Gynacological Cancers
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Gynaecological cancers are a group of different malignancies of the female reproductive system. The most common types of gynaecologic malignancies are cervical cancer, ovarian cancer, and endometrial (uterus) cancer. There are other less common gynaecological malignancies including cancer of the vagina, cancer of the vulva, gestational trophoblastic tumours, and fallopian tube cancer. Occasionally skin cancers or sarcomas can also be found in the female genitalia. Generally, most gynaecological cancers are found in women aged over 50, though the incidence rates for younger women have been rising.

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Cervical Cancer
Endometrial (Uterus) Cancer
Fallopian Tube Cancer
Gestational Trophoblastic Cancer
Ovarian Cancer
Vaginal Cancer
Vulva Cancer
Uterine Sarcoma
Gynecologic Oncology (specialty)
General Gynacological Cancer Resources
Latest Research Publications

General Gynacological Cancer Resources (15 links)

Latest Research Publications

This list of publications is regularly updated (Source: PubMed).

Ozler A, Evsen MS, Turgut A, et al.
CD147 expression in uterine smooth muscle tumors, and its potential role as a diagnostic and prognostic marker in patients with leiomyosarcoma.
J Exp Ther Oncol. 2014; 10(4):325-30 [PubMed] Related Publications
OBJECTIVE: To investigate the role of CD147 expression in uterine smooth muscle neoplasms, as a potential diagnostic and prognostic marker in patients with leiomyosarcoma (LMS).
STUDY DESIGN: We investigated CD147 protein expression in uterine smooth muscle tumor samples from patients diagnosed with leiomyoma (n = 22), atypical leiomyoma (BLM) (n = 5), smooth muscle tumor of uncertain malignant potential (STUMP) (n = 14), and LMS (n = 22). The intensity and extensity of immunohistochemical staining were compared to determine its potential role in differential diagnosis. Spearman's rank correlation tests were performed to determine the relationship between CD147 expression and prognostic clinical and pathological criteria in the patients with LMS.
RESULTS: CD147 was strongly expressed in 81.8% (n = 18) of the LMS tissue samples. In fact expression of CD147 in LMS tissues was significantly higher than that of the three other uterine smooth muscle tumor types (p = 0.000). However, high CD147 expression was found in only one BLM sample and one STUMP sample. Furthermore, CD147 percent expression positively correlated with Ki67 percent expression (r = 0.466, p<0.05) and mitotic index (r = 0.554, p<0.05), respectively.
CONCLUSION: Our results suggest that immunohistochemistry may be a helpful tool in determining whether CD147 is a useful marker in the differential diagnosis of certain uterine smooth muscle tumors. CD147 may also have prognostic value for patients with LMS. Yet, in order to determine the extent of this potential marker's utility as a diagnostic and prognostic indicator, a larger randomized multicenter study must be performed.

Related: MKI67


Gao X, Liu Y, Deeb D, et al.
Anticancer activity of pristimerin in ovarian carcinoma cells is mediated through the inhibition of prosurvival Akt/NF-κB/mTOR signaling.
J Exp Ther Oncol. 2014; 10(4):275-83 [PubMed] Free Access to Full Article Related Publications
Pristimerin isaquinonemethidetriterpenoidthathasshown anticancer activity against some cancer types. However, the antitumor effects of pristimerin (PM) in ovarian cancer cells have not been adequately studied. The objective of the present study was to determine the anticancer activity and its mechanism of action in human ovarian carcinoma cell lines. PM strongly inhibited the proliferation of ovarian cancer cells by inducing apoptosis characterized by increased annexin V-binding, cleavage of poly (ADP-ribose) polymerase (PARP-1) and procaspases-3, -8 and -9. Furthermore, PM caused mitochondrial depolarization. Western blot analysis showed inhibition of prosurvival phospho-AKT (p-AKT), nuclear factor kappa B (NF-κB) (p65) and phospho-mammalian target of rapamycin (p-mTOR) signaling proteins in cells treated with PM. Treatment with PM also inhibited the expression of NF-κB-regulated antiapoptotic Bcl-2, Bcl-xL, c-IAP1 and survivin. Thus, our data showing potent antiproliferative and apoptosis-inducing activity of PM in ovarian carcinoma cells through the inhibition of AKT/ NF-κB/ mTOR signaling pathway warrant further investigation of PM for the management of ovarian cancer.

Related: Apoptosis Mitochondrial Mutations in Cancer Ovarian Cancer AKT1 Signal Transduction MTOR


Topcu HO, Büke B, Taşdemir Ü, et al.
Hemangiopericytoma of the uterus: a rare case of pelvic mass.
J Exp Ther Oncol. 2014; 10(4):263-5 [PubMed] Related Publications
Hemangiopericytoma (HPC) is an uncommon perivascular tumor which may arise from anywhere in the body accounts for 1% of primary vascular tumors. Uterine hemangiopericytomas are usually low grade malignancies with better prognosis. The primary treatment is usually total hysterectomy and bilateral salpingo-oophorectomy. In this report, we aimed to evaluate the clinical characteristics of an 83 years of woman admitted to our clinic with pelvic mass who underwent laparotomy and underwent total hysterectomy and bilateral salpingo-ooforectomy. Postoperative pathology was hemangiopericytoma.


