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  • 1
    Electronic Resource
    Electronic Resource
    Recurrence patterns and complications in endometrial adenocarcinoma with cervical involvement (1995)
    Springer
    Annals of surgical oncology 2 (1995), S. 138-144 
    Details
    ISSN: 1534-4681
    Keywords: Stage II endometrial cancer ; Gross cervical involvement ; Radical hysterectomy ; Recurrence patterns ; Complications ; Primary surgical evaluation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Cervical involvement in endometrial carcinoma is a diverse entity, and the optimal management of these patients is not well understood. Methods: Recurrence patterns and complications in 202 patients with histologically confirmed endometrial carcinoma with cervical involvement were retrospectively studied. Results: The 5-year actuarial survival rate for all patients was 65%. Recurrences were documented in 80 (40%) of the patients, and the overall long-term survival rate in this group was 4%. Patients treated with radical hysterectomy (n=33) had a 6% isolated pelvic recurrence rate and the lowest serious complication rate among the five treatment groups despite having the highest frequency of risk factors for recurrence among any of the groups studied. Patients treated with extrafascial hysterectomy alone (n=37) had a 14% pelvic recurrence rate and very few complications. When radiotherapy preceded extrafascial hysterectomy (n=37), the frequency of pelvic recurrences was 30%, and 19% experienced serious gastrointestinal or genitourinary tract complications. When radiotherapy followed extrafascial hysterectomy (n=68), the pelvic recurrence rate was 24%, and 13% experienced serious complications. Overall, 24% of patients (49 of 202) had isolated pelvic recurrences, whereas 10% (21 of 202) had isolated distant recurrences and 5% (10 of 202) were simulataneously diagnosed with both pelvic and distant recurrences. Conclusions: This large data base suggests that older conventional forms of therapy, particularly those using preoperative radiotherapy, subject the patient to significant morbidity over a 5- to 10-year period and, in terms of local control, are not necessarily superior to therapeutic modalities using primary surgical evaluation, such as radical hysterectomy. Consideration of primary surgery should be given in the appropriate situation, and radical hysterectomy should be considered when gross cervical involvement is encountered and intraoperative exploration does not show obvious extrauterine disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02303629
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Dietary associations in a case-control study of endometrial cancer (1993)
    Springer
    Cancer causes & control 4 (1993), S. 239-250 
    Details
    ISSN: 1573-7225
    Keywords: Carbohydrate ; case-control study ; diet ; endometrial cancer ; fat ; protein ; United States
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Despite the established role of obesity in the etiology of endometrial cancer, limited data are available from analytical epidemiologic studies on the association of risk with dietary factors. A case-control study of 399 cases and 296 controls conducted in five areas of the United States from 1 June 1987 to 15 May 1990, enabled evaluation of risk related to dietary intakes adjusted for potential confounders. Caloric intake was associated modestly with increased risk (odds ratio [OR]=1.5,95 percent confidence interval [CI]=0.9–2.5 for highest cf lowest quartiles of intake), with the principal contributors being fat and protein calories. After adjustment for other risk factors, including body mass, increased risk was associated with higher intakes of fat. Several components of fat investigated were associated with increased risk, although associations were slightly stronger for saturated fat (OR=2.1, CI=1.2–3.7) and oleic acid (OR=2.2, CI=1.2–4.0) than for linoleic acid (OR=1.6, CI=0.9–2.8). Food-group analyses showed intake of complex carbohydrates—and specifically of breads and cereals—associated with reduced risks (OR=0.6, CI=0.4–1.1), whereas animal fat and fried foods were associated with elevated risks (OR=1.5 and 1.7, respectively). The relations of endometrial cancer with animal fat and complex carbohydrates were independent. No consistent associations were noted for intakes of cholesterol, fiber, vitamins A and C, individual carotenoids, or folate-rich foods. These data imply an etiologic role for a diet rich in total fat and/or animal fat and low in complex carbohydrates with endometrial cancer. These associations are consistent with a hormonal mechanism and were independent of the associations of obesity and other risk factors.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00051319
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    Paper (German National Licenses)
    Fulltext
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