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)

From July 1975 to April 1983, 237 patients had primary treatment for endometrial cancer at the Long Island Jewish-Hillside Medical Center. Included in this study were 74 of these patients with Stage I and 20 with Stage II endometrial carcinoma who underwent laparotomy without preoperative radiation. The purpose of the study was to determine the prevalence of extrauterine spread in endometrial carcinoma clinically confined to the uterus and to correlate risk variables with this spread. The parameters assessed were retroperitoneal nodal metastases, adnexal involvement, peritoneal implants and peritoneal cytology. The overall prevalence of extrauterine spread was 23.4% (Stage I, 18.9%; Stage II, 40.0%). The rate of nodal metastasis, adnexal involvement, peritoneal implant, and positive peritoneal cytology were 18.7, 7.4, 4.3, and 8.5%, respectively. No positive relationship was demonstrated between surface spread and risk variables. There was positive correlation between surface spread and peritoneal cytology (87.5%). Direct correlations were found between positive nodes and tumor growth over more than one-third of the endometrial surface (P less than 0.001), gross cervical involvement (P less than 0.001), deep myometrial invasion (p less than 0.001), length of uterine cavity, grade 3 tumor, papillary adenocarcinoma (40%), and stage of disease. Five-year survival rate of Stage I and Stage II in this small series was 77.8 and 55.6%. Complications of 16 radical hysterectomies in Stage II were minimal and transient. Because of frequent extrauterine spread in endometrial carcinoma clinically confined to the uterus, and exploratory laparotomy and peritoneal cytology may be desirable in Stage I and II disease before definitive treatment.
 ...
PMID:Extrauterine spread in endometrial carcinoma clinically confined to the uterus. 398 26

The present study was undertaken in patients with Stage I carcinoma of the endometrium to correlate risk factors and the prevalence of retroperitoneal lymph node metastases. From January 1975 to April 1983, 202 patients with Stage I disease had initial therapy at the Long Island Jewish-Hillside Medical Center, New Hyde Park, New York. Among these patients, 74 who had total abdominal hysterectomy, bilateral salpingo-oophorectomy, and selective lymph node biopsy without preoperative radiation were included in the study. Results indicate that risk factors associated with nodal metastasis were Grade 3 tumor (42.1%), papillary adenocarcinoma (28.6%), deep myometrial invasion (42.9%), surface extent of tumor growth greater than 1/3 of the endometrial cavity (31.8%), and a diffuse pattern of tumor growth (17.2%). In Stage 1 endometrial cancer with any of the above 5 risk factors, it is urged that a selective biopsy of para-aortic and pelvic nodes during hysterectomy should be performed.
 ...
PMID:Retroperitoneal lymph node metastases in Stage I carcinoma of the endometrium: correlation with risk factors. 665 76

Twenty-two patients with biopsy-proved para-aortic lymph node metastases from carcinoma of the cervix (15 patients) or endometrium (7 patients) received a median dose of 5,000 rad/25 fractions. Para-aortic nodal metastases were controlled in 77% of cases. Control was significantly lower following radical retroperitoneal lymph node dissection than less extensive sampling procedures. Obstruction of the small bowel developed in 3 patients with tumor recurrence in the para-aortic region. Eight of the 10 patients who were disease-free at 2 years received greater than 5,000 rad. Three patients were still alive without disease at 129, 63, and 60 months, respectively. The 5-year disease-free survival rate was 40% for cervical cancer and 60% for endometrial cancer: in the former group, it was significantly different depending on whether the para-aortic nodes were irradiated (40%) or not (0%). The authors suggest that 5,000-5,500 rad in 5-5.5 weeks is well tolerated and can control aortic nodal metastases in cervical and possibly endometrial cancer.
 ...
PMID:Irradiation of para-aortic lymph node metastases from carcinoma of the cervix or endometrium. Preliminary results. 682 38

A review was made of 240 women with endometrial carcinoma who were treated at the University Hospital in Seattle, Washington, between 1961 and 1979. The most common predisposing factor was a history of exogenous hormones, elicited in 46.7%. As predicted, such patients exhibited a more favorable outcome. Twelve percent of patients developed recurrent disease, and the vagina was the most common site of recurrence. However, 85% of patients with vaginal recurrence had received preoperative radiation therapy. Nodal sampling was a phase of the primary surgical treatment of the disease in 41 of the 240 patients. An effort to focus on this issue was made by including in a separate review 26 additional patients similarly managed in 1980 and 1981, thereby raising to 67 the total number of patients with nodal sampling. Fifty-nine of these patients had Stage I endometrial cancer. In these patients, histologic grade of tumor and depth of invasion determined at the time of operation appear to serve as reasonable predictors of nodal involvement.
 ...
PMID:Treatment variables in the management of endometrial cancer. 685 75

