Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0476089 (endometrial cancer)
 11,379 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Authors studied the application of vaginal hysterectomies performed on 790 patients, and abdominal hysterectomies performed on 892 patients over 15 years. The age of the patients was 41 to 60. In 233 cases the reason for the operation was a severe prolapse of the uterus in middle-aged and elderly women. 170 women underwent hysterectomy because of recidivist and persisting uterine hemorrhages. 67 elderly patients had a vaginal hysterectomy because of endometrial cancer. Vaginal hysterectomies were also performed on 58 patients with preclinical cancer of the cervix; these women were all over 40 years old. It appears that vaginal hysterectomies were mostly performed because of uterus mobility. These operations were done under lcoal infiltration anesthesia. No other operation was required for 217 patients. 237 cases necessitated plastic surgery on the vagina and on the peritoneum. 52 women had plastic surgery against frequent irretention of urine, and plastic surgery on the peritoneum. Meyo's procedure was used on 175 patients. 11 women suffered some complications after vaginal hysterectomy: severe hemorrhage, rectal injury, injury of the wall of the bladder. 15 women suffered complications after abdominal hysterectomy. It is concluded that vaginal hysterectomy is better tolerated by patients than abdominal hysterectomy. (Summary in ENG).
 ...
PMID:[Application of vaginal hysterectomy in surgical gynecology]. 60 74

A study was made of 201 asymptomatic women over age 40 (range, 40-74 years) who underwent uterine sounding and endometrial screening by the negative-pressure jet irrigation technique, without anesthesia, in private gynecologists' offices. Introduction of the irrigator was accomplished in 88 percent of these patients. In 97 percent of the successful irrigations, the specimens obtained were satisfactory for cytologic and histologic diagnosis of neoplasia. No occult endometrial carcinomas were discovered. The factors which interfered with endometrial screening by these methods are analyzed. Cervical stenosis prevented endometrial irrigation in 13 of the 24 unsuccessful attempts. Acceptance by the patients was high, in that 74.2 percent reported slight or no discomfort and only 4.7 percent complained of severe discomfort. Although 12.5 percent experienced pelvic cramping after irrigation, no other significant side effects were observed. The results of this investigation indicate the feasibility of using the endometrial irrigation technique for massive screening studies of asymptomatic women who are at risk for the development of endometrial carcinoma.
 ...
PMID:Endometrial screening of asymptomatic women by irrigation technique in the private gynecology office. 83 42

in 220 women with gynecologic symptoms, endometrial washings were obtained with the Gravlee Jet Washer-in 135 outpatients before office curettage without anesthesia or analgesia; in 85 hospitalized patients before fractional dilatation and curettage under anesthesia. The method was simple, inexpensive, virtually painless, and free of complications. Endometrial adenocarcinoma was present in 12 patients; the jet washing samples were diagnostic in 6 of these. Reported variations in diagnostic accuracy for endometrial carcinoma and precancerous phases raise doubts as to the value of this technic in asymptomatic patients. It is valid for screening symptomatic patients provided results other than normal or positive are further evaluated. Laboratory handling and interpretation must be improved if jet washing is to succeed in mass screening programs.
 ...
PMID:Value of the Gravlee Jet Washer in the diagnosis of endometrial cancer. 117 18

The purpose of this prospective clinical trial was to determine the reliability of the Pipelle endometrial biopsy instrument in recovering adequate tissue for confirmation of the diagnosis of endometrial cancer in patients with known endometrial carcinoma, and to compare endometrial histology of the sampling specimen with that of the subsequent hysterectomy specimen. Forty patients were enrolled in this study. All biopsies were performed in the office without anesthesia. The patients had a median age of 62 years (range 40-83). Discomfort was reported by the patient as mild, moderate, or severe; only two patients (5.0%) reported severe pain. There were no complications experienced with endometrial sampling. Thirty-nine of 40 specimens (97.5%) confirmed endometrial carcinoma; therefore, this study yielded a 97.5% sensitivity for the Pipelle endometrial sampling device. Comparing Pipelle and hysterectomy histology for individual patients, the histologic grade was the same in 29 (74.4%), while the Pipelle demonstrated a more advanced degree of differentiation in five (12.8%) and a lesser degree in five (12.8%). There was no residual tumor identified in one hysterectomy specimen (2.5%). Among the 12 patients who had a D&C for diagnostic purposes before referral, the Pipelle biopsy correlated with the D&C histology in ten of 12 (83.3%) and revealed a more advanced grade of tumor in one (8.3%) and a more differentiated grade in one (8.3%). In one patient, the D&C histology was adenocarcinoma grade 1, with the Pipelle demonstrating atypical hyperplasia and the hysterectomy specimen interpreted as endometrial adenocarcinoma in situ. This study demonstrates the Pipelle to be an accurate device for endometrial sampling in patients with endometrial carcinoma.
 ...
PMID:Pipelle endometrial sampling in patients with known endometrial carcinoma. 203 Aug 77

