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    Long-term survival in a patient with brain metastases preceding the diagnosis of endometrial cancer -: Report of two cases and review of the literature
    (Amer Assoc Neurological Surgeons, 2001) Petru, E; Lax, S; Kurschel, S; Gücer, F; Sutter, B
    Only five patients found to have brain metastasis preceding the diagnosis of endometrial cancer have been reported in the literature, and none of these survived beyond 38 months. The authors report on two patients with primary endometrial cancer who initially presented with cerebral metastasis. One of these patients died of disease 15 months after diagnosis. The other patient is still alive, with no evidence of disease, 171 months after she underwent radiosurgery for a solitary brain metastasis, aggressive cytoreductive abdominal and pelvic surgery, and doxorubicin-based chemotherapy. To the best of their knowledge, the authors believe that no similar observation has been made for any primary gynecological neoplasm, including endometrial, ovarian, or cervical cancer. This is the first report documenting that survival beyond one decade may be achieved after intensive multimodal therapy in selected patients in whom a solitary brain metastasis has been found before diagnosis of endometrial cancer. Aggressive therapy appears to be warranted in these patients.
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    Preoperative thrombocytosis is an independent prognostic factor in stage III and IV endometrial cancer
    (Int Inst Anticancer Research, 2000) Scholz, HS; Petru, E; Gücer, F; Haas, J; Tamussino, K; Winter, R
    Background: To identify prognostic factors in stage III and IV endometrial cancer with special attention to pretreatment platelet count. Materials and Methods: 59 patients with FIGO stage III or IV disease operated on between 1983 and 1993 were analyzed. Patients with preoperative thrombocytosis were compared with those without thrombocytosis. Prognostic factors were analyzed with a Cox proportional hazard model. Results: With the exception of age, there were no significant differences between patients with or without thrombocytosis. At multivariate analysis, five-year disease-free survival was influenced significantly by FIGO stage (stage III vs stage IV; p=0.009), thrombocytosis (p=0.02) and cervical involvement (p=0.024). Similarly, overall five-year survival was significantly influenced by stage (p<0.001), cervical involvement (p=0.005) and thrombocytosis (p=0.01). Age, histology, grade, myometrial invasion, lymph-vascular space involvement or spread to adnexae were not significantly associated with survival. Conclusion: Thrombocytosis is an independent prognostic factor in stage III and IV endometrial cancer.