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

A review of the pathologic material from patients in our population based uterine cancer registry in Louisville, Kentucky identified three subtypes of endometrial carcinoma with a favorable prognosis: adenoacanthoma, adenocarcinoma with no specific features, and secretory carcinoma. Three subtypes with a much less favorable prognosis were papillary carcinoma, mixed adenosquamous carcinoma, and clear cell carcinoma. The other important determinants of treatment results were: stage of disease, age, race, nuclear grade, and depth of myometrial invasion. This study evaluated these prognostic determinants for the favorable subtypes with Stage 1 disease that were fully treated. There were 595 patient eligible for five-year and 380 for ten-year vital status evaluation. Only three patients were lost to follow-up at five years and four at ten years. The five-year survival was 88.1% and the ten-year 74.5%. At five years 4.4% were dead of disease and at ten years 6.3%. There were 115 women younger than age 50. Their five-year survival was 98.3% and at ten years 94.6%. None was dead of disease at five years and only one at ten years. Black women had a significantly lower survival than did white women, but no black woman younger than age 50 died of disease. Nuclear grade was the most important histologic determinant of survival, followed by depth of myometrial invasion. Recommendations for treatment planning were formulated based on these prognosticators.
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PMID:Carcinoma of the endometrium. V. An analysis of prognosticators in patients with favorable subtypes and Stage I disease. 683 67

411 patients suffering from endometrial carcinoma were seen at the Roswell Park Memorial Institure in Buffalo, New York, between 1970 and 1978. These patients were matched and compared with 338 controls having no neoplastic disease or neoplasms other than of the female genital tract. There was a significantly higher incidence of diabetes, hypertension, and obesity in the uterine cancer patients than in the controls. On the other hand, nulliparity or family history of uterine or other cancer could not be correlated with endometrial cancer in these patients. The control and cancer groups did not differ markedly in the use of estrogens for menopausal or gynecologic reasons. Estrogen use in oral contraceptives (OCs) and for uncertain or unknown reasons was higher in the control than in the cancer group. The uterine cancer group was slightly older (median age 64.2) than the control group (median age 59.7), but this difference is small and believed unlikely to account for the results described.
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PMID:Estrogens and endometrial cancer. 694 29

Cervical cancer retains its character as a venereal disease associated with infections and multiple sexual partners, but poverty also is important. Precise incidence figures for cervical and endometrial cancer are almost nonexistent because in areas with precise case counts there is rarely accurate knowledge of hysterectomy prevalence. For endometrial cancer little recent attention has been paid to any risk factor except exogenous estrogen. It is now suggested that a low pregnancy rate is a cause, not a consequence, of ovarian pathology leading to cancer. Some progress has been made in separating the epidemiologies of various kinds of ovarian and uterine cancer. A few clues are available regarding the epidemiology of fallopian tube cancers and vaginal cancers other than those produced by maternal stilbestrol. Vulvar cancer becomes common only after the age of 75 and so has been neglected epidemiologically.
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PMID:High-risk factors in gynecologic cancer. 702 59

The slides of 233 patients included in a case-control study of estrogens and endometrial cancer were reviewed to determine how often endometrial cancer was misdiagnosed and whether patients with uterine cancer had other coexistent endometrial diseases. Reasonably close agreements were found among the original diagnoses and those of three additional reviewers (the total range of disagreements among all pathologists was from 2% to 16%). Proliferative and hyperplastic endometrium coexisted in many specimens from patients with endometrial cancer, and especially in those who had used estrogen replacement therapy. In contrast, estrogen therapy had seldom been used by patients whose cancers were not accompanied by these proliferative and hyperplastic lesions. In addition, these changes were found significantly more often in women with grade 1 cancers than grade 2 or 3 cancers. We conclude from these data that diagnostic misclassification is uncommon and that coexistent proliferative and hyperplastic lesions occur frequently, especially among women with grade 1 cancers. The data also suggest that the frequent finding of grade 1 cancer in estrogen users is due to bleeding that results from the stimulated coexistent benign proliferating endometrium.
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PMID:Histopathologic distinctions in the relationship of estrogens and endometrial cancer. 726 46

The trends in mortality from cancer of the uterine cervix, cancer of the endometrium and all uterus in Canada and the ten Canadian Provinces from 1951-53 to 1974-76 at ages 30-64 have been re-evaluated in relation to screening for cancer of the cervix in 1966 and 1971 and hysterectomies for non-malignant conditions from 1969 to 1976. By means of series of mathematical models, the effect of different prior extrapolations of the numbers of hysterectomies performed by age and province has enabled the potential impact of hysterectomies on the trends of mortality from uterine cancer to be evaluated by relating deaths to "uteri at risk" rather than "women at risk" irrespective of the presence of an intact uterus. It has been found that the numbers of hysterectomies performed have little impact on the fall in mortality certified to cancer of the cervix or to all uterine cancer, but in the decade 1964-66 to 1974-66 they convert an apparent fall in mortality from cancer of the endometrium to stability. Re-evaluation of the fall in mortality from 1960-62 to 1970-72 in relation to the intensity of screening shows little impact of the hysterectomies performed on the significant correlation reported previously. However, after extension of the analysis to 1974-76 the correlation disappears. This finding may indicate a more limited potential for the application of screening, as practised in Canada, to reduce mortality from cancer of the cervix, than has been anticipated previously.
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PMID:The effect of hysterectomies and screening on mortality from cancer of the uterus in Canada. 728 25

