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

The use of combined modality therapy in the primary management of gynecologic cancer continues to be explored. Although early ovarian cancer is treated with postoperative adjuvant treatment, the data to support its value is lacking. In advanced disease, paclitaxel has emerged as the most optimal treatment after maximal cytoreduction. Although studies on consolidative therapy using radiotherapy, intraperitoneal therapy, or further chemotherapy are reported, there are no comparative data against a control arm. In those subsets of endometrial cancer patients who have a poor survival, adjuvant treatment strategies using chemotherapy or wide-field whole-abdominal therapy is being evaluated to improve outcome. Small phase II studies of either sequential or concurrent chemotherapy with radiation continue to be reported in advanced cervix cancer, yet large prospective randomized trials comparing standard radiotherapy to combined chemotherapy and radiotherapy are scarce. Alternative strategies to standard surgery to limit morbidity is being explored in the management of vulvar cancer with encouraging results. More properly conducted phase III trials are necessary to evaluate the efficacy of these newer treatment strategies.
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PMID:Combined modality therapy for gynecologic cancer. 854 93

We reviewed the published medical literature to assess the impact of the use of estrogens, with and without progestogens, on the incidence of gynecologic cancer in postmenopausal women. Long-term use of an estrogen preparation that is not accompanied by a progestogen is associated with a large increase in the risk of endometrial cancer, an association that almost certainly is a causal one. The incidence of endometrial cancer in women who receive combined estrogen-progestogen therapy is not elevated to nearly the same degree. There are suggestions that, depending on the particular combined regimen, the incidence need not be elevated at all beyond that of a women who has never taken hormones. The occurrence of other forms of gynecologic cancer appear not to be associated with the use of unopposed estrogens, though relevant data on cervical cancer are sparse. The relation of ovarian, cervical and vulvar cancer to the prior use of combined estrogen-progestogen therapy has only begun to be evaluated.
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PMID:Postmenopausal estrogens and progestogens and the incidence of gynecologic cancer. 873 61

In 1995, an estimated 26,600 women in the United States will be diagnosed with ovarian cancer. During that same year, approximately 14,500 women will die from the disease. Although ovarian cancer accounts for only 33% of the gynecologic cancers and only 5% of all cancers affecting women in the United States, it results in 55% of the deaths from gynecologic cancer and 6% of the cancer deaths in women. The cure rate for ovarian cancer by stage at diagnosis is not significantly different from other gynecologic cancers. Ovarian cancer confined to the ovary (Stage I) can be cured in 90% of cases. Survival for patients with advanced disease (Stage III and IV) is 21%. Unfortunately, while 73% of endometrial cancers, 55% of breast cancers, and 50% of cervical cancers are diagnosed as Stage I, only 23% of ovarian cancers are diagnosed as Stage I. Thus, five-year survival for all endometrial cancer is 85%, for all breast cancer, 82%, for cervical cancer, 70%, and for ovarian cancer, only 42%. The lack of early symptoms and the absence of any proven method of screening for early ovarian cancer results in over 70% of women being diagnosed after the disease has spread beyond the ovary. Also, unlike breast, cervical, and endometrial cancer, there is no known premalignant phase for ovarian cancer; therefore, diagnosis and treatment of a premalignant condition to prevent the development of ovarian cancer is not possible. Theories to explain the development of ovarian cancer are based on observation that ovulation inhibition through pregnancy, oral contraceptive use, and a shorter ovulatory period (late menarche or early menopause) result in a decreased incidence of ovarian cancer. The incessant disruption of the ovarian capsule followed by repair may provide the opportunity for aberrant growth. Finally, therapy of women with ovarian cancer usually requires multiple surgical procedures, multiple courses of chemotherapy, and results in significant morbidity and health care costs. For most with the disease, the end result will still be a slow, painful death by starvation. There should be little doubt based on the above statistics that every effort should be directed towards prevention of ovarian cancer. Possible strategies in the prevention of ovarian cancer should be directed toward determining if a premalignant condition exists, developing screening tools to detect premalignant disease or disease confined to the ovary, and developing interventions to prevent the development of the disease. It is well established that use of oral contraceptives for five or more years can result in up to a 50% reduction in the occurrence of epithelial ovarian cancer. Given the low complication rates from oral contraception use, this medication should be considered as a method of prevention, especially in high-risk groups. In addition, this is a realistic starting point for research into the development of preventive regimens.
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PMID:Prospective on ovarian cancer: why prevent? 874 96

