scholarly journals Palliative treatment of endometrial cancer: what is the role of anastrozole in elderly women?

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Barbara Gardella ◽  
Mattia Dominoni ◽  
Stefano Bogliolo ◽  
Chiara Cassani ◽  
Giulia Vittoria Carletti ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Surgical Treatment ◽  
Palliative Treatment ◽  
Elderly Women ◽  
Population Aging ◽  
Endometrial Thickness ◽  
Developed Countries ◽  
Type I ◽  
Validated Questionnaire ◽  
Radiological Staging

Abstract Background Type I endometrial cancer is the most common gynaecological tumour in developed countries and its incidence is increasing also because of population aging. The aim of this work is to test the feasibility and safety of anastrozole as palliative treatment of endometrial cancer in elderly women ineligible for standard surgical treatment. Methods Patients with histological diagnosis of type I endometrial cancer not suitable for surgical treatment were enrolled in this pilot study. Anastrozole was administered 1 mg daily orally after performing an accurate clinical and radiological staging. Validated questionnaire and self-reported outcomes were used to evaluate quality of life and compliance during the study period. Results Eight patients with a mean age of 85 (range 80–88 years) were enrolled. All patients had endometrial cancer confined to the uterus, and none progression of disease was observed during the study period. A partial response to the therapy was reported in seven patients, while one patient had stable disease. Tumour symptoms improvement such as pain, vaginal bleeding and vaginal discomfort was reported. The endometrial thickness after twelve months has showed a reduction of 9.25 ± 4.77 mm. The average follow-up time was 18.25 months. Four women died for non oncological reasons, none death related to endometrial cancer was reported. Evaluation of symptoms showed a significant reduction of appetite loss and insomnia, while a significant increase of global health status and fatigue was reported. Conclusions Our preliminary data suggested that the palliative use of anastrozole may be a suitable therapy for the proper management of early stages endometrial cancer in elderly women not suitable for surgical treatment with good compliance and tolerance. Trial registration 2013000840. Date of registration: 21/09/2013. URL: trials.sanmatteo.loc.

scholarly journals Palliative treatment of endometrial cancer: which is the role of Anastrozole in elderly women?

2020 ◽  
Author(s):  
Barbara Gardella ◽  
Mattia Dominoni ◽  
Stefano Bogliolo ◽  
Chiara Cassani ◽  
Giulia Vittoria Carletti ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Surgical Treatment ◽  
Palliative Treatment ◽  
Elderly Women ◽  
Population Aging ◽  
Endometrial Thickness ◽  
Developed Countries ◽  
Type I ◽  
Validated Questionnaire ◽  
Radiological Staging

Abstract Background: Type I endometrial cancer is the most common gynaecological tumour in developed countries and its incidence is increasing also because of population aging. The aim of this work is to test the feasibility and safety of anastrozole as palliative treatment of endometrial cancer in elderly women ineligible for standard surgical treatment. Methods: Patients with histological diagnosis of type I endometrial cancer not suitable for surgical treatment were enrolled in this pilot study. Anastrozole was administered 1 mg daily orally after performing an accurate clinical and radiological staging. Validated questionnaire and self-reported outcomes were used to evaluate quality of life and compliance during the study period.Results: Eight patients with a mean age of 85 (range 80-88years) were enrolled. All patients had endometrial cancer confined to the uterus, and none progression of disease was observed during the study period. A partial response to the therapy was reported in seven patients, while one patient had stable disease. Tumour symptoms improvement such as pain, vaginal bleeding and vaginal discomfort was reported. The endometrial thickness after twelve months has showed a reduction of 9.25 ± 4.77 mm. The average follow-up time was 18.25 months. Four women died for non oncological reasons, none death related to endometrial cancer was reported. Evaluation of symptoms showed a significant reduction of appetite loss and insomnia, while a significant increase of global health status and fatigue was reported. Conclusions: Our preliminary data suggested that the palliative use of anastrozole may be a suitable therapy for the proper management of early stages endometrial cancer in elderly women not suitable for surgical treatment with good compliance and tolerance.Trial registration: 20130008401, 21/09/2013

scholarly journals Palliative treatment of endometrial cancer: what is the role of Anastrozole in elderly women?