Guzel AI, Yalinkaya A, Alomeroglu M
A rare case of acute abdomen: torsionated ovarian myoma.
J Exp Ther Oncol. 2014; 10(4):255-7 [PubMed] Related Publications
Ovarian leiomyoma is a rare ovarian tumor and also rare cause of acute abdomen. A 64 year old, postmenopausal woman applied to our clinic with severe acute abdominal pain. On abdominal examination, there were abdominal tenderness, defense and rebound. On ultrasonographic examination, we detected a 6 cm of pelvic mass. Because she had acute abdomen we performed laparotomy by midline incision and excised a 6cm ovarian mass on right ovary. The mass had been reported as ovarian leiomyoma on frozen section by pathology department.

Related: Ovarian Cancer


Thabet M, Hemida R, Hasan M, et al.
Human papillomavirus (HPV) is not the main cause of preinvasive and invasive cervical cancer among patients in Delta Region, Egypt.
J Exp Ther Oncol. 2014; 10(4):247-53 [PubMed] Related Publications
BACKGROUND: Cervical cancer remains a significant problem worldwide particularly in underdeveloped countries. It is necessary to have a persistent infection of the cervix with a high-risk or oncogenic human Papillomavirus (HPV) virus to develop cervical cancer.
OBJECTIVES: To study the association between HPV and pre-invasive and invasive cancer cervix among patients referred to Early Cancer Detection Clinic of Obstetrics and Gynecology Department, Mansoura University Hospital, Delta region, Egypt.
METHODS: Cervical specimens of 100 histologically confirmed premalignant and malignant cervical lesions were subjected to HPV detection and genotyping by extraction of DNA from cervical biopsy using a commercial PCR kit.
RESULTS: HPV DNA testing was done, 36 cases were positive (36%). Correlations of age, duration of marriage, and parity were non significant (P = 0.56, 0.72, and 0.35 respectively) while correlations of residence, oral contraceptive use, smoking, and immunosuppresion were sig- nificant (P = 0.006, 0.001, 0.001, and 0.01 respectively). The prevalence of HPV in premalignant and malignant cervical lesions in our study was 39.5% & 33.3% respec tively. The commonest HPV genotypes associated with premalignant cervical lesions were HPV16; 11/17(64.7%) and HPV18; 11/17 (64.7%) mostly in the form of mul- tiple infections with HPV16+18; 7/17 (41.17%). The commonest HPV genotypes associated with malignant cervical lesions in our cases were HPV16; 15/19 (78.9%) and HPV18; 13/19 (68.42%) also in the form of multiple infections with HPV16+18; 10/19 (52.63%).
CONCLUSION: The prevalence of HPV in premalignant and malignant cervical lesions was 39.5% & 33.3% respectively, this means that HPV is not the main cause of premalignant and malignant cervical lesions in Delta region in Egypt. HPV infection mostly in the form of multiple infections with HPV16+18 genotypes. Further studies are needed to clarify actual association of HPV and premalignant and malignant cervical lesions to determine the usefulness of HPV vaccination in our locality.

Related: Cervical Cancer


Gómez-Campelo P, Bragado-Álvarez C, Hernández-Lloreda MJ
Psychological distress in women with breast and gynecological cancer treated with radical surgery.
Psychooncology. 2014; 23(4):459-66 [PubMed] Related Publications
OBJECTIVES: The objective of this study is to compare psychological distress (body image disturbance,self-esteem, depression, and anxiety) in women with breast or gynecological cancer treated by radical surgery. Additionally, another objective is to analyze the association between psychological distress and sociodemographic characteristics, medical history, and social support to produce a prediction model for the outcome measures.
METHODS: A cross-sectional study was carried out with 100 women who had undergone radical surgery for breast or gynecological cancer. Both groups were divided into the following: younger than 50 years old and 50 years old or older. Body Image Scale, Rosenberg's Self-Esteem Scale, Beck Depression Inventory, and Beck Anxiety Inventory were used.
RESULTS: Age had a significant main effect on psychological distress but the type of cancer did not.Younger women showed significantly greater distress than older women (p-values<0.001). A significant interaction between age and type of cancer was found, indicating that older women with breast cancer had worse body image and more depression than those with gynecological cancer (p-values 0.001); no significant differences were found between younger groups.The prediction model for increased body image disturbance and depression included the joint effect of the following variables: being younger, inactive occupational status, and post-adjuvant therapy side effects. For lower self-esteem, the variables were: being younger, post-adjuvant therapy side effects,and dissatisfaction with social support. And for higher anxiety, the sole variable included was post-adjuvant therapy side effects.
CONCLUSIONS: Both mastectomy and hysterectomy/oophorectomy cause similar psychological distress in younger women, but mastectomy causes greater distress in older women than hysterectomy/oophorectomy.