During the past decades, the expansion of molecular biology has had a pivotal role in understanding the basis of cancer development and progression. In addition, real advances have been made in the application of DNA recombinant technology to cancer therapy and patient management. In gynecologic oncologic fields, there are also many investigations to explore the basic pathogenesis of gynecologic cancer, such as cervical cancer, ovarian cancer, and endometrial cancer. It is now known that specific types of human papilloma virus (HPV) are the principal etiologic agents for both cervical cancer and its precursors. However, the various kinds of alterations in oncogenes and tumor suppressor genes may play additional roles in carcinogenesis of cervical cancer. Although ovarian carcinoma is the most frequent cause of death from gynecologic malignancies, the histogenesis and biological characteristics of these tumors are not well understood. During the last several years, many key observations have been made concerning the genetic alterations associated with ovarian cancer. Recent researches including some dominant oncogenes and tumor suppressor gene mutations common to these malignancies are providing bases to elucidate the mechanisms underlying this cancer. The most important basis of endometrial cancer is that K-ras and p53 mutations are also frequently observed.
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PMID:Molecular genetics of gynecologic cancer. 936 94

Endometrial cancer is the most common pelvic gynecologic cancer in women. Its occurrence is associated with endometrial hyperplasia, unapposed estrogen therapy, and more recently, tamoxifen. The staging uses information obtained at the time of surgery. Hysterectomy continues to be the primary treatment for most patients with endometrial cancer, whereas postoperative radiation therapy is used in the treatment of patients with other than low-risk prognostic factors.
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PMID:Endometrial cancer: current concepts and management. 953 76

The purpose of this study was to evaluate retrospectively the surgical infectious morbidity in gynecologic cancer. We examined 1,180 gynecologic oncology patients: 608 women had carcinoma of the endometrium, 510 cancer of the cervix, 48 ovarian cancer and 14 vulvar cancer. Thirty-five (6%), 92 (18%), 7 (15%) and 2 (14%) were complicated by infection in carcinoma of the endometrium, cancer of the cervix, ovarian cancer and vulvar cancer, respectively. Our conclusion is that the highest surgical infectious morbidity occurs in patients with cervical cancer and the lowest in patients with carcinoma of the endometrium.
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PMID:Gynecologic cancer and surgical infectious morbidity. 974 77

From October 1985 through September 1989, 46 patients with gynecologic malignancy had an incidental cholecystectomy at the time of surgery for their primary disease at the Albany Medical Center Hospital. The mean age was 59 (range 20-87 years). Indications for the gynecologic oncologic operation included endometrial carcinoma in 21 patients, suspected ovarian carcinoma in 17 patients and carcinoma of the cervix in 8 patients. Twenty-three patients (50%) had a preoperative diagnosis of cholelithiasis, and in the remaining 23 patients, the diagnosis of significant gallbladder disease was made intraoperatively. There was only 1 (2.2%) postoperative complication secondary to the cholecystectomy. Prophylactic cholecystectomy accompanying gynecologic cancer surgery can be performed safely and avoids the potential for postoperative cholecystitis and a second operative procedure.
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PMID:Incidental cholecystectomy in the treatment of gynecologic malignancy. 1014 62

