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At least 19 recordsLinked to original sources
PubMed1994

The relationship between cigarette smoking and the risk of endometrial neoplasms.

BACKGROUND: Endometrial carcinoma and endometrial hyperplasia share a number of risk factors, particularly exposure to oestrogen stimulation. Studies have shown that cigarette smoking protects against carcinoma. This study was undertaken to confirm this finding in carcinoma, and to extend the investigation to hyperplasia. METHODS: Data from a previously published population-based case-control study, conducted in Toronto, Ontario were used to model risk estimates. RESULTS: Smoking modestly reduced the risk, (although not statistically significantly), for hyperplasia among pre- and postmenopausal women, and for carcinoma among postmenopausal women. In contrast, smoking appeared to elevate risk for carcinoma among premenopausal women, although the number of cases upon which these estimates are based are very small. CONCLUSIONS: Among the shared risk factors for endometrial hyperplasia and endometrial carcinoma is cigarette smoking. As these results are consistent with other studies, it seems apparent that the mechanism of action for cigarette smoking may be different in premenopausal women. Hyperplasia could provide a useful model for studying the smoking effect on endometrial neoplasms in premenopausal women.

Adult↗
PubMed2004

Panniculectomy: improving lymph node yield in morbidly obese patients with endometrial neoplasms.

OBJECTIVE: Panniculectomy has been used to facilitate pelvic surgery in obese women. The goal of this study was to determine the effect of panniculectomy on staging adequacy and lymph node yield in obese women with endometrial carcinoma undergoing staging laparotomy. METHODS: A retrospective review of patients with endometrial neoplasms who underwent panniculectomy at the time of hysterectomy was performed. For each subject, two control patients were matched by body mass index (BMI). RESULTS: Twenty-seven endometrial cancer patients who underwent panniculectomy at the time of staging were identified. Panniculectomy was successfully performed in all 27 patients. While the mean number of pelvic nodes was statistically similar between the two groups (16.2 vs. 13.7) (P = 0.199), the paraaortic node count was higher in patients who underwent panniculectomy (4.3 vs. 2.9) (P = 0.032). A paraaortic node dissection was not feasible in 3 (11.1%) of the panniculectomy patients and in 11 (20.4%) of the controls (P = 0.365). There were no differences in intraoperative or postoperative complications or in survival between the two groups. CONCLUSION: Among obese women with endometrial cancer, panniculectomy is well tolerated, feasible, and associated with acceptable morbidity. While the clinical significance of an increased paraaortic node count is uncertain, our findings suggest that panniculectomy may enhance operative exposure and facilitate endometrial cancer staging.

Adenocarcinoma↗
PubMed2000

[Place of value of pelvic lymphadenectomy for treatment of endometrial neoplasms].

OBJECTIVE: To explore the therapeutic value of pelvic lymphadenectomy for endometrial carcinoma. METHODS: One hundred and four cases undergoing pelvic lymphadenectomy were analyzed. Comparisons were carried out between various clinicopathologic factors and incidence of positive node, between 5 years survival rate with pelvic lymphadenectomy and that without pelvic lymphadenectomy. RESULTS: Four point four per cent case with positive node was found in clinical stage I cases. Positive node rate increased with deep myoinvasion and G3, accounting for 37.3% and 37.8% respectively. For clinical stage I and stage II cases, the 5 year survival rate of positive node and negative node was 38.9% and 74.2% respectively, with significant difference (P < 0.005). No significant difference was found between cases with pelvic lymphadenectomy and those without pelvic lymphadenectomy (P > 0.05) in pathologic stage I and stage II cases. CONCLUSIONS: Positive pelvic node is an important prognostic factor in endometrial carcinoma. Pelvic lymphadenectomy can not improve prognosis in early stage patients with endometrial carcinoma. It is not necessary to perform pelvic lymphadenectomy for stage I case, because of low incidence of positive node.