Related: Breast Cancer


Ezeanochie MC, Olagbuji BN
Human papilloma virus vaccine: determinants of acceptability by mothers for adolescents in Nigeria.
Afr J Reprod Health. 2014; 18(3):154-8 [PubMed] Related Publications
Vaccination of adolescent females against Human Papilloma Virus (HPV), the causative agent for cervical cancer has recently become available. As minors, parental acceptance of the vaccines for adolescent daughters requires exploration. This was a cross-sectional survey of 201 mothers attending the gynaecology clinic in a University Teaching Hospital in Nigeria on acceptability of the HPV vaccines and its determinants. Although 70% accepted vaccination of their daughters, 30% were unwilling and the commonest reason for unwillingness was that it may encourage sexual promiscuity (62.3%). Mothers with poor knowledge of STI were significantly more unwilling to accept HPV vaccines compared to those with average or good knowledge (p = 0.002). Furthermore, perception of susceptibility to HPV infection by daughters was significantly associated with acceptance of the vaccines (p = 0.0001). Increased advocacy and public enlightenment on cervical cancer control and the role of HPV vaccines in its prevention is still necessary especially in developing countries.

Related: Cervical Cancer Human Papillomavirus (HPV), Vaccination, and Cervical Cancer


Wan J, Li XM, Gu J
Primary choriocarcinoma of the fallopian tube: a case report and literature review.
Eur J Gynaecol Oncol. 2014; 35(5):604-7 [PubMed] Related Publications
Choriocarcinoma is a highly malignant tumor of trophoblastic origin. Primary fallopian tube choriocarcinoma is an extremely rare occurrence, especially in women over 50 years of age. This article concerns a case of tubal choriocarcinoma developing in a 54-year-old woman, which the authors present together with a brief review of the literature. The woman presented with irregular vaginal bleeding for two months, following three months of amenorrhea. Transvaginal dopolar and pelvic computed tomography (CT) scan showed an adnexal cystomic-solid mass. Her serum human chorionic gonadotropin (hCG) levels were 29,1116 mIU/ml. The patient underwent hysterectomy and bisalpingo-oophorectomy. Histology was suggestive of tubal choriocarcinoma. Immunohistochemistry tests were positive for the hCG, Ki 67, CK, PLAP, and negative for CD30, supporting the diagnosis of choriocarcinoma. A combination of 5-Fu and KSM was administrated postoperatively. After four cycles of chemotherapy, her serum hCG level fell to the normal range. The patient remains disease-free 14 months after disease diagnosis.

Related: Fallopian Tube Cancer


Yang SW, Kim WY, Cho SH, et al.
Multifocal microinvasive squamous cell carcinoma with extensive spread of squamous cell carcinoma in situ (CIS) into the uterine corpus, vagina, and left salpinx diagnosed five years after conization of cervical CIS.
Eur J Gynaecol Oncol. 2014; 35(5):600-3 [PubMed] Related Publications
BACKGROUND: Multifocal microinvasive squamous cell carcinoma (SCC) with extensive spread of squamous cell carcinoma in situ (CIS) into the uterine corpus, salpinx, and vagina is extremely unusual.
CASE: The authors present a case of 69-year-old woman with hydrometra who was found to have multifocal microinvasive SCC in the endometrium. The CIS had spread superficially throughout the entire endometrium up to the fundus, completely replacing the epithelium. The uterine cervix, vaginal surface and left salpingeal mucosa were involved. She had previously undergone conization due to cervical CIS five years prior. The pathologic reports showed clear resection margins at that time.
CONCLUSION: The present case suggests that CIS in the endometrium spread back to the cervix and vagina, although the definite origin of the first CIS was not determined.

Related: Cervical Cancer


Kanda M, Sonoyama A, Ohara N
Normal-sized ovary carcinoma syndrome (NOCS) detected with FDG-PET/CT.
Eur J Gynaecol Oncol. 2014; 35(5):597-9 [PubMed] Related Publications
BACKGROUND: Normal-sized ovary carcinoma syndrome (NOCS) is an ovarian cancer with ovaries being of normal size, accompanied by diffuse metastatic disease of the peritoneal cavity.
CASE: A 39-year-old woman presented with lower abdominal pains. The computed tomopraphy (CT) of the chest, esophagogastroduodenography, and colonoscopy showed no remarkable findings. Amagnetic resonance imaging (MRI) displayed a slightly enlarged right ovary, thickening of the peritoneum, and massive ascites. The right ovary showed high intensity on T2 images and scattered low intensity spots on diffusion-weighted images. The cytology of ascites suspected adenocarcinoma cells. A positron emission tomography (PET) and CT using 18F-fluorodeoxyglucose (FDG) demonstrated markedly increased FDG uptake at the right ovary and peritoneum. The presumptive diagnosis of normal-sized ovary carcinoma syndrome was made. She underwent a total hysterectomy, bilateral salpingo-oophorectomy, pelvic lymphadenectomy, and partial omentectomy. The pathological examination revealed serous cystadenocarcinoma of the right ovary.
CONCLUSION: FDG-PET/CT is useful for the detection of NOCS.

