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

The Syed template (Alpha-Omega Services, Bellflower, CA) has been established as an advance in interstitial gynecologic brachytherapy. Unfortunately, enthusiasm for the technique is often tempered by certain tumor geometries which require blind insertion of the interstitial needles, potentially risking inaccurate placement of the radioactive sources and viscus perforation. These concerns arise particularly in the management of anterior vaginal tumors where difficulties in negotiating the pubic arch can prevent optimal needle placement. In answer to this problem, a technique utilizing an open retropubic approach for Syed template interstitial implants in anterior vaginal tumors under direct visualization is described. To date, six procedures have been performed. The disease entities include advanced cervical squamous cell carcinoma, clear cell carcinoma of the vagina, recurrent vaginal carcinoma, recurrent endometrial carcinoma, and urethral adenocarcinoma. Complete response was noted in five of six patients but persistent local control of disease was achieved in only one of five complete responses over a relatively short follow-up interval. Complications included paravaginal abscess (n = 1), postoperative deep venous thrombosis (n = 1), abdominal incision cellulitis (n = 1), and radiation enteritis (n = 1). An open retropubic approach allows direct visualization of the bladder and urethra during interstitial implantation of anterior vaginal malignancies and facilitates negotiation of the pubic arch. In our experience, this technique results in improved needle positioning and is thus intuitively likely to aid in avoiding injury to surrounding normal tissues. Additional accrual of a larger cohort will be necessary to arrive at any meaningful objective conclusions regarding the technique's benefit over current modalities.
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PMID:A new technique for performing Syed template interstitial implants for anterior vaginal tumors using an open retropubic approach. 1009 92

The traditional approach to patients with stage II endometrial carcinoma is preoperative radiation therapy (RT) followed by surgery. Currently, many patients are treated with primary surgery and postoperative RT. We retrospectively reviewed the outcome of 44 stage II (32 IIA, 12 IIB) patients who underwent surgery and postoperative RT. Nine (20%) had microscopic cervical involvement noted before surgery, and 35 (80%) had occult involvement noted postoperatively. Postoperative RT consisted of whole pelvic RT (WPRT) (50%), vaginal brachytherapy (VB) (18%), or both (32%). At a median follow-up of 40 months, the 5-year actuarial disease-free survival was 72.4%. Two patients (4%) had recurrence in the pelvis (one vagina, one lateral pelvis). Eighteen stage IIA patients treated with WPRT alone and eight stage IIA patients, without deep myometrial invasion (MI), were treated with VB alone, and remained controlled in the pelvis. Extrapelvic recurrences occurred in 12 patients (25%), primarily in those with deep MI and/or grade 2-3 disease. Our results suggest that patients with stage II endometrial carcinoma with microscopic or occult cervical involvement treated with surgery and postoperative RT have a favorable outcome. A high rate of pelvic control is achieved with RT tailored to the pathologic findings.
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PMID:Surgery and postoperative radiation therapy in stage II endometrial carcinoma. 1044 Jan 86

The data on 132 patients with metastases of endometrial carcinoma into the vagina (MECV) were analysed. They had received complex (remote + contact) and contact radiotherapy alone with low-, medium- and high dosage. The following radiobiological models were employed to assess tissue response: time-dose-fractionation factor (TDFF), cumulative radiation effect (CRE) and linear-quadratic dose effect equation (LQDE) ("extrapolated dose of response"). There was no correlation between survival and dose in excess of connective tissue tolerance calculated for each radiobiological model or a dose below tolerance limit. When dosage exceeded tolerance limit the incidence of early- and late-onset radiation injuries increased significantly. In MECV patients who had received primarily radiotherapy and surgery, early-onset radiation injuries occurred in cases of overdosage from the most recent exposure. When high-dose brachiatherapy was employed as a component of complex treatment, late-onset moist epithelite of the vagina could develop, irrespective of whether radiotherapy had been given or not and whether tolerance limit had been exceeded. Late-onset injuries were recorded in cases of over-dosage who had received both radiation and surgery for primary endometrial carcinoma.
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PMID:[Clinico-radiobiological evaluation of radiation dosage and complications of radiotherapy for endometrial neoplasm metastasis to the vagina]. 1044 30

