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

Past studies have shown that patients with recurrent or advanced endometrial carcinoma respond favorably to treatment with progestin. Theories relate the success of the treatment to the concentration of progestin in the blood supplied to cancerous tissues. A study was undertaken to measure the plasma level of the steroid in patients with endometrial adenocarcinoma. Medroxyprogesterone Acetate (MPA) was administered to two groups of patients. One group received a single 100mg dose of MPA intramuscularly every day. The other group was subdivided and individuals received from 100 to 300mg of MPA orally everyday for a month. Plasma levels of MPA were measured daily twenty-four hours after the last dose. Radioimmunoassay techniques were used to measure MPA levels. Plasma levels of patients receiving 100 mg either orally or intramuscularly were the same. Patients who received the 200 mg and 300 mg dosage of MPA orally exhibited higher mean plasma values. Examination of cancerous tissues removed by surgery near the time of plasma MPA evaluation showed marked effects of the therapy. Two of the four patients who had the surgery had received the higher 200mg and 300mg dosage. Based on the results of this investigation, further studies on the effectiveness of treatment for recurrent or advanced endometrial adenocarcinoma should include a phase to monitor MPA plasma levels.
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PMID:Plasma medroxyprogesterone acetate levels following intramuscular or oral administration in patients with endometrial adenocarcinoma. 41 65

We report a family manifesting the cancer-family syndrome in which 11 family members had colonic carcinomas (predominantly involving the proximal colon, in the absence of polyposis), with an average age at onset of 35 years. Three women had endometrial or endocervical cancers. The kindred is notable in that its full evaluation was predicated upon the recognition of features consistent with the cancer-family syndrome in only two sisters. The ascertainment and evaluation of the kindred demonstrates the clinical utility of regarding such criteria (early cancer onset, multiple primary cancers, proximal colonic involvement) as a basis for selecting cases for more thorough family-history evaluation. Although such selection criteria are not pathognomonic for the syndrome, identification of a more extensive family cancer history sometimes enables the initiation of a highly specific cancer surveillance program. Specific attention has been given to the problems of screening patients at risk for the development of proximal colonic cancer, an important feature of the cancer-family syndrome. Innovative operative management is also indicated, such as total colectomy for initial colonic cancer, and consideration of prophylactic hysterectomy for women with colonic cancer (because of the high risk of development of endometrial carcinoma).
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PMID:The cancer-family syndrome: a pragmatic basis for syndrome identification. 42 75

3 studies reviewed by the Federal Drug Administration (FDA) have concluded that new research affirms that menopausal and postmenopausal women who take estrogens have an increased risk of endometrial cancer. The data also supports estrogen labelling which advises health professionals and women patients that the risk is reduced if estrogens are taken in the lowest possible dose and if chronic administration is avoided. Increased risk of endometrial cancer in estrogen users is proportional to the duration of use and is particularly high with use over 5 years. Increased risk was reported for use of 1-5 years. Cyclic therapy or progestins for 7 days each month does not protect against the risk of endometrial cancer. Use of progestins for longer periods has not been proven to provide adequate protection and not been adequately studied. Women who have uterine bleeding after estrogen therapy receive increased diagnostic attention, and their cancer is detected earlier than women not taking the drugs. Although women with endometrial cancer who take estrogens may be diagnosed sooner, ultimately all women with endometrial cancer will be diagnosed. Estrogens are effective for vasomotor symptoms of the menopause and can be used with no known increase in risk for treatment if doses are kept low and duration is less than 1 year.
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PMID:Update on estrogens and uterine cancer. 42 1

The use of medroxyprogesterone acetate (MPA) was incorporated into a nuclear receptor assay for progestin receptor in human endometrium. The assay was developed because MPA is a better ligand than progesterone since it does not bind to corticosteroid-binding globulin and gives greater kinetic stability to the nuclear complex. The MPA nuclear receptor complex for malignant endometrium dissociated at a faster rate than did the complex obtained from normal endometrium, an alteration in binding kinetics which could not be explained by instability of the receptors from malignant endometrium. Factors, including radiation therapy, plasma proteins, endogenous steroids, receptor degradation, tissue heterogeneity, and limited sample size, which influence the interpretation of receptor assay were systematically evaluated. In spite of these controls, it would be premature to conclude that the clinical observations indicate altered receptor from malignant tissue. Further studies are required on endometrial carcinoma which is free of normal tissue fragments. Clinically, nuclear receptor levels were highest in normal endometrium but decreased in samples of malignant endometrium as tumors became more anaplastic. The lowest nuclear binding activity was detected in samples of metastatic endometrial tissue (carcinoma). Hopefully, this nuclear receptor assay (which uses MPA because its dissociation was slower than progesterone) will provide data for correlating clinical response to therapy.
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PMID:Nuclear progestin receptors in normal and malignant human endometrium. 42 86

Recent articles have urged physicians to give increased attention to the use of cytologic and histopathologic technics in the detection of precancerous and cancerous endometrial lesions, since there is an increasing incidence of malignant disease at that site. A routine cervicovaginal smear is inadequate to diagnose cancer of the endometrium. This paper describes a technic for rapid smearing and fixation of endometrical cells. The method of obtaining endometrial cytologic and histologic material is by the use of a helix. A report on 1,748 endometrial cytologic smears is given.
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PMID:Simplified endometrial testing by the Milan-Markley technic. 43 86

