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Query: UMLS:C0476089 (endometrial cancer)
 11,379 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To determine the association between the incidence of endometrial cancer and the use of estrogen in menopausal and post-menopausal women, we retrospectively compared 317 patients with adenocarcinoma of the endometrium with an equal number of matched controls having other gynecologic neoplasms; 152 patients used estrogen, as compared to 54 of 317 controls. Thus, the risk of endometrial cancer was 4.5 times greater among women exposed to estrogen therapy. When estrogen use was adjusted for concomitant variables such as obesity, hypertension, diabetes, parity, referral pattern, age at diagnosis, year of diagnosis and other gynecologic neoplasms, the magnitude of the increased relative risk was associated with several of these variables, and was highest in patients without obesity and hypertension. Exogenous estrogen therapy is associated with an increased risk of endometrial carcinoma, but this increased relative risk is less apparent in patients with physiologic characteristics previously associated with an increased risk.
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PMID:Association of exogenous estrogen and endometrial carcinoma. 118 89

17 beta-Hydroxysteroid dehydrogenase (17HSD) and estrogen (ER) and progestin (PR) receptors were analyzed immunohistochemically in tissue specimens of 66 patients with endometrial adenocarcinoma. Plasma steroid concentrations were correlated to immunohistochemical data. 17HSD was detected in 48% of the specimens and was stained in the cytoplasm of epithelial cells. The tissues were characterized by a heterogeneous staining pattern for 17HSD. In some patients, intensively stained epithelial cell clusters were seen, indicating that local factors were responsible for the expression of the protein. Poorly differentiated adenocarcinoma specimens tended to have no 17HSD more frequently than did well or moderately differentiated tissues. ER and PR were detectable in 24% and 28% of patients, respectively, and were localized in the nuclei of epithelial and stromal cells. There was a significant correlation between 17HSD and PR staining and an inverse correlation between plasma progesterone concentrations and 17HSD staining. This is contrary to the data obtained with normal endometrium. The main reason for this inverse relation between endometrial 17HSD staining and plasma progesterone concentrations was that, in some postmenopausal patients with low plasma progesterone concentrations, intense staining for 17HSD was detectable in the endometrial carcinoma specimens. This indicates a major difference in the regulation of 17HSD expression in endometrial adenocarcinomas, compared with normal tissues of premenopausal women.
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PMID:Immunohistochemical study of the human 17 beta-hydroxysteroid dehydrogenase and steroid receptors in endometrial adenocarcinoma. 132 75

The prognostic significance of vascular invasion as compared with other pathologic features was evaluated in 102 cases of endometrioid adenocarcinoma confined to the uterus (Stage I) treated by hysterectomy. By univariate analysis, survival most closely correlated with patient age, architectural grade, depth of myometrial invasion, vascular invasion, and the presence of perivascular lymphocytic infiltrates. Among these, vascular invasion and the presence of perivascular lymphocytic infiltrates were the best indicators of prognosis. In contrast to perivascular lymphocytic infiltrates, the presence of a lymphocytic infiltrate at the tumor-myometrial junction was not related to outcome. The presence of vascular invasion was found to be associated closely with perivascular lymphocytic infiltrates. These two features may be related biologically and were designated "vascular invasion-associated changes." By multivariate analysis with the Cox proportional hazards model, the depth of myometrial invasion and the presence of vascular invasion-associated changes were found to provide a highly reliable model for predicting outcome. The highly predictive value of vascular invasion as a prognostic factor in Stage I endometrial carcinoma suggests that it is the mechanism by which occult metastasis develops in patients whose disease progresses after hysterectomy. It is likely that other variables correlating with recurrence, such as the presence of deep myometrial invasion and high tumor grade, may act by increasing the probability of vascular invasion and subsequent metastasis.
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PMID:Combined assessment of vascular and myometrial invasion as a model to predict prognosis in stage I endometrioid adenocarcinoma of the uterine corpus. 137 12

Fourteen cases of Papillary Endometrial Carcinoma (EC) were analyzed by Interactive Computerized Morphometry. Seven cases were diagnosed as well differentiated adenocarcinomas with papillary features (PF) and belonged to a group of EC with associated adenomatous hyperplasia (AH). Seven cases were diagnosed as uterine papillary serous carcinomas (PA) and belonged to a group of EC without associated AH. Two morphometric procedures were used. DRAW for the characterization of individual nuclei (area, perimeter, chord) and NU-MEAS for tissue architectural features (crowding and stratification). Using a stepwise discriminant multifactorial analysis, both methods proved to be accurate for the two diagnostic categories, as shown by the 100% posterior probabilities and by the two diagnostic categories, as shown by the 100% posterior probabilities and by the distances between group means. A doubtful case was analyzed and classified using a K-nearest neighbor procedure, compared to the individual case in the database. The distinction between the two types of papillary EC is important for the differential diagnosis of the two lesions. Well differentiated adenocarcinoma with papillary features is seen usually in the context of a well-differentiated adenocarcinoma, in a group of patients known to have estrogen-related less aggressive tumors. Uterine papillary serous carcinoma was described to have a biological behavior similar to that of papillary ovarian carcinoma and is encountered in a group of patients with more invasive and less differentiated EC2. Computerized interactive morphometry is a valuable method to use for the accuracy of this differential diagnosis in doubtful cases.
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PMID:Two types of endometrial papillary neoplasm. A morphometric study. 140 74