Related: Ovarian Cancer


Kalampokas E, Sofoudis C, Boutas I, et al.
Primary fallopian tube carcinoma: a case report and mini-review of the literature.
Eur J Gynaecol Oncol. 2014; 35(5):595-6 [PubMed] Related Publications
Primary fallopian tube carcinoma (PFTC) is an uncommon gynecologic tumor, responsible for 0.14% to 1.8% of genital malignancies, with a mean incidence of 3.6 per million women per annum. The factors that contribute to its appearance are not well-known. Overall survival percentages for patients with PFTC are generally low. Although the preoperative diagnosis rarely occurs and it is usually first confirmed by the pathologist, an earlier diagnosis occurs with early clinical manifestation and prompt investigation leading to better prognosis. Both PFTC and epithelial ovarian cancer (EOC) are treated with similar surgical and chemotherapy methods. The authors report a case of a patient with bilateral high grade serous carcinoma of the fallopian tube, whose initial presentation was bilateral cystic adnexal masses and serosanguinous discharge, with no other pelvic involvement. This article also reviews in brief and presents updates of this rare gynecological malignancy.

Related: Fallopian Tube Cancer


Pestana I, Costal A, Mota R, et al.
Paraneoplastic limbic encephalitis--neurologic paraneoplastic syndrome associated with ovarian malignancy--the importance of clinical recognition.
Eur J Gynaecol Oncol. 2014; 35(5):592-4 [PubMed] Related Publications
Paraneoplastic limbic encephalitis (PLE) is a rare disorder and it is also under-reported due to the difficulty in establishing the diagnosis. The delay in treatment could potentially lead to devastating neurological outcomes. The authors report a 32-year-old Caucasian, nullipara woman, who presented with a subacute dementia associated to generalized tonic-clonic seizure with rapid progression to coma. The diagnosis of immature ovarian teratoma surgical Stage FIGO IA R0 with PLE was confirmed. The patient began earlier oral corticosterois and human intravenous immunoglobulin. She was discharged one month after surgery with no neurologic deficit and remains three years later in oncological remission. A diagnosis of PLE should be considered in the differential diagnosis of unexplained dementias. Early diagnosis, treatment of the underlying malignancy, and prompt intervention with immunotherapy in this patient at the onset of presentation facilitated regression of the neurological syndrome and explains the favorable neurological outcome.

Related: Ovarian Cancer


Xin G, Du J, Xu Y
Isolated sacral metastases as the initial presentation from an endometroid ovarian carcinoma: a case report.
Eur J Gynaecol Oncol. 2014; 35(5):589-91 [PubMed] Related Publications
Bone metastases are rarely in ovarian carcainoma. It usually occurrs only when the cancer is advanced or recurrent. A case of endometrioid carcinoma in right ovary with intact capsule is reported. The isolated sacral metastasis was found as the initial presentation, and no distant metastases were reported.

Related: Ovarian Cancer


Ki EY, Park JS, Mun JB, Hur SY
Primary ovarian malignant mixed mesodermal tumor: report of four cases.
Eur J Gynaecol Oncol. 2014; 35(5):584-8 [PubMed] Related Publications
Malignant mixed mesodermal tumors (MMMTs) are highly aggressive and usually diagnosed at advanced stages. MMMT originates from either the ovary or the uterus. Because this disease is relatively rare, an optimal treatment modality has not yet been established. The authors report four cases of ovarian MMMT (one heterologous MMMT and three homologous MMMTs) during 1990-2011. The patients underwent operation immediately after histopathologically confirmation and were treated with platinum-based combination chemotherapy. The extent of operation, the outcomes of radiation therapy, and the proper chemotherapeutic regimen are still controversial. The authors report herein four cases of ovarian MMMTs alone with a brief literature review.

Related: Ovarian Cancer


Qiao N, Zhu Y, Li H, et al.
Expression of heat shock protein 20 inversely correlated with tumor progression in patients with ovarian cancer.
Eur J Gynaecol Oncol. 2014; 35(5):576-9 [PubMed] Related Publications
OBJECTIVE: To investigate a possible correlation between expression levels of heat shock protein 20 (HSP20) and tumor progression in patients with ovarian cancer.
MATERIALS AND METHODS: The study included 34 patients with ovarian cancer who were to undergo surgery, seven patients with ovarian carcinoid tumors, and five patients with normal ovaries as a control group. Ovarian tissues were obtained from patients by surgical resection and then analyzed by western blot.
RESULTS: Expression levels of HSP20 were inversely correlated with the grade of malignancy.
CONCLUSION: The present findings suggest that HSP20 may play a protective role against the progression of ovarian cancer. Thus, HSP20 may represent a new target for the prediction and treatment of ovarian cancer.

