OBJECTIVES: To assess the survival of patients who have received an operation for recurrent cervical and endometrial cancer and to determine prognostic variables for improved oncologic outcome. METHODS: A retrospective multicenter analysis of the medical records of 518 patients with cervical (N = 288) or endometrial cancer (N = 230) who underwent surgery for disease recurrence and who had completed at least 1 year of follow-up. RESULTS: The median survival reached 57 months for patients with cervical cancer and 113 months for patients with endometrial cancer after surgical treatment of recurrence (p = 0.036). Histological sub-type had a significant impact on overall survival, with the best outcome in endometrial endometrioid cancer (121 months), followed by cervical squamous cell carcinoma, cervical adenocarcinoma, or other types of endometrial cancer (81 vs 35 vs 35 months; p <0.001). The site of recurrence did not significantly influence survival in cervical or in endometrial cancer. Cancer stage at first diagnosis, tumor grade, lymph node status at recurrence, progression-free interval after first diagnosis, and free resection margins were associated with improved overall survival on univariate analysis. On multivariate analysis, the stage at first diagnosis and resection margins were significant independent predictive parameters of an improved oncologic outcome. CONCLUSION: Long-term survival can be achieved via secondary cytoreductive surgery in selected patients with recurrent cervical and endometrial cancer. An excellent outcome is possible even if the recurrence site is located in the lymph nodes. The possibility of achieving complete resection should be the main criterion for patient selection.

• Klíčová slova
• secondary cytoreductive surgery, uterine cancer,
• MeSH
• cytoredukční chirurgie metody   MeSH
• doba přežití bez progrese choroby MeSH
• dospělí MeSH
• kohortové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• lokální recidiva nádoru mortalita   patologie   chirurgie   MeSH
• míra přežití MeSH
• nádory dělohy mortalita   patologie   chirurgie   MeSH
• nádory děložního čípku mortalita   patologie   chirurgie   MeSH
• přežívající onkologičtí pacienti MeSH
• prognóza MeSH
• retrospektivní studie MeSH
• senioři MeSH
• staging nádorů MeSH
• výsledek terapie MeSH
• záchranná terapie metody   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

The thyroid gland is a relatively uncommon site for a metastatic disease, although it is richly supplied with blood. The metastases may originate from various primary sites, mainly kidney, lung, head and neck, and breast. Thyroid metastasis from cervical carcinomas is extremely rare; and only a few cases have been previously reported in the literature. In patient with thyroid nodules and an oncological history, the possibility of thyroid metastasis should be seriously considered. Despite the rarity of the metastasis of cervical carcinoma to the thyroid, it is difficult to say appropriate treatment approach for these lesions. When managing such patients, decision-making should balance the possibility of gaining long-term survival against estimation of the aggressiveness of the disease and its possible complications. Here, a case of thyroid metastasis from a squamous cell carcinoma of the uterine cervix presenting with cervical mass and difficulty in swallowing and its treatment is reported.

• Klíčová slova
• Cancer of the uterine cervix, Metastasis, Thyroid gland,
• MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory děložního čípku patologie   terapie   MeSH
• nádory štítné žlázy patologie   sekundární   MeSH
• spinocelulární karcinom patologie   sekundární   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

A different tumor concurrence of the uterine body is usually encountered as a coincidence of leiomyoma and endometrial cancer. Pure lipomatous tumors or fatty change in the leiomyoma or endometrium are rare affections with some diagnostic peculiarities. We present a case of association of the pure uterine lipoma, leiomyoma, and endometrial cancer as a tumor triplicity, which may contribute, to the pathogenesis of mesenchymal tumors in this location.

• MeSH
• leiomyom patologie   MeSH
• lidé MeSH
• lipom patologie   MeSH
• mnohočetné primární nádory patologie   MeSH
• nádory dělohy patologie   MeSH
• nádory endometria patologie   MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

