Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0476089 (endometrial cancer)
 11,379 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recurrent endometrial carcinoma, even when clinically confined to the vagina or pelvis, is associated with poor survival. Pelvic radiotherapy for patients with localized recurrences who have not been previously irradiated has not been highly effective. Our hypothesis was that local salvage therapy fails because a significant number of patients have occult, subclinical distant metastases at the time of relapse. In order to accurately assess disease status at the time of the recurrence, we prospectively evaluated eight patients with recurrent disease limited to the vagina/pelvis by physical examination, routine laboratory tests, and radiologic imaging. All patients underwent a "staging" procedure which included laparotomy, selective pelvic/periaortic lymphadenectomy, peritoneal biopsies, and washings. Three (37.5%) of eight patients had upper abdominal disease found at laparotomy (95% confidence interval 0.11 to 0.71). Presence of subclinical metastases was associated with larger tumor size (> or = 2 cm) and elevated serum CA 125 antigen levels. Treatment was modified in three patients according to the results of surgical staging. One patient was treated with chemotherapy while two patients received whole-abdominal radiation in addition to pelvic fields. Seven of eight patients are alive 21 to 61 months following salvage therapy. Three (43%) of seven patients treated with radiotherapy suffered nonneoplastic bowel obstruction requiring laparotomy at 3, 6, and 15 weeks following completion of radiation therapy. Since 37.5% of patients with recurrent endometrial carcinoma clinically confined to the pelvis had occult upper abdominal disease, surgical reassessment may be warranted, especially in those with elevated serum CA 125 levels or large tumors. Our limited sample size precludes any definitive conclusions regarding our data. Further research will determine the frequency of subclinical metastases and the value of serum CA 125 levels in assessing disease status.
 ...
PMID:Recurrent stage I endometrial adenocarcinoma in the nonirradiated patient: preliminary results of surgical "staging". 842 94

Cancers of the breast and endometrium, although hormonally-dependent, are not complete contraindications to hormonal replacement therapy. About 70% of women with endometrial cancer will be completely cured of their disease using appropriate surgical techniques and therefore can be given oestrogen without in any way compromising their long-term survival. In fact oestrogen will probably allow such women to survive longer with a higher quality of life. Most postmenopausal women with cancer of the breast should be offered an impeded oestrogen such as tamoxifen as their first line of hormonal treatment. There may be improvement in the vagina and bone calcium content following the use of this 'anti-oestrogen' but some women will continue to suffer from vasovagal symptoms. Women with breast cancer which is small, node-free and relatively non-aggressive may also do well on HRT. Because of the influence of progestogens in reducing oestrogen receptor production, in reducing the expression of various growth factors and in inducing apoptosis, it is wise to administer high-dose progestogens to these women as well as oestrogen. There is no clinical evidence that HRT administered to such women will induce any increase in tumour growth or recurrence. Women with a disease-free survival of 10 or more years can also be regarded as 'cured' and can also be offered oestrogen in conjunction with high-dose progestogens. Finally, those women with known secondary spread but who are severely disadvantaged by their oestrogen deficiency symptoms should be offered high-dose progestogens first and if their symptoms persist, then have oestrogen added to the regimen till the symptoms subside.
 ...
PMID:Hormone therapy following breast and uterine cancer. 843 54

The dose to the anterior rectal wall is a known limiting factor for the delivery of radical doses of radiation to the uterine cervix with brachytherapy. We developed a modification to the Fletcher-Suit afterloading applicator, consisting of two small inflatable balloons attached to the posterior end of each colpostat. The balloons are connected to catheters that emerge from the vagina attached to the colpostat's handles. The balloons were affixed to the colpostats with a plastic adaptor and are inserted empty. After an anterior radiograph is taken, the balloons are filled with radiological contrast material and a lateral orthogonal film is made. This lateral film taken with the balloons filled with contrast typically shows a significant posterior displacement of the anterior rectal wall away from the vaginal sources. The International Commission on Radiation Units (ICRU) rectal point is then determined 5 mm beyond the posterior boundary of the opacified balloons. We have performed 90 applications using this device, including brachytherapy applications for cervical cancer, as well as vaginal applications for endometrial carcinoma following TAH-BSO. On average, the ICRU rectal point was displaced 14 mm away from the colpostats, thus reducing the dose rate by 60% and resulting in an average dose sparing of about 1000 cGy to the anterior rectal wall.
 ...
PMID:Reduction of the rectal dose in gynecological brachytherapy: modification to the Fletcher-Suit applicator. 889 77

