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.

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

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.

scholarly journals High Expression of Ecto-Nucleotidases CD39 and CD73 in Human Endometrial Tumors

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Elisabet Aliagas ◽  
August Vidal ◽  
Laura Texidó ◽  
Jordi Ponce ◽  
Enric Condom ◽  
...  
Keyword(s):  
Gene Expression ◽  
Endometrial Cancer ◽  
Genital Tract ◽  
Female Genital Tract ◽  
Tumor Grade ◽  
Type I ◽  
Type Ii ◽  
Extracellular Adenosine ◽  
Serous Tumors ◽  
Female Genital

One of the strategies used by tumors to evade immunosurveillance is the accumulation of extracellular adenosine, which has immunosupressive and tumor promoting effects. The study of the mechanisms leading to adenosine formation at the tumor interstitium are therefore of great interest in oncology. The dominant pathway generating extracellular adenosine in tumors is the dephosphorylation of ATP by ecto-nucleotidases. Two of these enzymes acting sequentially, CD39 and CD73, efficiently hydrolyze extracellular ATP to adenosine. They have been found to play a crucial role in a variety of tumors, but there were no data concerning endometrial cancer, the most frequent of the invasive tumors of the female genital tract. The aim of the present work is to study the expression of CD39 and CD73 in human endometrial cancer. We have analyzed protein and gene expression, as well as enzyme activity, in type I endometrioid adenocarcinomas and type II serous adenocarcinomas and their nonpathological endometrial counterparts. High levels of both enzymes were found in tumor samples, with significantly increased expression of CD39 in type II serous tumors, which also coincided with the higher tumor grade. Our results reinforce the involvement of the adenosinergic system in cancer, emphasizing the relevance of ecto-nucleotidases as emerging therapeutic targets in oncology.

β-Catenin and FAT1 Protein Expressions for Prediction of Survival Outcome in Type I Endometrial Cancer

2021 ◽  
Vol 104 (5) ◽  
pp. 757-763
Keyword(s):  
Overall Survival ◽  
Endometrial Cancer ◽  
Female Genital Tract ◽  
Survival Outcome ◽  
Low Grade ◽  
Type I ◽  
Nuclear Staining ◽  
Cytoplasmic Staining ◽  
Prediction Of Survival ◽  
Outcome Type

ackground: Endometrial cancer (EC) is the second most common female genital tract malignancy and has adverse outcome in the advanced stage. A prognostic marker is needed for marking an accurate prognostic. Objective: To evaluate expression and clinical outcome of CTNNB1 (β-catenin) and FAT atypical cadherin 1 (FAT1), by using immunohistochemical staining in EC type I. Materials and Methods: Seventy-two EC type I cases were selected from Songklanagarind Hospital with clinical data collection. All cases were evaluated by immunohistochemistry using antibodies against β-catenin and FAT1. Results: All cases of EC type I were β-catenin positive and FAT1 negative. Moderate and strong intensity (2+ and 3+) β-catenin cytoplasmic staining showed statistically significant association with low grade EC, and low risk of recurrence disease or metastasis (p<0.05). β-catenin nuclear staining was present in 19 of 28 cases (68%) of EC grade 1 and associated with low grade EC. β-catenin and FAT1 expression were not associated with 5-year overall survival in both univariate and multivariate analyses. Conclusion: β-catenin cytoplasmic staining may be associated with low grade EC, and helpful to predict recurrent risk. However, FAT1 and β-catenin expressions have no statically significant correlation with 5-year overall survival and cannot be used to determine the prognosis in type I EC patients. Keywords: β-catenin, FAT1, Immunohistochemistry, Metastasis, Recurrence, Survival outcome, Type I endometrial cancer

scholarly journals erbB2Overexpression in Uterine Serous Cancer: A Molecular Target for Trastuzumab Therapy

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Karim S. ElSahwi ◽  
Alessandro D. Santin
Keyword(s):  
Endometrial Cancer ◽  
Early Stage ◽  
Case Reports ◽  
Uterine Cancer ◽  
Female Genital Tract ◽  
The United States ◽  
Type I ◽  
Type Ii ◽  
Erbb2 Overexpression

Endometrial cancer is the most common female genital tract malignancy in the United States. Type I endometrial cancer is usually diagnosed at an early stage, and has a good prognosis. Type II is very aggressive, and is responsible for most uterine cancer relapses and deaths. Uterine serous adenocarcinomas (USC) constitute the majority of Type II variants. They have a higher propensity for lymph node and distant metastases. They are frequently aneuploid and associated with p53 mutations. erbB2 overexpression in USC has been described. The incidence, which is higher in African Americans, ranges from 18–80%. erbB2 overexpression was found to be associated with higher stage, chemoresistance, and worse survival. Trastuzumab a humanized mAb was approved by the FDA for treatment of breast cancers that overexpress erbB2 in combination with standard chemotherapy. Evidence of trastuzumab activity in USC has been reported in vitro, as well as in case reports of advanced and recurrent cases. Promising results were obtained in these heavily pretreated patients either with trastuzumab alone or in combination with chemotherapy. This supports the hypothesis that trastuzumab may very well be an attractive and viable treatment option for advanced stage USC tumors that overexpress the erbB2, and is worthy of further study.

