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1. Frigerio L, Mangili G, Aletti G, Carnelli M, Garavaglia E, Beatrice S, Ferrari A: Concomitant radiotherapy and paclitaxel for high-risk endometrial cancer: first feasibility study. Gynecol Oncol; 2001 Apr;81(1):53-7
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  • [Title] Concomitant radiotherapy and paclitaxel for high-risk endometrial cancer: first feasibility study.
  • OBJECTIVE: Postoperative radiotherapy (RT) is the most used adjuvant treatment in high risk endometrial cancer (HREC), and it appears to reduce the incidence of pelvic relapses but doesn't seem to improve survival.
  • Paclitaxel (P) has shown in vitro and clinical activity against endometrial cancer, and it is also a potent radiosensitizer by blocking dividing cells in G2/M phase.
  • This is the first study that verifies the feasibility of a treatment with concomitant weekly chemotherapy and RT to potentially reduce the incidence of local and distant relapses in order to improve survival in HREC.
  • Four patients presented stage IC disease, 2 women had IIB stage tumors, 5 patients revealed IIIA stage disease, and 2 had stage IIIC.
  • /m(2)) via a continuous 1-h infusion once weekly during the 5 weeks of RT (mean radiation dose of 50.4 Gy).
  • One patient developed a subocclusion 8 weeks after the end of the treatment, with medical resolution.
  • No patients developed hypersensitivity reactions.
  • CONCLUSIONS: Concomitant P and RT is safe and acceptable treatment in patients with HREC.
  • [MeSH-major] Antineoplastic Agents, Phytogenic / adverse effects. Endometrial Neoplasms / drug therapy. Endometrial Neoplasms / radiotherapy. Paclitaxel / adverse effects. Radiation-Sensitizing Agents / therapeutic use
  • [MeSH-minor] Aged. Chemotherapy, Adjuvant. Diarrhea / chemically induced. Diarrhea / etiology. Drug Administration Schedule. Drug Eruptions / etiology. Feasibility Studies. Female. Hematologic Diseases / chemically induced. Hematologic Diseases / etiology. Humans. Middle Aged. Neoplasm Staging. Radiation Injuries / etiology. Radiodermatitis / etiology. Radiotherapy / adverse effects. Radiotherapy, Adjuvant. Risk Factors

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  • [Copyright] Copyright 2001 Academic Press.
  • (PMID = 11277649.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; 0 / Radiation-Sensitizing Agents; P88XT4IS4D / Paclitaxel
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2. Torizuka T, Nakamura F, Takekuma M, Kanno T, Ogusu T, Yoshikawa E, Okada H, Maeda M, Ouchi Y: FDG PET for the assessment of myometrial infiltration in clinical stage I uterine corpus cancer. Nucl Med Commun; 2006 Jun;27(6):481-7
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  • [Title] FDG PET for the assessment of myometrial infiltration in clinical stage I uterine corpus cancer.
  • OBJECTIVE: For surgical planning of uterine corpus cancer, prior knowledge of the depth of myometrial invasion is important.
  • Curative tumour resection is possible in superficial invasion (stages IA and IB), while post-surgical chemotherapy or radiation therapy is required in deep invasion (stage IC).
  • We evaluated the value of positron emission tomography with 2-[(18)F]fluoro-2-deoxy-D-glucose (FDG PET) for estimating the myometrial invasion in uterine corpus cancer.
  • METHODS: We studied 22 patients with clinical stage I uterine corpus cancer, who underwent FDG PET prior to surgery.
  • Standardized uptake value (SUV; tracer activity per injected dose normalized to body weight) was calculated on the PET image.
  • RESULTS: The surgical stage was IA in five, IB in 11 and IC in six patients.
  • Using 12.0 as a cut-off value of SUV for the differentiation of these two groups, PET results were correct in 19 patients but were incorrect in three patients.
  • Although both PET and MRI provided correct staging in 14 patients, only MRI overestimated the myometrial invasion in four patients with stage IB and showed inconclusive findings in one patient with stage IC.
  • CONCLUSIONS: The cut-off value of SUV (=12.0) may be a useful index for the differentiation of superficial invasion and deep invasion.
  • FDG PET may be feasible for predicting the myometrial infiltration of uterine corpus cancer, especially when uterine atrophy makes it difficult at MRI in post-menopausal patients.
  • [MeSH-major] Fluorodeoxyglucose F18. Myometrium / pathology. Myometrium / radionuclide imaging. Neoplasm Staging / methods. Positron-Emission Tomography / methods. Uterine Neoplasms / pathology. Uterine Neoplasms / radionuclide imaging
  • [MeSH-minor] Adult. Aged. Female. Humans. Middle Aged. Neoplasm Invasiveness. Preoperative Care / methods. Prognosis. Radiopharmaceuticals. Reproducibility of Results. Sensitivity and Specificity

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  • (PMID = 16710101.001).
  • [ISSN] 0143-3636
  • [Journal-full-title] Nuclear medicine communications
  • [ISO-abbreviation] Nucl Med Commun
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
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3. Goonatillake S, Khong R, Hoskin P: Chemoradiation in gynaecological cancer. Clin Oncol (R Coll Radiol); 2009 Sep;21(7):566-72
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  • [Title] Chemoradiation in gynaecological cancer.
  • In the radical treatment of cervical cancer there is now overwhelming evidence to support cisplatin-based chemoradiation with radical radiotherapy for locally advanced disease.
  • In the setting of the developing world it is important to note that the impact of chemoradiation over radiotherapy alone diminishes with advancing stage and the overall benefit where the patients have predominantly stage III and IV disease is small and particularly where supportive therapy is limited may be outweighed by increased toxicity.
  • Endometrial cancer is a rare tumour compared with cervical cancer in the developing world.
  • The evidence for chemotherapy having a role in the routine management of high-risk disease defined by high-grade histology or stage IC and above is tenuous and cannot be recommended for healthcare systems where resources are limited.
  • There is clearly an increasing trend in developed countries to offer patients with advanced inoperable vulval carcinoma chemoradiation, but without any primary evidence of increased efficacy.
  • It is associated with increased toxicity and as with cervical cancer an emphasis on high-quality, high-dose, carefully planned megavoltage radiotherapy alone may make far greater gains in this population.
  • [MeSH-major] Genital Neoplasms, Female / drug therapy. Genital Neoplasms, Female / radiotherapy
  • [MeSH-minor] Combined Modality Therapy. Developing Countries. Female. Humans

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  • (PMID = 19581073.001).
  • [ISSN] 1433-2981
  • [Journal-full-title] Clinical oncology (Royal College of Radiologists (Great Britain))
  • [ISO-abbreviation] Clin Oncol (R Coll Radiol)
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 30
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4. Tropé C, Kristensen GB, Abeler VM: Clear-cell and papillary serous cancer: treatment options. Best Pract Res Clin Obstet Gynaecol; 2001 Jun;15(3):433-46
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  • [Title] Clear-cell and papillary serous cancer: treatment options.
  • Clear-cell carcinoma (CCC) and serous papillary carcinoma of the endometrium (UPSC) are rare subtypes of endometrial carcinoma (10%).
  • The histological diagnosis can be made on the dilation and curettage specimens in both types in a very high percentage of the cases.
  • This is important in the planning of treatment.
  • CCC and UPSC are associated with about 50% of all relapses occurring in endometrial carcinoma, and the 5-year survival rate is, on average, 42% and 27% respectively.
  • Surgico-pathological stage, age, and vessel invasion are independent prognostic factors for both groups.
  • Stage Ia patients treated with complete surgical staging alone have a low risk of relapse and need not be offered adjuvant systemic therapy or pelvic radiation.
  • The treatment of patients with CCC and UPSC stage Ib, Ic, II and III should include radical debulking surgery and some form of adjuvant therapy, but it is not clear which type is most effective.
  • Adjuvant pelvic radiotherapy plus intracavitary radiotherapy is usually given in early-stage disease and pelvic radio therapy/or whole abdomen irradiation plus adjuvant systemic chemotherapy (PAC) in advanced disease.
  • [MeSH-major] Adenocarcinoma, Clear Cell / therapy. Cystadenocarcinoma, Papillary / therapy. Endometrial Neoplasms / therapy
  • [MeSH-minor] Age Factors. Aneuploidy. Combined Modality Therapy. Dilatation and Curettage. Female. Genes, p53. Humans. Liver Neoplasms / secondary. Lung Neoplasms / secondary. Neoplasm Invasiveness / genetics. Neoplasm Staging. Prognosis. Transcriptional Activation. Treatment Outcome

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  • [Copyright] Copyright 2001 Harcourt Publishers Ltd.
  • (PMID = 11476564.001).
  • [ISSN] 1521-6934
  • [Journal-full-title] Best practice & research. Clinical obstetrics & gynaecology
  • [ISO-abbreviation] Best Pract Res Clin Obstet Gynaecol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 61
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5. Kuoppala T, Mäenpää J, Tomas E, Puistola U, Salmi T, Grenman S, Lehtovirta P, Fors M, Luukkaala T, Sipilä P: Surgically staged high-risk endometrial cancer: randomized study of adjuvant radiotherapy alone vs. sequential chemo-radiotherapy. Gynecol Oncol; 2008 Aug;110(2):190-5
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  • [Title] Surgically staged high-risk endometrial cancer: randomized study of adjuvant radiotherapy alone vs. sequential chemo-radiotherapy.
  • OBJECTIVE: Our purpose was to establish whether platinum-based chemotherapy combined with standard surgery and radiotherapy will improve overall and disease-free survival and lower the recurrence rate in patients with high-risk endometrial cancer.
  • STUDY DESIGN: A total of 156 patients with Stage IA-B Grade 3 (n=28), or Stage IC-IIIA Grade 1-3 (n=128) were postoperatively randomized to receive radiotherapy (56 Gy) only (Group A, n=72) or radiotherapy combined with three courses of cisplatin (50 mg/m(2)), epirubicin (60 mg/m(2)) and cyclophosphamide (500 mg/m(2)) (Group B, n=84).
  • As calculated from the operation, the median time to recurrence was 15 (range 6-37) months in Group A, and 20 (range 8-60) months in Group B, respectively (p=0.170).
  • Chemotherapy was associated with an acceptable rate of acute toxicity.
  • A total of 10 patients developed intestinal complications demanding surgery, 2 in Group A (2.7%) and 8 (9.5%) in Group B, respectively.
  • CONCLUSION: Adjuvant chemotherapy with cisplatin, epirubicin and cyclophosphamide failed to improve overall survival or lower the recurrence rate in patients operated on and radiated for high-risk endometrial carcinoma.
  • Chemotherapy was associated with a low rate of acute toxicity but appeared to increase the risk of bowel complications.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Endometrial Neoplasms / drug therapy. Endometrial Neoplasms / radiotherapy
  • [MeSH-minor] Aged. Aged, 80 and over. Chemotherapy, Adjuvant / adverse effects. Cisplatin / administration & dosage. Cisplatin / adverse effects. Cyclophosphamide / administration & dosage. Cyclophosphamide / adverse effects. Epirubicin / administration & dosage. Epirubicin / adverse effects. Female. Humans. Middle Aged. Neoplasm Recurrence, Local. Neoplasm Staging. Radiotherapy, Adjuvant / adverse effects. Risk Factors. Survival Rate