Related: Ovarian Cancer


Xiaolei C, Taot H, Zongli S, Hongying Y
The role of ureaplasma urealyticum infection in cervical intraepithelial neoplasia and cervical cancer.
Eur J Gynaecol Oncol. 2014; 35(5):571-5 [PubMed] Related Publications
AIM: To investigate the role of ureaplasma urealyticum (UU) infection in cervical intraepithelial neoplasia (CIN) and cervical cancer and to study the correlation between UU and HPV infection in CIN/cervical cancer.
MATERIALS AND METHODS: A total of 233 research subjects were divided into the case group and the control group. UU and pathogenic load UU were detected in the case group and the control group by fluorescence quantitative polymerase chain reaction (PCR) method, human papillomavirus (HPV) in case group by PCR + membrane hybridization method.
RESULTS: There was statistically significant difference in the case group and control group with respect to the positive rate and pathogenic load of UU (p < 0.05). The positive rate of UU among CIN II group, CIN III group, and the cervical cancer group were not statistically significant difference (p > 0.05). There may be statistically significant difference in the result of testing UU coinfection with HPV (p = 0.002).
CONCLUSION: Positive rate and the pathogenic load of UU infection may be related to the genesis of cervical cancer. Significant combined effect could strengthen the process of the disease and lead to the pathogenesis of cervical cancer between infection of HPV and UU.

Related: Cervical Cancer


Demirkiran F, Bese T, Meseci E, et al.
The surgical outcomes of abdominal radical trachelectomy: does transrectal ultrasonography determine the cervical incision site during surgery?
Eur J Gynaecol Oncol. 2014; 35(5):566-70 [PubMed] Related Publications
PURPOSE: To evaluate the surgical outcomes of abdominal radical trachelectomy(ART) and the efficacy of transrectal ultrasonography in determining the upper end of cervical incision during this operation.
MATERIALS AND METHODS: ART was performed in five patients with early-stage cervical cancer in the present clinic. In the first three patients, uterine corpus was transacted blindly at a level of approximately five mm below the internal os. In the last two patients, the authors performed transrectal ultrasonography before vaginal incision to evaluate the distance between upper margin of tumoral mass and internal os of cervical canal.
RESULTS: Mean follow-up was 21 months. During this period, menstrual abnormality occurred in three patients. The two patients in which transrectal ultrasonographies were taken intraoperatively had 9- and 12-mm postoperative cervical canal length and both of them were asymptomatic postoperatively.
CONCLUSIONS: ART is usually associated with menstrual abnormality at late postoperative period and transrectal ultrasonograph during this procedure may decrease postoperative morbidity.

Related: Cervical Cancer


Tianmin X, Weiqin C, Shuying W, et al.
Protection of ovarian function during chemotherapy for ovarian cancer.
Eur J Gynaecol Oncol. 2014; 35(5):562-5 [PubMed] Related Publications
The protection of ovarian function during chemotherapy is an urgent issue to be resolved after the fertility preserving surgery on patients with ovarian cancer. The paper summarizes and analyzes the research progress on the protective measures in the aspects of gonadotropin releasing hormone analogue (GnRHa), cell protecting agents, and traditional Chinese medical science and drugs.

Related: Ovarian Cancer


Li C, Ma C, Zhang W, Wang J
The immune function differences and high-risk human papillomavirus infection in the progress of cervical cancer.
Eur J Gynaecol Oncol. 2014; 35(5):557-61 [PubMed] Related Publications
INVESTIGATION: To study the differences immune function in normal cervix, cervical intraepithelial neoplasia (CIN) and cervical cancer tissue, and study the relationship between human papillomavirus (HPV) infection and cervical local immune function.
MATERIALS AND METHODS: This study determined the form, quantity, distribution, and intensity of CD4+Th cells, S-100+ dendritic cells (DCs) and CD57+NK cells in the normal cervical tissue, CIN cervical tissue, and cervical cancer by histopathological and image analyses.
RESULTS: The immune function was differences in the progress of cancer genesis. The numbers of the CD4+ Th cells, S-100+ DCs, and CD57+NK cells increased with the progress of the disease in CIN, but when cancer occurred, immune cells decreased in local cervical tissue.
CONCLUSION: From lesion precancerous to infiltrating carcinoma, the form, quantity, and intensity of expression of immune cells changed, which may indicate that the cervical local immune function has changed. Furthermore, high-risk HPV infections are more active in local immune function.

Related: Cervical Cancer


Coşar E, Gencer M, Hacivelioğlu SO, et al.
HPV and HPV vaccination: knowledge and consciousness of young women.
Eur J Gynaecol Oncol. 2014; 35(5):554-6 [PubMed] Related Publications
AIM: The aim of the study was to explore the knowledge and the awareness of the young Turkish women regarding cervical cancer and human papilloma virus (HPV) vaccines. The authors analyze a probable relationship between the overall knowledge level and a few socio-demographic parameters.
MATERIALS AND METHODS: The authors interviewed with students from Canakkale 18 March University and young women that did not continue with school in the same city from January to September 2011. All the students answered the questionnaire voluntarily and independently.
RESULTS: The participants had low level of knowledge about the risk factors for cervical cancer. Smoking is the major risk factor that was known by the participants (65%). Proportion of the participants that were aware of pap smear test and HPV were 65% and 17% respectively. A small proportion of young women had knowledge regarding protection from HPV. Educational stream, educational level, family income, and family size had significant association knowledge level (p < 0.05).
CONCLUSION: There has not been any improvement in HPV and risk factor of cervical cancer awareness in young women. Health members of the National Cancer Control Programme and delegates of the vaccine corporations have major work in order to increase the level of knowledge so that general public can easily take preventative measures.

