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

The relationship between monopausal estrogen treatment and endometrial cancer is discussed. One must consider the facultative co-carinogeninity of certain hormones. In lower dosages they may have a terrain effect or unspecific permissive effect on the development of cancer, yet when used in high dosages, e.g. estriol, they can inhibit cancer growth. There are also many predisposing factors to developing cancer which should be taken into consideration when interpreting research results. Although American studies have shown a relationship between therapeutic menopausal estrogen treatment and endometrial cancer, European studies indicate that there is no increased risk if certain guidelines are followed. These include: cyclical treatment, lowest possible hormone dosages, use of gestagen, use of estriol where possible, and consideration of predisposing factors. These guidelines were not followed in the U.S. studies.
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PMID:[Estrogens and endometrial carcinoma. Position paper on the publication of the drug commission]. 3 20

Circulating carcinoembryonic antigen (CEA) and alpha fetoprotein (AFP) levels were measured by radioimmunoassay in 53 patients with carcinoma of the ovary, 16 patients with other malignant genital tumors, and 31 women with nonmalignant diseases of the genital tract. The serum CEA concentration was elevated (greater than 5 ng/ml) in 11 patients with ovarian cancer, 2 patients with endometrial cancer, 1 patient with carcinoma of the cervix, and 1 patient with a benign embryonal cystic teratoma. Elevated CEA levels were found only in patients with advanced malignant disease, while early stages were associated with normal CEA concentrations. AFP levels were normal in all but 1 patient. Both CEA and AFP levels were markedly raised in a case of advanced genital carcinoma arising probably from the ovary. Ascitic fluid of another patient with ovarian cancer contained a high concentration of CEA, giving an identical reaction in immunodiffusion with CEA from colon cancer. The present results indicate that while the increased expression of carcinofetal components takes place in some malignant tumors of the female genital tract, it is usually a late phenomenon.
Cancer 1975 May
PMID:Carcinoembryonic antigen and alpha fetoprotein in malignant tumors of the female genital tract. 4 62

Many scientists have criticized the mandatory use of dogs for studies of the chronic toxicity of synthetic steroidal contraceptive hormones. The estimated annual incidence rates for cancer of all sites in dogs is 381.2/100,000 dogs. The estimated relative risk (R) value for the occurrence of tumors in the Beagle breed is 0.9; for malignant tumors, the R value in the Beagle is 0.8. A review of the hormonal potency of various contraceptive steroids in the Beagles indicates that progestogenic compounds generally produce a much lower progestational activity in dogs than in women, and the the predominant hormonal action of norethisterone in dogs is estrogenicity rather than progestogenicity. This weak activity for the canine species may account for some of the toxicological findings for norethisterone and related compounds in the Beagle. It is also possible that there are species differences in the relative affinities of estrogen and progesterone receptors for contraceptive steroids. Studies on long-term administration to female Beagle dogs suggest that the nodules found in the mammary gland are not histologically comparable to mammary tumors found in the human female although there is a superficial morphological resemblance to some forms of human mammary dysplasia. Several authors suggest that the results of testing progestational compounds in Beagles are unlikely to be indicative of a potential hazard to the human female. In testing megestrol acetate, it is suggested that the unique sensitivity of the canine females to megestrol acetate is exemplified by intense mammary development at dose levels 10 times the human oral contraceptive level. In contrast, daily dose levels of 500 mg/day in women as a palliative for endometrial cancer have been used with no serious side effects or mammary enlargement. Also the canine mammary gland produces certain pathological changes following administration of natural or synthetic progesterones in a way not readily seen in other species. Possible alternative models (cat, pig) for contraceptive steroid toxicological studies and recommendations for future research are discussed.
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PMID:Contraceptive steroid toxicology in the Beagle dog and its relevance to human carcinogenicity. 6 32

Two hundred patients at high risk for endometrial adenocarcinoma were screened using the Gravlee Jet Washer. Tissue obtained from the first 100 patients was processed by cell block technic alone; tissue from the second 100 patients was processed by cell block plus direct smear and Nucleopore filtration stained by the Papanicolaou method. All patients had histologic diagnosis by fractional curettage. Six of 12 patients with a tissue diagnosis of carcinoma were missed by the jet washer using the cell block technic alone. In the second 100 patients, no cases of cancer were missed using both cell block and cytologic technics. Technic and application of the jet washer in screening for endometrial carcinoma are discussed. We conclude that the Gravlee Jet Washer is a safe, effective screening tool which frequently may replace diagnostic curettage; however, if abnormal bleeding persists, curettage must be done.
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PMID:Evaluation of the Gravlee Jet Washer using combined cell block/cytologic interpretations. 6 43

The treatment regimens are described in 74 patients with endometrial disease among 850 climacteric women receiving oestrogen therapy. Cystic hyperplasia was associated with unopposed oestrogen therapy without progestagen. Two courses of 21 days of 5 mg norethisterone daily caused reversion to normal in all 57 cases of cystic hyperplasia and 6 of the 8 cases of atypical hyperplasia. 4 cases of endometrial carcinoma referred from elsewhere demonstrated the problems of inappropriate and unsupervised unopposed oestrogen therapy and the difficulty in distinguishing severe hyperplasia from malignancy. Cyclical low-dose oestrogen therapy with 7--13 days of progestagen does not seem to increase the risk of endometrial hyperplasia or carcinoma.
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PMID:Prevention and treatment of endometrial disease in climacteric women receiving oestrogen therapy. 8 11

