Ovarian cancer screening in asymptomatic postmenopausal women by transvaginal sonography

Article Abstract:

It is estimated that 20,700 cases of ovarian cancer will be diagnosed in the US this year, and that 12,500 women will die of this disease. The cure rate for Stage I ovarian cancer may be as high as 90 percent, but because the disease causes no symptoms in its early stages, the majority of cases are diagnosed late. In more advanced stages, five-year survival rates fall to 15 or 20 percent. It is estimated that if the fraction of cases diagnosed in early stages could be increased to 80 percent the mortality rate could be cut in half. One method for improving the diagnosis of early stage ovarian cancer is by screening using transvaginal ultrasonography. With this method, a ultrasonic sound generator is inserted into the vagina to obtain a clearer image than can be obtained from the body's surface. The ultrasound image is then used to calculate the volume of the ovaries. An abnormally large volume or an unusual echo is indication for further tests. The efficacy of this method for early screening was evaluated in 1,300 postmenopausal women without any history of pelvic tumors. Transvaginal ultrasonography revealed ovarian abnormalities in 33 patients; 27 of these patients underwent exploratory laparotomy, the opening of the abdomen for direct examination of the tissues. All 27 patients had some sort of ovarian tumor. The most common finding was the serous cystadenoma, a benign tumor, which was observed in 14 cases. However, malignant adenocarcinoma of the ovary was found in two patients. In both cases, the Stage I cancer was undetectable by physical examination or by blood tests for tumor markers. Both patients were successfully treated and are alive and well. During follow-up, none of the other patients had negative findings on the imaging screening test developed ovarian cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)

Ultrasound imaging, Medical screening, Health screening, Adenocarcinoma

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Preoperative radiation therapy followed by extrafascial hysterectomy in patients with Stage II endometrial carcinoma

Article Abstract:

In 1989, the International Federation of Gynecology and Obstetrics (FIGO), changed their system for defining the stages of endometrial cancer. In the new system, the stage is determined by surgical findings. While this new system may provide better data, implicit in the staging system is that surgery is the first step of treatment. The authors recount their success using radiation therapy prior to surgery in the treatment of Stage II endometrial cancer. In Stage II endometrial cancer, the uterine cervix is involved. The five-year survival rate for Stage II disease is thought to range from 60 to 70 percent, in contrast with the 85 percent survival found among Stage I patients. Over a 22-year-period, the authors treated 74 patients with Stage II endometrial carcinoma. The patients were given external beam irradiation followed by the implantation of a radioactive capsule. Surgery was performed no sooner than four weeks after the completion of radiation therapy. The uterus and cervix were removed, as were the ovaries and adjacent tissues. The lymph nodes were dissected to determine if the spread of cancer had begun. Over follow-up periods, which averaged 5.4 years, 11 patients developed recurrent cancer. The five-year disease-free survival rate was 88 percent and the 10-year disease-free survival rate was 76 percent. These results indicate great success using preoperative radiation in the treatment of Stage II endometrial cancer. The new FIGO staging system might incline physicians to administer radiotherapy after surgery. This inclination should be resisted until it can be reliably shown that the excellent results of preoperative radiotherapy can be preserved. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Radiotherapy, Endometrial cancer, Hysterectomy

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Management of adnexal masses in postmenopausal women

Article Abstract:

Accurate preoperative assessment of the risk of malignancy in adnexal tumors is important because management of benign ovarian tumors and ovarian cancer is very different. An effective system for predicting risk of malignancy in ovarian tumors allows proper individualization of treatment.

United States, Adnexitis, Adnexal diseases

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