OBJECTIVE: Uterine sarcomas are a rare and heterogeneous group of malignancies that include different histological sub-types. The aim of this study was to identify and evaluate the impact of the different prognostic factors on overall survival and disease-free survival of patients with uterine sarcoma. METHODS: This international multicenter retrospective study included 683 patients diagnosed with uterine sarcoma at 46 different institutions between January 2001 and December 2007. RESULTS: The 5-year overall survival for leiomyosarcoma, endometrial stromal sarcoma, undifferentiated sarcoma, and adenosarcoma was 65.3%, 78.3%, 52.4%, and 89.5%, respectively, and the 5-year disease-free survival was 54.3%, 68.1%, 40.3%, and 85.3%, respectively. The 10-year overall survival for leiomyosarcoma, endometrial stromal sarcoma, undifferentiated sarcoma and adenosarcoma was 52.6%, 64.8%, 52.4%, and 79.5%, respectively, and the 10-year disease-free survival was 44.7%, 53.3%, 40.3%, and 77.5%, respectively. The most significant factor associated with overall survival in all types of sarcoma except for adenosarcoma was the presence of residual disease after primary treatment. In adenosarcoma, disease stage at diagnosis was the most important factor (hazard ratio 17.7; 95% CI 2.86 to 109.93). CONCLUSION: Incomplete cytoreduction, tumor persistence, advanced stage, extra-uterine and tumor margin involvement, and the presence of necrosis were relevant prognostic factors significantly affecting overall survival in uterine sarcoma. The presence of lymph vascular space involvement and administration of adjuvant chemotherapy were significantly associated with a higher risk of relapse.

• Klíčová slova
• sarcoma, uterine cancer,
• MeSH
• adenosarkom * terapie   patologie   MeSH
• endometriální stromální sarkom * terapie   patologie   MeSH
• leiomyosarkom * patologie   MeSH
• lidé MeSH
• lokální recidiva nádoru MeSH
• nádory dělohy * patologie   MeSH
• nádory endometria * patologie   MeSH
• nádory pánve * MeSH
• prognóza MeSH
• retrospektivní studie MeSH
• sarkom * diagnóza   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

AIM: A review of diagnostic options and standardized methods for specifying clinical symptoms associated with uterine myomatosis. METHODS: A literature search of databases aimed at finding validated metrics for assessing myomas symptomatology. RESULTS: Summary of obligatory and optional examination methods in the diagnosis of uterine fibroids and methods of examination of reproductive parameters of the couple in relation to myomatosis. Defining the metrics of bleeding manifestations of myomatosis with emphasis on the "Pictorial Bleeding Assessment Chart". Reviewing metrics of algic manifestations of myomatosis and quality of life with emphasis on the "Quality of Life Questionnaire - Myomatosis - Severity Symptom Scale". CONCLUSION: The purpose of the applicable metrics, which summarize objective findings and subjective complaints of patients, is to describe and evaluate possible correlations and dynamics of changes in the health status, depending on the chosen therapy.

• Klíčová slova
• uterine fibroid symptoms,
• MeSH
• kvalita života * MeSH
• leiomyom * diagnóza   komplikace   MeSH
• lidé MeSH
• nádory dělohy * diagnóza   komplikace   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

• Klíčová slova
• PHOSPHORUS ISOTOPES *, RADIOTHERAPY *, UTERINE NEOPLASMS *,
• MeSH
• fosfor dietní * MeSH
• fosfor * MeSH
• izotopy fosforu * MeSH
• lidé MeSH
• nádory dělohy * MeSH
• radioaktivita * MeSH
• radioterapie * MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• fosfor dietní * MeSH
• fosfor * MeSH
• izotopy fosforu * MeSH

• Klíčová slova
• UTERUS NEOPLASMS/diagnosis *,
• MeSH
• fyzikální vyšetření * MeSH
• lidé MeSH
• nádory dělohy diagnóza   MeSH
• nádory ženských pohlavních orgánů * MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE OF REVIEW: For uterine cervical cancer, the recently revised International Federation of Gynecology and Obstetrics (FIGO) staging system (2018) incorporates imaging and pathology assessments in its staging. In this review we summarize the reported staging performances of conventional and novel imaging methods and provide an overview of promising novel imaging methods relevant for cervical cancer patient care. RECENT FINDINGS: Diagnostic imaging during the primary diagnostic work-up is recommended to better assess tumor extent and metastatic disease and is now reflected in the 2018 FIGO stages 3C1 and 3C2 (positive pelvic and/or paraaortic lymph nodes). For pretreatment local staging, imaging by transvaginal or transrectal ultrasound (TVS, TRS) and/or magnetic resonance imaging (MRI) is instrumental to define pelvic tumor extent, including a more accurate assessment of tumor size, stromal invasion depth, and parametrial invasion. In locally advanced cervical cancer, positron emission tomography-computed tomography (PET-CT) or computed tomography (CT) is recommended, since the identification of metastatic lymph nodes and distant metastases has therapeutic consequences. Furthermore, novel imaging techniques offer visualization of microstructural and functional tumor characteristics, reportedly linked to clinical phenotype, thus with a potential for further improving risk stratification and individualization of treatment. Diagnostic imaging by MRI/TVS/TRS and PET-CT/CT is instrumental for pretreatment staging in uterine cervical cancer and guides optimal treatment strategy. Novel imaging techniques may also provide functional biomarkers with potential relevance for developing more targeted treatment strategies in cervical cancer.

