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Uterine papillary serous carcinoma
422
Citations from the Literature
psychologlc disorder. Couples with a sexual dysfunction were more likely (P = 0.05) to have unexplained infertility. Norms for psychologic evaluation as part of IVF are suggested and the role of such evaluation discussed. A prospective study of intrauterine hsemination of proceswd sperm from men with 0Ugoastbenospermia in superovuhted women. Cruz RI; Kemmann E; Brandeis VT; et al Depcrrfment of Obstetrics and Gynecology, Division of Reproductive Endocrinology-Infertility, Academic Health Science Center, University of Medicine and Dentistry of New Jersey (UMDNJ)-Rutgers Medical School. New Brunswick, NJiWQ3, USA FERTIL. STERIL.; 46/4 (673-677) 1986 The effectiveness of intrauterine insemination (IUI) was compared with that of intracervical insemination (ICI) in 49 infertile couples, in whom the major cause for infertility was oligoasthenospermia. All women had ovulation stimulated with either a clomiphene citrate (CC)-human gonadotropin combination or human gonadotropins alone. The ovulatory dose of human chorionic gonadotropin (hCG) was given after adequate estradiol levels were reached. The timing of inseminations was standardized-IUI was 28 hours after hCG and ICI was immediately after hCG administration. Only one insemination per month was performed with either IUI or ICI. The first treatment cycle was assigned randomly to be either IUI or ICI, and subsequent inseminations were alternated. A total of 182 cycles were completed, with % IUIs and 86 ICIs. Pregnancy occurred in eight patients, seven with IUI (14.3070) and one with ICI (2.0%); the difference is significant at P < 0.05). The pregnancy rate per treatment cycle was 7.3% versus 1.2% (P < 0.001). This study supports the use of IUI with processed sperm in the treatment of infertility due to oligoasthenospermia. A new approach to foUicular stimulation for in vitro fertilization programed oocyte retrieval Frydman R; Forman R; Rainhom J-D; et al Hopital A. Beciere, 92141 Clamart, France FERTIL. STERIL.; 46/4 (657-662) 1986 Programed oocyte retrieval was performed in a group of 35 patients undergoing in vitro fertilization (IVF) treatment. The date of follicular aspiration was decided several months in advance and the cycle prior to oocyte recovery was modified with a progestagen or an estrogen-progestagen contraceptive pill. This was followed by a fured-schedule ovulation stimulation and induction regimen. Follicular growth was not monitored. Thirty-four of the 35 patients had follicular aspiration, and at least one embryo was obtained in 30 of them. The clinical pregnancy rate (excluding cryopreserved embryos) was 20% per IVF cycle, 21% per attempted oocyte retrieval procedure, and 23% per embryo transfer cycle. Programed oocyte retrieval is a realistic option for follicular stimulation for IVF treatment and is associated with significant practical and economic benefits.
Int JGynaecol Obstet 25
ONCOLOGY Atypical squamous cells in Papanicolau smears Davis GL; Hemandez E; Davis JL; Miyazawa K Department of Obstetrics and Gynecology, Tripler Army Medical Center, Honolulu, HI 96S59-5oo0, USA OBSTET. GYNECOL.; 69/l (43-46) 1987 Between 1980 and 1984, 406 patients were referred to Tripler Army Medical Center’s cervical clinic for the evaluation of atypical squamous cells in a Papanlcolaou smear. Their evaluation included repeating the smear, colposcopy in all cases, colposcopically directed biopsies, and/or endocervical curretage in 7Ori’o.The results of the repeat Papanicolaou smear in 400 patients were 274 (68.5%) negative, 77 (190/,) atypical squamous cells, 40 (10%) cervical intraepithelial neoplasia (GIN) 1, seven (2a) CIN2, and two (0.5%) CIN 3. No invasive cancer was detected. Dysplasia was documented histopathologically in 18.7%. a repeat smear was reported as negative in 10.9% of patients with biopsy-proven dysplasia. A Papanicolaou smear report of atypical squamous cells should not be considered normal, and further evaluation of the patient is required. If colposcopy is impractical, serial follow-up smears are recommended.
Uterine papillary seroas carcinoma Chambers JT; Merino M; Kohorn El; et al Department of Obstetrics and Gynecology, Yale School of Medicine. New Haven, CT 06510-8063. USA OBSTET. GYNECOL.: 69/l (109-113) 1987 Reviewed are 37 patients with the diagnosis of uterine papillary serous carcinoma. Clinically, 19 patients presented as stage I. 9 as stage II. 1 as stage III, and 8 as stage IV. Four of 18 patients with clinical stage I disease who underwent surgery had pelvic metastases and five had disease spread beyond the pelvis. Three of nine clinical stage II patients had intraabdominal metastases. At least 5Orl0 myometrial invasion was found in 43% of the 30 hysterectomy specimens, and lymphatic invasion in the myometrium was demonstrated in 78% of the specimens. Each of the 15 patients with surgical stage I or II disease received local radiation therapy: 10 are alive and of these 9 are disease-free. Each of nine clinical stage II patients received intense radiation therapy and hysterectomy; seven are alive and of these four are disease free. The five-year survival for combined surgical stages I and II patients was 45%. The three-year survival for combined surgical stages III and IV was 11%. Thirteen patients have been treated with combination chemotherapy, 11 cis-platinum-based combinations. Nine of these patients are dead; four are alive, with three of these having progressive disease.