Controversy continues as to how and when radiation therapy can best be combined with surgery in order to improve treatment results in patients, with endometrial cancer. Various prognostic factors--tumor grade, depth of myometrial invasion, size of the uterine cavity, and the presence of nodal or parametrial spread--must all be considered when planning therapy. Well-differentiated Stage IA endometrial cancers hav an excellent prognosis when treated by surgery alone. Evidence suggests, however, that all other Stage I tumors benefit from combined radiation and surgical treatment. Patients with advanced stages of disease are candidates for combined surgery and radiation or radiation alone, owing to the high frequency of pelvic node involvement. Areas of active investigation include the addition of systemic therapy in patients with Stage III disease and the evaluation of extended field radiation in patients with histologically confirmed high pelvic or paraaortic nodal involvement.
 ...
PMID:Carcinoma of the endometrium. 702 66

A retrospective study was undertaken of 189 patients with Stage I or Stage II endometrial cancer in whom selective lymphadenectomy had been performed between the years 1974 and 1981. Pelvic and para-aortic nodal involvement increased with increasing stage, grade, and depth of myometrial invasion. The incidences of pelvic and para-aortic node metastases in Stage I were 1.4% and 3.8%, respectively, while 17.6% of Stage II patients had para-aortic metastases. Mortality was significantly greater for Stage I adenosquamous carcinoma (10.5%) and papillary serous adenocarcinoma (37.5%) than for Stage I adenocarcinoma (2.2%). In Stage I, grade 3 nonrandomized cases of endometrial cancer, no significant difference in survival or morbidity occurred between those patients treated with external radiation and those who were not. Intraperitoneal or adnexal spread occurred in 12 of the 189 patients, and lymph nodes were diseased in two of these. Sixteen of 17 recurrences developed at extrapelvic sites, indicating the need for effective systemic chemotherapy in high-risk patients. The overall 5-year survival rates for Stage I and II patients were 88.0% and 83.3%, respectively.
 ...
PMID:Endometrial cancer: evaluation of spread and follow-up one hundred eighty-nine patients with Stage I or Stage II disease. 711 27

This study includes 183 patients with clinical stage I endometrial carcinoma. All patients had standard surgical staging procedure including peritoneal cytology, total abdominal hysterectomy, bilateral pelvic and paraaortic lymphadenectomy. The factors analysed for recurrence were age, menopausal state, cell type, grade, mitotic activity, myometrial invasion, lymphovascular space invasion, cervical involvement, microscopic vaginal metastases, adnexal metastases, peritoneal cytology, concomitant endometrial hyperplasia and pelvic and paraaortic node metastases. The overall recurrence rate was 14.2% (26/183). Of the 26 patients with recurrence, 11 had local and 13 had distant metastases. In the remaining two patients (7.7%), both local and pelvic metastases were observed. Of the factors analysed, age, grade, mitotic activity, myometrial invasion, lymphovascular space invasion, microscopic vaginal metastases, adnexal involvement and pelvic and paraaortic nodal metastases were found to be significant predictors of recurrence. After multivariate analysis, advanced age (RR = 1.05), marked mitotic activity (RR = 3.11), pelvic and/or paraaortic nodal metastases (RR = 6.37) were chosen as the most important determinants of recurrence. In terms of surgical pathological stages, recurrence risk reaches up to 45.4% for stage IIIC disease. Using surgical pathological parameters, it is possible to predict recurrence but because of high rate of distant failures it still seems hard to improve survival of this group. Detection of a substantial risk of recurrence even in stage IA/B grade 1 group warrants adjuvant therapy in all patients after primary surgery.
 ...
PMID:Risk factors for recurrence in clinically early endometrial carcinoma: an analysis of 183 consecutive cases. 771 90

