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

The stem bark of Erythrina lysistemon, one of the traditionally used "women remedies", has been assessed for its estrogenic activity. The ethyl-acetate extract of the stem bark of E. lysistemon showed estrogenic activities in vitro either in a yeast-based estrogen receptor assay or on the estrogen-dependent stimulation of alkaline phosphatase activity in the human endometrial carcinoma cell line Ishikawa. The estrogenic activity was investigated in vivo in young ovariectomized Wistar female rats after a 7-day treatment. The estrogenicity was evaluated through the proliferative status of target sex organs such as uterus and vagina. The results obtained showed that oral administration of 200 mg/kg BW/d of E. lysistemon extract in comparison to untreated ovariectomized rats significantly increased the vaginal epithelial height by 47.23% (from 8.71+/-0.47 to 12.34+/-1.31 microm); and induced a weak increase of uterine epithelial height by 6.76% (from 5.42+/-0.52 to 5.84+/-0.91 microm). Both were not as pronounced as those elicited in the positive control of 100 microg/kg BW/d of ethinylestradiol given orally. Overall our results suggest that the extract of E. lysistemon contains secondary metabolites endowed with estrogenic activity.
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PMID:Estrogenic effects of the ethyl-acetate extract of the stem bark of Erythrina lysistemon Hutch (Fabaceae). 1648 90

The purpose of our research is to compare CT-based volumetric calculations and International Commission on Radiation Units and Measurements (ICRU) reference-point estimates of radiation doses to the target volume, bladder, rectum, and sigmoid colon in patients with carcinoma of the endometrium treated with high dose rate intracavitary Rotte 'Y' applicator brachytherapy (HDRB). Eleven patients with cancer of the endometrium were treated with CT-compatible HDR intracavitary Rotte 'Y' applicators (Nucletron) and underwent post-implant pelvic CT scans with applicators in place. All patients were treated using orthogonal radiography-based planning. The dose was prescribed to uterine point (a point located 2 cm below the center of a line drawn between the tips of the two ends of the Rotte applicator extending laterally from the tandem by half the maximum uterine width), Point A, and 0.5 cm depth along the upper 3 cm vagina. CT-images were transferred to the PLATO treatment planning system version 14.2.6 and retrospectively planned for volumetric calculations. The clinical target volume (CTV) included the entire uterus, cervix, and upper 3 cm of vagina. The volumes of organs at risk (OAR) were digitized. Dwell positions were identified and registered in both the uterine tandem for each patient. For those receiving HDRB alone, the prescribed dose was 7 Gy x 5 fractions. Patients who were treated following external beam radiation therapy (EBRT) received 4 Gy x 5 fractions. The interfraction interval was 6-8 hours. The DVHs were computed for the CTV, bladder, rectum, and sigmoid colon. To compare doses of OARs, 1.0 cc, 2.0 cc, and 5.0 cc volumes receiving the highest dose were calculated from DVHs. 3D optimization was done to improve target coverage and decrease dose to critical organs and compared with the 2D orthogonal radiograph-based plan. The mean of percentage of prescribed dose +/- S.D to 1 cc, 2 cc, and 5 cc of the OARs of interest were as follows: Rectum 44 +/- 21%, 39 +/- 18%, and 33 +/- 15%; bladder 104 +/- 36%, 91 +/- 31%, and 73.9 +/- 24%; and sigmoid 124 +/- 35%, 109 +/- 30%, and 89 +/- 25%, respectively. The corresponding dose to ICRU 38 bladder and rectal points were 98 +/- 55% and 50.5 +/- 32%, respectively. The mean dose to uterine point and point A were 99 +/- 1.7% and 98 +/- 3%, respectively. The mean CTV volume was 160 +/- 89 cc with the percentage of volume getting 100% and 90% of the dose being 62 +/- 12% and 68 +/- 12% with 2D plan versus 57 +/- 8% and 67 +/- 8.9% with 3D plan. The dose to critical organs were reduced with 3D optimization for rectum, bladder, and sigmoid by 5.6% (p = 0.04), 20.6% (p = 0.02), and 26.8% (p = 0.005), respectively. Compared to the 3-D volume dose, the prescription points overestimated the dose to the target volume. The under-dosing was because of inability of two channel applicator to cover volumes in the region of the cervix and vagina. The dose to sigmoid colon was high and attention should be given to the sigmoid dose at the time of treatment planning. 3D planning helped in reducing the dose to the critical organs without compromising target coverage. Correlations with outcome are needed to better define the role of 3D dosimetry in treatment planning.
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PMID:Comparison of 2D vs. 3D dosimetry for Rotte 'Y' applicator high dose rate brachytherapy for medically inoperable endometrial cancer. 1698 95

