title: Occult, high-risk endometrial cancer.
abstract: In a series of 173 consecutive patients with endometrial cancer treated by a fixed protocol 62 tumors (36%) appear "estrogen independent," i.e. there is no history of estrogen ingestion and no recognized risk factors such as obesity or diabetes mellitus. A high proportion of these tumors are of advanced stage and grade. Prognosis is poorer and mortality higher than for "estrogen-dependent" tumors. Twenty-two tumors were truly occult (no spontaneous vaginal bleeding). Factors which identify this high-risk group are described and the reasons for delay in diagnosis discussed. Spread by intraperitoneal dissemination is considered a major factor in the poorer prognosis. Cytology of peritoneal washings is a useful diagnostic and prognostic aid. An estrogen provocation test is suggested as a means of earlier recognition which could reduce mortality in this group.
mesh_terms: D000367:Age Factors; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000009:adverse effects; D001168:Arthritis / Q000188:drug therapy; D003075:Coitus; D004717:Endometrium / Q000473:pathology; D004967:Estrogens; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D009765:Obesity / Q000150:complications; D010298:Parity; D011379:Prognosis; D011960:Receptors, Estrogen / Q000032:analysis; D012306:Risk; D014594:Uterine Neoplasms / Q000032:analysis / Q000209:etiology / Q000401:mortality / Q000473:pathology
chemical_list: D000893:Anti-Inflammatory Agents; D004967:Estrogens; D011960:Receptors, Estrogen