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  • (PMID = 18534669.001).
  • [ISSN] 1095-6859
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study; Randomized Controlled Trial
  • [Publication-country] United States
  • [Chemical-registry-number] 3Z8479ZZ5X / Epirubicin; 8N3DW7272P / Cyclophosphamide; Q20Q21Q62J / Cisplatin
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6. Jereczek-Fossa BA: Postoperative irradiation in endometrial cancer: still a matter of controversy. Cancer Treat Rev; 2001 Feb;27(1):19-33
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  • [Title] Postoperative irradiation in endometrial cancer: still a matter of controversy.
  • Although endometrial cancer is the most common female malignancy, evidence-based uniform guidelines for postoperative therapy have not been established.
  • Currently, the only widely accepted treatment recommendations are no further therapy in low-risk patients who underwent extensive surgical staging, and external beam radiotherapy (EBRT) in high-risk patients.
  • A combination of BRT and EBRT should however be considered in patients with stage II disease, for infiltration of the lower uterine segment, vaginal involvement, positive or close surgical margins, capillary space involvement or unfavourable histology.
  • Two ongoing Gynecologic Oncology Group (GOG) studies compare adjuvant chemotherapy with pelvic or abdominal irradiation in patients with high risk of local relapse.
  • The role of adjuvant radiotherapy (EBRT with or without BRT) in high-risk patients as well as the value of lymphadenectomy in patients fit for such surgery is being addressed in a trial co-ordinated by the Medical Research Council.
  • Future studies are warranted to define whether any irradiation should be employed in intermediate-risk patients and which radiotherapy modality should be used in high-risk node-negative patients with stage I tumours (stage Ib grade 3 and all stage Ic).
  • Other issues which should be addressed in future studies include the extent of surgery, the role of systemic therapies, the relevance of novel biologic prognostic factors, salvage therapies after recurrence, cost-benefit analysis and quality of life.
  • [MeSH-major] Endometrial Neoplasms / radiotherapy. Endometrial Neoplasms / surgery

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  • [Copyright] Copyright 2001 Harcourt Publishers Ltd.
  • (PMID = 11237775.001).
  • [ISSN] 0305-7372
  • [Journal-full-title] Cancer treatment reviews
  • [ISO-abbreviation] Cancer Treat. Rev.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 160
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7. Suzuki A, Horiuchi A, Ashida T, Miyamoto T, Kashima H, Nikaido T, Konishi I, Shiozawa T: Cyclin A2 confers cisplatin resistance to endometrial carcinoma cells via up-regulation of an Akt-binding protein, periplakin. J Cell Mol Med; 2010 Sep;14(9):2305-17
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  • [Title] Cyclin A2 confers cisplatin resistance to endometrial carcinoma cells via up-regulation of an Akt-binding protein, periplakin.
  • Although overexpression of cyclin A2 is reportedly an indicator of a poor prognosis of various malignancies including endometrial carcinoma, its molecular mechanism remains undetermined.
  • To address this issue, we examined the effect of cyclin A2 on the development of resistance to chemotherapeutic drugs.
  • The expression of cyclin A2 protein was increased in advanced-stage and chemotherapy-refractory stage endometrial carcinomas compared with that in early-stage tumours.
  • The expression levels of cyclin A2 in endometrial carcinoma cell lines correlated positively with the IC(50) for cisplatin.
  • Endometrial carcinoma HHUA cells that overexpressed cyclin A2 showed increased resistance to cisplatin in vitro and in vivo, via the activation of a survival pathway, the inositol-3 phosphate kinase (PI3K) cascade.
  • The cyclin A2-induced up-regulation of periplakin was mediated via direct binding of Sp1 to the promoter that was activated by cyclin A2 along with chromatin remodelling involving CBP/p300, and the siRNA-mediated silencing of periplakin suppressed the PI3K pathway.
  • These results indicate cyclin A2 to be involved in the acquisition of aggressive behaviour of tumour cells through the activation of PI3K by cyclin A2-induced periplakin, and to be a promising therapeutic target.
  • [MeSH-major] Cisplatin / pharmacology. Cyclin A2 / metabolism. Drug Resistance, Neoplasm / drug effects. Endometrial Neoplasms / pathology. Plakins / metabolism. Proto-Oncogene Proteins c-akt / metabolism. Up-Regulation / drug effects
  • [MeSH-minor] Animals. Apoptosis / drug effects. Binding Sites. Cell Line, Tumor. Cell Proliferation / drug effects. Enzyme Activation / drug effects. Female. Gene Expression Regulation, Neoplastic / drug effects. Humans. Mice. Mice, Inbred BALB C. Oligonucleotide Array Sequence Analysis. Phosphatidylinositol 3-Kinases / metabolism. Promoter Regions, Genetic / genetics. Protein Binding / drug effects. Reproducibility of Results. Signal Transduction / drug effects. Sp1 Transcription Factor / metabolism

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  • [Copyright] © 2009 The Authors Journal compilation © 2010 Foundation for Cellular and Molecular Medicine/Blackwell Publishing Ltd.
  • (PMID = 19583808.001).
  • [ISSN] 1582-4934
  • [Journal-full-title] Journal of cellular and molecular medicine
  • [ISO-abbreviation] J. Cell. Mol. Med.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Cyclin A2; 0 / PPL protein, human; 0 / Plakins; 0 / Sp1 Transcription Factor; EC 2.7.1.- / Phosphatidylinositol 3-Kinases; EC 2.7.11.1 / Proto-Oncogene Proteins c-akt; Q20Q21Q62J / Cisplatin
  • [Other-IDs] NLM/ PMC3822571
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8. Foad I, Sharawy I, Mostafa E, Margergis M, Hussein T: Concurrent cisplatin/radiation followed by adjuvant cisplatin/paclitaxel in treatment of patients with stage IB grade 3, IC and IIA endometrial carcinoma. J Egypt Natl Canc Inst; 2007 Jun;19(2):163-9
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  • [Title] Concurrent cisplatin/radiation followed by adjuvant cisplatin/paclitaxel in treatment of patients with stage IB grade 3, IC and IIA endometrial carcinoma.
  • BACKGROUND: Postoperative radiotherapy (RT) is the most commonly used adjuvant treatment in high risk endometrial carcinoma (HREC), it reduces the incidence of pelvic relapses but doesn't improve survival.
  • OBJECTIVE: This study was conducted to evaluate the efficacy and safety of concomitant weekly cisplatin and postoperative RT in HREC (stages IB grade 3, IC and IIA) followed by adjuvant cisplatin and weekly paclitaxel.
  • PATIENTS AND METHODS: Eighteen patients with pathologically confirmed endometrial carcinoma were enrolled in this study.
  • Five patients (28%), 4 patients (22%) and 9 patients (50%) presented with stages IB grade 3, IC and IIA respectively.
  • RESULTS: Between May 2000 and March 2002, a total of 18 patients with pathologically confirmed endometrial carcinoma, presented to Radiation Oncology & Nuclear Medicine Department, Ain Shams University Hospitals, were enrolled in this study.
  • Grade 3 hematological toxicities, leucopenia, neutropenia and anemia were recorded in one patient (5.6%) each during adjuvant chemotherapy.
  • Two patients (11%) relapsed with distant metastases and one patient (5.6%) developed pelvic recurrence.
  • Median time to progression was 67 months.
  • CONCLUSION: Concomitant cisplatin and postoperative RT followed by adjuvant cisplatin and weekly paclitaxel is safe and acceptable treatment in patients with HREC.
  • This study verifies the feasibility of this treatment to potentially reduce the incidence of local and distant relapses in order to improve survival.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Endometrial Neoplasms / therapy
  • [MeSH-minor] Aged. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Combined Modality Therapy. Feasibility Studies. Female. Follow-Up Studies. Humans. Hysterectomy. Middle Aged. Neoplasm Invasiveness. Neoplasm Recurrence, Local / diagnosis. Neoplasm Recurrence, Local / therapy. Neoplasm Staging. Ovariectomy. Paclitaxel / administration & dosage. Prognosis. Radiotherapy Dosage. Survival Rate. Treatment Outcome

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  • (PMID = 19034346.001).
  • [ISSN] 1110-0362
  • [Journal-full-title] Journal of the Egyptian National Cancer Institute
  • [ISO-abbreviation] J Egypt Natl Canc Inst
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] Egypt
  • [Chemical-registry-number] P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin
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9. Eltabbakh GH, Shamonki J, Mount SL: Surgical stage, final grade, and survival of women with endometrial carcinoma whose preoperative endometrial biopsy shows well-differentiated tumors. Gynecol Oncol; 2005 Nov;99(2):309-12
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  • [Title] Surgical stage, final grade, and survival of women with endometrial carcinoma whose preoperative endometrial biopsy shows well-differentiated tumors.
  • OBJECTIVE: The purpose of our study was to assess the surgical stage, final grade, and survival of women with endometrial carcinoma whose preoperative endometrial biopsy showed well-differentiated (FIGO grade 1) carcinoma.
  • MATERIALS AND METHODS: A retrospective study was conducted including all women treated at the University of Vermont between 1992 and 2004 whose preoperative endometrial biopsy was reviewed by the staff at the Pathology Department and diagnosed as FIGO grade 1 adenocarcinoma and who received peritoneal washings, total abdominal (or laparoscopic) hysterectomy, bilateral salpingo-oophorectomy, and pelvic +/- para-aortic lymphadenectomy as part of their surgery.
  • The surgical stages were: IA: 55 (30.2%), IB: 61 (33.5%), IC: 26 (14.3%), IIA: 9 (4.9%), IIB: 8 (4.4%), IIIA: 10 (5.5%), IIIB: 2 (1.1%), IIIC: 8 (4.4%), and IV: 3 (1.6%).
  • Postoperatively, 131 (72%) patients received no additional treatment, 47 (25.8%) received radiation therapy, 3 (1.6%) received chemotherapy, and 1 (0.5%) received Megace.
  • CONCLUSIONS: Approximately 30% of women with endometrial carcinoma whose preoperative endometrial biopsy shows grade 1 tumors have grade 2 or 3 in the hysterectomy specimen and 12.6% have advanced surgical stage (stage III and IV) disease.
  • Women with preoperative endometrial biopsy showing grade 1 tumors who undergo surgical staging have excellent survival and acceptable operative morbidity.
  • [MeSH-major] Endometrial Neoplasms / pathology
  • [MeSH-minor] Adenocarcinoma, Mucinous / pathology. Adenocarcinoma, Mucinous / surgery. Adult. Aged. Aged, 80 and over. Biopsy. Carcinoma, Endometrioid / pathology. Carcinoma, Endometrioid / surgery. Cell Differentiation / physiology. Female. Humans. Middle Aged. Neoplasm Staging. Prognosis. Retrospective Studies. Survival Rate

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  • (PMID = 16005945.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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10. Kodama J, Seki N, Ojima Y, Nakamura K, Hongo A, Hiramatsu Y: Efficacy and prognostic implications of administering adjuvant chemotherapy to patients with endometrial cancer that is confined to the uterus. Eur J Obstet Gynecol Reprod Biol; 2007 Mar;131(1):76-80
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Efficacy and prognostic implications of administering adjuvant chemotherapy to patients with endometrial cancer that is confined to the uterus.
  • OBJECTIVE: The purpose of this study was to determine the value of prognostic factors and to assess the efficacy of adjuvant chemotherapy in patients with endometrial cancer confined to the uterus.
  • STUDY DESIGN: Patients surgically stage IB, IC and II endometrial cancer according to the International Federation of Gynecology and Obstetrics were enrolled in this study.
  • Stage IIIA tumors with positive peritoneal cytology, in the absence of other evidence of extra uterine disease, were also included.
  • RESULTS: One hundred and sixty-seven patients fulfilled the eligibility criteria and 58 patients (34.7%) underwent combination chemotherapy.
  • Disease recurrence occurred in 10 patients within a median time of 17 months.
  • Fourteen of 23 patients with histologic grade 3 tumors received adjuvant chemotherapy consisting of cyclophosphamide (or etoposide), epirubicin and cisplatin (in 1989-1999) or paclitaxel, pirarubicin and carboplatin (in 2000-2002).
  • The 5-year disease-free and overall survival rates for these individuals was 92.3%, a value significantly higher than those in patients who had not undergone chemotherapy (50.0%).
  • CONCLUSIONS: Histologic grade of 3 is an independent prognostic marker in patients with endometrial cancer confined to the uterus and adjuvant chemotherapy might improve the survival rates in these patients.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Endometrial Neoplasms / diagnosis. Endometrial Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Antineoplastic Agents / administration & dosage. Carboplatin / administration & dosage. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Cyclophosphamide / administration & dosage. Epirubicin / administration & dosage. Etoposide / administration & dosage. Female. Humans. Middle Aged. Neoplasm Staging. Paclitaxel / administration & dosage. Prognosis. Treatment Outcome. Uterus / pathology

