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

A hysteroscope is a useful tool for detecting uterine tumors developed in the cervical canal and uterine cavity which are invisible areas. The hysteroscopy discloses easily the findings, location, size and extent of the lesions. Consequently more correct biopsies may be obtained than the conventional curettages which are blind procedures. This paper comprises the instrumentation, technique and hysteroscopic findings of the malignant uterine tumors. Observation of the cervical canal, namely cervicoscopy reveals mainly the appearance of normal cervical wall, preinvasive and invasive squamous cell carcinoma, adenocarcinoma and sarcoma. Hysteroscopy reveals the appearance of normal uterine cavity, endometrial carcinoma, sarcoma, metastatic uterine carcinoma, invasive carcinoma infiltrated from the adjacent organs and trophoblastic tumors. As a result, endoscopic features of each uterine malignant tumor are summarized as useful criteria for differential diagnosis.
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PMID:[Diagnostic endoscopy for malignant uterine tumors]. 221 46

There is general evidence that the incidence of adenocarcinoma of the cervix has been rising, particularly among younger women. The determinants of these trends, however, remain largely unknown. We have reviewed the epidemiology of adenocarcinoma of the cervix using descriptive data from cancer registration and clinical series and two main sources of analytical data: clinical studies comparing cervical adenocarcinoma (AC) and squamous carcinoma (SC) and formal case-control and cohort epidemiological studies. In both the United States and northern Europe there is evidence of the rising frequency of AC in absolute and relative terms as compared to SC. These trends are generally restricted to younger women: under-age-35 AC incidence approximately doubled from the early 1970s to the early 1980s. Available data, although scanty, consistently show that the frequency of cervical adenocarcinoma rises with the number of partners and with decreasing age at first intercourse, suggesting a potential role for sexually transmitted (viral) factors. In clinical series, nulliparity was reported more frequently in AC than in SC cases but an inconsistent association was found in three formal epidemiological studies. Similarities with the epidemiology of endometrial cancer are also suggested from the association with overweight, while a possible relation with hypertension and diabetes is based on clinical series only and hence more difficult to interpret. Thus, adenocarcinoma of the cervix appears to share epidemiological characteristics with both adenosquamous cancer of the cervix and adenocarcinoma of the endometrium, although uncertainties in classification and registration leave several questions unanswered.
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PMID:Epidemiology of adenocarcinoma of the cervix. 222 71

CA125 (reference value [RV] = 35 U/mL), CA50 (RV = 20 U/mL), CA72.4 (RV = 3.8 U/mL) and SCC (RV = 3.6 ng/mL) levels were retrospectively assayed in blood samples collected at diagnosis from 42 patients with endometrial carcinoma, 45 patients with cervical carcinoma and 68 patients with benign uterine pathology as controls. Among the patients with endometrial carcinoma. CA50 was the antigen with the highest sensitivity (SE) (34.4%) followed by CA125 (26.2%), CA72.4 (21.9%) and SCC (16.7%). The incidence of elevated serum CA125 and CA72.4 levels was significantly greater in advanced stages than in early ones (66.7% vs 19.4%, p = 0.032 for CA125; 66.7% vs 11.5%, p = 0.012 for CA72.4), while CA50 positivity was not significantly correlated with the extent of disease (50% in advanced stages vs 30.8% in early ones, p = 0.38). Among the patients with cervical carcinoma, CA125 and CA50 respectively showed a SE of 33.3% and of 42.9% for adenocarcinoma, while SCC had a SE of 33.3% and of 42.9% for squamous cell adenocarcinoma; in particular among the patients with squamous cell carcinoma, the incidence of elevated SCC levels was correlated with the extent of tumor (57.1% in advanced stages vs 12.5% in early ones, p = 0.013). In conclusion, CA50 and CA125 were the most sensitive tumor markers in both endometrial carcinoma and cervical adenocarcinoma, while SCC was the most reliable antigen for squamous cell carcinoma of the cervix. Because of the affinity of SCC, CA50 and CA125 for different histological types of cervical carcinoma, the combined evaluation of SCC with CA50 or CA125 showed an increased SE with respect to each marker alone.
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PMID:A comparison of pretreatment serum levels of four tumor markers in patients with endometrial and cervical carcinoma. 224 12

