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

(18)F-FDG PET imaging is underutilized in patients with gynecologic malignancies, and its role in current clinical practice has yet to be established. In cervical cancer, it has high sensitivity in detection of nodal disease. Its use is probably most suitable in patients with negative or ambiguous findings on other types of radiographic imaging. Data support its usefulness in asymptomatic cervical cancer patients with high tumor markers and negative conventional-imaging findings, although more data are needed to ascertain whether it has a positive impact on survival. Similarly, its role in monitoring response to therapies needs to be consolidated. In ovarian cancer, (18)F-FDG PET holds promise in evaluation of recurrent or residual disease when other radiographic data are uncertain. In endometrial cancer, there are encouraging, although limited, data supporting the use of (18)F-FDG PET in patients with recurrent disease. To reduce extensive lymph node dissection in patients and to decrease subsequent morbidity, investigators have advocated applying the sentinel node technique to patients with cervical, endometrial, or vulvar cancers. The overall results are encouraging for the use of LS in planning surgical procedures, although more data and larger planned studies are needed to establish clinical utility in the surgical management of patients with these malignancies.
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PMID:Oncologic imaging in gynecologic malignancies. 1626 98

The purposes of this study were to compare the relationships between para-aortic lymph node metastasis and various clinicopathologic factors to evaluate whether para-aortic lymph node dissection is necessary when treating endometrial cancer. A retrospective study was performed on 841 patients with endometrial cancer, who underwent the initial surgery at the Keio University Hospital. Clinicopathologic factors related to para-aortic lymph node metastasis significant on a univariate analysis were analyzed in a multivariate fashion using a logistic model. According to the multivariate analysis, the clinicopathologic factor most strongly related to the existence of para-aortic lymph node metastasis was positive pelvic lymph node metastasis (P < 0.01). Among the 155 patients who underwent pelvic and para-aortic lymph node dissection, the difference of 5-year overall survival by the presence of retroperitoneal lymph node metastasis was examined by Kaplan-Meier method. The prognosis was poor even if para-aortic lymph node dissection was performed in cases of positive para-aortic lymph node metastasis. In conclusion, when deciding whether to perform para-aortic lymph node dissection in patients with endometrial cancer, it is necessary to consider the pelvic lymph nodal status. If there is no pelvic lymph node metastasis, it could not be necessary to perform para-aortic lymph node dissection.
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PMID:Analysis of clinicopathologic factors predicting para-aortic lymph node metastasis in endometrial cancer. 1668 64

In this study, we examine the prevalence of finding isolated tumor cells (ITCs) in negative lymph nodes of endometrial cancer patients using immunohistochemistry. Seventy-six endometrial cancer patients with lymph nodes histologically negative for metastatic disease were examined. Nodal tissue sections were stained with anticytokeratin antibodies AE-1 and CAM 5.2. Nodes with single or groups of cells (two to four cells) < or =0.2 mm and showing cytokeratin reactivity were positive for ITCs. Findings were compared to features of the primary tumor and patient outcome. ITCs were present in 31 of 1712 lymph nodes. Fifteen (19.7%) patients had ITC-positive nodes. ITCs involved only pelvic nodes in nine cases, only para-aortic nodes in five cases, and pelvic and para-aortic in one case. Tumor in adnexa was the only pathologic feature associated with nodal ITCs (P= 0.0485). All 15 patients with nodal ITCs were alive at follow-up. One (6.7%) patient suffered recurrent disease but was alive at last encounter. Disease recurred in 5 (8.8%) of 57 patients without nodal ITCs. Two are alive without disease, two alive with disease, and one died from her cancer. In summary, a significant proportion of endometrial cancer patients have ITCs detected by immunohistochemistry in histologically negative regional lymph nodes.
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PMID:Endometrial cancer patients have a significant risk of harboring isolated tumor cells in histologically negative lymph nodes. 1680 26