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  • (PMID = 16459012.001).
  • [ISSN] 0301-2115
  • [Journal-full-title] European journal of obstetrics, gynecology, and reproductive biology
  • [ISO-abbreviation] Eur. J. Obstet. Gynecol. Reprod. Biol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] Ireland
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 3Z8479ZZ5X / Epirubicin; 6PLQ3CP4P3 / Etoposide; 8N3DW7272P / Cyclophosphamide; BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin
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11. Hiura M, Nogawa T, Matsumoto T, Yokoyama T, Shiroyama Y, Wroblewski J: Long-term survival in patients with para-aortic lymph node metastasis with systematic retroperitoneal lymphadenectomy followed by adjuvant chemotherapy in endometrial carcinoma. Int J Gynecol Cancer; 2010 Aug;20(6):1000-5
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  • [Title] Long-term survival in patients with para-aortic lymph node metastasis with systematic retroperitoneal lymphadenectomy followed by adjuvant chemotherapy in endometrial carcinoma.
  • OBJECTIVE: The purposes of this study were to assess modified radical hysterectomy including systematic pelvic and para-aortic lymphadenectomy followed by adjuvant chemotherapy in patients with para-aortic lymph node (PAN) metastasis in endometrial carcinoma and to identify the multivariate independent prognostic factors for long-term survival during the past 10 years.
  • METHODS: Between December 1987 and December 2002, we performed modified radical hysterectomy with bilateral salpingo-oophorectomy including systematic pelvic and para-aortic lymphadenectomy and peritoneal cytology in 284 endometrial carcinoma patients according to the classification of the International Federation of Gynecology and Obstetrics (stage IA, n = 66; stage IB, n = 96; stage IC, n = 33; stage IIA, n = 5; stage IIB, n = 20; stage IIIA, n = 28; stage IIIC, n = 28; and stage IV, n = 8) who gave informed consents at our institute.
  • Patients with tumor confined to the uterus (stages IC and II) were treated by 3 courses of cyclophosphamide 750 mg/m2, epirubicin 50 mg/m2, and cisplatin 75 mg/m2 regimen 3 to 4 weeks apart, and patients with extrauterine lesions involving adnexa and/or pelvic lymph node (PLN) were treated by 5 courses.
  • Patients with PLN metastasis received adjuvant chemotherapy, and adjuvant radiation was not part of our institutional protocol.
  • RESULTS: The overall incidence of retroperitoneal lymph node metastasis assessed by systematic pelvic and para-aortic lymphadenectomy was 12.0% (34/284) in stages I to IV endometrial carcinoma, and incidences of PLN and PAN metastases were 9.2% (26/284) and 7.4% (21/284), respectively.
  • Univariate analysis of prognostic factors revealed that International Federation of Gynecology and Obstetrics clinical stage (P < 0.0001), histological finding (P = 0.0292), myometrial invasion (P < 0.0001), adnexal metastasis (P < 0.0001), lymphovascular space invasion (P < 0.0001), tumor diameter (P = 0.0108), peritoneal cytology (P = 0.0001), and retroperitoneal lymph node metastasis (P < 0.0001) were significantly associated with 10-year overall survival.
  • CONCLUSIONS: It is suggested that surgery with systematic pelvic and para-aortic lymphadenectomy followed by adjuvant chemotherapy could improve long-term survival in patients with PAN metastasis, although there are only 21 patients with PAN metastasis.
  • [MeSH-major] Carcinoma / mortality. Carcinoma / secondary. Chemotherapy, Adjuvant. Endometrial Neoplasms / mortality. Endometrial Neoplasms / therapy. Retroperitoneal Neoplasms / secondary. Retroperitoneal Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Analysis of Variance. Aorta, Abdominal. Biopsy, Needle. Cohort Studies. Combined Modality Therapy. Disease-Free Survival. Female. Follow-Up Studies. Humans. Hysterectomy / methods. Immunohistochemistry. Lymph Node Excision / methods. Lymph Nodes / pathology. Lymph Nodes / surgery. Lymphatic Metastasis. Middle Aged. Neoplasm Staging. Retroperitoneal Space. Retrospective Studies. Risk Assessment. Survival Analysis. Treatment Outcome

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  • (PMID = 20683408.001).
  • [ISSN] 1525-1438
  • [Journal-full-title] International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
  • [ISO-abbreviation] Int. J. Gynecol. Cancer
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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12. Siow TR, Yeo MC, Khoo-Tan HS, Yap SP, Soong YL, Chua EJ, Soh LT, Lim YK, Chia YN, Yam KL: Stage 1C grade 3 endometrial cancer: the KK Hospital gynaecological oncology group experience. Int J Gynecol Cancer; 2010 Dec;20(9):1557-62
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  • [Title] Stage 1C grade 3 endometrial cancer: the KK Hospital gynaecological oncology group experience.
  • OBJECTIVE: It is our standard of care to include pelvic lymph node dissection (PLND) in the staging of endometrial cancer, followed by adjuvant vaginal vault brachytherapy.
  • We report our experience and outcome of patients with stage 1C grade 3 endometrial cancer from KK Hospital Singapore.
  • METHODS: Records of patients with a diagnosis of stage 1C grade 3 endometrial cancer (based on the 1988 FIGO [International Federation of Gynecology and Obstetrics] staging system) from 1995 to 2008 were retrospectively reviewed.
  • Details of surgery, chemotherapy, and radiotherapy were recorded, as were prognostic factors such as histological subtype and number of lymph nodes removed.
  • RESULTS: A total of 31 cases were reviewed; 29 had sufficient records to be analyzed, of which one was excluded as she had a second primary cancer (breast).
  • All but 1 case received postoperative vaginal vault brachytherapy.
  • Eight of 10 patients with nonendometrioid adenocarcinoma (eg, clear cell) histology also received adjuvant chemotherapy.
  • Adjuvant chemotherapy should also be considered for cases with poor prognostic factors.
  • [MeSH-major] Carcinoma, Endometrioid / diagnosis. Carcinoma, Endometrioid / pathology. Endometrial Neoplasms / diagnosis. Endometrial Neoplasms / pathology
  • [MeSH-minor] Adult. Aged. Algorithms. Brachytherapy. Combined Modality Therapy. Female. Gynecology / organization & administration. Hospitals. Humans. Hysterectomy. Lymphatic Metastasis. Medical Oncology / organization & administration. Middle Aged. Neoplasm Staging. Prognosis. Retrospective Studies. Singapore. Societies, Medical. Treatment Outcome

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  • (PMID = 21119369.001).
  • [ISSN] 1525-1438
  • [Journal-full-title] International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
  • [ISO-abbreviation] Int. J. Gynecol. Cancer
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] United States
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13. Kim S, Wu HG, Lee HP, Kang SB, Song YS, Park NH, Ha SW: Patterns of failure after postoperative radiation therapy for endometrial carcinoma. Cancer Res Treat; 2006;38(3):133-8
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  • [Title] Patterns of failure after postoperative radiation therapy for endometrial carcinoma.
  • PURPOSE: We tried to investigate the outcome and patterns of failure of endometrial cancer patients who were treated with surgery and postoperative radiation therapy (RT).
  • MATERIALS AND METHODS: Eighty-three patients with endometrial cancer who received postoperative RT between May 1979 and August 2000 were included in this retrospective study.
  • All the patients were staged according to 1988 FIGO (International Federation of Gynecology and Obstetrics) staging system; 2 were stage IA, 23 were stage IB, 20 were stage IC, 4 were stage IIA, 5 were stage IIB, 9 were stage IIIA, 2 were stage IIIB and 18 were stage IIIC.
  • RESULTS: Overall, 11 patients (13%) experienced disease relapse: 4 with initial stage I or II disease and 7 with initial stage III disease.
  • Among the 54 stage I or II patients, 1 (2%) relapsed in the pelvis only, 2 (4%) relapsed in the vagina and distant organs, and 1 (2%) relapsed in the paraaortic lymph nodes (PANs).
  • Among the 29 stage III patients, 1 (3%) relapsed in the vagina.
  • The most common sites of failure for the stage III patients were the peritoneum (3 patients, 10%), PANs (2 patients, 7%), and lung (2 patients, 7%).
  • The five-year DFS rate was 93%, 100% and 74% for the stage I, II and III patients, respectively.
  • Three patients experienced severe radiation-related late complications: RTOG (Radiation Therapy Oncology Group) grade 3 radiation cystitis was seen in one patient, and grade 3 bowel obstruction was seen in two patients.
  • The major patterns of failure for stage III patients were peritoneal seeding and distant metastasis.
  • Selective use of whole abdominal radiotherapy or adjuvant chemotherapy may improve the therapeutic outcome of these patients.

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  • [Cites] Gynecol Oncol. 2001 Feb;80(2):233-8 [11161865.001]
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  • (PMID = 19771273.001).
  • [ISSN] 1598-2998
  • [Journal-full-title] Cancer research and treatment : official journal of Korean Cancer Association
  • [ISO-abbreviation] Cancer Res Treat
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Korea (South)
  • [Other-IDs] NLM/ PMC2741680
  • [Keywords] NOTNLM ; Endometrial neoplasms / Patterns of failure / Postoperative radiation therapy
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14. Mehta N, Yamada SD, Rotmensch J, Mundt AJ: Outcome and pattern of failure in pathologic stage I-II papillary serous carcinoma of the endometrium: implications for adjuvant radiation therapy. Int J Radiat Oncol Biol Phys; 2003 Nov 15;57(4):1004-9
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  • [Title] Outcome and pattern of failure in pathologic stage I-II papillary serous carcinoma of the endometrium: implications for adjuvant radiation therapy.
  • PURPOSE: To evaluate the outcome and patterns of failure in women with pathologic Stage I-II papillary serous carcinoma of the uterus and to discuss the implications for adjuvant radiation therapy (RT).
  • METHODS: Twenty-three pathologic Stage I-II uterine papillary serous carcinoma patients were treated at our institution between 1980 and 2001.
  • FIGO stages were as follows: IA = 3, IB = 8, IC = 6, IIA = 5, and IIB = 1.
  • Adjuvant therapies included the following: 9 none, 10 RT (6 pelvic, 1 vaginal brachytherapy, 3 both), 4 chemotherapy, and 1 hormonal therapy.
  • No patient received whole abdominal radiation therapy or para-aortic RT.
  • Nine patients developed recurrent disease.
  • However, neither developed an isolated abdominal recurrence.
  • CONCLUSION: Although patients with pathologic Stage I-II uterine papillary serous carcinomas have organ-confined disease, recurrence is common, particularly in the pelvis and distant sites.
  • Contrary to traditional assumptions, however, abdominal recurrence was uncommon in our patients, despite the lack of whole abdominal radiation therapy.
  • Future studies should investigate the role of adjuvant chemotherapy.
  • [MeSH-major] Cystadenocarcinoma, Papillary / radiotherapy. Cystadenocarcinoma, Papillary / surgery. Endometrial Neoplasms / radiotherapy. Endometrial Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Disease-Free Survival. Female. Humans. Hysterectomy. Middle Aged. Neoplasm Recurrence, Local. Neoplasm Staging. Radiotherapy Dosage. Radiotherapy, Adjuvant

