Eur J Gynaecol Oncol
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Eur J Gynaecol Oncol · Jan 2003
Comparative StudyPreoperative and postoperative correlation of histopathological findings in cases of endometrial hyperplasia.
To determine the preoperative and postoperative correlation of histopathological findings in cases of endometrial hyperplasia. ⋯ Postoperative diagnosis of endometrial pathology might be different from that of preoperative especially in cases with simple endometrial hyperplasia without atypia.
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Eur J Gynaecol Oncol · Jan 2003
Comparative StudyThe value of ultrasonography in preoperative assessment of selected prognostic factors in endometrial cancer.
To determine the efficiency of transabdominal and transvaginal ultrasonography (TAS and TVS) in the assessment of myometrial invasion, cervical involvement, pelvic lymph nodes, adnexal and omental metastases (preoperative staging) of endometrial cancer. ⋯ These results suggest that 2D TAS and TVS evaluation of endometrial cancer are reliable methods for preoperative assessment of selected prognostic factors, e.g. myometrial invasion, cervical involvement and adnexal metastases. However in assessing lymph-node metastases, TVS with its low sensitivity, did not provide additional information. Preoperative ultrasound examination should be speculated as an important tool in the establishment of different surgical choices which can be made after a correct pretreatment prognosis.
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Eur J Gynaecol Oncol · Jan 2003
Prognostic factors in definitive radiotherapy of uterine cervical cancer.
To determine the prognostic factors related to local control and survival in 257 patients with uterine cervical cancer treated with definitive radiotherapy (RT). ⋯ Definitive RT is an effective treatment for patients with uterine cervical cancer. There are many prognostic factors influencing treatment outcome. Brachytherapy and chemotherapy must be added in appropriate patients to improve the outcome. Future prospective trials should be undertaken to confirm the validity of these factors and to individualize the treatment strategy for every patient.
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Eur J Gynaecol Oncol · Jan 2003
Prediction of cervical infiltration in Stage II endometrial cancer by different preoperative evaluation techniques (D&C, US, CT, MRI).
Our clinical practice for FIGO Stage II endometrial cancer consists of Wertheim's radical hysterectomy as first choice of treatment. The evaluation of patients is based on D&C. The accuracy of this preoperative staging method is examined here. ⋯ We can conclude that "overtreatment" seems to have occurred in 19 patients, whose cervical infiltration by endometrial cancer could not be proved by pathological staging. It can also be assessed that understaging took place in two cases, which can be explained by two reasons; we did not make use of preoperative imaging techniques since US was applied in six patients, CT in 16 and the most accurate, MRI, on three patients only. The other possible reason, which can point out the bad efficacy of the imaging techniques as well, could be that a major part of the patients received preoperative AL treatment, which could also have influenced the cervical progression. This is possible, but has not been proved. The difference in the number of cervical infiltrations in the group of patients who received preoperative radiotherapy and in the group where they did not, is not significant (p = 0.9742), and infiltration of the endometrium was present in all cases. In the future, proper selection of imaging modalities can improve the staging of gynaecological disorders and preclude unnecessary procedures. In endometrial cancer cases US, especially with the use of TVUS, is often considered to be the primary imaging approach. However, in patients where ultrasound is suboptimal, where there is a large tumour present or the result of imaging studies will directly influence the choice of therapy and guide therapy planning then the higher accuracy of MRI warrants its use. CT is of use in the later stages of disease; differentiation between Stage I and II is difficult and CT is limited in the assessment of myometrial invasion.
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In this study the pathophysiology and characteristics of cancer pain together with cancer pain syndromes and guidelines of management are reviewed. Tumour-associated pain may be nociceptive (somatic or visceral) if the sustaining mechanisms are related to ongoing tissue pathology, or neuropathic when pain is associated with injury to neural tissues. The mechanism by which tumours produce pain include obstruction of lymphatic and vascular channels, distension of a hollow viscous, oedema and tissue inflammation or necrosis. ⋯ Cancer pain characteristics provide some of the data essential for syndrome identification. These characteristics include intensity, quality, distribution and temporal relationships. The principles of tumour-directed pain control include modifying the source of pain by treating the cancer and the inflammatory response to cancer, altering the central perception of pain and interfering with nociceptive transmission within the central nervous system.