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1. Marttunen MB, Cacciatore B, Hietanen P, Pyrhönen S, Tiitinen A, Wahlström T, Ylikorkala O: Prospective study on gynaecological effects of two antioestrogens tamoxifen and toremifene in postmenopausal women. Br J Cancer; 2001 Apr 6;84(7):897-902
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  • To assess and compare the gynaecological consequences of the use of 2 antioestrogens we examined 167 postmenopausal breast cancer patients before and during the use of either tamoxifen (20 mg/day, n = 84) or toremifene (40 mg/day, n = 83) as an adjuvant treatment of stage II-III breast cancer.
  • Detailed interview concerning menopausal symptoms, pelvic examination including transvaginal sonography (TVS) and collection of endometrial sample were performed at baseline and at 6, 12, 24 and 36 months of treatment.
  • In a subgroup of 30 women (15 using tamoxifen and 15 toremifene) pulsatility index (PI) in an uterine artery was measured before and at 6 and 12 months of treatment.
  • The mean (+/-SD) follow-up time was 2.3 +/- 0.8 years.
  • 35% of the patients complained of vasomotor symptoms before the start of the trial.
  • This rate increased to 60.0% during the first year of the trial, being similar among patients using tamoxifen (57.1%) and toremifene (62.7%).
  • Endometrial thickness increased from baseline (3.9 +/- 2.7 mm) to 6.8 +/- 4.2 mm at 6 months (P< 0.001), and no difference emerged between the 2 regimens in this regard.
  • Before the start of the antioestrogen regimen, the endometrium was atrophic in 71 (75.5%) and proliferative in 19 of 94 (20.2%) samples; 4 patients had benign endometrial polyps.
  • During the use of antioestrogen altogether 339 endometrial samples were taken (159 in tamoxifen group, 180 in toremifene group).
  • The endometrium was proliferative more often in the tamoxifen group (47.8%) than in the toremifene group (32.2%) (P< 0.0001).
  • One patient in the toremifene group developed endometrial adenocarcinoma at 12 months, and one patient had breast cancer metastasis on the endometrium.
  • Tamoxifen failed to affect the PI in the uterine artery, but toremifene reduced it by 15.0% (P< 0.05) by 12 months.
  • Neither regimen led to the development of premalignant endometrial changes.
  • Our data suggest that so close endometrial surveillance as used in our study may not be mandatory during the first 3 years of use of antioestrogen treatment.
  • [MeSH-major] Endometrium / drug effects. Estrogen Receptor Modulators / pharmacology. Postmenopause. Tamoxifen / pharmacology. Toremifene / pharmacology. Vagina / drug effects
  • [MeSH-minor] Aged. Aged, 80 and over. Antineoplastic Agents, Hormonal / adverse effects. Antineoplastic Agents, Hormonal / pharmacology. Antineoplastic Agents, Hormonal / therapeutic use. Breast Neoplasms / drug therapy. Female. Humans. Middle Aged. Prospective Studies. Vasomotor System / drug effects

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  • [Copyright] Copyright 2001 Cancer Research Campaign.
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  • (PMID = 11286468.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial
  • [Publication-country] Scotland
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Estrogen Receptor Modulators; 094ZI81Y45 / Tamoxifen; 7NFE54O27T / Toremifene
  • [Other-IDs] NLM/ PMC2363827
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2. Yahata H, Hirakawa T, Fujita T, Ariyoshi K, Sonoda K, Amada S, Kobayashi H, Nakano H: Postoperative adjuvant chemotherapy with cisplatin, cyclophosphamide, and anthracycline (doxorubicin, epirubicin, pirarubicin) for endometrial cancer. Int J Clin Oncol; 2004 Aug;9(4):317-21
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  • [Title] Postoperative adjuvant chemotherapy with cisplatin, cyclophosphamide, and anthracycline (doxorubicin, epirubicin, pirarubicin) for endometrial cancer.
  • BACKGROUND: Doxorubicin and cisplatin are the most commonly used chemotherapeutic agents in the treatment of endometrial cancer, but their clinical efficacy is still controversial.
  • The aim of this study was to retrospectively assess the efficacy and toxicity of combination chemotherapy using cisplatin, cyclophosphamide, and anthracy-clines in patients with stage III/IV adenocarcinoma of the endometrium.
  • METHODS: Forty patients with advanced endometrial cancer received postoperative adjuvant combination chemotherapy, using cisplatin (50 or 70 mg/m2), cyclophosphamide (500 mg/m2), and one of three anthracyclines (10 patients with doxorubicin [50 mg/m2], 18 with epirubicin [50 mg/m2], and 12 with pirarubicin [40 mg/m2]), from 1987 to 1999.
  • No patients in stage IIIa (n = 10), however, had recurrence.
  • In group 2, 6 of the 13 (46%) showed response to chemotherapy (complete response [CR], 31%; partial response [PR], 15%).
  • CONCLUSION: In group 1, the survival of patients receiving chemotherapy was considered favorable, but patients with recurrent lesions had poor prognosis.
  • On the other hand, in group 2, the efficacy of the chemotherapy was almost equal to that reported in the literature; however, this regimen did not contribute to an improvement in the survival rate.
  • In conclusion, a new effective regimen of postoperative adjuvant therapy is highly desirable in patients with measurable residual lesions.
  • [MeSH-major] Adenocarcinoma / drug therapy. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Endometrial Neoplasms / drug therapy. Neoplasm Recurrence, Local / therapy
  • [MeSH-minor] Adult. Aged. Anthracyclines / administration & dosage. Chemotherapy, Adjuvant / methods. Cisplatin / administration & dosage. Cyclophosphamide / administration & dosage. Female. Gynecologic Surgical Procedures / methods. Humans. Middle Aged. Neoplasm Staging. Neoplasm, Residual. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • (PMID = 15375709.001).
  • [ISSN] 1341-9625
  • [Journal-full-title] International journal of clinical oncology
  • [ISO-abbreviation] Int. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Anthracyclines; 8N3DW7272P / Cyclophosphamide; Q20Q21Q62J / Cisplatin
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3. Aoki Y, Kase H, Watanabe M, Sato T, Kurata H, Tanaka K: Stage III endometrial cancer: analysis of prognostic factors and failure patterns after adjuvant chemotherapy. Gynecol Oncol; 2001 Oct;83(1):1-5
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  • [Title] Stage III endometrial cancer: analysis of prognostic factors and failure patterns after adjuvant chemotherapy.
  • OBJECTIVE: This study was performed to assess the prognostic factors and patterns of recurrence in stage III endometrial carcinoma treated with surgery and adjuvant chemotherapy.
  • METHODS: A retrospective review of 61 stage III endometrial carcinoma patients treated between 1988 and 1998 at Niigata University Hospital was performed.
  • All patients underwent surgery, followed by adjuvant chemotherapy consisting of intravenous cisplatin, doxorubicin, and cyclophosphamide.
  • The role of new adjuvant chemotherapy should be investigated to control distant failure in node-negative high-risk patients.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Endometrial Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Cyclophosphamide / administration & dosage. Disease-Free Survival. Doxorubicin / administration & dosage. Female. Humans. Middle Aged. Multivariate Analysis. Neoplasm Recurrence, Local. Neoplasm Staging. Retrospective Studies. Risk Factors