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  • (PMID = 14575831.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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15. Kelly MG, O'malley DM, Hui P, McAlpine J, Yu H, Rutherford TJ, Azodi M, Schwartz PE: Improved survival in surgical stage I patients with uterine papillary serous carcinoma (UPSC) treated with adjuvant platinum-based chemotherapy. Gynecol Oncol; 2005 Sep;98(3):353-9
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  • [Title] Improved survival in surgical stage I patients with uterine papillary serous carcinoma (UPSC) treated with adjuvant platinum-based chemotherapy.
  • OBJECTIVE: Uterine papillary serous carcinoma (UPSC) is an aggressive form of endometrial cancer characterized by a high recurrence rate and a poor prognosis.
  • Prior studies evaluating treatment of UPSC have been limited by small numbers of patients and inclusion of partially staged patients.
  • The purpose of this study was to evaluate the efficacy of adjuvant platinum-based chemotherapy and vaginal cuff radiation in a large cohort of surgical stage I UPSC patients.
  • METHODS: We retrospectively reviewed 74 stage I patients with UPSC who underwent complete surgical staging at our institution between 1987 and 2004.
  • RESULTS: Stage IA patients were divided into two groups: patients with no cancer in the hysterectomy specimen (defined as no residual uterine disease) and patients with cancer in the hysterectomy specimen (defined as residual uterine disease).
  • Stage IA patients with no residual uterine disease had no recurrences, regardless of adjuvant therapy (n = 12).
  • Stage IA patients with residual uterine disease who were treated with platinum-based chemotherapy had no recurrences (n = 7).
  • However, 6 of 14 (43%) stage IA patients with residual uterine disease who did not receive chemotherapy recurred.
  • The 15 patients with stage IB UPSC who received platinum-based chemotherapy had no recurrences but 10 of the 13 (77%) stage IB patients who did not receive chemotherapy recurred.
  • One of the 7 patients with stage IC UPSC who received platinum-based chemotherapy recurred and 4 of the 5 (80%) stage IC patients who did not receive chemotherapy recurred.
  • Overall platinum-based chemotherapy was associated with improved disease-free survival (P < 0.01) and improved overall survival (P < 0.05) in patients with stage I UPSC.
  • CONCLUSIONS: Platinum-based chemotherapy improves the disease-free and overall survival of patients with stage I UPSC and vaginal cuff radiation provides local control.
  • Stage IA UPSC patients with no residual uterine disease can be observed but concomitant platinum-based chemotherapy and vaginal cuff radiation (referred to as chemoradiation) should be offered to all other stage I UPSC patients.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cystadenocarcinoma, Papillary / drug therapy. Cystadenocarcinoma, Papillary / surgery. Cystadenocarcinoma, Serous / drug therapy. Cystadenocarcinoma, Serous / surgery. Uterine Neoplasms / drug therapy. Uterine Neoplasms / surgery
  • [MeSH-minor] Aged. Biopsy, Needle. Chemotherapy, Adjuvant. Dilatation and Curettage. Disease-Free Survival. Female. Humans. Hysterectomy. Neoplasm Staging. Organoplatinum Compounds / administration & dosage. Retrospective Studies

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  • (PMID = 16005947.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Organoplatinum Compounds
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16. Lackman FD, Craighead PS: Therapeutic dilemmas in the management of uterine papillary serous carcinoma. Curr Treat Options Oncol; 2003 Apr;4(2):99-104
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Therapeutic dilemmas in the management of uterine papillary serous carcinoma.
  • Uterine papillary serous carcinoma (UPSC) affects 1% to 10% of patients with endometrial malignancies.
  • UPSC is more aggressive than conventional endometrial cancer because UPSC presents with advanced disease, similar to epithelial ovarian cancer.
  • There are several biomarkers for UPSC, which indicate that the pathogenesis of this condition is different than epithelial ovarian and conventional endometrial cancer.
  • Patients with stage IA disease do not benefit from further adjuvant therapy.
  • Adjuvant pelvic radiotherapy reduces pelvic relapse in intermediate- and high-risk patients (stage IC, II, and III disease) and extends survival rates of patients when administered with chemotherapy.
  • In this setting, chemotherapy (with or without adjuvant radiotherapy) is a platinum-based regimen, combined with doxorubicin and cyclophosphamide.
  • The results of Gynecologic Oncology Group protocol 122, which involves patients with UPSC who are being treated with chemotherapy and whole abdominal radiotherapy, are expected to reveal a minimal difference between these arms in overall survival rates.
  • In patients experiencing distant or extensive abdominal relapse, management has been palliative, using platinum-based regimens or single-agent therapy to assess response.
  • Treatment for patients with further relapse must be individualized because there are no studies addressing these scenarios.
  • Many of these patients face a significant risk of treatment failure and death because of distant relapse.
  • Therefore, the use of randomized trials to evaluate new therapies is critical.
  • [MeSH-major] Carcinoma, Papillary / therapy. Uterine Neoplasms / therapy
  • [MeSH-minor] Diet. Female. Humans. Life Style. Neoplasm Staging

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  • (PMID = 12594935.001).
  • [ISSN] 1527-2729
  • [Journal-full-title] Current treatment options in oncology
  • [ISO-abbreviation] Curr Treat Options Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 19
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17. Lin O: Challenges in the interpretation of peritoneal cytologic specimens. Arch Pathol Lab Med; 2009 May;133(5):739-42
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  • CONTEXT: The presence of malignant cells in peritoneal washings leads to classification as International Federation of Gynecology and Obstetrics stage IC or higher in ovarian carcinomas and at least International Federation of Gynecology and Obstetrics stage IIIA in endometrial carcinomas.
  • Malignant cells might be few in number and might be unrecognized among a large population of mesothelial cells and/or macrophages, or reactive mesothelial cells might be misinterpreted as neoplastic cells leading to unnecessary chemotherapy.
  • OBJECTIVE: To evaluate the main pitfalls in the evaluation of peritoneal washings in patients with gynecologic malignancies and analyze the ancillary studies that might be helpful to achieve the correct diagnosis with an emphasis on immunocytochemistry.
  • [MeSH-major] Adenocarcinoma / pathology. Ascitic Fluid / pathology. Cytodiagnosis / methods. Genital Neoplasms, Female / pathology. Peritoneal Lavage
  • [MeSH-minor] Biomarkers, Tumor / metabolism. Epithelial Cells / metabolism. Epithelial Cells / pathology. Female. Humans. Neoplasm Staging

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  • (PMID = 19415948.001).
  • [ISSN] 1543-2165
  • [Journal-full-title] Archives of pathology & laboratory medicine
  • [ISO-abbreviation] Arch. Pathol. Lab. Med.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
  • [Number-of-references] 63
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18. Kim JH, Lee SJ, Bae JH, Lee SH, Bae SN, Namkoong SE, Park JS: Adjuvant therapy in high-risk early endometrial carcinoma: a retrospective analysis of 46 cases. J Gynecol Oncol; 2008 Dec;19(4):236-40
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  • [Title] Adjuvant therapy in high-risk early endometrial carcinoma: a retrospective analysis of 46 cases.
  • OBJECTIVE: We assessed the prognostic factors and the efficacy of adjuvant therapy and reviewed randomized studies carried out on patients receiving adjuvant therapy with early endometrial carcinoma.
  • METHODS: One hundred and five patients that received primary surgical treatment for stage IB, IC and II endometrial cancer were enrolled in this study.
  • The clinical outcomes were compared among the patients with variable prognostic factors and adjuvant treatments.
  • RESULTS: One hundred and five patients fulfilled the eligibility criteria and 46 patients (43.8%) underwent adjuvant therapy.
  • Disease recurrence occurred in nine patients within a median time of 24 months.
  • Eight of 16 patients with FIGO stage II disease received adjuvant chemotherapy consisting of cisplatin and etoposide (or cyclophosphamide) or combined chemoradiation.
  • The 5-year disease-free survival rate for these patients was 87.5%, a value significantly higher than for patients that received radiation therapy alone (30%).
  • CONCLUSION: Adjuvant chemotherapy or combination chemo-radiotherapy might be superior to radiation therapy alone in high-risk early endometrial cancer patients.

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  • (PMID = 19471649.001).
  • [ISSN] 2005-0380
  • [Journal-full-title] Journal of gynecologic oncology
  • [ISO-abbreviation] J Gynecol Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Korea (South)
  • [Other-IDs] NLM/ PMC2676478
  • [Keywords] NOTNLM ; Adjuvant therapy / Endometrial carcinoma / Prognostic factor
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19. Ishibashi M, Nakayama K, Shamima Y, Katagiri A, Iida K, Nakayama N, Miyazaki K: [Two cases of endometrial stromal sarcoma (ESS) in which survival was prolonged by administration of MPA]. Gan To Kagaku Ryoho; 2008 May;35(5):857-61
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  • [Title] [Two cases of endometrial stromal sarcoma (ESS) in which survival was prolonged by administration of MPA].
  • Endometrial stromal sarcoma (ESS) is very rare.
  • It accounts for 0.5% of all uterine corpus malignant tumors and 10% of all malignant non-epithelial tumors.
  • MPA is one effective hormonal treatment for ESS.
  • We describe two cases in which patients with metastatic low-grade ESS lesions had prolonged survival with MPA therapy.
  • Case 1 was a 50-year-old woman with a low-grade uterine endometrial stromal tumor who had been operated on at another hospital.
  • She had an incomplete response to chemotherapy.
  • We initiated MPA therapy, which resulted in significant improvement in her metastatic lesions.
  • Case 2 was a 58-year-old woman with stage Ic low-grade ESS who presented with abnormal uterine bleeding.
  • Following surgery (TAH+BSO), MPA therapy was initiated and she had no recurrence.
  • Her cancer recurred with pelvic and paraaortic lymph node metastasis.
  • She was treated with chemotherapy, MPA and radiotherapy.
  • Her metastases improved, and the patient has continued to survive on MPA therapy alone.
  • These cases suggest that MPA might be an effective hormonal therapy for patients with low-grade ESS.
  • [MeSH-major] Antineoplastic Agents, Hormonal / therapeutic use. Endometrial Neoplasms / drug therapy. Medroxyprogesterone Acetate / therapeutic use. Sarcoma, Endometrial Stromal / drug therapy
  • [MeSH-minor] Female. Humans. Middle Aged. Neoplasm Metastasis

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  • (PMID = 18487930.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; C2QI4IOI2G / Medroxyprogesterone Acetate
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20. Muzii L, Palaia I, Sansone M, Calcagno M, Plotti F, Angioli R, Panici PB: Laparoscopic fertility-sparing staging in unexpected early stage ovarian malignancies. Fertil Steril; 2009 Jun;91(6):2632-7
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  • [Title] Laparoscopic fertility-sparing staging in unexpected early stage ovarian malignancies.
  • OBJECTIVE: To assess feasibility and safety of fertility-sparing laparoscopic staging in women affected by unexpected ovarian cancer desiring to preserve their fertility.
  • RESULT(S): Histologic findings after first surgery: 12 low malignant potential neoplasms, 11 invasive epithelial ovarian carcinomas,1 sex-cord stromal, and 3 germ cell neoplasms.
  • Fertility-sparing staging consisted of exploration of the peritoneal cavity, peritoneal washing cytology, multiple peritoneal biopsies, omolateral adnexectomy (except in borderline tumors), omentectomy, omolateral or bilateral pelvic and aortic lymph node sampling (except in borderline tumors, well differentiated, mucinous, and granulosa cell (GC) neoplasms), endometrial biopsy, appendectomy in mucinous type.
  • Six patients received adjuvant platinum-based chemotherapy.
  • After a median follow-up of 20 months all patients are alive; one patient has FIGO stage Ic clear cell carcinoma, which recurred 8 months after surgery.
  • [MeSH-major] Fertility / physiology. Laparoscopy / methods. Ovarian Cysts / surgery. Ovarian Neoplasms / surgery
  • [MeSH-minor] Counseling. Cystectomy. Female. Humans. Neoplasm Invasiveness. Neoplasm Staging. Ovariectomy. Prospective Studies