In cancer patients impaired blood rheology in the presence of coagulation activation may reduce blood flow in the vascular microcirculation that favors thrombosis but may also support tumor progression and metastasis. In 451 patients with gynecological cancer and 177 patients with corresponding benign tumor disease preoperatively, during adjuvant treatment, when venous thrombosis (VT) or cancer progression was diagnosed hematocrit (micro centrifuge), hemoglobin, leukocytes, platelets (Coulter Counter); red blood cell (RBC) aggregation (aggr.) during stasis and low shear conditions (MA 1, Myrenne), plasma viscosity (viscosimeter KSPV 1 Fresenius), and fibrinogen (Multifibren Behring Dade) were investigated. One hundred and twelve healthy women served as controls. Preoperatively, mean plasma viscosity (pv) was significantly higher in cancer patients as compared to patients with the corresponding benign tumor disease (breast cancer: n = 261; pv = 1.32 vs. 1.27 mPa s; p = 0.023; ovarian cancer: n = 68; pv = 1.39 vs. 1.31 mPa s; p < 0.001; endometrial cancer: n = 70; pv = 1.37 vs. 1.25 mPa s; p < 0.001; cervical cancer: n = 52; pv = 1.33 vs. 1.26 mPa s; p = 0.004). RBC aggr. was significantly lower in controls compared to the preoperative values in cancer patients but mean (median) values (RBC aggr. stasis < 21) were within the normal range in all. Preoperatively, plasma viscosity was a significant risk factor for the overall survival in ovarian cancer patients (p = 0.02) and for subsequent thrombosis in ovarian (p = 0.02) and cervical cancer patients (p = 0.007). In the multivariate analysis plasma viscosity was an independent prognostic marker for the overall survival of breast cancer patients (r = 99.45; 95% CI: 7.32-980.2; p < 0.0001). An optimized preoperative cut-off value above 1.40 mPa s (Log-Rank-test) was significantly associated with poor outcome in the Kaplan-Mayer survival estimates, even in node-negative breast cancer. In gynecologic cancer patients the combination of an increase in RBC aggregation and plasma viscosity impairs blood-flow-properties and may induce hypoxia in the microcirculation that favors thrombosis, settlement of tumor-cells and thus metastasis. Improvement of blood fluidity and thus oxygen transfer in the tumor-vascular-microcirculation may increase susceptibility of systemic anti-cancer therapy.
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PMID:Association between blood rheology, thrombosis and cancer survival in patients with gynecologic malignancy. 1083 Oct 62

The availability of screening modalities and improvements in prevention have reduced the risk of developing some cancers over the last few decades. Methods for optimal screening of gynecologic cancers are still being investigated. Cervical cancer is the only gynecologic malignancy for which a screening modality is widely accepted and recommended to all women. Annual screening of cervical cells has been shown to reduce the incidence of cervical cancer by 78%. Unfortunately, more than 50% of cervical cancers occur in women who have not been screened optimally. In the year 2000, an estimated 12,800 women developed cervical cancer. Of these women, 89% were seen by a physician but not screened. Vaginal cancer is associated with a similar etiology, pathobiology, and symptomatology as is cervical cancer. Vaginal dysplasia and cancer can also be detected by the Pap test, but the prevalence of the disease is low. Endometrial carcinoma is the most common gynecologic cancer. The widespread availability of outpatient biopsy devices has been the most significant advance in the early diagnosis of corpus cancers. Ovarian cancer is the gynecologic malignancy associated with the highest death rate. No modality has been shown as an effective screening method for this cancer. Women with a family history of ovarian cancer may benefit from combined modality screening; prophylactic oophorectomy should be offered to those with hereditary ovarian cancer syndromes. A complete physical examination by the physician offers the best method for early detection of vulvar cancer. Awareness and implementation of recommended screening guidelines for gynecologic cancers by primary care and specialty physicians can decrease the incidence and mortality of cervical cancer. Including the genital tract in the complete examination of the female patient could decrease markedly the mortality from the other gynecologic cancers.
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PMID:Optimum screening interventions for gynecologic malignancies. 1123 59

Laparoscopic management of endometrial cancer, although gaining in acceptance, has been associated with recurrent disease at trocar insertion sites in advanced disease. We report on a patient with a port site recurrence in early stage endometrial cancer. An 84-year-old patient with cancer of the endometrium underwent a laparoscopic surgical staging, vaginal hysterectomy, and adjunct radiation treatment. The final surgical pathology was grade 3, stage IC endometrioid adenocarcinoma. Seven months post-treatment, she presented with bilateral port site recurrences in the lower abdominal wall. Trocar port site recurrence in gynecologic cancer patients may be enhanced by laparoscopic management and are not limited only to patients with advanced disease.
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PMID:Port site recurrences following laparoscopically managed early stage endometrial cancer. 1124 Jul 76


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