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 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One hundred and forty-five patients with confirmed endometrial carcinoma treated at Kumamoto University Hospital were studied from the clinicopathological point of view. As risk factors, the incidence of high age, postmenopause, atypical genital bleeding, sterility, nulliparity, diabetes mellitus, hypertension and obesity was showed to be high. These factors may be expected to assist in screening for early diagnosis by using each factor or combination of factors. As prognostic factors, we examined the relationship between stage, depth of myometrial invasion, histological grade, histological type and survival rate. The stage was shown to be a most important predicator of survival. The depth of myometrial invasion and the histological grade closely correlated with the stage. The relationship between the histological subtype, especially papillary serous carcinoma (PSC) and prognosis, was investigated in our series of studies. PSC found in an incidence of 9.4% had a relatively poor prognosis compared with endometrioid carcinoma. Its 5-year survival rate was only 30%. Because PSC has a potential for aggressive invasion and rapid metastasis as compared to endometrioid carcinoma, careful histological examination and aggressive treatment are warranted.
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PMID:[Clinical studies of 145 cases of endometrial carcinoma--analysis of prognostic factors, especially pathological types]. 377 1

Among 30 cases of uterine body cancers, in eight cases (Stage IA, two cases; Stage IB, six cases) uterine adenomyosis was demonstrated microscopically. The age range was from 46 to 66 years with a median of 56. When these eight cases were compared with the 12 cases of Stage I endometrial cancer without adenomyosis, there was no difference in either menstrual history or family history, although past histories of hypertension and diabetes mellitus were found in these eight cases. The mean obesity index was 127 in eight cases and 116 in 12 cases. Seven of these eight cases were pure tubular adenocarcinoma. From the standpoint of early myometrial infiltration of the endometrial cancer, these eight cases not only provided a good model to survey early endometrial cancer but also suggested a common stimulus, such as estrogen, in both endometrial cancer and uterine adenomyosis.
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PMID:Clinicopathologic study of eight cases of uterine body cancers associated with endometriosis interna (uterine adenomyosis). 382 17

Early diagnosis of endometrial carcinoma enables one to achieve a cure rate of 80%. The purpose of this study is to characterize the patients who are prone to develop adenocarcinoma by simple epidemiologic and clinical data. The data of 109 consecutive patients who developed adenocarcinoma were compared with those of 146 control hysterectomy patients using logistic regression analysis. The following characteristics of patients who developed adenocarcinoma were identified: parity (P less than 0.0001), diabetes mellitus (P less than 0.003), hypertension (P less than 0.0001), obesity (P less than 0.0006), treatment with exogenous estrogen (P less than 0.001), and second primary tumor. The logistic regression formula classified correctly 77% of all patients to their actual group. The study showed that the relative risk of a patient to develop adenocarcinoma can be estimated from simple and readily available epidemiologic and clinical data.
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PMID:A novel approach to the analysis of risk factors in endometrial carcinoma. 398 36

The clinical records and pathologic specimens from 150 patients with endometrial carcinoma were reviewed to test the hypothesis that constitutionally predisposed patients with evidence of endogenous hyperestrinism (i.e., obesity, hypertension, diabetes, nulliparity, leiomyomata, adenomyosis) have a more benign form of carcinoma than do patients who do not fit this profile. Our results do not support this hypothesis, but do reveal certain other prognostic indicators, in addition to factors relating to the tumor itself, including stage, grade, histologic type, and extent of invasion. These indicators include: (a) age and menopausal status--women over 50 years of age, and more impressively, postmenopausal women of any age, have less favorable histology, staging, and survival; (b) race--black women have higher-grade tumors, higher-stage tumors, and poorer survival rates than white women; (c) hyperplasia--when hyperplasia is found in the biopsy, curettage, or hysterectomy specimen, the accompanying carcinoma is of a much more favorable type and extent, and survival rates are significantly better. The reasons for these correlations are not fully understood, and possible explanations are discussed. There may be two distinct patterns of endometrial carcinoma: a prognostically favorable one arising on a background of hyperplasia predominantly in premenopausal women, and a prognostically unfavorable one, occurring principally in postmenopausal women without hyperplasia. Empirically, we advise pathologists to comment on the presence or absence of hyperplasia in any specimen in which endometrial carcinoma is diagnosed.
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PMID:Endometrial carcinoma: nontumor factors in prognosis. 401 9

It was shown that the risk for endometrial cancer development in uterine myoma increases 43-fold in cases of diabetes mellitus, hypertension and obesity, 20-fold in adnexitis, 15-fold in hyperplastic endometrial lesions and 9.8-fold in the multipara.
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PMID:[Risk factors for the development of endometrial cancer in uterine myoma]. 402 48

