Uterine Sarcoma Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage II Endometrial Cancer
Standard treatment options:If cervical involvement is documented, options include radical hysterectomy, bilateral salpingo-oophorectomy, and pelvic and para-aortic lymph node dissection.If the cervix is clinically uninvolved but extension to the cervix is documented on postoperative pathology, radiation therapy should be considered.The completed GOG-LAP2 trial included 2,616 patients with clinical stage I to IIA disease and randomly assigned them two-to-one to comprehensive surgical staging via laparoscopy or laparotomy. Time to recurrence was the primary endpoint, with noninferiority defined as a difference in recurrence rate of less than 5.3% between the two groups at 3 years. The recurrence rate at 3 years was 10.24% for patients in the laparotomy arm, compared with 11.39% for patients in the laparoscopy arm, with an estimated difference between groups of 1.14% (90% lower bound, -1.278; 95% upper bound, 3.996). Although this difference was lower than the prespecified limit, the
Cervical Cancer Screening (PDQ®): Screening - Patient Information [NCI] - Treatment Options for Recurrent Endometrial Cancer
Treatment of recurrent endometrial cancer may include the following:Radiation therapy as palliative therapy to relieve symptoms and improve the patient's quality of life.Hormone therapy.Clinical trials of chemotherapy.Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent endometrial carcinoma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Cervical Cancer Screening (PDQ®): Screening - Patient Information [NCI] - Changes to This Summary (04 / 22 / 2014)
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.
Cervical Cancer Screening (PDQ®): Screening - Patient Information [NCI] - Evidence of Benefit
Measuring endometrial thickness (ET) with transvaginal ultrasound (TVU) and endometrial sampling with cytological examination have been proposed as possible screening modalities for endometrial cancer. The Papanicolaou (Pap) test, used successfully for screening for cervical cancer, is too insensitive to be used as a screening technique for the detection of endometrial cancer, although occasionally the Pap test may fortuitously identify endometrial abnormalities, such as endometrial cancer. Routine screening of asymptomatic women for endometrial cancer has not been evaluated for its impact on endometrial cancer mortality.[2,3] Although high-risk groups can be identified, the benefit of screening in reducing endometrial cancer mortality in these high-risk groups has not been evaluated. Using the same cutoffs to define an abnormal ET in asymptomatic women  as used in symptomatic women  would result in large numbers of false-positive test results and larger numbers of
Cervical Cancer Screening (PDQ®): Screening - Patient Information [NCI] - Treatment Option Overview
There are different types of treatment for patients with cervical cancer. Different types of treatment are available for patients with cervical cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.Three types of standard treatment are used:Surgery Surgery (removing the cancer in an operation) is sometimes used to treat cervical cancer. The following surgical procedures may be used:Conization: A procedure to remove a cone-shaped piece of tissue from the cervix and cervical canal. A pathologist
Cervical Cancer Screening (PDQ®): Screening - Health Professional Information [NCI] - About This PDQ Summary
Purpose of This SummaryThis PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about the treatment of gestational trophoblastic disease. It is intended as a resource to inform and assist clinicians who care for cancer patients. It does not provide formal guidelines or recommendations for making health care decisions.Reviewers and UpdatesThis summary is reviewed regularly and updated as necessary by the PDQ Adult Treatment Editorial Board, which is editorially independent of the National Cancer Institute (NCI). The summary reflects an independent review of the literature and does not represent a policy statement of NCI or the National Institutes of Health (NIH). Board members review recently published articles each month to determine whether an article should:be discussed at a meeting,be cited with text, orreplace or update an existing article that is already cited.Changes to the summaries are made through a
Cervical Cancer Screening (PDQ®): Screening - Patient Information [NCI] - About This PDQ Summary
No standard treatment is available for patients with recurrent cervical cancer that has spread beyond the confines of a radiation or surgical field. For locally recurrent disease, pelvic exenteration can lead to a 5-year survival rate of 32% to 62% in selected patients.[1,2] These patients are appropriate candidates for clinical trials testing drug combinations or new anticancer agents. The Gynecologic Oncology Group (GOG) has reported on several randomized phase III trials, (GOG-0179 [NCT00003945], GOG-0240 [NCT00803062]) in this setting. Single-agent cisplatin administered intravenously at 50 mg/m² every 3 weeks was the most-used regimen to treat recurrent cervical cancer since it was initially introduced in the 1970s.[3,4]Various combinations containing cisplatin [3,4] failed to reach their primary endpoint of improving survival, however, a doubling of the cisplatin dose-rate did improve survival. Combinations with paclitaxel and with ifosfamide improved response rates
Cervical Cancer Screening (PDQ®): Screening - Health Professional Information [NCI] - Stage IA Cervical Cancer Treatment
Equivalent treatment options:Total hysterectomy. If the depth of invasion is less than 3 mm proven by cone biopsy with clear margins  and no vascular or lymphatic channel invasion is noted, the frequency of lymph node involvement is sufficiently low that lymph node dissection is not required. Oophorectomy is optional and should be deferred for younger women. Conization. If the depth of invasion is less than 3 mm, no vascular or lymphatic channel invasion is noted, and the margins of the cone are negative, conization alone may be appropriate in patients wishing to preserve fertility.Modified radical hysterectomy. For patients with tumor invasion between 3 mm and 5 mm, radical hysterectomy with pelvic node dissection has been recommended because of a reported risk of lymph node metastasis of as much as 10%. However, a study suggests that the rate of lymph-node involvement in this group of patients may be much lower and questions whether conservative therapy might be
Cervical Cancer Screening (PDQ®): Screening - Health Professional Information [NCI] - Description of Evidence
Incidence and MortalityAn estimated 12,340 new cervical cancers and 4,030 cervical cancer deaths will occur in the United States in 2013. An additional 1,250,000 women will be diagnosed with precancers annually by cytology using the Papanicolaou (Pap) smear. A continuum of pathologic changes may be diagnosed, ranging from atypical squamous cells of undetermined significance to low-grade squamous intraepithelial lesions (LSIL) to high-grade squamous intraepithelial lesions (HSIL) to invasive cancer. The precancerous conditions LSIL and HSIL are also referred to as cervical intraepithelial neoplasia (CIN) 1, 2, and 3. Lesions can regress, persist, or progress to an invasive malignancy, with LSIL (CIN 1) more likely to regress spontaneously and HSIL (CIN 2/CIN 3) more likely to persist or progress. The average time for progression of CIN 3 to invasive cancer is estimated to be 10 to 15 years.The incidence of cervical cancer has decreased dramatically with the advent and widespread
Cervical Cancer Screening (PDQ®): Screening - Patient Information [NCI] - Recurrent Cervical Cancer
Recurrent cervical cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back in the cervix or in other parts of the body.