Endometrial Neoplasms ; drug therapy ; pathology ; Female ; Humans ; Precancerous Conditions ; drug therapy ; pathology ; Progestins ; therapeutic use

OBJECTIVE: To analyze the efficacy and prognosis of fertility-sparing therapy of the patient with complex atypical hyperplasia (CAH) and endometrial cancer (EC). METHODS: Clinical data of 191 EC and CAH patients who received fertility-sparing therapy in Peking University People's Hospital between January 2009 and September 2021 were recruited retrospectively. Outcomes of remission, recurrence and pregnancy were analyzed. RESULTS: (1) Efficacy and efficacy-related factors: The complete response (CR) rate was 86.1% (161/187) for all the patients, and the CR rate of the CAH patients were higher than that of the EC patients (92.7% vs. 79.1%, P=0.007), the CR rate was significant higher in the CAH patients (OR=2.786, P=0.035). (2) The recurrence rate was 19.3% (31/161), and the recurrence rate of the EC patients were much higher than that of the CAH patients (26.4% vs. 13.5%, P=0.039). The median recurrence time was 22.5 (9.0, 50.0) months. (3) The high risk factors of recurrence were pathological type of EC (χ²=4.880, P=0.027), without the use of metfor-min (χ²=7.075, P=0.008), longer time to complete remission (>7 months) (χ²=6.204, P=0.013), and no pregnancy (χ²=6.765, P=0.009). (4) Results of pregnancy and related factors: Among the patients who achieved CR, 108 patients had fertility willing with the pregnancy rate of 41.7% (45/108), and the live birth rate was 34.3% (37/108). The live birth rate was lower in EC than that in the CAH patients (28.6% vs. 42.4%, P=0.045). The median time to achieve pregnancy was 10.50 (5.75, 33.25) months. The pregnancy rate was significant higher in the patients with pregnancy history (OR=9.468, P < 0.001) and in those who received assisted reproductive therapy (OR=7.809, P < 0.001). CONCLUSION Fertility-sparing therapy of CAH and EC patients is effective resulting in high disease remission and certain pregnancy. However, the high recurrence rate and low pregnancy rate are still key problems for EC and CAH patients, therefore close monitoring and follow-up are indicated.
Endometrial Hyperplasia/pathology* ; Endometrial Neoplasms/drug therapy* ; Female ; Fertility Preservation/methods* ; Humans ; Hyperplasia ; Retrospective Studies ; Treatment Outcome

OBJECTIVE: The aim of this study is to investigate the effect of tamoxifen on endometrial thickness in postmenopausal women taking adjuvant tamoxifen therapy for breast cancer after chemotherapy. METHODS: Fifty-eight tamoxifen-treated postmenopausal breast cancer patients underwent periodically transvaginal ultrasonography twice a year for 2 years and then once a year. We analyzed the correlation between the sonographic endometrial thickness and the duration of tamoxifen therapy. RESULTS: The mean endometrial thickness of breast cancer patients before tamoxifen therapy was 4.68 mm. But the mean endometrial thickness increased to 5.03 mm at 6 months, 5.21 mm at 12 months, after which it slightly declined to 5.13 mm at 18 months. And then it increased to 5.15 mm at 24 months, and 5.24 mm at 36 months. There was a significant increase in endometrial thickness after tamoxifen therapy compared with before tamoxifen therapy (p<0.05). Overall, proliferative endometrium was the most common histopathologic finding (5/14) in tamoxifen-treated postmenopausal women who had endometrial thickness >or=5 mm. No cases of endometrial cancer were detected. CONCLUSION: Significant increase in endometrial thickness with the duration of tamoxifen therapy in postmenopausal tamoxifen-treated patients may be associated with a high risk of endometrial pathologies in these patients.
Breast Neoplasms* ; Breast* ; Drug Therapy ; Endometrial Neoplasms ; Endometrium ; Female ; Humans ; Pathology ; Tamoxifen ; Ultrasonography

