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

A long experience in the treatment of endometrial cancer shows that the therapeutic measures vary considerably with regard to the extention of the tumor, the age of the patient and her general condition. This circumstances and particularly the critical study of the therapeutical results give the limits, within a certain kind of operation can reasonably be recommended. The intercurrent deaths are an important factor in the statistical evaluation of therapeutical success. As long as the tumor is limited to the body of the uterus, the corrected 5-year recoveries are about 90%. Considering all the circumstances, it becomes obvious, that in this stage, the simple abdominal hysterectomy with removal of the adnexa is still the operation of choice. Beside the histological degree of differentiation, the depth of the muscular invasion is the most important prognostic factor which might lead to additional measures. Postoperative radiation therapy of the vagina reduces considerably the incidence possibility of vaginal apex recurrence. In stage II radical hysterectomy must be considered, although we are aware of the fact, that a simple hysterectomy and bilateral salpingo-oophorectomy combined with radiation treatment may yield just as good results. In the clinical stage III laparotomy ought to be used more frequently. Also in case of operative intervention additional radiotherapy is mostly useful.
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PMID:[Aminoacid-p-nitroanilides splitting activities in the mature human placenta (author's transl)]. 1 5

The epidemiological and clinical evidence for various forms of exogenous estrogens altering the risk of neoplasms of the female genital system, breast, and liver are reviewed and evaluated. It is virtually certain that in utero exposure to diethylstilbestrol can cause clear cell adenocarcinomas of the vagina and cervix. There is strong evidence that various estrogens given for treatment of menopausal symptoms can cause endometrial carcinoma and that sequential oral contraceptives probably also do so. Oral contraceptives very probably reduce the risk of both cystic disease and fibroadenoma of the breast and increase the risk of liver cell adenomas. Studies to date do not provide consistent and convincing evidence that any form of exogenous estrogen alters the risk of cancers of the breast or ovary or that oral contraceptives alter the risk of cervical neoplasia or focal nodular hyperplasia of the liver, although recent reports suggest that continued vigilance is warranted. Specific topics requiring further epidemiological investigation are suggested.
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PMID:Role of exogenous female hormones in altering the risk of benign and malignant neoplasms in humans. 21 85

The tissues from 30 cases of endometrial cancer and 44 cases of cervical cancer were examined for oestrogen receptor activity. Twenty of the endometrial and 9 of the cervical tumours contained oestrogen receptor levels above 4 fmol/mg protein. The proportion of oestrogen receptor-positive tumours was significantly greater in adenocarcinomas of the cervix than in squamous carcinomas of the cervix. Tissues from 3 mixed mesodermal tumours of the uterus, 2 carcinomas of the vagina, a carcinoma in situ of the cervix and a carcinoma in situ of the endometrium were receptor-negative. One ovarian carcinoma and a single case of uterine sarcoma were receptor-positive. The implications of these findings in relation to hormonal therapies are discussed.
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PMID:Oestrogen receptor studies in carcinoma of the endometrium, carcinoma of the uterine cervix and other gynaecological malignancies. 27 89

Surgery is the prime method of therapy for endometrial carcinoma. However, in nearly all cases radiotherapy is combined with it either before or after operation. High risk factors include hyperoestrinism, cervical spread, myometrial invasion, cellular anaplasia, and metastatic spread to adnexa, vagina and the pelvic lymph nodes. The latter involvement of the last factor is analysed in some detail, on the base of 216 dissections with an incidence of 8%. Analysis of other authors' findings are reviewed on the basis of autopsy and selection. The place for Wertheim hysterectomy is discussed, also vaginal hysterectomy and the timing of surgery when irradiation is given preoperatively. The author's statistics are derived from a previous study of 468 patients treated between 1956 and 1971.
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PMID:The current status of surgery for endometrial carcinoma: facts and fantasy. 28 72

Authors studied the application of vaginal hysterectomies performed on 790 patients, and abdominal hysterectomies performed on 892 patients over 15 years. The age of the patients was 41 to 60. In 233 cases the reason for the operation was a severe prolapse of the uterus in middle-aged and elderly women. 170 women underwent hysterectomy because of recidivist and persisting uterine hemorrhages. 67 elderly patients had a vaginal hysterectomy because of endometrial cancer. Vaginal hysterectomies were also performed on 58 patients with preclinical cancer of the cervix; these women were all over 40 years old. It appears that vaginal hysterectomies were mostly performed because of uterus mobility. These operations were done under lcoal infiltration anesthesia. No other operation was required for 217 patients. 237 cases necessitated plastic surgery on the vagina and on the peritoneum. 52 women had plastic surgery against frequent irretention of urine, and plastic surgery on the peritoneum. Meyo's procedure was used on 175 patients. 11 women suffered some complications after vaginal hysterectomy: severe hemorrhage, rectal injury, injury of the wall of the bladder. 15 women suffered complications after abdominal hysterectomy. It is concluded that vaginal hysterectomy is better tolerated by patients than abdominal hysterectomy. (Summary in ENG).
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PMID:[Application of vaginal hysterectomy in surgical gynecology]. 60 74

Horones as a therapeutic agent are practically not used in gynecologic oncology, because gynecological malignomas are hormonally independent. Therapeutically succesful in only the use of Progesterone in metastases and relapses of endometrial cancer and of Estrogen in the palliative treatment of cervical cancer relapses. However, significant results are obtained by cytostatic therapy, particularly in carcinomas of the ovary and in choriocarcinomas; the therapy is somewhat less successful in the cancer of the oviduct and vulva, while in the cancer of the cervix and vagina it is not successful at all. Polychemotherapy is recommended because it results in better remissions and is less aggressive.
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PMID:[Cytostatic and hormonal therapy on oncologic gynecology (author's transl)]. 75 24

