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

The authors reviewed 2007 consecutive outpatient hysteroscopies performed in self-referred women to assess the detection rate of uterine cancer and the validity of different selection criteria for hysteroscopy. Thirty cases of uterine cancer (29 endometrial, 1 carcinosarcoma) were detected. Abnormal uterine bleeding was the indication most commonly associated with cancer (26 of 30 cases, cancer detection rate = 2.1%), whereas the presence of cervical polyps had no predictive value. Patients age was correlated to cancer detection rate, and the investigation of uterine cancer under the age of 45 was poorly cost effective. Hysteroscopy and endometrial biopsy, performed by Permacurette or Novak curette immediately after hysteroscopy, missed respectively 8 and 2 of 30 cancers. Hysteroscopy should be employed in combination with endometrial biopsy as a standard outpatient investigation whenever endometrial cancer is suspected. These procedures are safe and accurate and rule out more aggressive and costly procedures, such as dilatation and curettage, in most cases.
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PMID:Hysteroscopy and endometrial cancer diagnosis: a review of 2007 consecutive examinations in self-referred patients. 180 13

The efficacy of sialyl SSEA-1 antigen (SLX), a tumor-associated carbohydrate antigen, as a test for gynecological cancer was investigated. The test was found to be positive in 64.5% of all patients with ovarian cancers; this rate is lower than that obtained with CA 125. On the other hand, relatively few false-positive results were observed. Tests were false-positive in 25.0% of patients with endometrial cysts; 25.0% of women in the first trimester of pregnancy and 0.0% of menstruating woman had false-positive results. These percentages were lower than those for CA 125. It is concluded that SLX is a tumor marker with inferior sensitivity and high specificity, compared with CA 125. Since positive tests with SLX in patients with ovarian cancer mostly overlapped the positive tests for CA 125, the usefulness of a combination assay was considered to be low. The SLX test was positive in 18.6 and 25.0% of patients with cervical cancer and endometrial cancer, respectively, and it was concluded that SLX is useless as a serum tumor marker for uterine cancer.
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PMID:Clinical value of sialyl SSEA-1 antigen in patients with ovarian cancer. 196 79

A complete review of case series from 1963 to 1969 (603 patients) permits some considerations and conclusions on the clinical management of endometrial cancer. In the aims of prophylaxis, prevention and early diagnosis, personalized, not routine mass screenings, are the best in clinical practice by gynecologists. Surgical Pathological Staging (SPS) is mandatory for adequate treatment and prognosis. Operability is now 96%, with surgical pathological radicality in 98% of operated patients. In early stages lymphnode involvement was low (5%), in advanced, high (31%). In uterine cancer the simple surgical exploration, when negative, is reliable in 90.9% for parametrial and 89.9% for lymphnodal status; consequently in early stages surgical exploration can lead to pelvic lymphadenectomy, or not. Simple surgical operations are almost always enough for good radicality, while enlarged operations must be personalized only in particular advanced cases. Five-year survival is better with surgery alone in the early stages (SPS A1-A2) rather than surgery plus integrated therapies. On the contrary, in advanced stages limited to the corpus uteri (SPS A3) surgery plus integrated therapies gives the best results in 5-year survival rates. In advanced cases growing outside the corpus uteri (SPS B) both surgery alone and surgery plus integrated therapy are disappointing, and the 5-year survival is the same. The incidence of vaginal cuff relapses is the same, with or without complementary radiotherapy, which we have abandoned. Close follow-up allows for the early treatment of relapses, improving quality of life and survival.
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PMID:Clinical experience in gynecological cancer management. Endometrial cancer: report from the gynecological institutes of Padua university (1963-1989). 234 29

