Intraoperative evaluation of depth of myometrial invasion in stage I endometrial adenocarcinoma

Article Abstract:

Patients with stage I endometrial adenocarcinoma (cancer of the cells that line the uterus) may also have metastasis (spread) to nearby lymph nodes. This is more likely for tumors of higher grades (grades are categories that refer to the tumor's cellular characteristics) and for those that have penetrated deeper into the muscle layer of the uterus (myometrium). Decisions regarding the area to undergo radiation treatment after surgical removal of the uterus must take into account the extent of disease, so accurate identification of nodal metastases is essential. However, sampling the nodes near the aorta (para-aortic nodes; the aorta delivers blood to the lower parts of the body) is not without complications, and is ideally performed only when necessary. A method of judging the extent of myometrial involvement at the time of surgery in order to help decide when nodes should be sampled is described and evaluated. Its application in 148 women is discussed. The method relied on visual inspection of the uterus after the organ had been removed and opened up. If more than 50 percent of the depth of the myometrium appeared to have been invaded, para-aortic lymph nodes were sampled for subsequent histopathological examination. Patients with grade 3 tumors had lymph node sampling regardless of the extent of myometrial invasion. Ninety-one percent (135) of the patients were accurately evaluated based on visual examination of the uterus for depth of invasion into the myometrium. A description is given of the patients for whom incorrect assessments were made. Overall, the method may help identify patients with para-aortic nodal metastases. (Consumer Summary produced by Reliance Medical Information, Inc.)

Surgery, Metastasis, Cancer metastasis, Uterine cancer

---

Diagnosing the correct ovarian cancer syndrome

Article Abstract:

Awoman's greatest risk factor for ovarian cancer is a positive family history. Gynecologists need to be aware of the various familial ovarian cancer syndromes so they can advise and treat patients presenting with concerns of a history of cancer in their families. This study examined the cases of four sisters who had familial cancer histories on both the maternal and paternal sides of the family. The second and third sister (B and C) presented with the concern that both their mother and their sister (D) had been diagnosed with ovarian cancer. Their father had died of prostate cancer and his four siblings had developed cancers as well. A genetic review of the paternal side of the family indicated Cancer Family Syndrome; this diagnosis suggested that the sisters had an increased risk for colon, endometrial, and ovarian cancers. The mother's history indicated increased risk for site-specific ovarian cancer syndrome. The sisters were advised to have their ovaries and uteri removed and to undergo regular colon examinations. Ovarian and endometrial adenocarcinoma were discovered in sister B. Sister C had colon abnormalities. These cases are examples of how familial cancer syndromes can afflict relations. Patients presenting with family histories of cancer should be carefully screened. This will allow correct diagnosis of the syndrome or syndromes present in the family. Once this is known, proper cancer screening and prevention techniques can be performed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Genetic aspects, Ovarian cancer, Cancer, Cancer genetics, Familial diseases

---

Treatment failure in endometrial carcinoma

Article Abstract:

Endometrial carcinoma (cancer of the uterine lining) is the most common gynecological cancer and has lower mortality than ovarian or cervical cancer. However, the favorable prognosis is due in large measure to the fact that the disease is usually detected and treated early, since its main symptom (bleeding after the menopause) usually alerts women to seek medical care. Advanced or recurrent endometrial carcinoma presents a more dismal picture. Results from a 23-year experience with this disease at two major military hospitals describe 520 endometrial cancer patients with an average age of 55.7 years. Most of the patients (90 percent) had endometrial adenocarcinoma (the cell type that became malignant); stages (tumor size and spread) and grades (aggressiveness of the cancer) of the other cell types are noted. Hysterectomy (removal of the uterus and other organs, if necessary) was performed for 425 of the 438 stage I (the least serious stage) patients. Most patients underwent radiation treatment, the parameters of which varied according to current clinical practice. Survival for patients at different stages (1a, the least serious, and IV, the most serious) ranged from 89 percent to 0 percent. Thirty-eight patients developed recurrent disease after treatment; 27 women with malignancy in other organs died. Overall, conventional treatment is ineffective against advanced endometrial carcinoma or carcinoma associated with certain histological cell types. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Patient outcomes, Mortality, Prognosis

Similar abstracts:

• Abstracts: A prospective trial of postoperative vaginal radium/cesium for Grade 1-2 less than 50 percent myometrial invasion and pelvic radiation therapy for Grade 3 or deep myometrial invasion in surgical Stage I endometrial adenocarcinoma
• Abstracts: Prognostic factors associated with recurrence in clinical stage I adenocarcinoma of the endometrium. Serum interleukin-6 levels correlate with disease status in patients with epithelial ovarian cancer
• Abstracts: The historical evolution of the concept of negative symptoms in schizophrenia. The concept of negative symptoms
• Abstracts: Use of serum CA 125 measurement in posttreatment surveillance of early-stage endometrial carcinoma. Single-dose antibiotic prophylaxis for patients undergoing extended pelvic surgery for gynecological malignancy
• Abstracts: Antenatal diagnosis of twin-twin transfusion syndrome by Doppler ultrasound. Simultaneous measurement of CA 125, CA 19-9, tissue polypeptide antigen, and immunosuppressive acidic protein to predict recurrence of ovarian cancer

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.