Adult↗
PubMed1999

[Clinico-radiobiological evaluation of radiation dosage and complications of radiotherapy for endometrial neoplasm metastasis to the vagina].

The data on 132 patients with metastases of endometrial carcinoma into the vagina (MECV) were analysed. They had received complex (remote + contact) and contact radiotherapy alone with low-, medium- and high dosage. The following radiobiological models were employed to assess tissue response: time-dose-fractionation factor (TDFF), cumulative radiation effect (CRE) and linear-quadratic dose effect equation (LQDE) ("extrapolated dose of response"). There was no correlation between survival and dose in excess of connective tissue tolerance calculated for each radiobiological model or a dose below tolerance limit. When dosage exceeded tolerance limit the incidence of early- and late-onset radiation injuries increased significantly. In MECV patients who had received primarily radiotherapy and surgery, early-onset radiation injuries occurred in cases of overdosage from the most recent exposure. When high-dose brachiatherapy was employed as a component of complex treatment, late-onset moist epithelite of the vagina could develop, irrespective of whether radiotherapy had been given or not and whether tolerance limit had been exceeded. Late-onset injuries were recorded in cases of over-dosage who had received both radiation and surgery for primary endometrial carcinoma.

Brachytherapy↗
PubMed2001

[Retrospective analysis of endometrial neoplasms treated by different therapeutic modalities].

OBJECTIVE: To compare the therapeutic effects of different remedies in patients with endometrial carcinoma. METHODS: Total of 386 patients with metracarcinoma underwent 3 different treatments: (1) operation only 145 cases; (2) operation and complemental radiotherapy 161 cases; (3) radiotherapy only 80 cases. Then they were followed up for 5 years and more. RESULTS: The 5-year survival rates of operation group were 78.9% (56/71), 61.0% (25/41) and 18.2% (6/33) in stage I, stage II, and stage III-IV respectively, for operation and complemental radiotherapy, they were 75.0% (33/44), 59.5% (44/74) and 48.8% (21/43), for radiotherapy, 34.8% (8/23), 18.8% (3/16) and 0.0% (0/41). There was no difference between operation group and operation plus radiotherapy in patients with stage I and stage II (P > 0.05). However the 5-year survival rates were significantly higher in operation plus complemental radiotherapy group and those only received operation in stage III stage IV patients (P < 0.001). And no matter in what stages, the therapeutic effect was worse in radiotherapy group than other two groups (P < 0.001). CONCLUSION: The remedies with operation as main measure are the best choice for metacarcinoma, radiotherapy merely is fit with those who can not be operated on.

Adult↗
PubMed2000

[Value of fractional curettage of prehysterectomy in endometrial neoplasms].

OBJECTIVE: To evaluate the value of fractional curettage in the histologic type, histologic grade and cervical involvement of the endometrial carcinoma. METHODS: A total of 691 cases of endometrial carcinoma in fractional curettage specimen were analyzed retrospectively, patients with no carcinoma postoperatively in the removed uterus were excluded from the study. Those endocervical curettages with adenocarcinoma according the histologic relationship between tumor tissue and endocervical tissue were divided into 4 main groups. RESULTS: (1) The inaccurate rate of histologic type in prehysterectomy curettage was 8.83% (61/691). About a half poorly differentiated adenocarcinomas were undergraded in the prehysterectomy curettage. (2) In 691 cases of endometrial carcinomas, 159 (23.01%) cases were determinated cervical involvement by tumor in the hysterectomy specimen, of which 88 cases had tumor tissue in the prehysterectomic curettage. In a variety of histologic appearances of endocervical curettage, the ratio of cervical involvement by tumor in hysterectomy was respectively group I 30.30% (10/33), group II 9 cases (9/9), group III 100.00% (40/40), group IV 46.88% (29/63), those without tumor tissue in the endocervical curettage 12.68% (71/560). CONCLUSIONS: (1) The reliability of histologic type of endometrial carcinoma based on the findings of the fractional curettage specimen in related to the tumor type. The diagnosis of poorly differentiated adenocarcinomas in the prehysterectomy specimen is limited. (2) Determinating the presence or absence of cervical involvement can't only depend upon the endocervical curettage with or without tumor tissue. It is suggested that those endocervical curettage with tumor tissue be divided into 4 main groups according the histologic relationship between tumor tissue and endocervical tissue, group II and group III are good predictors of cervical involvement by tumor.