The aim of this study was to evaluate the correlation of preoperative serum CA 125 levels and lymph node metastasis in patients with endometrial cancer. Preoperative levels of serum CA 125 were determined in 64 patients with endometrial cancer treated with total abdominal hysterectomy with a lymph node dissection as initial therapy. Lymph node status, determined by histopathology, was correlated with both normal and elevated CA 125 levels, determined preoperatively. A serum CA 125 level of >30 IU/ml was considered elevated. There were five patients (7.8%) with pelvic or paraaortic lymph node metastases and 59 patients (92.2%) without nodal metastases. In all five patients with lymph node metastases, serum CA 125 was within normal limits. Preoperative serum CA 125 levels were above normal in eight lymph node-negative patients. In the remaining group of 51 node-negative patients, serum CA 125 levels were within normal limits. Among the five lymph node-positive patients, four had endometrioid and one had serous papillary cancer. One patient had histologic grade 2 tumor and four patients had histologic grade 3. Preoperative serum CA 125 levels do not offer any information for predicting lymph node metastasis in patients with endometrial cancer.
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PMID:Serum CA 125 levels and lymph node metastasis in patients with endometrial cancer. 1681 47

The role of minimally invasive surgery in the management of gynecologic cancers continues to expand. Radical vaginal trachelectomy with laparoscopic pelvic lymphadenectomy has emerged as a safe, reasonable option for women with early-stage cervical cancer desiring fertility preservation. Similarly, laparoscopically assisted radical vaginal hysterectomy has been systematically described, is feasible, and can be offered to women with early-stage cervical cancer who do not desire future childbearing. In the treatment of early-stage endometrial cancer, the surgical approach of laparoscopic hysterectomy, peritoneal washings, and pelvic and para-aortic lymph node dissection, with or without an omentectomy, is being compared with the same surgery performed via laparotomy in the cooperative Gynecologic Oncology Group LAP 2 study, which has completed accrual, and appears to be a reasonable surgical option. In ovarian cancer, minimally invasive surgery has been incorporated to manage early-stage, advanced-stage, and recurrent disease, as well as second-look procedures. Hand-assisted laparoscopy has also recently been described in managing larger volume primary and recurrent gynecologic cancers. Extraperitoneal laparoscopy for para-aortic and pelvic lymph node dissections has been shown to yield adequate nodal counts and to be safe and feasible in the management of gynecologic cancers.
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PMID:Role of minimally invasive surgery in gynecologic cancers. 1695 93

Two hundred and eight patients with a clinical stage I endometrial carcinoma were studied (164 fulfilled the inclusion criteria). High risk was defined as nonendometrioid, or endometrioid tumors grade 3 (G3), or G2 with any or G1 with deep (>1/2) myometrial infiltration. The low-risk group consisted of the remaining patients. Surgical staging in the high-risk group included pelvic lymphadenectomy with para-aortic lymphadenectomy in selected cases. Twelve percent of the high-risk patients had nodal metastasis. Patients with low-risk (group A, n = 85) and high-risk disease confined to the uterus (group B, n = 57) did not receive adjuvant radiotherapy. Patients with nodal metastases (group C, n = 10) received postoperative irradiation. The total recurrence rate of the entire population was 12.5%, and the actuarial overall survival, disease-specific survival, and disease-free survival were 90%, 94%, and 88%, respectively. All patients with only vaginal relapse (n = 9) were cured locally with salvage radiotherapy until the date of analysis. The pelvic relapse rate was low as only one patient of group B recurred in the pelvis. In conclusion, lymphadenectomy remains indicated to better select patients at high risk of pelvic recurrence that may benefit from postoperative radiotherapy.
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PMID:Role of lymphadenectomy and pelvic radiotherapy in patients with clinical FIGO stage I endometrial adenocarcinoma: An analysis of 208 patients. 1700 87