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  • [Copyright] Copyright 2001 Academic Press.
  • (PMID = 11585406.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; Q20Q21Q62J / Cisplatin
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4. Li J, Kong WM: [Prognostic factors of stage III endometrial carcinoma]. Zhonghua Yi Xue Za Zhi; 2009 Jan 20;89(3):198-200

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  • [Title] [Prognostic factors of stage III endometrial carcinoma].
  • OBJECTIVE: To investigate the prognostic factors of surgery-pathological stage III endometrial cancer.
  • METHOD: The clinical data of 102 patients with stage III endometrial cancer, aged 54.9 (27-79), 71 with endometrioid adenocarcinoma, 31 with non-endometrioid adenocarcinoma, 9 undergoing simple surgical treatment, and 42 receiving radiation, 16 receiving chemotherapy, and 35 receiving chemoradiation after surgery, were analyzed retrospectively.
  • RESULTS: Cox risk model analysis showed that the risk factors for the prognosis of stage III endometrial cancer were pathological types, method of treatment, vascular thrombosis, and age (all P < 0.05).
  • The average survival time of stage III a endometrial cancer patients purely positive in peritoneal cytology was 74.4 months, significantly longer than that of the patients with serosa and/or annex involvement (53.8 months, P < 0.05).
  • CONCLUSION: The independent prognostic factors of stage III endometrial cancer are pathological type, method of treatment, vascular thrombosis, and age.
  • The patients with, the prognosis of stage III a endometrial cancer simply positive in peritoneal cytology is better than that with serous and/or annex involvement.
  • [MeSH-major] Carcinoma, Endometrioid / diagnosis. Carcinoma, Endometrioid / pathology. Endometrial Neoplasms / diagnosis. Endometrial Neoplasms / pathology

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  • (PMID = 19537039.001).
  • [ISSN] 0376-2491
  • [Journal-full-title] Zhonghua yi xue za zhi
  • [ISO-abbreviation] Zhonghua Yi Xue Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] China
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5. Georgopoulos NA, Adonakis GL, Fotopoulos A, Koika V, Spinos N, Saltamavros A, Keramopoulos A, Koukouras D, Decavalas G, Kourounis GS: Estrogen receptor polymorphisms in tamoxifen-treated women with breast cancer. Gynecol Endocrinol; 2006 Apr;22(4):185-9
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  • [Title] Estrogen receptor polymorphisms in tamoxifen-treated women with breast cancer.
  • In postmenopausal women with estrogen receptor (ER)-positive breast cancer, long-term tamoxifen administration has proved beneficial after surgical treatment and subsequent chemotherapy.
  • One of the major adverse effects of tamoxifen is the development of endometrial pathology (polyps, endometrial hyperplasia and endometrial cancer).
  • PvuII and XbaI polymorphisms of the estrogen receptor-alpha gene (ERalpha) and RsaI and AluI polymorphisms of the estrogen receptor-beta gene (ERbeta) have been associated with breast cancer.
  • Thus the present study aimed to identify whether ER gene polymorphisms are associated with breast cancer stage or endometrial responsiveness to long-term tamoxifen treatment in 87 postmenopausal, tamoxifen-treated women with ER-positive breast cancer.
  • The mean age of the patients was 58.7 +/- 4.7 years and the mean duration of tamoxifen treatment was 3.9 +/- 1.1 years.
  • At diagnosis, the stage of breast cancer was determined as follows: 29 women (32%) at Stage I, 49 (58%) at Stage II and 9 (10%) at Stage III.
  • The frequency distributions of the estrogen receptor polymorphisms in all women with breast cancer were not different from those predicted by the Hardy-Weinberg equilibrium hypothesis (p > 0.10).
  • None of the ER polymorphisms studied was linked to either the presence of endometrial pathology or the stage of breast cancer.
  • [MeSH-major] Breast Neoplasms / genetics. Endometrium / pathology. Estrogen Receptor alpha / genetics. Estrogen Receptor beta / genetics. Polymorphism, Genetic / genetics. Selective Estrogen Receptor Modulators / adverse effects. Tamoxifen / adverse effects
  • [MeSH-minor] Endometrial Neoplasms / etiology. Endometrial Neoplasms / pathology. Female. Genetic Predisposition to Disease. Humans. Middle Aged. Neoplasm Staging / adverse effects