Cervix Uteri↗
PubMed2000

[Recurrence, metastasis and complications of stage I and II endometrial neoplasms treated by different therapeutic modalities].

OBJECTIVE: To make an approach to the relationship between recurrence, metastasis and complication of stage I and II endometrial carcinoma treated by 4 different therapeutic modalities. METHODS: To compare the rates of recurrence, metastasis and complication in 4 treatment groups (surgery, full-dose preoperative intracavitary irradiation, non-full dose preoperative intracavitary irradiation and radiation alone). RESULTS: Recurrence and metastasis in surgery, full-dose preoperative intracavitary irradiation, non full-dose preoperative intracavitary and radiotherapy alone groups were 19.8%, 8.1%, 22.2% and 34.6%, respectively. The recurrent rates of vaginal stump were 6.2%, 1.6%, 11.1% and 11.5%, respectively. The rates of proctitis and cystitis in full dose preoperative intracavitary irradiation group were 3.2% and 3.2%, 2.8 and 0.0% in non-full dose preoperative intracavitay irradiation group, and 0.0% and 3.8% in radiotherapy alone group. CONCLUSIONS: The rates of recurrence and metastasis in full-dose preoperative intracavitary irradiation group were the lowest compared with other groups and incidence of complication was also low. This therapeutic method is the optimal choice for the treatment of endometrial carcinoma with stage I and II.

Endometrial Neoplasms↗
PubMed2000

[Microsatellite instability in endometrial neoplasms correlation with clinicopathologic parameters and estrogen receptor or progesterone receptor status].

OBJECTIVE: To assess the prevalence of microsatellite instability in a series of endometrial carcinomas as well as to define the clinicopathologic features and estrogen receptor (ER) and progesterone receptor (PR) status associated with microsatellite instability (MI). METHODS: We examined 40 cases for replication error (RER) using polymerase chain reaction, polyacrylamide gel electrophoresis and silver stain at 8 microsatellite loci. Immunohistochemical staining of 27 paraffin sections was performed using antibodies to ER and PR. Finally, MI was compared with the clinicopathologic characteristics as well as ER and PR status. RESULTS: MI was observed in 9 (23%) at two or more loci, which is defined as RER positive phenotype. The 9 RER positive cases were all endometrioid type. Four non-endometrioid tumors failed to show MI in any locus. RER positive phenotype was more frequent in poorly differentiated (50%) than in well differentiated tumors (15%). We found no significant correlation of RER with stage and depth of invasion. Of 27 carcinomas, 19 (70%) showed homogeneous positive staining for ER and PR. ER and PR positive staining occured more frequently in RER negative endometrioid cancers than in RER positive cases. CONCLUSIONS: MI is one of the molecular mechanisms of a subset of endometrial carcinomas. Its frequency is associated with tumor grade, histological type and ER or PR status.

Adult↗
PubMed2005

[Ovarian and endometrial neoplasms and the use of hormone replacement therapy].

Our research work summarize our and foreign Experience in the field of hormone replacement therapy and its use in endometrial and ovarian cancers. We look at the effects of the treatment on coronary heart diseases, venous thromboembolism, breast cancer and colorectal cancer. Results and examinations from other centers and clinics were included in our study treating the endometrial and ovarian cancers and the hormonal replacement therapy. Our aim was to work out guidelines and rules on prescribing hormone replacement therapy in clinical practice especially in oncogynecological malignancies.

Endometrial Neoplasms↗
PubMed1997

[Immediate and long-term results of combined therapy of patients with endometrial neoplasms depending on the effect of counter-suppression of blood lymphocytes].

