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Estrogen Actions on Endometrial Adenocarcinoma

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Steroid Receptors in Health and Disease

Part of the book series: Serono Symposia, USA ((SERONOSYMP))

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Abstract

Information about the role of hormones in the development of endometrial adenocarcinoma has been collected from a variety of sources. Epidemiologic studies have shown that the risk for endometrial cancer increases under conditions of chronic stimulation with estrogens, unopposed by progesterone (1). These conditions arise in some endocrinopathies resulting in anovulation (2) or during exogenous administration of estrogenic drugs, mostly for climacteric syndrome (3–5). Treatment of endometrial cancer with progestins (6,7) or, more recently, with antiestrogens (8), causes remissions in a significant proportion of patients with metastatic tumors; these results have been interpreted to indicate hormonal responsiveness in at least some endometrial adenocarcinomas. In fact, there is a convincing relation between presence of estrogen or progesterone receptors in metastatic tumors and responsiveness to hormone-related therapy, as shown in Table 1, and unresponsiveness to chemotherapy (13). Similarly, patients with primary endometrial adenocarcinoma tumors containing steroid receptors have a better prognosis for survival (Fig. 1). All of these correlations involving receptor levels suggest that estrogens and progestins affect tumor growth and invasiveness by acting as hormones. However, the effects of progestins used for therapy are obtained at such large drug concentrations that their actions may have to be considered cytotoxic or cytostatic rather than hormonal. Furthermore, the prognostic value of hormone receptor levels may be more a reflection of the relation of these levels to the degree of differentiation of the tumor, as shown in Table 2, than to any hormonal involvement in its development. It may then be reasonable to consider an alternative concept for the interpretation of these findings, namely that the presence of steroid receptors characterizes a physiologic state of the cancer cell and is associated with, rather than responsible for, responses to therapy.

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Authors and Affiliations

  1. Departments of Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine, New York, NY, USA

    Erlio Gurpide, Christian F. Holinka, Yuzuru Anzai, Sharon Kassan & Leszek Markiewicz

  2. Department of Obstetrics and Gynecology, Kitasato University, Kanagawa-Ken, Japan

    Hiroki Hata & Hiroyuki Kuramoto

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  1. Erlio Gurpide
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  2. Christian F. Holinka
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  3. Yuzuru Anzai
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  4. Hiroki Hata
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  5. Hiroyuki Kuramoto
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  6. Sharon Kassan
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  7. Leszek Markiewicz
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  1. Oakland University, Rochester, Michigan, USA

    Virinder K. Moudgil (Chairman) (Chairman)

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© 1988 Plenum Press, New York

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Gurpide, E. et al. (1988). Estrogen Actions on Endometrial Adenocarcinoma. In: Moudgil, V.K. (eds) Steroid Receptors in Health and Disease. Serono Symposia, USA. Springer, Boston, MA. https://doi.org/10.1007/978-1-4684-5541-0_20

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  • DOI: https://doi.org/10.1007/978-1-4684-5541-0_20

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