Estrogen and progesterone are female sex hormones that play an important role in endometrial cancer. The presence of estrogen- and progesterone-receptor in cancer cells conveys a favourable prognosis. This thesis demonstrates three groups with distinct prognosis: a group with estrogen/progesterone-receptor presence in 0-10% of cancer cells with unfavourable prognosis, a group with 20-80% with intermediate prognosis and a group with 90-100% with excellent prognosis.
Hormones can be used in the treatment of endometrial cancer. This thesis demonstrates an increase in hormonal therapy use. Progesterone therapy is the most effective form of hormones.
Results of this thesis show that progesterone-receptor should be used to prediction efficacy of hormones. Hormones are effective if progesterone-receptor is present in more than 50% of cancer cells.
Another test for hormone sensitivity, estrogen-receptor pathway test is also investigated in this thesis. The estrogen-receptor pathway test might have additional value in predicting prognosis and effect of hormones.
Willem Jan van Weelden graduated from the study medicine in 2011 and started his residency in gynaecology in 2014. In 2017, he started this PhD trajectory into the role of estrogen and progesterone in development, prognosis and treatment of endometrial cancer. In 2023, Willem Jan will start working as a gynecologist in Canisius Wilhelmina hospital in Nijmegen.