From 1973 through 1985, 49 women received postoperative open-field whole abdominal radiotherapy as primary management for peritoneal metastases from uterine cancer. The 5-year relapse-free rate was 63% in women with endometrial carcinoma, and two prognostic subsets were identified. Five-year relapse-free rates fell from 77% in women with spread to the adnexa or peritoneal fluid to 36% in women with macroscopic spread of cancer beyond the adnexa. Any peritoneal spread of cervical carcinoma yielded a 3-year relapse-free rate of 31%. Although abdominal spread of cervical cancer was associated with other poor prognostic factors, peritoneal metastases frequently occurred in otherwise early endometrial cancer. Four percent of patients developed small bowel obstruction requiring surgical intervention. The utility and limitations of whole abdominal radiation are discussed.
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PMID:Abdominal radiotherapy for cancer of the uterine cervix and endometrium. 254 96

The relation between use of conjugated estrogens and the risk of uterine cancer was examined among 188 white women with newly diagnosed endometrial cancer and 428 controls hospitalized for nonmalignant conditions requiring surgery at the Boston Hospital for Women-Parkway Division, Boston, Massachusetts, in January 1970-June 1975. As in prior studies, the greatest increases in risk were associated with dosages of 0.625 mg or greater (relative risk (RR) = 3.8, 95% confidence interval (CI) = 2.2-6.6) and duration of use of 10 or more years (RR = 7.6). Risk was elevated whether or not use was cyclic. Cyclic use was associated with a higher risk (RR = 3.6, 95% CI = 2.2-6.6) than continuous use (RR = 2.4, 95% CI = 1.3-4.1), but the difference between these risk estimates was not statistically significant. Risk remained increased even among women who had discontinued use of conjugated estrogens five or more years previously (RR = 4.5). Cases who were previous users had less advanced lesions at diagnosis than had never users. The highest risk associated with use of conjugated estrogens was that for stage I, grade 1 disease with no myometrial invasion. However, increases in risk of more advanced disease were seen among long-term users.
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PMID:Conjugated estrogen use and risk of endometrial cancer. 301

Between 1982 and 1984 330 women in postmenopause for at least one year were admitted to the First Clinic of Obstetrics and Gynecology, Catania University Medical School, Catania, Italy, with a frequency of 10.04% of gynecological admissions. The most frequent pathologies were metrorrhagia (32.72%; 108 cases) from an atrophic endometrium or glandular hyperplasia of the endometrium, vaginoperineal lacerations with cystorectocoele with or without urinary incontinence (10.90%; 36 cases), cancer (11.21%; 37 cases) and ovarian cystoma (11.21%; 37 cases), uterine prolapse (9.30%; 31 cases), and endometrial polyps (9.09%; 30 cases). Uterine fibromyoma (3.93%; 13 cases) and carcinoma of the portio (3.93%; 13 cases) were among the rare pathologies. Uterine pathologies were the most prevalent (68.78%; 227 cases), followed by ovarian (15.15%; 50 cases), pathology of involving the pelvic and perineal containment (10.90%; 36 cases), vulvar pathology (2.72%; 6 cases), and vaginal pathology (1.51%; 5 cases). Malignant neoplastic pathology was reported in 25.45% of cases (84 cases) consisting only of uterine cancer (47.61%; 40 cases) and ovarian cancer (45.23%; 38 cases). In comparison with the study performed by Cetroni in 1952 one notes a net reduction in the frequency of uterine prolapse (by about three times), and a smaller reduction in cancer of the uterine cervix with a slight increase in cervical polyps, endometrial cancer, and above all in metrorrhagia from atrophic endometrium or glandular hyperplasia of the endometrium.
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PMID:Current aspects of gynecological pathology in postmenopause. 340 88

The present study correlated the hysterographic and nonradiation-affected uterine histologic findings in 91 patients with suspected uterine cancer. Hysterography helped diagnose correctly a benign or malignant lesion, and helped identify the correct primary site of a malignant lesion in 11 patients. In 65 patients with a final diagnosis of endometrial carcinoma, all five cases of true endocervical involvement were identified, 69% were determined to have either no residual tumor or no myometrial invasion, and 88% were predicted correctly to have a myometrial invasion of greater than one-half. Prediction of the volume, distribution, and point of maximum invasion permitted the uterus to be opened so as to permit the best histologic assessment of the depth and extent of the lesion.
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PMID:Hysterography in patients with suspected uterine cancer: radiographic and histologic correlations and clinical implications. 355 62