Surgery should be an integral part of the management of the patient suffering from endometrial cancer. Only patients with severe internal diseases should be treated with radiation therapy alone. Although radiation therapy alone can cure endometrial cancer, the survival figures are poorer than for the operation. At the University of Vienna (1st Department of Gynaecology), 267 patients with endometrial cancer were treated by radiation therapy alone (Afterloading iridium192 technique). 5-year survival (life table method) for all patients was 65.2%. In stage I, 5-year survival was 66.9%, and in stage II 46.7%, respectively. For up to 69 years of age the survival was 76.6%, for 70 years and more 61.8%, for grading I 78.8%, for grading II and III only 55.4%, respectively. With radium226 technique, the survival rate was only 56%, while 65.2% were reached with the Iridium technique. All differences are significant. External irradiation (cobalt60) was employed as combined treatment in only 9.4% of the cases. Intrauterine and intravaginal applications were performed without anaesthesia and the hospitalisation time was only one day per week. The relapse rate in stage I/b was 14.8% and in stage II 30%, respectively. Therefore, the dose of intracavitary treatment should be changed and external irradiation used more often.
 ...
PMID:[Value of irradiation alone of generally inoperable endometrial cancer with high dose rate iridium 192]. 212 Jan 6

Current practice of investigating abnormal uterine bleeding via dilatation and curettage is sometimes open to question, and outpatient procedures are emphasised. The therapeutic effect of curettage in normalising menstrual patterns is being discussed. In a prospective study we answered the question of diagnostic and therapeutic effects of curettage. Over a period of 6 months, all patients with curettage treated in our department were investigated (history, risk factors, previous hormonal treatment, preoperative haemoglobin value, type of anaesthesia, complications, histology). Curettages performed for the purpose of abortion, as well as in combination with conisation of the uterine cervix, were not included in the study. 234 curettages were carried out. Clinical indications were as follows: in 29% of the cases recurrent preclimacteric metrorrhagia, in 27% climacteric metrorrhagia, in 24% PMB (postmenopausal bleeding). In 19 cases we found an Hb value lower than 10.5 g%. Risk factors (obesity, hypertension, diabetes mellitus) for endometrial cancer were found in 38% of MB and in 20% of climacteric metrorrhagia. In 9 cases, the histological diagnosis was endometrial cancer (clinical indications: 5 PMB, 3 climacteric metrorrhagia, 1 recurrent preclimacteric metrorrhagia). Our study shows, that the indication for curettage should be applied generously, especially in cases of abnormal postmenopausal and perimenopausal bleeding.
 ...
PMID:[The value of curettage in the assessment of abnormal uterine bleeding]. 221 Mar 9

Basically, endometrial carcinomas are treated by surgery. The standard operation consists of total hysterectomy with ablation of the adnexae and bilateral dissection of the external iliac lymph nodes. Invasion of the parametrium is extremely rare, and colpohysterectomy is justified only when the cervix is involved. Improvements in anaesthesia and intensive care have limited the contra-indications of surgery. As a rule, hysterectomy is combined with vaginal curietherapy which has reduced recurrences at the vaginal fornices from 12 p. 100 to 3 p. 100. Uterovaginal curietherapy is necessary only in cases where the endometrium and cervix are involved. Invasion of the myometrium in depth and a histological diagnosis of undifferentiated epithelioma are predictive of a poor prognosis and may justify a complementary treatment. Post-operative external radiotherapy of the pelvis is indicated when the lymph nodes and adnexae are involved and the deep myometrium is invaded. It reduces the local recurrence rate but its influence on survival has not yet been formally demonstrated. Local and regional recurrences are treated by radiotherapy if the initial treatment was surgical and by surgery if radiotherapy was part of the initial treatment. Chemotherapy and hormonotherapy are effective against advanced, recurrent or metastatic carcinomas. Chemotherapy is used in undifferentiated types and hormonotherapy in differentiated types. However, when used as adjuvants in early endometrial carcinoma their beneficial effect on survival has not been established.
 ...
PMID:[Treatment of cancer of the endometrium]. 230 Jul 61

