Endometrial Cancer

Tamoxifen and endometrial cancer – pro

Tamoxifen is a venerable drug that revolutionized breast cancer care when it was first introduced. More recently, it has been largely supplanted by aromatase inhibitors(AI), but tamoxifen is still useful in pre-menopausal women, in whom AIs do not work. Tamoxifen has a variety of bothersome side effects, related mostly to forced early menopause. In addition, a rare complication of tamoxifen is uterine lining overgrowth, which can proceed to endometrial

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PET for endometrial cancer – pro

Lay Summary: Not much is known about PET scans in endometrial cancer. The bladder can interfere with visualizing the uterus. Restaging is an integral part of treatment for metastatic disease. The issue is whether PET/CT is a SOC restaging modality for endometrial cancer. PET scan is coming into wider use for endometrial cancer, either for diagnosis, staging or restaging. It has been shown that endometrial cancer is generally highly FDG-avid and that

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Standard chemotherapy for endometrial cancer – pro

Lay Summary: Adjuvant chemo is standard for endometrial cancer and has a limited role for metastatic disease. However, chemotherapy may be useful for metastatic cases. There is currently little hope for cure in patients with metastatic endometrial carcinoma. Selected patients will respond to hormonal therapy, particularly progestins; however, for most women with advanced disease, chemotherapy is currently the standard antineoplastic treatment option.

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Adjuvant chemotherapy and radiation for endometrial cancer – pro

Adjuvant chemo is standard for adjuvant therapy of endometrial cancer. There is no evidence of benefit to support the use of adjuvant therapy for low and low-intermediate risk groups. The adjuvant medical therapy of endometrial cancer remains poorly investigated but seems only worthy of consideration in high risk patients. A systematic review and meta-analysis of the Cochrane Collaboration revealed that the adjuvant use of progestational agents may

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Definitive radiation for early stage endometrial cancer – pro

Occasionally in early endometrial cancer the best teatment, surgery, is not possible. There is very litlle information on what to do in such situations. In advanced endometrial cancer there are some physicians who think that radiation is as good as chemo. There is a study: Radiation Therapy Compared With Combination Chemotherapy inTreating Patients With Advanced Endometrial Cancer, NCT00002493. It is a Randomized phase III trial to compare radiation

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vastin for endometrial cancer – pro

There is not much published information on Avastin for endometrial cancer. In 2015 American Society of Clinical Oncology annual meeting a study was presented that was a phase 2 randomized trial conducted by investigators in Italy, who reported that the addition of bevacizumab (Avastin®) to carboplatin plus paclitaxel in patients with recurrent or primary advanced endometrial cancer improved both the objective response rate (72.7% vs 54.3%) and progression-free

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Weekly Taxol for uterine cancer – pro

Cytotoxic chemotherapy has a limited place in the management of advanced or recurrent endometrial cancer. Commonly used agents include cisplatin and doxorubicin, but the side-effect profile may be unacceptable for many patients. More intense combination chemotherapy significantly improves the disease-free survival and the data indicate a modest improvement in OS. The addition of anthracyclines (e.g. doxorubicin) or the taxanes [e.g. paclitaxel (Taxol)]

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Robotic hysterectomy – pro

Robotic hysterectomy, bilaterla salpingo-oophorectomy and lymph nodes dissection is a new procedure but the preliminary evidence and reports suggest that it does not produce more compication or a longer hospital stay than the open procedure. In a 2009 report, it reduced blood loss and improved lymph node retrieval with no cost to survival compared with conventional hysterectomy. In one study, LOS was 1.0 ± 0.5 for the robotic procedure vs. 3.2 ±

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Topotecan for endometrial cancer – pro

There are several trials of topotecan for recurrent metstatic uterine cancer with encouraging results.  For example, in a phase II trial, 29 patients were treated with topotecan 1.5 mg/m2 day on days 1-5 of a 21-day cycle. Of these patients, 61%, 39%, and 25% experienced grade 4 neutropenia, leukopenia, and thrombocytopenia, respectively. These preliminary results suggest that single-agent topotecan might have limited activity in patients with advanced

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Mullerian endometrial cancers: Chemotherapy for metastatic disease – pro

Mullerian cancer is also called carcinosarcoma. For metastatic mullerian tumors,paclitaxel has activity. A Phase III trial has demonstrated that the combination of paclitaxel with ifosfamide results in improved survival in advanced uterine carcinosarcomas, compared with ifosfamide alone. The median overall survival for the combination regimen was 13.5 months, compared with 8.4 months with single-agent ifosfamide (p = 0.03). Iit is reasonable to suggest

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