Endometrial adenocarcinoma in Norway: a study of a total population

Article Abstract:

Pathologists classify cancers on the basis of their appearance under the microscope. Therefore, a cancer such as endometrial cancer may actually have several different names, depending upon the classification. (Endometrial cancer involves the uterine lining.) The term ''adenocarcinoma'' is used to describe cancers in which the cancerous tissue has an appearance that resembles secretory tissues such as glands. Estimates vary on the actual proportion of endometrial cancers that are adenocarcinomas; the proportions seem to be different for different patient groups and for different geographical areas. Anywhere from 40 to 95 percent of endometrial cancers may be classified as endometrial adenocarcinoma. A study was conducted on all endometrial cancers that were diagnosed in the country of Norway over a nine-year-period. Of all 2,090 cases, 1,985 were confirmed as endometrial cancer by the authors. Of these, a total of 78.9 percent were adenocarcinoma. The five-year survival rate of endometrial adenocarcinoma was 74.1 percent. As might be expected, patients whose cancer was limited to the mucosal layer, the innermost layer of the uterus, survived longer; their five-year survival rate was 88.7 percent. When the cancer had invaded the underlying serosal layer of the uterus, the five-year survival rate dropped to 46.9 percent. Similarly, survival was found to be better when the cancer had not invaded any blood vessels; 66 percent of the patients whose cancer had invaded blood vessels survived for five years in contrast with 88.6 percent survival for those without blood vessel involvement. However, the depth of the invasion of the cancerous tissue was found to be the second most important prognostic variable. The age of the patient at the time of diagnosis was the most important variable affecting the likelihood of survival. Younger patients had a greater chance of survival; their cancers also appeared to be less aggressive under the microscope. (Consumer Summary produced by Reliance Medical Information, Inc.)

Statistics, Norway

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Undifferentiated carcinoma of the endometrium: a histopathologic and clinical study of 31 cases

Article Abstract:

As is the case for many types of cancer, the term endometrial cancer describes not a single type of cancer, but rather a set of cancers all affecting the endometrium (lining) of the uterus. Undifferentiated carcinoma of the endometrium is a relatively uncommon form of endometrial cancer, and accounts for only about 1 percent of all endometrial cancers. There have been few studies, however, which describe the characteristics of this type of endometrial cancer. In a review of 1,985 cases of endometrial cancer, 31 (1.6 percent) were found to be of the undifferentiated type. These could be further divided into two types: the large cell type, which accounted for 48 percent of the cancers, and the intermediate/small cell type, accounting for the other 52 percent. While these cancers appeared different under the microscope, there were no statistically significant differences in survival between the two types. The average age at diagnosis for the undifferentiated carcinoma was 64 years, and the five-year and 10-year survival rates were 58 and 48 percent, respectively. As is often the case, the patients with the earlier stage cancer had a significant survival advantage. Cancer of the endometrium often invades the myometrium, which is the smooth uterine muscle surrounding it. For the patients whose cancer invaded only half the depth of the myometrium, the survival at five years was 100 percent. For the patients with greater invasion of the muscle, the five-year survival was only 46 percent. A similar effect on survival was found for the invasion of blood vessels by the cancer. The five-year survival of patients whose cancer had not invaded blood vessels was 89 percent, in contrast with a five-year survival of 54 percent for the patients in whom blood vessel invasion had occurred. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cases, Identification and classification, Cancer cells

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Management of malignant ovarian immature teratoma: role of adriamycin

Article Abstract:

Immature teratomas account for only about one percent of all ovarian malignant tumors; taken as a group, malignant germ cell tumors account for three percent of ovarian cancers. However, the immature teratoma often occurs early in life, with 10 to 20 percent being observed in the first two decades. With the advent of chemotherapy, the survival rate of women with immature teratoma is excellent. About 85 percent of patients are cured and many may remain fertile. The first-line treatment is surgical; the affected ovary or ovaries are removed, or the ovaries are removed along with the uterus and associated tissues. Adjuvant chemotherapy is usually administered. In a series of 16 patients with immature teratoma, the median age at presentation was 22. In only two patients, was residual tumor observed at the time of surgery. These two patients were given adjuvant treatment with vincristine, dactinomycin, and cyclophosphamide or cisplatin, vincristine, and bleomycin. All but one of the remaining 14 patients, among whom residual tumor was not observed, were given adjuvant doxorubicin (brand name, Adriamycin). Among the 16 patients, 9 ovaries were conserved. After follow-up, ranging from 22 to 166 months, all 16 patients are without evidence of disease. These observations indicate that Adriamycin alone is an effective agent against immature teratoma. Extrapolating from results with cisplatin and etoposide in the treatment other germ cell tumors, the authors suggest that this combination may be worth investigating for the few cases in which residual tumor is observed at surgery for teratoma. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Prognosis, Surgery, Chemotherapy, Teratoma, Doxorubicin

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