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  • (PMID = 18555237.001).
  • [ISSN] 1556-5653
  • [Journal-full-title] Fertility and sterility
  • [ISO-abbreviation] Fertil. Steril.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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21. Thomas L, Bataillard A, Brémond A, Fondrinier E, Fervers B, Achard JL, Lansac J, Bailly C, Hoffstetter S, Basuyau JP, d'Anjou J, Descamps P, Farsi F, Guastalla JP, Laffargue F, Rodier JF, Vincent P, Pigneux J: [Standards, options, and recommendations for the radiotherapy of patients with endometrial cancer. FNCLCC (National Federation of Cancer Campaign Centers) and CRLCC (Regional Cancer Campaign Centers)]. Cancer Radiother; 2001 Apr;5(2):163-92
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  • [Title] [Standards, options, and recommendations for the radiotherapy of patients with endometrial cancer. FNCLCC (National Federation of Cancer Campaign Centers) and CRLCC (Regional Cancer Campaign Centers)].
  • [Transliterated title] Standards, Options et Recommandations pour la radiothérapie des patientes atteintes de cancer de l'endomètre.
  • OBJECTIVES: To develop clinical practice guidelines according to the definitions of the Standards, Options and Recommendations project for the radiotherapy of carcinoma of the endometrium.
  • Once the guidelines were defined, the document was submitted for review to independent reviewers, and to the medical committees of the 20 French Cancer Centres.
  • RESULTS: The main recommendations for the radiotherapy of carcinoma of the endometrium are:.
  • 1) For grade 1 and 2 stage IA tumours, follow-up alone is standard as additional treatment.
  • For grade 1 and 2 stage IB tumours, vaginal brachytherapy or follow-up alone are options.
  • For grade 3, stage IB tumours and stage IC disease, there are two treatment options: external pelvic radiotherapy with a brachytherapy boost or vaginal brachytherapy.
  • 2) Treatment for stage II disease can be preoperative when stage II disease has been suggested by a positive endometrial curettage.
  • Postoperative vaginal brachytherapy is given for stage IIA tumours if the penetration of the myometrium is less than 50% or if the tumour is grade 1 or 2.
  • In the case of deep penetration, or higher grade disease, or for stage IIB external radiotherapy with brachytherapy boosting must be undertaken routinely.
  • 3) After surgery, for stage IIIA disease, either external pelvic radiotherapy or abdomino-pelvic radiotherapy is indicated, along with medical treatment in certain patients.
  • For stage IIIB tumours, postoperative external radiotherapy with brachytherapy (if possible) should be undertaken.
  • For stage IIIC tumours, standard treatment is external (pelvic or pelvic and para-aortic) radiotherapy followed or not by a brachytherapy boost.
  • In case of extrauterine sites involved abdomino-pelvic irradiation is recommended.
  • 4) Standard treatment for inoperable stage I and II disease is external radiotherapy and brachytherapy.
  • For patients with inoperable stage III or IV disease, treatment is often symptomatic, combining external radiotherapy and medical treatment.
  • [MeSH-major] Endometrial Neoplasms / radiotherapy. Radiotherapy / standards
  • [MeSH-minor] Brachytherapy / adverse effects. Carcinoma / drug therapy. Carcinoma / pathology. Carcinoma / radiotherapy. Carcinoma / surgery. Cesium Radioisotopes / therapeutic use. Chemotherapy, Adjuvant. Combined Modality Therapy. Female. Humans. Hysterectomy. Indium Radioisotopes / therapeutic use. Lymphatic Irradiation / adverse effects. Lymphatic Metastasis / radiotherapy. Neoplasm Staging. Pelvic Neoplasms / radiotherapy. Pelvic Neoplasms / secondary. Peritoneal Neoplasms / radiotherapy. Peritoneal Neoplasms / secondary. Postoperative Period. Preoperative Care. Radiation Injuries / etiology. Radiotherapy Dosage. Radiotherapy, Adjuvant / adverse effects. Radiotherapy, High-Energy / adverse effects. Radium / therapeutic use

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  • (PMID = 11355582.001).
  • [ISSN] 1278-3218
  • [Journal-full-title] Cancer radiothérapie : journal de la Société française de radiothérapie oncologique
  • [ISO-abbreviation] Cancer Radiother
  • [Language] fre
  • [Publication-type] Comparative Study; English Abstract; Guideline; Journal Article; Practice Guideline; Research Support, Non-U.S. Gov't
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Cesium Radioisotopes; 0 / Indium Radioisotopes; W90AYD6R3Q / Radium
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22. Fujimura H, Kikkawa F, Oguchi H, Nakashima N, Mizutani S: Adjuvant chemotherapy including cisplatin in endometrial carcinoma. Gynecol Obstet Invest; 2000;50(2):127-32
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  • [Title] Adjuvant chemotherapy including cisplatin in endometrial carcinoma.
  • To determine the outcome of patients with endometrial endometrioid adenocarcinoma following adjuvant chemotherapy, CAP (cyclophosphamide, pirarubicin and cisplatin) and EP (etoposide and cisplatin) were assigned at random to patients with Ic or more advanced stage carcinoma, and their efficacy was compared.
  • These patients were treated by the Tokai Endometrial Cancer Study Group (Nagoya University and related institutions) between January 1992 and June 1996.
  • In conclusion, the EP chemotherapy had no significant advantage in terms of survival and disease-free survival compared to CAP, although these rates were superior in the EP group compared to the CAP group.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / administration & dosage. Endometrial Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. CA-125 Antigen / analysis. Chemotherapy, Adjuvant. Cyclophosphamide / administration & dosage. Disease-Free Survival. Doxorubicin / administration & dosage. Doxorubicin / analogs & derivatives. Etoposide / administration & dosage. Female. Humans. Lymphatic Metastasis. Middle Aged. Multivariate Analysis. Survival Rate. Treatment Outcome

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  • [Copyright] Copyright 2000 S. Karger AG, Basel.
  • (PMID = 10965198.001).
  • [ISSN] 0378-7346
  • [Journal-full-title] Gynecologic and obstetric investigation
  • [ISO-abbreviation] Gynecol. Obstet. Invest.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Randomized Controlled Trial
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / CA-125 Antigen; 6PLQ3CP4P3 / Etoposide; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; Q20Q21Q62J / Cisplatin; CAP-1 protocol; VP-P protocol
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23. Eltabbakh GH, Mount SL: Laparoscopic surgery does not increase the positive peritoneal cytology among women with endometrial carcinoma. Gynecol Oncol; 2006 Feb;100(2):361-4
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  • [Title] Laparoscopic surgery does not increase the positive peritoneal cytology among women with endometrial carcinoma.
  • OBJECTIVE: The purpose of our study was to find if uterine manipulation at the time of laparoscopic hysterectomy among women with endometrial carcinoma increases the incidence of malignant cells in the peritoneal washings.
  • MATERIAL AND METHODS: We conducted a prospective study including women with clinical stage I endometrioid endometrial carcinoma undergoing laparoscopic surgery between 07/01/2000 and 07/01/2004.
  • Two sets of peritoneal washings were obtained, one before and one after the insertion of the Pelosi uterine manipulator.
  • The two sets of washings were blindly reviewed by the same cytopathologist for the presence of malignant cells.
  • The procedure was converted to laparotomy in 3 (7.6%) patients after obtaining the two sets of washings.
  • The preoperative tumor grades were: G1: 22 (52.4%), G2: 12 (28.6%), and G3: 8 (19.0).
  • No patients had positive washings after the insertion of the uterine manipulator if the washings were negative before the insertion.
  • The surgical stages were: IA: 14 (33.3%), IB: 12 (28.6%), IC: 7 (16.7%), IIA: 1 (2.4%), IIB: 1 (2.4%), IIIA: 4 (9.5%), IIIB: 1 (2.4%), IIIC: 1 (2.4%), and IV: 1 (2.4%).
  • Twenty-nine patients received no postoperative treatment, 2 received chemotherapy, 3 received Megace, and 9 received radiation therapy.
  • Two patients had tumor recurrence, and one patient died secondary to her disease.
  • CONCLUSIONS: We conclude that uterine manipulation at the time of laparoscopic hysterectomy does not increase the incidence of positive peritoneal cytology among women with endometrial carcinoma.
  • [MeSH-major] Carcinoma, Endometrioid / secondary. Carcinoma, Endometrioid / surgery. Endometrial Neoplasms / pathology. Endometrial Neoplasms / surgery. Neoplasm Seeding. Peritoneal Neoplasms / secondary

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  • (PMID = 16185754.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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24. Greven K, Winter K, Underhill K, Fontenesci J, Cooper J, Burke T: Final analysis of RTOG 9708: adjuvant postoperative irradiation combined with cisplatin/paclitaxel chemotherapy following surgery for patients with high-risk endometrial cancer. Gynecol Oncol; 2006 Oct;103(1):155-9
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  • [Title] Final analysis of RTOG 9708: adjuvant postoperative irradiation combined with cisplatin/paclitaxel chemotherapy following surgery for patients with high-risk endometrial cancer.
  • PURPOSE: A phase II study was completed by the RTOG to assess the feasibility, safety, toxicity, and patterns of recurrence and survival when chemotherapy was combined with adjuvant radiation for patients with high-risk endometrial cancer.
  • MATERIALS AND METHODS: Pathologic requirements included grade 2 or 3 endometrial adenocarcinoma with either >50% myometrial invasion, cervical stromal invasion, or pelvic-confined extrauterine disease.
  • Radiation included 45 Gy in 25 fractions to the pelvis along with cisplatin (50 mg/m(2)) on days 1 and 28.
  • Follow-up times range from 6.8 to 72 months with a median of 4.3 years.
  • Four-year rates for survival and DFS for Stage III patients are 77% and 72%, respectively.
  • There have been no recurrences for patients with stage IC, IIA, or IIB.
  • CONCLUSION: Local-regional control is excellent following combined modality treatment in all patients suggesting additive effects of chemotherapy and radiation.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Endometrial Neoplasms / therapy
  • [MeSH-minor] Cisplatin / administration & dosage. Cisplatin / adverse effects. Disease-Free Survival. Female. Follow-Up Studies. Humans. Hysterectomy. Middle Aged. Paclitaxel / administration & dosage. Paclitaxel / adverse effects. Radiotherapy, Adjuvant / adverse effects. Risk Factors. Treatment Outcome