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  • (PMID = 16723304.001).
  • [ISSN] 0951-3590
  • [Journal-full-title] Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology
  • [ISO-abbreviation] Gynecol. Endocrinol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Estrogen Receptor alpha; 0 / Estrogen Receptor beta; 0 / Selective Estrogen Receptor Modulators; 094ZI81Y45 / Tamoxifen
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6. Gocheva L, Slavchev B: Whole abdominal irradiation in endometrial cancer - a single institution study. J BUON; 2009 Oct-Dec;14(4):613-8
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  • [Title] Whole abdominal irradiation in endometrial cancer - a single institution study.
  • PURPOSE: To examine the use of whole abdominal irradiation (WAI) open field technique in patients with stage III endometrial cancer (EC).
  • METHODS: Between 1993 and 2007, 26 patients (age 39-70 years, median 58) with stage III EC (IIIA 15, IIIB 2, IIIC 8) were treated with WAI after primary surgery.
  • In 84% of the patients WAI consisted of 30 Gy, delivered mainly in daily fractions of 1.5 Gy (81%), 5 fractions per week.
  • For the remaining patients the dose was 25 Gy (8%) and 20 Gy (8%), respectively.
  • After abdominal RT, 85% of the patients were given a pelvic boost to reach 45 - 50 Gy with 1.8 Gy/fraction/day, using a Co 60 unit.
  • In 5 (19%) patients boost to 45-50 Gy with 1.8 Gy/fraction/day to other risk sites was also given.
  • Two (8%) of 26 patients received 2 cycles of platinum-based chemotherapy.
  • The mean follow-up time was 13.41 years.
  • RESULTS: The treatment time ranged from 14-74 days, median 48.
  • Ten (38.5%) patients received their treatment with no interruption, and in 16 (61.5%) patients RT was transiently interrupted because of acute gastrointestinal and hematological toxicity.
  • Neither grade 4 acute complications nor mortality while receiving treatment were observed.
  • Late side effects (grade 2 gastrointestinal complications) developed in 1 (5%) patient.
  • CONCLUSION: WAI achieves a quite favorable 5- and 14-year survival rate with an acceptable risk of acute and late side effects in properly selected patients with stage III EC.
  • WAI as a sole or a part of combined treatment warrants further investigation in patients with high-risk EC.
  • [MeSH-major] Abdomen / radiation effects. Adenocarcinoma / radiotherapy. Endometrial Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Female. Humans. Middle Aged. Neoplasm Staging. Prognosis. Radiotherapy Dosage. Survival Rate. Treatment Outcome

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  • (PMID = 20148451.001).
  • [ISSN] 1107-0625
  • [Journal-full-title] Journal of B.U.ON. : official journal of the Balkan Union of Oncology
  • [ISO-abbreviation] J BUON
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] Greece
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7. 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.
  • 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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8. Ivanov SI: [Modern tendencies in treatment of endometrial cancer stage III C]. Akush Ginekol (Sofiia); 2008;47(3):29-31
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  • [Title] [Modern tendencies in treatment of endometrial cancer stage III C].
  • OBJECTIVE: The aim of our research work was to evaluate the potential of treatment in patients with endometrial cancer stage IIIC, with positive enlarged lymph nodes.
  • MATERIAL AND METHODS: 102 patients with endometrial cancer stage IIIC were researched for the period of 1990 till 2008.
  • In 30 patients--postoperative paraaortal radiotherapy, and 25 patients was applied postoperative chemotherapy.
  • In multivariation analysis, the independent prognostic factors were: the size of the lymph node, the residual tumour/metastatic lymph nodes/--p < 0,001, the age < 65 years--p = 0,001, and the implementation of adjuvant chemotherapy/p = 0,016/.
  • CONCLUSIONS: In patients with endometrial cancer stage IIIC, the resection/debulking/ of macroscopic enlarged lymph nodes and the implementation of adjuvant chemotherapy in addition to radiotherapy is connected with better survival rate.
  • [MeSH-major] Endometrial Neoplasms / pathology. Endometrial Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Chemotherapy, Adjuvant. Disease-Free Survival. Female. Humans. Kaplan-Meier Estimate. Lymphatic Metastasis. Middle Aged. Neoplasm Staging. Proportional Hazards Models. Radiotherapy, Adjuvant. Retrospective Studies

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  • (PMID = 18756829.001).
  • [ISSN] 0324-0959
  • [Journal-full-title] Akusherstvo i ginekologii︠a︡
  • [ISO-abbreviation] Akush Ginekol (Sofiia)
  • [Language] bul
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Bulgaria
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9. 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.
  • 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.
  • Of 25 patients examined by CT/MRI, pelvic masses were found in 13 cases and enlarged uterus in 11 cases.
  • All 15 patients who underwent endometrial biopsies were proven to have endometrial carcinomas.
  • 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.
  • 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-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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10. Nguyen NP, Sallah S, Karlsson U, Vos P, Ludin A, Semer D, Tait D, Salehpour M, Jendrasiak G, Robiou C: Prognosis for papillary serous carcinoma of the endometrium after surgical staging. Int J Gynecol Cancer; 2001 Jul-Aug;11(4):305-11
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  • [Title] Prognosis for papillary serous carcinoma of the endometrium after surgical staging.
  • BACKGROUND: To investigate the pattern of failure and the prognosis following pathological staging for uterine papillary serous carcinoma (UPSC).
  • Two patients with advanced disease received chemotherapy only.
  • Two patients with early-stage disease were followed without further treatment.
  • RESULTS: Seven patients (32%) developed distant metastases, three out of seven (42%) after WART.
  • Four out of seven patients who had distant metastases died from disease progression during subsequent chemotherapy.
  • All patients with distant metastases had locally advanced-stage disease at presentation (six stage III, one stage IV).
  • Four patients with pelvic recurrences developed concurrent (2) and subsequent (2) distant metastases.
  • No patient with early stage-disease (stage I and II) died from disease progression.
  • CONCLUSION: Pathological staging should be performed for all patients with UPSC to determine the prognosis as well as to tailor the treatment.
  • The role of abdominal irradiation in the treatment of UPSC is yet to be determined; however, such an approach may not be necessary for the control of disease for patients with early-stage (I and II) disease.
  • Patients with locally advanced-stage (stage III) disease are at risk of local regional failures and distant metastases despite WART.
  • Therefore, the benefit of WART for advanced-stage disease is also questionable.
  • Paclitaxel-based chemotherapy is currently being investigated in this setting.
  • [MeSH-major] Carcinoma, Papillary / mortality. Carcinoma, Papillary / pathology. Endometrial Neoplasms / mortality. Endometrial Neoplasms / pathology
  • [MeSH-minor] Aged. Aged, 80 and over. Female. Humans. Middle Aged. Neoplasm Staging. North Carolina. Prognosis. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • (PMID = 11520370.001).
  • [ISSN] 1048-891X
  • [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
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11. Sakuragi N, Hareyama H, Todo Y, Yamada H, Yamamoto R, Fujino T, Sagawa T, Fujimoto S: Prognostic significance of serous and clear cell adenocarcinoma in surgically staged endometrial carcinoma. Acta Obstet Gynecol Scand; 2000 Apr;79(4):311-6
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  • [Title] Prognostic significance of serous and clear cell adenocarcinoma in surgically staged endometrial carcinoma.
  • BACKGROUND: The serous adenocarcinoma (SA) and clear cell adenocarcinoma (CCA) of endometrium have been shown to be associated with high relapse rate and poor survival.
  • It is not clear whether prognostic significance of these specific cell types of tumor is independent of retroperitoneal lymph node metastasis and other histopathologic prognostic factors in endometrial carcinoma.
  • METHODS: We examined 240 consecutive patients with clinical stage I to stage III endometrial carcinoma who were treated prospectively with radical surgery and/or platinum-based chemotherapy.
  • Of 216 clinically staged stage I or II disease, seven of 12 cases of SA/CCA had extrauterine disease.
  • A multivariate Cox regression analysis revealed that cell type, grade, LVSI, and paraaortic node metastasis (PANM) were independent prognosticators.
  • CONCLUSIONS: Prognosis of patients with endometrial carcinoma depends on cell type, grade, LVSI, and PANM.
  • [MeSH-major] Adenocarcinoma, Clear Cell / secondary. Cystadenocarcinoma, Serous / secondary. Endometrial Neoplasms / pathology. Lymph Nodes / pathology. Neoplasm Recurrence, Local

