[Patogenetic types of body of womb cancer and therapeutic management].

The surgical treatment of body of womb cancer (after surgical hormonotherapy, radiation therapy) was conducted on 353 patients. Of which 264 patients had the first stage of disease; 50-the second stage of disease; 34-the third stage of disease; and 5-the fourth stage of disease. Most women with endometrial carcinoma were 50-59 years old. The youngest patient with body of womb cancer was 25 years old; the oldest patient was 78 years old. The amount of patients over 70 years old reached 5,4%. The research showed that the treatment depends on the stage of the tumour and its histological type, degree of the pathogenetic type of cancer endometrium. At the first stage of the treatment of the two patogenetic types it is enough to perform a radical operation in the field of extirpation of uterine appendages. At the cancer of the second and third stages of the patogenetic type it is necessary hormonotherapy after the operation. And at the second type it is necessary to use radical uterus extirpation in addition with radiation therapy.

[Peculiarities of diagnostics and treatment efficiency in uterine sarcoma].

In the department of gynecology of A. Gvamichava National Center of Oncology 43 patients with uterine sarcoma were treated during 2000-2004 years. The youngest woman who visited the Center with uterine sarcoma was diagnosed at 25 years of age and the oldest one was 77 years old. Patients distribution in age groups was as follows: up to 30 years - 1 (20,9%), 30-39 years - 9 (20,9%), 40-49 years - 16 (37,2%), 50-59 years - 15 (34,8%), 60 years and more - 4 (9,3%). Among 4 hystological types of sarcomas, the most prevalent were leiomyosarcoma uteri. Treatment of each patient was started by surgical intervention on uterus and its appendixes, extirpation and further conservative therapy.

[Clinical-morphological parallels of malignant ovarian tumours].

The detection of the malignant ovarian tumor takes place at a later stage because of a symptomless process of the tumor formation at an earlier stage, hence leading to the delayed diagnostics and inefficient treatment. The objective of the research is the development of an efficient treatment of the malignant ovarian tumor patients, finding the most adequate methods and a delineation of the proper tactics for the achievement of the improved long-term results. We have studied the medical cards of the patients checked into A. Gvamichava Gynecological Clinic of the National Oncology Center in 1990-2000. The research has led to the conclusion that the epithelial malignant ovarian tumors outnumber the non-epithelial malignant ovarian tumors by 5 to 2. The most widespread histotype of the epithelial malignant ovarian tumors is the serous carcinoma, most frequently detected among the 50-69 year old patients and diagnosed at the third and the fourth stages. In non-epithelial malignant ovarian tumors, the most widespread histotype is the granule-cellular tumors, most frequently detected in the 50-69 age group, diagnosed at the II and the III stages. In our clinic, the surgical treatment, with a subsequent chemotherapy is preferential.

[Strategy and results of treatment in trophoblastic disease]. / Taktika i resul'taty lecheniia trofoblasticheskoi bolezni.

The study involved 457 cases of ordinary (261), invasive (75) vesicular mole and choriocarcinoma (121-stage I-51.2; stage II-19.8 and stage III-27.3%). Enhanced chorionic gonadotrophin titer in urine was registered in 67-72%. Choriocarcinoma had no link to pregnancy in 6.6%. It is suggested that cases with a 10-year latency period and longer should be referred to this category of patients. Five-year survival was observed in 98-99% of patients with vesicular mole and in 74.1% with choriocarcinoma in 1977-1989. A special synoptic procedure has been developed for optimal planning the therapy and rehabilitation of cases of trophoblastic disease. Four forms of non-invasive vesicular mole have been identified, and strategies of treatment versus type of tumor and patient's peculiarities worked out. The extent of therapeutic effort has been decreased.

Optimal variants of treatment of stage I endometrial carcinoma and its choice.

2195 patients affected by endometrial carcinoma were treated at the Tbilisi and the St. Petersburg Oncological Institutes from 1968 to 1987. The incidence of different stages was respectively: I 78.8%; II 11.6%; III 9.0%; IV 0.4%. Adenocarcinoma was the histotype more frequently observed and the grade of differentiation was respectively: G1 39.3%; G2 51.3%; G3 9.4%. The incidence of lymphnodal invasion was equal to 6.2% in I Stage, 12.2% in II Stage and 37.8% in III Stage. In Stage I surgery was the treatment of choice in all cases and in the 70.5% of cases additional treatments were added: in G1, G2 grade endometrial cancer additional hormone therapy, remote irradiation and postoperative hormone therapy were used, whereas in G3 tumours intracavitary irradiation was frequently added in the St. Petersburg Institute. The 5 year survival rate of patients at Stage I was equal to 70.9% in retrospective analysis (1968-1982) and 84.6% in patients followed prospectively (1983-1987).

The methods and results of uterine body cancer: a twenty-year experience of treatments at the Tbilisi Oncological Center.

In the period 1968-1987 at the Oncological Scientific Center of Tbilisi 1100 Endometrial Cancer were observed. All patients were treated surgically and in particular 89.9% cases with total hysterectomy and adnexectomy; 9.8% with hysterectomy, adnexectomy and lymphadenectomy; 0.3% with Wertheim's operation. The Author suggests a pathological staging system with in the first stage (cancer limited to the uterus) in order to better select the treatment and prognosis of patients. According to his classification 5 years survival was 88.1% when tumour was absent in the operative specimen; 82.6% when the tumor was less 2 cm; 67.5% for tumour more than 2 cm; 60.3% when less than half of the myometrium was involved and 40.8% with more than half of the myometrium. The Author confirms the validity of surgical therapy in endometrial cancer eventually associated with hormonal and/or radiotherapy for the cases more at risk.