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

In an attempt to create uniform nation-wide guidelines for the management of all stages of endometrial cancer, and to limit the use of adjuvant irradiation in stage I disease to high-risk patients only, a protocol was developed by the Danish Endometrial Cancer (DEMCA) group. As histologic grading and degree of myometrial invasion are useful indicators of high risk, it was decided not to deliver preoperative irradiation. In order to evaluate the effect of sequential endocrine treatment with anti-estrogen and progestin in stage IV endometrial cancer and recurrences a phase II protocol was developed. From September 1986, the great majority of women in Denmark with newly diagnosed cancer of the endometrium have been treated according to these protocols. The DEMCA protocols are described, and preliminary data from the first year of the study are presented. Mean follow-up time is still short and does not permit analysis in respect to treatment results.
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PMID:The Danish Endometrial Cancer Study (DEMCA). 278 38

Forty-six eligible women with metastatic endometrial cancer were randomly allocated to receive monthly cycles of either CAF (cyclophosphamide, adriamycin, 5-fluorouracil) or CAF plus Provera 200 mg daily for 3 weeks followed cyclically by Tamoxifen 20 mg daily for 3 weeks. Overall response rates of 15 and 43% were seen with CAF and CAF plus hormonal therapy. Using a multivariate analysis of the results, this difference is significant (P value 0.05). In 8 patients with operable endometrial cancer, negative estrogen receptor concentration (ER less than 15 fmole/mg protein) and Grade 3 disease, the clinical course was aggressive in 4 patients with systemic and local relapse. In 10 other similar patients (negative ER and Grade 3) who received adjuvant cyclical hormonal therapy only 1 relapsed and the other 9 are disease-free for an average of more than 31 months. Sequential cyclical hormonal therapy with ER and progesterone receptor analysis has a place in the management of endometrial carcinoma.
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PMID:Efficacy of sequential cyclical hormonal therapy in endometrial cancer and its correlation with steroid hormone receptor status. 297 97

Spinal cord or cauda equina compression secondary to epidural metastasis rarely develops in patients with endometrial carcinoma and the early signs and symptoms of compression can therefore be inadvertently overlooked. A 78-year-old patient who developed bone metastasis with destruction of the fifth lumbar vertebral body and blockage of the cauda equina at L-4, L-5 as the only sites of metastasis is reported. This occurred 2 years after initial treatment of a stage IB, well-differentiated, grade I, adenosquamous carcinoma of the endometrium. The patient remains alive, with good neurological function and free of metastatic disease, 2 1/2 years following vertebrectomy, radiation therapy, and adjuvant Provera (medroxyprogesterone acetate) therapy. This patient represents the only case of metastatic endometrial cancer with cauda equina compression in the literature in whom long-term disease-free follow-up has been noted.
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PMID:Cauda equina compression secondary to metastatic carcinoma of the uterine corpus: preservation of neurologic function and long-term survival following surgical decompression and radiation therapy. 397 89

Progestin therapy is indicated for advanced or metastatic endometrial cancer as well as a adjuvant therapy for primary cancer. There are several predictors of tumor responsiveness to the hormone. Sex steroid receptor(R) is a biochemical marker. Receptor analysis was done in 73 cases of primary endometrial cancer. The concentrations of estrogen (E), progestin (P) and androgen (A) were found to correlate with the degree of tumor differentiation; well-differentiated tumor contains significantly greater receptors than moderately-and poorly-differentiated tumors. Both ER and PR were positive in about 80% of the well-differentiated tumor, but negative in 50% of the poorly-differentiated tumors. Analysis of 13 cases of death shows some correlation of the PR concentrations with the survival time. Receptor dynamics in tumor of the patients enables us to predict possible site(s) of impaired responsiveness to progestin. Furthermore, in addition to progestin and estrogen test, tamoxifen challenge test is useful as in vivo sensitivity test. Moreover, receptor manipulation by tamoxifen may be employed to enhance hormonal sensitivity of the tumor, particularly the low receptor one.
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PMID:[Hormonal therapy of endometrial cancer]. 405 75

Estrogen receptors and progesterone receptors were measured in tumors from patients with previously untreated endometrial carcinoma before and after a 5-day course of tamoxifen citrate. On initial biopsy, 13 of 25 tumors (52%) were progesterone receptor-positive, whereas 21 of 25 tumors (84%) were progesterone receptor-positive after tamoxifen. Grades 1 and 2 tumors were more likely to demonstrate this increased incidence of measurable progesterone receptors. Considering these results, and the work of others who have shown that progesterone receptor-positive metastatic endometrial cancer is more responsive to progestin therapy than are progesterone receptor-negative tumors, we instituted a phase II clinical trial of tamoxifen plus progestin for patients with recurrent endometrial carcinoma. Thus far, however, the 33% total response rate achieved with the combination therapy has not been superior to standard progestin therapy.
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PMID:Tamoxifen and endometrial carcinoma: alterations in estrogen and progesterone receptors in untreated patients and combination hormonal therapy in advanced neoplasia. 623 50