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  • (PMID = 10746848.001).
  • [ISSN] 0001-6349
  • [Journal-full-title] Acta obstetricia et gynecologica Scandinavica
  • [ISO-abbreviation] Acta Obstet Gynecol Scand
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] DENMARK
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12. Miyagi E, Onose R, Ochiai K, Nozawa S, Noda K, Japan Multicenter Study Group: Phase II trial of paclitaxel in patients with adenocarcinoma of endometrium. J Clin Oncol; 2004 Jul 15;22(14_suppl):5121

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Phase II trial of paclitaxel in patients with adenocarcinoma of endometrium.
  • : 5121 Background: The antitumor activity and safety of paclitaxel monotherapy in patients (pts) with endometrial cancer still remain to be clarified.
  • METHODS: Eligibility criteria included: advanced or recurrent histopathologically proven endometrial adenocarcinoma with measurable lesion(s), age between 20 and 75, ECOG PS 2 or less, adequate organ functions, and written informed consent.
  • No more than one regimen of prior chemotherapy was allowed.
  • Pts characteristics include: endometrioid adenocarcinoma (15), adenoacanthoma (2), serous adenocarcinoma (2), clear cell adenocarcinoma (2), adenosquamous carcinoma (1) and mixed adenocarcinoma (1), Stage III/Stage IV/Recurrent = 2/4/17, PS 0/1/2 = 14/7/2.
  • Thirteen pts had received prior chemotherapy.
  • All adverse reactions were successfully managed by prolonging treatment interval, dose reduction, interrupting administration, discontinuation, and/or administration of G-CSF.
  • Four pts discontinued treatment due to toxicity.
  • CONCLUSIONS: The results suggest that three-hour intravenous infusion of paclitaxel 210 mg/m2 is well-tolerated and active therapy for advanced or recurrent endometrial cancer, and is worthy of further study in combination with carboplatin.

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  • (PMID = 28016767.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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13. 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 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

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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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14. Terada T: KIT-positive primary small cell carcinoma of the endometrium: a case report with immunohistochemical and molecular genetic analysis of KIT and PDGFRA genes. Arch Gynecol Obstet; 2010 Oct;282(4):413-6
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  • [Title] KIT-positive primary small cell carcinoma of the endometrium: a case report with immunohistochemical and molecular genetic analysis of KIT and PDGFRA genes.
  • BACKGROUND: Primary small cell carcinoma of the endometrium is very rare, and there have been no reports on KIT and PDGFRA in endometrial small cell carcinoma.
  • Endometrial cytology and biopsy revealed small cell carcinoma.
  • Scrutiny of the body showed stage III endometrial carcinoma with metastases.
  • The patient received chemotherapy and radiation, but showed a downhill course, and died of carcinomatosis 6 months after the initial presentation.
  • CONCLUSION: The present case is the first reported case of primary small cell carcinoma of the endometrium with an examination of KIT and PDGFRA expressions and KIT and PDFGRA gene mutations.
  • [MeSH-major] Carcinoma, Small Cell / genetics. Endometrial Neoplasms / genetics. Proto-Oncogene Proteins c-kit / genetics. Receptor, Platelet-Derived Growth Factor alpha / genetics
  • [MeSH-minor] Aged, 80 and over. Biopsy. DNA Mutational Analysis. Drug Therapy. Fatal Outcome. Female. Humans. Immunohistochemistry. Polymerase Chain Reaction. Radiotherapy