Twenty-one (8%) of 264 consecutive evaluable patients with clinical stage 1 endometrial carcinoma had histologic evidence of pelvic and/or para-aortic lymph node metastases. DNA flow cytometry was performed on both the primary tumor and nodal metastasis. Seventeen of 21 sets could be analyzed. Overall, 11 (65%) of the primary carcinomas were aneuploid. Nine of 17 (53%) had consistent ploidy patterns when the primary tumor and lymphatic metastasis were compared. The remaining 8 (47%) had aneuploid primaries with diploid nodal metastases. Five (83%) of the 6 patients with diploid primary tumors were alive without evidence of disease compared to 3 of 11 (27%) patients with aneuploid tumors (P < 0.05). Other predictors of disease outcome included tumor histology, lymph vascular space invasion, and depth of myometrial invasion. Ploidy status of the lymphatic metastasis was not important in terms of overall survival. All 8 patients with para-aortic nodal metastases had aneuploid primary carcinomas compared to 4 (44%) of 9 patients with pelvic node involvement only (P < 0.01). Mean survival was 31 months for patients with para-aortic node metastases compared to 51 months for patients with only pelvic node metastases. Comparison of survival curves among these two groups demonstrated a significant survival advantage in patients with regional nodal metastases (P = 0.032). S-phase fraction of both the primary tumor and lymphatic metastasis did not correlate with survival or predict disease outcome. DNA index of the primary tumor, as a continuous variable, was inversely proportional to survival, demonstrating poorer survivorship with incremental increases of DI. Ploidy status of the lymph node metastasis was an inconsistent reflection of the primary tumor's expression and behavior and, therefore, little additional information was gained by knowledge of the lymphatic ploidy status.
 ...
PMID:DNA flow cytometric analysis of clinical stage I endometrial carcinomas with lymph node metastases. 834 59

158 patients with endometrial cancer who were treated between 1980-1990 at the Department of Obstetrics and Gynecology, Hospital Berlin-Buch, were reviewed retrospectively with regard to prognostical and therapeutical aspects. The 5-year-survival rate of all patients amounted to 84%. The 5-year-survivals were 92.6% for stage I, 87.5% for stage II and 47.6% for stage III (old FIGO classification). Depth of myometrial invasion, lymph-vascular space involvement, lymph-nodal status, tumor type and grading are of dominant prognostic value. Surgery was the treatment of choice in all reviewed cases. No statistically significant difference was observed in the 5-year survival rate between vaginal and abdominal hysterectomy. The 5-year survival rate for cases with vaginal hysterectomy was 85.4% and for abdominal hysterectomy 87.8%.
 ...
PMID:[Prognostic factors and results of treatment in endometrial carcinoma]. 890 Jun 5

CD44 is known as an adhesion molecule which is involved in lymphocyte activation and lymphocyte homing. In recent years, its role in the invasion and metastasis of malignant tumors has attracted the attention of investigators. In this study, the expression of CD44 variants was investigated in primary lesions and metastasis into the lymph node in 53 patients with gynecological cancer. The following patients with various types of gynecological carcinoma, established by operation and pre-treatment biopsy, were included in this study: 19 patients with cancer of the uterine cervix, 23 with cancer of the uterine endometrium, and 11 with ovarian cancer. Tissue samples were obtained from a primary lesion and a nodal metastasis of each patient, and immunohistochemical staining was performed by the ABC method through the use of monoclonal antibodies against CD44v1-10. Specimens proving CD44v1-10 positive were then submitted to immunohistochemical staining through the use of monoclonal antibodies against CD44v6 and CD44v9. Expression of CD44v was judged positive when DAB revealed color development, irrespective of the degree of staining intensity. CD44v were all expressed in the cancer cell membrane. In normal endometrium, expression of CD44v1-10 and v9 was observed in the endometrial gland cell membrane. In normal ovarian tissues, CD44v6 and v9 were not detected. The expression of CD44v6 in patients with endometrial cancer was noted in 13 (72.2%) of 18 patients with vascular invasion and in one (20.0%) of 5 patients without it, indicating a significant relation to vascular invasion. It was also remarkably higher in those for whom the invasion exceeded 1/2 of the myometrium than in those for whom the invasion did not exceed 1/2 of the myometrium, and was higher too in advanced stages and in node-positive patients. In one patient, CD44v6 was detected not in the primary lesion but in the nodal metastasis. The expression of CD44v6 in patients with ovarian cancer occurred more frequently in node-positive patients. Our study results suggest that the expression of CD44v6 in endometrial adenocarcinoma cells is involved in the progression of the carcinoma, nodal metastasis, myometrial invasion, and vascular invasion, and that in ovarian cancer, the expression of CD44v6 is involved in nodal metastasis.
 ...
PMID:Expression of CD44 alternative splicing variants in primary and lymph node metastatic lesions of gynecological cancer. 911 64


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>