Ten percent of all patients with endometrial carcinoma have Stage III disease at the time of presentation. The management, the features of their disease, and their prognosis are quite different than those of patients with Stage I disease. This report is based on 37 patients with Stage III carcinomas. For their treatment, a program of definitive radiation therapy was applied. Eleven patients had a prior total abdominal hysterectomy (TAH) and bilateral salpingo-oophorectomy (BSO). On the basis of the tumor extension, three main patterns were identified: 1) downward into the vagina or the vagina and the cervix; 2) lateral into the parametrium and the pelvic wall; and 3) to the ovaries. This classification carries therapeutic and prognostic significance. Ovarian extension has the best prognosis when treated by TAH and BSO followed by postoperative radiotherapy. Extension to the vagina or to the vagina and the cervix can be treated successfully by a combination of external beam and local radium placements. Patients with pelvic wall extension have the poorest prognosis. They comprise maore than 50% of all cases with Stage III tumors and have exhibited persistent or recurrent disease even when treated at high dose levels. The cumulative survival rates for the entire stage were 50% at the end of the first year, 32% at the end of the second year, and 25% at the end of the fifth year.
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PMID:The management of stage III carcinoma of the endometrium. 82 19

The course of development of the human genital tract is undifferentiated up to the 9th week (32 mm). At this time both Wolffian (mesonephric) and Mullerian (paramesonephric) ducts are present as symmetric paired structures. These, together with the urogenital sinus and the metanephric ducts, provide the tissue sources for the internal genital and urinary apparatus, exclusive of the gonads and kidneys. Configuration of the oviducts varies among species. Most human anomalies may be represented in other species so that some authors consider them to be atavistic reversions. The gonad of the developing male fetus plays a critical role in the formation of the genital tract. It elaborates androgenic steroids and a polypeptide, a Mullerian inhibiting substance, which induced suppression and resorotion of the Mullerian ducts. In the female the Mullerian ducts grow and develop into their adult morphology while the Wolffian ducts persist only as microscopic islands. The development of the external genitals and secondary sex characteristics depends upon further exposure to androgenic or estrogenic hormone milieu. a case is reported of an instance of congenital absence of the upper vagina. At laparotomy normal sized uterus, tubes, and ovaries were found. Further plastic surgery via the vagina corrected the condition. 15 years later (age 32) it was learned that she had been married and had 3 pregnancies. The adenosis, areas of squamous metaplasia, and deformities of the cervix of girls exposed in utero to diethylestibestrol are examples of deranged development. The shallow depth or absence of the vaginal canal of individuals with testicular feminization are also due to faulty development. Both Mullerian tissue and that of the urogenital sinus origin normally participate in the development of the vagina. In the normal adult the squamous cells that line the vagina contain abundant glycogen indicating urogenital origin. Glycogen-deficient squamous cells and adenosis are thought to be of Mullerian origin. In an accompanying discussion additional details of development are mentioned. It was noted that 7 cases of adenocarcinoma of the prostatic utricle in males have been reported as resembling endometrial carcinoma. The prostatic utricle is a homologue of the uterus and upper vagina and may be involved in similar deranged developments
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PMID:The embryologic development of the human vagina. 103 67

The effect of oral contraceptives on the development of cancer indirectly is explored with regard to cancer of the female genital tract and the breast. No correlation between oral contraception and squamous cell carcinomas of the vulva and vagina and tumors of the ovary is known. As yet no statistics are available on the incidence of carcinoma of the endometrium in women who took oral contraceptives during their reproductive life span. Because of the direct hormonal suppression of the endometrial growth by oral contraception, a protective effect against endometrial hyperplasia and endometrial cancer must be expected. For cancer of the female breast no protective and no enhancing cancer risk due to progestational agents can be postulated. The known fragmentary data suggest rather a protective effect. Regarding dysplasia and carcinoma in situ of the uterine cervix, large investigations with great numbers of patients are available. An increase of the risk of developing cancer of the cervix by using oral contraception cannot be shown with sufficient accuracy at our present state of knowledge by statistical means. Some observations suggest that oral contraception increases the relevant exogenous factors for carcinogenesis of the uterine cervix such as sexual behavior and hygiene.
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PMID:[Does oral contraception cause cancer? (author's transl)]. 126 87

Because of increase of endometrial carcinoma the frequency rate of invasive cervix carcinoma and carcinoma of uterine corpus has been changing in the last ten years and at several places in the world it is approaching 1:1. That shows the importance of early detection of endometrial carcinoma. A summary of cytology diagnostic of normal and pathological endometrium is given. Especially it is pointed to the great difference between the cytomorphical cell criteria of endometrial malignancies dependent on the differentiation grade of endometrial carcinoma. The predominance of cell atypia is found by the undifferentiated carcinoma of uterine corpus whereas the cells of frequently found well differentiated endometrial carcinoma often cannot be differentiated from normal endometrium cells. The observation of cells of endometrial carcinoma in normal cellular samples of cervix and vagina is no more than 60--70 percent; at this rate the endocervical aspiration has the greatest chance of detection. To correct the early cellular diagnosis of uterine carcinoma the appearance of normal endometrium cells by screening must be noticed and each finding at an untypical moment, for example in postmenopause, must be an alarm signal. The different intrauterine aspiration techniques obtained more than 90 percent accuracy in the detection of endometrial carcinoma. This method is qualified for special indications in a limited number of cases.
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PMID:[Cytological diagnosis of endometrial carcinoma]. 126 53


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