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

Six hundred and five cases of endometrial carcinoma, pathologic stage I, without definable extrauterine disease were initially treated with total abdominal hysterectomy and bilateral salpingo-oophorectomy, followed by high-dose-rate iridium-192 irradiation of the vagina. External irradiation of the pelvis was performed only for patients with poor prognostic factors. Five-year survival was calculated by the product-limit method of Kaplan and Meier. Three hundred and forty-eight patients with tumor invasion of the inner third, of any tumor grade, received postoperative vaginal irradiation only. Twenty-eight patients with grade 1 tumor invasion of the middle third received vaginal irradiation only. One hundred and six patients with grade 2 or 3 tumor and infiltration of the middle third received vaginal and external irradiation of the pelvis. One hundred and twenty-three patients with deep muscle invasion of the external third of the myometrium received vaginal and pelvic irradiation. Differences in survival figures were not significant. Survival of the treatment group with good prognosis who received vaginal irradiation alone (91%) was similar to that of the group with poor prognosis who received additional pelvic irradiation (87.7%). Despite the unfavorable situation of patients with poor prognostic factors, treatment results after additional external irradiation were relatively equal to the results for patients with good prognostic factors who had not received external irradiation. Therefore, the benefit of external irradiation in patients with stage I endometrial carcinoma with unfavorable prognostic factors seems evident.
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PMID:Benefit of external irradiation in pathologic stage I endometrial carcinoma: a prospective clinical trial of 605 patients who received postoperative vaginal irradiation and additional pelvic irradiation in the presence of unfavorable prognostic factors. 219 8

Transvaginal sonography is a recent addition to the diagnostic techniques available for the evaluation of the female pelvis. Transvaginal sonography is performed with a high-frequency transducer placed in the vagina where it is in close anatomic proximity to the pelvic structures. The procedure overcomes difficulties in imaging obese patients, those with a large amount of bowel gas, and those with inadequate bladder filling. Our experience in over 200 cases of postmenopausal women is the subject of this review. This technique has been employed to detect ovarian and adnexal abnormalities, endometrial changes (hyperplasia and endometrial carcinoma), myometrial invasion, fibroids, adnexal torsion and free fluid in the rectouterine fossa. The results suggest that transvaginal sonography has considerable advantages in the evaluation of pelvic structures in postmenopausal women prior to planned surgical exploration.
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PMID:Surgery in postmenopausal women--the value of transvaginal sonography. 219 47

From 1977 to 1985 160 endometrial carcinoma stage I patients were treated with total abdominal hysterectomy and bilateral salpingo-oophorectomy and postoperative irradiation. Hundred-thirty-one patients received postoperative pelvic telecobalt-therapy, total dose 45-50 Gy and 29 patients received postoperative endocavitary curietherapy (Cs137) to the vagina vault, total dose 50 Gy. Median follow-up was 5.6 years (range 3-11 years). Overall actuarial five-years disease-free survival was 89% +/- 2.7. For the group of patients treated with external radiotherapy and group receiving curietherapy 5-years D.F. survival was respectively 88% +/- 2.9 83% +/- 4.7. There is no statistically significant difference in survival time between the two groups (p = 0.688). There were no cases of vaginal recurrence (0%) and 2/160 cases (1.2%) there pelvic relapse. In 2/160 cases (1.2%) distant metastases occurred. Late I II grade effects were found in 15/160 cases (9.3%). Retrospective analysis of results and casuistry lead to the conclusion that radiotherapy must, in cases at risk, follow surgery in the treatment of stage I endometrial carcinoma with the aim of reducing the loco-regional relapses and increasing survival time.
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PMID:[Surgery and postoperative radiotherapy in the treatment of stage I endometrial carcinoma]. 233 72