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  • (PMID = 16545437.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Multicenter Study
  • [Publication-country] United States
  • [Chemical-registry-number] P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin
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25. Bakrin N, Cotte E, Sayag-Beaujard A, Raudrant D, Isaac S, Mohamed F, Gilly FN, Glehen O: Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for the treatment of recurrent endometrial carcinoma confined to the peritoneal cavity. Int J Gynecol Cancer; 2010 Jul;20(5):809-14
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  • [Title] Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for the treatment of recurrent endometrial carcinoma confined to the peritoneal cavity.
  • Our objective was to determine if cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is a feasible therapeutic option for treatment of peritoneal recurrence of endometrial carcinoma.
  • Between August 2002 and May 2007, 5 patients with recurrent endometrial carcinoma confined to the peritoneal cavity who underwent CRS with HIPEC.
  • Of the 5 patients treated, histopathological type and International Federation of Gynecology and Obstetrics stage were as follows: IB endometrioid (n = 1), IIIA endometrioid (n = 1), IIIC endometrioid (n = 2), and IC endometrioid + pseudosarcomatoid component (n = 1).
  • One patient with pseudosarcomatoid component developed recurrent disease 10 months after surgery and died 2 months later.
  • One patient experienced early recurrence with a malignant pleural effusion and died.
  • Regarding the toxicity of the procedure, highly selected patients with recurrent endometrial carcinoma confined to the peritoneal cavity may benefit from improved survival after CRS with HIPEC.
  • [MeSH-major] Adenocarcinoma / therapy. Antineoplastic Agents / administration & dosage. Endometrial Neoplasms / therapy. Neoplasm Recurrence, Local / therapy. Peritoneal Neoplasms / therapy
  • [MeSH-minor] Aged. Cisplatin / administration & dosage. Combined Modality Therapy. Female. Gynecologic Surgical Procedures. Humans. Hyperthermia, Induced. Infusions, Parenteral. Middle Aged. Mitomycin / administration & dosage

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  • (PMID = 20973274.001).
  • [ISSN] 1525-1438
  • [Journal-full-title] International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
  • [ISO-abbreviation] Int. J. Gynecol. Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 50SG953SK6 / Mitomycin; Q20Q21Q62J / Cisplatin
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26. Murphy KT, Rotmensch J, Yamada SD, Mundt AJ: Outcome and patterns of failure in pathologic stages I-IV clear-cell carcinoma of the endometrium: implications for adjuvant radiation therapy. Int J Radiat Oncol Biol Phys; 2003 Apr 1;55(5):1272-6
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  • [Title] Outcome and patterns of failure in pathologic stages I-IV clear-cell carcinoma of the endometrium: implications for adjuvant radiation therapy.
  • PURPOSE: To evaluate the outcome and patterns of failure in women with uterine clear-cell carcinoma and discuss implications for adjuvant radiation therapy (RT).
  • METHODS: Between 1980 and 2000, 686 endometrial carcinoma patients underwent primary surgery at our institution.
  • Thirty-eight women (5.5%) had clear-cell tumors (18 clear-cell only, 8 clear-cell + adenocarcinoma, and 12 clear-cell + other unfavorable histologies [10 papillary serous, 1 uterine sarcoma, 1 both]).
  • FIGO stages were as follows: 3 IA, 4 IB, 5 IC, 4 IIA, 6 IIB, 8 IIIA, 2 IIIB, 3 IIIC, and 6 IV.
  • Adjuvant therapies included the following: 5 none, 22 RT (13 pelvic RT, 2 vaginal brachytherapy, 7 both), 11 chemotherapy (8 alone, 3 after pelvic RT), and 3 hormones.
  • No correlation was seen between relapse and stage, myometrial invasion, cytology, cervical extension, or involvement of extrauterine sites.
  • Corresponding pelvic failure rates in the Stage IA-IIB patients with and without RT were 0/16 (0%) and 5/6 (83%) (p < 0.0001).
  • Only 1 (2%) patient developed an isolated abdominal failure (This patient had a mixed clear-cell/papillary serous tumor).
  • CONCLUSION: Clear-cell carcinoma comprises a small percentage of endometrial cancers, frequently presents as a mixed histology, and has a poor overall outcome.
  • Unlike papillary serous tumors, clear-cell carcinoma does not seem to have a high propensity for abdominal failure.
  • Future protocols should focus instead on combinations of locoregional RT and chemotherapy to reduce the risk of local and systemic recurrence.
  • [MeSH-major] Adenocarcinoma, Clear Cell / pathology. Endometrial Neoplasms / pathology. Radiotherapy, Adjuvant
  • [MeSH-minor] Abdominal Neoplasms / secondary. Adenocarcinoma / drug therapy. Adenocarcinoma / mortality. Adenocarcinoma / pathology. Adenocarcinoma / radiotherapy. Adenocarcinoma / secondary. Adenocarcinoma / surgery. Adult. Aged. Aged, 80 and over. Bone Neoplasms / secondary. Brachytherapy. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Combined Modality Therapy. Cystadenocarcinoma / pathology. Disease-Free Survival. Female. Follow-Up Studies. Humans. Hysterectomy. Life Tables. Lung Neoplasms / secondary. Lymphatic Metastasis. Middle Aged. Neoplasm Staging. Neoplasms, Multiple Primary / drug therapy. Neoplasms, Multiple Primary / mortality. Neoplasms, Multiple Primary / pathology. Neoplasms, Multiple Primary / radiotherapy. Neoplasms, Multiple Primary / surgery. Pelvic Neoplasms / secondary. Prognosis. Sarcoma / pathology. Treatment Failure. Treatment Outcome. Uterine Neoplasms / pathology. Vaginal Neoplasms / secondary

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  • (PMID = 12654437.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin
  • [Number-of-references] 30
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27. Watanabe Y, Kitagawa R, Aoki D, Takeuchi S, Sagae S, Sakuragi N, Yaegashi N, Disease Committee of Uterine Endometrial Cancer, Japanese Gynecologic Oncology Group: Practice pattern for postoperative management of endometrial cancer in Japan: a survey of the Japanese Gynecologic Oncology Group. Gynecol Oncol; 2009 Dec;115(3):456-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Practice pattern for postoperative management of endometrial cancer in Japan: a survey of the Japanese Gynecologic Oncology Group.
  • OBJECTIVE: To determine the current status of postoperative management of endometrial cancer in Japan by surveying members of the Japanese Gynecologic Oncology Group (JGOG).
  • METHOD: We conducted an original mail survey regarding the status of postoperative treatment including indication criteria, treatment procedures, and chemotherapeutic regimen among all 226 active member institutions of the JGOG.
  • A total of 4063 patients with endometrial cancer were treated at the member institutions of the JGOG over a year.
  • As adjuvant therapy, chemotherapy (79.9%) was significantly (p<0.01) preferred over radiotherapy (13.0%) or hormonal therapy (7.1%).
  • Furthermore, more than 50% of respondent institutions performed adjuvant therapy when patients exhibited International Federation of Gynecology and Obstetrics (FIGO) stage IB/G3/positive lymph-vascular space invasion (LVSI)/endometrioid adenocarcinoma or FIGO IB/G3/non-endometrioid histology, and more than 90% institutions administered adjuvant therapy when patients exhibited FIGO IC/G3/positive LVSI/endometrioid adenocarcinoma or FIGO stage IC/G3/regardless of LVSI/non-endometrioid histology.
  • A combination of paclitaxel and carboplatin was the most preferred first-line regimen for adjuvant chemotherapy followed by combination regimens consisting of anthracycline and platinum.
  • CONCLUSION: The present survey provides relevant information regarding the current status of adjuvant therapy in Japanese patients with endometrial cancer.
  • [MeSH-major] Endometrial Neoplasms / drug therapy. Endometrial Neoplasms / surgery. Practice Patterns, Physicians'
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carboplatin / administration & dosage. Chemotherapy, Adjuvant. Female. Humans. Japan. Neoplasm Staging. Paclitaxel / administration & dosage. Postoperative Care / methods

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  • (PMID = 19765806.001).
  • [ISSN] 1095-6859
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel
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28. Cirisano FD Jr, Robboy SJ, Dodge RK, Bentley RC, Krigman HR, Synan IS, Soper JT, Clarke-Pearson DL: The outcome of stage I-II clinically and surgically staged papillary serous and clear cell endometrial cancers when compared with endometrioid carcinoma. Gynecol Oncol; 2000 Apr;77(1):55-65
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  • [Title] The outcome of stage I-II clinically and surgically staged papillary serous and clear cell endometrial cancers when compared with endometrioid carcinoma.
  • PURPOSE: The aim of this study was to compare survival and recurrence in clinical and surgical stage I-II papillary serous (PS), clear cell (CC), and endometrioid (EM) cancers of the endometrium and examine the prognostic utility of myometrial invasion.
  • METHODS: Clinical, surgicopathologic, and survival data were retrospectively collected on 574 clinical stage I-II endometrial cancer patients, including 53 PS and 18 CC (based on postoperative histology), undergoing hysterectomy at Duke University Medical Center between 1967 and 1990.
  • Prognostic variables examined included age, stage, grade, myometrial invasion, lymph-vascular space invasion (LVSI), and histology.
  • Among PS, CC, and EM3 patients with recurrences there were no statistical differences in the proportion that received preoperative or postoperative radiotherapy or chemotherapy.
  • Prognostic factors for shorter survival included age >=60, surgical stage III+IV, presence of LVSI, histology (PS, CC, or EM3), and >=50% myometrial invasion.
  • PS + CC tumors confined to the endometrium had a 5-year survival of 0.60 compared to 0.98 and 1.00 for EM and EM3, respectively.
  • The 5-year survival for surgically staged IA patients (0.57) was not different from stages IB and IC combined (0.53) (P = 0.72).
  • The 5-year survival for surgical stage I + II PS + CC patients (0.56) was comparable to that for clinical stage I + II PS + CC patients (0.46) and remained significantly smaller than that for EM patients (0.86) (P < 0.001).
  • When controlled for surgical stage I-II tumors, 5-year survival for PS + CC patients remains comparable to that of clinical stage I-II patients and below that of EM.
  • Prognostic factors for survival in PS and CC patients include age, stage, and LVSI.
  • Thorough extended surgical staging is indicated in PS and CC tumors, and prospective trials of aggressive adjuvant therapies for surgical stage I-II tumors are needed to improve outcome in PS and CC patients.
  • [MeSH-major] Adenocarcinoma, Clear Cell / pathology. Carcinoma, Endometrioid / pathology. Cystadenocarcinoma, Papillary / pathology. Endometrial Neoplasms / pathology
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Hysterectomy. Middle Aged. Neoplasm Invasiveness. Neoplasm Recurrence, Local. Neoplasm Staging. Prognosis. Survival Analysis

