically staged endometrial adenocarcinoma of endometrioid histology. Int J Gynecol Cancer; 18(2):269-273. https://doi.org/10.1111/j.1525-1438.2007.00996.xCrossRefPubMed

40.

Murakami T, Kurachi H, Nakamura H, et al (1995). Cervical invasion of endometrial carcinoma--evaluation by parasagittal MR imaging. Acta Radiol; 36(3):248-253CrossRef

41.

Nougaret S, Lakhman Y, Vargas HA, et al (2017). From Staging to Prognostication: Achievements and Challenges of MR Imaging in the Assessment of Endometrial Cancer. Magn Reson Imaging Clin N Am; 25(3):611-633. https://doi.org/10.1016/j.mric.2017.03.010CrossRefPubMed

42.

Sokalska A, Timmerman D, Testa AC, et al (2009). Diagnostic accuracy of transvaginal ultrasound examination for assigning a specific diagnosis to adnexal masses. Ultrasound Obstet Gynecol; 34(4):462-470. https://doi.org/10.1002/uog.6444CrossRefPubMed

43.

Wang L, Sui Y, Zhang G, et al (2019). Comparative study of B-ultrasound and CT in preoperative diagnosis of myometrial invasion and lymph node metastasis in endometrial carcinoma. Int J Clin Exp Med; 12:1018–1024

44.

Solmaz U, Mat E, Dereli ML, et al (2015). Lymphovascular space invasion and positive pelvic lymph nodes are independent risk factors for para-aortic nodal metastasis in endometrioid endometrial cancer. Eur J Obstet Gynecol Reprod Biol; 186:63-67. https://doi.org/10.1016/j.ejogrb.2015.01.006CrossRefPubMed

45.

McMahon CJ, Rofsky NM, Pedrosa I (2010). Lymphatic metastases from pelvic tumors: anatomic classification, characterization, and staging. Radiology; 254(1):31-46. https://doi.org/10.1148/radiol.2541090361CrossRefPubMed

46.

Lin G, Ho KC, Wang JJ, et al (2008). Detection of lymph node metastasis in cervical and uterine cancers by diffusion-weighted magnetic resonance imaging at 3T. J Magn Reson Imaging; 28(1):128-135. https://doi.org/10.1002/jmri.21412CrossRefPubMed

47.

Rechichi G, Galimberti S, Signorelli M, et al (2011). Endometrial cancer: correlation of apparent diffusion coefficient with tumor grade, depth of myometrial invasion, and presence of lymph node metastases. AJR Am J Roentgenol; 197(1):256-262. https://doi.org/10.2214/AJR.10.5584CrossRefPubMed

48.

Kim JK, Kim KA, Park BW, Kim N, Cho KS (2009). Feasibility of diffusion-weighted imaging in the differentiation of metastatic from nonmetastatic lymph nodes: early experience. J Magn Reson Imaging; 29(5):1242. https://doi.org/10.1002/jmri.21480

49.

Barwick TD, Rockall AG, Barton DP, Sohaib SA (2006). Imaging of endometrial adenocarcinoma. Clin Radiol; 61(7):545-555. https://doi.org/10.1016/j.crad.2006.03.011CrossRefPubMed

50.

Paik ES, Yoon A, Lee YY, et al (2015). Pulmonary metastasectomy in uterine malignancy: outcomes and prognostic factors. J Gynecol Oncol; 26(4):270-276. https://doi.org/10.3802/jgo.2015.26.4.270CrossRefPubMedPubMedCentral

51.

D'Orsi CJ, Bruckman J, Mauch P, Smith EH (1979). Lung metastases in cervical and endometrial carcinoma. AJR Am J Roentgenol; 133(4):719-722. https://doi.org/10.2214/ajr.133.4.719CrossRefPubMed

52.

Descamps P, Calais G, Moire C, et al (1997). Predictors of distant recurrence in clinical stage I or II endometrial carcinoma treated by combination surgical and radiation therapy. Gynecol Oncol; 64(1):54-58. https://doi.org/10.1006/gyno.1996.4511CrossRefPubMed

53.

Chura JC, Marushin R, Boyd A, Ghebre R, Geller MA, Argenta PA (2007). Multimodal therapy improves survival in patients with CNS metastasis from uterine cancer: a retrospective analysis and literature review. Gynecol Oncol; 107(1):79-85. https://doi.org/10.1016/j.ygyno.2007.05.027CrossRefPubMed

54.

Fujiwara H, Saga Y, Takahashi K, et al (2008). Omental metastases in clinical stage I endometrioid adenocarcinoma. Int J Gynecol Cancer; 18(1):165-167. https://doi.org/10.1111/j.1525-1438.2007.00961.xCrossRefPubMed

55.