The results of the treatment of 550 Stages I-III endometrial cancer patients are analysed. The postoperative radiation therapy was employed in 311 (56.5 +/- 2.8%) patients. In the pathological Stage I 235 (50.5 +/- 3.2%) out of 465 women were irradiated postoperatively, but the distant irradiation was used in only 93 (20.6%), the others began prophylactic irradiation of vagina. With the aim of regression the nonparametric Cox model it was stated, that some factors, such as hormonosensitivity of the tumor, pathogenic type, histology, stage and mode of operation have a significant influence on survival, and the postoperative irradiation has not. The comparison of the results of treatment in Stage I revealed a slight tendency to increased survival in prognostically unfavourable subgroups with the aim of postoperative irradiation. The 5-year survival in Stage I 90.3%. The individualized indications for postoperative radiation therapy in Stage I endometrial cancer are elaborated deep myometrial invasion, lowering of differentiation of the tumors, hormonoresistence.
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PMID:Individualization of indications for postoperative irradiation in stage I endometrial cancer. 234 33

Three patients with recurrent ovarian and/or endometrial cancer involving the vagina underwent successful palliative surgical debulking with the Cavitron Ultrasonic Surgical Aspirator (CUSA). Its use minimized bleeding and accomplished temporary control of the tumor.
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PMID:Use of Cavitron Ultrasonic Surgical Aspirator (CUSA) for palliative resection of recurrent gynecologic malignancies involving the vagina. 246 54

For the last 40 years oestrogens have been prescribed for treating the menopause and their effects are beginning to be well recognised. Many epidemiological surveys have shown that giving oestrogens by themselves increases the risk of cancer of the endometrium. This most undesirable secondary effect can be neutralised if progestogens are given at the same time. It is even possible to treat endometrial hyperplasia, the precursor stage of cancer of the endometrium. No effects on cancers of the ovary, of the cervix, of the vagina and of the vulva have been found resulting from the use of replacement oestrogens. The epidemiological surveys to study the risk of cancer of the breast linked with oestrogen treatment have not shown that there is any increased risk. There are, however, still some doubts about sub-groups and in particular those women whose ovaries have been removed. As with cancer of the endometrium, taking progestogens at the same time lessens the risk, doubtless because the deficiency in progesterone is more important as a causative agent for the development of tumours in the breast than excess oestrogens. It is necessary to weigh the risks and the benefits of hormone replacement therapy after the menopause, but overall the results of studies that have been carried out until now favour greatly the prescription of such therapy.
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PMID:[Cancer risk of hormone replacement treatment in the menopause]. 265 35

Effects of oral contraception on cancers of the female breast and reproductive tract are critically reviewed from human studies reported since 1980. The cumulative risk of breast cancer through 59 years of age appears to bear no relationship to oral contraceptive (OC) use whatsoever. Studies restricted to women under age 45, however, raise concern about a possible adverse effect from OC use before a 1st term pregnancy. A duration-related protective effect against endometrial cancer occurs from the use of combined OCs. The risk is reduced by about 40% with 2 years of use, and by about 60% with 4 or more years of OC use. OC use in excess of 3 years protects against ovarian cancer. 4 years of use confers a 50% reduction in risk, and 7 or more years of use confers a 60-80% reduction in ovarian cancer risk. Studies of cervical dysplasia and carcinoma in situ suggest elevated risks with 2 or more years of OC use, although results are difficult to interpret in view of numerous factors that might distort the findings. The risk of invasive cervical cancer appears to be unaffected by up to 5 years of oral contraception. Beyond this, there is evidence suggesting an elevated risk which approaches a 2-fold increase at 10 years of use. Cancers of the vagina and fallopian tube are extremely rare. Their risks have yet to be characterized in relation to OC use.
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PMID:Cancer of the breast and reproductive tract in relation to use of oral contraceptives. 267 58

