Cytoreduction and intraperitoneal heated chemotherapy for the treatment of endometrial carcinoma recurrent within the peritoneal cavity

2007 ◽  
Vol 17 (1) ◽  
pp. 204-209 ◽  
Author(s):  
C. W. Helm ◽  
C. R. Toler ◽  
R. S. Martin ◽  
M. E. Gordinier ◽  
L. P. Parker ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Carcinoma ◽  
Residual Disease ◽  
Abdominal Cavity ◽  
Retrospective Chart Review ◽  
Exploratory Laparotomy ◽  
Chemotherapy Agent ◽  
Postoperative Serum ◽  
Recurrent Endometrial Cancer ◽  
Lost To Follow Up

Our experience with hyperthermic intraperitoneal chemotherapy (IPHC) in conjunction with surgical resection for endometrial cancer recurrent within the abdominal cavity was reviewed. Eligible patients underwent exploratory laparotomy with the aim of resecting disease to ≤5 mm maximum dimension followed immediately by intraperitoneal perfusion of cisplatin (100 mg/m2) heated to 41–43°C (105.8–109.4°F) for 1.5 h. Data for analysis was extracted from retrospective chart review. Five patients underwent surgery and IPHC between September 2002 and January 2005 for abdomino-pelvic recurrence. Original stage and histology were 1A papillary serous (1), 1C endometrioid with clear cell features (1), and 1B endometrioid (3). Mean age was 61 (41–75) years, mean prior laparotomies were 1.4 (1–2), and mean chemotherapy agent exposure was 1.6 (0–4). Mean time from initial treatment to surgery and IPHC was 47 (29–66) months. Mean length of surgery was 9.8 (7–11) h after which three patients had no residual disease and two had ≤5 mm disease. The mean duration of hospital stay was 12.6 (6–20) days. Postoperative surgical complications included wound infection with septicemia in one patient. Mean maximum postoperative serum creatinine was 1.02 (0.6–1.70) mg/dL. There was no ototoxicity or neuropathy and no perioperative mortality. No patients have been lost to follow-up. Two are living disease free at 28 and 32 m and two are living with disease at 12 and 36 m. One patient died at 3 m without evidence of cancer. Two patients who had no residual macroscopic disease at the end of surgery are alive at 32 and 36 m. The combination of IPHC with surgery for recurrent endometrial carcinoma is relatively well tolerated. The unexpectedly long survival seen in this cohort supports a phase II trial of IPHC with cisplatin for recurrent endometrial cancer.

scholarly journals A clinical case of successful treatment of a giant serous endometrial carcinoma imitating ovarian cancer

2021 ◽  
Vol 12 (4) ◽  
pp. 80-85
Author(s):  
Aleksander I. Berishvili ◽  
Yuri V. Ivanov ◽  
Dmitry P. Lebedev ◽  
Fedor G. Zabozlaev ◽  
Edward V. Kravchenko ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Endometrial Cancer ◽  
Endometrial Carcinoma ◽  
Umbilical Hernia ◽  
Clinical Case ◽  
Skin Flap ◽  
Abdominal Cavity ◽  
Correct Diagnosis ◽  
Greater Omentum ◽  
Excess Skin

Background: Giant tumors of the abdominal cavity, as a rule, occur in elderly patients with characteristic features and represent a serious problem in terms of choosing a radical method of therapy. Of particular difficulty are cases of giant serous endometrial cancer, requiring a differential diagnosis with ovarian cancer. Clinical case description: A clinical case of giant serous endometrial cancer mimicking ovarian cancer in a 55-year-old woman is presented. The patient came to the oncology department with complaints of abdominal enlargement, difficulty breathing and bloody discharge from the genital tract. The examination revealed the following: a giant formation (4065 cm), occupying the entire pelvic and the entire abdominal cavities, ascites, lesions of the retroperitoneal lymph nodes, and the greater omentum, an umbilical hernia. A chest CT showed multiple contrast-accumulating circular shadows of 313 mm (metastases). By the decision of the council, after the preliminary chemoembolization of both the uterine and ovarian arteries, a supravaginal amputation of the uterus with appendages was performed, along with the resection of the greater omentum, removal of the umbilical hernia with positioning a plastic mesh implant and excision of an excess skin flap. The histological examination of the intraoperative material made it possible to verify the diagnosis of a serous endometrial carcinoma with subtotal tumor necrosis, the myometrium invasion of more than a half of its thickness, with the egress to the perimetrium, metastatic lesions of both ovaries, the greater omentum, anterior abdominal wall. Stage T3b (FIGO IIIB). In the postoperative period, 6 courses of Paclitaxel / Carboplatin (AUC4-5) chemotherapy were carried out with a pronounced clinical effect. The patient was discharged in a satisfactory condition. The control PET-CT scan after the 6th chemotherapy course showed no pathology in the thoracic cavity, and no process progress in the abdominal cavity. Currently, the remission of the disease is 9 months. Conclusion: An algorithm for the diagnostic measures aimed at making the correct diagnosis is presented, and the tactics of treating a patient with giant serous endometrial cancer is described.

