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On the prognosis and treatment of early stage endometrial carcinoma : Studies with special reference to uterine papillary serous carcinoma

Rosenberg, Per, (författare)
Linköpings universitet, Onkologi, Linköpings universitet, Hälsouniversitetet
Sorbe, Bengt, Docent (opponent)
ISBN 91-7870-646-7
Linköping : Linköpings universitet, 1992
Engelska 39s.
Serie: Linköping University Medical Dissertations, 0345-0082
  • Doktorsavhandling (övrigt vetenskapligt)
Abstract Ämnesord
  • <p>The prognosis and therapy in the subgroup of endometrial malignancies called Uterine Papillary Serous Carcinoma (UPSC) was investigated. This entity constitutes about 6-8 % of all endometrial carcinomas clinical stage I but, as has been shown here, accounts for one third of the cancer mortality in the early stages of endometrial carcinoma.</p><p>-The prognostic significance of nuclear atypia, FIGO grade and age was determined in patients with clinical stage 1-11 Uterine Papillary Serous Carcinoma.</p><p>-DNA-index and S-phase fraction, determined by flow cytometry on formalin-fixed, paraffin-embedded endometrial curettage material was evaluated in relation to nuclear atypia, FIGO grade and age in early stage endometrial carcinoma.</p><p>-A new method of minimizing the dilution of non-epithelial cells in the malignant curettage material when performing flow cytometry was developed.</p><p>-The survival and pattern of metastasis in a population-based patient material was investigated -The effects on survival of a new aggressive treatment regimen was assessed.</p><p>The results show that: Patients with uterine papillary serous carcinoma have a much worse prognosis than do patients with ordinary endometrial carcinoma.</p><p>DNA ploidy and S-phaseratederived from flow cytometryperformed on disintegrated, previously paraffinembedded, endometrial curettings are important prognostic factors.</p><p>It is possible to exclude contaminating non-epithelial cells from the DNA analysis by the use of an anticytokeratin antibody, Patients with uterine papillary serous carcinoma clinical stage I have a significantly higher risk of recurrence than patients with non-UPSC. The localisation of the recurrences among the UPSC patients is more similar to that of serous papillary ovarian carcinoma than that of ordinary adenocarcinoma of the endometrium. A primary treatment ofUPSC with a more extensive surgery, adjuvant external radiation and platinum-based chemotherapy seems to improve the outcome.</p>





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