Related: Cervical Cancer Human Papillomavirus (HPV), Vaccination, and Cervical Cancer


Cossu A, Capobianco G, Budroni M, et al.
Report on incidence and mortality trends of cervical cancer in northern Sardinia, Italy.
Eur J Gynaecol Oncol. 2014; 35(5):544-7 [PubMed] Related Publications
INTRODUCTION: The aim of this study was to analyze and describe the incidence and mortality trends of cervical cancer in northern Sardinia, Italy, in the period 1992-2010.
MATERIALS AND METHODS: Data were obtained from the tumor registry of Sassari province which is part of a wider registry web, coordinated today by the Italian Association for Tumor Registries.
RESULTS: The overall number of cervical cancer cases registered in the period under investigation was 311. The mean age of the patients was 51.8 years. The standardized incidence and mortality rates were 6.6 / 100.000 and 0.7 / 100.000, respectively. A stable trend in incidence and mortality of cervical cancer was evidenced. Relative survival at five years from diagnosis was fairly good (66.3%).
CONCLUSIONS: The incidence and mortality trends of cervical cancer in northern Sardinia remained relatively stable in the last decades. Furthermore, survival of patients with cervical cancer is good in the area, sanctioning the adequacy of the preventive and clinical measures in use.

Related: Cervical Cancer


Nakamura H, Takehara K, Samura O, Mizunoe T
Cytoreductive surgery for isolated para-aortic lymph node recurrence of endometrial cancer: report of four cases and a review of the literature.
Eur J Gynaecol Oncol. 2014; 35(5):535-8 [PubMed] Related Publications
Isolated para-arotic lymph node recurrence of endometrial cancer occurs occasionally, but management of such patients has been controversial. The authors performed cytoreductive surgery in four patients with isolated para-aortic lymph node metastasis of recurrent endometrial cancer. They resected metastatic foci by laparoscopic method for three cases and by laparotomy for one case. After the surgery, three cases underwent radiation therapy and one case was given chemotherapy as adjuvant therapy. After the treatment for recurrence, progression-free interval was from 64 to 127 months and all cases had no evidence of disease. Cytoreductive surgery may improve prognosis of isolated para-aortic lymph node metastasis of recurrent endometrial cancer. As laparoscopic surgery is superior to laparotomy in terms of less invasiveness, further examinations will reveal that it is feasible for such an isolated lymph node recurrence situation.

Related: Endometrial (Uterus) Cancer Endometrial Cancer


Jin Z, Gu J, Xin X, et al.
Expression of hexokinase 2 in epithelial ovarian tumors and its clinical significance in serous ovarian cancer.
Eur J Gynaecol Oncol. 2014; 35(5):519-24 [PubMed] Related Publications
"Warburg effect" emphasizes that malignant cells exhibit active glycolysis even under aerobic conditions. Hexokinase 2 (HK2) is a key glycolytic enzyme that helps to exhibit a "Warburg effect". In the present study, the main aim was to detect the expression of HK2 in epithelial ovarian tumor tissues. Immunohistochemistry and qRT-PCR were used to examine the expression of HK2 in different epithelial ovarian tissues. The expression of HK2 in ovarian cancer tissues was significantly higher than that in normal ovarian, benign, and borderline tumors both in protein (p < 0.001) and mRNA (p < 0.05) levels. HK2 expression was significantly higher in Stage III/IV compared to Stage III (p < 0.001). Expression of HK2 in poorly-differentiated carcinoma was higher than that in well-differentiated carcinoma (p = 0.008). The level of HK2 was higher in serous groups than in non-serous groups in both protein (p = 0.008) and mRNA (p < 0.05) level. Collectively, HK2 is highly expressed in epithelial ovarian cancer, especially in serous groups. Its expression is related with clinical stage and histological differentiation.