Kurra V, Krajewski KM, Jagannathan J, Giardino A, Berlin S, Ramaiya N (2013). Typical and atypical metastatic sites of recurrent endometrial carcinoma. Cancer Imaging; 13(1):113-122. https://doi.org/10.1102/1470-7330.2013.0011CrossRefPubMedPubMedCentral

56.

Levy AD, Shaw JC, Sobin LH (2009). Secondary tumors and tumorlike lesions of the peritoneal cavity: imaging features with pathologic correlation. Radiographics; 29(2):347-373. https://doi.org/10.1148/rg.292085189CrossRefPubMed

57.

DiSaia PJ, Creasman WT, Boronow RC, Blessing JA (1985). Risk factors and recurrent patterns in Stage I endometrial cancer. Am J Obstet Gynecol; 151(8):1009-1015. https://doi.org/10.1016/0002-9378(85)90371-0CrossRefPubMed

58.

Benedetti Panici P, Basile S, Maneschi F, et al (2008). Systematic pelvic lymphadenectomy vs. no lymphadenectomy in early-stage endometrial carcinoma: randomized clinical trial. J Natl Cancer Inst; 100(23):1707–1716. https://doi.org/10.1093/jnci/djn397

59.

ASTEC study group, Kitchener H, Swart AM, Qian Q, Amos C, Parmar MK (2009). Efficacy of systematic pelvic lymphadenectomy in endometrial cancer (MRC ASTEC trial): a randomized study. Lancet; 373(9658):125-136. https://doi.org/10.1016/S0140-6736(08)61766-3

60.

Khoury-Collado F, Glaser GE, Zivanovic O, et al (2009). Improving sentinel lymph node detection rates in endometrial cancer: how many cases are needed? Gynecol Oncol; 115(3):453-455. https://doi.org/10.1016/j.ygyno.2009.08.026CrossRefPubMed

61.

SGO Clinical Practice Endometrial Cancer Working Group, Burke WM, Orr J, et al (2014). Endometrial cancer: a review and current management strategies: part I. Gynecol Oncol; 134(2):385-392. https://doi.org/10.1016/j.ygyno.2014.05.018CrossRef

62.

Navarria I, Usel M, Rapiti E, et al (2009). Young patients with endometrial cancer: how many could be eligible for fertility-sparing treatment? Gynecol Oncol; 114(3):448-451. https://doi.org/10.1016/j.ygyno.2009.05.038CrossRefPubMed

63.

Shah MM, Wright JD (2011). Management of endometrial cancer in young women. Clin Obstet Gynecol; 54(2):219-225. https://doi.org/10.1097/GRF.0b013e318218607cCrossRefPubMed

64.

Won S, Kim MK, Seong SJ (2020). Fertility-sparing treatment in women with endometrial cancer. Clin Exp Reprod Med; 47(4):237-244. https://doi.org/10.5653/cerm.2020.03629CrossRefPubMedPubMedCentral

65.

Barlin JN, Puri I, Bristow RE (2010). Cytoreductive surgery for advanced or recurrent endometrial cancer: a meta-analysis. Gynecol Oncol; 118(1):14-18. https://doi.org/10.1016/j.ygyno.2010.04.005CrossRefPubMed

66.

Alvarez Secord A, Havrilesky LJ, Bae-Jump V, et al (2007). The role of multi-modality adjuvant chemotherapy and radiation in women with advanced stage endometrial cancer. Gynecol Oncol; 107(2):285-291. https://doi.org/10.1016/j.ygyno.2007.06.014CrossRefPubMed

67.

Onda T, Yoshikawa H, Mizutani K, et al (1997). Treatment of node-positive endometrial cancer with complete node dissection, chemotherapy and radiation therapy. Br J Cancer; 75(12):1836-1841. https://doi.org/10.1038/bjc.1997.313CrossRefPubMedPubMedCentral

68.

Vaidya AP, Littell R, Krasner C, Duska LR (2006). Treatment of uterine papillary serous carcinoma with platinum-based chemotherapy and paclitaxel. Int J Gynecol Cancer; 16 Suppl 1:267–272. https://doi.org/10.1111/j.1525-1438.2006.00413.x

69.

Martell K, Doll C, Barnes EA, Phan T, Leung E, Taggar A (2019). Radiotherapy practices in postoperative endometrial cancer: A survey of the ABS membership. Brachytherapy; 18(6):741-746. https://doi.org/10.1016/j.brachy.2019.07.004CrossRefPubMed

70.

Koh WJ, Abu-Rustum NR, Bean S, et al (2018). Uterine Neoplasms, Version 1.2018, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw; 16(2):170–199. https://doi.org/10.6004/jnccn.2018.0006

71.

Emons G, Vordermark D (2019). Adjuvant treatment for endometrial cancer. Curr Opin Oncol; 31(5):404-410. https://doi.org/10.1097/CCO.0000000000000558CrossRefPubMed

72.

