[Diagnosis of cervical and endometrial cancer]. / Diagnostic des cancers du col de l'utérus et de l'endomètre.

Updated French guidelines for clinical practice have been published by the National Cancer Institute in 2010, concerning the diagnosis and the treatment of cervix and endometrial cancers. The diagnosis of cervix cancer, suspected when a cervix tumour is observed in a patient presenting with vaginal bleeding, especially in women with risk factors (previous cervix dysplasia, HIV infection, tobacco use). The diagnosis is confirmed by pathology of cervix biopsy (macroscopic cervix tumour or microscopic lesions detected by screening). The diagnosis of endometrial cancer should be evoked in post-menopausal women presenting with vaginal bleeding, especially in high risk populations (obese, long exposure to estrogens). The diagnosis is based on histologic examination of endometrial biopsy. The assessment of pelvic extension must include clinical examination and pelvic and lombo-aortic MRI imaging.

Long-term follow up of high-dose chemotherapy with autologous stem cell rescue in adults with Ewing tumor.

Ewing tumors remain of poor prognosis, with 5-year overall survival of 55% to 65% in localized patients and not exceeding 25% in primarily metastatic disease. Several reports, mainly in children, have reported that some patients with poor-risk Ewing tumors may benefit from high-dose chemotherapy (HDCT) with autologous stem cell rescue. This retrospective study analyzed 46 patients treated in our institution between 1987 and 2000 for localized or primary metastatic Ewing tumors by HDCT followed by stem cell rescue. Median follow up was 7.1 years. Median age was 21 years (range, 15-46 years). Twenty-two percent of patients had metastases at diagnosis. The tumor site was axial in 56% of patients. Median tumor size was 9.5 cm. The treatment regimen consisted of induction chemotherapy, local treatment, maintenance chemotherapy, and consolidation HDCT based on alkylating agents. No toxic death was observed in the intensive therapy phase. Five-year overall survival and progression-free survival were 63 +/- 7.7% and 47 +/- 7.6%, respectively. Pejorative prognostic factors in this population were metastases at diagnosis (5-year overall survival 34% vs.71%, P = 0.017) and poor pathologic response (5-year overall survival 44% vs.77%, P = 0.03). This retrospective study shows a high long-term survival rate with high-dose chemotherapy in adults.