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

In recent years, the incidence of endometrial cancer has a tendency to increase gradually in our country. Its majority (stage I and II) is a case to be treated by hysterectomy alone. However, to patients with advanced inoperable cancer (stage III and more), a radiotherapy, which is not so sensitive to endometrial cancer, has been used. Since the progression of endometrial cancer is dependent on sex steroid hormones (estrogen and progesterone), anti-tumor effects of progestogen are expected to be effective to patients with estrogen receptor (ER) positive and progesterone receptor (PR) positive cancer or with well-differentiated adenocarcinoma (G1 type) histologically. The most widely used progestogens are medroxyprogesterone acetate (MPA) and megestrol acetate (MGA). Many investigators have reported that progestogen with high dosage shows a good response to advanced endometrial cancer. On the other hand, the monochemotherapy responsive to endometrial cancer is adriamycin (ADR), cyclophosphamide (CPA), 5-fluorouracil (5-FU) or cisplatin (CDDP). The drugs in polychemotherapy regimens are used to be combined basically the above anti-cancer agents. The polychemotherapy is more effective than monochemotherapy. The combined chemotherapy regimen (CPA, ADR and CDDP; CAP regimen) obtained a good clinical results to advanced endometrial cancer. Thus, in recent years, the combined hormonochemotherapy of high dose progestogen and polychemotherapy was recommended as the best therapy to advanced endometrial cancer, and reported a good results. In conclusion, the treatment of advanced endometrial cancer is based on the use of progestogen therapy and on polychemotherapy. The choice of treatment is made on the basis of patients' conditions and the biological characteristics of the endometrial carcinoma.
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PMID:[Therapy of advanced endometrial cancer]. 214 5

Forty-one patients with clinical stage III and IV carcinoma of the endometrium presented to Jackson Memorial Hospital between the years 1977 and 1988. These patients were studied as to their presenting symptoms, prognostic factors, therapeutic regimens, and survival. Sixty-one percent of our patients presented with postmenopausal bleeding. Prognostic factors included extent of disease and tumor bulk rather than histologic type, grade, or depth of myometrial invasion. Overall 5-year survival was 7/32 (22%), with 6/22 (27%) for stage III and 1/10 (10%) for stage IV. Those patients who received surgery plus radiation fared better than those who received either alone. Hormonal therapy offered little, if any, benefit. CAP-M chemotherapy was used as adjunctive treatment in 10 patients and its use is discussed. It is our hope that we may later use this study to compare the newer surgical staging in advanced cases of endometrial carcinoma with the previously used clinical staging system.
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PMID:Stage III and stage IV endometrial carcinoma: a review of 41 cases. 238 38

Cardiotoxicity was evaluated by multigated radionuclide angiocardiography using in vivo 99mTc labeling of red blood cells in the multiagent chemotherapies of gynecologic malignancies. The left ventricular ejection fraction (LVEF) was determined by computer-assisted analysis of left ventricle time activity curves (TAC) of the angiocardiograms. The mean age of fifteen patients was 52.3 (38-66) years. Ovarian carcinoma (13 patients), the endometrial carcinoma (one) and uterine leiomyosarcoma (one) were treated with a total of 69 combination chemotherapy of CAP every 4 weeks. Fifteen patients underwent a total of 76 quantitative radionuclide angiocardiograms (three to seven studies per patient). The values of LVEF before treatment were 57.5 +/- 8.3 (mean +/- SD) (48.7-75.4), which were greater than those of normal persons (45). The values of LVEF during treatment were 44.9 +/- 6.2 (mean +/- SD) (37.6-58.5), which were significantly (p less than 0.001) lower than the pretreatment values. The decrease rates of LVEF in fifteen patients were 21.0 +/- 10.4% (mean +/- SD). Over 20% decrease of LVEF was observed in eight patients (53.3%) following chemotherapies. The patients showing a decrease of the values of LVEF were treated with lower dosage of chemotherapeutic agents in three, changed in seven and discontinued in six the agents. Nine patients who changed the chemotherapeutic regimens showed improvement of the values of LVEF in six (66.7%), no change in two (22.2%) and deterioration in one (11.1%). The values of LVEF were decreased in four patients (44.4%) at 6.7 (3-11) months following chemotherapies. It is suggested from these findings that the determination of left ventricular ejection fraction using multigated radionuclide angiocardiography may prevent development of cardiotoxicity before, during and after the chemotherapies of gynecologic malignancies and allow a clinically important assessment of the cardiotoxicity of the chemotherapeutic agents.
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PMID:[Evaluation of cardiotoxicity by radionuclide angiocardiography in the chemotherapy of gynecologic malignancies]. 239

