GYNECOLOGICAL DISEASES AND ENDOMETRIAL CANCER: CLINICAL MANIFESTATIONS AND SURGICAL EVALUATION

Abstract

Gynecological diseases encompass a wide range of conditions that affect the female reproductive system, including infections, hormonal disorders, endometriosis, uterine fibroids and gynecological cancers. Among these, endometrial cancer stands out as the most common type of uterine cancer, generally occurring in postmenopausal women. Its clinical manifestations include abnormal vaginal bleeding, pelvic pain, and unexplained weight loss. Surgical evaluation is a crucial component of both diagnosis and treatment, with procedures ranging from endometrial biopsies to complete hysterectomies, depending on the stage and severity of the disease. The scientific literature highlights the importance of an early and accurate diagnosis to improve treatment results and patient survival. Objective: to synthesize existing evidence on the clinical manifestations and surgical evaluation of gynecological diseases, with an emphasis on endometrial cancer, aiming to provide a comprehensive overview of current practices and identify gaps in knowledge that can guide future research. Methodology: the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist was followed, using the PubMed, Scielo and Web of Science databases. The descriptors used were: "gynecological diseases", "endometrial cancer", "clinical manifestations", "surgical evaluation" and "diagnosis". Three inclusion criteria were: studies published in the last 10 years, articles in English, Portuguese or Spanish, and studies involving human beings. Exclusion criteria included: literature reviews, studies with fewer than 50 participants and articles that did not directly address endometrial cancer or its clinical manifestations and surgical evaluation. Results: showed that the most common clinical manifestations of endometrial cancer include postmenopausal vaginal bleeding, pelvic pain and unexplained weight loss. Surgical evaluation varied widely, with hysterectomy being the most frequent surgical treatment, especially in advanced cases. Laparoscopy and robotic surgery were also mentioned as less invasive and effective approaches. Furthermore, the importance of a multidisciplinary approach to diagnosis and treatment was emphasized, involving gynecologists, oncologists, radiologists and pathologists. Conclusion: This review highlighted the importance of early diagnosis and adequate surgical evaluation in the management of endometrial cancer. Clinical manifestations, although variable, are crucial for the initial detection of the disease. The diversity in surgical approaches reflects the complexity of the treatment, which must be personalized according to the individual characteristics of each patient. Interdisciplinary collaboration was essential for the success of the treatment and improvement of the patients’ quality of life.