Blog dedicated to the continuous education in Gynecology and Endocrinology

 

The fertility-sparing treatment in patients with endometrial atypical hyperplasia and early endometrial cancer : a debated therapeutic option


Angiolo Gadducci, Nicoletta Spirito, Elena Baroni, Roberta Tana, and Andrea Riccardo Genazzani .

Abstract: Fertility-sparing treatment may represent a realist option for accurately selected young patients with endometrial atypical hyperplasia or well differentiated, early endometrial cancer. more

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INFLUENCE OF THE TIME INTERVAL BETWEEN HYSTEROSCOPY, DILATION AND CURETTAGE, AND HYSTERECTOMY ON SURVIVAL IN PATIENTS WITH ENDOMETRIAL CANCER.

3) Obstet Gynecol. 2008 Nov;112(5):1098-101.

Hefler L, Leipold H, Hinterberger S, Concin N, Klotz R, Reinthaller A.

OBJECTIVE: To evaluate whether a prolonged time interval between dilation and curettage (D&C) and hysterectomy has an effect on survival in patients with surgically treated endometrial cancer. more

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MOLECULAR TARGET THERAPIES IN ENDOMETRIAL CANCER: FROM THE BASIC RESEARCH TO THE CLINIC

Angiolo Gadducci, Roberta Tana, Stefania Cosio, Antonio Fanucchi, Andrea Riccardo Genazzani

Molecular targeted therapies represent an interesting field of pharmacological research in endometrial cancer. The loss of PTEN function, with consequent activation of the PI3K – AKT- mTOR signalling pathway, occurs in 32–83% of endometrioid-type endometrial carcinomas, thus suggesting a role for mTOR inhibition in this malignancy. Some analogues of rapamycin (CCI—799, RAD-001 and AP-23573) have been developed and tested in different tumours including endometrioid-type endometrial carcinoma. For instance AP-23573 achieved a clinical benefit response in 33% of 27 heavily pre-treated patients, and CCI—799 obtained a 26% partial response rate and a 63% stable disease rate in 19 patients. ErbB-2 over-expression has been detected in 18-80% of uterine papillary serous carcinomas [UPSC]s, thus providing a biological rationale for the use of trastuzumab in these aggressive tumours. UPSC often over-expresses claudin-3 and claudin-4, that represent the epithelial receptors for Clostridium perfringens enterotoxin [CPE]. CPE-mediated therapy might be a novel treatment modality for UPSC resistant to chemotherapy. A better understanding of the signalling transduction pathways that are disregulated in the endometrioid-type endometrial carcinoma and UPSC will allow the development of  novel molecular  targeted therapies.

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CLINICAL USEFULNESS OF 3-DIMENSIONAL SONOGRAPHY AND POWER DOPPLER ANGIOGRAPHY FOR DIAGNOSIS OF ENDOMETRIAL CARCINOMA.

3) J Ultrasound Med. 2007 Oct;26(10):1279-87

Mercé LT, Alcázar JL, López C, Iglesias E, Bau S, de Los Heros JA, Bajo JM.

OBJECTIVE: The purpose of this study was to assess whether endometrial volume (EV) and 3-dimensional (3D) power Doppler indices can discriminate between hyperplasia and endometrial carcinoma and can predict extension of the endometrial carcinoma. more

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