The short-term (wound healing) and end-results (relapse and metastasis frequency, duration of relapse-free survival and 2-, 3- and 5-year survival) of combined treatment (surgery + gamma therapy) of 97 patients with endometrial carcinoma (stage I-II and stage III-IV) (FIGO, 1988) versus the effect of preoperative counter-suppression of blood lymphocytes were investigated. Both short-term and end-results appeared to be much better in patients showing the counter-suppression effect; they were much worse in patients who revealed the effect prior to combined therapy, and still worse--in cases of inverse effect involving enhanced suppression. It is suggested that the effect of blood lymphocyte counter-suppression before combined treatment is a factor of favorable prognosis in patients with endometrial carcinoma.

Combined Modality Therapy↗
PubMed1998

[Radiotherapy alone in endometrial neoplasms. The authors' own experience].

INTRODUCTION: Adenocarcinoma of the endometrium is the most common invasive genital malignancy in women and the majority of the cases are in stage I (80-85%) at the time of diagnosis. Total abdominal hysterectomy with bilateral salpingo-oophorectomy is the treatment of choice for most patients with uterine carcinoma. However, a number of women with endometrial cancer cannot undergo surgical treatment because of poor medical conditions. In these patients, who cannot tolerate surgery, radiation therapy is the only effective alternative. It is performed either as external treatment plus intracavitary brachytherapy or as brachytherapy alone. This retrospective study reports our data on survival, complications and local control in a consecutive series of patients treated with curative radiotherapy. MATERIAL AND METHODS: From January, 1985, to December 1995, at the Radiotherapy Department of "Casa Sollievo della Sofferenza" Hospital in San Giovanni Rotondo (Foggia, Italy), 60 patients were treated with combined external beam radiation therapy (ERT) and high-dose-rate intracavitary brachytherapy (HDR-BRT) or with high dose rate intracavitary brachytherapy alone. The average age of patients was 69 years (range 50-90). FIGO stage distribution was: 41 patients in stage I, 11 in stage II and 8 in stage III. The ERT was given by means of 6-8 MV linear accelerator, with conventional technique (with two opposed AP-PA pelvic fields in 15 patients, with the four fields-box technique in 41 patients) and a daily fraction to a total dose of 45-50 Gy. HDR-BRT was delivered by means of an HDR remote afterloading unit, containing a linear source of 192-Iridium (370 Gbq). The dose was specified to Point A in 32 patients and to uterine outline in 26. 2-3 intracavitary insertions (mean dose 6-8 Gy per fraction) were performed with weekly intervals. RESULTS: At the time of the analysis, all the patients were available for follow-up. Median follow-up was 25 months. 60% of patients were alive and well with no evidence of disease; 3.3% were alive with disease; 20% had died of this and 16.7% of other diseases. Five-year actuarial specific survival, obtained with the Kaplan and Meier method, was 77.7% in stage I, 90% in stage II, and 75% in stage III. Local relapses were observed in 14 patients. Complications (grade 2-3) scored with the French-Italian Glossary, were gastrointestinal in 10% of cases and genital in 6.6%. CONCLUSIONS: Radical radiotherapy achieved acceptable specific survival, local control and complications rates in patients with medically or surgically inoperable uterine carcinomas. Complications and survival rates, in our experience, are consistent with the literature data. The treatment is comfortable for the patients, because there is no need for long immobilization and it can frequently be performed on an outpatient basis. Besides, the completely standardized procedure was carried out easily with remote control allowing maximal radiation protection.

Aged↗
PubMed1996

[The role of hysteroscopy in the early diagnosis of small, focal endometrial neoplasms].

Hysteroscopy is a useful methodology for the diagnosis of uterine intracavitary disorders in women suffering from abnormal uterine bleeding. The authors report a case of small endometrial adenocarcinoma and then they discuss on validity of hysteroscopy in comparison with blind curettage of uterine cavity for the precocious diagnosis of such lesion.

Adenocarcinoma↗