A 60-year-old woman with recurrent stage II endometrial cancer (clear cell adenocarcinoma) was treated with combination chemotherapy containing cisplatin (CDDP). She had undergone abdominal radical hysterectomy (Okabayashi operation) and pelvic lymph node dissections. Endometrial cancerous tissue infiltrated the cervix and lymph nodes. Six months after the operation, the patient had ascites and dyspnea. She was given 25 mg CDDP intra-abdominally and combination chemotherapy containing CDDP (CAP: CDDP 100 mg, ADR 30 mg, CAP 500 mg) three times intravenously. After an administration of CDDP and combination chemotherapy, the amount of ascites and the serum level of CA 125 decreased remarkably. Although the combination chemotherapy containing CDDP for gynecological malignancy has not been sufficiently evaluated as for ovarian carcinomas, the therapy deserves further evaluation in patients with recurrent of endometrial cancer.
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PMID:[A case of recurrent endometrial cancer (clear cell adenocarcinoma) remarkably responsive to combination chemotherapy containing cisplatin]. 273 95

Several general conclusions are beginning to emerge from the series of prospective trials in the treatment of ovarian cancer. Combination chemotherapy continues to demonstrate higher overall response rates and higher complete remission rates than single alkylating agents, although in some studies survival is not significantly different. Nevertheless, long-term disease-free survivals, although uncommon, are more frequent with combinations, particularly when the dose intensity of the combination is adequate. Although CAP is the most commonly used combination, evidence continues to suggest that cyclophosphamide/cisplatin alone may be equivalent. Several studies have incorporated alkylating agent maintenance into their clinical trials and each reports acute leukemic complications. In light of the absence of a major contribution for this approach, alkylating agent maintenance in ovarian cancer should not be encouraged. Several studies this year emphasize the discouraging results associated with the use of total abdominal radiation therapy post-induction chemotherapy even with patients with minimal or no residual disease. In light of the publications this year and of previously published studies, this approach, although based on sound rationale, appears to be of limited benefit. Salvage chemotherapy, in general, has been unsatisfactory. The 2 interesting reports this year were the activity of low-dose mitomycin C and the potential utility of VP-16/cisplatin combinations in a salvage setting. In cervix carcinoma, trials have documented significant activity for the new drugs, carboplatin (28% response) and ifosfamide (30%), but each has significant side effects. Whether these will prove more active than cisplatin or whether they may be used in combination is unresolved. The continued investigation into the use of radiation sensitizers in cervical carcinoma is of interest and several studies using weekly low-dose cisplatin have established the feasibility of this approach, although long-term survival benefits have not yet been documented. In endometrial carcinoma, epidemiologic studies continue to define the role of postmenopausal estrogens in endometrial carcinoma risk. This year a Swedish study documents a smaller overall risk from estrogen treatment, perhaps related to a substantially lower use of conjugated estrogens in that country. Combination chemotherapy continues to show some activity, although the contribution of combinations in excess of the single agent activity of doxorubicin is still poorly documented. One study does demonstrate significant activity for the commonly used CAP regimen with an overall response rate of 56% and 28% complete remissions.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Gynecologic malignancies. 285 38

Forty-six eligible women with metastatic endometrial cancer were randomly allocated to receive monthly cycles of either CAF (cyclophosphamide, adriamycin, 5-fluorouracil) or CAF plus Provera 200 mg daily for 3 weeks followed cyclically by Tamoxifen 20 mg daily for 3 weeks. Overall response rates of 15 and 43% were seen with CAF and CAF plus hormonal therapy. Using a multivariate analysis of the results, this difference is significant (P value 0.05). In 8 patients with operable endometrial cancer, negative estrogen receptor concentration (ER less than 15 fmole/mg protein) and Grade 3 disease, the clinical course was aggressive in 4 patients with systemic and local relapse. In 10 other similar patients (negative ER and Grade 3) who received adjuvant cyclical hormonal therapy only 1 relapsed and the other 9 are disease-free for an average of more than 31 months. Sequential cyclical hormonal therapy with ER and progesterone receptor analysis has a place in the management of endometrial carcinoma.
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PMID:Efficacy of sequential cyclical hormonal therapy in endometrial cancer and its correlation with steroid hormone receptor status. 297 97

Between May 1980 and September 1983, 30 progestin-refractory patients with metastatic endometrial carcinoma were assigned at random to treatment groups receiving either cisplatin (CDDP) 60 mg/m2 every 3 weeks or a combination of cyclophosphamide, doxorubicin, and cisplatin every 4 weeks in doses of 400, 40, and 40 mg/m2, respectively. Those who failed cisplatin were then offered cyclophosphamide 500 mg/m2 plus doxorubicin 40 mg/m2 every 3 weeks. Reduced doses were utilized in both of the combination regimens for patients who had received extensive pelvic radiation. Of the 14 patients initially receiving cisplatin alone, 3 experienced objective tumor regression. One of these three and one other who failed primary cisplatin therapy later responded favorably to cyclophosphamide plus doxorubicin as secondary treatment. Among the 16 patients who took all three drugs simultaneously (CAP) 5 experienced objective partial tumor regression. Survival experience for these relatively late-stage patients has been uniformly poor, with only 7 and 12% surviving at 2 years after beginning CDDP and CAP, respectively. Thus, while cisplatin is clearly an active agent against endometrial carcinoma, its therapeutic index as a single drug or in combination (CAP) is not adequate to preclude new-agent Phase II studies early in patients with advanced disease.
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PMID:Randomized phase II studies of cisplatin and a combination of cyclophosphamide-doxorubicin-cisplatin (CAP) in patients with progestin-refractory advanced endometrial carcinoma. 365 66