2021 ◽  
Author(s):  
Barbara Gardella ◽  
Mattia Dominoni ◽  
Stefano Bogliolo ◽  
Chiara Cassani ◽  
Giulia Vittoria Carletti ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Palliative Treatment ◽  
Elderly Women ◽  
Endometrial Thickness ◽  
Average Rate ◽  
Female Genital Tract ◽  
Good Control ◽  
Common Disease ◽  
Type I ◽  
Progression Of Disease

Abstract Purpose: Type I endometrial cancer is a common disease which takes place in female genital tract. The aim of the work is to asset the feasibility and safety of anastrozole in the palliative treatment of endometrial cancer in elderly women not eligible to standard surgical treatment. Methods: eight patients with histological diagnosis of endometrial cancer were enrolled in this pilot study. Anastrozole was administered 1 mg daily per os after performing an accurate radiological mapping of the lesion. A questionnaire evaluated the quality of life of these patients. Results: the median age was 85 (range 80-88years). The endometrial cancer was confined to the uterus in all patients. No progression of disease was observed. A partial response to the therapy was reported in seven patients, while no response was reported in one patient. A decrease in the symptoms such as pain, vaginal bleeding and vaginal discomfort was reported, as well as no progression of disease. The endometrial thickness after twelve months has showed a reduction of 9.25 ± 4.77 mm. The average rate of follow-up was 18.25 months. Four women died for other reasons, none of them related to endometrial cancer. Evaluation of symptoms showed a significant reduction of appetite loss and insomnia, while a significant increase of global health status and fatigue was reported. Conclusion: our preliminary data reported that the palliative use of anastrozole may be a suitable therapy for a good control of early stages of endometrial cancer in inoperable elderly women, having a good compliance and tolerance.

scholarly journals Palliative treatment of endometrial cancer type 1 in elderly women with Anastrozole.

2020 ◽  
Author(s):  
Barbara Gardella ◽  
Mattia Dominoni ◽  
Stefano Bogliolo ◽  
Chiara Cassani ◽  
Giulia Vittoria Carletti ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Palliative Treatment ◽  
Elderly Women ◽  
Endometrial Thickness ◽  
Average Rate ◽  
Female Genital Tract ◽  
Common Disease ◽  
Type I ◽  
Cancer Type ◽  
Progression Of Disease

Abstract Purpose: Type I endometrial cancer is a common disease which takes place in female genital tract. The aim of the work is to asset the feasibility and safety of anastrozole in the palliative treatment of endometrial cancer in elderly women not eligible to standard surgical treatment. Methods: eight patients with histological diagnosis of endometrial cancer were enrolled in this pilot study. Anastrozole was administered 1 mg daily per os after performing an accurate radiological mapping of the lesion. A questionnaire evaluated the quality of life of these patients. Results: the median age was 85 (range 80-88years). The endometrial cancer was confined to the uterus in all patients. No progression of disease was observed. A partial response to the therapy was reported in seven patients, while no response was reported in one patient. A decrease in the symptoms such as pain, vaginal bleeding and vaginal discomfort was reported, as well as no progression of disease. The endometrial thickness after twelve months has showed a reduction of 9.25 ± 4.77 mm. The average rate of follow-up was 18.25 months. Four women died for other reasons, none of them related to endometrial cancer. Evaluation of symptoms showed a significant reduction of appetite loss and insomnia, while a significant increase of global health status and fatigue was reported. Conclusion: our preliminary data reported that the palliative use of anastrozole may be a suitable therapy for a good control of early stages of endometrial cancer in inoperable elderly women, having a good compliance and tolerance.

Hormonal interactions in endometrial cancer.

2000 ◽  
pp. 227-242 ◽  
Author(s):  
G Emons ◽  
G Fleckenstein ◽  
B Hinney ◽  
A Huschmand ◽  
W Heyl
Keyword(s):  
Endometrial Cancer ◽  
Molecular Mechanisms ◽  
Elderly Women ◽  
Precancerous Lesions ◽  
Hormone Replacement ◽  
Female Genital Tract ◽  
Good Prognosis ◽  
Hormonal Contraceptives ◽  
Type I ◽  
History Of

