ABSTRACT
An analysis of 155 patients with endometrial carcinoma, first seen more than five years ago, shows that 31 per cent died with tumour. Trans-coelomic spread of tumour was the most frequent cause of death and occurred in 13.6 per cent of all patients and in 17.1 per cent of those who were operable. A second important cause of death was haematogenous spread of tumour (6.5 per cent). Local pelvic recurrence was the cause of death in 25 per cent of those who did not survive, and local spread was found in 2.2 per cent of operable patients. A rational approach to therapy for endometrial carcinoma is suggested.
Subject(s)
Neoplasm Metastasis , Uterine Neoplasms/pathology , Female , Humans , Hysterectomy , Neoplasm Recurrence, Local/pathology , Uterine Neoplasms/radiotherapy , Uterine Neoplasms/surgeryABSTRACT
An analysis has been made of all the patients with endometrial carcinoma who were seen in our department between 1959 and 1968. A total of 155 patients with a minimum follow-up period of 5 years were evaluated. About 20% of the patients who die, do so more than 5 years after diagnosis and treatment of the primary cancer. A disconcertingly high incidence of death from active tumours is found when patients are followed up for long enough, i.e. 1 in 3 patients who do not die of intercurrent disease. Late deaths are even caused by poorly-differentiated tumours, and also by haematogenous spread. When the results of different treatment regimens are compared, it will thus be necessary to take 10-year survival rates into account.
Subject(s)
Uterine Neoplasms/mortality , Aged , Female , Follow-Up Studies , Humans , Middle Aged , Neoplasm Metastasis , Neoplasm Recurrence, Local/mortality , Uterine Neoplasms/radiotherapy , Uterine Neoplasms/surgeryABSTRACT
An analysis of 78 patients with surgical stage 1 adenocarcinoma of the endometrium reveals that several factors influence the prognosis. Differentiation of the tumour, and the depth of the uterine cavity, play a role, but a depth of 10 cm seems to be of greater assistance in prognostication than one of 8 cm. The menopausal state is very important, since not one patient who was less than 5 years postmenopausal died from carcinoma, and the majority who developed metastases were between 5 and 10 years postmenopausal. Prognosis did seem to be dependent on age, since the group aged between 60 and 70 years had the worst prognosis. Crude survival figures are useless for determining prognostic factors, and an analysis of patients dying from carcinoma must be made. That definite factors besides the method of treatment affect the survival of patients, makes it virtually impossible to make an accurate comparison of survival figures in different series.
Subject(s)
Adenocarcinoma/mortality , Uterine Neoplasms/mortality , Adenocarcinoma/pathology , Age Factors , Aged , Female , Follow-Up Studies , Humans , Hysterectomy , Menopause , Middle Aged , Neoplasm Metastasis , Prognosis , Uterine Neoplasms/pathology , Uterus/pathologyABSTRACT
An analysis of all cases (121) of endometrial carcinoma treated by pre-operative radium in the uterine cavity revealed that the menopausal status of a patient affects the radiosensitivity of her tumour. It was found that if the patient is more than ten years post-menopausal at time of diagnosis her carcinoma will be more resistant to radiation. The technique used by the authors is adequate in eradicating a considerable percentage (68%) of endometrial carcinomas.
