Factors affecting survival of patients with endometrial adenocarcinoma

Sall, Sanford; Sonnenblick, B. P.; Stone, Michael E.

doi:10.1016/s0002-9378(16)33899-6

Cited by 57 publications

(5 citation statements)

References 13 publications

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“…Histological dedifferentiation has been shown to affect both local control and survival adversely. 3,5+7, 8,9,10,11 In the present series, a high percentage of lesions were Grade I1 and I11 (75%), the remaining being Grade I. This is in contrast to distributions observed in general series, where Grade I lesions account for 50% of all material.…”

Section: Discussioncontrasting

confidence: 72%

The Management of Stage Iii Carcinoma of the Endometrium

Antoniades

Brady

Lewis

1977

Obstetrical & Gynecological Survey

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Ten percent of all patients with endometrial carcinoma have Stage 111 disease at the time of presentation. The management, the features of their disease, and their prognosis are quite different than those of patients with Stage I disease. This report is based on 37 patients with Stage 111 carcinomas. For their treatment, a program of definitive radiation therapy was applied. Eleven patients had a prior total abdominal hysterectomy (TAH) and bilateral salpingo-oophorectomy (BSO). On the basis of the tumor extension, three main patterns were identified: 1) downward into the vagina o r the vagina and the cervix; 2) lateral into the parametrium and the pelvic wall; and 3) to the ovaries. This classification carries therapeutic and prognostic significance. Ovarian extension has the best prognosis when treated by TAH and BSO followed by postoperative radiotherapy. Extension to the vagina o r to the vagina and the cervix can be treated successfully by a combination of external beam and local radium placements. Patients with pelvic wall extension have the poorest prognosis. They comprise more than 50% of all cases with Stage 111 tumors and have exhibited persistent o r recurrent disease even when treated at high dose levels. The cumulative survival rates for the entire stage were 50% at the end of the first year, 32% at the end of the second year, and 25% at the end of the fifth year. In contrast, the serious problems facing patient and physician in cases of the locally advanced tumors have not been specifically addressed. We present our observations on the clinical and pathologic manifestations of Stage I11 endometrial carcinoma and report the results of a program of definitive management.

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Section: Discussioncontrasting

confidence: 72%

The Management of Stage Iii Carcinoma of the Endometrium

Antoniades

Brady

Lewis

1977

Obstetrical & Gynecological Survey

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“…I in group C, while the small metrial invasion allowed no conclusions to be made. Many reports have shown younger patients to have more favourable prognosis than older patients (2,6,46). In spite of that there was no difference in the survival between C and R groups although the patients in group C were shghtly older.…”

Section: Surgical Diflculties and Early Postsurgical Morbiditymentioning

confidence: 87%

A Comparison of Clinical Results Following High Dose‐Rate Intracavitary Afterloading Irradiation with Co⁶⁰ (Cathetron) and Conventional Radium Therapy for St. I‐II Endometrial Carcinoma

Taina

1981

Acta Obstet Gynecol Scand

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Absrruct. From 1970From to 1976,91 patients with St. 1-11 endometrial carcinoma associated with a small uterine cavity (59 cm) were treated with the Cathetron (C) and 125 with radium (R). Surgery was carried out on 59.3 % of the patients in group C and 80.0 % in group R two weeks after the intracavitary radiotherapy and 56.0 % of the patients in group C and 39.2 % in group R received external irradiation with or without an operation. There was no statistical difference in the survival between the two treatment groups, the 5-year crude survival being 79.4 % for group C and 82.4 % for group R, and the 3-year crude survival rates 82.4 YO and 88.0 % respectively. There was no statistically significant difference in the local recurrence of tumour between group C (3.3 YO) and R (0 %); nor were the rates of early complications different, 3.3 % in group C against 4.0 % in group R. No differences were found in operative difficulties or early postoperative morbidity between the two groups during or after hysterectomies and bilateral salpingo-oophorectornies after intracavitary radiotherapy.

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“…Many gynaecologists favour the use of the radical procedure in Stage I1 endometrial carcinoma (Bunker, 1959;Gusberg et al, 1960;Jeffcoate, 1967;Allen and Fraleigh, 1963;Copenhaver and Barsamian, 1967 ;Rickford, 1968;Sall et al, 1970). Few authors give 5-year survival rates for patients who had positive pelvic lymph nodes and a lymphadenectomy ( Table 111).…”

Section: Results Of Wertheim's Hysterectomy and Lymphadenectomy For Ementioning

confidence: 98%

The Case Against Wertheim's Hysterectomy in Endometrial Carcinoma

Mûelenaere

1973

BJOG

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Summary One hundred and four women with clinically operable endometrial cancer were treated by intrauterine radium followed by removal of the uterus and appendages without lymphadenectomy. Patients with recurrence confined to the pelvis were given external radiotherapy only. From review of these cases and study of the literature it is concluded that there is a high incidence of lymphatic metastases but these are not usually confined to the pelvis. Most of the deaths from the disease are due to distant lymphatic, transcoelomic or haematogenous spread without pelvic recurrence of the neoplasm. It is difficult to suggest a logical basis for selecting patients with endometrial cancer for Wertheim's hysterectomy with lymphadenectomy, an operation which does not offer a higher 5‐year survival rate in unselected patients. cology and Obstetrics, and Dr. Kenny, Superintendent, H. F. Verwoerd Hospital, for access to their records. The results of the present study formed part of an M.D. thesis for the University of Pretoria in 1972.

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Factors affecting survival of patients with endometrial adenocarcinoma

Cited by 57 publications

References 13 publications

The Management of Stage Iii Carcinoma of the Endometrium

The Management of Stage Iii Carcinoma of the Endometrium

A Comparison of Clinical Results Following High Dose‐Rate Intracavitary Afterloading Irradiation with Co⁶⁰ (Cathetron) and Conventional Radium Therapy for St. I‐II Endometrial Carcinoma

The Case Against Wertheim's Hysterectomy in Endometrial Carcinoma

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Factors affecting survival of patients with endometrial adenocarcinoma

Cited by 57 publications

References 13 publications

The Management of Stage Iii Carcinoma of the Endometrium

The Management of Stage Iii Carcinoma of the Endometrium

A Comparison of Clinical Results Following High Dose‐Rate Intracavitary Afterloading Irradiation with Co60 (Cathetron) and Conventional Radium Therapy for St. I‐II Endometrial Carcinoma

The Case Against Wertheim's Hysterectomy in Endometrial Carcinoma

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A Comparison of Clinical Results Following High Dose‐Rate Intracavitary Afterloading Irradiation with Co⁶⁰ (Cathetron) and Conventional Radium Therapy for St. I‐II Endometrial Carcinoma