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  • (PMID = 20035340.001).
  • [ISSN] 1432-0711
  • [Journal-full-title] Archives of gynecology and obstetrics
  • [ISO-abbreviation] Arch. Gynecol. Obstet.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] EC 2.7.10.1 / Proto-Oncogene Proteins c-kit; EC 2.7.10.1 / Receptor, Platelet-Derived Growth Factor alpha
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15. Emons G, Heyl W: Hormonal treatment of endometrial cancer. J Cancer Res Clin Oncol; 2000 Nov;126(11):619-23
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Hormonal treatment of endometrial cancer.
  • In developed western countries endometrial cancer is the most common malignant tumor of the female genital tract.
  • 75% of cases are diagnosed in stage I where cure rates of 75-90% are achieved.
  • In stage II, 5-year survival rates amount only to 50%, in stage III up to 30%, and in stage IV to less than 10%.
  • Despite the preponderance of early stage endometrial cancer, about 20-30% of affected patients will die from this disease.
  • As surgical treatment and/or irradiation are not able to control advanced disease, many investigators have been searching for systemic treatment modalities.
  • Cytotoxic chemotherapy achieves high initial response rates of about 40-60%.
  • As endometrial cancer develops from hormone dependent cells, endocrine treatment has been the traditional palliative therapy of advanced tumor stages.
  • Several studies to date have failed to demonstrate an efficacy of adjuvant hormonal therapy in cases of high-risk endometrial cancer.
  • For the conservative treatment of precancerous, non-invasive hyperplastic lesions of the endometrium, endocrine therapies have been shown to be efficacious.
  • [MeSH-major] Antineoplastic Agents, Hormonal / therapeutic use. Endometrial Neoplasms / drug therapy
  • [MeSH-minor] Female. Humans. Neoplasms, Hormone-Dependent / drug therapy. Palliative Care

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  • (PMID = 11079725.001).
  • [ISSN] 0171-5216
  • [Journal-full-title] Journal of cancer research and clinical oncology
  • [ISO-abbreviation] J. Cancer Res. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] GERMANY
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal
  • [Number-of-references] 30
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16. Hoogendoorn WE, Hollema H, van Boven HH, Bergman E, de Leeuw-Mantel G, Platteel I, Fles R, Nederlof PM, Mourits MJ, van Leeuwen FE, Comprehensive Cancer Centers TAMARISK-group: Prognosis of uterine corpus cancer after tamoxifen treatment for breast cancer. Breast Cancer Res Treat; 2008 Nov;112(1):99-108
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  • [Title] Prognosis of uterine corpus cancer after tamoxifen treatment for breast cancer.
  • Tamoxifen increases the risk of uterine corpus cancer.
  • Since only few, mostly small, studies have examined prognosis of uterine corpus cancer following tamoxifen, we conducted a large retrospective cohort study to further investigate this.
  • We examined histopathologic and immunohistochemical characteristics of 332 patients with uterine corpus cancer following breast cancer, according to tamoxifen use.
  • An increased proportion of FIGO stage III and IV tumors was also observed (20.0% vs. 11.3%, P=0.049).
  • Within FIGO stage I, both short-term and long-term tamoxifen users showed a higher proportion of tumors limited to the endometrium than non-users (35.7% vs. 22.9%, P=0.049 and 0.004 respectively).
  • Uterine corpus cancers in long-term tamoxifen users were more often steroid receptor-negative (ERalpha, PRA and PRB, P<0.05) and P53-positive (P=0.015).
  • Three-year uterine corpus cancer-specific survival was worse for long-term tamoxifen users than for non-users (82% vs. 93% P=0.0001).
  • Our results can be applied when weighing risks and benefits of tamoxifen versus other hormonal agents used in the prevention and treatment of breast cancer.
  • [MeSH-major] Antineoplastic Agents, Hormonal / therapeutic use. Breast Neoplasms / drug therapy. Tamoxifen / therapeutic use. Uterine Neoplasms / diagnosis
  • [MeSH-minor] Adenocarcinoma, Clear Cell / chemically induced. Adenocarcinoma, Clear Cell / diagnosis. Adenocarcinoma, Clear Cell / mortality. Aged. Cohort Studies. Cystadenocarcinoma, Serous / chemically induced. Cystadenocarcinoma, Serous / diagnosis. Cystadenocarcinoma, Serous / mortality. Endometrial Neoplasms / chemically induced. Endometrial Neoplasms / diagnosis. Endometrial Neoplasms / mortality. Female. Follow-Up Studies. Humans. Immunoenzyme Techniques. Middle Aged. Neoplasm Staging. Neoplasms, Second Primary / chemically induced. Neoplasms, Second Primary / diagnosis. Prognosis. Retrospective Studies. Risk Factors. Sarcoma / chemically induced. Sarcoma / diagnosis. Sarcoma / mortality. Survival Rate

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  • (PMID = 18064567.001).
  • [ISSN] 0167-6806
  • [Journal-full-title] Breast cancer research and treatment
  • [ISO-abbreviation] Breast Cancer Res. Treat.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 094ZI81Y45 / Tamoxifen
  • [Investigator] Visser O; Damhuis RA; Louwman WJ; van Dijck JA; Westerman Y; Dirx MJ; Jansen-Landheer ML; de Munck L; Siesling S
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17. Bergman L, Beelen ML, Gallee MP, Hollema H, Benraadt J, van Leeuwen FE: Risk and prognosis of endometrial cancer after tamoxifen for breast cancer. Comprehensive Cancer Centres' ALERT Group. Assessment of Liver and Endometrial cancer Risk following Tamoxifen. Lancet; 2000 Sep 9;356(9233):881-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Risk and prognosis of endometrial cancer after tamoxifen for breast cancer. Comprehensive Cancer Centres' ALERT Group. Assessment of Liver and Endometrial cancer Risk following Tamoxifen.
  • BACKGROUND: Tamoxifen increases the risk of endometrial cancer.
  • However, few studies have produced reliable risk estimates by duration, dose, and recency of use, or addressed the prognosis of endometrial cancers in tamoxifen-treated women.
  • METHODS: We did a nationwide case-control study on the risk and prognosis of endometrial cancer after tamoxifen use for breast cancer.
  • Information on tamoxifen use and other risk factors for endometrial cancer was obtained from 309 women with endometrial cancer after breast cancer (cases), and 860 matched controls with breast cancer but without endometrial cancer.
  • For 276 cases, we obtained tissue blocks of endometrial cancer to review the diagnosis, and used immunohistochemistry to examine hormone-receptor status and overexpression of p53.
  • Risk of endometrial cancer increased with longer duration of tamoxifen use (p < 0.001), with relative risks of 2.0 (1.2-3.2) for 2-5 years and 6.9 (2.4-19.4) for at least 5 years compared with non-users.
  • Endometrial cancers of stage III and IV occurred more frequently in long-term tamoxifen users (> or = 2 years) than in non-users (17.4% vs 5.4%, p=0.006).
  • Long-term users were more likely than non-users to have had malignant mixed mesodermal tumours or sarcomas of the endometrium (15.4% vs 2.9%, p < or = 0.02), p53-positive tumours (31.4% vs 18.2%, p=0.05), and negative oestrogen-receptor concentrations (60.8% vs 26.2%, p < or = 0.001).
  • 3-year endometrial-cancer-specific survival was significantly worse for long-term tamoxifen users than for non-users (76% for > or = 5 years, 85% for 2-5 years vs 94% for non-users, p=0.02).
  • INTERPRETATION: Long-term tamoxifen users have a worse prognosis of endometrial cancers, which seems to be due to less favourable histology and higher stage.
  • However, the benefit of tamoxifen on breast-cancer survival far outweighs the increased mortality from endometrial cancer.
  • Nevertheless, we seriously question widespread use of tamoxifen as a preventive agent against breast cancer in healthy women.
  • [MeSH-major] Antineoplastic Agents, Hormonal / therapeutic use. Breast Neoplasms / drug therapy. Endometrial Neoplasms / chemically induced. Estrogen Antagonists / therapeutic use. Tamoxifen / therapeutic use
  • [MeSH-minor] Aged. Case-Control Studies. Female. Gene Expression Regulation, Neoplastic. Humans. Middle Aged. Neoplasm Staging. Prognosis. Proportional Hazards Models. Receptors, Estrogen / analysis. Risk Assessment. Risk Factors. Survival Rate. Time Factors. Tumor Suppressor Protein p53 / genetics