With the apparently increasing incidence of endometrial carcinoma, much importance has been attached to the early and exact diagnosis of endometrial carcinoma. This article mainly focuses on diagnostic techniques of endometrial carcinoma, especially diagnostic hysteroscopy and its assessment of myometrial invasion as well as stage of endometrial carcinoma. Whether hysteroscopy increases the risk of microscopic extrauterine spread is also discussed in this article.
Endometrial Neoplasms ; diagnosis ; pathology ; therapy ; Female ; Humans ; Hysteroscopy ; adverse effects ; methods ; Neoplasm Staging

Adenocarcinoma ; drug therapy ; pathology ; secondary ; surgery ; Chemotherapy, Adjuvant ; Endometrial Neoplasms ; drug therapy ; pathology ; surgery ; Female ; Humans ; Hysterectomy ; Middle Aged ; Splenectomy ; Splenic Neoplasms ; drug therapy ; pathology ; secondary ; surgery

In 2014, 9 topics were selected as major advances in clinical research for gynecologic oncology: 2 each in cervical and corpus cancer, 4 in ovarian cancer, and 1 in breast cancer. For cervical cancer, several therapeutic agents showed viable antitumor clinical response in recurrent and metastatic disease: bevacizumab, cediranib, and immunotherapies including human papillomavirus (HPV)-tumor infiltrating lymphocytes and Z-100. The HPV test received FDA approval as the primary screening tool of cervical cancer in women aged 25 and older, based on the results of the ATHENA trial, which suggested that the HPV test was a more sensitive and efficient strategy for cervical cancer screening than methods based solely on cytology. For corpus cancers, results of a phase III Gynecologic Oncology Group (GOG) 249 study of early-stage endometrial cancer with high-intermediate risk factors are followed by the controversial topic of uterine power morcellation in minimally invasive gynecologic surgery. Promising results of phase II studies regarding the effectiveness of olaparib in various ovarian cancer settings are summarized. After a brief review of results from a phase III study on pazopanib maintenance therapy in advanced ovarian cancer, 2 outstanding 2014 ASCO presentations cover the topic of using molecular subtypes in predicting response to bevacizumab. A review of the use of opportunistic bilateral salpingectomy as an ovarian cancer preventive strategy in the general population is presented. Two remarkable studies that discussed the effectiveness of adjuvant ovarian suppression in premenopausal early breast cancer have been selected as the last topics covered in this review.
Biomedical Research/*trends ; Endometrial Neoplasms/drug therapy/pathology/surgery ; Female ; Genital Neoplasms, Female/diagnosis/*therapy ; Humans ; Ovarian Neoplasms/drug therapy/pathology/surgery ; Uterine Cervical Neoplasms/drug therapy/pathology/surgery

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carboplatin ; administration & dosage ; Carcinoma in Situ ; pathology ; Cystadenocarcinoma, Papillary ; etiology ; pathology ; therapy ; Cystadenocarcinoma, Serous ; etiology ; pathology ; therapy ; Disease Progression ; Endometrial Hyperplasia ; pathology ; Endometrial Neoplasms ; etiology ; pathology ; therapy ; Female ; Humans ; Hysterectomy ; methods ; Paclitaxel ; administration & dosage ; Precancerous Conditions ; etiology ; pathology ; therapy ; Radiotherapy, Adjuvant ; Uterine Neoplasms ; pathology

OBJECTIVETo evaluate antisense technology for human telomerase inhibition in the treatment of endometrial cancer.

METHODSAn antisense oligodeoxynucleotides (AODN) directed against the human telomerase transcriptase (hTERT), designed and synthesized to serve as a telomerase inhibitor, was transfected into endometrial carcinoma cell line HEC-1A by lipofectin. Reverse transcription-polymerase chain reaction (RT-PCR) and Western blot were used to test the expression of hTERT mRNA and hTERT protein before and after transfection. Telomerase activity was tested by telomeric repeat amplification protocol. The proliferation and growth of HEC-1A were also studied by methyl thiazolyl tetrazolium and cell growth curve before and after transfection.

