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

Irradiation using the afterloading therapy equipment enabling monitored short-term high-dose radiation, not only reduces exposure of the medical staff to radiation, but also places less strain on the patients. 94 patients with endometrial carcinoma were treated by irradiation alone between 1980-1985 and could be followed up for at least 12 months up to 5 years. Evaluation was performed with regard to a recurrence-free survival rate and radiation side effects. The 5-year survival rates with radiation alone are compared with a previously recorded control group. Before the afterloading technique had become available, the 5-year survival for endometrial carcinoma treated by intracavitary radium-226 was 50%. Using the afterloading iridium-192 technique, the 3-year recurrence-free rate was 81% and the 5-year survival rate 70%. There was no difference between younger (50-69 years of age) and older (70-85 years of age) patients, nor was there any difference between highly and less differentiated tumours. Incidence of severe damage caused by radiation in the overall group: 2 cases of ileus, 1 case of rectovaginal fistula, 3 cases of rectal ulcers and 1 case of severe vaginal necrosis. Severe complications did not occur with the optimal intrauterine fraction dose of 850 cGy (4 times) and 700 cGy intravaginal (once), nor could any complications be observed when the total rectal dose did not exceed 500 cGy. In only 5% of the patients the treatment was combined with percutaneous telecobalt irradiation (stage II). Intrauterine and intravaginal applications were performed without anaesthesia or sedation, and outpatient treatment was possible in almost all cases.
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PMID:[Afterloading short-term irradiation of inoperable uterine cancer]. 375 33

A new endometrial aspiration technique for office screening of endometrial carcinoma without an anesthesia was studied. In patients without apparent signs of cervical canal stenosis, all of whom were 50 years of age or older, the aspiration attempt was successful in 96%. The aspirates were used for cytologic study and tumor marker assays. The results indicate that screening for endometrial carcinoma should be based on the determination of biochemical tumor markers in the uterine fluid. Lactate dehydrogenase (LD) is recommended as a primary marker, determined as total LD and as LD isoenzyme activity. Endometrial cytology is recommended as a supplementary screening technique in selected cases.
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PMID:Screening for endometrial carcinoma by endouterine aspiration cytology with analysis of tumor markers in the aspirates. Development and application of a new screening technique. 403 3

In the period of 1.6. 1980 to 31.12. 1981 110 patients with inoperable endometrial carcinoma were treated by fractionated short-time afterloading with high dose rates (Buchler, Germany; Iridium-192) or with conventional intracavitary radium-therapy (low dose rates). First clinical results concerning 12-months-survival rate and the observed reactions of bladder and rectum in the afterloading-group and in the radium-group are represented. The one-year-survival rate and the side effects in the afterloading-group were comparable to those in the radium-group. 35 out of 40 patients (87,5%) with stage I of the disease treated with Iridium-192 were alive after one year, as compared to 46 out of 59 (77,9%) patients treated with Radium. The rate of radiation side effects showed no statistically significant difference in both groups. In the afterloading-group a hospitalization was not necessary, because anesthesia was not performed during short-time irradiation.
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PMID:[Fractionated short-time-afterloading with high dose rates in ambulant treatment of inoperable cancer of the uterine corpus]. 619 42

.he Prevical curette is a new instrument for an early diagnosis of carcinoma of the endometrium. The good acceptance of this method, which can be practised on an outpatient basis without anaesthesia, has been described by other groups of researchers. To check its reliability, we analysed endometrium specimens of 105 patients both cytologically and histologically. The collection of the material by the cytological method was successful in 99% of the cases, whereas clinical interpretation was possible in 94%. With nine carcinomas of the endometrium in the examined women, no false negative result was obtained. Hence, the use of this curette seems to be useful in patients with special risk factors and patients who cannot be anaesthetised. It should, always be kept in mind that the Prevical curette is conceived as a screening method which cannot replace histological clarification.
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PMID:[Accuracy and practicability of the Prevical curette for the early diagnosis of endometrial carcinoma]. 655 71

Because of the advent of the Papanicolaou smear as a diagnostic test, cervical cancer rates have declined due to early detection and therapy. The same cannot be said of endometrial cancer, and this article outlines some possible diagnostic tests and indications for them in the hope of reducing incidence of and severity of endometrial cancer in peri- and postmenopausal women. Women at high risk of endometrial carcinoma are those with adenomatous hyperplasia, which must be recognized as a precursor of invasive endometrial cancer: carcinoma in situ of the endometrium also qualifies as a true precursor. This author recommends histologic sampling of high-risk menopausal patients, with or without the presence of dysfunctional uterine bleeding. A discussion of the technology of obtaining histological specimens follows, with emphasis on the need to devise a means of obtaining histologic samples in all menopausal women on an ambulatory basis without anesthesia for screening purposes. Vacuum curettage may be a part of such a screening. The need to adopt a regular staging formula to characterize clinically the virulence of endometrial cancer is underscored, and such a formula is presented. Other factors, in addition to screening, which will help control the incidence of endometrial cancer are recognition of the place for radiation and surgical intervention, recognition of menopause as the time of life when high risk patients may get identified, and caution in hormonal treatment in perimenopausal and postmenopausal women until evidence of its efficacy supercedes evidence of possible etiological roles in endometrial aberrations.
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PMID:An approach to the control of carcinoma of the endometrium. 676 46