A retrospective analysis was performed of 51 patients with locoregional recurrence of endometrial carcinoma, treated by radiotherapy between 1959 and 1986. There were 17 patients (33%) with isolated vaginal recurrence, 12 patients (24%) with vaginal recurrence with pelvic extension, 7 patients (14%) with pelvic recurrence only, and 15 patients (29%) with simultaneous locoregional and distant failure. Eighty percent of the recurrences occurred within 3.5 years from primary treatment; time to relapse was shorter in patients with advanced-stage, high-grade malignancy at original diagnosis. Locoregional control was achieved in 18 patients (35%). Complete tumor regression in the vagina, irrespective of extravaginal pelvic disease status or distant metastasis, occurred in 28 of 34 patients with vaginal involvement (82%). The 5- and 10-year overall actuarial survivals for all patients were 18 and 12.5%, respectively. The 5- and 10-year progression-free survivals of patients with isolated vaginal recurrences were 40% and 29%, respectively; the 5-year progression-free survival of patients with vaginal recurrence with pelvic extension was 20%. There were no survivors beyond 1.5 years among patients with pelvic recurrence (p = 0.02). All patients with simultaneous locoregional and distant failure were dead by 3.5 years. Stage at original diagnosis, time to relapse from primary treatment, histologic pattern, and grade of malignancy were prognosticators of survival. Five patients (10%) developed a total of ten radiation-related sequelae.
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PMID:Results of radiotherapy in recurrent endometrial carcinoma: a retrospective analysis of 51 patients. 274 4

In a prospective therapeutic study, 571 cases of endometrial cancer in pathological stage I were treated initially with total hysterectomy and received 6 weeks after surgery double high-dose-rate iridium 192 irradiation of the vagina (afterloading technique). The single dose was 700 cGY (at 2 cm distance from the applicator axis). Postoperative treatment planning was based on the prognosticators of depth of myometrial invasion and tumor grading with subtypes. External irradiation was prescribed only for patients with poor prognostic factors (Cobalt-60,5600 cGY on the pelvis wall, 30 fractions). At the time of this report, the patients had been followed up for 6 to 96 months after their original therapy. Survival was calculated by the life table method. 327 cases with slight tumor infiltration, independent of the tumor morphology, received postoperative vaginal irradiation only. Survival rate was 90.6%. 27 cases with tumor infiltration of the middle third of the myometrium and grade 1 tumors, received also only vaginal irradiation. Survival rate was 100%. 101 cases with tumor infiltration of the middle third of the myometrium and grade 2 and 3 tumors, received vaginal irradiation plus external irradiation. Survival rate was 89.9%. 116 cases with tumor infiltration of the external third of the mymetrium and any tumor grade, received vaginal irradiation plus also external irradiation. In these patients with poor prognosis, the survival rate was 85%. Differences between groups are not significant. Considering the treatment group with good prognosis and the group with poorer prognosis and the additional external irradiation, the survival figures were quite similar (90.6% and 87.9% respectively). In spite of the unfavorable situation of patients with poor prognosticators, treatment results after the additional external irradiation were rather similar to those cases with good prognosticators and without external irradiation. The value of external irradiation in cases of endometrial cancer in stage I with unfavorable prognosticators seems to be quite clear. This therapy improvement was all the better, because side effects of external irradiation were low (0.2% rectovaginal fistulas) and in case of irradiation of the vagina only, no severe side effects occurred. Relapse rate for the treatment group with good prognosis and vaginal irradiation only was 0.6% (2 from 354) and for the group with poor prognosis and additional external irradiation 2.8% (6 from 217) respectively.
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PMID:[The value of postoperative irradiation in endometrial cancer of pathohistologic stage I]. 277 49

This study was based on clinical and histological diagnosis of 1251 consecutive cases, referred to Harare Central Hospital for Specialist attention between January 1981 and December 1983. The frequency of each gynaecological malignancy was as follows: cervix - 78%, choriocarcinoma - 8%, endometrial carcinoma - 6%, ovarian carcinoma - 5%, vulva and vagina - 3%. The study showed that cancer of the cervix was the commonest type in African women who were 99% semiliterate rural women of low socio-economic status and who presented in 76% of the cases with advanced malignancy. It was concluded that the most practicable way of preventing cervical cancer in African women is intensive health education in rural areas to make women aware of the early symptoms of the disease.
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PMID:The pattern of gynaecological malignancy in Zimbabwe. 279 44


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