Vaginal recurrences of endometrial carcinoma: The prognostic value of staging by a primary vaginal carcinoma system

Curran, Walter J.; Whittington, Richard; Peters, Albert J.; Fanning, James

doi:10.1016/0360-3016(88)90110-1

Cited by 105 publications

(49 citation statements)

References 9 publications

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“…It has been speculated that neoplastic seeding (i.e., "spillage") at the time of hysterectomy may account for the development of vaginal apical recurrences, while retrograde spread via the rich network of lymphatics could account in particular for suburethral and distal vaginal recurrences. Still other investigators favor [19] 1988 46 5 42 Poulsen [20] 1988 21 10 47 Kuten [21] 1989 17 4.8 40 Morgan [22] 1993 34 5 60 Pai [23] 1997 20 10 46 venous dissemination over lymphatic spread as a mechanism of vaginal recurrence in endometrial cancer, since vaginal metastases are relatively uncommon in other cancers where lymphatic spread is common, such as carcinoma of the cervix. Indeed, other malignant neoplasms notorious for hematogenous metastases, such as choriocarcinoma and hypernephroma, often seed the vaginal wall.…”

Section: Discussionmentioning

confidence: 99%

“…In 1992, Podczaski and coworkers from Hershey Medical Center reported that the site of recurrence, time interval of surgery to recurrence, and use of postoperative pelvic radiotherapy were statistically related to patient prognosis [32]. In 1988, Curran and colleagues from the Fox Chase Cancer Center in Philadelphia applied a primary vaginal carcinoma staging system to vaginal recurrences of endometrial carcinoma and observed that a higher rate of pelvic control was observed for apical than for suburethral recurrences [19]. In many of the vaginal recurrence series previously cited, survival analyses often combined patients with both upper and distal vaginal relapses.…”

Section: Discussionmentioning

confidence: 99%

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Interstitial Brachytherapy for Vaginal Recurrences of Endometrial Carcinoma

Tewari¹,

Cappuccini²,

Brewster³

et al. 1999

Gynecologic Oncology

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Objective. The aim of this study was to evaluate the efficacy of interstitial brachytherapy in the management of vaginal recurrences of endometrial carcinoma.Methods. Thirty patients received interstitial irradiation, with or without external beam radiotherapy. They were followed for a minimum of 5 years or until death.Results. The median age was 66 years at initial diagnosis of endometrial cancer. FIGO stages included Stage I (n ‫؍‬ 18), Stage II (n ‫؍‬ 7), and Stage III (n ‫؍‬ 5). All patients were treated originally by total abdominal hysterectomy and bilateral salpingooophorectomy, with or without lymphadenectomy, and 13 (43%) also received postoperative adjuvant whole pelvis radiotherapy as part of their primary treatment. Vaginal recurrences were diagnosed at a mean interval of 29 months after hysterectomy (range, 3-119 months). No patient had clinical evidence of pelvic sidewall extension or of distant metastatic disease. All patients were treated with interstitial brachytherapy; each implant delivered a mean maximal tumor dose of 25.5 Gy. Eighteen patients (60%) also received external beam radiotherapy (mean dose, 48 Gy) as part of their treatment for vaginal recurrence. Twenty-eight patients (93%) experienced a complete clinical response. Ten patients relapsed in the vagina (n ‫؍‬ 5) or at distant sites (n ‫؍‬ 5). Eleven patients are dead of disease. From the time of vaginal recurrence, the median overall survival was 60 months and the cause of death adjusted 5-year survival rate was 65%. Major morbidity included radiation proctitis (n ‫؍‬ 2), fistula (n ‫؍‬ 2), and radiation stricture (n ‫؍‬ 1).Conclusion. Interstitial irradiation resulted in favorable local control as well as a 5-year survival rate and morbidity comparable to that reported previously for conventional brachytherapy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Interstitial Brachytherapy for Vaginal Recurrences of Endometrial Carcinoma

Tewari¹,

Cappuccini²,

Brewster³

et al. 1999

Gynecologic Oncology

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“…Overall survival for recurrent endometrial cancer gory as we have defined them in this paper, i.e., greater than ranges from 10% [5,6] to approximately 30% [7,8]. The 50% myometrial invasion any grade or Grade 3, any degree major explanation for these apparent poor results is that the of invasion.…”

Section: Methodsmentioning

confidence: 95%

“…The major impact survival of 37% and 50% survived if disease was confined of pelvic external-beam therapy may be to improve pelvic to the vagina and central pelvis. Curran et al [8] showed control. Pelvic radiotherapy can only improve survival in that the extent of pelvic recurrence was the most important those with disease confined to the pelvis.…”

Section: Methodsmentioning

confidence: 96%

Endometrial Carcinoma—Relative Effectiveness of Adjuvant Irradiation vs Therapy Reserved for Relapse

Ackerman

Malone

Thomas

et al. 1996

Gynecologic Oncology

125

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“…Local control, defined as eradicating pelvic disease, is possible in 40%-75% of women treated with salvage radiation therapy [3,7,9,11]. In a series of 91 patients with isolated vaginal recurrences, local control was seen in 75% of those treated with salvage radiation therapy [9].…”

Section: Radiation Therapy For Locally Recurrent Endometrial Cancermentioning

confidence: 99%

Treatment for Advanced and Recurrent Endometrial Carcinoma: Combined Modalities

Rauh‐Hain

Carmen

2010

The Oncologist

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After completing this course, the reader will be able to:1. Discuss the role of radiation therapy for advanced stage endometrial cancer in order to differentiate between patients who should receive only radiation therapy and patients requiring surgery and/or chemotherapy in addition to radiation.2. Evaluate the role of surgery for stage IV and recurrent endometrial cancer in order to select patients most likely to benefit from cytoreductive surgery.3. Evaluate the role of chemotherapy, particularly in conjunction with radiotherapy, in advanced stage endometrial carcinoma and select appropriate candidates for multimodality therapy.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME ABSTRACTWomen with recurrent or advanced endometrial cancer constitute a heterogeneous group of patients. Depending on previous treatment, women with recurrent endometrial cancer may be appropriate candidates for surgery, radiation therapy, hormonal therapy, or chemotherapy. Women with advanced stage disease at presentation may also be appropriate candidates for systemic and local therapies. We review the treatment options available to treat recurrent and locally advanced endometrial cancer. Treatment choice depends largely on the localization of disease, the patient's performance status and previ-

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Vaginal recurrences of endometrial carcinoma: The prognostic value of staging by a primary vaginal carcinoma system

Cited by 105 publications

References 9 publications

Interstitial Brachytherapy for Vaginal Recurrences of Endometrial Carcinoma

Interstitial Brachytherapy for Vaginal Recurrences of Endometrial Carcinoma

Endometrial Carcinoma—Relative Effectiveness of Adjuvant Irradiation vs Therapy Reserved for Relapse

Treatment for Advanced and Recurrent Endometrial Carcinoma: Combined Modalities

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