Hysteroscopy does not increase the risk of microscopic extrauterine spread in endometrial carcinoma

2003 ◽  
Vol 13 (2) ◽  
pp. 223-227 ◽  
Author(s):  
L. Selvaggi ◽  
G. Cormio ◽  
O. Ceci ◽  
G. Loverro ◽  
A. Cazzolla ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Carcinoma ◽  
Cancer Patients ◽  
Abdominal Cavity ◽  
Primary Diagnosis ◽  
Peritoneal Cytology ◽  
Clinicopathologic Characteristics ◽  
Diagnostic Modality ◽  
Tumor Dissemination ◽  
Positive Peritoneal Cytology

Fluid hysteroscopy has been suspected to cause tumor dissemination in the abdominal cavity in endometrial cancer patients. The aim of our study was to evaluate the incidence of microscopic extrauterine spread according to diagnostic modality (dilatation & curretage, D&C, hysteroscopy, or both) in patients with endometrial carcinoma. A retrospective study was conducted on 147 patients with histologically proven diagnosis of endometrial carcinoma without macroscopic extrauterine disease. Fluid hysteroscopy was performed by using saline solution irrigated at a final flow of 150 ml/min with a intrauterine pressure ranging between 25 and 50 mmHg. Microscopic intraperitoneal disease and positive peritoneal cytology were considered the primary end-points of this analysis. Fifty-two patients (35%) had diagnosis of endometrial cancer made only by D&C, 56 (39%) underwent D&C and then hysteroscopy, and 39 (26%) had only hysteroscopy. Distribution of the patients in this three groups was casual, and clinicopathologic characteristics of the patients in the three groups were similar. Peritoneal cytology was positive in nine patients, 13 had microscopic ovarian metastases, and eight had microscopic involvement of the pelvic peritoneum or of omentum. Neither the presence of positive peritoneal cytology nor the findings of microscopic intraperitoneal dissemination were significantly associated with the diagnostic procedure employed for primary diagnosis (D&C or D&C plus hysteroscopy or hysteroscopy alone). We conclude that fluid hysteroscopy does not increase the risk of microscopic intraperitoneal spread in endometrial cancer patients as compared to D&C.

scholarly journals IMPACT OF HORMONAL BIOMARKERS ON RESPONSE TO HORMONAL THERAPY IN ADVANCED AND RECURRENT ENDOMETRIAL CANCER:

2021 ◽  
Author(s):  
Willem Jan VAN WEELDEN ◽  
Roy I. LALISANG ◽  
Johan BULTEN ◽  
Kristina LINDEMANN ◽  
Heleen J. VAN BEEKHUIZEN ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Hormonal Therapy ◽  
Recurrent Endometrial Cancer

scholarly journals CD133 Expression in the Nucleus Is Associated with Endometrial Carcinoma Staging and Tumor Angioinvasion

2021 ◽  
Vol 10 (10) ◽  
pp. 2144
Author(s):  
Milosz Pietrus ◽  
Kazimierz Pitynski ◽  
Marcin Waligora ◽  
Katarzyna Milian-Ciesielska ◽  
Monika Bialon ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Plasma Membrane ◽  
Tumor Progression ◽  
Endometrial Carcinoma ◽  
Molecular Level ◽  
Risk Group ◽  
High Risk Group ◽  
Cd133 Expression ◽  
Transmembrane Glycoprotein ◽  
The Impact

