One hundred and one cases of cervical cancer were randomized by a card selection system into two treatment groups. Group A patients (48) were treated according to the radiotherapy plans used at the University of Mississippi Medical Center. Group B patients (53) were treated according to the radiotherapy plan used at the M.D. Anderson Hospital and Tumor Insitute. The purpose was to evaluate these two different therapy programs in terms of survival, complications, and physician radiation exposure. The latter has been reported. Life-table techniques revealed an over-all five-year survival rate of 68.6 per cent in Group A and 86.7 per cent in Group B (statistically significant to P = 0.05). Over-all radiation complication rates were similar although there were four radiation-induced vaginal fistulas in Group A and one in Group B. Our institution has converted to the treatment plan represented in Group B.

Adult↗

PubMed1977

Stage I cervix cancer and pelvic node metastasis: special reference to the implications of the new and the recently replaced FIGO classifications on Stage Ia.

The current staging system for cervix cancer of the International Federation of Gynecology and Obstetrics (FIGO) has been in use for less than 2 years. It is criticized by many because of a lack of quantitative features. While quantative features are important, the over-all morphology of the histologic pattern--the qualitative features--are those utilized by most pathologists in interpretating the "invasiveness" of a lesion and therefore its biologic potential. The most recent, as well as the previous FIGO Staging System was applied to 108 personal cases with particular reference to lymih node metastasis. By comparing results of the new and older staging system, the validity of the new system is suggested, and the inordinately high rate of node metastasis when using the older system appears to be at least one reason for the relatively high rate of node metastasis reported in earlier series of Stage Ia lesions reported in the literature.

Cervix Uteri↗

PubMed1977

Stage II endometrial adenocarcinoma. Memorial Hospital for Cancer, 1949-1965.

Of 617 patients receiving initial therapy for endometrial adenocarcinoma from 1949 to 1965, 90 patients were retrospectively assigned to Stage II (FIGO) by reviewing preoperative, operative, and pathologic findings. In 66 patients (73%) the cervical spread of endometrial cancer was occult and detected only microscopically in the hysterectomy specimen, whereas in the other 24 (27%) it was detected clinically prior to surgery. The survival rate for patients with occult cervical involvement was better (61%) than in those patients with gross cervical spread of tumor (48%), but the difference was not statistically significant. When the surgical specimen revealed that the only spread was to the cervix, those having only occult spread had a better 5-year corrected survival rate (89%) than those with grossly detectable spread (57%). Spread of tumor beyond the uterus occurred in over one-third of the patients with each kind of cervical spread. Study of lymphadenectomy specimens in 31 patients revealed a similar incidence of lymph node metastases for both groups: 25% in those with grossly detectable spread and 21% in those with occult spread. Only 1 of the 7 patients with positive pelvic lymph nodes had clinically positive paraaortic nodes in addition to the positive pelvic nodes. Thus, only 1 of the 31 patients having the stnadard pelvic lymph node dissection was found to have paraaortic metastasis, as it was routine to sample only clinically positive paraaortic lymph nodes. These data suggest that in Stage II endometrial adenocarcinoma both gross and occult cervical involvement have a relatively bad prognosis and require aggressive therapy.

Adenocarcinoma↗

PubMed1976

Endometrial adenocarcinoma and the polycystic ovary syndrome.

While endometrial adenocarcinoma is the second most common female genital malignancy, only four per cent of the cases occur in women less than 40 years of age. The relative rarity of this disease in young women requires that we be especially attuned to those who are at high risk. This paper presents two case reports of women with polycystic ovarian disease who developed endometrial adenocarcinoma at 24 years of age. The pathophysiology ovarian disease and its relationship to the development of endometrial adenocarcinoma are discussed.

Adenocarcinoma↗

PubMed1976

Adenocarcinoma of the endometrium: its metastatic lymph node potential. A preliminary report.

Explore the source record for details and available documents.

Adenocarcinoma↗

PubMed1976

Treatment of adenocarcinoma of the endometrium at Memorial-James Ewing Hospitals, 1949-1965.

This retrospective study of patients receiving initial therapy for endometrial adenocarcinoma at Memorial-James Ewing Hospitals from 1949-1965 confirmed that the most important factor related to survival was extent of disease at presentation. Those patients with spread beyond the corpus had a much poorer prognosis regardless of method of therapy. Within Stage I, histologic grade and depth of myometrial penetration were of much greater prognostic significance than uterine size. Advanced age was associated with a higher incidence of poorly differentiated tumors. Apparently for Stage I, simple hysterectomy alone was not as effective as simple hysterectomy combined with preoperative radium or radical hysterectomy with or without node dissection. There was a 6% incidence of positive nodes when node dissection was performed in Stage I patients who had no spread of disease to the cervix confirmed at operation. Pure vaginal recurrence rate was low for all methods of therapy in Stage I. Eradication of recurrences by any means was relatively ineffective.

Adenocarcinoma↗

PubMed1976

Surgical management of radiation injury to the small intestine.

A survey of the literature and of the present series demonstrate a distinct difference in surgical mortality and intestinal morbidity in the immediate postoperative periods. Resection of the intestine with anastomosis has a significantly higher complication rate than does bypass. In this study, the over-all advantage in resecting radiation injured small intestine with reference to reducing severe chronic intestinal signs and symptoms has not been demonstrated.

Chronic Disease↗

PubMed1976

Endometrial cancer: not a benign disease.

Endometrial cancer is by no means a benign disease. While many adequate treatment plans now exist for early endometrial cancer, the best method of treadtment of this disease has yet to be defined. The prognostic factors need further study and definition. Pelvic and aortic nodes are of more than passing significance in certain subsets of Stage 1 endometrial cancer, and there is much to be learned about the biologic behavior of apparent early endometrial cancer. Prospective studies may yield sufficient data to provide a solid base for further clinical therapeutic trials.

Adenocarcinoma↗

PubMed1975