Recurrent and Resistant Gestational Trophoblastic Neoplasia
Recurrent gestational trophoblastic neoplasia (GTN) is cancer that has recurred (come back) after it has been treated. The cancer may come back in the uterus or in other parts of the body.Gestational trophoblastic neoplasia that does not respond to treatment is called resistant GTN.
Stage III Uterine Sarcoma
Standard treatment options:Surgery (total abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic and periaortic selective lymphadenectomy, and resection of all gross tumor).Treatment options under clinical evaluation:Surgery plus pelvic radiation therapy.Surgery plus adjuvant chemotherapy. Carcinosarcomas (the preferred designation by the World Health Organization) are also referred to as mixed mesodermal or mullerian tumors. Controversy exists about the following issues:Whether they are true sarcomas.Whether the sarcomatous elements are actually derived from a common epithelial cell precursor that also gives rise to the usually more abundant adenocarcinomatous elements. The stromal components of the carcinosarcomas are further characterized by whether they contain homologous elements (such as malignant mesenchymal tissue considered possibly native to the uterus) or heterologous elements (such as striated muscle, cartilage, or bone, which are foreign to the uterus).
Stage 0 Cervical Cancer
Consensus guidelines have been issued for managing women with cervical intraepithelial neoplasia or adenocarcinoma in situ. Properly treated, tumor control of in situ cervical carcinoma should be nearly 100%. Either expert colposcopic-directed biopsy or cone biopsy is required to exclude invasive disease before therapy is undertaken. A correlation between cytology and colposcopic-directed biopsy is also necessary before local ablative therapy is done. Even so, unrecognized invasive disease treated with inadequate ablative therapy may be the most common cause of failure. Failure to identify the disease, lack of correlation between the Pap smear and colposcopic findings, adenocarcinoma in situ, or extension of disease into the endocervical canal makes a laser, loop, or cold-knife conization mandatory. The choice of treatment will also depend on several patient factors including age, desire to preserve fertility, and medical condition. Most importantly, the extent of disease must
Cellular Classification of Gestational Trophoblastic Disease
Gestational trophoblastic disease (GTD) may be classified as follows:Hydatidiform mole (HM).Complete HM.Partial HM.Gestational trophoblastic neoplasia.Invasive mole.Choriocarcinoma.Placental-site trophoblastic tumor (PSTT; very rare).Epithelioid trophoblastic tumor (ETT; even more rare). Choriocarcinoma, PSTT and ETT are often grouped under the heading gestational trophoblastic tumors. HMHM is defined as products of conception that show gross cyst-like swellings of the chorionic villi that are caused by an accumulation of fluid. There is disintegration and loss of blood vessels in the villous core. Complete HMA complete mole occurs when an ovum that has extruded its maternal nucleus is fertilized by either a single sperm, with subsequent chromosome duplication, or two sperm, resulting in either case in a diploid karyotype. The former case always yields a mole with a karyotype of 46 XX, since at least one X chromosome is required for viability and a karyotype of 46 YY is rapidly
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Call 1-800-4-CANCERFor more information, U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 8:00 a.m. to 8:00 p.m., Eastern Time. A trained Cancer Information Specialist is available to answer your questions.Chat online The NCI's LiveHelp® online chat service provides Internet users with the ability to chat online with an Information Specialist. The service is available from 8:00 a.m. to 11:00 p.m. Eastern time, Monday through Friday. Information Specialists can help Internet users find information on NCI Web sites and answer questions about cancer. Write to usFor more information from the NCI, please write to this address:NCI Public Inquiries Office9609 Medical Center Dr. Room 2E532 MSC 9760Bethesda, MD 20892-9760Search the NCI Web siteThe NCI Web site provides online access to information on cancer, clinical trials, and other Web sites and organizations that offer support
Changes to This Summary (05 / 10 / 2013)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.Editorial changes were made to this summary.
General Information About Endometrial Cancer
Endometrial cancer is a disease in which malignant (cancer) cells form in the tissues of the endometrium. The endometrium is the lining of the uterus,a hollow,muscular organ in a woman’s pelvis. The uterus is where a fetus grows. In most nonpregnant women,the uterus is about 3 inches long. The lower,narrow end of the uterus is the cervix,which leads to the vagina. Cancer of the ...
Treatment Option Overview
Patients with endometrial cancer who have localized disease are usually curable by hysterectomy and bilateral salpingo-oophorectomy. Best results are obtained with either of two standard treatments: hysterectomy or hysterectomy and adjuvant radiation therapy (when deep invasion of the myometrial muscle [50% of the depth] or grade 3 tumor with myometrial invasion is present). Results of two randomized trials on the use of external-beam radiation therapy (EBRT) in patients with stage I disease did not show improved survival but did show reduced locoregional recurrence (3%–4% vs. 12%–14% after 5–6 years' median follow-up, P 50% myometrial invasion or grade 3 with <50% myometrial invasion).Vaginal cuff
Hydatidiform Mole (HM) Management
Treatment of HM is within the purview of the obstetrician/gynecologist and will not be discussed separately here. However, following the diagnosis and treatment of HM, patients should be monitored to rule out the possibility of metastatic gestational trophoblastic neoplasia. In almost all cases, this can be performed with routine monitoring of serum beta human chorionic gonadotropin (beta-hCG) to document its return to normal. An effective form of contraception is important during the follow-up period to avoid the confusion that can occur with a rising beta-hCG as a result of pregnancy. Chemotherapy is necessary when there is the following: A rising beta-hCG titer for 2 weeks (3 titers).A tissue diagnosis of choriocarcinoma.A plateau of the beta-hCG for 3 weeks.Persistence of detectable beta-hCG 6 months after mole evacuation.Metastatic disease.An elevation in beta-hCG after a normal value.Postevacuation hemorrhage not caused by retained tissues.Chemotherapy is ultimately required for
Changes to This Summary (08 / 22 / 2013)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above. Editorial changes were made to this summary.