No abstract

Some endometrial cancer (EMC) patients are not good candidates for primary surgery. The three major types of treatment for inoperable EMC are radiation therapy, chemotherapy, or their combination as neoadjuvant treatment before surgery. Radiation therapy alone (of different modes) has been used as the sole definitive therapeutic modality, particularly for early-stage disease that is limited to the uterine body and cervix with or without parametrial invasion. The most common treatment modality is neoadjuvant treatment before surgery. Postoperative adjuvant treatment is also occasionally used, depending mainly on the sites of the disease and the results of surgery. Data on neoadjuvant hormonal or radiation therapy are limited, with studies focusing on laboratory outcomes or having only a small number of patients. Most neoadjuvant treatments before surgery involved chemotherapy and fewer combined chemoradiotherapy. Surgery was generally performed, particularly in patients who had shown responses or at least stable disease to neoadjuvant treatment. Perioperative outcomes after neoadjuvant treatment were superior to those after primary surgery, whereas survival data were still inconsistent. Features that had or tended to have a favorable prognosis were younger age, early-stage disease, response to neoadjuvant treatment, low preoperative cancer antigen-125 level, and optimal surgery. Among different modalities of neoadjuvant treatment, which has become a frequent mode of treatment, neoadjuvant chemotherapy was more common than radiation therapy alone or chemoradiation.

Contents 21.0. The p-value of 0.05 was consider statistically significant. Results: There were 562 cases recruited in the study. Mean age of patients was 43 years. The mean BMI was 25.74 kg/m 2 (range, 14.38-66.12). The BMI was divided into 3 groups: 1) Normal weight (BMI, 18.5-22.9 kg/m 2 ) was 210 cases (37.3%); 2) Over-weight (BMI, 23-24.9 kg/m 2 ) was 90 cases (16.0%); and 3) Obese (BMI ≥25 kg/m 2 ) was 262 cases (46.6%). The pathological reports demonstrated 36 cases of endometrial hyperplasia and 22 cases of endometrial cancer. There was a correlation between obese women and endometrial hyperplasia with odds ratio 5.9 and p-value 0.015. However, there were no statistically significant between other BMI patterns and endometrial pathology. Conclusion:There was a significant correlation between obesity and endometrial hyperplasia in premenopausal women with abnormal uterine bleeding.

Background: Neuroendocrine carcinoma of the cervix (NECC) is a rare tumor with an aggressive natural course.Objective: This study was to investigate the outcomes and prognostic factors for NECC patients who had been treated at the National Cancer Institute of Thailand (NCI). Methods: NECC patients who had been treated between January 2008 to December 2017 at NCI of Thailand were review. Data were collected from medical records, tumor registry files, and civil registration system. The impacts of clinical and pathologic risk factors on the overall survival (OS) and progression-free survival (PFS) were evaluated using Kaplan–Meier survival analyses and the prognostic factor was determined by univariate Cox regression analysis.Result: Thirty-three NECC patients including 12 patients early-stage patients (FIGO stage I-IIA) and 21 patients advanced stage patients (FIGO stage IIB-IVA) were reviewed. All of the patients in the early stage underwent radical hysterectomy and lymph node dissection (RHND) with or without neoadjuvant chemotherapy. Ten patients received adjuvant therapy with pelvic radiation and/or cisplatin-etoposide following operation. Median OS and PFS among early-stage patients were 25.69 months and 18.65 months, respectively. Treatments among patients with advanced-stage included initial chemotherapy, initial concurrent chemoradiation (CCRT), and only CCRT. Patients receiving initial chemotherapy had better PFS (81.4 months) and OS (81.4 months) compared to those who received initial CCRT (PFS 9.0 months; OS 13.2 months; P=0.013) or only CCRT (PFS 13.0 months; OS 16.1months; P=0.016). No statistically significant factors associated with survival were noted.Conclusion: Patients with NECC carried a poor prognosis even in the early stage of the disease. Systemic chemotherapy may be required for all stages of this highly aggressive cancer.