A case-controlled study of risk factors for sarcomas of the uterus

Article Abstract:

Sarcomas account for only one-tenth of the cancers of the uterus, but their prognosis is significantly worse than for the more common types of uterine cancer, such as endometrial carcinoma. Due to their relative rarity, little is known about the epidemiology of these tumors and the relevant risk factors. Although radiation is known to be a risk factor, the majority of these tumors occur in women without significant radiation exposure. As a part of the World Health Organization Collaborative Study of Neoplasia and Steroid Contraceptives, 29 patients with uterine sarcoma were identified and matched with 198 control subjects. The patients and controls were interviewed about their medical and reproductive history, including birth control, sexually transmitted diseases, and sexual relationships. Women with children had a lower risk of uterine sarcoma than women without children, and women who had their first child after 25 years of age had higher risk. The risk of uterine sarcoma seemed to drop with each additional child. There was no evidence that infertility, oral contraceptives, or sexual activity was related to uterine sarcoma. Women with late menarche and early menopause were at higher risk. These results are almost completely opposite to those of a Norwegian study involving 29 cases of uterine sarcoma from a cohort of 62,000 women. This significant discrepancy points out the need to involve greater number of cases in the epidemiological study of uterine sarcoma. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Demographic aspects

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Treatment of uterine sarcomas

Article Abstract:

Tissues, including muscle and connective tissues, that arise from the mesoderm of a embryo during development are collectively referred to a mesodermal; when cancers arise from these tissues, the cancers are called sarcomas. Sarcomas of the uterus are uncommon, and may arise from connective tissue, smooth muscle, or the endometrial stroma. Uterine sarcomas account for only one to three percent of cancers of the uterus. In a review of 66 patients with uterine sarcomas, it was found that the addition of radiotherapy to surgical excision of the affected tissues significantly reduced the chances of tumor recurrence in the pelvis. Of the 66 patients, 11 patients developed metastatic spread, 15 developed recurrent tumor in the abdomen, 6 in the pelvis, and 3 in the vagina, for an overall treatment failure rate of 53 percent. While the rate of pelvic recurrence was reduced for those patients who received radiation in addition to surgery, the overall recurrence rate was the same as for patients treated only by surgery. Disease-free survival at 5 years was better for patients receiving radiation in addition to surgery at 38 percent, compared with 18 percent disease-free survival for surgery alone. The authors recommend that radiotherapy be added to surgery in the treatment of patients with Stage I and II uterine sarcoma. For patients with more localized advanced disease, participation in a trial of a drug such as cisplatin may be more appropriate. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Surgery

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Randomized comparison of doxorubicin and vindesine to doxorubicin for patients with metastatic soft-tissue sarcomas

Article Abstract:

Soft-tissue sarcomas are cancerous tumors of a variety of soft tissues, such as smooth muscles, blood vessels, fat cells, and a variety of other tissues. At present, the most effective agent for treating soft-tissue sarcomas is doxorubicin, which is the standard of comparison for new treatment protocols. Since combinations of effective chemotherapeutic drugs have proved to be more efficacious that single agents for the treatment of a great many tumors, investigators have shown great interest in evaluating drug combinations for the treatment of soft-tissue tumors as well. Previously, carboximide was used in combination with doxorubicin and was found to increase toxicity without providing significant therapeutic benefit. Now, in a study involving 298 cases of soft-tissue tumors, investigators have observed a similar result for vindesine. In a randomized trial comparing doxorubicin alone with doxorubicin plus vindesine, significantly greater severe toxicity was observed for the doxorubicin plus vindesine group, while there was no significant therapeutic improvement. These results indicate that the combination of doxorubicin and vindesine is not justified in the treatment of soft-tissue tumors. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Evaluation, Physiological aspects, Chemotherapy, Chemotherapy, Combination, Combination chemotherapy, Doxorubicin, Vindesine

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