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

The aim of this study was to evaluate the long-term use of endometrial cytology with the Endopap sampler in clinical practice. Emphasis was placed on diagnostic accuracy, reduction of the number of curettages and cost per diagnostic test. Blind comparisons of two diagnostic tests were made during an observation period of five years. Endometrial cytology was compared with endometrial curettage as a standard if both samples had been taken within a six-month period and sufficient material had been obtained with both methods. A total of 468 women were studied. All had undergone endometrial curettage because of vaginal bleeding or impending hysterectomy. Abnormal endometrial cytology was found in 129 of 134 (96%) samples from patients with endometrial cancer, in 23 of 25 (92%) with invasive cervical cancer, in 30 of 31 (97%) with atypical endometrial hyperplasia and in 90 of 100 (90%) with endometrial hyperplasia but no atypia. Specificity was 84%. The annual numbers of fractional curettages decreased from 900 in 1986 to 298 in 1991. The study clearly showed that endometrial cytology is useful in clinical practice.
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PMID:Routine use of endometrial cytology in clinical practice. 824 3

The role of surgery in the treatment of patients with invasive cervical cancer is undisputed, but how radical surgery should be is debatable. Every case requires detailed knowledge of the development and spread of cervical cancer. Tumor volume is the most important diagnostic factor in cervical cancer and also correlates with vascular invasion and lymph node involvement. As radical hysterectomy requires in cervical cancer besides the laparoscopically easy performable lymphadenectomy also the resection of parametria with sceletonisation of ureters we started to treat endometrial cancer with a combined laparoscopic and vaginal approach. In patients with the suspicion of stage I endometrial cancer prior to laparoscopic staging, the prerequisites of histological grading with ploidy and measurement of monoclonal antibodies were performed. All patients underwent a general check with radiography, computer tomography, liver scan, bone scan and lymphography. The performance of lymphadenectomy in cases of stage I endometrial cancer remains a controversial subject. We believe that laparoscopic assisted surgical staging of stage I endometrial cancer is an attractive alternative to the traditional laparotomy-surgical approach. The change from laparotomy to a laparoscopic assisted vaginal approach allows for a similar success rate with the less invasive approach. No complications occurred in this series and the results of our pilot study were satisfactory.
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PMID:Indications for laparoscopic surgery in cases of gynecological malignancies (endometrial cancer). 902 87

Fertility and gynaecological malignancies have an important relationship. A clear inverse relationship exists between family size and the incidence of ovarian and endometrial cancer. Current methods of fertility control have an influence on subsequent development of various gynaecological malignancies. A slightly increased risk of breast cancer has been reported in current users and those who had used hormonal contraceptives (OCs) within 10 years; this risk declined with time and disappeared after 10 years. Women who started OC before age 20 had a higher relative risk; the disease did not spread beyond the breast in the majority. Most studies found OC to reduce the risk of ovarian and endometrial cancer. The relative risks of squamous cell carcinoma and adenomatous carcinoma of the cervix have been reported to be 1.3 and 1.5, respectively in ever-users of OCs; however, the aetiology of cervical cancer is multifactoral. Several reports suggest the beneficial effect of tubal ligation and breast feeding in reducing the risk of ovarian cancer. Therapy of gynaecological malignancies may have an influence on subsequent fertility. Amenorrhoea developing after treatment of hydatidiform mole may be due to choriocarcinoma, recurrent mole or a normal pregnancy. Choriocarcinoma can also develop after a partial mole. The risk of fetal teratogenicity from chemotherapy is present only if conception occurs during or immediately following the treatment cycles. Fertility is not impaired following chemotherapy. Successful pregnancies have occurred in women who have had widespread GTD including cerebral metastases. In the young patient with gynaecological malignancy preservation of fertility is possible. Fertility-sparing surgery may be safe in early ovarian epithelial cancers and even in advanced germ cell tumours. Recently, the fertility-sparing surgery of radical trachelectomy and pelvic lymphadenectomy has been carried out for early invasive cervical cancer in young women. Gynaecological cancer occurring in pregnancy is uncommon; it presents the clinician with a difficult situation to manage. In most instances the cancer is treated as though the patient is not pregnant; the timing and mode of delivery needs individualization. The overall prognosis for breast cancer complicating pregnancy is poor. Survival in cervical cancers diagnosed antepartum is similar to the non-pregnant patient. Ovarian cancer in pregnancy has a good prognosis because of the early stage at diagnosis.
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PMID:Chien-Tien Hsu Memorial Lecture. Fertility and gynaecologic malignancies. 1133 Jul 24

The risk of breast cancer is increased by an early menarche, late age at 1st birth, and by a late menopause which implicates ovarian steroids in the initiation or promotion of breast cancer, as some breast cancers are estrogen dependent. A study from the Centers for Disease Control found no association between breast carcinoma and duration of combined oral contraceptive (COC) use. A recent analysis of 27 reports published between 1980 and 1990 suggests that the risk of breast cancer may be slightly increased in younger, nulliparous women who have used the older, higher dose COCs for more than 8 years. The ever-decreasing doses of estrogen and progestogen cause confusion regarding COCs and the risk of breast cancer. Of 15 major publications, 8 have identified no increased risk of cervical neoplasia and 7 have found significant increased risk. The Oxford Family Planning Association Study showed that both cervical intraepithelial neoplasia (CIN) and invasive cervical carcinoma occurred more frequently in the oral contraceptive group related to the duration of use. The Royal College of General Practitioners' Study showed that women taking the COC for more than 10 years had an increased risk of cervical cancer. With the effects of sexual activity controlled, COC users had no increased risk of invasive cervical cancer, however, they had an increased risk of CIN. A reduction in risk of endometrial cancer (an estrogen-dependent tumor) by 20%, 40%, and 60% after COC pill use containing potent progestogens for 1, 2, and 4 or more years has been reported. Several studies confirm the protective effect of COCs against the risk of ovarian cancer. Hepatocellular carcinomas seem to occur more frequently in COC users than in nonusers. Depot medroxyprogesterone acetate has been implicated in causing breast tumors, but it was successful in the treatment of endometrial carcinoma. There is some evidence that the risk of CIN may be increased with COC use, but the risk of breast cancer is still no clear.
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PMID:Contraception and the big "C". 1234 24

Never before have women with newly diagnosed gynecologic malignancies had more options for preservation of fertility. Girls or women of childbearing age with several ovarian cancer subtypes have a high probability of unilateral ovarian involvement, and, thus, may be candidates for fertility-sparing surgery with preservation of a contralateral normal ovary and uterus. These subtypes include ovarian tumors of low malignant potential, malignant ovarian germ cell tumors, and ovarian sex cord-stromal tumors. For women with invasive epithelial ovarian cancer who have early-stage disease, fertility-sparing surgery may be an option. In some cases, fertility-sparing surgery may be followed by postoperative chemotherapy. For women with invasive cervical cancer, fertility-sparing surgery may be possible. Options include conization alone for stage IA1 or IA2 disease, radical trachelectomy with stage IA2 or IB disease, or ovarian transposition for women undergoing chemoradiation. Non-operative options, such as hormonal therapy, may be considered for women with early-stage, low-grade endometrial cancer. For all women of childbearing age with gynecologic malignancies, in vitro fertilization techniques or cryopreservation of ovarian tissue may be an option prior to definitive treatment.
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PMID:Fertility-sparing surgery for malignancies in women. 1578 22


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