Dr Thom and her colleagues (Sept. 1, p. 455) are incorrect when they state that the U.S. case-control studies of endometrial cancer and oestrogen use "are open to criticism on grounds of selection of patients, poor medical supervision, inappropriate hormone therapy, and lack of clarification of the pathology by the addition of progestagens." It is not the studies which are open to criticism on the grounds stated but the way in which oestrogen therapy had been administered before the publication of these studies. A case-control study compares the frequency of exposure to a suspect carcinogen (oestrogens, in the example of endometrial carcinoma) to that of a control group. Since it was not at all a common practice to prescribe oestrogen with a progestagen when these studies were done, few histories of this combined regimen were found in either the cases or controls. But it is a great mistake to conclude that the absence of data on the risk of combined oestrogen and progestagen therapy means that there is no risk attached to combined therapy. The case-control studies that have thus far been reported shed no light on this risk because the regimen was too rarely used for these studies to have picked up a risk if indeed it was present. Thom et al. suggest that treatment with progestagen is effective in preventing or reversing endometrial hyperplasia. It is not yet well established that hyperplasia is a precursor to neoplasia. Thom et al. may be correct in believing that the combined regimen is safe but we must be perfectly clear about the meaning of the results of our case-control study, the largest reported to date. Our results do not put the combined regimen beyond suspicion but rather point up the need for continued monitoring of this regimen for cancer risk until the issue can be settled one way or the other. Meanwhile, the unfortunate experience with widely prescribed unopposed oestrogens should serve as a warning that any recommendations about prolonged use of these substances should be made with considerable caution.
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PMID:Oestrogen-replacement therapy. 9 Aug 98

Red cells containing Hb F (F cells) were detected by immunofluorescence using a specific antiserum. In normal persons, the number of F cells was 2.5 +/- 1.1%. A significantly increased number of F cells was found in 65% of patients with cancer of the ovary, 69% of patients with cancer of the endometrium and in 22% of patients with cancer of the cervix. Highest values were obtained in cancer of the ovary and endometrium. There was no correlation between the number of F cells and stage of disease or degree of differentiation. It is postulated that in patients with malignant disease a humoral factor is produced which interferes with normal erythropoiesis resulting in a process of dedifferentiation.
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PMID:F cells in gynaecologic malignancy. 9 26

Between January 1969, and August 1975, 40 patients with pathologic Stage II carcinoma of the endometrium were treated at the Joint Center for Radiation Therapy. The treatment policy included external and intracavitary irradiation combined with surgery. The majority of patients received 4000 mg/hours of radium exposure using a Fletcher-Suit applicator and 4000 rad whole pelvis external irradiation, followed by hysterectomy and bilateral salpingooophorectomy. Median age of the patients was 61 years (39--88) and the median follow-up of the patients still alive was 69 months (29--102). Relapse-free 5-year survival corrected for intercurrent disease was 83% and uncorrected, 78%. Overall survival was 80%. Five patients had relapsing disease, three patients failed at distant sites only, one patient died of treatment related complications, and two failed locally and distantly. There were no failures in the pelvis alone. Although the relationshop between histologic grade and failure is not statistically significant, there were four failures among the 12 Grade III patients compared to two failures in 27 with Grades I and II. Similarly, 4 of 12 patients with gross cervical involvement developed relapsing disease, but only 2 of 28 failed with microscopic cervical involvement. This treatment policy yields excellent survival and continues to be our treatment recommendation.
Cancer 1978 Sep
PMID:Combined irradiation and surgery in the treatment of stage II carcinoma of the endometrium. 10 Feb 5

All available data that have been used to either support or refute the suspicion that estrogens cause endometrial cancer have come from retrospective case-control studies. The present controversy rests on the willingness or unwillingness of investigators to accept conventional case-control studies as a suitable substitute for clinical trials or longitudinal cohort studies. In a clinical trial or longitudinal cohort study conducted with routine endometrial examinations, there would be no problem of differential detection, but the investigator has no way of knowing the magnitude of the problem in a conventional case-control study. "Community surveillance" is a problem that has been ignored in all of the conventional epidemiologic case-control studies. This bias has led to a spurious overestimation of the association between exogenous estrogens and endometrial cancer. The alleged causal association has been reported in 7 recent conventional studies that conflict with 2 older investigations and with subsequent research in which the magnitude of the association was substantially lower. The attempt is made to demonstrate how "community surveillance bias" has produced the contradictory findings in the cited studies. Community surveillance refers to medical examinations that take place before an individual becomes a case or control in the hospital. A bias in surveillance can arise unless medical attention was sought by the patient and received prior to hospitalization in a manner that permitted the exposed (estrogen-taking) and the non-exposed an equal chance to become classified as cases. When bias was reduced or eliminated by selecting control groups with comparable rates of diagnostic surveillance, the causal association vanished.
CA Cancer J Clin
PMID:Community surveillance bias and the estrogen-endometrial cancer dispute. 11 Apr 9

Twenty-nine patients with stage II endometrial carcinoma were reviewed and the possible risk factors involved in state II disease are presented. Twenty-four patients received external irradiation as part of their treatment with or without intracavitary or intravaginal radium and/or TAH BSO. The 5-year actuarial survival in our series was 81.4%. The data showed that preoperative external irradiation can be effectively administered without undue complication. A strong argument against the traditional use of preoperative intracavitary radium is presented. Preoperative external irradiation administered with a 4-field box technique to deliver a minimum dose of 5000 rad in 5--6 weeks to all the structures at risk is the recommended treatment for stage II endometrial carcinoma.
Cancer 1979 Oct
PMID:External irradiation in the management of stage II endometrial carcinoma. 11 71


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