Effect of adenomyosis on prognosis of patients with endometrial cancer

SUMMARY OBJECTIVE: Our goal was to contrast the prognoses of patients with endometrial cancer who had adenomyosis against those that did not. METHODS: All patients who had received surgical staging for hysterectomy-based endometrial cancer had their medical data retrospectively examined. The analysis covered 397 patients, who were split into two groups depending on the presence of adenomyosis. Comparisons were made between patients covering type of surgery, histopathology, endometrial cancer stage, lymphovascular space invasion, presence of biochemical or histochemical markers, adjuvant therapy, presence of adenomyosis in the myometrial wall, and outcomes in terms of overall survival and disease-free survival. RESULTS: There is no statistically significant difference in the 5-year disease-free survival or overall survival rates between endometrial cancer patients with and without adenomyosis. This is based on comparisons of tumor stage, tumor diameter, histological type and grade of tumor, myometrial invasion, lymphovascular space invasion, and biochemical markers that affect the course of the disease. The median follow-up times were 61 months for the adenomyosis-positive group and 56 months for the group without adenomyosis. CONCLUSION: Coexisting adenomyosis in endometrial cancer has no bearing on survival rates and is not a prognostic factor.

Preoperative Serum CA 125 is Associated With Myometrial and Cervical Invasion in Endometrial Carcinoma

@#Introduction: Endometrial carcinoma is the most common gynaecological malignancy in developed countries and the sixth most common cancer among women worldwide. Cancer staging is vital in treatment decisions and the prediction of prognoses, and is based on imaging studies, histological results and surgery. Therefore, a simple and fast preoperative tool to predict the precise cancer stage of patients is needed. CA 125, a cancer antigen, is used in assessing therapeutic response and cancer surveillance in endometrial carcinoma. However, this tumour marker is not routinely performed in the mentioned circumstances. Studies have shown that preoperative CA 125 was significantly high in patients in a higher stage of endometrial cancer. Thus, this study aims to assess the primary role of CA 125 in predicting the stage of endometrial carcinoma, by correlating preoperative serum CA 125 with clinicopathological parameters. Method: The retrospective data of endometrial carcinoma cases consisting of demographic and clinicopathological parameters as well as preoperative serum CA 125 levels were retrieved from Laboratories Information System (LIS) at Hospital Selayang, Selangor, Malaysia, from January 2000 until June 2016. Only 20 cases fulfilled the inclusion and exclusion criteria. Preoperative serum CA 125 was correlated with demographic and clinicopathological parameters, and was analysed using a Kruskal-Wallis test. Results: There was a significant association between elevated serum CA 125 with myometrial and cervical stroma invasion in endometrial carcinoma (p<0.05). Conclusion: Preoperative serum CA 125 is a useful marker in predicting early stages of endometrial carcinoma, and plays a role in pre-operative cancer staging in endometrial carcinoma.

The significance of sonographically thickened endometrium in asymptomatic postmenopausal women

OBJECTIVE: To investigate the correlation between sonographic, hysteroscopic, and pathological findings in postmenopausal asymptomatic patients with sonographically thickened endometrium. METHODS: The records of postmenopausal patients who attended the Menopause Outpatient Clinic of a tertiary women's hospital in Ankara, Turkey between January 1, 2012 and December 15, 2013 were retrieved. A total of 266 postmenopausal women without vaginal bleeding underwent hysteroscopic evaluation and endometrial sampling. Patients whose pathological records indicated an endometrial thickness equal to or greater than 6 mm (double layer) on transvaginal ultrasonography without any symptoms were included in the study. RESULTS: The most frequently detected focal intrauterine lesions in asymptomatic women were endometrial polyps, which were diagnosed in 168 (63.1%) cases. Twenty-four (9%) patients were diagnosed as having simple hyperplasia, 4 (1%) atypical hyperplasia, and 8 (3%) endometrial adenocarcinoma. Two of the patients with adenocarcinoma were diagnosed based on endometrial polyps, and 6 cases showed endometrial hyperplasia on hysteroscopy, while histological examination showed endometrial carcinoma. CONCLUSION: We suggest 10.5 mm as the cutoff value for endometrial thickness and recommend hysteroscopy following dilatation and curettage to increase diagnostic efficacy and provide definitive treatment in asymptomatic postmenopausal women with thickened endometrium.

Treatment outcome and prognostic factors in intermediate risk stage I endometrial carcinoma.

Introducton: The aim of this study was to evaluate the clinical characteristics, post-surgery adjuvant treatment approach and posttreatment disease course in patients with intermediate risk stage I endometrium cancer and also to assess the effects of known prognostic factors on this group of patients. Patients and Methods: A total of 148 patients followed up postoperatively or after adjuvant treatment between 1996 and 2007 were evaluated retrospectively. Median follow-up duration was 67 months (range: 7-166). Among the study population 14.9% had Ib and 83.1% had stage Ic disease. 72 were treated by external beam radiotherapy (EBRT), 7 by intracavitary radiotherapy (ICRT), 65 by external + intracavitary radiotherapy (EBRT + ICRT), and one by chemoradiotherapy (CRT). Results: Vaginal vault is found to be the most common site of recurrences. Five and 10-year local control (LC) rates were 96.6% and 95.9%, respectively, while 5 and 10-year distant control (DC) rates were 94.6% and 91.9%, respectively. One, 5 and 10-year overall survival rates (OS) were 99.3%, 87.6% and 71.2%, respectively, while 1, 5 and 10-year progression-free survival rates (PFS) were 97.3%, 87.6% and 71.2%, respectively. Univariate analysis has revealed that prognostic factors as age (P = 0.0001), menopausal status (P = 0.049) and EBRT duration (P = 0.003) statistically significantly affected OS; while age (P = 0.0001) and EBRT duration (P = 0.006) affected PFS. Multivariate analysis has revealed that only age (P = 0.001) (P = 0.0001) and ERT duration (P = 0.021) (P = 0.027) affected both OS and PFS. Conclusion: LC and OS rates are high in the intermediate risk group. Age over 60 years and EBRT duration of 35 days and over both have negative effects on outcome in this group.

Effect of pseudo CO_2 pneumoperitoneum on cell adhesion capability of cultured endometrium cancer cells / 第三军医大学学报

Objective To investigate the effect of CO2 pneumoperitoneum on the cell adhesion capability of cultured endometrium cancer cells.Methods After treated in a pneumoperitoneum model for 4 h,the changes in cell growth and adhesion of the endometrium cancer were detected by MTT.The expression of ?1-integrin and E-cadherin in the cancer cells were compared with the control that were not treated with CO2,by the immunohistochemical method.Results After treated with CO2 for 4 h,the cell growth was enhanced and the cell adhesion capability increased as compared with the control group.At the same time,the expression of ?1-integrin and E-cadherin was lower in treated cells than that in untreated ones.Conclusion The adhesion capability of endometrium cancer cells in CO2 pneumoperitoneum could be enhanced by the reduction of the expression of ?1-integrin and E-cadherin,and thereby influences the metastasis of cancer.