scholarly journals Effect of 12-weeks elastic band resistance training on MyomiRs and osteoporosis markers in elderly women with Osteosarcopenic obesity: a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ebrahim Banitalebi ◽  
Majid Mardaniyan Ghahfarrokhi ◽  
Mortaza Dehghan
Keyword(s):  
Vitamin D ◽  
Randomized Controlled Trial ◽  
Type I Collagen ◽  
Assessment Tool ◽  
Elderly Women ◽  
Controlled Trial ◽  
Type I ◽  
Elastic Band ◽  
Randomized Controlled ◽  
Osteosarcopenic Obesity

Abstract Background Interorgan communication networks established during exercise in several different tissues can be mediated by several exercise-induced factors. Therefore, the present study aimed to investigate the effects of resistance-type training using elastic band-induced changes of myomiRs (i.e., miR-206 and miR-133), vitamin D, CTX-I, ALP, and FRAX® score in elderly women with osteosarcopenic obesity (OSO). Methods In this randomized controlled trial, 63 women (aged 65–80 years) with Osteosarcopenic Obesity were recruited and assessed, using a dual-energy X-ray absorptiometry instrument. The resistance-type training via elastic bands was further designed three times per week for 12-weeks. The main outcomes were Fracture Risk Assessment Tool score, bone mineral content, bone mineral density, vitamin D, alkaline phosphatase, C-terminal telopeptides of type I collagen, expression of miR-206 and miR-133. Results There was no significant difference between the study groups in terms of the Fracture Risk Assessment Tool score (p = 0.067), vitamin D (p = 0.566), alkaline phosphatase (p = 0.334), C-terminal telopeptides of type I collagen (p = 0.067), microR-133 (p = 0.093) and miR-206 (p = 0.723). Conclusion Overall, the results of this study illustrated 12-weeks of elastic band resistance training causes a slight and insignificant improvement in osteoporosis markers in women affected with Osteosarcopenic Obesity. Trial registration Randomized controlled trial (RCT) (Iranian Registry of Clinical Trials, trial registration number: IRCT20180627040260N1. Date of registration: 27/11/2018.

scholarly journals Risk Assessment of Endometrial Hyperplasia or Endometrial Cancer with Simplified Ultrasound-Based Scoring Systems

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 442
Author(s):  
Norbert Stachowicz ◽  
Agata Smoleń ◽  
Michał Ciebiera ◽  
Tomasz Łoziński ◽  
Paweł Poziemski ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Hyperplasia ◽  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Menopausal Status ◽  
Power Doppler ◽  
Uterine Cavity ◽  
Abnormal Uterine Bleeding ◽  
Scoring Systems ◽  
Diagnostic Challenge

Background: Abnormal uterine bleeding (AUB) represents a common diagnostic challenge, as it might be related to both benign and malignant conditions. Endometrial cancer may not be detected with blind uterine cavity sampling by dilatation and curettage or suction devices. Several scoring systems using different ultrasound image characteristics were recently proposed to estimate the risk of endometrial cancer (EC) in women with AUB. Aim: The aim of the present study was to externally validate the predictive value of the recently proposed scoring systems including the Risk of Endometrial Cancer scoring model (REC) for EC risk stratification. Material and methods: It was a retrospective cohort study of women with postmenopausal bleeding. From June 2012 to June 2020 we studied a group of 394 women who underwent standard transvaginal ultrasound examination followed by power Doppler intrauterine vascularity assessment. Selected ultrasound features of endometrial lesions were assessed in each patient. Results: The median age was 60.3 years (range ±10.7). The median body mass index (BMI) was 30.4 (range ± 6.0). Histological examination revealed 158 cases of endometrial hyperplasia (EH) and 236 cases of EC. Of the studied ultrasound endometrial features, the highest areas under the curve (AUCs) were found for endometrial thickness (ET) (AUC = 0.76; 95% CI: 0.71–0.81) and for interrupted endomyometrial junction (AUC = 0.70, 95% CI: 0.65–0.75). Selected scoring systems presented moderate to good predictive performance in differentiating EC and EH. The highest AUC was found for REC model (AUC = 0.75, 95% CI: 0.70–0.79) and for the basic model that included ET, Doppler score and interrupted endometrial junction (AUC = 0.77, 95% CI: 0.73–0.82). REC model was more accurate than other scoring systems and selected single features for differentiating benign hyperplasia from EC at early stages, regardless of menopausal status. Conclusions: New scoring systems, including the REC model may be used in women with AUB for more efficient differentiation between benign and malignant conditions.

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