In 1998, FIGO (International Federation of Gynecologists and Obstetricians) required a change from clinical to surgical staging in early endometrial cancer. This staging requirement raised numerous controversies around the importance of determining nodal status and its impact on outcomes. A diversity of opinions exists as to the actual benefits and toxicities associated with surgical staging which includes lymph node sampling, ranging from those whose opinion is that staging is required for all patients even when the a priori risk of nodal involvement is extremely low through to those who consider that staging is unnecessary in any patient. While knowledge of the presence or absence of extra uterine sites of disease may change treatment approaches and direct different treatment interventions in some patients, the impact of those changes on survival is much less clear. This paper examines recommendations for surgical staging in various subgroups of patients with clinically early endometrial cancer and the impact on survival and toxicity of the various approaches and the subsequent use of adjuvant irradiation and/or chemotherapy.
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PMID:Endometrial cancer--revisiting the importance of pelvic and para aortic lymph nodes. 1824 83

Although surgical staging is the primary method of assessing prognostic factors in endometrial cancer, cross-sectional imaging may help in treatment planning by providing information about factors such as the depth of myometrial invasion, cervical involvement, and nodal status. The pretreatment evaluation of cervical cancer traditionally has consisted of clinical evaluation, laboratory tests, and conventional radiographic studies, but more advanced imaging methods allow additional insights into the morphologic and metabolic features of cervical cancer. This article reviews the applications of modern imaging modalities in the assessment of endometrial cancer and cervical cancer and their impact on treatment planning and posttreatment follow-up.
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PMID:Imaging of uterine cancer. 1715 28

Carcinoma of the uterine cervix and endometrium are common gynecologic malignancies. Both carcinomas are staged and managed by means of the International Federation of Gynecology and Obstetrics (FIGO) staging system. In uterine cervical cancer, the FIGO staging system is determined preoperatively by limited conventional procedures. Although this system is effective for early stage disease, it has inherent inaccuracies in advanced stage diseases and does not address nodal involvement. CT and MR imaging are widely used as comprehensive imaging modalities to evaluate tumor size and extent, and nodal involvement. MR imaging is an excellent modality for depicting invasive cervical carcinoma and can provide objective measurement of tumor volume, and provides high negative predictive value for parametrial invasion and stage IVA disease. In contrast, endometrial cancer is surgically staged. Beside recognition of the important prognostic factors, including histologic subtype and grade, accurate assessment of the tumor extent on preoperative MR imaging is expected to greatly optimize surgical procedure and therapeutic strategy. Contrast-enhanced MR imaging can offer "one stop" examination for evaluating the depth of myometrial invasion cervical invasion and nodal metastases. Evaluation of myometrial invasion on MR imaging may be an alternative to gross inspection of the uterus during the surgery.
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PMID:Staging of carcinoma of the uterine cervix and endometrium. 1721 42

Aberrant expression of human leukocyte antigen G (HLA-G) has been proposed to be involved in tumor escape mechanisms. It has been also proposed that detection of HLA-G might service as a potential biomarker for diagnosis or prediction of the clinical outcomes in ovarian and breast cancers, carcinoma of the lung and endometrial cancer. The aim of this current study is to determine if HLA-G is expressed in colorectal carcinomas and if the expression is associated with clinicopathological and prognostic data. The expression of HLA-G was investigated immunohistochemically in 201 patients with colorectal carcinomas. The correlation between HLA-G status, clinicopathological factors and the overall survival rate was analyzed. In this prospectively study, HLA-G protein expression was observed in 64.6% (130/201) of the primary site colorectal carcinomas, but not in the normal colorectal tissues or benign adenomas. HLA-G expression in the tumors was significantly correlated with the depth of invasion, histological grade, host immune response, lymph nodal metastasis and clinical stages of the disease (P=0.001, 0.0001, 0.002, 0.001 and 0.031, respectively). Patients with HLA-G positive tumors had a significantly shorter survival time than those patients with tumors that were HLA-G negative (P=0.0001). As well, in multivariate analysis, HLA-G demonstrated an independent prognostic factor (P=0.021, relative risk 3.14; 95% confidence interval, 1.34-8.10). Therefore, it can be gathered that HLA-G might serve as an independent prognostic factor for colorectal cancer patients.
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PMID:Human leukocyte antigen G expression: as a significant prognostic indicator for patients with colorectal cancer. 1727 60


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