Calphobindin I (CPB I) is a member of the family of Ca(2+)-dependent phospholipid binding proteins collectively termed as annexins. CPB I (Annexin V) has recently been shown to be an endogenous inhibitor of protein kinase C, a key enzyme in the cellular signal transduction and its inhibition by CPB I is presumed to be related ultimately to carcinogenesis. We therefore examined the level of production of CPB I in uterine cancer cells. Immunohistochemical analysis, northern blot, and in situ hybridization showed that the production of CPB I was markedly suppressed at the level of transcription in both cervical and endometrial carcinoma cells when compared to their normal counterparts. Decrease in production of CPB I may lead to dysregulated activation of protein kinase C and, accordingly, may be involved in a disorder of cell differentiation, proliferation, and carcinogenesis.
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PMID:Suppression of calphobindin I (CPB I) production in carcinoma of uterine cervix and endometrium. 767 95

Several reports have noted an association between the use of tamoxifen in breast cancer patients and the subsequent development of endometrial carcinoma. Magriples et al. (J. Clin. Oncol. 11, 485-490, 1993) recently reported that 67% of uterine cancers that developed in 15 breast cancer patients on tamoxifen had high-grade lesions or high-risk histologies, compared to 24% of those developing in 38 breast cancer patients not receiving tamoxifen. To confirm these results, we conducted a retrospective review of 73 patients with a history of breast cancer who subsequently developed uterine cancer and underwent surgery at our institution. Twenty-three (32%) had received tamoxifen for at least 1 year, with a median duration of use of 4.5 years, while 50 (68%) did not receive tamoxifen. The median interval between diagnosis of breast and corpus cancer was less in the group that received tamoxifen than in the group that did not (4.6 vs 6.7 years), but this was not statistically significant. Seventy-four percent of the corpus cancers in the tamoxifen group were adenocarcinomas, while 26% were considered high-risk histologies, which was identical to the findings for the group that did not receive tamoxifen. The distribution by FIGO stage was I, 15 (65%); II, 2 (9%); III, 5 (22%); and IV, 1 (4%) for the tamoxifen group, and I, 37 (74%); II, 1 (2%); III, 8 (16%); IV, 3 (6%); and unstaged, 1 (2%) for the group not receiving tamoxifen (P = NS). For patients with endometrial adenocarcinoma, 23% of the tamoxifen group had grade 3 lesions, compared with 19% of the no tamoxifen group (P = NS). Our review of corpus cancers developing in breast cancer patients demonstrated no significant difference in stage, grade, or histologic subtype based on tamoxifen use.
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PMID:Tamoxifen use in breast cancer patients who subsequently develop corpus cancer is not associated with a higher incidence of adverse histologic features. 795 77

Endometrial cancer occurs more frequently than any other cancer of the female reproductive tract. The overall five-year survival rate for patients with endometrial carcinoma in a series of 13,000 patients was 68%. If diagnosed with Stage I disease, the patient's five-year survival increases to 75% (17). Early diagnosis of uterine cancer is accomplished by physician recognition of risk factors, symptoms and signs.
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PMID:Endometrial cancer: risk factors and diagnosis. 859 45

Carcinoma of the endometrium is the most common gynecologic malignancy, expected to account for 33,000 new cases and 6,000 deaths in 1995. Most endometrial cancers occur in postmenopausal women and produce abnormal vaginal bleeding. Some women exhibit the premalignant changes of atypical endometrial hyperplasia before developing an overt carcinoma. Identified epidemiologic risk factors include obesity, diabetes mellitus, use of unopposed exogenous estrogens, estrogen-secreting tumors, and a reproductive history characterized by prolonged estrogenic predominance. Diagnosis can be readily established by outpatient endometrial biopsy. Because clinical estimates of disease extent and spread are subject to substantial error, endometrial cancer is now a surgically staged neoplasm. A well-defined set of surgicopathologic risk factors have been incorporated into the staging scheme. Women with extrauterine disease comprise about 20% of cases and are at greatest risk for tumor recurrence and death from disease. Within the much larger group of women whose tumors are limited to the uterus, recurrence risk can be stratified by cytologic grade, cell type, depth of myometrial invasion, and extension to the cervix. About two-thirds of women have low-risk disease confined to the uterus when these criteria are employed, while the remaining one-third have high-risk subtypes. Recent areas of investigation have focused on molecular and genetic markers. Two clinical observations currently being examined are the poorer survival of Black women with uterine cancer and the apparent association of endometrial lesions with chronic tamoxifen suppression in women with breast carcinomas.
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PMID:Clinical aspects of risk in women with endometrial carcinoma. 874 87

Women at risk of uterine cancer include those with one or more of the following characteristics: obesity, nulliparity, late menopause, diabetes mellitus, prolonged unopposed estrogen use, and tamoxifen therapy. Risk is additionally increased by the presence of endometrial hyperplasia. The incorporation of biomarkers into the selection criteria of cohort groups at risk for developing endometrial cancer offers an innovative approach to the clinical design of chemoprevention trials of endometrial adenocarcinoma. Biomarkers that may be useful in cohort selection include nuclear morphometry, specific genetic abnormalities, and markers of proliferation and differentiation.
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PMID:Potential criteria for cohort selection in chemoprevention trials of uterine adenocarcinoma. 874 95


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