Laminaria tents have been used to dilate the cervix for interruption of pregnancy and other intrauterine procedures. Their use is presented in 5 patients with cervical and endometrial carcinoma where general anesthesia was contraindicated. Cervical dilation was sufficient with a single Laminaria to carry out intrauterine and intravaginal instrumentation for radiation therapy with no local or general anesthesia.
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PMID:The use of Laminaria japonica in intracavitary radiation therapy when anesthesia is contraindicated. 688 54

A new method for obtained cytological material from the uterine cavity with the Exploret-Fatol is described. The results in 38 patients with atypical vaginal bleeding is reported. In 4 women the tight cervical canal necessitated general anaesthesia. In all cases adequate cytological material for examination was retrieved from the endometrium. It was not always possible to differentiate endometrium from endocervical cels by their morphology. Nevertheless all benign premalignant lesions and all malignant lesions of the endometrium were cytologically recognized. This method may find application in many high risk patients and therefore improve the early diagnosis of carcinoma of the endometrium. The methods success depends upon good knowledge of endometrial cytology by the examining cytologist.
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PMID:[Results of the cytological examinations of cells from the uterine cavity (author's transl)]. 691 62

Endometrial samples were obtained with the Accurette and the Vabra aspirator and were compared with samples obtained by dilation and curettage in 40 patients with postmenopausal bleeding. The degree of discomfort and patient acceptability of the two outpatient procedures, the adequacy of the samples for cytological and histological examination, and the cytological and histological diagnosis were compared. The Accurette and the Vabra aspirator could not be inserted in 5 out of 40 patients because of cervical stenosis. From approximately 30 of the remaining 35 patients, adequate samples were obtained. Six cases of endometrial hyperplasia and 3 of endometrial carcinoma were diagnosed by all the methods employed, except for 1 case of endometrial hyperplasia in which the sample obtained with the Accurette was inadequate for histological examination but was nevertheless adequate for cytological examination. Of the 5 patients in whom endometrial sampling by both the Accurette and the Vabra aspirator could not be performed because of cervical stenosis, 2 cases of endometrial carcinoma were found on uterine curettage. In patients with cervical stenosis, however, dilatation and curettage under general anaesthesia is mandatory. The Accurette has the advantage of being less expensive and more suitable for routine endometrial sampling for the detection of endometrial hyperplasia or carcinoma and dating of the endometrium in cases of infertility. Both the Accurette procedure and Vabra aspiration appeared to be reliable methods of obtaining endometrial samples.
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PMID:A comparison of endometrial sampling with the Accurette and Vabra aspirator and uterine curettage. 705 25

Of 332 patients for whom endometrial biopsy was indicated, vacuum curettage by the Vabra method was performed on 296 (89%) women as an outpatient procedure without anesthesia. The age range was 23-71 years, with a mean of 45.7. Material sufficient for histological diagnosis was obtained in 276 (93.3%), 7 (2.4%) of whom had endometrial cancer, 14 (4.7%) who had adenomatous hyperplasia, and 29 (9.8%) who had cystic hyperplasia. Of the 20 patients in whom the curettings could not be assessed, subsequent conventional curettage showed postmenopausal mucosa in 12 cases, endometrial polyps in 4, and atrophic mucosa due to the oral contraceptive pill in 4. 47 (15.8%) and 7 (2.3%) patients experienced moderate and severe pain respectively, and 2 (0.6%) had a vasovagal reaction. There was 1 case (0.3%) of endometritis and 6 (2%) of postoperative bleeding. During a follow-up period of 1-5.5 (mean 2.4) years, 16 patients have developed bleeding again, but repeated vacuum curettage disclosed benign conditions in all, with no endometrial cancer apart from the cases diagnosed primarily. Vacuum curettage is a quick, simple, and cheap method for histological diagnosis of endometrial tissue. It does not require anesthesia, patient acceptability is high, and reliability is satisfactory.
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PMID:Vacuum curettage by the Vabrar method. A simple procedure for endometrial diagnosis. 714 13

The incidence of endometrial carcinoma is particularly high in postmenopausal women. Screening techniques are not yet satisfactory. Postmenopausal anatomic physiologic changes in the genitalia may prevent visualization and exploration of the uterine cervix. A case report is presented of an 87-year-old woman with a 6-month history of genital bleeding. Severe vaginal stenosis prevented diagnostic curettage, even under adequate anesthesia. To perform the indicated hysteroscopy, a panendoscope had to be employed for direct visualization of the cervix and uterine cavity. Selective biopsy specimens revealed endometrial adenocarcinoma. The hysteroscopy technique is easy to learn. However, if the patient's physician has not acquired this experience, a urologist, who must necessarily use endoscopy extensively, can be of great help in the evaluation fo gynecologic patients with uterine problems similar to those described in this report.
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PMID:Hysteroscopy in the diagnosis of endometrial carcinoma: case report. 735 6


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