Can we prescribe hormone replacement therapy (HRT) safely for women, with postmenopausal complaints who were treated for a gynaecological malignancy? Only three retrospective studies have investigated this issue in endometrial cancer patients. No recurrences or deaths occurred in these treated groups. However, the physician introduced bias through the selection of favourable groups. At present, combined estrogen and progestogen therapy is probably not contra-indicated in endometrial cancer stage I and probably also not in stage II, although so far there is only circumstantial evidence. Squamous cell cancers of the cervix, vulva, and vagina are unlikely to be influenced by HRT. In the only study available of women with ovarian cancer, < or = 50 years, estrogen replacement therapy did not have a negative influence on (disease-free) survival. According to the data currently available, no evidence exists that HRT adversely influences survival and overall survival after treatment for ovarian cancer. In general, adenocarcinomas of the cervix and leiomyosarcomas of the uterus may be managed such as the adenocarcinomas of the uterus. During the last 25 years, HRT has been shown to substantially reduce the risk of cardiovascular diseases, osteoporotic fractures and colon carcinoma. On the other hand there is a significant increase of the risk in breast cancer with prolonged use of > 5 years. Re-evaluation of the current view that HRT should no be given to women treated for a gynaecological malignancy is strongly warranted after evaluating the advantages and the disadvantages of HRT use in each individual patient. Long-term HRT in women treated for a gynaecological cancer must be based on the medical history of the individual patient (and her family).
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PMID:Hormone replacement therapy in women treated for gynaecological malignancy. 1046 74

Tamoxifen was administered orally to neonatal rats on days 2-5 after birth and the subsequent effects on the uterus were characterized, morphometrically, over the following 12 months. Tamoxifen inhibited development of the uterus and glands in the endometrium, indicating a classical oestrogen antagonist action. Between 24 and 35 months after tamoxifen treatment there was a significant increase in the incidence (26%) of uterine adenocarcinomas and a 9% incidence of squamous cell carcinomas of the vagina/cervix in the absence of any oestrogen agonist effect in the uterus. This demonstrates that an oestrogen agonist effect is not an absolute requirement for the carcinogenic effect of tamoxifen in the reproductive tract of the rat. The unopposed oestrogen agonist effect of tamoxifen on the endometrium may not be the only factor involved in the development of endometrial cancers. It is possible that tamoxifen causes these tumours via a genotoxic mechanism similar to that seen in rat liver. However, using (32)P-post-labelling we failed to find evidence of tamoxifen-induced DNA adducts in the uterus. Tamoxifen may affect hormonal imprinting of oestrogen receptor responses in stem cells of the uterus, causing reproductive tract cancers to arise at a later time, in the same way as has been proposed for diethylstilbestrol. If these rodent data extrapolate to humans, then women who are taking tamoxifen as a chemopreventative may have an increased risk of vaginal/cervical cancer, as well as endometrial cancer.
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PMID:Tamoxifen induces endometrial and vaginal cancer in rats in the absence of endometrial hyperplasia. 1075 17

The occurrence of both non-Hodgkin's lymphoma and carcinoma involving the female genital tract of the same patient is rare; we describe three such cases. In case 1, a 56-year-old woman with endometrioid endometrial carcinoma had synchronous follicular lymphoma of the uterus and ovary. In case 2, a 57-year-old woman with diffuse large B-cell lymphoma of the uterine cervix presented 5 years later with an endometrioid endometrial carcinoma. In case 3, a 69-year-old woman with an endometrioid endometrial carcinoma presented with a diffuse large B-cell lymphoma of the vagina 3 years later. In two patients, the non-Hodgkin's lymphoma was unsuspected clinically and would have been missed without biopsy and tissue diagnosis.
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PMID:Endometrial carcinoma and non-Hodgkin's lymphoma involving the female genital tract: a report of three cases. 1078 9

