The aim of this paper was the presentation of the modern standards of the menopausal symptoms treatment in women after breast and endometrial cancer treatment. Increase of number of women after breast and endometrial cancer treatment and going to menopausal age provokes to intensive resolution of this problem. Knowledge about the problems mentioned above was collected basing on own experience and literature data. Retrospective analysis which was provided, not formulated final comprehensive conclusions. The dates of Scandinavian scientists although prospective and randomised have also not formulated final conclusions in this item. Using hormonal methods should be provided with individual factors being taken into consideration and analysed very accurately. In such cases it is very important to use low doses of hormones, and therapy should last short period. As the routine before administration hormonal drugs not hormonal substances should be used. Every doubts about safety of treatment in women after breast and endometrial cancer treatment should be very detailed discussed.
Inhibin and activin represent THF-β growth factors, a family of compounds of a similar chemical structure but significantly different function. Inhibin is produced in the granular cells of the ovarian follicles as well as in the luteal cells of the corpus luteum. The presence of activin was confirmed in the granular cells, hypophysis and hypothalamus. The basic physiological function of these glycoproteins is controlling the hypothalamus-hypophysis-ovaries feedback axis. Inhibin is a renowned neoplastic marker in assessing the efficacy of the surgical treatment, in monitoring and detection of early relapses in patients with granulosa cell tumours. Using RIA tests, elevated inhibin concentrations can be detected in about 80% of the patients with mucous epithelial neoplasms of the ovary. Activin is also likely to be a valuable marker, especially in diagnosing a recurrence of the disease. Both inhibin and activin are involved in the process of proliferation in ovarian cancers. In experimental mice deprived of inhibin, a rapid growth of the tumours occurs, which, in turn, implies that this compound is a negative regulator of proliferation. Simultaneously, high FSH concentrations prove that gonadotropins take an active part in the ovarian carcinogenesis.
Unlike inhibin, which seems to protect from high gonadotropin concentrations and inhibit proliferation, activin is considered in numerous studies to be a factor that intensifies proliferation of the ovarian cancer cells, hence contributing to the disease progression.
Introduction: The authors performed an analysis of therapeutic value of lymphadenectomy in patients with ovarian cancer. Material and method: The study encompassed a population of 437 female patients treated at the Centre of Oncology in Warsaw, Poland, since 2000 thru 2002. The influence of lymphadenectomy on disease-free survival and overall survival was analysed. The study population was subdivided into two groups: the first one included 296 patients where lymph nodes were preserved and the second one, including 141 patients, who underwent lymphadenectomy. These groups differed not only as regards lymph node resection, but also in the respect of percentage of optimal procedures. Results: Analysis of this material using proportional risk model revealed, that independent factors related with overall survival were clinical grade, kind of lymphadenectomy and size of residual tumour. The worst prognosis was in the case of patients after pelvic lymphadenectomy only (log-rank p=0.03). Noteworthy is, that patients after both periaortal and pelvic lymphadenectomy, as well as those with their lymph nodes preserved, have similar overall survival rate. Evaluation of disease-free survival revealed, that independent factors were the same as those related to overall survival. Patients after total lymphadenectomy have a 2.6-fold greater chance for longer symptom-free survival. Conclusions: Based on our material we conclude, that lymphadenectomy does not influence overall survival, while extending time to disease progression. These results are concordant with those presented this year after termination of the European randomised clinical trial.
Introduction: The aim of this study was to determine the influence of hypoxia on invasiveness of the human term trophoblast cultured in vitro. Material and method: Placental samples, obtained in standardized manner after normal term pregnancies (N=6) were subjected to enzymatic digestion, and the resultant cell suspension was filtrated and centrifuged in 5-70% Percoll. The cell layers between Percoll 40-50% were collected and developed into two trophoblast cultures: normoxic (20% O2; group I), and hypoxic (2% O2; group 2). In order to examine trophoblast invasiveness, the Cell Invasion Assay Kit (Chemicon International, USA), equipped with extra cellular matrix proteins-coated permeable polycarbonate membrane, was used. After 48 hours, invasive cells on the bottom surface of the polycarbonate membrane were counted in both groups in calibrated areas, using morphometric software. Results: The mean number of identified trophoblastic cells in the group II amounted 184.57±19%±SD of the mean number counted in the Group I. Conclusions: The statistically significant (p=0.05) increase of the trophoblast, cultured in vitro in hypoxic conditions, when compared with the culture in normoxic conditions, was ascertained. The trophoblast cells in full-term pregnancy preserve the ability to answer for local hypoxia, typical for the first trimester trophoblast.
Introduction: Radiation plays a major role in the management of gynaecological malignancies. Usually, the treatment involves the combination of external-beam and intracavitary irradiation. The external-beam radiation therapy causes the shrink of tumour mass and delivers the conditions to brachytherapy at the same time. The tumour geometry improvement enables the optimal dose distribution during brachytherapy. In the cases where the conditions to brachytherapy are not obtained, the external-beam irradiation is continued, limited only to the area of genital organ with the tumour. The aim of this paper: The comparison of treatment results of advanced cervical cancer depending on the radiation techniques used (external-beam irradiation only vs combination of external-beam and intracavitary radiation), as well as the analysis of factors influencing on survivals. Material and method: The analysis involved 387 patients with cervical cancer stage IIIB, treated with radiotherapy in the Department of Gynaecological Oncology, Memorial Cancer Centre, Warsaw. All patients had external-beam irradiation up to the dose of 44-50 Gy as the first step of treatment. Brachytherapy was conducted in 246 (64%) patients. The dose of 45 Gy was delivered to the point A. In the remaining group of 141 (36%) patients, the external-beam irradiation was continued to the total dose of 54-62 Gy. Results: The significantly worse survivals were obtained in the group of patients, who were irradiated from external fields only, without brachytherapy. The 5-years survivals were 31% and 56%, respectively. Moreover, the factors significantly influencing on survivals appeared to be: total dose (p=0.00285), tumour size (p=0.00594), haemoglobin level (p=0.00042), patients general condition (p=0.045) and concomitant coronary heart disease (p=0.034). Conclusions: The total dose delivered to the tumour shows the determining effect on the radiation treatment results in cervical cancer. In patients with no optimal conditions to brachytherapy obtained, the dose should be increased with using conformal radiotherapy, up to the values on the level acceptable for the risk of late radiation-induced complications.