Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Accurate diagnosis of early stage uterine cancer requires lymph-node check

02.06.2003


Research at Washington University School of Medicine in St. Louis suggests that the accurate diagnosis of early stage endometrial cancer requires that the abdominal lymph nodes always be removed and checked for signs of cancer. The recommendation extends even to women with tumors that seem to have the smallest risk of spread. The study will be presented June 2 at the American Society of Clinical Oncology (ASCO) meeting in Chicago, Ill.



The study indicates that by examining the lymph nodes in all women with this disease, doctors can save patients from unnecessary radiation therapy, give the appropriate level of therapy to those who need it and save millions of dollars nationally.

"These findings are important," says Washington University lead investigator Thomas J. Herzog, M.D., associate professor of obstetrics and gynecology and a cancer specialist at the Siteman Cancer Center and Barnes-Jewish Hospital. "If confirmed, they will have direct clinical application and may change how many surgeons treat endometrial cancer."


Accurately determining how far cancer has progressed, a process known as staging, is essential for determining the most effective treatment for cancer patients. A tumor that has spread, or metastasized, to the lymph nodes requires stronger treatment than one that is still confined to the uterus.

"The problem is that many physicians believe early stage endometrial cancer is readily curable just by removing the uterus," says co-author Matthew A. Powell, M.D., instructor in the Division of Gynecologic Oncology. "They feel it is unnecessary to refer women to a surgical oncologist for removal and examination of the nodes."

Presently, fewer than half of women with stage 1 endometrial cancer have lymph nodes removed and checked for malignant cells. Instead, many doctors stage endometrial cancer by looking only at the tumor’s microscopic appearance and how far it has penetrated the uterine wall.

Endometrial cancer is the most common gynecological cancer in the United States, with doctors diagnosing about 40,000 cases annually. About 6,800 women die of the disease each year. About half of the women diagnosed have grade 1 endometrial cancer. The overall survival for these women is more than 90 percent.

Powell notes, however, that in 3 to 5 percent of women with grade 1 disease, the cancer has spread to the lymph nodes. Once that happens, the survival rate falls to about 60 percent.

Staging of endometrial cancer is done during surgery. Currently, an early stage tumor is treated by removal of the uterus, a procedure known as a hysterectomy. If the tumor has not spread, hysterectomy alone will usually cure the cancer. If the tumor has spread to the lymph nodes, additional therapy is needed. If the spread is minor, doctors often treat the vagina with localized radiation therapy. If the spread is broader, an external beam of radiation is used.

Often, patients are treated with radiation following surgery without checking the lymph nodes to see if the cancer has spread.

"Our findings show that if we check the lymph nodes and find no sign of cancer, we don’t need to give radiation," says Powell.

The retrospective study conducted by Herzog, Powell and colleagues looked at 144 women diagnosed with grade 1, apparent stage 1 endometrial cancer. Lymph node removal was done in 102 of these patients. The researchers looked at the records of the 102 women and determined what treatment they would have received based only on the characteristics of the tumor, as if the lymph-node examine had not been done.

They found that additional radiation therapy would have been recommended for 40 of the patients. The lymph-node exam, however, showed that only 18 of those patients actually required radiation, thereby preventing unneeded treatment in 22 patients. Another five patients would have received radiation therapy that would have been more intense than necessary. The lymph node exam also identified three women with disease that was more advanced than would have been suspected.

A cost analysis done by the researchers estimated that avoiding the unnecessary use of radiation therapy for early stage endometrial cancer could save $28 million annually in the United States.

"Based on these findings we concluded that all women with endometrial cancer, even those with minimum risk factors, should have lymph nodes examined to spare patients unnecessary treatment and reduce the cost of care," Herzog says.


Horowitz NS, Powell MA, Smith JH, Rader JS, Gibb RK, Mutch DG, Brouwer ES, Herzog TH. Staging grade 1 endometrial cancer: saving dollars and lives. American Society of Clinical Oncology annual meeting, Abstract number 1835, June 2, 2003.

The full-time and volunteer faculty of Washington University School of Medicine are the physicians and surgeons of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is one of the leading medical research, teaching and patient-care institutions in the nation. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.

Darrell E. Ward | EurekAlert!
Further information:
http://medinfo.wustl.edu/

More articles from Health and Medicine:

nachricht NIST scientists discover how to switch liver cancer cell growth from 2-D to 3-D structures
17.11.2017 | National Institute of Standards and Technology (NIST)

nachricht High speed video recording precisely measures blood cell velocity
15.11.2017 | ITMO University

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: A “cosmic snake” reveals the structure of remote galaxies

The formation of stars in distant galaxies is still largely unexplored. For the first time, astron-omers at the University of Geneva have now been able to closely observe a star system six billion light-years away. In doing so, they are confirming earlier simulations made by the University of Zurich. One special effect is made possible by the multiple reflections of images that run through the cosmos like a snake.

Today, astronomers have a pretty accurate idea of how stars were formed in the recent cosmic past. But do these laws also apply to older galaxies? For around a...

Im Focus: Visual intelligence is not the same as IQ

Just because someone is smart and well-motivated doesn't mean he or she can learn the visual skills needed to excel at tasks like matching fingerprints, interpreting medical X-rays, keeping track of aircraft on radar displays or forensic face matching.

That is the implication of a new study which shows for the first time that there is a broad range of differences in people's visual ability and that these...

Im Focus: Novel Nano-CT device creates high-resolution 3D-X-rays of tiny velvet worm legs

Computer Tomography (CT) is a standard procedure in hospitals, but so far, the technology has not been suitable for imaging extremely small objects. In PNAS, a team from the Technical University of Munich (TUM) describes a Nano-CT device that creates three-dimensional x-ray images at resolutions up to 100 nanometers. The first test application: Together with colleagues from the University of Kassel and Helmholtz-Zentrum Geesthacht the researchers analyzed the locomotory system of a velvet worm.

During a CT analysis, the object under investigation is x-rayed and a detector measures the respective amount of radiation absorbed from various angles....

Im Focus: Researchers Develop Data Bus for Quantum Computer

The quantum world is fragile; error correction codes are needed to protect the information stored in a quantum object from the deteriorating effects of noise. Quantum physicists in Innsbruck have developed a protocol to pass quantum information between differently encoded building blocks of a future quantum computer, such as processors and memories. Scientists may use this protocol in the future to build a data bus for quantum computers. The researchers have published their work in the journal Nature Communications.

Future quantum computers will be able to solve problems where conventional computers fail today. We are still far away from any large-scale implementation,...

Im Focus: Wrinkles give heat a jolt in pillared graphene

Rice University researchers test 3-D carbon nanostructures' thermal transport abilities

Pillared graphene would transfer heat better if the theoretical material had a few asymmetric junctions that caused wrinkles, according to Rice University...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Ecology Across Borders: International conference brings together 1,500 ecologists

15.11.2017 | Event News

Road into laboratory: Users discuss biaxial fatigue-testing for car and truck wheel

15.11.2017 | Event News

#Berlin5GWeek: The right network for Industry 4.0

30.10.2017 | Event News

 
Latest News

NASA detects solar flare pulses at Sun and Earth

17.11.2017 | Physics and Astronomy

NIST scientists discover how to switch liver cancer cell growth from 2-D to 3-D structures

17.11.2017 | Health and Medicine

The importance of biodiversity in forests could increase due to climate change

17.11.2017 | Studies and Analyses

VideoLinks
B2B-VideoLinks
More VideoLinks >>>