Passarello K, Kurian S, Villanueva V (2019). Endometrial Cancer: An Overview of Pathophysiology, Management, and Care. Semin Oncol Nurs; 35(2):157-165. https://doi.org/10.1016/j.soncn.2019.02.002CrossRefPubMed

73.

Morice P, Leary A, Creutzberg C, Abu-Rustum N, Darai E (2016). Endometrial cancer. Lancet; 387(10023):1094-1108. https://doi.org/10.1016/S0140-6736(15)00130-0CrossRefPubMed

74.

Kelley RM, Baker WH (1961). Progestational agents in the treatment of carcinoma of the endometrium. N Engl J Med; 264:216-222. https://doi.org/10.1056/NEJM196102022640503CrossRefPubMed

75.

van Weelden WJ, Massuger LFAG; ENITEC, Pijnenborg JMA, Romano A (2019). Anti-estrogen Treatment in Endometrial Cancer: A Systematic Review. Front Oncol; 9:359. https://doi.org/10.3389/fonc.2019.00359CrossRefPubMedPubMedCentral

76.

Makker V, Rasco D, Vogelzang NJ, et al (2019). Lenvatinib plus pembrolizumab in patients with advanced endometrial cancer: an interim analysis of a multicentre, open-label, single-arm, phase 2 trial. Lancet Oncol; 20(5):711-718. https://doi.org/10.1016/S1470-2045(19)30020-8CrossRefPubMed

77.

Makker V, Taylor MH, Aghajanian C, et al (2020). Lenvatinib Plus Pembrolizumab in Patients With Advanced Endometrial Cancer. J Clin Oncol; 38(26):2981-2992. https://doi.org/10.1200/JCO.19.02627CrossRefPubMedPubMedCentral

78.

Barrington DA, Dilley SE, Smith HJ, Straughn JM Jr (2019). Pembrolizumab in advanced recurrent endometrial cancer: A cost-effectiveness analysis. Gynecol Oncol; 153(2):381-384. https://doi.org/10.1016/j.ygyno.2019.02.013CrossRefPubMed

79.

Ytre-Hauge S, Dybvik JA, Lundervold A, et al (2018). Preoperative tumor texture analysis on MRI predicts high-risk disease and reduced survival in endometrial cancer. J Magn Reson Imaging; 48(6):1637-1647. https://doi.org/10.1002/jmri.26184CrossRefPubMed

80.

Fasmer KE, Hodneland E, Dybvik JA, et al (2021). Whole-Volume Tumor MRI Radiomics for Prognostic Modeling in Endometrial Cancer. J Magn Reson Imaging; 53(3):928–937. https://doi.org/10.1002/jmri.27444

81.

Yan BC, Li Y, Ma FH, Feng F, Sun MH, Lin GW, Zhang GF, Qiang JW (2020). Preoperative Assessment for High-Risk Endometrial Cancer by Developing an MRI- and Clinical-Based Radiomics Nomogram: A Multicenter Study. J Magn Reson Imaging; 52(6):1872-1882. doi: https://doi.org/10.1002/jmri.27289.CrossRefPubMed

82.

Chen J, Gu H, Fan W, et al (2021). MRI-Based Radiomic Model for Preoperative Risk stratification in Stage I Endometrial Cancer. J Cancer; 12(3):726-734. https://doi.org/10.7150/jca.50872CrossRefPubMedPubMedCentral

83.

Veeraraghavan H, Friedman CF, DeLair DF, et al (2020). Machine learning-based prediction of microsatellite instability and high tumor mutation burden from contrast-enhanced computed tomography in endometrial cancers. Sci Rep; 10(1):17769. https://doi.org/10.1038/s41598-020-72475-9CrossRefPubMedPubMedCentral

84.

Yan BC, Li Y, Ma FH, et al (2021). Radiologists with MRI-based radiomics aids to predict the pelvic lymph node metastasis in endometrial cancer: a multicenter study. Eur Radiol; 31(1):411–422. https://doi.org/10.1007/s00330-020-07099-8

85.

Xu X, Li H, Wang S, et al (2019). Multiplanar MRI-Based Predictive Model for Preoperative Assessment of Lymph Node Metastasis in Endometrial Cancer. Front Oncol; 9:1007. https://doi.org/10.3389/fonc.2019.01007

Title: Endometrial cancer from early to advanced-stage disease: an update for radiologists
Authors: Cibele Luna
Patricia Balcacer
Patricia Castillo
Marilyn Huang
Francesco Alessandrino
Publication date: 01-11-2021
Publisher: Springer US
Keywords: Endometrial Cancer
Endometrial Cancer
Published in: Abdominal Radiology / Issue 11/2021
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI: https://doi.org/10.1007/s00261-021-03220-7

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