Related: Ovarian Cancer


Baser E, Gungor T, Togrul C, et al.
Preoperative prediction of poor prognostic parameters and adjuvant treatment in women with pure endometrioid type endometrial cancer: what is the significance of tumor markers?
Eur J Gynaecol Oncol. 2014; 35(5):513-8 [PubMed] Related Publications
UNLABELLED: Summary
PURPOSE OF THE STUDY: The study was conducted to determine whether preoperative serum levels of cancer antigen (CA) 125, CA15- 3, CA19-9, carcinoembryonic antigen (CEA), and alpha-fetoprotein (AFP) are associated clinicopathologically with poor prognostic parameters and adjuvant treatment requirements in women with pure endometrioid endometrial cancer (EEC).
MATERIALS AND METHODS: The authors performed a retrospective review of EEC cases that were treated between January 2008 and January 2011. The association between preoperative tumor markers and prognostic parameters, recurrence risk, and adjuvant treatment requirements were investigated. Following univariate analyses, receiver-operating characteristic (ROC) curves were constructed for each marker to assess their capacity to predict prognostic parameters and need for adjuvant treatment.
RESULTS: A total of 166 EEC cases were identified. Mean CA125, CA15-3, and CA19-9 levels were higher in cases that required adjuvant treatment (p < 0.05). CA125 had significant power for prediction of extrauterine disease, tumor size > two cm, lymphovascular space invasion (LVSI), deep myometrial invasion, cervical involvement, adnexal involvement, positive cytology, lymph node metastasis, and adjuvant treatment requirement. CA15-3 was a significant marker for adjuvant treatment prediction. CA19-9 could predict deep myometrial invasion, cervical involvement, and adjuvant treatment requirement. However, CEA and AFP did not have adequate capacity to predict any of the poor prognostic parameters and adjuvant treatment requirements. CONCLUSIONs: CA125 is currently one of the most important preoperative markers for identifying EEC cases that exhibit postoperatively poor prognostic pathologic findings and a consequent need for adjuvant treatment. CA15-3 and CA19- 9 were also significant markers with limited capacity in detecting prognostic parameters.

Related: Endometrial (Uterus) Cancer Endometrial Cancer


Liu L, Yi J, Zhang D
The progress of ALDH-1 in gynecologic oncology.
Eur J Gynaecol Oncol. 2014; 35(5):508-12 [PubMed] Related Publications
The authors present a review of the literature to illustrate the progress of ALDH-1 in gynecological malignancies.

Related: Endometrial (Uterus) Cancer Endometrial Cancer Ovarian Cancer Cervical Cancer


Yamashita H, Niibe Y, Okuma K, et al.
Treatment results for Stage Ib cervical cancer after stage subdivision by MRI evaluation.
Eur J Gynaecol Oncol. 2014; 35(5):499-502 [PubMed] Related Publications
PURPOSE OF INVESTIGATION: The authors analyzed treatment results for cervical cancer after subdividing Stage Ib into Stages Ib1 and Ib2 according to magnetic resonance imaging (MRI) information.
MATERIALS AND METHODS: The subjects comprised 40 cases of Stage Ib cervical cancer treated by definitive radiotherapy in Kitasato University hospital and Tokyo University hospital from January 2000 to December 2008. The patients' ages ranged from 28 to 85 years (median: 68 years). The maximum tumor diameter measured with MRI ranged from undetectable to 60 mm (median: 25 mm). The authors classified tumors with the greatest dimension less than 40 mm as Stage Ib1 (29 cases) and those with the greatest dimension more than 40 mm as Ib2 (11 cases). All cases were treated with a combination of external beam irradiation and high-dose-rate intra-cavitary brachytherapy. Chemotherapy was combined with radiotherapy in 11 cases.
RESULTS: The follow-up time was from four to 109 months (median: 53 months). At the time of last observation, 37 cases survived, local recurrence was seen in none, and two cases showed distant metastasis. The two- and five-year overall survival rates of all cases were 97.5% and 89.5%, respectively. When a stage was subdivided and examined, the five-year overall survival rate of Stage Ib1 was 100% and that of Stage Ib2 was 50.5% (p = 0.001).
CONCLUSION: The authors suggest that the subdivision of stages using image information reflects the prognosis of Stage Ib cervical cancer.

Related: Cervical Cancer


Martins Filho A, Jammal MP, Nomelini RS, Murta EF
The immune response in malignant ovarian neoplasms.
Eur J Gynaecol Oncol. 2014; 35(5):487-91 [PubMed] Related Publications
The objective of this study was to review studies that have investigated the immune response in the presence of a malignant ovarian neoplasia. A review of the literature was performed to identify studies of malignant ovarian neoplasia, particularly studies that addressed the potential for cytokines, nitric oxide, and lymphocytes to mediate an immune response against ovarian cancer. Certain subsets of tumor-infiltrating leukocytes and/or tumor-associated leukocytes have been found to correlate with an improved disease prognosis, while other lymphocyte subsets (such as CD3+/CD4+/CD25+ T cells) have been associated with a poor prognosis. These data suggest that cytokines can have a protective role, or can promote an immune system defense against a cancer. In particular, certain cytokines (e.g., IL 8, IL 10) represent attractive candidates for the development of new diagnostic, prognostic, and therapeutic strategies for the treatment of ovarian cancer.