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  • [Copyright] Copyright 2000 Academic Press.
  • (PMID = 10739691.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] UNITED STATES
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29. Amato NA, Partipilo V, Mele F, Boscia F, De Marzo P: [Pelvic lymphadenectomy as an alternative to adjuvant radiotherapy in early stage endometrial cancer at high risk of recurrent lymphatic metastases (stage I)]. Minerva Ginecol; 2009 Feb;61(1):1-12
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  • [Title] [Pelvic lymphadenectomy as an alternative to adjuvant radiotherapy in early stage endometrial cancer at high risk of recurrent lymphatic metastases (stage I)].
  • [Transliterated title] Linfoadenectomia pelvica come alternativa alla radioterapia adiuvante nel carcinoma endometriale ad alto rischio di metastasi linfonodali in fase precoce (stadio I).
  • AIM: The aim of this study was to evaluate if the surgical approach without pelvic lymphadenectomy and with adjuvant radiotherapy in the patients suffering from endometrioid adenocarcinoma type at high risk (of lymphatic metastasis) in early stage can be substituted by only surgery with pelvic lymphadenectomy (with or without para-aortic lymphadenectomy).
  • The cancer grading (G) was defined before the surgery with an hystological exam on endometrial biopsies.
  • The follow-up had a medium duration of 30 months (range: 9-44 months) and consisted of the evaluation of: cancer related survival (CRS); recurrence free survival (RFS).
  • Both were evaluated according to age, risk type, and therapy adopted.
  • RESULTS: Four patients (7.1%) showed relapse during the period of study in a medium time of 24 months (range: 12-36): 2 of these patients (C and D cases; 36%) had a relapse both locally (pelvic wall) and distantly; the other two (A and B cases; 36%) had only a distant relapse.
  • None of the patients at the stage IA had a relapse, but it occurred in the 8.7% of the cases (N.=2) IB and in the 10.5 % of the patients IC (N.=2).
  • One patient of the low risk group (3.8%) (case A) had a distant relapse (lungs) 12 months after the surgery and died 6 months after the appearance of the relapse without any additional treatment, because of age and of concomitant pathologies which suggested another illness.
  • One of them with distant relapse (36 months after the primary treatment) (case B) is still alive, even though she has got a controlled cancer, 8 months after the rescue treatment (chemotherapy), whereas two of them died in a medium time of 14 months (range 13-15 months) from the rescue treatment (C and D cases).
  • One of the three patients of the high risk group underwent the standard surgical treatment with lympho-adenectomy (case B) whereas the other two underwent the standard surgical treatment with aiding radiotherapy (C and D cases).
  • The degree of differentiation of the cancer is the most important prognostic factor in relation to the survival free from relapse (RFS).
  • [MeSH-major] Carcinoma, Endometrioid / radiotherapy. Carcinoma, Endometrioid / surgery. Endometrial Neoplasms / radiotherapy. Endometrial Neoplasms / surgery. Lymph Node Excision. Neoplasm Recurrence, Local
  • [MeSH-minor] Aged. Aged, 80 and over. Biopsy. Early Detection of Cancer. Female. Follow-Up Studies. Humans. Hysterectomy. Lymphatic Metastasis / prevention & control. Middle Aged. Neoplasm Staging. Pelvis. Prognosis. Radiotherapy, Adjuvant. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • (PMID = 19204656.001).
  • [ISSN] 0026-4784
  • [Journal-full-title] Minerva ginecologica
  • [ISO-abbreviation] Minerva Ginecol
  • [Language] ita
  • [Publication-type] Comparative Study; English Abstract; Journal Article
  • [Publication-country] Italy
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30. Ma SK, Zhang HT, Sun YC, Wu LY: [Synchronous primary cancers of the endometrium and ovary: review of 43 cases]. Zhonghua Zhong Liu Za Zhi; 2008 Sep;30(9):690-4
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  • [Title] [Synchronous primary cancers of the endometrium and ovary: review of 43 cases].
  • OBJECTIVE: To investigate the clinical and pathological characteristics, treatment methods, and prognosis of synchronous primary cancers of the endometrium and ovary.
  • METHODS: The clinical data of 43 patients with synchronous primary cancers of the endometrium and ovary were retrospectively reviewed.
  • RESULTS: The median age at diagnosis was 49 years (range, 28-73 years).
  • The most common symptoms were abnormal vaginal bleeding (69.8%) and abdominal or pelvic pain (44.2%).Pelvic masses were found in 39.5% of the patients and enlarged corpus in 27.9% at physical examination, while pelvic masses were found in 67.4% of the 43 patients (29 cases) and thickening or abnormal endometrium in 23.3% (10 cases) during ultrasound examination.
  • All 15 patients who underwent endometrial biopsies were proven to have endometrial carcinomas.
  • Serum CA125 level was found to be elevated in 22 of the 34 examined cases (64.7%) with a median value of 500 U/ml (range, 39-3439 U/ml).
  • FIGO stages of endometrial carcinomas: IA 18 cases, IB 20 cases, IC 2 cases, IIA 3 cases; Stages of ovarian carcinomas: IA 19 cases, IB 4 cases, IC 7 cases, II 4 cases, III C 9 cases.
  • Twenty-four patients (55.8%) were in stage I both endometrial and ovarian carcinomas.
  • Thirty-eight of the 43 patients (88.4%) had a pathologically proven endometrial adenocarcinoma.
  • The predominant ovarian histology was endometrioid or mixed tumor with endometrioid components (30/43, 69.8%).
  • Postoperatively, 26 patients (60.5%) received adjuvant chemotherapy alone, 12 had chemotherapy plus radiotherapy, only one patient had radiation alone and the remaining 4 cases received no adjuvant treatment.
  • The 3- and 5-year survival rates of patients with both endometrioid and ovarian carcinomas were higher than that of those with non-endometrioid or mixed subtypes (93.8%, 82.0% vs. 79.7%, 69.0%).
  • The 3-year and 5-year survival rates of patients with early stage disease were better than those of the other patients (93.3%, 93.3% vs. 69.7%, 36.7%).
  • Recurrence developed in 15 patients (34.9%).
  • It was showed by univariate analysis that lower CA125 level, early FIGO stage, and adjuvant chemotherapy plus radiotherapy significantly and positively affect the 5-year survival rates, while only early FIGO stage and chemotherapy plus radiotherapy were revealed by multivariate analysis as independent prognostic factors.
  • CONCLUSION: Synchronous primary cancers of the endometrium and ovary are different from either primary endometrial carcinoma or ovarian cancer, while it can usually be detected in early stage and with a good prognosis.
  • Surgical treatment alone may be enough for early stage patients.
  • Chemotherapy plus radiotherapy may be necessary for advanced stage patients.
  • [MeSH-major] Carcinoma, Endometrioid. Endometrial Neoplasms. Hysterectomy / methods. Neoplasms, Multiple Primary. Ovarian Neoplasms
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Female. Humans. Lymph Node Excision. Lymphatic Metastasis. Middle Aged. Neoplasm Recurrence, Local. Neoplasm Staging. Proportional Hazards Models. Proteins / metabolism. Radiotherapy, Adjuvant. Retrospective Studies. Survival Rate

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  • (PMID = 19173912.001).
  • [ISSN] 0253-3766
  • [Journal-full-title] Zhonghua zhong liu za zhi [Chinese journal of oncology]
  • [ISO-abbreviation] Zhonghua Zhong Liu Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0 / NBR1 protein, human; 0 / Proteins
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31. Craighead PS, Sait K, Stuart GC, Arthur K, Nation J, Duggan M, Guo D: Management of aggressive histologic variants of endometrial carcinoma at the Tom Baker Cancer Centre between 1984 and 1994. Gynecol Oncol; 2000 May;77(2):248-53
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Management of aggressive histologic variants of endometrial carcinoma at the Tom Baker Cancer Centre between 1984 and 1994.
  • OBJECTIVE: The aim of this study was to determine the patient characteristics and outcome of patients with aggressive histologic variants (AV) of endometrial carcinoma, including uterine papillary serous carcinoma (UPSC), uterine clear cell carcinoma (UCCC), and mixed type.
  • METHODS AND MATERIALS: All cases with AV histological type of endometrial carcinoma from January 1984 to December 1994 at the Tom Baker Cancer Centre were identified using the Alberta Cancer Registry.
  • Relevant data from the charts of these patients were entered into a study database (Microsoft Excel) and analyzed for presentation, demography, treatment parameters, and outcome of treatment.
  • All pathology was reviewed at the time of diagnosis.
  • Statistical analysis was performed using the S-plus statistics computer program.
  • RESULTS: A total of 103 patients with AV histological type were identified and analyzed; there were 61, 31, and 11 cases of UPSC, CCC, and mixed tumors, respectively.
  • Sixty-three patients had Stage I, 11 had Stage II, 15 had Stage III, and 14 had Stage IV disease.
  • The Cox proportional hazards model showed that lymphvascular space invasion and stage are the two independent prognostic factors affecting recurrence and survival.
  • Forty six percent of all cases underwent surgery alone, 39% underwent treatment which included pelvic RT, and 17% underwent treatment which included chemotherapy.
  • Chemotherapy improved overall survival, but made little difference in distant relapse rates.
  • CONCLUSIONS: Stage Ia cases treated by surgery alone have a low risk of relapse and need not be offered adjuvant systemic therapy or pelvic radiation.
  • Patients with Ib, Ic, II, and III have significantly lower pelvic failure rates if treated with pelvic radiation, but still have a high distant failure rate.
  • Systemic therapy did not significantly improve distant relapse-free survival, but did extend overall survival.
  • Stage IV patients usually died within 6 months with a few responding to systemic chemotherapy.
  • [MeSH-major] Adenocarcinoma, Clear Cell / therapy. Carcinoma, Papillary / therapy. Endometrial Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Chemotherapy, Adjuvant. Demography. Female. Humans. Middle Aged. Neoplasm Recurrence, Local. Prognosis. Radiotherapy, Adjuvant. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • [Copyright] Copyright 2000 Academic Press.
  • (PMID = 10785473.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] UNITED STATES
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32. Mangili G, De Marzi P, Beatrice S, Rabaiotti E, Viganò R, Frigerio L, Gentile C, Fazio F: Paclitaxel and concomitant radiotherapy in high-risk endometrial cancer patients: preliminary findings. BMC Cancer; 2006;6:198
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  • [Title] Paclitaxel and concomitant radiotherapy in high-risk endometrial cancer patients: preliminary findings.
  • BACKGROUND: There is still much debate about the best adjuvant therapy after surgery for endometrial cancer (EC) and there are no current guidelines.
  • METHODS: Twenty-three patients with high-risk EC (stage IIB, IIIA, IIIC or IC G3 without lymphadenectomy or with aneuploid tumor) underwent primary surgery and were then referred for adjuvant therapy.
  • P was given at a dose of 60 mg/m2 once weekly for five weeks during RT, which consisted of a total radiation dose of 50.4 Gy.
  • Overall survival and disease-free survival were calculated from the time of surgery.
  • RESULTS: A total of 157 cycles of P were administered both during radiotherapy and consolidation chemotherapy.
  • Median time to recurrence was 18.6 months (range 3-28).
  • In this group median time to recurrence was 19.2 months (range 3-28).
  • CONCLUSION: This small series demonstrates pelvic radiotherapy in combination with weakly P followed by three consolidation chemotherapy cycles as an effective combined approach in high risk endometrial carcinoma patients.
  • [MeSH-major] Chemotherapy, Adjuvant / methods. Endometrial Neoplasms / drug therapy. Endometrial Neoplasms / radiotherapy. Paclitaxel / therapeutic use. Radiation-Sensitizing Agents / therapeutic use
  • [MeSH-minor] Aged. Disease-Free Survival. Female. Humans. Middle Aged. Pilot Projects. Ploidies. Radiation Dosage. Recurrence. Risk Factors. Treatment Failure

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  • (PMID = 16869961.001).
  • [ISSN] 1471-2407
  • [Journal-full-title] BMC cancer
  • [ISO-abbreviation] BMC Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Radiation-Sensitizing Agents; P88XT4IS4D / Paclitaxel
  • [Other-IDs] NLM/ PMC1559635
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33. Straughn JM, Huh WK, Orr JW Jr, Kelly FJ, Roland PY, Gold MA, Powell M, Mutch DG, Partridge EE, Kilgore LC, Barnes MN, Austin JM Jr, Alvarez RD: Stage IC adenocarcinoma of the endometrium: survival comparisons of surgically staged patients with and without adjuvant radiation therapy. Gynecol Oncol; 2003 May;89(2):295-300
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  • [Title] Stage IC adenocarcinoma of the endometrium: survival comparisons of surgically staged patients with and without adjuvant radiation therapy.
  • OBJECTIVE: The goal of this study was to determine the outcomes of stage IC endometrial carcinoma patients who are managed with and without adjuvant radiation therapy after comprehensive surgical staging.
  • METHODS: Patients with FIGO stage IC adenocarcinoma of the endometrium diagnosed from 1988 to 1999 were identified from tumor registry databases at four institutions.
  • RESULTS: Of the 220 stage IC patients, 56 (25%) patients received adjuvant brachytherapy (BT), 19 (9%) received whole-pelvis radiation (WPRT), and 24 (11%) received both WPRT and BT.
  • Seven of fourteen recurrences in the observation group were local, and all local recurrences were salvaged with radiation therapy.
  • Two of seven distant recurrences in this group were also salvaged with surgery and chemotherapy.
  • CONCLUSION: Adjuvant radiation therapy improves disease-free survival in surgical stage IC patients; however, overall survival is not improved with adjuvant radiation therapy since the majority of local recurrences in conservatively managed patients can be salvaged with radiation therapy.
  • [MeSH-major] Adenocarcinoma / radiotherapy. Adenocarcinoma / surgery. Endometrial Neoplasms / radiotherapy. Endometrial Neoplasms / surgery
  • [MeSH-minor] Aged. Aged, 80 and over. Brachytherapy. Cohort Studies. Disease-Free Survival. Female. Humans. Middle Aged. Neoplasm Staging. Radiotherapy, Adjuvant. Retrospective Studies