Background: (1) Endometrial cancer is one of the most common cancers affecting women, with a growing incidence. To better understand the different behaviors associated with endometrial cancer, it is necessary to understand the changes that occur at a molecular level. CD133 is one of the factors that regulate tumor progression, which is primarily known as the transmembrane glycoprotein associated with tumor progression or cancer stem cells. The aim of our study was to assess the impact of subcellular CD133 expression on the clinical course of endometrial cancer. (2) Methods: CD133 expression in the plasma membrane, nucleus, and cytoplasm was assessed by immunohistochemical staining in a group of 64 patients with endometrial cancer representing FIGO I-IV stages, grades 1–3 and accounting for tumor angioinvasion. (3) Results: Nuclear localization of CD133 expression was increased in FIGO IB-IV stages compared to FIGO IA. Furthermore, CD133 expression in the nucleus and plasma membrane is positively and negatively associated with a higher grade of endometrial cancer and angioinvasion, respectively. (4) Conclusions: Our findings suggest that positive nuclear CD133 expression in the tumor may be related to a less favorable prognosis of endometrial carcinoma patients and has emerged as a useful biomarker of a high-risk group.

scholarly journals 429 Identification of clinicopathological prognostic factors in recurrent endometrial cancer

2020 ◽  
Author(s):  
Y Koike ◽  
M Takenaka ◽  
J Suzuki ◽  
Y Shoburu ◽  
K Tomita ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Prognostic Factors ◽  
Recurrent Endometrial Cancer

Successful treatment of two patients with recurrent endometrial cancer by weekly paclitaxel

2000 ◽  
Vol 160 (1) ◽  
pp. 9-12 ◽  
Author(s):  
Shunichiro Ota ◽  
Toru Sugiyama ◽  
Kimio Ushijima ◽  
Kan Komai ◽  
Keizo Fujiyoshi ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Successful Treatment ◽  
Weekly Paclitaxel ◽  
Recurrent Endometrial Cancer

Phase II Trial of the Pegylated Liposomal Doxorubicin in Previously Treated Metastatic Endometrial Cancer: A Gynecologic Oncology Group Study

2002 ◽  
Vol 20 (9) ◽  
pp. 2360-2364 ◽  
Author(s):  
Franco M. Muggia ◽  
John A. Blessing ◽  
Joel Sorosky ◽  
Gary C. Reid
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Carcinoma ◽  
Liposomal Doxorubicin ◽  
Gynecologic Oncology ◽  
Pegylated Liposomal Doxorubicin ◽  
Median Number ◽  
Gynecologic Oncology Group ◽  
Pretreated Patients ◽  
Central Pathology ◽  
Wbc Count

PURPOSE: To determine whether pegylated liposomal doxorubicin (PLD) has antitumor activity in pretreated patients with persistent or recurrent endometrial carcinoma and to define the nature and degree of toxicity of PLD. PATIENTS AND METHODS: Women with histologically documented recurrent or persistent measurable endometrial carcinoma and with failure of one prior treatment regardless of prior anthracycline therapy were enrolled. PLD was administered intravenously over a 1-hour period at a dose of 50 mg/m2 every 4 weeks; the dosage was modified in accordance with observed toxicity. RESULTS: Of 46 patients entered, 42 were assessable for response, as three were declared ineligible on central pathology review and one was not assessable for response. Forty had received prior chemotherapy, 11 hormonal therapy, and 29 radiation therapy. Doxorubicin had been given to 32 patients, carboplatin with paclitaxel to six, carboplatin to one, and fluorouracil to one. Four patients had partial responses lasting 1.1, 2.1, 3.3, and 5.4 months; the overall response rate was 9.5% (95% confidence interval, 2.7% to 22.6%). Three of these responses (in liver and in lymph node) occurred in patients who had progressed after doxorubicin with either paclitaxel or cisplatin. The median number of courses was 2.5 (range, one to 14). Toxicity was generally mild: only 25 patients experienced leukopenia, with a median WBC count of 2,900 (range, 800 to 3,900) at nadir. The only grade 4 toxicities were one episode each of esophagitis, hematuria, and vomiting. The median overall survival was 8.2 months. CONCLUSION: PLD has only limited activity in pretreated advanced, recurrent endometrial cancer, but further trials in anthracycline-naive patients and in previously untreated patients are ongoing. Its toxicity profile should permit its use in combination with myelosuppressive drugs.

Dasatinib, paclitaxel, and carboplatin in women with advanced-stage or recurrent endometrial cancer: A pilot clinical and translational study

2021 ◽  
Vol 161 (1) ◽  
pp. 104-112
Author(s):  
Robert L. Coleman ◽  
Wei Hu ◽  
Pamela Soliman ◽  
Alpa Nick ◽  
Pedro T. Ramirez ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Advanced Stage ◽  
Translational Study ◽  
Recurrent Endometrial Cancer
Sign in / Sign up

Export Citation Format

Share Document