An association between the administration of tamoxifen in patients with breast cancer and the development of endometrial cancer has been suggested in a number of clinical studies, none of which was designed prospectively to study the endometrial effects of tamoxifen. Because of this observation, some have equated tamoxifen with "estrogen," and inferences have been drawn about its possible carcinogenic effect. This presentation analyzes the effect of tamoxifen on the lower genital tract in the adult human female, compares it with the effect of estradiol, and compares and contrasts the effect of these substances on the end organs of laboratory animals, cell lines, transplants, and their differential effects in the human uterus, cervix, and vagina. Of note is the fact that in patients who have not had breast cancer, there is no report of the development of endometrial cancer in women taking tamoxifen. Careful monitoring of this population may define with better precision the mechanism of action of tamoxifen as well as the process of oncogenesis in the human endometrium.
 ...
PMID:Tamoxifen and endometrial cancer: tamoxifen effects on the human female genital tract. 904 17

The International Federation of Gynecology and Obstetrics (FIGO) changed the staging criteria for endometrial cancer in 1988 and adopted a surgical-pathological staging involving also pelvic and/or para-aortic lymphadenectomy. A total of 236 patients were treated for endometrial adenocarcinoma at Department B of the Gynecologic and Obstetrics Institute, University of Turin, between January 1976 and December 1995. Our protocol for surgical staging always entails pelvic and para-aortic lymphadenectomy and a simple total hysterectomy and bilateral adnexectomy with removal of the upper third of the vagina. The aim of this study was to carry out a retrospective evaluation of the morbidity in patients with endometrial cancer after surgical treatment, either TAH-BSO alone or TAH-BSO with pelvic and para-aortic lymphadenectomy.
 ...
PMID:Complications of pelvic and para-aortic lymphadenectomy in patients with endometrial cancer. 917 38

Endometrial cytology has been studied for more than 25 years, and a variety of cytologic devices have been developed for direct sampling of the endometrium. The quality of endometrial samples procured by various devices is markedly different and greatly affects the diagnostic accuracy. A new endometrial sampling device, the IUMC Endometrial Sampler, was developed at the Indiana University Medical Center and approved by the Food and Drug Administration for general medical use. This device is intended for the early detection of endometrial carcinoma and its precursors. It can be used to monitor the endometrial condition of patients receiving estrogen replacement therapy or tamoxifen. It is also useful for the procurement of uncontaminated endometrial samples for microbiologic studies from patients with suspected endometritis. It has the potential to be used for endometrial dating for patients with infertility disorders. In our clinical trials and sampling tests using hysterectomy specimens, adequate and representative endometrial samples without contamination from endocervix and vagina were consistently obtained by this device. The procedure of endometrial sampling using this device and the preparation techniques for endometrial brushing specimens are discussed and illustrated.
 ...
PMID:Direct intrauterine sampling: the IUMC Endometrial Sampler. 925 25

In the treatment of locally advanced carcinoma of the uterine cervix the multimodal therapeutic approach is useful to improve overall survival and disease-free survival. Two studies of concomitant radiochemotherapy were conducted. In the first, recurrences of gynecologic tumors were treated, in the second primary tumors of the uterine cervix. In the first study 29 patients, of whom 15 with endometrial cancer recurrence, 10 with cervical cancer recurrence and 4 with vulvar cancer recurrence were treated with FUMIR schedule (5-FU and mitomycin C plus concomitant radiotherapy to the pelvis in two cycles of 23.4 Gy) and subsequent brachytherapy boost. In the second study 17 patients, of whom 14 evaluable, were treated with external beam radiotherapy (ERT 40 Gy) and concomitant chemotherapy (5-FU and CDDP). Before and after treatment the patients were examined with MRI. After radiochemotherapy radical hysterectomy and histology of surgical specimen was performed. Results of first study were as follows: acute G1-G2 (RTOG) hematologic toxicity 56%, G3 4%; G1-G2 gastrointestinal 54%, G1-G2 skin 29%; G1-G2 rectum 24%; G1-G2 bladder 25%; G1-G2 vagina 30%. Local control, overall survival and disease-free survival at 24 months were 45%, 76% and 67%, respectively. Results of the second study showed 9/14 patients with complete response and 4/4 patients with partial response (93%), no change in 1, with 100% MRI accuracy as compared to histology. Based on these results a phase III clinical trial was planned in primary cancer of the uterine cervix using concomitant radiochemotherapy (CDDP + 5-FU) plus intracavitary brachytherapy for organ preservation.
 ...
PMID:Organ preservation in locally advanced carcinoma of the uterine cervix. 944 53

