Beschreibung
During the past 20 years, endometrial carcinoma has continued to increase in frequency and it is quite possible that this carcinoma will become the major gynecologic malignancy in the future. For many years, endometrial carcinoma was considered less malignant than other gynecologic malignancies, simple hysterectomy and bil ateral salpingo-oophorectomy or surgery combined with radiation being effective in certain circumstances. It is unfortunate to note that the global 5-year survival rate for patients with advanced or recurrent endometrial carcinoma has improved only slightly. Therefore any complacency regarding this 'benign malignancy' should be reconsidered. There is a growing awareness of the nature of end ometrial carcinoma, with advances in our knowledge ranging from its etiology through its epidemiology to its clinical findings. This volume has been designed to fill a hiatus in the literature in China. To achieve this aim, we have attempted to review the world-wide advances on endometrial carcinoma and summarize systematically and comprehensively this common gynecologic malig nancy, including the clinical experiences gathered at the Cancer Institute (Hospital) of the Chinese Academy of Medical Sciences since 1958 as well as a brief description of the psychological problems in patients with gyneco logic cancers.
Autorenportrait
Inhaltsangabe1 Epidemiology and Etiology.- 1.1 Epidemiology.- 1.2 Etiology.- 1.2.1 Age.- 1.2.2 Obesity.- 1.2.3 Nulliparity.- 1.2.4 Late Menopause.- 1.2.5 Diabetes Mellitus, Hypertension, and Associated Internal Medical Diseases.- 1.2.6 Ovarian Tumors and Ovarian Diseases.- 1.2.7 Oral Contraceptives.- 1.2.8 Exogenous Estrogen.- 1.2.9 Previous Pelvic Irradiation.- 1.2.10 Summary.- References.- 2 Pathology.- 2.1 Pathologic Manifestation of Endometrial Carcinoma.- 2.1.1 Gross Characteristics.- 2.1.2 Microscopic Appearances.- 2.1.3 Histologic Grade.- 2.1.4 Pattern of Spread.- 2.2 Ultrastructural, Chromosomal Karyotyping, and Nuclear DNA Studies.- 2.2.1 Ultrastructural Studies.- 2.2.2 Chromosomal Karyotyping and Nuclear DNA Studies.- 2.3 Rare Types of Endometrial Carcinoma.- 2.3.1 Argyrophil Cell Carcinoma of Small Cell Carcinoma.- 2.3.2 Primary Pure Squamous Cell Carcinoma of the Endometrium.- 2.4 Endometrial Hyperplasia and Adenocarcinoma in Situ.- 2.4.1 Classification of Endometrial Hyperplasia.- 2.4.2 Pathology of Endometrial Hyperplasia.- 2.4.3 Relationships of Various Forms of Endometrial Hyperplasia.- 2.4.4 Etiology and Pathogenesis of Endometrial Hyperplasia.- 2.4.5 Carcinoma in Situ of the Endometrium.- 2.4.6 Distinction Between Hyperplasia and Adenocarcinoma.- References.- 3 Diagnosis of Endometrial Carcinoma.- 3.1 Clinical Manifestation.- 3.1.1 Age.- 3.1.2 Symptoms.- 3.1.3 Pelvic Examination.- 3.2 Diagnosis.- 3.2.1 Endometrial Sampling of the Uterine Cavity.- 3.2.2 Cytologic Examination.- 3.2.3 Hysteroscopy.- 3.2.4 Computerized Tomography.- 3.2.5 Magnetic Resonance Imaging.- 3.2.6 Ultrasonographic Assessment of Endometrial Carcinoma.- 3.2.7 Pelvic Lymphography.- 3.3 Differential Diagnosis.- 3.3.1 Differential Diagnosis of Endometrial Carcinoma.- 3.3.2 Association of Endometrial Carcinoma with Other Malignancies or Pregnancy.- 3.3.3 Rare Cases of Endometrial Carcinoma.- 3.4 Clinical Staging.- References.- 4 Treatment of Endometrial Carcinoma.- 4.1 Historical Review.- 4.2 Surgical Treatment.- 4.2.1 Value of Surgical Treatment.- 4.2.2 Common Surgical Approaches for Endometrial Carcinoma.- 4.2.3 Problems of Surgery.- 4.3 Radiotherapy.- 4.3.1 Indication and Value.- 4.3.2 Intracavitary Irradiation.- 4.3.3 External Beam Therapy.- 4.4 Hormonal Treatment.- 4.4.1 Progestogens.- 4.4.2 Antiestrogens.- 4.4.3 Combination of Progestogens with Antiestrogens.- 4.4.4 Use of Estrogen After Surgery and Irradiation for Endometrial Carcinoma.- 4.5 Chemotherapy.- 4.5.1 Single-Agent Chemotherapy.- 4.5.2 Combination Chemotherapy.- 4.6 Suggested Therapy in Each Stage of Endometrial Carcinoma.- 4.6.1 Stage I.- 4.6.2 Stage II.- 4.6.3 Stages III and IV.- 4.6.4 Recurrent Disease.- References.- 5 Prognosis of Endometrial Carcinoma.- 5.1 Treatment Result.- 5.2 Recurrence.- 5.2.1 Recurrence Rate.- 5.2.2 Interval Between Primary Treatment and Recurrence.- 5.2.3 Recurrence Location.- 5.2.4 Treatment and Prognosis of Recurrence.- 5.3 Prognostic Factors.- 5.3.1 Age.- 5.3.2 Clinical Stages.- 5.3.3 Lymph Node Involvement.- 5.3.4 Myometrial Invasion.- 5.3.5 Cervical Involvement.- 5.3.6 Uterine Size.- 5.3.7 Histologic Differentiation.- 5.3.8 Histologic Type.- 5.3.9 Tumor Volume.- 5.3.10 Distance of the Lesion from the Internal Cervical Os.- 5.3.11 Pathology of Pericancerous Endometrium.- 5.3.12 Peritoneal Cytology.- 5.3.13 Hormone Receptor.- 5.3.14 Treatment Modalities.- References.- 6 Laboratory Research.- 6.1 Steroid Hormone Receptors of Endometrial Carcinoma.- 6.1.1 Discovery of Sex Steroid Hormone Receptors.- 6.1.2 Definition and Characteristics of Steroid Hormone Receptors.- 6.1.3 Intracellular Mechanism of Action of Steroid Receptors.- 6.1.4 Methodology of Steroid Hormone Receptor Detection.- 6.1.5 Physiology of Steroid Receptors in Normal Tissues.- 6.1.6 Estrogen Receptors and Progesterone Receptors in Endometrial Carcinoma.- 6.1.7 Estrogen Receptors and Progesterone Receptprs in Ovarian Carcinoma and Cervical Carcinoma.- 6.2 Monoclonal Antibody in Cancer.- 6.2.1 Basi