Evidence of Harms
Abnormal ultrasound typically requires further investigation including endometrial biopsy. The evidence is solid that endometrial biopsy (sampling) may result in discomfort,bleeding,infection,and rarely uterine perforation. A study designed to evaluate performance,patient acceptance,and cost-effectiveness of blind biopsy,hysteroscopy with biopsy,and ultrasound,in 683 women with vaginal ...
This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.Gestational Trophoblastic Tumors Treatment
High-Risk Gestational Trophoblastic Neoplasia (FIGO Score ≥7) Treatment
Multi-agent chemotherapy is standard for the initial management of high-risk gestational trophoblastic neoplasia (GTN). A systematic literature review revealed only one randomized controlled trial (and no high-quality trials)—conducted in the 1980s—comparing multiagent chemotherapy regimens for high-risk GTN. In the trial, only 42 women were randomly assigned to either a CHAMOMA regimen (i.e., methotrexate, folinic acid, hydroxyurea, dactinomycin, vincristine, melphalan, and doxorubicin) or MAC (i.e., methotrexate, dactinomycin, and chlorambucil). There was substantially more life-threatening toxicity in the CHAMOMA arm and no evidence of higher efficacy. However, there were serious methodologic problems with this trial. It was reportedly designed as an equivalency trial, but owing to the small sample size, the trial was inadequately powered to assess equivalence. In addition, the characteristics of the patients randomly assigned to the two study arms were not
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 (GTN). In almost all cases,this can be performed with routine monitoring of serum beta human chorionic gonadotropin ...
General Information About Cervical Cancer
Cervical cancer is a disease in which malignant (cancer) cells form in the tissues of the cervix. The cervix is the lower,narrow end of the uterus (the hollow,pear-shaped organ where a fetus grows). The cervix leads from the uterus to the vagina (birth canal). Cervical cancer usually develops slowly over time. Before cancer appears in the cervix,the cells of the cervix go through changes ...
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This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.Cervical Cancer Treatment
Cellular Classification of Uterine Sarcoma
A list of the most common histologic types of uterine sarcomas.
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. ...
Stage IV Uterine Sarcoma
Note: Some citations in the text of this section are followed by a level of evidence. The PDQ editorial boards use a formal ranking system to help the reader judge the strength of evidence linked to the reported results of a therapeutic strategy. (Refer to the PDQ summary on Levels of Evidence for more information.) There is currently no standard therapy for patients with stage IV disease. ...