Related: Cytokines Ovarian Cancer


Kandalaft PL, Gown AM, Isacson C
The lung-restricted marker napsin A is highly expressed in clear cell carcinomas of the ovary.
Am J Clin Pathol. 2014; 142(6):830-6 [PubMed] Related Publications
OBJECTIVES: We recently observed expression of the "lung" marker napsin A in ovarian clear cell carcinomas and therefore sought to determine the extent of napsin A expression in a subset of ovarian neoplasms.
METHODS: We identified an archival series of ovarian clear cell carcinomas (n = 36), serous borderline tumors (n = 21), high-grade serous carcinomas (n = 37), and endometrioid adenocarcinomas (n = 29). Using standard immunohistochemical techniques on whole sections of formalin-fixed, paraffin-embedded specimens, we employed a panel of antibodies: napsin A (IP64), estrogen receptor (SP1), WT-1 (6F-H2), PAX-8 (BC12), and TTF-1 (SPT24).
RESULTS: Thirty-six of 36 clear cell carcinomas showed napsin A expression, typically in a uniform pattern. None of the serous borderline tumors or high-grade serous carcinomas manifested napsin A expression. Napsin A was expressed in three (10%) of 29 endometrioid adenocarcinomas, generally in a focal pattern.
CONCLUSIONS: Our study showed that napsin A is an extremely sensitive (100%) marker of ovarian clear cell carcinomas and exhibits very high specificity (100%) in distinguishing clear cell carcinomas from high-grade serous carcinomas and serous borderline tumors and 90% specificity in discriminating clear cell carcinomas from endometrioid carcinomas.

Related: Ovarian Cancer


Reuschenbach M, Wentzensen N, Dijkstra MG, et al.
p16INK4a immunohistochemistry in cervical biopsy specimens: A systematic review and meta-analysis of the interobserver agreement.
Am J Clin Pathol. 2014; 142(6):767-72 [PubMed] Related Publications
OBJECTIVES: The interpretation of cervical biopsy specimens guides management of women with suspected cervical cancer precursors. However, morphologic evaluation is subjective and has low interobserver agreement. Addition of p16(INK4a) immunohistochemistry may improve interpretation.
METHODS: We performed a systematic review and meta-analysis of published data on interobserver agreement of p16(INK4a) positivity using p16(INK4a) immunohistochemistry and of cervical intraepithelial neoplasia grade 2 (CIN2+) and CIN grade 3 (CIN3+) classification using H&E morphology in conjunction with p16(INK4a) in comparison with H&E morphology alone.
RESULTS: The literature search revealed five eligible articles. The results show strong agreement of pathologists' interpretation of cervical biopsy specimens as p16(INK4a) positive or negative (pooled κ = 0.90; 95% confidence interval [CI], 0.88-0.92) and significantly higher agreement for a CIN2+ diagnosis with H&E morphology in conjunction with p16(INK4a) (κ = 0.73; 95% CI, 0.67-0.79) compared with H&E morphology alone (κ = 0.41; 95% CI, 0.17-0.65). Also, a slightly higher agreement for CIN3+ can be observed (κ = 0.66; 95% CI, 0.39-0.94 for H&E morphology in conjunction with p16(INK4a) and κ = 0.61; 95% CI, 0.44-0.78 for H&E morphology alone), but this difference was not statistically significant.
CONCLUSIONS: The published literature indicates improved interobserver agreement of the diagnosis of CIN2+ with the conjunctive use of H&E morphology with p16(INK4a) immunohistochemistry compared with H&E morphology alone.

Related: Cervical Cancer


Benard VB, Thomas CC, King J, et al.
Vital signs: cervical cancer incidence, mortality, and screening - United States, 2007-2012.
MMWR Morb Mortal Wkly Rep. 2014; 63(44):1004-9 [PubMed] Related Publications
BACKGROUND: Cervical cancer screening is one of the greatest cancer prevention achievements, yet some women still develop or die from this disease.
OBJECTIVE: To assess recent trends in cervical cancer incidence and mortality, current screening percentages, and factors associated with higher incidence and death rates and inadequate screening.
METHODS: Percentages of women who had not been screened for cervical cancer in the past 5 years were estimated using data from the 2012 Behavioral Risk Factor Surveillance System survey. State-specific cervical cancer incidence data from the United States Cancer Statistics and mortality data from the National Vital Statistics System were used to calculate incidence and death rates for 2011 by state. Incidence and death rates and annual percentage changes from 2007 to 2011 were calculated by state and U.S. Census region.
RESULTS: In 2012, the percentage of women who had not been screened for cervical cancer in the past 5 years was estimated to be 11.4%; the percentage was larger for women without health insurance (23.1%) and for those without a regular health care provider (25.5%). From 2007 to 2011, the cervical cancer incidence rate decreased by 1.9% per year while the death rate remained stable. The South had the highest incidence rate (8.5 per 100,000), death rate (2.7 per 100,000), and percentage of women who had not been screened in the past 5 years (12.3%).
CONCLUSIONS: Trends in cervical cancer incidence rates have decreased slightly while death rates have been stable over the last 5 years. The proportion of inadequately screened women is higher among older women, Asians/Pacific Islanders, and American Indians/Alaska Natives.
IMPLICATIONS FOR PUBLIC HEALTH PRACTICE: There continue to be women who are not screened as recommended, and women who die from this preventable cancer. Evidence-based public health approaches are available to increase women's access to screening and timely follow-up of abnormal results.

Related: USA Cervical Cancer


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