A verrucous carcinoma is a subtype of well-differentiated squamous-cell carcinomas, arising in the vagina, vulva, and uterine cervix. But a verrucous carcinoma very rarely arises in the uterine endometrium. The present paper presents a case of a verrucous carcinoma of the endometrium that is described in association with the tumor marker SCC; this paper also includes a review of the relevant literature.
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PMID:A case report: verrucous carcinoma of the endometrium--the difficulty of diagnosis, and a review of the literature. 1093 80

Fifteen percent of premenopausal women, 10-40% of postmenopausal women, and 10-25% of women receiving systemic hormone therapy experience urogenital atrophy. The most common symptoms are dryness, burning, pruritus, irritation, and dyspareunia. Estrogen loss, drugs, and chemical sensitivities are causes. Estrogen or hormone replacement therapy (ERT-HRT) is the treatment of choice in postmenopausal women. Dosages prescribed for menopause symptoms or to prevent osteoporosis (and, potentially, other conditions) can restore the vagina to premenopausal physiology and relieve symptoms. Concomitant progestins are necessary for women with an intact uterus to minimize or eliminate estrogen-induced endometrial cancer. Low-dosage oral and vaginal ERT can relieve urogenital atrophy but might not produce systemic effects. Progestins are not necessary with vaginal rings and vaginal tablets. If ERT is given only to treat urogenital atrophy, estrogen creams 1 or 2 times/week may prevent recurrence after symptoms are resolved. Progestins are not required for occasional estrogen cream use. Vaginal moisturizers provide longer relief by changing the fluid content of endothelium and lowering vaginal pH. Vaginal lubricants provide short-term relief. Women with contraindications to ERT-HRT could use lubricants for intercourse-related dryness or moisturizers for more continuous relief. The lay press promotes agrimony, black cohosh, chaste tree, dong quai, witch hazel, and phytoestrogens for vaginal dryness and dyspareunia; however, no evidence exists to support these specific claims. Pharmacists should be actively involved in identifying, preventing, and treating urogenital atrophy.
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PMID:Urogenital atrophy: prevention and treatment. 1131 May 20

It's a review of literature on the clinical effects of Livial. Livial (generic name-tibolone) makes a therapy of choice for postmenopausal women. It's a synthetic steroid with estrogenic, progestagenic and androgenic properties due to its tissue specific effects. Livial is effective in reducing wasomotors symptoms and has positive effects on mood and libido. It also prevents bone loss and reduces risk of fractures. Livial is safe for cardiovascular system. The incidence of side effects is very low, about 3 in every one hundred. Because of its progestagenic activity in endometrium it results in endometrial atrophy but in vagina the studies showed oestrogen--like effects, i.e. improvement in vaginal dryness. Livial may be used as an "add-back" therapy in conjunction with GnRH agonists treatment. The rates of discontinuation is lower than HTR preparations, about 25%. Livial may have benefits over conventional HRT in older women (over 65 years old), in women with history of endometrial cancer, breast cancer and endometriosis.
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PMID:[Clinical aspects of Livial in postmenopausal replacement therapy]. 1209 55

The effects of a new synthetic progestagen (3beta,17alpha diacetoxy 6chloro-pregnene-4, used experimentally in large doses in the treatment of endometrial carcinoma on the oral mucosa, were studied in 8 patients. Cytological changes were very similar to those found in the vagina after progesterone administration; the antimaturative effect of the gestagen was also visible in oral smears. The constant increase observed in the number of cells with eosinophilic cytoplasm suggests that some other factors may be operating indirectly; this factor could be the saliva, which may undergo changes due to the effects of the gestagen.
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PMID:[Effects of high doses of a progestagen on the cytology of the oral mucosa]. 1225 31


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