The distribution of DNA ploidy levels and its prognostic significance in cervical cancer (including squamous cell carcinoma and adenocarcinoma) and endometrial cancer is discussed. DNA aneuploidy was observed in most of the cases with either the histological type of cervical cancer and in half of those with endometrial cancer. The DNA ploidy level of the tumor showed a characteristic distribution according to its histological type or grade. Although several investigators have already reported that patients with DNA diploid uterine tumors had a better survival than those with DNA aneuploid uterine tumors, further research is required before a definite conclusion can be attained on the prognostic value of the degree of DNA ploidy measurement in uterine cancer.
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PMID:[Flow cytometric evaluation of DNA ploidy pattern in uterine cancer]. 144 14

A high incidence of endometrial adenocarcinoma and pre-neoplastic lesions was induced in ICR mice treated with N-methyl-N-nitrosourea and 17 beta-oestradiol within 23 weeks. The endometrial lesions were histopathologically similar to those of human subjects. To assess the cell proliferative activity of these lesions, a one-step silver colloid staining for nucleolar organizer regions was applied and the numbers of silver-stained nucleolar organizer regions (AgNORs) were counted. The mean numbers +/- SD of AgNORs in each lesion were as follows: simple hyperplasia, 2.07 +/- 0.36; complex hyperplasia without cytological atypia, 2.79 +/- 0.39; complex hyperplasia with cytological atypia, 3.43 +/- 0.38; and well-differentiated adenocarcinoma, 4.17 +/- 0.40. Significant differences were observed in each lesion (P < 0.001). These findings suggest that the mean numbers of Ag-NORs are increased in the progression of neoplastic changes in the mouse endometrium, as in human endometrial lesions. This rapid induction model of endometrial carcinoma in mice is useful in the understanding of the histogenesis of endometrial carcinoma in human subjects.
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PMID:Changes of silver-stained nucleolar organizer regions in mouse endometrial carcinogenesis induced by N-methyl-N-nitrosourea and 17 beta-oestradiol. 145 90

A retrospective analysis of treatment for endometrial carcinoma is reported here. From 1987 to 1989, 138 patients were referred to the oncology department following total abdominal hysterectomy and bilateral salpingo-oophorectomy for endometrial cancer. Forty-seven patients were not prescribed postoperative radiotherapy; 31 had Stage I well differentiated adenocarcinoma with minimal myometrial invasion, while the remaining 16 patients were considered unfit for postoperative radiotherapy. There were no instances of local relapse amongst the 31 patients with minimal myometrial invasion. The remaining 91 patients all received external beam irradiation to the pelvis and, according to the preference of the individual therapist, 51 were prescribed additional intracavitary vault caesium-137. Patients receiving postoperative radiotherapy were analysed according to whether or not they received additional intracavitary vault caesium. The two groups were also analysed for incidence of vaginal vault recurrence and treatment related morbidity. In the group receiving additional intracavitary treatment more patients had Stage II or III disease (P < 0.05), and had greater depth of myometrial invasion (P < 0.05). Vaginal vault recurrence was not observed in patients receiving intracavitary therapy in addition to external beam therapy. Four patients (10%) receiving external beam therapy alone developed vaginal vault recurrence. The incidence of Kottmeier-Perez grade 2 or 3 bowel toxicity following treatment was significantly higher in those patients receiving combined treatment (18% vs. 2.5%; P = 0.03).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Endometrial carcinoma: does the addition of intracavitary vault caesium to external beam therapy postoperatively result in improved control or increased morbidity? 146 90