For many years before the first case-control studies showing an increased risk of endometrial cancer among menopausal estrogen users were published, a considerable body of circumstantial evidence accumulated suggesting a tumor-promoting role for estrogens in specific target organs. In regard to endometrial cancer, an "estrogen hypothesis" has evolved based on observations such as an increased incidence of endometrial cancer in patients with chronic anovulation and in patients with estrogen-secreting ovarian tumors; development of endometrial cancer in certain estrogen treated animals; and successful treatment of some metastatic endometrial cancer with progesterone. Since 1975, a number of case-control studies have appeared relating estrogen treatment of menopausal women to a rising incidence of endometrial cancer. The same cannot be said, with a few exceptions, of studies of breast and ovarian cancer. An understanding of the physiology of the estrogens, particularly in obese women, aids in understanding the possible role of estrogen in promoting endometrial neoplasia. Although the case for estrogens promoting some forms of endometrial cancer is strong, at the present time it cannot unequivocally be stated that estrogens cause any form of cancer in humans.
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PMID:Estrogen--a cause of gynecologic cancer? 702 61

Recurrent endometrial cancer has grave prognosis. Chemotherapy and hormonal therapy are mainstays of palliative treatment. Unfortunately the frequency of complete response and duration of progression-free interval are limited. This case report describes a patient with recurrent metastatic endometrial cancer who was initially treated with radiotherapy followed by surgery. Her recurrent tumor progressed during treatment with external radiation and a progestogen. She received paclitaxel (135 mg/m2 i.v. infusion over 24 h) and carboplatin (AUC 7.5 microg x h/ml) every 4 weeks with complete remission after 8 months which has persisted for 22 months. Paclitaxel and carboplatin combination should be considered for the treatment of endometrial cancer.
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PMID:Prolonged remission of endometrial cancer with paclitaxel and carboplatin. 962 39

It has long been recognized that individuals with ovarian cancer who initially respond to a platinum-containing chemotherapeutic regimen may exhibt a second response to platinum (cisplatin or carboplatin) at the time of recurrence. In this report, we describe three individuals with metastatic endometrial cancer who demonstrated secondary responses to platinum/paclitaxel-based regimens. Endometrial cancer should be added to the list of malignancies for which platinum and/or paclitaxel are considered as second-line treatment options in patients previously responding to the agents.
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PMID:Persistent chemosensitivity to platinum and/or paclitaxel in metastatic endometrial cancer. 1036 71

Oral etoposide has activity in a wide variety of tumors and is well tolerated. Therefore, the efficacy of oral etoposide was assessed as a treatment of metastatic endometrial cancer. To be eligible for this group-wide Southwest Oncology Group trial, patients had to have histologically proven metastatic or recurrent endometrial carcinoma; no previous cytotoxic therapy; and adequate renal, hepatic, and hematologic function, and they had to have given informed consent. Therapy consisted of oral etoposide, 50 mg daily on days 1-21 on a 28-day schedule. Therapy was continued in the absence of toxicity or disease progression. Forty-four eligible women, with a median age of 68 years (range 38-84 years) were treated. Radiotherapy had been delivered to 33 and hormomal therapy to 21. The median duration of therapy was 69 days (range 7-510 days). The treatment was well tolerated. Only one patient had grade 4 neutropenia, and a second had grade 4 anemia. Three patients had grade 3 nausea. One complete and five partial responses (14%) were observed. An additional four patients had unconfirmed responses. Tumor regressions were noted in nodes, bone, and visceral organs. While oral etoposide has only a modest level of activity when used in chemonaive patients, the minimal toxicity of this drug makes it a candidate for use in combination chemotherapy.
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PMID:Phase II trial of oral etoposide in recurrent or refractory endometrial adenocarcinoma: a southwest oncology group study. 1047 5

Stage IV endometrial cancer is uncommon, often occurs in elderly patients and has a poor prognosis, which makes the choice of treatment difficult. 18 patients with stage IV endometrial cancer presenting over a 10 year period, between 1987 and 1997, were reviewed with regard to mode of treatment and response. The mean age was 65 years. Five had disease confined to the pelvis and 13 had extra pelvic disease. 15 of 18 patients had a total abdominal hysterectomy (TAH). One patient received radiotherapy alone and five received post-operative radiotherapy. Overall freedom from pelvic symptoms was achieved in seven of 18 patients. All seven had undergone TAH and two had received post-operative radiotherapy. Progestogens were given to 13 patients. Six received progestogens alone, without radiotherapy or chemotherapy. Of these, two responded, one for 9 months and one with verified lung metastases, who had a complete response, is still alive at 6.5 years. Eight patients received chemotherapy, with single agent cisplatin or carboplatin AUC 6. Three patients responded, one for 4.5 years. The overall median survival was 12 months from diagnosis. Actuarial 5 year survival was 15% (CI 3-36). There was no significant survival difference for, hormone therapy or chemotherapy. Stage IV endometrial cancer has a poor prognosis but durable response can be achieved in some patients.
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PMID:Stage IV endometrial carcinoma: a 10 year review of patients. 1050 14


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