Uterine lipoma (UL) is a rare tumor frequently presenting as leiomyolipoma. Even more uncommon is the association of UL and endometrial carcinoma (EC) for which only two cases have been reported. We present the case of a 73 years old female of French origin complaining of vaginal bleeding. Initial examination under general anesthesia found a 13 cm length uterine cavity with a large tumor located in the anterior wall. After curettage, the histopathologic analysis diagnosed a moderately differentiated adenocarcinoma of the endometrium. Patient work-up showed no evidence of extension outside the uterus (stage Ib). Treatment consisted of pelvic and iliac lymph node external irradiation with subsequent vaginal intracavitary irradiation followed, 6 weeks later, by total extra-fascial hysterectomy without lymph node dissection. Pathologic examination found a small EC with limited infiltration of the myometrium (stage Ia) associated with a 10 x 9 x 7 cm yellowish fibrolipoma type tumor without smooth muscle pattern. First described by Lobstein in 1816, UL are uncommon and casually diagnosed. The association with EC is rare and without evident relationship. Ultrasound (US) and computed tomographic (CT) appearances allow a diagnostic approach. US show a highly echogenic central tumor with a thin moderately echoic rim. CT appearance of UL is a central, well delimited fat-density tumor. The etiopathogenesis of UL is unclear, attributed to a possible leiomyoma evolution for Willen or a myometrial cell metaplasia for Brandfass.
 ...
PMID:[The association of uterine lipoma and cancer of the endometrium. Diagnostic and etiopathogenic approach]. 234 72

Dilatation and curettage (D&C) is routinely performed on patients with postmenopausal bleeding. The tendency is to rely on the results of the D&C rather than clinical judgment if the diagnosis is benign. In four of our patients treated with total abdominal hysterectomy, endometrial carcinoma was diagnosed even though earlier histologic examination with D&C had shown benign disease. All patients were 60 years of age or older. Three of the four patients had postmenopausal bleeding, and one patient had a Papanicolaou test that indicated an unexplained abnormality. All patients were obese (weighing more than 250 lb) and hypertensive. Other high-risk factors included diabetes mellitus in three and an elevated tumor marker antigen (CA125) in one. Frozen sections of tissue taken at D&C revealed no malignancy and failed to explain the postmenopausal bleeding. Rather than relying on these results, we assessed the high-risk factors and performed total abdominal hysterectomy immediately on all four patients. The results confirmed endometrial carcinoma. Immediate abdominal hysterectomy saved the patients additional anesthesia and delay in diagnosis.
 ...
PMID:Detection of endometrial carcinoma: clinical judgement versus histologic examination. 237 96

A prosthesis was designed to protect the intestinal loop from external beam radiation therapy when post-operative radiation is indicated. It is a silicone inflatable balloon, which, when implanted displaces the intestinal loops out of the pelvic irradiation field. The prosthesis can be deflated between each course of irradiation, without surgery. The device has been used in 8 patients: 6 patients with recurrent pelvic tumor (2 rectal cancers, 1 anal cancer, 1 cancer of the endometrium, 1 cervical carcinoma, 1 ovarian carcinoma), 2 patients with primary tumor (1 malignant paraganglioma, 1 cervical carcinoma). Radiotherapy was administered by means of high power appliances. After radiotherapy, the prosthesis was deflated, then removed through a 3 cm incision under local or peridural anesthesia. The tolerance of the small intestine to the radiation therapy has been satisfactory in each case with no bowel injury due to radiation. Therefore, this simple device might be useful to prevent bowel injury during postoperative radiation in the treatment of abdominal and retroperitoneal tumor masses.
 ...
PMID:[New surgical procedure for the protection of the small intestine before postoperative pelvic irradiation]. 237 97


1 2 3 4 5 6 7 Next >>