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

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

Between October 1985 and January 1989, 33 patients with stage I (31) or clinically occult stage II (2) endometrial cancer at a high risk for recurrence were entered in a prospective study evaluating adjuvant cisplatin, doxorubicin, and cyclophosphamide (PAC) chemotherapy. Eligibility criteria included grade 2 tumors with middle- or outer-third myometrial invasion (16), grade 3 tumors with any degree of myometrial invasion (17), presence of extrauterine disease with no gross residual (17), or a high-risk histologic subtype including papillary serous (4), adenosquamous (5), or clear cell (1) tumors. Patients received PAC (50/50/500 mg/m2) at 4-week intervals for six cycles. Thirty patients (90%) completed therapy. Toxicity included severe neutropenia in 14 patients, neutropenic sepsis in 2 patients, and doxorubicin-related cardiomyopathy in 1 patient. There were no treatment deaths. Current median follow-up is 25 months. Nine patients (27%) have developed a recurrence, 7 of whom died, after a median interval of 14 months. Eight of the 9 with recurrence initially had extrauterine disease (P = 0.02). The resulting 2-year actuarial progression-free and overall survival rates were 79 and 83%, respectively. The median progression-free interval was 29 months for patients with extrauterine disease and 45+ months for those with no extrauterine disease (P = 0.02). These results suggest that a phase 3 randomized trial comparing adjuvant PAC with radiation therapy is warranted.
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PMID:Adjuvant chemotherapy with cisplatin, doxorubicin, and cyclophosphamide (PAC) for early-stage high-risk endometrial cancer: a preliminary analysis. 222 40

A 64 year old woman with metastatic endometrial carcinoma was admitted to the hospital after three grand mal seizures. Blood cultures yielded Corynebacterium striatum. The patient responded to parenteral ampicillin therapy. This is believed to be the first case of sepsis caused by this organism.
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PMID:Septicaemia in a granulocytopenic patient caused by Corynebacterium striatum. 259 3

Forty-nine evaluable patients with advanced or recurrent endometrial carcinoma who were no longer controllable with surgery, radiotherapy, and hormonal therapy and who had not received prior chemotherapy were treated with cisplatin 50 mg/m2 intravenously every 3 weeks. Two complete responses (4%) and eight partial responses (16%) were observed among the 49 patients. Twenty-two (45%) exhibited stable disease for at least 2 months, while 17 patients (35%) progressed less than 2 months after initiating chemotherapy. Adverse effects included mild leukopenia (31%), nausea and vomiting (72%), and mild azotemia (51%). Only 2 patients experienced life-threatening toxicity; one related to renal failure and the other to sepsis and shock. Cisplatin thus has definite activity when given at the dose and schedule tested to patients with endometrial carcinoma who have not received prior chemotherapy.
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PMID:Phase II trial of cisplatin as first-line chemotherapy in patients with advanced or recurrent endometrial carcinoma: a Gynecologic Oncology Group Study. 270 69

Infections in patients with gynecologic malignancies occur frequently and are the cause of death in 50 to 60% of the cases. The patient with cancer is a compromised host with an increased susceptibility to infection due to the malignancy itself on the one hand and due to therapeutic-modalities, like extensive surgical procedures, radiation- and cytotoxic chemotherapy on the other hand. Aetiologically these infections are mostly due to a disruption of anatomic structures which normally prevent the invasion of exogenous or endogenous microorganisms, or to obstructive processes or to tumour necrosis. Septicaemia can result from propagation of such a localized infection beyond the site of the tumour. The causative pathogens infecting the compromised host are mostly members of the indigenous microbial flora of the genital tract, which is influenced by surgery, irradiation and chemotherapy. Postoperatively in the vaginal vault the number of most potentially pathogenic aerobic and anaerobic bacterial species is higher, polymicrobial mixed infections are frequent. Neither the intracavitary radiation-therapy with Radium or Iridium-192 (afterloading) nor the external high-voltage therapy decrease the number of pathogenic bacterial species in the uterus and in the vagina of patients with cervical or endometrial cancer. The symptoms of infection in cancer patients can be "masked". Fever in patients with genital malignancies is mostly due to local infections and influences the prognosis negatively. The 5-year survival rate of irradiated patients with fever is significantly lower. Infections following radical hysterectomy, irradiation and/or cytotoxic chemotherapy like pelvic abscesses, peritonitis, pneumonia and septicaemia can be fatal. Urinary-tract-, wound- and vaginal vault-infections occur frequently, but are rarely severe. Therapeutically in severe infections a combination antibiotic therapy, which is effective against most pathogenic members of the genital flora, is required. Short courses of perioperative prophylactic antibiotics are useful both in radical hysterectomy and with intracavitary irradiation.
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PMID:[Infections in patients with gynecologic malignancies]. 641 69