Primary vaginal adenocarcinoma of intestinal type is a rare malignant gynecologic disease. A 53-year-old woman was admitted to our institution with a diagnosis of endometrial adenocarcinoma. A physical examination revealed a 2-cm polypoid lesion of the vagina. The patient underwent surgery for endometrial cancer and wedge resection of the vaginal lesion. The diagnosis of primary vaginal adenocarcinoma of intestinal type was obtained after standard and immunohistochemical analyses of the specimen. No endometrial cancer was detected in the specimen. Radiological investigations excluded metastasis from the gastrointestinal tract. Subsequently, the patient underwent concomitant chemoradiation. At present, 32 months later, she is well and disease-free. Extensive radiological investigations and careful immunohistochemical analysis of the specimen are needed for a correct diagnosis of vaginal adenocarcinoma of intestinal type. Concomitant chemoradiation, as a primary treatment, should be considered.
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PMID:Incidental diagnosis of primary vaginal adenocarcinoma of intestinal type: a case report and review of the literature. 1788 3

The objective of this study was to determine if total laparoscopic hysterectomy using a uterine manipulator with an intrauterine balloon increases the risk of positive peritoneal washings in patients with endometrial cancer. Three sets of peritoneal washings were obtained during surgery from 46 women with endometrial cancer at the Center for Uterine Cancer, National Cancer Center, Korea, between May 2004 and July 2006: the first before the insertion of the uterine manipulator (premanipulator), the second after clipping the fallopian tubes and inserting the uterine manipulator (postmanipulator), and the third after the removal of the uterus through the vagina (posthysterectomy). The cytology samples were examined by the same cytopathologist for the presence of malignant cells. Two of 46 (4.3%) patients were upstaged to IIIA disease due to positive cytology conversion after the insertion of the uterine manipulator, one after the insertion of the uterine manipulator, and the other after the hysterectomy. However, during the follow-up for 3-28 months (median 18), neither of the 2 patients experienced a tumor recurrence. In conclusion, using a uterine manipulator with an intrauterine balloon during the laparoscopic surgery for endometrial cancer might be associated with positive cytologic conversion. Possible explanations are retrograde seeding of tumor cells into the peritoneal cavity, the pressure effect of the inflatable manipulator tip, and spillage of preexited tumor cells between the isthmus and the fimbriae. More effective preventive methods such as distal tubal clipping or coagulation of the fimbriae may be necessary in treating women with endometrial cancer.
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PMID:Does the use of a uterine manipulator with an intrauterine balloon in total laparoscopic hysterectomy facilitate tumor cell spillage into the peritoneal cavity in patients with endometrial cancer? 1821 79

The surgical treatment of endometrial cancer is still a matter of debate. Two of the most controversial issues are the beneficial effect of lymphadenectomy and the feasibility of laparoscopy. The aim of the case report was to describe the feasibility of total laparoscopic radical hysterectomy with pelvic lymphadenectomy in a 56-years-old Caucasian woman diagnosed with endometrial cancer. After a CO2 pneumoperitoneum was created the peritoneum was incised cranially to the para-colic fossa just above the external iliac vessels until the psoas muscle is visualized. The external iliac vessels were identified and lymph nodes from the anterior and the medial surface were removed until the iliac bifurcation and placed in an Endo-bag. The procedure continued with the identification of the hypo-gastric and the umbilical artery which were pulled medially in order to open the obturator fossa and remove the lymphatic tissue superior to the obturator nerve. The next step was the opening of the para-vesical and pararectal spaces by using blunt dissection; this maneuver was facilitated by pulling the uterine fundus towards the opposite direction with the uterine manipulator. The parametrium being isolated between the two spaces can be safely divided. At the superior limit of the parametrium the uterine artery is identified and divided at its origin. Thereafter, by placing the uterine fundus in median and posterior position, the vesicouterine peritoneal fold was opened by scissors and a bladder dissection from the low uterine segment down to the vagina was performed. Then the ureter is dissected, freed from its attachments to the parametria and de-crossed from the uterine artery down to its entry into the bladder. Next the rectovaginal space is opened and the utero-sacral ligaments divided; this allows the division of para-vaginal attachments. The vagina is sectioned and the specimen is extracted transvaginally. Then the vaginal stump was sutured by laparoscopy. Total laparoscopic radical hysterectomy with pelvic lymphadenectomy was not associated with an increased operative time or blood loss and appears to be a feasible alternative to conventional surgical approach in patients with endometrial carcinoma.
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PMID:Total laparoscopic radical hysterectomy with pelvic lymphadenectomy for endometrial cancer. 1845 5