To explore further the relation between infertility and breast and female reproductive cancers, cancer incidence among 2,632 Israeli women treated for infertility between 1964 and 1974 was evaluated. Cancer incidence through December 1981 was determined by matching the study cohort to the Israel Cancer Registry. The observed number of cancers was compared with sex-age-ethnic and calendar-year, site-specific national cancer rates. There were 42 cancers observed compared with 37.4 expected, yielding a standardized incidence ratio of 1.1 (95% confidence interval (CI) = 0.8-1.5). Analysis by infertility diagnosis demonstrated no significant excess of total cancer incidence; the standardized incidence ratio was 1.3 (95% CI = 0.8-1.8) for infertility due to hormonal deficiency, 0.7 (95% CI = 0.3-1.4) for mechanical infertility, 1.6 (95% CI = 0.6-3.6) for infertility of the male partner, and 1.1 (95% CI = 0.5-2.2) for unclassified diagnosis. Site-specific analyses revealed a significantly increased risk (8.0; 95% CI = 2.5-19.3; four cases observed, 0.50 expected) of endometrial cancer for the hormonal group and a nonsignificant excess of breast cancer and melanoma. Although numbers were small, women with disorders causing unopposed estrogen production had a risk of 1.4 (95% CI = 0.8-2.2) for all cancer sites, which reached 10.3 (95% CI = 2.6-28.2; three cases observed, 0.29 expected) for endometrial cancer and 1.8 (95% CI = 0.8-3.4; eight cases observed, 4.43 expected) for breast cancer. Among women with nonhormonal infertility, there was a suggestion of increased risks of carcinoma of the ovary (3.2; 95% CI = 0.3-32.9; two cases observed, 0.63 expected) and thyroid (3.0; 95% CI = 0.3-24.6; two cases observed; 0.67 expected). No evidence of an association between ovulation-inducing drugs and cancer was found. This study supports the hypothesis that infertility caused by hormone deficiency is a risk factor for uterine cancer, but is inconclusive regarding breast cancer.
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PMID:Cancer incidence in a cohort of infertile women. 356 53

Thirty-eight women with surgically confirmed periaortic lymph node metastases from cervical or endometrial carcinoma received radiation therapy. The 5-year observed actuarial survival and relapse-free rates were 42% and 41%, respectively. Concomitant peritoneal metastases conferred a bleak prognosis. There were no differences in survival as a function of site of origin, histologic characteristics, or bulk of periaortic metastases. Earlier stage disease tended to have a higher probability of cure. Morbidity was acceptable. The results confirmed the importance of radiation therapy in the management of lymph node metastases in uterine cancer.
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PMID:Radiation therapy of periaortic node metastases in cancer of the uterine cervix and endometrium. 365 86

Diagnosis and treatment for the uterine cancer since 1949 were reviewed. During the period of 1949 to 1975, a total of 6986 cases of cervical cancer, including stage 0, were treated. Whereas the five year survival rate for the first five years was 56.3%, it rose 80.8% for the latest five years. This improvement depends mainly on the marked increase in stage 0 cases. There is not so much difference in survival rate between surgery and radiotherapy. Adequate therapy for the recurrent diseases, which were found by the follow-up examinations after the primary treatments, contributed to 2.24% raise in five year survival rates. This fact shows the important role of the periodical follow up examinations for all patients previously treated. As the endometrial cancer has been gradually increasing in Japan, the necessity for paying attention to the early detection were pointed out.
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PMID:[Review on diagnosis and treatment in cancer of the uterus]. 663 90


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