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

The treatment regimens are described in 74 patients with endometrial disease among 850 climacteric women receiving oestrogen therapy. Cystic hyperplasia was associated with unopposed oestrogen therapy without progestagen. Two courses of 21 days of 5 mg norethisterone daily caused reversion to normal in all 57 cases of cystic hyperplasia and 6 of the 8 cases of atypical hyperplasia. 4 cases of endometrial carcinoma referred from elsewhere demonstrated the problems of inappropriate and unsupervised unopposed oestrogen therapy and the difficulty in distinguishing severe hyperplasia from malignancy. Cyclical low-dose oestrogen therapy with 7--13 days of progestagen does not seem to increase the risk of endometrial hyperplasia or carcinoma.
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PMID:Prevention and treatment of endometrial disease in climacteric women receiving oestrogen therapy. 8 11

Dr Thom and her colleagues (Sept. 1, p. 455) are incorrect when they state that the U.S. case-control studies of endometrial cancer and oestrogen use "are open to criticism on grounds of selection of patients, poor medical supervision, inappropriate hormone therapy, and lack of clarification of the pathology by the addition of progestagens." It is not the studies which are open to criticism on the grounds stated but the way in which oestrogen therapy had been administered before the publication of these studies. A case-control study compares the frequency of exposure to a suspect carcinogen (oestrogens, in the example of endometrial carcinoma) to that of a control group. Since it was not at all a common practice to prescribe oestrogen with a progestagen when these studies were done, few histories of this combined regimen were found in either the cases or controls. But it is a great mistake to conclude that the absence of data on the risk of combined oestrogen and progestagen therapy means that there is no risk attached to combined therapy. The case-control studies that have thus far been reported shed no light on this risk because the regimen was too rarely used for these studies to have picked up a risk if indeed it was present. Thom et al. suggest that treatment with progestagen is effective in preventing or reversing endometrial hyperplasia. It is not yet well established that hyperplasia is a precursor to neoplasia. Thom et al. may be correct in believing that the combined regimen is safe but we must be perfectly clear about the meaning of the results of our case-control study, the largest reported to date. Our results do not put the combined regimen beyond suspicion but rather point up the need for continued monitoring of this regimen for cancer risk until the issue can be settled one way or the other. Meanwhile, the unfortunate experience with widely prescribed unopposed oestrogens should serve as a warning that any recommendations about prolonged use of these substances should be made with considerable caution.
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PMID:Oestrogen-replacement therapy. 9 Aug 98

Our method of irradiation of the endometrial carcinoma is described. The patient collective concerned represents a negative selection, as only inoperable cases with an endometrial carcinoma undergo primary irradiation. The 5-year survival rate amounted to 50.4% of 802 patients in the period from 1950 through 1970. Additional therapy with gestagens is discussed and recommended. The histological alterations in the material obtained by so-called "second-look curettages" are reported. Application of gestagens to other hormonesensitive tumors such as carcinoma of the ovary or adenocarcinoma of the cervix uteri is considered.
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PMID:[Therapy with gestagens for gynecological tumors sensitive to hormones (author's transl)]. 9 Dec 47

Red cells containing Hb F (F cells) were detected by immunofluorescence using a specific antiserum. In normal persons, the number of F cells was 2.5 +/- 1.1%. A significantly increased number of F cells was found in 65% of patients with cancer of the ovary, 69% of patients with cancer of the endometrium and in 22% of patients with cancer of the cervix. Highest values were obtained in cancer of the ovary and endometrium. There was no correlation between the number of F cells and stage of disease or degree of differentiation. It is postulated that in patients with malignant disease a humoral factor is produced which interferes with normal erythropoiesis resulting in a process of dedifferentiation.
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PMID:F cells in gynaecologic malignancy. 9 26

Between January 1969, and August 1975, 40 patients with pathologic Stage II carcinoma of the endometrium were treated at the Joint Center for Radiation Therapy. The treatment policy included external and intracavitary irradiation combined with surgery. The majority of patients received 4000 mg/hours of radium exposure using a Fletcher-Suit applicator and 4000 rad whole pelvis external irradiation, followed by hysterectomy and bilateral salpingooophorectomy. Median age of the patients was 61 years (39--88) and the median follow-up of the patients still alive was 69 months (29--102). Relapse-free 5-year survival corrected for intercurrent disease was 83% and uncorrected, 78%. Overall survival was 80%. Five patients had relapsing disease, three patients failed at distant sites only, one patient died of treatment related complications, and two failed locally and distantly. There were no failures in the pelvis alone. Although the relationshop between histologic grade and failure is not statistically significant, there were four failures among the 12 Grade III patients compared to two failures in 27 with Grades I and II. Similarly, 4 of 12 patients with gross cervical involvement developed relapsing disease, but only 2 of 28 failed with microscopic cervical involvement. This treatment policy yields excellent survival and continues to be our treatment recommendation.
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PMID:Combined irradiation and surgery in the treatment of stage II carcinoma of the endometrium. 10 Feb 5