Endometrial carcinoma is the most common malignancy arising in the female genital tract. Intracavitary vaginal cuff irradiation may be given alone or with external beam irradiation in patients determined to be at risk for locoregional recurrence. Vaginal cylinders are often used to deliver a brachytherapy dose to the vaginal apex and upper vagina or the entire vaginal surface in the management of postoperative endometrial cancer or cervical cancer. The dose distributions of HDR vaginal cylinders must be evaluated carefully, so that clinical experiences with LDR techniques can be used in guiding optimal use of HDR techniques. The aim of this study was to optimize dose distribution for Gammamed plus vaginal cylinders. Placement of dose optimization points was evaluated for its effect on optimized dose distributions. Two different dose optimization point models were used in this study, namely non-apex (dose optimization points only on periphery of cylinder) and apex (dose optimization points on periphery and along the curvature including the apex points). Thirteen dwell positions were used for the HDR dosimetry to obtain a 6-cm active length. Thus 13 optimization points were available at the periphery of the cylinder. The coordinates of the points along the curvature depended on the cylinder diameters and were chosen for each cylinder so that four points were distributed evenly in the curvature portion of the cylinder. Diameter of vaginal cylinders varied from 2.0 to 4.0 cm. Iterative optimization routine was utilized for all optimizations. The effects of various optimization routines (iterative, geometric, equal times) was studied for the 3.0-cm diameter vaginal cylinder. The effect of source travel step size on the optimized dose distributions for vaginal cylinders was also evaluated. All optimizations in this study were carried for dose of 6 Gy at dose optimization points. For both non-apex and apex models of vaginal cylinders, doses for apex point and three dome points were higher for the apex model compared with the non-apex model. Mean doses to the optimization points for both the cylinder models and all the cylinder diameters were 6 Gy, matching with the prescription dose of 6 Gy. Iterative optimization routine resulted in the highest dose to apex point and dome points. The mean dose for optimization point was 6.01 Gy for iterative optimization and was much higher than 5.74 Gy for geometric and equal times routines. Step size of 1 cm gave the highest dose to the apex point. This step size was superior in terms of mean dose to optimization points. Selection of dose optimization points for the derivation of optimized dose distributions for vaginal cylinders affects the dose distributions.
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PMID:Optimized dose distribution of Gammamed plus vaginal cylinders. 1918 Dec 51

It was the objective of this study to construct a model of the uterine vascular supply through vascular casting and thin slice computed tomography scanning. This will provide a teaching aide for the understanding of uterine artery embolization (UAE) procedures, as well as normal uterine and ovarian arterial anatomy. Using 20% chlorinated poly vinyl chloride, we infused and cast a set of a normal uterus, vagina and bilateral adnexa through the uterine artery and ovarian artery. After thin slice CT scanning, we obtained the three-dimensional (3D) reconstruction by maximum intensity projection (MIP) and surface-shaded display (SSD), and then observed its figure and characteristics. A model of the uterine vascular supply can be successfully reconstructed by vascular casting and thin slice CT scanning. The 3D reconstruction offers a clear view of the course of the uterine artery and its blood supply distribution. It has two major branches: The intramuscular uterine branch and the cervicovaginal branch (1). Blood supply is generally unilateral, with communicating branches between the two sides and possible anastomoses between the arterial blood supply of the uterus and the ovaries. The major blood supply of the cervix comes from the cervicovaginal branch of the uterine artery, while the vaginal arterial supply derives directly from the internal iliac artery. The CT technique allows real-time 360 degrees rotation and changes in model for in-depth study of the vascular network and its adjacent tissues. It is possible to construct an in vitro uterine arterial network by vascular casting and CT scanning, which can provide unique insight into the female genitourinary system arterial network. Based on this, we can create reconstructions as well as models for different diseases such as leiomyomata, adenomyosis, and endometrial cancer. These models will provide morphological evidence to the interventional therapy and UAE teaching in Obstetrics and Gynecology.
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PMID:Three-dimensional reconstruction of the uterine vascular supply through vascular casting and thin slice computed tomography scanning. 1992 2