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  • [CommentIn] Lancet. 2001 Jan 6;357(9249):65-6; author reply 67 [11197376.001]
  • [CommentIn] Lancet. 2001 Jan 6;357(9249):66-7 [11197379.001]
  • [CommentIn] Lancet. 2001 Jan 6;357(9249):68 [11197381.001]
  • [CommentIn] Lancet. 2001 Jan 6;357(9249):68 [11197382.001]
  • [CommentIn] Lancet. 2000 Sep 9;356(9233):868-9 [11036885.001]
  • [CommentIn] Lancet. 2001 Jan 6;357(9249):67-8 [11197380.001]
  • (PMID = 11036892.001).
  • [ISSN] 0140-6736
  • [Journal-full-title] Lancet (London, England)
  • [ISO-abbreviation] Lancet
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] ENGLAND
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Estrogen Antagonists; 0 / Receptors, Estrogen; 0 / Tumor Suppressor Protein p53; 094ZI81Y45 / Tamoxifen
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18. 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

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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19. Sinawat S, Chiyabutra T: Endometrial thickening in postmenopausal breast cancer patients taking tamoxifen: a cross-sectional study. J Med Assoc Thai; 2004 Oct;87 Suppl 3:S59-63
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  • [Title] Endometrial thickening in postmenopausal breast cancer patients taking tamoxifen: a cross-sectional study.
  • OBJECTIVE: To determine the prevalence of endometrial thickening (endometrial thickness > 5 mm) in postmenopausal breast cancer patients taking tamoxifen.
  • SUBJECTS: Total of 37 postmenopausal breast cancer patients receiving 20-40 mg/day of tamoxifen treatment for at least 6 months were included in the study.
  • The mean age at diagnosis of breast cancer was 51.84 years.
  • The majority of patients (75.68%) had stage II disease while the rest of patients were diagnosed with stage III (16.22%), I (5.40%) and IV (2.70%), respectively.
  • The mean +/- SD of endometrial thickness (ET) found in this study was 7.53 +/- 5.16 mm.
  • The prevalence of thickened endometrium (defined as ET > 5 mm from TVS) was 59.46%.
  • Other pelvic pathologies detected by ultrasonography were multiple small hypoechogenic areas in the endometrium (32.43%), and myoma uteri (5.41%).
  • CONCLUSION: The prevalence of thickened endometrium in postmenopausal breast cancer patients taking tamoxifen found in this study was extraordinarily high.
  • Therefore it seems to be justified to propose a transvaginal ultrasound screening in all postmenopausal breast cancer patients taking tamoxifen to detect endometrial thickening and possibly pathologies which could be resulted from tamoxifen treatment.
  • [MeSH-major] Antineoplastic Agents, Hormonal / adverse effects. Breast Neoplasms / drug therapy. Endometrium / drug effects. Postmenopause / physiology. Tamoxifen / adverse effects