All available data that have been used to either support or refute the suspicion that estrogens cause endometrial cancer have come from retrospective case-control studies. The present controversy rests on the willingness or unwillingness of investigators to accept conventional case-control studies as a suitable substitute for clinical trials or longitudinal cohort studies. In a clinical trial or longitudinal cohort study conducted with routine endometrial examinations, there would be no problem of differential detection, but the investigator has no way of knowing the magnitude of the problem in a conventional case-control study. "Community surveillance" is a problem that has been ignored in all of the conventional epidemiologic case-control studies. This bias has led to a spurious overestimation of the association between exogenous estrogens and endometrial cancer. The alleged causal association has been reported in 7 recent conventional studies that conflict with 2 older investigations and with subsequent research in which the magnitude of the association was substantially lower. The attempt is made to demonstrate how "community surveillance bias" has produced the contradictory findings in the cited studies. Community surveillance refers to medical examinations that take place before an individual becomes a case or control in the hospital. A bias in surveillance can arise unless medical attention was sought by the patient and received prior to hospitalization in a manner that permitted the exposed (estrogen-taking) and the non-exposed an equal chance to become classified as cases. When bias was reduced or eliminated by selecting control groups with comparable rates of diagnostic surveillance, the causal association vanished.
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PMID:Community surveillance bias and the estrogen-endometrial cancer dispute. 11 Apr 9

A test is described for the evaluation of hormone sensitivity of endometrial cancer in vivo. The concentrations of progesterone and estradiol receptors, and the activities of ornithine-decarboxylase and 17 beta-hydroxysteroid oxido-reductase enzymes have been measured in the tumor, before and after administration of the anti-estrogen tamoxifen. The responses observed, in particular the increase of progesterone receptor, could allow a more rational approach to hormonal therapy of endometrial cancer.
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PMID:[Response to an antiestrogen as a criterion for hormonal sensitivity of endometrial cancer]. 11 15

Carcinoma of the cervix or endometrium was evaluated in 1,021 patients at the Joint Center for Radiation Therapy, Boston, between July 1968 and December 1977. The patients were retrospectively evaluated for the presence of lung metastases, appearing initially or during their disease course. On chest radiography, 42 patients were found to have metastases. Lung metastases were seen in 5.1% of patients with carcinoma of the cervix and in 3.6% of patients with carcinoma of the endometrium. Median time from initial disease staging to detection of lung metastases was 12 months. Once pulmonary spread was discovered, 80% of patients expired within 1 year. Lung nodules varied greatly in size. In 11 patients they were solitary; five patients had pleural effusions; three had mediastinal or hilar adenopathy; and none had excavation.
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PMID:Lung metastases in cervical and endometrial carcinoma. 11 20

Twenty-nine patients with stage II endometrial carcinoma were reviewed and the possible risk factors involved in state II disease are presented. Twenty-four patients received external irradiation as part of their treatment with or without intracavitary or intravaginal radium and/or TAH BSO. The 5-year actuarial survival in our series was 81.4%. The data showed that preoperative external irradiation can be effectively administered without undue complication. A strong argument against the traditional use of preoperative intracavitary radium is presented. Preoperative external irradiation administered with a 4-field box technique to deliver a minimum dose of 5000 rad in 5--6 weeks to all the structures at risk is the recommended treatment for stage II endometrial carcinoma.
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PMID:External irradiation in the management of stage II endometrial carcinoma. 11 71

The serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH) and, prolactin (PRL) were measured before and after gonadotrophin releasing hormone (GnRH) and thyrotrophin releasing hormone (TRH) stimulation in 17 patients with endometrial cancer, in 15 patients with uterine fibroids, in 11 patients with ovarian cystadenomas or cancer and in 14 age-matched controls. The women with fibroids had a low FSH level and a diminished FSH response to GnRH but an excessive PRL response to TRH while the other patient groups did not differ from the controls. The results indicate no relation between pituitary function and endometrial or ovarian tumor.
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PMID:Pituitary gonadotrophins and prolactin in patients with endometrial cancer, fibroids or ovarian tumours. 11 72


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