In a series of 173 consecutive patients with endometrial cancer treated by a fixed protocol 62 tumors (36%) appear "estrogen independent," i.e. there is no history of estrogen ingestion and no recognized risk factors such as obesity or diabetes mellitus. A high proportion of these tumors are of advanced stage and grade. Prognosis is poorer and mortality higher than for "estrogen-dependent" tumors. Twenty-two tumors were truly occult (no spontaneous vaginal bleeding). Factors which identify this high-risk group are described and the reasons for delay in diagnosis discussed. Spread by intraperitoneal dissemination is considered a major factor in the poorer prognosis. Cytology of peritoneal washings is a useful diagnostic and prognostic aid. An estrogen provocation test is suggested as a means of earlier recognition which could reduce mortality in this group.
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PMID:Occult, high-risk endometrial cancer. 405 14

In a prospective study, mortality ratios were computed in relation to overweight, cancer, and other diseases. The study included 750 000 men and women followed for 12 years. Each person was given a weight index. Death rates for overweight and underweight persons were compared with rates for persons of average weight. Men who were 40% or more overweight had a mortality ratio for cancer of 1.33; women, 1.55. This ratio was much lower than that for coronary heart disease (men, 1.95; and women, 2.07); diabetes (5.19 and 7.90), and digestive diseases (3.99 and 2.29). Overweight men had significantly higher mortality ratios for colorectal and prostate cancer; overweight women had much higher rates for cancer of the endometrium, gall bladder, and cervix; and also significantly higher rates for ovary and breast cancer.
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PMID:Overweight and cancer. 406 20

Information on whether a woman had ever had any children was recorded for all deaths registered to ever-married women in England and Wales between 1938 and 1960. Analysis of the relation between parity and cause of death for 1.2 million women aged 45-74 years revealed that parous women had lower mortality from breast, ovarian, and endometrial cancer than did nulliparous women but a higher mortality from diabetes mellitus, gallbladder disease, cancer of the uterine cervix, nephritis and nephrosis, hypertension, ischaemic and degenerative heart disease, cerebrovascular disease, and all causes of death. There is a parallel between the long term effects of pregnancy and of oral contraceptives on health.
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PMID:Long term effects of childbearing on health. 408 66

This is a general review of the types of steroid contraceptives, their mode of action and efficacy, and major complications, including thromboembolism, cancer, jaundice, diabetes and hypertension. Tables show combined and sequential pills available in Belgium, by brand name, manufacturer, and composition. About 300,000 Belgian women use the pill. Since endometrial cancer is probably, and cervical cancer certainly, not enhanced by the pill, the maternal death rate among pill users is about 5% of the rate among unprotected sexually active women.
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PMID:[Hormonal contraception]. 472 79

This prospective study determines the presence of a consistent endocrine disturbance in patients with endometrial carcinoma. A major requirement of the study was an unbiased control group matched as to age, race, economic status, and primary reason for referral. All patients with untreated endometrial carcinoma or postmenopausal bleeding were studied and grouped into: 1) endometrial carcinoma (n=56), and 2) atrophic endometrium (n=83), or the "bleeding" controls. Average age of patients with carcinoma was 63.9 years and that of controls, 61.3 years. Factors studied were glucose metabolism, estrogenic activity, gonadotropin excretion, obesity, hypertension, time of climacteric, fertility, and menstrual history. By averaging deviations from ideal weight, cancer patients were found to be 13.1 pounds heavier than the control group (49.8 pounds vs. 36.7 for the controls). Analysis of fertility data showed that age at time of marriage in patients who were parous compared with those who were nulliparous was 20.1 and 26.8 years respectively for the carcinoma group, and 20.4 and 27.5 years for the bleeding controls. Of parous cancer patients, 6.3% used contraception vs. 13% of the controls. These data do not suggest that pregnancy prevention by late marriage or contraception plays a significant role in the later development of endometrial carcinoma. Hypertension, time of menopause, diabetes, estrogenic activity, and gonadotropin excretion did not exhibit significant effects in the development of carcinoma. The findings support those of Corscaden, Fertig, and Gusberg that obesity and infertility are statistical concomitants with endometrial carcinoma but contradict current belief that there is direct evidence of abnormal endocrine state (e.g., glucose metabolism, estrogen stimulation, or anterior pituitary activity).
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PMID:Endocrine factors in endometrial carcinoma. A preliminary report. 601 48


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