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  • (PMID = 21218592.001).
  • [ISSN] 0125-2208
  • [Journal-full-title] Journal of the Medical Association of Thailand = Chotmaihet thangphaet
  • [ISO-abbreviation] J Med Assoc Thai
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Thailand
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 094ZI81Y45 / Tamoxifen
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20. Howell SJ, Johnston SR, Howell A: The use of selective estrogen receptor modulators and selective estrogen receptor down-regulators in breast cancer. Best Pract Res Clin Endocrinol Metab; 2004 Mar;18(1):47-66
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The use of selective estrogen receptor modulators and selective estrogen receptor down-regulators in breast cancer.
  • Tamoxifen is one of the most effective treatments for breast cancer through its ability to antagonize estrogen-dependent growth by binding estrogen receptors (ERs) and inhibiting proliferation of breast epithelial cells.
  • However, tamoxifen has estrogenic agonist effects in other tissues such as bone and endometrium due to liganded ER activating target genes in these different types of cell.
  • Several novel anti-estrogen compounds have been developed which have a reduced agonist profile on breast and gynaecological tissues.
  • In advanced breast cancer clinical data exist for two groups of agents: the selective estrogen receptor modulators (SERMs), further divided into "tamoxifen-like" (e.g. toremifene, droloxifene and idoxifene) and "fixed ring" compounds (e.g. raloxifene, arzoxifene and EM-800), and the selective estrogen receptor down-regulators (SERDs; e.g. fulvestrant (ICI 182780), SR 16234 and ZK 191703) also termed "pure anti-estrogens".
  • In phase II trials in tamoxifen-resistant metastatic breast cancer the SERMs show low objective response rates (range 0-15%), suggesting cross resistance with tamoxifen.
  • Randomized phase III trials for toremifene and idoxifene in over 1500 patients showed no significant difference compared with tamoxifen.
  • Fewer clinical data exist for the "fixed ring" SERMs and it remains unclear whether any clinical advantage exists for the "fixed ring" SERMs over tamoxifen as first-line therapy.
  • The main advantage for SERMs such as tamoxifen and raloxifene probably remains in early-stage disease (adjuvant therapy or prevention).
  • Of the SERDs, only fulvestrant has entered the clinic and this new agent is showing promising clinical activity in the treatment of advanced breast cancer.
  • Recently published phase III studies have shown fulvestrant to be at least as effective as the third-generation aromatase inhibitor anastrozole in patients whose disease has relapsed or progressed on prior endocrine therapy.
  • Surprisingly, however, in a phase III trial versus tamoxifen for the first-line therapy of advanced breast cancer fulvestrant did not attain the requirements for equivalence to tamoxifen, and in terms of time-to-treatment failure was inferior (5.9 versus 7.8 months for fulvestrant and tamoxifen, respectively; P=0.029).
  • Future clinical studies will evaluate fulvestrant in the neoadjuvant setting together with its optimal sequencing in relation to tamoxifen and other endocrine therapies in advanced disease.
  • [MeSH-major] Antineoplastic Agents, Hormonal / therapeutic use. Breast Neoplasms / drug therapy. Estrogen Antagonists / therapeutic use. Neoplasms, Hormone-Dependent / drug therapy. Selective Estrogen Receptor Modulators / therapeutic use
  • [MeSH-minor] Clinical Trials, Phase II as Topic. Down-Regulation / drug effects. Estrogens / metabolism. Evidence-Based Medicine / methods. Female. Humans. Receptors, Estrogen / metabolism

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  • (PMID = 14687597.001).
  • [ISSN] 1521-690X
  • [Journal-full-title] Best practice & research. Clinical endocrinology & metabolism
  • [ISO-abbreviation] Best Pract. Res. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Estrogen Antagonists; 0 / Estrogens; 0 / Receptors, Estrogen; 0 / Selective Estrogen Receptor Modulators
  • [Number-of-references] 130
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21. Johnston SR: Endocrine manipulation in advanced breast cancer: recent advances with SERM therapies. Clin Cancer Res; 2001 Dec;7(12 Suppl):4376s-4387s; discussion 4411s-4412s
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Endocrine manipulation in advanced breast cancer: recent advances with SERM therapies.
  • Tamoxifen is one of the most effective treatments for breast cancer through its ability to antagonize estrogen-dependent growth by binding estrogen receptors (ERs) and inhibiting breast epithelial cell proliferation.
  • However, tamoxifen has estrogenic agonist effects in other tissues such as bone and endometrium because of liganded ER-activating target genes in these different cell types.
  • Several novel antiestrogen compounds have been developed that are also selective ER modulators (SERMs) but that have a reduced agonist profile on breast and gynecological tissues.
  • In advanced breast cancer clinical data exist for three first-generation SERMs (toremifene, droloxifene, idoxifene), which are related to the triphenylethylene structure of tamoxifen.
  • As first-line therapy for advanced breast cancer, the median response rate was 31% (range, 20-68%) with a median time to progression of 7 months.
  • Randomized Phase III trials for toremifene and idoxifene in more than 1500 patients showed no significant difference compared with tamoxifen.
  • It remains unclear whether any clinical advantage exists for second- and third-generation SERMs over tamoxifen as first-line therapy.
  • With the emergence of potent aromatase inhibitors (AIs) that are superior to tamoxifen, the clinical questions in advanced disease have shifted to which antiestrogen (including SERMs) may be effective following failure of AIs, and whether any merit exists for combined AI/SERM therapy.
  • The main advantage for SERM therapy probably remains in early stage-disease (adjuvant therapy or prevention), in which the estrogenic effects on bone and reduced gynecological side effects may prove more beneficial than either tamoxifen or AI.
  • The issue is whether the current clinical data for SERMs in advanced breast cancer are sufficiently strong to encourage that further development.
  • [MeSH-major] Adenocarcinoma / drug therapy. Breast Neoplasms / drug therapy. Neoplasms, Hormone-Dependent / drug therapy. Selective Estrogen Receptor Modulators / therapeutic use
  • [MeSH-minor] Clinical Trials as Topic. Estrogens / metabolism. Female. Forecasting. Humans. Receptors, Estrogen / drug effects

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  • (PMID = 11916228.001).
  • [ISSN] 1078-0432
  • [Journal-full-title] Clinical cancer research : an official journal of the American Association for Cancer Research
  • [ISO-abbreviation] Clin. Cancer Res.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Estrogens; 0 / Receptors, Estrogen; 0 / Selective Estrogen Receptor Modulators
  • [Number-of-references] 119
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22. Adamian RT: [Therapy of atypical hyperplasia and adenocarcinoma of the endometrium with the combination of progestins and anticoagulants]. Vopr Onkol; 2001;47(3):359-62
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Therapy of atypical hyperplasia and adenocarcinoma of the endometrium with the combination of progestins and anticoagulants].
  • The data on clinical trials of newly-developed hormonotherapy of atypical hyperplasia (AH) and cervical adenocarcinoma (CAC) are presented.
  • The study included 34 patients with histologically--confirmed AH and 86--CAC (stage I-II and III-IV).
  • All patients were given preoperative "shock therapy" with a combination of progestins and anticoagulants: 500 mg, i.v., 10 days--(AH) and well-differentiated cell CAC; 20 days--moderately- and poorly-differentiated cell CAC.
  • For comparison, identical numbers of AH and CAC patients received similar preoperative progestin therapy without anticoagulants.
  • It was found that hormonotherapy used in conjunction with anticoagulants reinforced significantly all features of hormonal pathomorphosism both in AH and CAC stage I-II while, in well-differentiated cell adenocarcinoma, the difference from control was significant (p < 0.05).
  • [MeSH-major] Adenocarcinoma / drug therapy. Anticoagulants / therapeutic use. Antineoplastic Agents, Hormonal / therapeutic use. Endometrial Neoplasms / drug therapy. Endometrium / pathology. Progesterone Congeners / therapeutic use
  • [MeSH-minor] Drug Therapy, Combination. Estrogen Antagonists / therapeutic use. Female. Humans. Hydroxyprogesterones / therapeutic use. Hyperplasia / drug therapy. Medroxyprogesterone Acetate / therapeutic use. Neoplasm Staging. Treatment Outcome