The aim of this retrospective study was to assess the predictive value of different clinicopathological variables (patient age, tumour size, FIGO grade, myometrial invasion, lymph-vascular space involvement [LVSI], invasion margins, peri-tumour phlogistic infiltrate and mitotic activity) for the risk of distant haematogenous recurrences in patients with endometrioid-type stage Ib-II endometrial cancer. Between August 1990 and April 2005, 259 patients had undergone laparotomy, peritoneal washing, total abdominal hysterectomy and bilateral salpingo-oophorectomy, with or without pelvic +/- para-aortic lymphadenectomy for endometrioid-type endometrial cancer. Thirty-six (13.9%) patients had developed recurrent disease after a median time of 17 months (range, 2-128 months). The relapse had been locoregional in 9, distant in 21 and both locoregional plus distant in 6 cases. This study assessed 12 patients with FIGO stage Ib-II disease who had developed distant haematogenous recurrences and 20 randomly chosen control patients with FIGO stage Ib-II disease who had remained recurrence-free after a median follow-up of 52 months (range, 37-66 months). Adjuvant therapy had been: no further treatment in 15 patients, external pelvic irradiation in 14 patients, adjuvant external pelvic irradiation plus brachytherapy in 2 patients and platinum-based chemotherapy followed by external pelvic irradiation in 1 patient. The site of distant failure had been the lung in 9 patients, liver in 2 patients and lung plus liver in 1 patient. A concomitant locoregional relapse (vagina or lymph nodes) had occurred in 3 patients. The median interval between surgery and the development of distant failure had been 16.5 months (range, 5-113 months). On univariate analysis, a higher incidence of FIGO grade 3 (50% versus 10%, p=0.0114), outer one-third myometrial invasion (91.7% versus 35.0%, p=0.0051) and LVSI (75.0.% versus 20.0%, p=0.0022) was found in the patients who had developed distant haematogeneous metastases compared to the recurrence-free women. Multivariate analysis showed that LVSI (p=0.0264) and deep myometrial invasion (p=0.0345) were independent predictive variables for the risk of distant haematogeneous failure. Patients with these pathological findings should be enrolled in randomised trials designed to assess the role of adjuvant chemotherapy alone or combined with sequential and/or concomitant external pelvic irradiation.
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PMID:Lymph-vascular space involvement and outer one-third myometrial invasion are strong predictors of distant haematogeneous failures in patients with stage I-II endometrioid-type endometrial cancer. 1944 92

To overview the status of gynecologic cancer in Indonesia. Information regarding Indonesia obtained from World Bank Report and Statistical Yearbook of Indonesia 2007, epidemiological data obtained from Histopathological Data of Cancer in Indonesia 2002, Department of Health-Registry Body of Indonesian Specialist of Pathology Association-Indonesian Cancer Society; Various Hospitals in big Cities in Indonesia. Indonesia is an Archipelago with a total area of 1,922,570.00 km(2), the population is 222,192,000 (2006), the fourth world rank. Female is 49.86% with life expectancy 69 years. Gross National Product per Capita is 690.00 USD. Histopathological report in 2002 revealed that cervical cancer, ovarian cancer and uterine cancer were the most frequent cancer among female, which were the first (2,532 cases), the third (829 cases) and the eighth (316 cases) rank respectively. The peak age for cervical, uterine and ovarian cancer was 45-54 years. HPV 16, 18 were found in 82% of invasive cervical. Data from various academic hospitals in 2007 showed that cervical cancer is the most common malignancy followed by ovary, uterus, vulva and vagina. Five-year survival rate of stage I, II, III, IV cervical cancer were 50%, 40%, 20%, and 0% respectively. Overall five-year survival rate of carcinoma of the ovary was 54.8%. If sub-classified by stage, five-year survival rate are 94.3%, 75.0%, 31%, and 11.7% for stage I, II, III, and IV respectively. Five-year disease-free survival rate of endometrial cancer was 71.9%. Indonesia is the biggest Archipelago with a dense population but the income per capita still low (poor country). The most common gynecologic cancer is cervical cancer, followed by ovarian and uterine cancer. These cancers are included in top ten cancers in Indonesia. HPV 16, 18 were the most cause of cervical cancer. The five-year survival rates are comparable with world report.
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PMID:Gynecological cancer in Indonesia. 1947 61

Gynecologic oncology involves the study of preinvasive disease and cancers of the vulva, vagina, cervix, uterus, ovaries, and gestational trophoblastic disease. Endometrial cancer is the most common of the pelvic malignancies however, ovarian cancer is the most lethal. The other gynecologic cancers have not been studied in relation to physical activity (PA) and prognosis, and therefore are not included. Research addressing the relationship between PA and ovarian and endometrial cancer is sparse nevertheless, there are some emerging concepts. Studies suggest that overweight/obesity is associated with reduced survival from ovarian cancer, but the role that PA plays in these results, and whether survival can be altered by changes in body weight and/or PA following diagnosis is unknown. Limited research reveals that increased PA in older ovarian cancer patients is feasible and safe. The majority of endometrial cancer patients are overweight or obese. Obesity is associated with higher mortality, probably from cardiovascular disease and not cancer. Research reveals that increasing PA in overweight/obese endometrial cancers is feasible and successful. The effects of increased PA on recurrence or survival in gynecological cancers are not yet established, and randomized controlled trials are needed for definitive data.
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PMID:Physical activity and gynecologic cancer survivorship. 2111 70


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