In a histological review of all 1985 cases of endometrial carcinoma in Norway diagnosed in the period 1970 through 1977, 22 patients (1.1%) with serous papillary carcinoma (ESPC) were identified. Mean age at diagnosis was 72 years, which was significantly higher than for patients with ordinary adenocarcinoma. All patients were followed at least 10 years. The crude 5- and 10-year survival rates were 27 and 14%. Only three patients survived longer than 10 years and all of these had had stage I tumors. In 19 available curettage specimens ESPC could be identified in 18. This could have implications regarding choice of therapy because this subtype of endometrial carcinoma is very aggressive. It is most often found in elderly women.
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PMID:Serous papillary carcinoma of the endometrium: a histopathological study of 22 cases. 225 69

In 1988, the Federation of International Gynecologic Oncologists (FIGO) adopted a new staging system mandating preradiotherapy surgical staging in endometrial cancer. To evaluate the potential impact of this recommendation on patients with cervical involvement (stage II), an analysis of 184 consecutive patients with clinical or pathologic stage II carcinoma of the endometrium treated with definitive intent at three institutions was performed. Median follow-up time was 5.7 years. Treatment consisted of total abdominal hysterectomy and bilateral salpingo-oophorectomy with preoperative radiation therapy (RT) (54%), postoperative RT (37%), or both (1%); definitive RT (7%); or radical hysterectomy (1%). The median total RT dose for combined intracavitary and external beam or either alone was 70.6 Gy with a range of 32.4-105.0 Gy. The overall 5-year survival rate and disease-free survival (DFS) rate at 5 years were 70 and 79%, respectively. Of patients treated with surgery and adjuvant radiation, 13% (22/168) had infield pelvic failure (PF) and 18% (31/168) had distant metastases (DM). Patterns of failure in patients receiving preoperative and postoperative radiotherapy are presented. Univariate analysis of pretreatment and treatment factors, including histology, grade, clinical stage, extent of cervical involvement, and timing of adjuvant radiation, revealed histology and grade to be significant predictors of DFS, PF, and DM. Clinical stage was a significant predictor of DFS only in univariate analysis. Multivariate analysis found only histology (P less than 0.001) and grade (P = 0.002) to be predictors of DFS. From this review, we conclude that histology and grade are independent predictors of DFS, and more aggressive treatment should be directed at patients with stage II endometrial cancer found to have high grade adenocarcinoma or papillary serous/clear cell histologic variants. The timing of radiotherapy was not an independent predictor of outcome; therefore, preradiotherapy surgical staging should not impact on DFS and should provide surgicopathologic information to tailor treatment and predict prognosis. The FIGO clinical staging system used in this analysis was not an independent predictor of outcome, and future multivariate analyses will be necessary to test the predictive value on outcome of the new 1988 FIGO surgical staging.
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PMID:Influence of grade, histologic subtype, and timing of radiotherapy on outcome among patients with stage II carcinoma of the endometrium. 225 85

Ninety-two patients with invasive cervical cancer initially treated by standard hysterectomy were evaluated for features related to survival. The cell type included squamous cell (64) and adenocarcinoma (28). Posthysterectomy therapy included radiation therapy (78), pelvic lymphadenectomy (3), and radical parametrectomy (1). Hysterectomy was initially performed for the following indications: invasive lesion missed on cone biopsy, 17; hemorrhage at cone biopsy, 2; bleeding, 16; abnormal cytology, 13; presumed endometrial cancer, 9; known cancer, 7; pelvic relaxation, 5; planned therapy, 3; fibroids, 3; adnexal mass, 2; chronic discharge, 1; pyometra, 1; postpartum endometritis, 1. The cumulative 5-year survival for all patients was 68%, for squamous cell 80%, and for adenocarcinoma 41% (P = 0.0001). On postoperative evaluation 84 patients had presumed Stage I and 7 had parametrial involvement (Stage II). Patients with Stage I disease were then examined separately by cell type. Fifty-seven patients with squamous cell disease had cumulative 5-year survival of 85%. Radiation therapy in the immediate postoperative period produced a survival of 88%, compared to observation only with a 69% survival (P = .10). Patients with squamous cell disease and more than 50% cervical invasion had a 75% survival compared to a 96% survival for those with less than 50% (P = .02). The presence of disease at the surgical margins, grade, age, and increase in radiation therapy did not influence survival. Twenty-seven patients with presumed Stage I adenocarcinoma had a cumulative 5-year survival rate of 42%. Survival was significantly influenced by tumor grade (P = .018) and the amount of postoperative radiation therapy (P = .03), while age, amount of residual tumor, and presence of tumor at surgical margins did not influence survival. Patients with invasive squamous cell carcinoma treated by standard hysterectomy and postoperative radiation therapy have a prognosis similar to those treated initially by either radical surgery or radiation therapy. Patients with adenocarcinoma appear to have a significantly decreased survival when compared to patients with squamous cell disease and their prognosis is related to tumor grade and the amount of postoperative pelvic radiation.
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PMID:Invasive cervical cancer treated initially by standard hysterectomy. 229 56