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  • (PMID = 11544839.001).
  • [ISSN] 0507-3758
  • [Journal-full-title] Voprosy onkologii
  • [ISO-abbreviation] Vopr Onkol
  • [Language] rus
  • [Publication-type] Clinical Trial; English Abstract; Journal Article; Randomized Controlled Trial
  • [Publication-country] Russia
  • [Chemical-registry-number] 0 / Anticoagulants; 0 / Antineoplastic Agents, Hormonal; 0 / Estrogen Antagonists; 0 / Hydroxyprogesterones; 0 / Progesterone Congeners; 276F2O42F5 / 17-alpha-hydroxy-progesterone caproate; C2QI4IOI2G / Medroxyprogesterone Acetate
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23. Semiglazov VF, Maksimov SIa, Bulgatova EA, Meshkova IE, Chepik OF, Berstein LM: [Risk of endometrial hyperplasia and carcinoma in breast cancer patients receiving adjuvant tamoxifen]. Vopr Onkol; 2003;49(2):198-204
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Risk of endometrial hyperplasia and carcinoma in breast cancer patients receiving adjuvant tamoxifen].
  • The antiestrogen drug tamoxifen, which is widely used in adjuvant hormone therapy of breast cancer, presents certain risk of causing hyperplasia and endometrial carcinoma.
  • Our clinical data on 1,969 breast cancer patients (stage I-III) (tamoxifen--947; control--1,022) showed a double rise in endometrial carcinoma risk in cases receiving hormone therapy.
  • Endometrial carcinoma incidence in tamoxifen-treated patients was 3% while in the untreated ones--1.6% (p < 0.05).
  • According to the endometrial tissue study in 439 breast cancer patients, proliferative effect of tamoxifen in the form of endometrial hyperplasia was 5--6 times in tamoxifen users.
  • Meanwhile, endometrial carcinoma and hyperplasia risk increased during a much longer exposure to tamoxifen and in combination with such factors as obesity, diabetes mellitus, uterine myoma and estrogen-type colpocytological response.
  • Hence, breast cancer patients need to undergo dynamic follow-up of the endometrium including ultrasonic examination of the small-pelvis organs and cytological study of ecto- and endocervical smears and endometrial aspirates.
  • [MeSH-major] Antineoplastic Agents, Hormonal / adverse effects. Breast Neoplasms / drug therapy. Endometrial Neoplasms / chemically induced. Endometrium / drug effects. Estrogen Receptor Modulators / adverse effects. Tamoxifen / adverse effects

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  • (PMID = 12785205.001).
  • [ISSN] 0507-3758
  • [Journal-full-title] Voprosy onkologii
  • [ISO-abbreviation] Vopr Onkol
  • [Language] rus
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Russia
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Estrogen Receptor Modulators; 094ZI81Y45 / Tamoxifen
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24. Irvin WP, Rice LW, Berkowitz RS: Advances in the management of endometrial adenocarcinoma. A review. J Reprod Med; 2002 Mar;47(3):173-89; discussion 189-90

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Advances in the management of endometrial adenocarcinoma. A review.
  • Endometrial adenocarcinoma is the most common and curable gynecologic neoplasm; the five-year survival for women with surgical stage I disease ranges from 83% to 93%; stage II, 73%; stage III, 52%; and stage IV, 27%.
  • The absence of an asymptomatic latency phase amenable to detection through screening and the already excellent cure rates seen with early-stage disease have precluded the need for endometrial cancer screening programs.
  • Adenocarcinomas constitute 97% of endometrial cancers, with endometrioid the most common histologic subtype.
  • Two different pathways of endometrial carcinogenesis exist.
  • The use of oral contraceptives has consistently been shown to decrease the risk of developing endometrial carcinoma via this pathway, with 12 months or more of continuous use decreasing the lifetime risk by 40-50%.
  • The alternate pathway of endometrial carcinogenesis represents malignant transformation of atrophic endometrium and proceeds through endometrial intraepithelial carcinoma as the malignant precursor of the more virulent serous papillary and clear cell endometrial adenocarcinomas.
  • The staging of endometrial cancer (according to the International Federation of Obstetrics and Gynecology) is surgical.
  • Recent studies suggest a therapeutic benefit associated with extensive retroperitoneal lymph node evaluation to determine the disease extent and thereby more effectively direct potentially life-saving adjuvant therapy.
  • Adjuvant radiation therapy, known to have survival benefit in advanced-stage disease, may also have survival benefit in intermediate-risk surgical stage I disease on the basis of results recently released from a Gynecologic Oncology Group study.
  • The use of radiation therapy, systemic chemotherapy and hormonal therapy, alone or in combination, is recommended for primary advanced and recurrent disease.
  • [MeSH-major] Adenocarcinoma / radiotherapy. Adenocarcinoma / surgery. Endometrial Neoplasms / radiotherapy. Endometrial Neoplasms / surgery. Neoplasm Staging
  • [MeSH-minor] Chemotherapy, Adjuvant. Combined Modality Therapy. Female. Humans. Incidence. Radiotherapy, Adjuvant. Risk Factors

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  • (PMID = 11933681.001).
  • [ISSN] 0024-7758
  • [Journal-full-title] The Journal of reproductive medicine
  • [ISO-abbreviation] J Reprod Med
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 126
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