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

1. It has become evident that the estrogen secreting tumors of the ovary are associated with endometrial carcinoma, but this association is most easily observed in the postmenopausal patient where the incidence of carcinoma has been reported at 10.3% (1. 02) to 24% (83). 2. The most consistent association of endometrial carcinoma is with polycystic ovarian disease, where 19 (34), 21 (152), and 25% (150) of young women with endometrial carcinoma had Stein-Leventhal syndrome (67). 3. A very significant discovery became known in 1967 when the peripheral aromatization of delta4 androstenedione to estrone was reported by Kase (94) and MacDonald (111,112). Since that time we have learned that endometrial carcinoma patients have an increased peripheral conversion (139) (0.1% compared to 0.027%), which is similar to that found in obese and aging patients, by Hemsell, et al (77). This can be 2 to 4 times greater than the young adult or the patient without cancer. Estrone produced peripherally in normal postmenopausal women can amount to 40-60 microng/day and rise as high as 120-180 microng/day in the endometrial neoplasia group (39). Similarly patients with polycystic ovary disease, hyperthecosis and lipoid cell tumors of the ovary demonstrate androgen excess with extraglandular conversion to estrone (2). 4. It has become apparent that the principal estrogen in the postmenopausal patient is estrone and that the estrone-estradiol ratio in the serum is higher in postmenopausal women with corpus cancer than similar patients without cancer (135). Clearly, we must find the effect of this estrone excess at the nuclear "acceptor" level; and does this imbalance create a hormonal environment conducive to the development of endometrial carcinoma when age (an extremely important factor) and an oncogenic agent are added? 5. With the lack of ovarian estrogen there is a relative excess of adrenal testosterone, dihydrotestosterone and delta4 androstenedione, the available precursors of extraglandular estrone (1). 6. With the passage of time it appears that endometrial carcinoma is associated with hypothalamic "hyperactivity" (31) which exhibits immunologic-biologic dissociation of LH as previously observed in persistent trophoblastic disease when measuring hCG. The significance of this is still unknown. In a like fashion a significant number of the at risk polycystic ovary disease patients have an increased LH secretion. 7. Patient susceptibility is required as seen in animal experiments where prolonged administration of stilbestrol is used and still only rabbits and mice developed a malignant change. 8. Long term exogenous estrogen appears to have caused malignant changes in the endometrium, but it was universally given over a prolonged period (4 or more years). The recent retrospective studies demonstrate an association of oral estrogen therapy with endometrial cancer, but prospective studies investigating dose and duration of all estrogen preparations need to be undertaken. 9...
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PMID:Estrogen and endometrial carcinoma. 32 64

For a population-based, case-control study of cancer of the endometrium in Greater Boston from 1965 through mid-1969, 440 cases were drawn from nearly all hospitals in the area; controls were drawn at random from the general population. The age-adjusted incidence rate was 18.1/100,000 woman-years, with a peak at ages 55-59 and a gradual decline thereafter. Information was provided from 212 cases and 1,198 controls by mall questionnaire. A trend of reduced risk of endometrial cancer with increased parity was noted, the relative incidence (RI) for multiparous women being 0.3 compared to a RI of unity for married nulliparous women. The association of risk with age at first birth was irregular. Early menarche (RI=1.6) and late menopause (RI=1.7) were associated with increased risk of disease. Endometrial cancer risk was also found to be directly related to socioeconomic status, relative weight, diabetes, hypertension, and arthritis. The findings supported the idea that hormone activity during, and perhaps after, reproductive life is an important cause of this disease.
J Natl Cancer Inst 1977 Oct
PMID:Epidemiology of endometrial cancer. 33 20

A patient with gonadal dysgenesis who developed endometrial carcinoma in her 31st year of estrogen therapy is discussed in relation to thirteen previously reported cases of carcinoma of the uterus in patients with Turner's syndrome. The pattern of steroid receptor proteins in the endometrial carcinoma was found to correlate with the degree of differentiation of the tumor as assessed by light and electron microscopy. The findings reflect a potential for continued hormonal responsiveness of the tumor.
Cancer 1978 Aug
PMID:Gonadal dysgenesis with adenocarcinoma of the endometrium: an electron microscopic and steroid receptor analyses with a review of the literature. 35 68

The factors that increase the risk of development of endometrial cancer are reviewed. Many of these conditions are frequently associated with an elevated production of estrone in peripheral (nonendocrine) tissues from circulating androstenedione. Elevated estrone production may occur in young, anovulatory or postmenopausal women whose ovaries secrete higher than normal amounts of androstenedione. Alternatively, conditions such as obesity and liver disease are associated with higher than normal rates of conversion of androstenedione to estrone, resulting in high estrone levels. Neither the exact tissue site(s) of conversion nor the normal function of this process has yet been established. Much less information concerning steroid hormone receptor measurements in endometrial cancer than in breast cancer is available. However, it seems certain that measurement of progesterone receptors will provide a useful guide in the selection of progestational therapy.
Cancer Res 1978 Nov
PMID:Steroid hormones and endometrial cancer. 35 36

Forty-three patients with advanced or recurrent endometrial carcinoma no longer amenable to management with surgery or radiotherapy were treated with adriamycin. Sixteen of the 43 patients demonstrated objective response to drug therapy with a greater than or equal to 50% reduction in the size of measurable disease. There were 11 complete responses among these 16 responders. Responders had a significantly better survival than nonresponders (P less than 0.05). Initial performance status was the only factor of demonstrable prognostic significance. Toxicity was similar to that observed in other phase II trials of adriamycin. Adriamycin, based on these data, is an active agent in the treatment of advanced or recurrent endometrial carcinoma.
Cancer Treat Rep 1979 Jan
PMID:Phase II trial of adriamycin in the treatment of advanced or recurrent endometrial carcinoma: a Gynecologic Oncology Group study. 36 91

Hormones may act as promoters in the carcinogenic process, and occasionally their metabolites may act as antihormones or have new physiologic effects. Drugs can interact with the endocrine system in many ways. They can promote secretion of a hormone, alter its rate of removal from plasma, change plasma protein-binding characteristics, or modify routes of metabolism. Estrogens have a preparative effect on the uterine endometrium. There are biologic, clinical and epidemiologic reasons for believing that estrogen administration to postmenopausal women increases the risk for endometrial cancer. Although there are similar biologic reasons to associate prolonged estrogenic stimulation with breast cancerr, evidence for such an association is weak. Oral contraceptive use has been associated with a variety of hepatocellular tumors. Although estrogens, per se, can effect several hepatic functions, it seems likely that the 17 alpha-alkyl and 17 alpha-ethinyl functions of the progestins and estrogens are involved in this process. The role of estrogen use during pregnancy in the causation of vaginal cancer in female offspring and the role of androgens in prostate cancer have been discussed.
Cancer 1979 May
PMID:Interaction of drugs, hormones, and nutrition in the causes of cancer. 37 2

Using a sensitive enzyme immunoassay, carcinoplacental alkaline phosphatase (CPAP) was determined in sera of 1266 patients with gyneocological cancers. All these patients were referred after initial surgical treatment elsewhere. There were 95 patients with evidence of disease at the time of the study and 1171 without evidence of disease. Of the 95 patients with active disease, 47 were treated for ovarian carcinoma, 36 for carcinoma of the cervix and 12 for endometrial carcinoma. Raised levels of CPAP were seen in 40% of patients with ovarian carcinoma, in 22% with carcinoma of the cervix and in 41% in the small group with endometrial carcinoma. In patients without evidence of disease, raised levels of CPAP were seen in 12% of patients with carcinoma of the cervix, in 6% of endometrial carcinoma and only in 2% of patients with carcinoma of the ovary. Therefore it was considered that in the latter group CPAP studies would prove of some value. In the group of patients with carcinoma of the ovary and evidence of disease, raised levels of CPAP were seen almost exclusively in patients with epithelial tumors. It is considered that CPAP may be of value as a tumor marker in this group of patients. When compared with CEA, CPAP tends to give fewer false positives and correlates better with the presence of disease.
Int J Cancer 1979 Sep 15
PMID:The value of a sensitive assay of carcino-placental alkaline phosphatase (CPAP) in the follow-up of gynecological cancers. 38 13

The epidemiology of cancer of the endometrium has been reviewed by going through the literature in order to find a high risk category. A particular type seems to be discernable: obestiy, endometrial hyperplasia, and the contribution of endogenous or exogenous oestrogens and lack of progesterone are the most marked elements. These factors for cancer of the endometrium are similar to those for cancer of the breast. It has been astonishing to find that these two hormone dependent cancers have a very similar background.
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PMID:[Cancer of the endometrium. The evaluation of high risk cases (author's transl)]. 38 9

In women with gynecologic malignancies the para-aortic lymph nodes are not routinely treated. However, pretherapy surgical staging has now disclosed an incidence of para-aortic node metastasis of 10.3% for presumed stage I and II ovarian cancer, 8.0% for stage I endometrial carcinoma, and 23.5% for stage II, III, and IV cervical cancer. Prospective trials to evaluate therapy directed to the para-aortic nodes in women with early ovarian and endometrial carcinoma have not been carried out. Moreover, the results of high dose irradiation to biopsy proven metastasis to the aortic lymph nodes from cervical cancer has resulted in only 11.9% survival without recurrence at two years.
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PMID:Para-aortic node biopsy in staging women with cervical, ovarian and endometrial carcinoma: a review. 39 98

This lengthy discussion of possible associations between both endogenous and exogenous estrogens and progestins to occurrence of human cancers begins by discussing endogenous metabolism of the 2 sex steroid types. For example, the endogenous production of estrogen is associated with anovulation and endometrial cancer, although clearly other risk factors are associated with these diseases, and breast cancer, which account for some or all of the sex hormones apparent carcinogenic effect. Also discussed are the modulating effects of estriol on response of the breast and endometrium to estradiol and estrogens, and the modulating effects of androgens on development of breast cancer. The bulk of the monograph concerns summaries of data on the correlations of exogenous sex hormones and human cancers. Attention is also paid to the use of exogenous sex hormones for treatments of human cancers. Estrogens have been used to treat endometrial cancer, breast cancer, and benign breast disease. Side effects of hormonal contraception discussed include gross and microscopic changes in the breast, benign breast disease, and breast cancer; in the uterus, exogenous hormonal contraception is associated with neoplastic changes in the cervix, cervical neoplasia, endometrial cancer, trophoblastic tumors, and uterine fibroids. Ovarian effects include nonneoplastic and benign lesions and ovarian cancers. Oral contraception may also correlate with incidences of pituitary and melanoma malignancies. Liver effects include both benign neoplasms and malignant tumors.
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PMID:Oestrogens and progestins in relation to human cancer. 39 83


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