Tamoxifen and endometrial cancer: new data for an old problem. Review.

Tamoxifen, a nonsteroidal antiestrogen, is used for pre- and postmenopausal patients with breast cancer. Data on a possible association of endometrial pathologies with Tamoxifen treatment have been accumulating. The current literature and our experience are presented.

Cervical cerclage for malformed uterus.

The role of cervical cerclage was evaluated in six pregnant women with anomalous uterus. Early prophylactic cerclage according to the Shirodkar and McDonald technique was done on all cases of uterine malformation (except septate uterus) with or without cervical incompetence in association with progesterone and antispastic therapy. Improvement in obstetrical outcome was noted after cerclage.

Surgical management of leiomyomata in pregnancy.

A review was made of the medical records of 26 patients with uterine myomas during pregnancy between 1983 and 1992 among 12,965 deliveries. Thirteen patients underwent myomectomies before pregnancy. In three patients myomectomy was performed during pregnancy between the 12th and the 19th week of pregnancy.

Complications of pelvic and para-aortic lymphadenectomy in patients with endometrial cancer.

The International Federation of Gynecology and Obstetrics (FIGO) changed the staging criteria for endometrial cancer in 1988 and adopted a surgical-pathological staging involving also pelvic and/or para-aortic lymphadenectomy. A total of 236 patients were treated for endometrial adenocarcinoma at Department B of the Gynecologic and Obstetrics Institute, University of Turin, between January 1976 and December 1995. Our protocol for surgical staging always entails pelvic and para-aortic lymphadenectomy and a simple total hysterectomy and bilateral adnexectomy with removal of the upper third of the vagina.

Grand multiparity: a study of 168 cases.

The aim of this retrospective study was to consider the problem of grand multiparity in our female population to evaluate if grand multiparity represents a real risk factor for pregnancy, delivery and fetal well-being. From 1981 to 1989 the Gynaecology and Obstetrics Institute of Turin University together with St. Anna Hospital of Turin carried out a retrospective study on pregnancy course, delivery and fetal status in 168 women who had had four or more pregnancies and in 5320 multiparous women who had parity < 4.