Results of cisplatin, adriamycin and etoposide chemotherapy in patients with recurrent and metastatic endometrial cancer.

The efficacy of the combination treatment of cisplatin, adriamycin and etoposide were retrospectively evaluated in 26 recurrent or metastatic endometrial cancer patients. One hundred and twenty-three treatment courses were observed. Patients received 20 mg/m2 cisplatin and 80 mg/m2 etoposide by continuous i.v. infusion for three days and adriamycin 40 mg/m2 i.v. the second day. Treatment courses were repeated every four weeks. Megestrol acetate, 160 mg/day, was added in six patients who had positive progesterone receptors. Ten (38.5%) women had complete and three (11.5%) patients had partial response with an overall response rate of 50%. Median follow-up was 24 months. Surviving patients were alive for four months and six years. Toxicity was mainly hematological and gastrointestinal ulcerations and stomatitis were also observed.

Angiogenesis in endometrial carcinoma: correlation with survival and clinicopathologic risk factors.

Association among angiogenesis, survival and clinicopathologic parameters in endometrial carcinoma was evaluated. Sixty patients who had been diagnosed as endometrial carcinoma, from 1993 to 1998, were included in the study. All patients had been surgically staged with bilateral pelvic and para-aortic lymph node dissection. All hysterectomy specimens were stained immunohistologically for factor VIII-related antigen. The area with the most intensified microvasculature was determined under low-power (x100) magnification, and the microvessel count of this area under high-power (x200) magnification was determined as the microvessel density (MVD) of the tumor. The mean MVD was 26.2 +/- 13.0 (range 6-68), and it was considered as high (n = 24; 40%), moderate (n = 19; 31.7%) and low (n = 17; 28.3%) when the MVD was >30, between 15-30 and <15, respectively. Statistical analysis included Mann-Whitney, Kruskal-Wallis and Spearman rank correlation tests. The Kaplan-Meier method was used to evaluate the difference between angiogenesis and survival. Multivariate analysis with the Cox regression model was used in MVD values and different clinicopathological parameters. There was positive correlation between MVD increase and surgicopathological stage (p < 0.05). A significant difference was seen between MVD increase and lymph node metastasis (p < 0.05). There were no differences between MVD and age, histological type, grade and lymphovascular invasion. MVD did not change in association with myometrial invasion depth. There was a significant difference in means of survival between the low and high MVD groups (p = 0.01). However, MVD was not an independent prognostic factor in multivariate analysis. Increased angiogenesis was found to be associated with advanced stage and decreased survival in endometrial carcinoma.