Endometrial cancer (EC) is the most frequent malignant tumor of the female genital tract. Increasing evidence suggests that at least two different types of EC exist. Type I is associated with an endocrine milieu of estrogen predominance. These tumors are of endometrioid histology and develop from endometrial hyperplasia. They have a good prognosis and are sensitive to endocrine manipulation. Type II EC is not associated with a history of unopposed estrogens and develops from the atrophic endometrium of elderly women. They are of serous histology, have a poor prognosis, and do not react to endocrine manipulation. Both types of EC probably differ markedly with regard to the molecular mechanisms of malignant transformation. This article reviews reproductive and lifestyle factors modifying the risk of developing type I EC, including the use of hormonal contraceptives, hormone replacement therapy and tamoxifen. The roles of established and novel therapies for precancerous lesions and for invasive EC in the adjuvant and palliative settings are discussed.

DJ-1 in Endometrial Cancer: A Possible Biomarker to Improve Differential Diagnosis Between Subtypes

2014 ◽  
Vol 24 (4) ◽  
pp. 649-658 ◽  
Author(s):  
Michele Morelli ◽  
Domenica Scumaci ◽  
Annalisa Di Cello ◽  
Roberta Venturella ◽  
Giuseppe Donato ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Surgical Treatment ◽  
Western Blot ◽  
Serum Levels ◽  
Differentially Expressed ◽  
Type I ◽  
Healthy Controls ◽  
Ms Analysis ◽  
Annexin 2 ◽  
Dimensional Electrophoresis

ObjectiveThe objectives of this study were to characterize the well-defined endometrial cancer (EC) type I (endometrioid [EEC] G1-G2) versus the prototype of EC type II (serous [ESC]) and to evaluate the expression of specific biomarkers differentially expressed between 2 well-defined types, in those EC subtypes (such as EEC G3) disputed between types I and II.MethodsData from 25 patients (10 EEC G1-G2, 8 EEC G3, 5 ESC, and 2 clear cell) submitted to the surgical treatment were collected. Two-dimensional electrophoresis and mass spectrometry (MS) analysis were performed on 5 EEC G1-G2 and 5 healthy endometrial samples of the same patients. Differentially expressed proteins, such as DJ-1, were validated by Western blot. In patients with EEC G1-G2, serum levels of DJ-1, an overexpressed oncoprotein related to EC pathogenesis and progression, were evaluated and then compared with levels identified in patients with ESC and healthy controls. The DJ-1 immunohistochemical (IHC) staining was performed on neoplastic and healthy endometrium collected from the same patients. The 8 stored samples of EEC G3 were submitted to DJ-1 IHC assays.ResultsThe 2-dimensional electrophoresis analysis identified 1040 protein spots differentially expressed in EEC G1-G2 compared with healthy endometrium. Forty-two spots were subjected to liquid chromatography–MS/MS analysis. Thirty-three up-regulated (like an annexin 2 [ANXA2] shorter isoform, CAPG [macrophage-capping protein], DJ-1/PARK7) and 9 down-regulated (like calreticulin and ubiquitin carboxyl-terminal hydrolase isozyme L1) proteins were identified and validated by Western blot. A significant increase in serum DJ-1 levels of EEC G1-G2 versus the healthy controls and in ESC versus EEC patients was observed. DJ-1 IHC score was significantly higher in ESC versus those EEC G1-G2. In 3 cases of EEC G3, the DJ-1 expression was similar to the ESC subtype.ConclusionsThe identification of proteins, such as DJ-1, differentially expressed, between well-defined EC types I and II allows to make a subtype-specific presurgical diagnosis and help surgeon to safely preoperatively choose a proper surgical treatment.

Malignant melanoma of the vulva: clinicopathological features

1991 ◽  
Vol 1 (2) ◽  
pp. 81-87 ◽  
Author(s):  
K. Blessing ◽  
N. M. Kernohan ◽  
I. D. Miller ◽  
A. I. Al Nafussi
Keyword(s):  
Lymph Node ◽  
Surgical Treatment ◽  
Survival Rate ◽  
Malignant Melanoma ◽  
Palliative Treatment ◽  
Elderly Women ◽  
Clinicopathological Features ◽  
Node Dissection ◽  
The Mean ◽  
Radical Vulvectomy