RESULTSAODN could down-regulate the expression of hTERT mRNA and protein, inhibiting telomerase activity and proliferation of endometrial cancer cell line in a dose- and period-dependent manner.

CONCLUSIONAntisense oligodeoxynucleotides of human telomerase transcriptase definitely inhibits the proliferation of endometrial cancer cell line. Telomerase inhibitor may thus become a new gene therapeutic agent for endometrial carcinoma.

Caspases ; metabolism ; Cell Line, Tumor ; Cell Proliferation ; Endometrial Neoplasms ; pathology ; therapy ; Female ; Genetic Therapy ; Humans ; Oligonucleotides, Antisense ; genetics ; RNA, Messenger ; analysis ; Telomerase ; antagonists & inhibitors ; genetics

OBJECTIVE: The aims of this study were to identify clinical and pathologic characteristics of patients with uterine papillary serous carcinoma (UPSC) and to evaluate the overall survival. METHODS: Sixteen patients with FIGO stage I-IV UPSC who were surgically staged except one at the Asan medical Center between 1995 and 2004 were identified. For each patient, medical records, pathology reports and treatment modality were reviewed. The Kaplan-Meier method was used to generate survival data. RESULTS: There were 8 patients with stage I disease, 1 with stage II, 3 with stage III, and 4 with stage IV. The median age at the time of diagnosis was 64 years (range, 38-81 years). It occurred in 14 postmenopausal women who usually present with abnormal vaginal bleeding. Obesity, diabetes, hypertension, or a history of hormone replace therapy, known as risk factor of endometrial cancer, were not usually seen. Of the 15 patients who had surgical staging, 12 patients received adjuvant therapy, 2 patients no adjuvant therapy and 1 patient chemotherapy before and after surgery. 1 patient with advanced stage received chemotherapy without surgical staging. The 3-year survival rate was 21.4% and the median survival time for patients with early stage and advanced stage was 31.0 and 14.6 months respectively. CONCLUSION: In this patients with UPSC, there was a high proportion with abdominal metastasis and poor prognosis compared to endometrioid adenocarcinoma. Therefore, complete surgical staging like in case of ovarian cancer is vital in determining their prognosis and vigorous adjuvant therapies are required.
Carcinoma, Endometrioid ; Chungcheongnam-do ; Diagnosis ; Drug Therapy ; Endometrial Neoplasms ; Female ; Humans ; Hypertension ; Medical Records ; Neoplasm Metastasis ; Obesity ; Ovarian Neoplasms ; Pathology ; Prognosis ; Risk Factors ; Survival Rate ; Uterine Hemorrhage

UNLABELLEDTo investigate the clinical and pathological characteristics, treatment, and The data of 12 patients prognosis of synchronous primary cancer of the endometrium and ovary. Methods with synchronous primary cancer of the endometrium and ovary were retrospectively reviewed . Results Eight patients had the same histological type of endometrioid carcinoma in both uterus and ovary, 4 patients had different histological types in uterus and ovary. Synchronous primary cancer of the endometrium and ovary was difficult to be dignosed preoperatively. All ovarian tumors were small with an average diameter of 7 cm. Infertility was common among these patients(40.7%). Most of them had early stage I lesion (66.7%). endometrioid carcinomas was the main pathologic type (66.7%). All patients were treated surgically followed by chemotherapy with a 3-year survival rate of 66.7% (8/12).

CONCLUSIONSynchronous primary endometrium and ovary cancer is a specific kind of tumor different from either the primary endometrium carcinoma or ovary carcinoma, and usually can be detected in early stage with a good prognosis.

Adenocarcinoma ; pathology ; therapy ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma, Endometrioid ; pathology ; therapy ; Cisplatin ; therapeutic use ; Combined Modality Therapy ; Cyclophosphamide ; therapeutic use ; Cystadenocarcinoma, Papillary ; pathology ; therapy ; Endometrial Neoplasms ; pathology ; therapy ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Middle Aged ; Neoplasms, Multiple Primary ; pathology ; therapy ; Ovarian Neoplasms ; pathology ; therapy ; Retrospective Studies ; Survival Analysis