Estrogen receptor-related orphan receptor alpha 1 is a member of the steroid/thyroid nuclear receptor superfamily. We have previously cloned the human estrogen receptor-related orphan receptor alpha 1 (hERR alpha 1) cDNA and demonstrated that it enhances estrogen responsiveness of the lactoferrin gene promoter in transfected human endometrial carcinoma cells. In the present study, we used the hERR alpha 1 cDNA as a probe and isolated the mouse homologue of ERR alpha 1 from the cDNA libraries of the brain and kidney. Sequence comparison between human and mouse ERR alpha 1 (mERR alpha 1) revealed that the homologies are 89% in nucleotides and 97% in amino acids. By electrophoresis mobility shift assay, we showed that the glutathione S-transferase-mERR alpha 1 fusion protein produced in a bacterial system bound to the human ERR alpha 1 DNA-binding element. Mouse uterine nuclear extract also interacted with this DNA element and produced three complexes in the mobility shift assay, one of which was supershifted by the hERR alpha 1 antiserum. A 2.2 kbp transcript was detected by Northern analysis in all adult mouse tissues tested; however, large variations in the amount of ERR alpha 1 mRNA were found among them. Multiple immunoreactive forms of mouse ERR alpha 1 were detected by Western analysis in non-reproductive tissues, whereas a major 53 kDa protein was found in reproductive tissues such as uterus, cervix and vagina. Diethylstilbestrol (DES) stimulated the expression of ERR alpha 1 mRNA in the uterus of 19-day-old mouse. We showed that DES and estradiol, but not progesterone or dexamethasone, enhanced the level of immunoreactive ERR alpha 1 in the mouse uterus. These results demonstrated that the ERR alpha 1 is an estrogen-responsive gene in the mouse uterus and provides a model system with which to study the biological roles of this nuclear orphan receptor.
 ...
PMID:The mouse estrogen receptor-related orphan receptor alpha 1: molecular cloning and estrogen responsiveness. 946 Jun 51

Gynecological tumors of cervix uteri, corpus uteri, ovary, vagina, and vulva are classified by the TNM systems. The definitions of the T categories correspond to several stages accepted by FIGO (Federation Internationale de Gynecologie et d'Obstetrique). Those of regional lymph nodes are different among primary sites. The relationships between 5-year survival rates and TNM stages were investigated in cervical and endometrial carcinoma cases in 1985 by the Japan Society of Obstetrics and Gynecology (JSOG). The pTNM pathological classification had a better relationship with survival than the TNM clinical classification, respectively. According to the rules for TNM classification, T categories should be assessed by physical examination, cytoscopy and urography. These data indicate that prognostic factors could not be accurately assessed by these procedures. Radiotherapy for cervical carcinoma is selected in many cases. The JSOG adopts the clinical classification in 1997, but it had a pathological classification for corpus uteri and ovary in 1995.
 ...
PMID:[TNM classification of gynecological tumors]. 957 79

The data on 132 patients with metastases of endometrial carcinoma into the vagina (MECV) were analysed. Among the modalities used were complex (remote + contact) and contact radiotherapy with low-, medium- and high dosage. The following radiobiological models were employed to assess tissue response: time-dose-fractionation factor, cumulative radiation effect and linear-quadratic dose effect equation ("extrapolated dose of response"). There was a correlation between five-year survival in radiation-treated patients and metastasis size. Stage of disease proved a major prognostic factor in MECV treatment. Complex radiotherapy was of crucial importance in MECV treatment whatever the size of disseminated tumor. There was no correlation between efficacy of MECV treatment and therapy used to treat primary endometrial carcinoma (surgery, combined or radiotherapy).
 ...
PMID:[Clinical evaluation of the effectiveness of radiotherapy in vaginal metastases of uterine cancer]. 988 7


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>