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  • (PMID = 12713994.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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34. Abahssain H, Kairouani M, Gherman R, M'rabti H, Errihani H: Granulosa cell tumor of the ovary and antecedent of adjuvant tamoxifen use for breast cancer. World J Surg Oncol; 2010;8:67
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  • [Title] Granulosa cell tumor of the ovary and antecedent of adjuvant tamoxifen use for breast cancer.
  • BACKGROUND: Adult granulosa cell tumor associated with antecedent use of tamoxifen as adjuvant hormonotherapy for breast cancer is rare.
  • CASE PRESENTATION: A 47 year-old women was treated with surgery, chemotherapy, radiotherapy and tamoxifen for stage III estrogen receptor positive breast carcinoma.
  • Ten months after stopping tamoxifen, we diagnosed a stage Ic granulosa cell tumor of the ovary.
  • CONCLUSIONS: Use of tamoxifen has been found to be associated with gynecological tumors like endometrial carcinoma.
  • Its association with granulosa cell tumor of the ovary is uncommon.
  • [MeSH-major] Antineoplastic Agents, Hormonal / adverse effects. Breast Neoplasms / drug therapy. Granulosa Cell Tumor / chemically induced. Neoplasms, Second Primary / chemically induced. Ovarian Neoplasms / chemically induced. Tamoxifen / adverse effects

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  • (PMID = 20704728.001).
  • [ISSN] 1477-7819
  • [Journal-full-title] World journal of surgical oncology
  • [ISO-abbreviation] World J Surg Oncol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 094ZI81Y45 / Tamoxifen
  • [Other-IDs] NLM/ PMC2928230
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35. Kim HS, Kim JW, Wu HG, Chung HH, Park NH, Song YS, Kang SB, Lee HP: Comparison of the efficacy between paclitaxel/carboplatin and doxorubicin/cisplatin for concurrent chemoradiation in intermediate- or high-risk endometrioid endometrial cancer: a single institution experience. J Obstet Gynaecol Res; 2010 Jun;36(3):598-604
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  • [Title] Comparison of the efficacy between paclitaxel/carboplatin and doxorubicin/cisplatin for concurrent chemoradiation in intermediate- or high-risk endometrioid endometrial cancer: a single institution experience.
  • AIM: We sought to compare survival and toxicity between paclitaxel/carboplatin (TC) and doxorubicin/cisplatin (AP) for concurrent chemoradiation (CCR) in intermediate- or high-risk endometrioid endometrial cancer.
  • METHODS: The clinical data of 40 patients with intermediate- (FIGO stage IC-IIB, n = 12) or high-risk endometrioid endometrial cancer (FIGO stage IIIA-IVA, n = 28) were reviewed retrospectively between March 2000 and December 2007, who were treated with TC (n = 23, group 1) or AP (n = 17, group 2) for CCR after surgery.
  • However, >or=6 cycles of chemotherapy improved PFS compared with 3-5 cycles of chemotherapy (51 vs 21 months, P = 0.04), suggesting that >or=6 cycles of chemotherapy was an independent prognostic factor improving PFS (adjusted HR, 0.27; 95% CI, 0.08 to 0.91; P = 0.04).
  • Grade 3 or 4 hematological and non-hematological, especially, gastrointestinal, toxicities related with chemotherapy during CCR were more common in group 2 than in group 1, whereas there was no difference in grade 3 or 4 late complication by CCR between the 2 groups.
  • CONCLUSION: These findings suggest that TC may have comparable efficacy to AP for CCR with lesser toxicity, and >or=6 cycles of chemotherapy may be more beneficial than 3-5 cycles of chemotherapy in intermediate- or high-risk endometrioid endometrial cancer.
  • [MeSH-major] Carboplatin / therapeutic use. Carcinoma, Endometrioid / drug therapy. Cisplatin / therapeutic use. Doxorubicin / therapeutic use. Endometrial Neoplasms / drug therapy. Paclitaxel / therapeutic use
  • [MeSH-minor] Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Databases, Factual. Disease-Free Survival. Female. Humans. Middle Aged. Neoplasm Staging. Radiotherapy, Adjuvant. Retrospective Studies. Statistics, Nonparametric. Treatment Outcome

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  • (PMID = 20598043.001).
  • [ISSN] 1447-0756
  • [Journal-full-title] The journal of obstetrics and gynaecology research
  • [ISO-abbreviation] J. Obstet. Gynaecol. Res.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Australia
  • [Chemical-registry-number] 80168379AG / Doxorubicin; BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin
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36. Small W Jr, Mahadevan A, Roland P, Vallow L, Zusag T, Fishman D, Massad S, Rademaker A, Kalapurakal JA, Chang S, Lurain J: Whole-abdominal radiation in endometrial carcinoma: an analysis of toxicity, patterns of recurrence, and survival. Cancer J; 2000 Nov-Dec;6(6):394-400
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Whole-abdominal radiation in endometrial carcinoma: an analysis of toxicity, patterns of recurrence, and survival.
  • PURPOSE: The purpose of this study was to determine the toxicity, patterns of recurrence, and survival in high-risk endometrial cancer patients treated with whole-abdominal radiation.
  • MATERIALS AND METHODS: All patients with endometrial cancer treated at Northwestern University since 1994 and at Rush University since 1993 were retrospectively reviewed.
  • Forty-seven percent of the patients were found to have serous histology as a component of their tumor.
  • Surgical staging results included 19% stage 1B, 4% stage IC, 8% stage IIB, 37% stage IIIA, 26% stage IIIC, and 7% stage IVB.
  • Megestrol acetate (Megace) was used as an adjuvant treatment in 37% of patients, and no cases received initial chemotherapy.
  • CONCLUSIONS: Utilizing a conservatrive total whole-abdominal radiation dose and limited para-aortic nodal boost resulted in very tolerable treatments.
  • [MeSH-major] Abdominal Neoplasms / prevention & control. Abdominal Neoplasms / secondary. Endometrial Neoplasms / radiotherapy. Neoplasm, Residual / radiotherapy
  • [MeSH-minor] Adenocarcinoma, Papillary. Brachytherapy. Female. Humans. Hysterectomy. Middle Aged. Neoplasm Staging. Ovariectomy. Radiotherapy Dosage. Retrospective Studies. Survival Analysis

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  • (PMID = 11131490.001).
  • [ISSN] 1528-9117
  • [Journal-full-title] Cancer journal (Sudbury, Mass.)
  • [ISO-abbreviation] Cancer J
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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37. Susumu N, Sagae S, Udagawa Y, Niwa K, Kuramoto H, Satoh S, Kudo R, Japanese Gynecologic Oncology Group: Randomized phase III trial of pelvic radiotherapy versus cisplatin-based combined chemotherapy in patients with intermediate- and high-risk endometrial cancer: a Japanese Gynecologic Oncology Group study. Gynecol Oncol; 2008 Jan;108(1):226-33
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Randomized phase III trial of pelvic radiotherapy versus cisplatin-based combined chemotherapy in patients with intermediate- and high-risk endometrial cancer: a Japanese Gynecologic Oncology Group study.
  • OBJECTIVE: To establish an optimal adjuvant therapy for intermediate- and high-risk endometrial cancer patients, we conducted a multi-center randomized phase III trial of adjuvant pelvic radiation therapy (PRT) versus cyclophosphamide-doxorubicin-cisplatin (CAP) chemotherapy in women with endometrioid adenocarcinoma with deeper than 50% myometrial invasion.
  • The PRT group received at least 40 Gy.
  • These rates were also not significantly different in a low- to intermediate-risk group defined as stage IC patients under 70 years old with G1/2 endometrioid adenocarcinoma.
  • However, among 120 patients in a high- to intermediate-risk group defined as (1) stage IC in patients over 70 years old or with G3 endometrioid adenocarcinoma or (2) stage II or IIIA (positive cytology), the CAP group had a significantly higher PFS rate (83.8% vs. 66.2%, log-rank test P=0.024, hazard ratio 0.44) and higher OS rate (89.7% vs. 73.6%, log-rank test P=0.006, hazard ratio 0.24).
  • CONCLUSION: Adjuvant chemotherapy may be a useful alternative to radiotherapy for intermediate-risk endometrial cancer.
  • [MeSH-major] Adenocarcinoma / drug therapy. Adenocarcinoma / radiotherapy. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Endometrial Neoplasms / drug therapy. Endometrial Neoplasms / radiotherapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Cisplatin / adverse effects. Cyclophosphamide / administration & dosage. Cyclophosphamide / adverse effects. Doxorubicin / administration & dosage. Doxorubicin / adverse effects. Female. Humans. Middle Aged. Neoplasm Recurrence, Local / pathology. Neoplasm Staging. Patient Compliance. Prognosis. Radiotherapy, Adjuvant. Risk Factors. Treatment Outcome


38. Straughn JM Jr, Huh WK, Kelly FJ, Leath CA 3rd, Kleinberg MJ, Hyde J Jr, Numnum TM, Zhang Y, Soong SJ, Austin JM Jr, Partridge EE, Kilgore LC, Alvarez RD: Conservative management of stage I endometrial carcinoma after surgical staging. Gynecol Oncol; 2002 Feb;84(2):194-200
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Conservative management of stage I endometrial carcinoma after surgical staging.
  • OBJECTIVE: The aim of this study was to determine the outcomes of Stage I endometrial carcinoma patients who are managed without adjuvant radiation after comprehensive surgical staging.
  • METHODS: A computerized hospital database identified women diagnosed with adenocarcinoma of the endometrium from 1993 to 1998.
  • A chart review identified 864 women as having primary surgery for adenocarcinoma of the endometrium.
  • RESULTS: A total of 321 of 325 Stage IB patients (99%) did not receive adjuvant radiation.
  • Seventy-seven patients were diagnosed with Stage IC disease; 53 (69%) received no adjuvant therapy.
  • Three of 4 patients (75%) were salvaged, 2 with XRT/BT and 1 with surgery and chemotherapy.
  • For all Stage I patients, the 5-year disease-free survival was 93% and the 5-year overall survival was 98%.
  • CONCLUSIONS: Surgically staged patients with endometrial carcinoma confined to the uterine corpus have a small risk of recurrence and the majority of these recurrences can be salvaged with radiation therapy.
  • Conservative management of Stage I endometrial carcinoma patients is an effective treatment strategy.
  • [MeSH-major] Adenocarcinoma / surgery. Endometrial Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Disease-Free Survival. Female. Humans. Hysterectomy. Middle Aged. Neoplasm Staging. Radiotherapy, Adjuvant. Risk Factors. Survival Rate. Treatment Outcome

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  • [Copyright] ©2001 Elsevier Science.
  • [CommentIn] Gynecol Oncol. 2002 Feb;84(2):191-3 [11812073.001]
  • (PMID = 11812074.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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