• Klíčová slova
• Cervical cancer, Diffusion-weighted imaging, Imaging biomarkers, Magnetic resonance imaging, Positron emission tomography, Transvaginal ultrasound,
• MeSH
• lidé MeSH
• lymfatické metastázy MeSH
• magnetická rezonanční tomografie metody   MeSH
• nádory děložního čípku diagnostické zobrazování   patologie   terapie   MeSH
• PET/CT metody   MeSH
• počítačová rentgenová tomografie metody   MeSH
• staging nádorů MeSH
• ultrasonografie metody   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

Uterine artery dissection is a new minimally invasive surgical technique used for the treatment of leiomyomas and adenomyomas. Three women underwent laparoscopically-assisted bilateral uterine dissection using ultrasonically activated shears. Surgery was uneventful, and patients were discharged on the second day after. Reduction in tumor volume measured by ultrasound was impressive (36%-68%), and the women felt their symptoms had improved. A larger series and longer follow-up are required to evaluate which patients will benefit from this technique. To our knowledge, this is the first report in the literature of origin uterine artery dissection in the area of the off-going part from the hypogastric artery using ultrasonically activated shears in symptomatic leiomyomas.

• MeSH
• arterie chirurgie   MeSH
• dospělí MeSH
• elektrokoagulace * MeSH
• laparoskopie * MeSH
• leiomyom chirurgie   MeSH
• lidé MeSH
• nádory dělohy chirurgie   MeSH
• ultrazvuk MeSH
• uterus krevní zásobení   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

This is the first study carried out to describe the role of fetal microchimerism (FM) in the pathogenesis of uterine cancer. The prevalence and concentration of male fetal microchimeric cells (FMCs) were examined in endometrial tissues in relation to subtypes of uterine cancer, and the histological grade and stage of the tumor. FM occurrence was analyzed in relation to risk factors, including hypertension, obesity, type 2 diabetes, dyslipidemia, age at cancer diagnosis, and patient pregnancy history. The prevalence and concentration of FMCs were examined in endometrial tissues using real-time polymerase chain reaction, SRY and β-globin sequences as markers for male fetal FMCs and total DNA. The studied group involved 47 type 1 endometrial cancers, 28 type 2 endometrial cancers, and 41 benign uterine diseases. While the prevalence of FM was decreased only in type 1 endometrial cancer, compared with benign uterine disorders (38.3% vs.70.7%; odds ratio [OR]=0.257, 95% confidence interval [CI]: 0.105 to 0.628, p=0.003), FMC concentrations did not differ within examined groups. The lower FM prevalence was detected in low-grade (grade 1 and grade 2) endometrioid cancer (38.3% vs. 70.7%, OR=0.256, 95% CI: 0.105 to 0.627, p=0.003) and in FIGO 1 tumors (40.7% vs. 70.7%, OR=0.285, 95% CI: 0.120 to 0.675, p=0.004). No correlation between FM prevalence or FMC concentrations and risk factors was demonstrated. A lower prevalence of male FM seemed to be associated with better prognoses in uterine cancer based on tumor subtype, histological grade, and stage of the tumor.

• MeSH
• časná diagnóza MeSH
• chimérismus statistika a číselné údaje   MeSH
• dospělí MeSH
• endometrium cytologie   patologie   MeSH
• fetální kmenové buňky MeSH
• kvantitativní polymerázová řetězová reakce MeSH
• lidé středního věku MeSH
• lidé MeSH
• maternofetální výměna látek genetika   MeSH
• nádory dělohy diagnóza   genetika   patologie   MeSH
• nemoci dělohy diagnóza   patologie   MeSH
• prognóza MeSH
• rizikové faktory MeSH
• senioři MeSH
• staging nádorů MeSH
• těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH