The prognostic significance of peritoneal cytology for stage I endometrial cancer

Article Abstract:

Endometrial cancer affects the endometrial cells lining the uterus. Although most patients are diagnosed early with potentially curable disease, the five-year survival rate of the disease is only 75-85 percent. Treatment failures are blamed on incorrect classification of the disease stage and the extent of cancer spreading (metastasis). A method of determining the degree of metastasis entails bathing the abdominal cavity with fluid, peritoneal washings. The fluid is agitated, removed and analyzed for cancer cells. The interpretation of pelvic washings with positive cancer cells is not clear-cut. Some researchers speculate that positive washings can be used to develop a prognosis of patients with endometrial cancer. The significance of pelvic washings in patients with early stage endometrial cancer was evaluated. Out of 567 patients, 28 had cancer cells in their pelvic washings (4.9 percent). Patients with positive washings were more likely to have abnormal results from a Pap smears, a diagnostic test that removes a sample of cervical cells to be analyzed for cancer. Tumors recurred in 49 women (8.6 percent), 7 percent of the women with negative washings and 32 percent of the women with positive washings. The progression-free survival was lower in patients having positive pelvic washings. Conversely, patients with negative washings had better five-year survival rates. It is concluded that a positive pelvic washing performed on patients with stage I endometrial cancer is associated with poor prognosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Diagnosis, Metastasis, Cancer metastasis, Cytodiagnosis

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Endometrial carcinoma: the relevance of cervical cytology

Article Abstract:

The extent to which endometrial carcinoma (cancer of the lining of the uterus) has progressed is often determined through surgery used to 'stage' the disease. But preoperative evaluation of the degree of disease may improve the success of treatment. Endometrial cells can be analyzed before surgery to determine the stage of cancer by using cervical cytology to identify abnormal or malignant cells. Cervical cytology was performed in 86 patients (average age was 66 years, age ranged from 29 to 87) with endometrial carcinoma before surgical staging. Normal, atypical, and malignant cells were found in 23, 27 and 50 percent of patients, respectively. In patients who had malignant cells found in the cytology studies, the cancer was found to be more advanced when surgery was performed. In contrast, the patients who had normal cells had less extensive disease. Patients who have malignant cells detected by cervical cytology associated with endometrial carcinoma appear to be at an increased risk of having advanced-stage, deeply invasive tumors. Therefore, cervical cytology may be a useful method for predicting the extent of disease in these patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Development and progression, Tumor staging, Cancer staging

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DNA content as a prognostic factor in endometrial carcinoma

Article Abstract:

The prognosis of many kinds of cancer, including ovarian cancer, can be made on the basis of DNA content. DNA content correlates with tumor grade and clinical outcome in patients with carcinoma of the endometrium. A total of 238 cases of endometrial adenocarcinoma diagnosed during a 10-year period were analyzed for DNA content using specialized techniques. Histologic slides and paraffin blocks were examined. Aneuploidy, an abnormal number of chromosomes, was found in 18 percent of tumors and was associated with adverse histologic type, high grade, and depth of invasion in the uterus. Tumors with a DNA index (a calculated index of DNA content inside a cell) higher than 1.5 were strongly predictive of death from the disease. Further study of DNA content in patients with carcinoma may be useful in selecting subgroups of patients suitable for particular adjuvant therapy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, DNA, Identification and classification, Tumors

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