Citations from the Literature
psychologlc disorder. Couples with a sexual dysfunction were more likely (P = 0.05) to have unexplained infertility. Norms for psychologic evaluation as part of IVF are suggested and the role of such evaluation discussed. A prospective study of intrauterine hsemination of proceswd sperm from men with 0Ugoastbenospermia in superovuhted women. Cruz RI; Kemmann E; Brandeis VT; et al Depcrrfment of Obstetrics and Gynecology, Division of Reproductive Endocrinology-Infertility, Academic Health Science Center, University of Medicine and Dentistry of New Jersey (UMDNJ)-Rutgers Medical School. New Brunswick, NJiWQ3, USA FERTIL. STERIL.; 46/4 (673-677) 1986 The effectiveness of intrauterine insemination (IUI) was compared with that of intracervical insemination (ICI) in 49 infertile couples, in whom the major cause for infertility was oligoasthenospermia. All women had ovulation stimulated with either a clomiphene citrate (CC)-human gonadotropin combination or human gonadotropins alone. The ovulatory dose of human chorionic gonadotropin (hCG) was given after adequate estradiol levels were reached. The timing of inseminations was standardized-IUI was 28 hours after hCG and ICI was immediately after hCG administration. Only one insemination per month was performed with either IUI or ICI. The first treatment cycle was assigned randomly to be either IUI or ICI, and subsequent inseminations were alternated. A total of 182 cycles were completed, with % IUIs and 86 ICIs. Pregnancy occurred in eight patients, seven with IUI (14.3070) and one with ICI (2.0%); the difference is significant at P < 0.05). The pregnancy rate per treatment cycle was 7.3% versus 1.2% (P < 0.001). This study supports the use of IUI with processed sperm in the treatment of infertility due to oligoasthenospermia. A new approach to foUicular stimulation for in vitro fertilization programed oocyte retrieval Frydman R; Forman R; Rainhom J-D; et al Hopital A. Beciere, 92141 Clamart, France FERTIL. STERIL.; 46/4 (657-662) 1986 Programed oocyte retrieval was performed in a group of 35 patients undergoing in vitro fertilization (IVF) treatment. The date of follicular aspiration was decided several months in advance and the cycle prior to oocyte recovery was modified with a progestagen or an estrogen-progestagen contraceptive pill. This was followed by a fured-schedule ovulation stimulation and induction regimen. Follicular growth was not monitored. Thirty-four of the 35 patients had follicular aspiration, and at least one embryo was obtained in 30 of them. The clinical pregnancy rate (excluding cryopreserved embryos) was 20% per IVF cycle, 21% per attempted oocyte retrieval procedure, and 23% per embryo transfer cycle. Programed oocyte retrieval is a realistic option for follicular stimulation for IVF treatment and is associated with significant practical and economic benefits.
Int JGynaecol Obstet 25
ONCOLOGY Atypical squamous cells in Papanicolau smears Davis GL; Hemandez E; Davis JL; Miyazawa K Department of Obstetrics and Gynecology, Tripler Army Medical Center, Honolulu, HI 96S59-5oo0, USA OBSTET. GYNECOL.; 69/l (43-46) 1987 Between 1980 and 1984, 406 patients were referred to Tripler Army Medical Center’s cervical clinic for the evaluation of atypical squamous cells in a Papanlcolaou smear. Their evaluation included repeating the smear, colposcopy in all cases, colposcopically directed biopsies, and/or endocervical curretage in 7Ori’o.The results of the repeat Papanicolaou smear in 400 patients were 274 (68.5%) negative, 77 (190/,) atypical squamous cells, 40 (10%) cervical intraepithelial neoplasia (GIN) 1, seven (2a) CIN2, and two (0.5%) CIN 3. No invasive cancer was detected. Dysplasia was documented histopathologically in 18.7%. a repeat smear was reported as negative in 10.9% of patients with biopsy-proven dysplasia. A Papanicolaou smear report of atypical squamous cells should not be considered normal, and further evaluation of the patient is required. If colposcopy is impractical, serial follow-up smears are recommended.
Uterine papillary seroas carcinoma Chambers JT; Merino M; Kohorn El; et al Department of Obstetrics and Gynecology, Yale School of Medicine. New Haven, CT 06510-8063. USA OBSTET. GYNECOL.: 69/l (109-113) 1987 Reviewed are 37 patients with the diagnosis of uterine papillary serous carcinoma. Clinically, 19 patients presented as stage I. 9 as stage II. 1 as stage III, and 8 as stage IV. Four of 18 patients with clinical stage I disease who underwent surgery had pelvic metastases and five had disease spread beyond the pelvis. Three of nine clinical stage II patients had intraabdominal metastases. At least 5Orl0 myometrial invasion was found in 43% of the 30 hysterectomy specimens, and lymphatic invasion in the myometrium was demonstrated in 78% of the specimens. Each of the 15 patients with surgical stage I or II disease received local radiation therapy: 10 are alive and of these 9 are disease-free. Each of nine clinical stage II patients received intense radiation therapy and hysterectomy; seven are alive and of these four are disease free. The five-year survival for combined surgical stages I and II patients was 45%. The three-year survival for combined surgical stages III and IV was 11%. Thirteen patients have been treated with combination chemotherapy, 11 cis-platinum-based combinations. Nine of these patients are dead; four are alive, with three of these having progressive disease.