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At least 451 records · Page 25Linked to original sources
PubMed1979

Primary invasive squamous carcinoma of the vagina.

Forty-three cases of primary vaginal squamous cell cancer were treated at the University of Wisconsin Hospital between 1956 and 1971. These cases comprised 1.2% of patients admitted to the University Hospital with female genital tract cancer. Evidence is presented to support a modification of the currently accepted FIGO staging system for vaginal carcinoma (Stage II disease). Radiation therapy using both external beam and brachyradium equivalents or interstitial implantation of suitable isotopes was an effective method for the treatment of patients having early and locally advanced invasive vaginal cancer. The 5-year absolute survival rate for the entire series was 37.2%. Absolute survival rate by modified FIGO clinical staging was 66% for Stages I and IIA, 31% for Stage IIB, 25% for Stage III, and 0% for Stage IV.

Adult↗
PubMed2002

Endometrial thickness as a test for endometrial cancer in women with postmenopausal vaginal bleeding.

OBJECTIVE: To assess the value of endometrial thickness measurement as a test for endometrial cancer in postmenopausal women with vaginal bleeding (symptomatic women). DATA SOURCES: We conducted a literature search using the MEDLINE database from 1991 to 1997, and the key words "vaginal ultrasonography" and "endometrial thickness measurement." The review was limited to original research reports written in English, concerning symptomatic women having vaginal ultrasonography before a diagnostic test and not receiving tamoxifen. STUDY SELECTION: A total of 48 studies were identified. A questionnaire was sent to the corresponding author of each paper requesting supplementary information. Data were included in our analysis if the corresponding author was able to supply information on the median endometrial thickness in unaffected symptomatic women and the endometrial thickness values in affected women. Nine studies were thus included in our meta-analysis, representing 3483 women without endometrial cancer and 330 women with endometrial cancer. TABULATION, INTEGRATION, AND RESULTS: The median endometrial thickness in women with endometrial cancer was 3.7 times that in unaffected women at the same center, and with the same menopausal status and same hormone replacement therapy use category. The detection rate was 63% (95% confidence interval 58, 69) for a 10% false-positive rate, or 96% (95% confidence interval 94, 98) for a 50% false-positive rate. CONCLUSION: Endometrial thickness measurement in symptomatic women does not reduce the need for invasive diagnostic testing because 4% of the endometrial cancers would still be missed with a false-positive rate as high as 50%.

Endometrial Neoplasms↗
PubMed1998

[Clinical evaluation of the effectiveness of radiotherapy in vaginal metastases of uterine cancer].

The data on 132 patients with metastases of endometrial carcinoma into the vagina (MECV) were analysed. Among the modalities used were complex (remote + contact) and contact radiotherapy with low-, medium- and high dosage. The following radiobiological models were employed to assess tissue response: time-dose-fractionation factor, cumulative radiation effect and linear-quadratic dose effect equation ("extrapolated dose of response"). There was a correlation between five-year survival in radiation-treated patients and metastasis size. Stage of disease proved a major prognostic factor in MECV treatment. Complex radiotherapy was of crucial importance in MECV treatment whatever the size of disseminated tumor. There was no correlation between efficacy of MECV treatment and therapy used to treat primary endometrial carcinoma (surgery, combined or radiotherapy).

Brachytherapy↗
PubMed2002

Postoperative intravaginal brachytherapy for endometrial cancer; dosimetric analysis of vaginal colpostats and cylinder applicators.

PURPOSE: To investigate the dosimetric differences between colpostats and cylinder applicators for intravaginal brachytherapy. METHODS AND MATERIALS: Dose distributions near vaginal colpostats and dome cylinders were computed with a commercial high-dose-rate treatment-planning system and verified by spot measurements by using LiF thermoluminescent dosimeters. Taking source anisotropy into account, dwell times were optimized by the computer by using the polynomial optimization on dose points method to give uniform doses along the lateral surfaces of the applicators. In addition, the effects of vaginal packing and the separation distance between colpostats were studied by computing the dose to the vaginal mucosa, assuming 0.5 and 1.0 cm of vaginal packing and colpostat separation, respectively. RESULTS: The computed and measured doses agreed within +/- 7%. Surface doses were similar for both types of applicators when the effect of shielding in the colpostats was neglected. However, percent depth doses in the anterior/posterior and lateral directions were higher for the cylinder, whereas the dose fall-off along the longitudinal patient axis was less pronounced for the colpostats. When vaginal packing at the anterior and posterior surface of the colpostats was increased from 0 to 5, 10, and 15 mm, the corresponding vaginal dose decreased from 97% of the prescription dose to 60%, 39%, and 26%, respectively. Separating the colpostats from 0 to 5 and 10 mm reduced the surface dose near the bladder/rectum to 80% and 67%, respectively, whereas the respective apex dose decreased from 105% of prescription to 91% and 77%. CONCLUSIONS: Colpostats and cylinder applicators for intracavitary brachytherapy have their advantages and disadvantages in depth dose distribution and clinical use. If treatment is confined to the vaginal apex, either applicator can be used. However, the colpostat separation should be kept to a minimum, and vaginal packing should be applied with great care to avoid generating cold spots along the upper vaginal surface and vaginal cuff.

Brachytherapy↗
PubMedDate not supplied

Association of endometrial thickness assessed at trans-vaginal ultrasonography to endometrial cancer in postmenopausal women asymptomatic or with abnormal uterine bleeding.

PURPOSE: To define the normal cut off of endometrial thickness as measured at transvaginal ultrasonography (TVUS) in order to define postmenopausal women without symptoms or with abnormal uterine bleeding (AUB) at risk of endometrial carcinoma (EC). MATERIALS AND METHODS: 3460 postmenopausal women (2240 asymptomatic, 1220 with AUB) undergoing TVUS. These series was linked with the Tuscany Cancer Registry archives in order to identify subjects who developed EC subsequent (within two years) to TVUS. RESULTS: Thickness (half layer) was significantly reduced in 2234 subjects not developing EC (1.68 mm; range = 0-20, SD 3.14) as compared to 6 subjects developing EC (4.67 mm, range = 0-10, SD 3.67) (p=0.02). A 4 mm cut off was associated with a sensitivity of 66.7%, a specificity of 92.1%, a positive predictive value of 2.2% and a negative predictive value of 99.9%. Similarly, in subjects with AUB, thickness (half layer) was significantly smaller in the 1175 subjects not developing EC (2.46 mm, range 0-20, SD 3.59) as compared to 45 subjects developing EC (8.0 mm, range 0-44, SD 6.76) (p<0.001). The best cut off for clinical purposes was 4 mm, with a sensitivity of 91.1%, a specificity of 79.8%, a positive predictive value of 14.8% and a negative predictive value of 99.6%. CONCLUSIONS: The study confirms the usefulness of measuring endometrial thickness (half layer cut off = 4 mm) with TVUS in asymptomatic postmenopausal women, both in asymptomatic subjects to indicate further special surveillance and in subjects with AUB to indicate immediate invasive assessment.

Aged↗