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Results for “UTERINE NEOPLASMS”

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PubMed1978

A reassessment of uterine neoplasms originally diagnosed as leiomyosarcomas.

Twenty-eight uterine tumors originally diagnosed as leiomyosarcomas were histologically reclassified without prior knowledge of follow-up or clinical data. Thirteen (46%) neoplasms were reinterpreted as cellular or pleomorphic leiomyomas. They had sparse mitotic activity with three or fewer mitotic figures per 10 high power microscopic fields (MF/10 HPF). None recurred or metastasized, and all patients were alive from 6.3 to 23 years after operation (median of 14.2 years). In 15 cases the diagnosis of leiomyosarcoma (LMS) was confirmed. All showed hypercellularity, nuclear atypism and high mitotic activity. Mitosis counts ranged from 6 to more than 50 MF/10 HPF with 93% of LMS having at least 15 MF/10 HPF. These patients all died of LMS after post-operative intervals of 3 months to 7.5 years (median survival of 13 months). No consistent correlation was found between length of survival and the patient's menopausal status or histologic grade of LMS. The degree of mitotic activity is the single most reliable diagnostic criterion of malignant potential, albeit not the only one. Surgery alone is ineffective treatment for LMS and combination therapy with radiation therapy and/or chemotherapy should be considered.

Adult↗
PubMed1975

[Results of radiotherapy with cobalt 60 beads compared to surgery in 725 uterine neoplasms].

From 1958 to 1970, in 435 cases (60%) out of 725 carcinomas of the uterus sole radiation therapy by cobalt-60 beads was performed; in 288 cases (39.7%) surgery was done (combined with tele-cobalt-irradiation in almost all cases, 5000 to 6000 rd TD). Two cases (0.3%) received no treatment. The unfavorable selection of the irradiated women (average age 64,6 years) as against the surgically treated ones (average age 50.9 years) did allow a complete intracavitary irradiation only in 60.6% of the cases; in 39.4%, the dose had to be reduced considerably. The five-year survival amounted to: 64.4% after sole irradiation, 93.2% after operation/postirradiation in stage I; 46.9% after sole irradiation, 75.0% after operation/postirradiation in stage II; 30.8% after sole irradiation in stage III. No survivors existed in stage IV. Mortality from treatment with sole irradiation amounted to 1.8% (8/435). Radiation fistulas were observed after sole irradiation in 0.4% (1/435), after operation/postirradiation in 0.7% (2/288). As long as there is no satisfactory afterloading technique for intracavitary irradiation of the carcinoma of the uterus, an application of cobalt-60 beads seems to offer the following advantages as compared to an implant of radium filters: Shorter duration of the application, better adaptability to the cavitary lumen, diminished risk of perforation. No perforation was observed.

Adult↗