The morphology of the pars intramuralis of the fallopian tube has been histological examined in 500 uteri which were exstirpated in the Department of Gynaecology and Obstetrics of the University of Kiel in the years of 1972 to 1973. It was found that the interstitial pars of the endometrium changes regularly during the menstrual cycle. In the same way the endometrium in the interstitial part of the tubal canal suffers from an atrophy if patients were treated with gestagens. The adenomatous hyperplasie or the polypes of the endometrium which are often found near the utero-tubal junction are to be considered as the matrix of the carcinoma of the endometrium; continuous changes between the adenomatous hyperplasie and the carcinoma of the endometrium can be observed. The frequency of precancers near the utero-tubal junction underlines the demand for an accurate curettage in this region of the cavum uteri. The histological examination of the region of the utero-tubal junction after the extirpation of the uterus is absolutely necessary and has to be generally to be asked for.
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PMID:[Morphology of the tubal drainage angle of the human uterus and of the pars intramuralis of the tuba uterina]. 43 96

The results in treatment of 288 patients with endometrial carcinoma (1968 to 1972) were compared to results achieved in a similar series of 236 patients (1962 to 1967) at The University of Alberta, Edmonton, Alberta, Canada. The overall 5 year survival rate for the 524 patients was 76.1% (75.4% when Stage 0 is excluded), with generally better results in the more recent series except in treating Stage II disease. The overall 5 year survival rate for Stage I disease in the more recent series was 89.1%. Parameters for assessing a prognosis and management plan are indicated, with emphasis on the identification of high-risk Stage I cases.
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PMID:Experience in treating two hundred and eighty-eight patients with endometrial carcinoma from 1968 to 1972. 43 85

20 postmenopausal patients with serious and painful decalcifying osteosis were treated with an association of estrogens, progesterone, calcium and phosphates. Symptomatology disappeared completely in 7 cases, and was enormously improved in 9 cases. Improvement was very rapid, beginning after only 4 weeks of treatment. 2 patients did not receive any benefit from the treatment, and 2 more had a relapse after initial improvement. Estrogen therapy does reduce bone resorption and has a definite preventive and curative action whenever there is lack of estrogens. It is imperative, however, to eliminate from this kind of treatment patients with risk of breast or endometrial cancer.
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PMID:[Oestrogen therapy of osteoporosis (author's transl)]. 43 26

Annual endometrial biopsy had been advocated for patients with Turner's syndrome. The practicality of using this procedure on patients with no symptoms of abnormal bleeding has been questioned; this study attempts to answer this issue. Charts of patients with Turner's syndrome from the Cleveland Clinic for the period 1951-75 were reviewed. A criteria was established for inclusion of patients in the study. 34 of 43 women who met the criteria returned for the follow-up and were given pelvic exam, Pap smear, and endometrial biopsy by Vabra aspiration. Of the 43 patients given substitution therapy, 13 were taking estrogen alone; 24 were on estrogen-progesterone therapy, and 6 had stopped taking estrogen (Table 1). The presenting symptom in all cases of endometrial adenocarcinoma was abnormal bleeding (menorrhagia or menometrorrhagia), suggesting a change from previous menstrual patterns. At high risk for developing endometrial carcinoma at an early age was patients with dysgenesis who were receiving estrogen replacement therapy. The results of this study suggest that annual endometrial sampling is not necessary for patients with Turner's syndrome. It is recommended, however, that an annual examination and a Pap smear of an endocervical specimen be performed. Should there be any sign of menstrual aberration, endometrial biopsy or dilatation and curettage should be done. The importance of careful follow-up should also be impressed on patients who are on estrogen therapy; not more than 1 year's supply of estrogen should be given to such patients.
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PMID:Turner's syndrome: results of estrogen therapy. 43 70

Endometrial carcino-sarcoma is a rare rapidly growing mixed muellerian tumor. The pathogenesis of this tumor is not definitely known. However, the current explanation favors the theory of the growth of this tumor from pluripotential sub-epithelial cells. The incidence of the tumor is increased in post-menopausal women. Many of these women have a history of radiotherapy of the genital organs for benign gynaecological disease. A causal relationship between occurence of carcino-sarcoma and estrogen treatment as in carcinoma of the endometrium is not mentioned in the literature. The clinical signs and symptoms are non-specific as in many other malignant tumors of the uterine body. The prognosis is very bad. The average survival from the onset of the first symptoms is only a few months. The treatment of choice appears to be total abdominal hysterectomy and bilateral salpingo-oophorectomy. Radical operations and ancillary radiotherapy and chemotherapy do not appear to improve the survival rate. The extremely rare coincidence of a carcino-sarcoma in a young woman with Turner Syndrome gonadal dysgenesis after five years of treatment with estrogen led to the present case report.
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PMID:[Endometrial carcino-sarcoma in a young woman with Turner syndrome (author's transl)]. 43 57


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