From the files of the Scottish Melanoma Group, we have identified 41 cases of vulval malignant melanoma, which represents 1.7% of all the melanomas occurring in women in Scotland, during the period 1979–1989. Thirty-seven were aged 50 years or older with the mean age being 70 years. The average Breslow depth of the lesions was 6.0 mm, with 29 being greater than 3.0 mm in depth. Nineteen cases were polypoidal and 37 were ulcerated. Six patients had radical vulvectomy with lymph node dissection, three had biopsy and palliative treatment, and the majority of the remaining patients had local excision only, with surgical margins of less than 2 cm. The 5-year survival rate (available for 23 patients) is 21.7%, compared to 72% for cutaneous melanoma in females, in general, in the same population. In this series, the survival rate is poor, as the lesions occurred in elderly women and the melanomas were thick at presentation. Surgical treatment appears to have been rather conservative in those who were dead from their disease at 5 years.

scholarly journals Fertility-Sparing Methods in Adolescents Affected by Endometrial Cancer: A Comprehensive Review

2021 ◽  
Vol 10 (5) ◽  
pp. 1020
Author(s):  
Krzysztof Gałczyński ◽  
Piotr Olcha ◽  
Katarzyna Romanek-Piva ◽  
Maciej Jóźwik ◽  
Andrzej Semczuk
Keyword(s):  
Endometrial Cancer ◽  
World Literature ◽  
Young Patients ◽  
Developed Countries ◽  
Type I ◽  
Genetic Syndromes ◽  
Patient Death ◽  
Future Fertility ◽  
Fertility Sparing

Although in developed countries endometrial cancer (EC) is the most common gynecological malignancy, its occurrence in adolescents is exceedingly rare. The increasing rate of obesity in children and adolescents is held responsible for the increasing prevalence of EC in younger cohorts of patients. The diagnosis of this malignancy can have devastating consequences for future fertility because standard treatment protocols for EC include hysterectomy. Here, we present the first detailed review of the world literature on EC in subjects aged 21 years or younger (n = 19). The mean age at diagnosis was 16.7 ± 0.6 years. One patient (5.3%) had a Type II (high-risk) disease. No communication retrieved from the search reported on patient death; however, two (10.5%) patients were lost to follow-up. There was also a high proportion (five subjects, or 26.3%) of cases with genetic background (Cowden syndrome and Turner syndrome), therefore genetic screening or a direct genetic study should be considered in very young patients with EC. The current fertility-sparing options, limited to Type I (low-risk) disease, are presented and discussed. Such information, obtained from studies on older women, translates well to adolescent girls and very young women. Careful anatomopathological monitoring at follow-up is essential for the safety of a conservative approach. Improved survival in very young EC patients makes the preservation of fertility a central survivorship issue, therefore both patients and caregivers should undergo counseling regarding available options. Moreover, our study suggests that genetic syndromes other than Lynch syndrome may be associated with EC more frequently than previously thought.

Health-related quality of life one year after surgical treatment of the type I chronic aortic dissection

2019 ◽  
Vol 38 (1) ◽  
Author(s):  
Oksana Kamenskaya ◽  
Asya Klinkova ◽  
Irina Loginova ◽  
Alexander Chernyavskiy ◽  
Dmitry Sirota ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Aortic Dissection ◽  
Type I ◽  
Health Related Quality ◽  
Chronic Aortic Dissection ◽  
Related Quality ◽  
Health Related ◽  
One Year

Sarginio limfmazgio nustatymas sergant endometriumo vėžiu: nauja chirurginio stadijavimo kryptis

2020 ◽  
Vol 23 (1) ◽  
Author(s):  
Linas Andreika ◽  
Margarita Montrimaitė ◽  
Juliana Andreičik
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Gynecological Cancer ◽  
Developed Countries ◽  
Lymph Node Biopsy ◽  
Sentinel Lymph Nodes ◽  
Cancer Management ◽  
Node Biopsy

Summary. Endometrial cancer is the most common gynecological cancer in developed countries. Biopsy of the sentinel lymph node can be considered as an alternative to full lymphadenectomy. In order to identify sentinel lymph nodes, a tracer substance is injected into the uterus to visualize the lymphatic tract. Commonly used tracer substances are Technetium-99m (99mTc) colloid, blue dyes, and indocyanine green (ICG). In this review the significance of sentinel lymph node biopsy in endometrial cancer management and the technique of the procedure is discussed.

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