Adenocarcinoma of the Body of the Uterus

Abstract

AND SummaryA series of 129 cases of adenocarcinoma of the uterus treated by Wertheim's hysterectomy and lymphadenectomy is reported. Preoperative radium was given together with postoperative irradiation when pelvic lymph nodes were involved in metastatic cancer. The five-year survival was 71 -5 per cent. This figure rose to 74 per cent when the growth did not involve the cervix. The incidence of lymph node involvement was 13-2 per cent, or 11.2 per cent when the cervix was free from growth. The incidence of node involvement was related to the degree of differentiation of the tumour and the depth of myometrial invasion. Thirty-six per cent of patients with positive nodes survived 5 years when lymphadenectomy was combined with external radiation. When death occurred the metastatic deposits were usually outside the pelvis. It is concluded that lymphadenectomy need be performed only in patients with poorly differentiated and deeply invasive growth. Postoperative external irradiation is indicated if the nodes contain cancer.

Adenocarcinoma of the endometrium in Israel, 1960–1968

“…We recorded a five-year survival rate of 78.1% in Stage I, whereas in Stages I11 and IV, the respective percentages decreased to 43.8% and 8.8%, results that are in keeping with those appearing in the Pelvic and paraaortic node involvement may be a very accurate indicator as to the stage of the disease; it has a high prognostic value and serves as a guide to the s~r g e o n .~ The Oxford group, headed by Stallworthy , stressed the greater importance of nodal involvement (14%) over vault recurrence (1 .9%). 14 The degree of myometrial invasion by carcinomatous cells may be a prognostic factor, but since this information is not available until after surgery, it has no value in selecting primary treatment. It has been shown that histologic grading of the tumor directly correlates with the depth of myometrial invasion, aortic lymph node involvement, vaginal cuff recurrence, and five-year survival rate.…”

The management of endometrial cancer

“…The importance of surgical staging first became apparent when the experience of Stallworthy's team in performing radical hysterectomy and pelvic lymphadenectomy in endometrial cancer was published in 1970 1 . They reported pelvic node metastases in 5.5% of Grade 1 tumours, 10% in Grade 2 and 26% in Grade 3.…”

Endometrial Carcinoma: 128 Cases at Stages I and II

“…Finally we noticed that 10-20% of the patients did not respond to the treatment [7,26,28], These failures could be due either to lymph node metastases, 10-15% at stage I [21,22,29], or to the presence of systemic micrometastases.…”