Among the malignancies of the female genital organs, endometrial cancer is reckoned to have a comparatively good prognosis. The main methods of its treatment remain surgery and radiotherapy. Chemotherapy in endometrial cancer is always palliative. Over the recent decade, chemotherapy has been believed to be the proper management of endometrial cancer metastases, particularly to the lungs and the liver. The combined therapy proves to surpass the single agent therapy in terms of efficacy. Using three cytostatic agents (an anthracycline, a taxane and a platinum-based compound) results in the response rate of 73%. Combining chemo- and hormonotherapy has a similar efficacy to chemotherapy alone. In case of a disseminated disease, the key role is still attributed to gestagens. If a progression during the hormonotherapy is observed the chemotherapy should be used. However, in case of recurrence, surgery should always be taken into account.
High mortality rate from cervical cancer in our country still remains a burning problem. The epidemiological data have been unsatisfactory for many years despite the fact that diagnostic tests enabling the secondary prevention of this cancer have been in use since the works of Papanicolaou. Over the recent years, there have been numerous programs aiming at early detection of cervical cancer in Poland and the number of cytologic smears is increasing. Unfortunately, it is not mirrored in the mortality rate. The cause of this situation is in question, as well as the possibility of adapting European experience, Scandinavian in particular, to the Polish conditions. It would require additional staff training and increasing the efficacy of the diagnostic and therapeutic procedures being carried out. According to the authors, the key element is providing a logistic background to organize mass screening. Applying the guidelines of early detection to the Polish health service seems to be the only way to improve the epidemiological figures of cervical cancer.
Objectives: The assessment of the prognostic value of Ca 125 tumor marker in ovarian cancer patients measured after debulking surgery on the disease free survival. Design: To indicate, that the serum Ca 125 level after debulking surgery has an impact on survival. Material: The subject of retrospective analysis was the group of 465 ovarian cancer patients, clinical stage: IC-III, treated in Gynecological Department of Maria Sklodowska-Curie Memorial Cancer Center and 15 other oncological departments during the year 2001. All patients were treated with initial surgery and adjuvant chemotherapy. Methods: The analysis of the serum Ca 125 tumor marker normalization rate after debulking surgery and its impact on disease free survival was performed. Results: Among the analyzed group of patients, the highest rate of survival was observed in the group of patients with normal Ca 125 serum level after surgery, the statistically worst prognosis was observed in the group without Ca 125 normalization neither after surgery nor after chemotherapy. Conclusions: The normalization rate of Ca 125 serum concentration after initial debulking surgery may be an important prognostic factor.
In the article the authors present current views on conservative surgery of early vulvar cancer.
Objectives: The postirradiation complications are rare subject of independent elaborations, though the interest of that problem increases. In the most of elaborations we can come across statement that late injury are not able to be foreseen. Design: The aim of this investigation was to discover the connection between incidence of early and late injury in the rectum and the bladder in the group of women with cervical cancer treated with radiotherapy. Materials and methods: Postirradiation injury was estimated retrospectivelly in 125 women with cervical cancer treated with radiotherapy (external beam and brachytherapy with Ra 226 or Cs 137) during the period 1992-1996 in WOO Opole. The estimate was done in EORTC/RTOG score. Test Chi2 was applied in statistic analysis. The level of statistic substantiality was received p<0.05. Results: The early complications in the bladder appeared in 29.6% of treated women, in the rectum – in 32%. The late complications in the bladder appeared in 27.2% of treated women and in rectum in 28.8% of events. The connection between the duration of early injury and the risk of late postirradiation complications in the rectum (p=0.0006) and the bladder (p=0.0045) was discovered. Conclusions: If early complications in the bladder and rectum lasted longer the risk of late injury in these organs increased.
Background: Radiotherapy for carcinoma of the cervix and endometrium inevitably leads to the development of acute reaction in about 10% of patients. The incidence of urinary complications especially from the bladder might be influenced by urinary tract infections.
The aim of the study was to assess the incidence of urinary tract infections in the analyzed population and their potential influence on the subsequent development of acute post irradiation complications from the bladder. Material and methods: Two hundred and twenty patients irradiated at Cancer Center and Institute of Oncology between 2000 and 2002 were the subject of the analysis. Voided urine was obtained for urinalysis and culture at the beginning, the end and 3 months after radiotherapy. Results: A total of 62 patients (72%) with positive bacteriuria developed bladder reaction. From 134 patients with no bladder reaction in only 24 (18%) cases urine culture was positive. There was a strong correlation of urinary tract infection and subsequent development of early bladder reaction (p<0.034, Chi2=12.78). Conclusion: Urinary tract infections can be recognized as an important factor contributing to the increased risk of early post irradiation bladder complications. Routine urinalysis and culture before radiotherapy allows earlier diagnosis and more effective treatment of urinary tract infections, thus preventing bladder reactions.
A case of 26-year-old female with primary vaginal squamous cell carcinoma has been described. Diagnosis, radical radiation therapy (tele- and brachytherapy), 3 years follow-up and treatment morbidity has been discussed.