Objective: To analyze the hormonal, ultrasonographic, and color Doppler parameters in a population- based follow- up study of female childhood cancer survivors with regular menstrual cycle and normal early follicular ...Objective: To analyze the hormonal, ultrasonographic, and color Doppler parameters in a population- based follow- up study of female childhood cancer survivors with regular menstrual cycle and normal early follicular FSH values. Design: Controlled, prospective clinical study. Setting: University hospital. Patient(s): Twenty- eight female patients affected by a malignant tumor during childhood and 14 age- matched healthy controls. Intervention(s): Hormonal, ultrasonographic, and color Doppler analyses. Main Outcome Measure(s): In the midluteal phase of the cycle, the patients underwent hormonal assay of gonadotropins, E2, and P; ultrasonographic evaluation of the uterine and ovarian volume, the endometrial thickness, and of the corpus luteum characteristics; color Doppler analysis of uterine, intraovarian, and periluteal arteries. Result(s): A greater uterine volume and a better utero- ovarian vascularization was observed in controls in comparison with cancer survivors. In patients who suffered from childhood malignancies the P values were lower than in controls. On the basis of circulating P (> or < 20 nmol/L)values, we divided the former group in ovulatory and nonovulatory patients. We observed that even if there were no differences between ovulatory cancer survivors and controls, the nonovulatory group showed a reduced uterine volume associated with elevated resistance at the level of uterine and intraovarian arteries. Among these two groups the time elapsed between the diagnosis of cancer and menarche was shorter in nonovulatory than in ovulatory women, and was directly correlated with both uterine volume (r = 0.660) and ovarian volume (r = 0.597). Conclusion(s): Ultrasonographic and Doppler analyses may noninvasively study the subtle utero- ovarian modifica- tion after anticancer therapies.展开更多
Objective: To analyse the frequency and the determinants of recurrence rate of clinically detectable endometriosis. Study design: Prospective cohort multicenter study. Eligible for the study were all women observed fo...Objective: To analyse the frequency and the determinants of recurrence rate of clinically detectable endometriosis. Study design: Prospective cohort multicenter study. Eligible for the study were all women observed for the first time during the period January-June 1998 at the participating centres with a laparoscopically confirmed first diagnosis of endometriosis. After diagnosis, patients were treated according to standard care of each centre and desire for pregnancy. The protocol required all women to be followed up at the centre each year for 2 years with a clinical examination, an ultrasound pelvic examination and a CA125 assay, unless pregnancy occurred. Second look laparoscopy was performed on a clinical basis. Results: A total of 311 women (median age 36 years) entered the study. The two-year recurrence rate was 5.7% among cases stage I- II and 14.4% among stage III- IV (χ 2 adjusted for indication for surgery, p < 0.05). The recurrence rates tended to increase with age, being 4.6% among women aged 20- 30 and 13.1% among women aged >30, but this finding was not statistically significant. Conclusion: The recurrence rate of clinically detectable endometriosis tends to be higher in older women with advanced stages of the disease and lower in women with infertility.展开更多
文摘Objective: To analyze the hormonal, ultrasonographic, and color Doppler parameters in a population- based follow- up study of female childhood cancer survivors with regular menstrual cycle and normal early follicular FSH values. Design: Controlled, prospective clinical study. Setting: University hospital. Patient(s): Twenty- eight female patients affected by a malignant tumor during childhood and 14 age- matched healthy controls. Intervention(s): Hormonal, ultrasonographic, and color Doppler analyses. Main Outcome Measure(s): In the midluteal phase of the cycle, the patients underwent hormonal assay of gonadotropins, E2, and P; ultrasonographic evaluation of the uterine and ovarian volume, the endometrial thickness, and of the corpus luteum characteristics; color Doppler analysis of uterine, intraovarian, and periluteal arteries. Result(s): A greater uterine volume and a better utero- ovarian vascularization was observed in controls in comparison with cancer survivors. In patients who suffered from childhood malignancies the P values were lower than in controls. On the basis of circulating P (> or < 20 nmol/L)values, we divided the former group in ovulatory and nonovulatory patients. We observed that even if there were no differences between ovulatory cancer survivors and controls, the nonovulatory group showed a reduced uterine volume associated with elevated resistance at the level of uterine and intraovarian arteries. Among these two groups the time elapsed between the diagnosis of cancer and menarche was shorter in nonovulatory than in ovulatory women, and was directly correlated with both uterine volume (r = 0.660) and ovarian volume (r = 0.597). Conclusion(s): Ultrasonographic and Doppler analyses may noninvasively study the subtle utero- ovarian modifica- tion after anticancer therapies.
文摘Objective: To analyse the frequency and the determinants of recurrence rate of clinically detectable endometriosis. Study design: Prospective cohort multicenter study. Eligible for the study were all women observed for the first time during the period January-June 1998 at the participating centres with a laparoscopically confirmed first diagnosis of endometriosis. After diagnosis, patients were treated according to standard care of each centre and desire for pregnancy. The protocol required all women to be followed up at the centre each year for 2 years with a clinical examination, an ultrasound pelvic examination and a CA125 assay, unless pregnancy occurred. Second look laparoscopy was performed on a clinical basis. Results: A total of 311 women (median age 36 years) entered the study. The two-year recurrence rate was 5.7% among cases stage I- II and 14.4% among stage III- IV (χ 2 adjusted for indication for surgery, p < 0.05). The recurrence rates tended to increase with age, being 4.6% among women aged 20- 30 and 13.1% among women aged >30, but this finding was not statistically significant. Conclusion: The recurrence rate of clinically detectable endometriosis tends to be higher in older women with advanced stages of the disease and lower in women with infertility.