One hundred and six patients with endometrial cancer were treated at Tsukuba University Hospital between 1983 and 1992. Sixteen patients who underwent complete resection were at high risk for recurrence and were given adjuvant platinum-based, multiagent chemotherapy instead of adjuvant radiotherapy. Eligibility criteria included outer-third myometrial invasion (group 1; n = 5), pelvic lymph node metastasis (group 2; n = 3) or both myometrial invasion and lymph node metastasis (group 3; n = 8). Of these three groups at high risk for recurrence, each patient in groups 1 and 2 developed recurrence and died. In group 3 two patients developed recurrence and one patient has died. There was one treatment death due to neutropenic sepsis in group 3. The recurrence sites in all four patients were local and no distant recurrence was noted. In other words, of 15 patients (excluding one treatment death) at high risk for recurrence, three of 12 patients (25%) with deep myometrial invasion and three of 10 patients (30%) with positive pelvic lymph nodes developed recurrence and died. The other 12 patients (include one patient with recurrence; 100 months) have survived for a long interval (range, 45-131 months). The survival rates for stage I, II, III, and IV are 92.6, 89.5, 60.0%, respectively. Patients with stage I in this study had a better survival than those with stage I in the 1984 annual report of the Japan Society of Obstetrics and Gynecology (p < 0.05). The findings of this prospective clinical trial supported those of the randomized trial comparing adjuvant CAP with radiation therapy.
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PMID:[Adjuvant chemotherapy with cyclophosphamide, adriamycin, and CDDP (CAP) for high risk endometrial cancer after complete surgery]. 857 21

The purpose of this study was to evaluate the combination of paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) and carboplatin in patients with endometrial cancer known to be resistant to standard therapy. Subjects were taken from three groups: (1) recurrent or persistent disease following surgery and/or radiation, (2) advanced disease at diagnosis, and (3) high-risk histology. The combination of carboplatin (pharmacologically dosed at an area under the concentration-time curve of 5) and paclitaxel (135 to 175 mg/m2 over 3 hours) was given intravenously every 4 weeks for eight courses. Data about response, overall and progression-free survival, and toxicity were collected. Response and toxicity were evaluated by physical examinations, x-ray films, and blood tests. Twenty patients have participated to date, including eight considered evaluable for response. Due to limited follow-up, survival and progression-free intervals are not yet assessable. Of patients with measurable disease, five of eight (63%) have had significant reduction in the size of evaluable tumor masses, constituting a partial response. Although two patients had clinical and radiographic complete responses, occult disease was found at surgery. There were no complete responders. Fifteen patients had grade 3 or 4 hematologic toxicity, but none had neutropenic fever or hospitalization for sepsis. One patient was taken off study for grade 3 neuropathy. There was one possible treatment-related death. In this preliminary report, this combination is active against tumors of the endometrium, with acceptable levels of toxicity. Further follow-up will be required to determine the duration of response and whether progression-free and overall survival are influenced by treatment with these drugs.
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PMID:A trial of outpatient paclitaxel and carboplatin for advanced, recurrent, and histologic high-risk endometrial carcinoma: preliminary report. 934 28

Pelvic exenteration is generally not considered an operation with curative value for women with recurrent endometrial carcinoma. We reviewed our experience with pelvic exenteration performed in patients with recurrent endometrial adenocarcinoma from 1947 through 1994. A total of 44 patients were identified, with a mean age of 60 years (range 35-69 years). Primary therapy usually consisted of total abdominal hysterectomy with bilateral salpingo-oophorectomy, with most receiving either pre- or postoperative radiotherapy. Prior to exenteration, 10 of 44 (23%) patients had never received any form of radiotherapy. The median interval between initial surgery and exenteration was 28 months (range 2-189 months). The type of exenteration performed was total in 23 patients (52%), anterior in 20 patients (46%), and posterior in 1 patient. Major postoperative complications occurred in 35 patients (80%) and included urinary/intestinal tract fistulas, pelvic abscess, septicemia, pulmonary embolism, and cerebrovascular accident. Median survival for the entire group of patients was 10.2 months. Nine patients (20%) achieved long-term survival (>5 years). Pelvic exenteration for recurrent endometrial cancer is associated with a high operative morbidity and poor overall survival. Although only 20% of patients achieved long-term survival, this procedure remains the only potentially curative option for the few patients with central recurrence of endometrial cancer who have failed surgical and radiation therapy.
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PMID:Pelvic exenteration for recurrent endometrial cancer. 1050 33

Our experience with hyperthermic intraperitoneal chemotherapy (IPHC) in conjunction with surgical resection for endometrial cancer recurrent within the abdominal cavity was reviewed. Eligible patients underwent exploratory laparotomy with the aim of resecting disease to < or =5 mm maximum dimension followed immediately by intraperitoneal perfusion of cisplatin (100 mg/m(2)) heated to 41-43 degrees C (105.8-109.4 degrees F) for 1.5 h. Data for analysis was extracted from retrospective chart review. Five patients underwent surgery and IPHC between September 2002 and January 2005 for abdomino-pelvic recurrence. Original stage and histology were 1A papillary serous (1), 1C endometrioid with clear cell features (1), and 1B endometrioid (3). Mean age was 61 (41-75) years, mean prior laparotomies were 1.4 (1-2), and mean chemotherapy agent exposure was 1.6 (0-4). Mean time from initial treatment to surgery and IPHC was 47 (29-66) months. Mean length of surgery was 9.8 (7-11) h after which three patients had no residual disease and two had < or =5 mm disease. The mean duration of hospital stay was 12.6 (6-20) days. Postoperative surgical complications included wound infection with septicemia in one patient. Mean maximum postoperative serum creatinine was 1.02 (0.6-1.70) mg/dL. There was no ototoxicity or neuropathy and no perioperative mortality. No patients have been lost to follow-up. Two are living disease free at 28 and 32 m and two are living with disease at 12 and 36 m. One patient died at 3 m without evidence of cancer. Two patients who had no residual macroscopic disease at the end of surgery are alive at 32 and 36 m. The combination of IPHC with surgery for recurrent endometrial carcinoma is relatively well tolerated. The unexpectedly long survival seen in this cohort supports a phase II trial of IPHC with cisplatin for recurrent endometrial cancer.
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PMID:Cytoreduction and intraperitoneal heated chemotherapy for the treatment of endometrial carcinoma recurrent within the peritoneal cavity. 1729 Dec 54

Pyomyositis is a rare complication of chemotherapy that is commonly seen in tropical climates and in patients with immunodeficiency states. Owing to its rarity and subacute presentation, its diagnosis is often delayed. It has been reported after intense chemotherapy for hematological cancers. We present a case of a 58-year-old woman with endometrial cancer who developed pyomyositis after the first cycle of carboplatin and paclitaxel with no prior predisposing factor except for cancer and premedication with corticosteroids. The patient improved once the diagnosis was established and managed with antibiotics and drainage of abscess. Full recovery was made with a protracted course of antibiotics.Early diagnosis of this entity with appropriate investigations and treatment prevents septicemia, which can often be life threatening.
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PMID:Pyomyositis after chemotherapy for endometrial cancer. 2129 56


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