Uterine lipoma (UL) is a rare tumor frequently presenting as leiomyolipoma. Even more uncommon is the association of UL and endometrial carcinoma (EC) for which only two cases have been reported. We present the case of a 73 years old female of French origin complaining of vaginal bleeding. Initial examination under general anesthesia found a 13 cm length uterine cavity with a large tumor located in the anterior wall. After curettage, the histopathologic analysis diagnosed a moderately differentiated adenocarcinoma of the endometrium. Patient work-up showed no evidence of extension outside the uterus (stage Ib). Treatment consisted of pelvic and iliac lymph node external irradiation with subsequent vaginal intracavitary irradiation followed, 6 weeks later, by total extra-fascial hysterectomy without lymph node dissection. Pathologic examination found a small EC with limited infiltration of the myometrium (stage Ia) associated with a 10 x 9 x 7 cm yellowish fibrolipoma type tumor without smooth muscle pattern. First described by Lobstein in 1816, UL are uncommon and casually diagnosed. The association with EC is rare and without evident relationship. Ultrasound (US) and computed tomographic (CT) appearances allow a diagnostic approach. US show a highly echogenic central tumor with a thin moderately echoic rim. CT appearance of UL is a central, well delimited fat-density tumor. The etiopathogenesis of UL is unclear, attributed to a possible leiomyoma evolution for Willen or a myometrial cell metaplasia for Brandfass.
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PMID:[The association of uterine lipoma and cancer of the endometrium. Diagnostic and etiopathogenic approach]. 234 72

Thirty-eight patients with irregular perimenopausal hemorrhage in whom carcinoma of the endometrium had been diagnosed by fractional curettage were included in the study. In all patients, the concentration of CA-125 tumor marker was determined preoperatively. Findings were compared to the depth of penetration of stage I adenocarcinoma into the endometrium. A statistically significantly higher CA-125 value was recorded when the tumor had penetrated more than one-third of the uterine wall. This method could be successfully combined with other techniques in therapy planning.
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PMID:Concentrations of CA-125 tumor marker in endometrial carcinoma. 235 23

Much evidence has been suggested that cystic, adenomatous, and atypical hyperplasia as well as adenocarcinoma in situ of the endometrium may ultimately progress to invasive cancer. Consequently, these lesions should be considered to be precursors of endometrial cancer. Twelve postmenopausal and three perimenopausal women with vaginal bleeding due to endometrial hyperplasia received 400 mg/d of danazol orally for 3 months. After 15 to 30 days of continuous danazol therapy, the endometrial glands ceased to grow and became smaller and rounder. The lumina of glands were narrow and contained no secretion. The nucleic mitosis of the glands disappeared. All women showed regression of hyperplastic endometrium within 2 to 3 months of initial treatment. In the 15 cases treated, endometrial hyperplasia could be controlled successfully with danazol without further recurrence and/or progression of the disease. In summary, danazol should be an effective and safe alternative therapy to progesterone for the treatment of endometrial hyperplasia.
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PMID:Clinical effects of danazol on endometrial hyperplasia in menopausal and postmenopausal women. 238 26

Two kinds of clones were isolated successfully from the HHUA 95 cells that were derived from a human well-differentiated adenocarcinoma of endometrium, with 6-thioguanine (6-TG) selection and transfection with plasmid containing the neo gene (pSV2 neo). One clone was resistant to the 6-TG (6-TGr 95) and the other to both the 6-TG and the G418 (6-TGr-neor 95). Karyotypes of these three kinds of cells were normal, even though random chromosome abnormalities were observed in some cells. Two types of cell fusion were performed: one consisted of the hybridization between 6-TGr 95 cells and normal human fibroblasts (HF), and the other, between 6-TGr-neor 95 and human choriocarcinoma cells (CC1). Tumorigenicity of both hybrid cell types was completely suppressed. Complementation for genetic lesions given by cell hybridization was assumed to be responsible for the suppression of tumorigenicity. These results suggest that genetic losses played an essential role in the evolution of the malignant phenotype of endometrial carcinoma cells. The data obtained from the endometrial carcinoma could not be used directly for the understanding of suppression mechanisms of choriocarcinoma.
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PMID:Isolation of clones resistant to 6-thioguanine and G418 from HHUA endometrial carcinoma cells and their application to cell hybridization. 239 65


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