Cancer Therapy Vol 1, page 385 Table 9. Rates and sites of recurrence in patients with early stage endometrial cancer Reference
patients
Patients with recurrence
Sites of recurrences Distant Local Dostant 264 33 (12.5%) 3 27 3 300 47 (15.6%) 16 29 2 317 53 (16.7%) 25 28 398 44** (11.1%) 15 16 8 133 24 (18.0%) 6 17 1 recurrent disease but complete follow-up data were available only for 39 of them Local
Lurain et al, 1991 Podczaski et al, 1992 Shumsky et al, 1994 Reddoch et al, 1995 Gadducci et al, 2000 ** 44 patients developed
+
Table 10. Examinations that detected recurrent disease in asymptomatic patients with relapsed endometrial cancer Reference
Patients
Recurred patients
Asymptomatic Physical Chest PAP US CT other Recurred exam x-ray test patients Podczaski et al, 1992 300 47 24 14* 10* 1 Shumsky et al, 1994 317 53 13 5 6 2 Reddoch et al, 1995 398 44** 23 13 1 1 2 6 Gadducci et al, 2000 133 24 13 3 1 1 3 5 * one patient with concomitant local and distant failure had both an abnormal physical examination and an abnormal chest X-ray ** 44 patients developed recurrent disease but complete follow-up data were available only for 39 of them US: ultrasound; CT: computed tomography Alektiar KM, McKee A, Venkatraman E, McKee B, Zelefsky MJ, Mychalczak BR, Hoskins WJ, Barakat RR. (2002) Intravaginal high-dose-rate brachytherapy for Stage IB (FIGO Grade 1, 2) endometrial cancer. Int J Radiat Oncol Biol Phys 53, 707-713. Asbury RF, Brunetto VL, Lee RB, Reid G, Rocereto TF. Gynecologic Oncology Group (2002). Goserelin acetate as treatment for recurrent endometrial carcinoma: a Gynecologic Oncology Group study. Am J Clin Oncol 25, 557-560. Ayhan A, Taskiran C, Celik C, Yuce K, Kucukali T. (2002) The influence of cytoreductive surgery on survival and morbidity in stage IVB endometrial cancer. Int J Gynecol Cancer 12, 448-453. Ayhan A, Tuncer R, Tuncer ZS, Yuce K, Kucukali T. (1994) Correlation between clinical and histopathologic risk factors and lymph node metastases in early endometrial cancer (a multivariate analysis of 183 cases). Int J Gynecol Cancer 4, 306-309. Ball HG, Blessing JA, Lentz SS, Mutch DG. (1996) A phase II trial of taxol in advanced and recurrent adenocarcinoma of the endometrium. Gynecol Oncol 62, 278-281. Bancher-Todesca D, Neunteufel W, Williams KE, Prainsack D, Breitenecker G, Friedlander ML, Hacker NF. (1998) Influence of postoperative treatment on survival in patients with uterine papillary serous carcinoma. Gynecol Oncol 71, 344-347. Barakat RR, Goldman NA, Patel DA, Venkatraman ES, Curtin JP. (1999) Pelvic exenteration for recurrent endometrial cancer. Gynecol Oncol 75, 99-102. Bar-Am A, Ron IG, Kuperminc M, Gal I, Jaffa A, Kovner F, Wigler N, Inbar M, Lessing J. (1998) The role of routine pelvic lymph node sampling in patients with stage I endometrial carcinoma: Second thoughts. Acta Obstet Gynecol Scand. 77, 347-350. Bell JG, Minnick A, Reid GC, Judis J, Brownell M. (1997) Relationship of nonstaging pathological risk factors to lymph
improve patient survival. Interesting fields of research are represented by the assessment of new hormonal drugs, such as SERMs (Chan, 2002; Burke and Walker, 2003; McMeekin et al, 2003) and antisense estrogen receptor oligodeoxyribonucleotides (Taylor et al, 2002), and of investigational agents able to interfere with the activity of protooncogenes, onco-suppressor genes, mismatch repair genes, and molecules involved in tumor invasiveness and angiogenesis (Elit and Hirte, 2002; Fujiwaki et al, 2002; Santin et al, 2002). For instance Santin et al (2002) suggested the administration of trastuzumab to patients with uterine serous papillary l cancer that often shows HER-2/neu overexpression. Further developments in understanding the molecules involved in tumor growth and spreading will allow the synthesis of specific and selective inhibitors (Fujiwaki et al, 2002).
References Aalders J, Abeler V, Kolstad P, Onsrud M. (1980) Postoperative external irradiation and prognostic parameters in stage I endometrial carcinoma: clinical and histopathologic study of 540 patients. Obstet Gynecol 56, 419-427. Aapro M, Bolis G, Chevallier B, van der Burg MEL, Poveda A, de Oliveira C, Pawinski A, Sahmoud T, Pecorelli S. (1994) An EORTC-GCCG randomized phase II trial of doxorubicin (DOX) versus DOX-cisplatin (CDDP) in endometrial carcinoma. Proc Am Soc Clin Oncol 13, 275 (abstract 885). Ackerman I, Malone S, Thomas G, Franssen E, Balogh J, Dembo A. (1996) Endometrial carcinoma--relative effectiveness of adjuvant irradiation vs therapy reserved for relapse. Gynecol Oncol 60, 177-183 Agboola OO, Grunfeld E, Coyle D, Perry GA. (1997) Costs and benefits of routine follow-up after curative treatment for endometrial cancer. CMAJ 157, 879-886.
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