Predictors of distant recurrence in clinical stage I or II endometrial carcinoma treated by combination surgical and radiation therapy.

A retrospective analysis of 201 patients with clinical Stage I or II endometrial carcinoma treated by combined surgery and radiation therapy from January 1976 to December 1992 is reported. The aim of the study was to determine predictors, if any, for distant recurrence. Twenty-eight patients (13.9%) in our series developed a recurrence. The most common sites were peritoneal carcinosis (28.6%), bones (28.6%), and lungs (21.4%). Seventy-eight percent appeared within 3 years, and actuarial survival rates at 12, 36, and 60 months after recurrence were 39.2, 14.2, and 7.1%, respectively. An analysis of predictive factors significant for the development of distant recurrence was performed. Significant factors by univariate analysis were age (P = 0.019), stage (P = 0.02), grade (P = 0.014), depth of myometrial invasion (P = 0.007), lymph node involvement (P < 0.001), and peritoneal cytology (P = 0.006). A multivariate analysis of these variables showed that lymph node involvement was the strongest predictor for distant recurrence.

[Stage I and II endometrial cancer: should lymphadenectomy still be done?]. / Cancer de l'endomètre stades I et II: faut-il encore effectuer des lymphadénectomies?

Surgical treatment for endometrial carcinomas stage I and II is radical hysterectomy. The role of lymphadenectomy (pelvic and paraaortic) is under discussion. From a retrospective study (multivariate analysis of 320 patients treated by radiosurgical association) and a review of the literature, the authors limit the indications of lymphadenectomy to stage I grade 1 or 2 tumours and without deep tumours invasion into the myometrium (in that case only 10% of pelvic nodes will be involved). Stage II patients or stage I with grade 3 and/or deep tumour invasion into the myometrium do not require lymphadenectomy as post-operative pelvic external beam irradiation will be performed in all cases. Para-aortic lymphadenectomy is not useful as it increases morbidity and the adjuvant treatment in case of lymph node involvement does not improve the survival rate.

3-aminopyridazine derivatives with atypical antidepressant, serotonergic, and dopaminergic activities.

Minaprine [3-[(beta-morpholinoethyl)amino]-4-methyl-6-phenylpyridazine dihydrochloride] is active in most animal models of depression and exhibits in vivo a dual dopaminomimetic and serotoninomimetic activity profile. In an attempt to dissociate these two effects and to characterize the responsible structural requirements, a series of 47 diversely substituted analogues of minaprine were synthesized and tested for their potential antidepressant, serotonergic, and dopaminergic activities. The structure-activity relationships show that dopaminergic and serotonergic activities can be dissociated. Serotonergic activity appears to be correlated mainly with the substituent in the 4-position of the pyridazine ring whereas the dopaminergic activity appears to be dependent on the presence, or in the formation, of a para-hydroxylated aryl ring in the 6-position of the pyridazine ring.