In recent years, the incidence of endometrial cancer has tended to increase gradually in Japan. Most cases (early cancer of stage I and II) are treated by hysterectomy alone, and the prognosis has been relatively good. From analysis of the poor prognostic factors in endometrial cancer, we understood that additional therapy is necessary for patients who have the following factors: degree of differentiation: G3; invasion to > 1/2 myometrium; metastases to pelvic or para-aortic lymph node, isthumus-cervix extension; surgical stage III and more. However, for patients with advanced inoperable and recurrent cancer, a radiotherapy, is not so sensitive to endometrial cancer has been used. A first line establish a chemotherapy has not been established either. Various attempts have been made to establish a chemotherapy for endometrial cancer. As a result, adriamycin (ADR) and cisplatin (CDDP) have proved effective as single agents. For patients with early cancer who have the poor prognostic factors mentional above, irradiation and polychemotherapy regimens (CAP and AP) are effective. Since the progression of endometrial cancer is dependent on sex steroid hormones, antitumor effects of Medroxyprogesterone acetate (MPA) are expected to be effective for patients with estrogen receptor (ER) positive and progesterone receptor (PR) positive cancer, or with well-differentiated adenocarcinoma (G1 type) histologically. Although several forms of therapy are capable of inducing objective remission as adjuvant treatment, all treatment for advanced and recurrent disease remains palliative, and responses and survival for patients treated with irradiation and chemotherapy remain short. Furthermore, we should examine new methods such as new drug application of key drugs like ADR and Pt pharmaceutical preparation, improvement of Dose intensity of the key drugs and Biochemical modulation, CPT-11, Taxol and assembly of key drugs, along with the Circadian approach in the light of Biochronology.
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PMID:[Chemotherapy of uterine endometrial cancer]. 766 68

One hundred and six patients with endometrial cancer were treated at Tsukuba University Hospital between 1983 and 1992. Sixteen patients who underwent complete resection were at high risk for recurrence and were given adjuvant platinum-based, multiagent chemotherapy instead of adjuvant radiotherapy. Eligibility criteria included outer-third myometrial invasion (group 1; n = 5), pelvic lymph node metastasis (group 2; n = 3) or both myometrial invasion and lymph node metastasis (group 3; n = 8). Of these three groups at high risk for recurrence, each patient in groups 1 and 2 developed recurrence and died. In group 3 two patients developed recurrence and one patient has died. There was one treatment death due to neutropenic sepsis in group 3. The recurrence sites in all four patients were local and no distant recurrence was noted. In other words, of 15 patients (excluding one treatment death) at high risk for recurrence, three of 12 patients (25%) with deep myometrial invasion and three of 10 patients (30%) with positive pelvic lymph nodes developed recurrence and died. The other 12 patients (include one patient with recurrence; 100 months) have survived for a long interval (range, 45-131 months). The survival rates for stage I, II, III, and IV are 92.6, 89.5, 60.0%, respectively. Patients with stage I in this study had a better survival than those with stage I in the 1984 annual report of the Japan Society of Obstetrics and Gynecology (p < 0.05). The findings of this prospective clinical trial supported those of the randomized trial comparing adjuvant CAP with radiation therapy.
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PMID:[Adjuvant chemotherapy with cyclophosphamide, adriamycin, and CDDP (CAP) for high risk endometrial cancer after complete surgery]. 857 21

Endometrial carcinoma is one of the most common gynaecological cancers in Western countries. About 75% of the patients present limited disease, confined to the uterus that can be cured by surgery. However, one third of the patients will need systemic treatment because of metastatic or relapsing disease. Hormonotherapy response rates are less than 20%. In monochemotherapy, the higher response rates are constantly observed with doxorubicin or cisplatinum (25-35%). Most commonly used combination are CAP (cyclophosphamide, doxorubicin, cisplatinum) or AP (doxorubicin, cisplatinum), giving 35 to 60% of objective responses. Recent results of large randomized trials have demonstrated marginal, if any, effect of cyclophosphamide and superiority of doxorubicin-cisplatinum combination compared to doxorubicin alone for response and survival. Chemotherapy as hormonotherapy remains palliative. Median response duration is 4 to 6 months and median overall survival duration is 7 to 10 months. Currently, hormonotherapy-chemotherapy combination have not been proved to be more effective than chemotherapy alone.
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PMID:[Chemotherapy of metastatic endometrial carcinoma. Review of the literature]. 874 66


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