Uterine papillary serous carcinoma (UPSC) is an aggressive malignancy that accounts for a disproportionate number of intraabdominal failures among endometrial carcinoma patients. The histologic appearance and tendency toward intraabdominal spread resemble those of papillary serous adenocarcinoma of the ovary. Because approximately 70% of untreated ovarian carcinoma patients respond to platinum-based chemotherapy, it has been suggested that UPSC patients might respond to similar treatment regimens. Twenty patients with UPSC were treated with cisplatin, doxorubicin (Adriamycin), cyclophosphamide (PAC) chemotherapy between January 1982 and December 1989. They included 9 patients with advanced primary disease, 5 with recurrence, and 6 who received PAC as adjuvant therapy. Patients received a mean of five cycles of PAC. Only 2 of 11 patients with measurable disease greater than 2 cm achieved complete clinical responses of 12 and 31 months duration; there were no partial responses. Actuarial 5-year survival for all patients was 23%. The mean progression-free interval was 9 months. Patients with clinical stages I or II disease had a higher survival rate than those with stage III or IV disease (P = 0.003). Survival did not correlate with depth of myometrial invasion (P = 0.81) or size of residual tumor following initial surgery (P = 0.16). Estrogen or progesterone receptors were detected in 10 of 11 tumors tested. Seven of 9 patients tested had elevated serum levels of CA-125 (greater than 35 U/ml). Correlation between CA-125 value and clinical course was demonstrated in 3 of 5 patients who had serial measurements. Of all patients, 3 are currently alive; 1 has documented disease. Moderate to severe toxicity was seen in 14 patients (70%). There was one possible treatment-related death from cardiomyopathy. UPSC, despite its histologic and clinical similarities to ovarian carcinoma, was relatively resistant to PAC chemotherapy in this mixed group of patients.
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PMID:Uterine papillary serous carcinoma (UPSC) treated with cisplatin, doxorubicin, and cyclophosphamide (PAC). 152 8

A retrospective analysis is reported in 858 patients with clinical Stage I carcinoma of the endometrium treated definitively with combined irradiation and total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH-BSO) from January 1960 through December 1986. Most patients received a preoperative intracavitary insertion (3500-4000 mgh to the uterus and a 6500 cGy surface dose to the upper vagina) followed by a TAH-BSO within 1-2 weeks. Some patients received postoperative external beam irradiation (2000 cGy whole pelvis and an additional 3000 cGy to the parametria, with a midline stepwedge) when factors such as deep myometrial invasion were present. Occasionally patients were treated with a preoperative intracavitary insertion and preoperative external beam irradiation (2000 cGy whole pelvis). The 5-year progression-free survivals by FIGO (1988) surgical stage were 93% for IA, 90% for IB, and 91% for Stage IC. An analysis of multiple variables was performed to ascertain their prognostic significance. Factors that significantly affected the 5-year progression-free survivals by univariate analysis were grade (grade 1 = 95%, grade 2 = 88%, grade 3 = 73%; p less than 0.0001), histology (adenoacanthoma = 96%, clear cell = 89%, adenocarcinoma = 89%, papillary = 81%, adenosquamous = 80%; p = 0.04), lower uterine segment involvement (uninvolved = 89%, involved = 73%; p = 0.006), depth of myometrial invasion (no residual tumor = 91%, limited to the endometrium = 96%, less than 1/3 myometrial penetration = 92%, 1/3 - 2/3 = 100%, greater than 2/3 = 50%; p = 0.02), peritoneal cytology (negative = 92%, positive = 56%, p less than 0.0001), uterine serosal involvement (uninvolved = 89%, involved = 55%; p less than 0.0001), vascular space invasion (absent = 89%, present = 75%; p = 0.001), and the presence of extrauterine disease (absent = 90%, present = 64%; p less than 0.0001). A multivariate analysis of these prognostic variables showed that histological grade (p = 0.001), peritoneal cytology (p = 0.004), and uterine serosal involvement were prognostic for local failure and that peritoneal cytology (p less than 0.001), grade (p = 0.001), age (p = 0.002), and extrauterine disease (p = 0.02) were prognostic for the development of distant metastasis.
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PMID:Clinical stage I endometrial cancer: prognostic factors for local control and distant metastasis and implications of the new FIGO surgical staging system. 155 83

Patients with dysgenetic gonads and Turner syndrome are unlikely to develop endometrial carcinoma unless they have received unopposed estrogen replacement therapy. This case describes a 54-year-old woman with Turner syndrome and primary amenorrhea who developed adenocarcinoma of the endometrium without having received hormone replacement. Vaginal bleeding, a pelvic mass, and sepsis were the presenting symptoms. The patient also had diabetes mellitus and hypothyroidism. Polyglandular endocrine patterns are known to occur with a high frequency in these patients. The woman's chromosome studies revealed a modified 46,X,i(Xq) (isochromosome X). This is the first report of an isochromosome X patient to develop endometrial cancer without receiving estrogen replacement. The etiology of this rare case may be an increased propensity for patients with X-chromosome deletions to develop neoplasms in general, or extragonadal estrogen production.
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PMID:Endometrial adenocarcinoma without prior hormone replacement in a diabetic patient with gonadal dysgenesis. 156 85


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