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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Menu: Gynacological Cancers

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).

Davis AN, Afshar-Kharghan V, Sood AK
Platelet effects on ovarian cancer.
Semin Oncol. 2014; 41(3):378-84 [PubMed] Article available free on PMC after 01/06/2015 Related Publications
Growing understanding of the role of thrombocytosis, high platelet turnover, and the presence of activated platelets in the circulation in cancer progression and metastasis has brought megakaryocytes into focus. Platelet biology is essential to hemostasis, vascular integrity, angiogenesis, inflammation, innate immunity, wound healing, and cancer biology. However, before megakaryocyte/platelet-directed therapies can be considered for clinical use, understanding of the mechanism and biology of paraneoplastic thrombocytosis in malignancy is required. Here, we provide an overview of the clinical implications, biological significance, and mechanisms of paraneoplastic thrombocytosis in the context of ovarian cancer.

Related: Ovarian Cancer

Wang Z, Zeng X, Ma Y, et al.
Antitumor efficiency of D-alpha-tocopheryl polyethylene glycol 1000 succinate-b-poly(epsilon-caprolactone-ran-lactide) nanoparticle-based delivery of docetaxel in mice bearing cervical cancer.
J Biomed Nanotechnol. 2014; 10(8):1509-19 [PubMed] Related Publications
Pharmaceutical nanotechnology holds potential in cancer chemotherapy. In this research, the docetaxel-loaded D-alpha-tocopheryl polyethylene glycol 1000 succinate-b-poly(epsilon-caprolactone-ran-lactide) (TPGS-b-(PCL-ran-PLA)) nanoparticles were prepared by a modified nanoprecipitation method and then the particle size, surface morphology, nanoparticle stability, in vitro drug release and cellular uptake of nanoparticles were characterized. Finally, we evaluated the therapeutic effects of nanoparticle formulation in comparison with Taxotere both in vitro and in vivo. The size of TPGS-b-(PCL-ran-PLA) nanoparticles was about 150 nm and much smaller than PCL nanoparticles (about 185 nm) and the absolute value of zeta potential was higher than PCL nanoparticles (16.49 mV vs. 13.17 mV). FESEM images further confirmed the morphology and size of nanoparticles. The drug-loaded nanoparticles were considered to be stable, showing no change in the particle size and surface charge during three-month storage of its aqueous solution. In vitro drug release of TPGS-b-(PCL-ran-PLA) nanoparticles was much faster than PCL and PCL-TPGS nanoparticles. The cumulative drug release of docetaxel-loaded TPGS-b-(PCL-ran-PLA), PCL-TPGS, and PCL NPs were 38.00%, 34.48% and 29.04%, respectively. TPGS-b-(PCL-ran-PLA) nanoparticles showed an obvious increase of cellular uptake. Due to the advantages of TPGS-b-(PCL-ran-PLA) nanoparticles, it could achieve significantly higher level of cytotoxicity in vitro and better inhibition effect of tumor growth on xenograft BALB/c nude mice tumor model than commercial Taxotere at the same dose (1.49-fold more effective). The TPGS-b-(PCL-ran-PLA) could be used as a novel and potential biodegradable polymeric material for nanoformulation in cervical cancer chemotherapy.

Related: Cervical Cancer Docetaxel

Magnowska M, Zaborowski M, Surowiak P, et al.
COX-2 expression pattern is related to ovarian cancer differentiation and prognosis, but is not consistent with new model of pathogenesis.
Ginekol Pol. 2014; 85(5):335-41 [PubMed] Related Publications
OBJECTIVE: Numerous studies suggest that cyclooxygenase-2 (COX-2) is overexpressed in cancer. Our objective was to investigate the relationship between COX-2 expression in ovarian carcinoma and clinicopathological factors. An emphasis was put on the association with the new pattern of tumorigenesis that divides tumors into type I--less aggressive, and type II--more aggressive one. The prognostic significance of COX-2 expression was evaluated.
METHODS: Ovarian cancer tissues were obtained from 65 patients in FIGO III stage (23 with type I and 42 with type II ovarian cancer). COX-2 expression was evaluated by immunohistochemistry. The statistical analysis was performed in order to assess the connection between COX-2 expression and characteristic factors of ovarian cancer patients as well as the new division for type I and type II ovarian cancer
RESULTS: COX-2 expression was detected in 91% of tissue samples. It was markedly elevated in well differentiated tumors (p = 0.0041). The platinum-resistant tumors had significantly higher expression of COX-2 (p = 0.0337). There was no difference between COX-2 expression in type I and type II ovarian cancer (p = 0.6720). The COX-2 staining was not associated to age, CA125 level, the presence of ascites or any special histological type. An increased expression of COX-2 was an unfavorable prognostic factor for overall survival (p = 0.0369) and progression-free survival (p = 0.0218). Multivariate analysis confirmed that COX-2 overexpression is an independent unfavorable prognostic factor of shorter progression-free survival (p = 0.048).
CONCLUSIONS: COX-2 expression is an unfavorable prognostic factor for progression-free survival and overall survival in ovarian cancer There is no relationship between COX-2 expression in ovarian cancer tissue and the examined model of ovarian cancer pathogenesis.

Related: PTGS2 Ovarian Cancer

Penaranda E, Molokwu J, Hernandez I, et al.
Attitudes toward self-sampling for cervical cancer screening among primary care attendees living on the US-Mexico border.
South Med J. 2014; 107(7):426-32 [PubMed] Related Publications
BACKGROUND: Hispanic women living along the US border with Mexico have one of the highest cervical cancer mortality rates in the nation, owing in part to lower rates of screening. The barriers to screening in this population include lack of access to care and fear of and embarrassment about the pelvic examination. Screening for oncogenic or high-risk human papillomavirus during cervical cytology has been added to screening recommendations. A novel method for human papillomavirus testing is self-sampling, in which women collect their own cervicovaginal samples. There is lack of information about the acceptability of self-sampling as an alternative to cytology for cervical cancer screening in women living along the US-Mexico border.
METHODS: We conducted five focus groups with women between the ages of 30 and 65 who were primary care patients of clinics along the US-Mexico border. We used constructs from different health behavioral theories as a framework for the interview guide.
RESULTS: A total of 21 women participated in the focus groups, 80% of whom were Hispanic; mean age was 53.4 (standard deviation 7.9). More than one-third (38%) of the participants had not undergone a Papanicolaou test in the last 3 years. Women identified the perceived benefits of self-sampling as ease, convenience, practicability, less embarrassment, and need for child care as compared with a Papanicolaou test. The main barrier to self-sampling was concern about not performing the test correctly.
CONCLUSIONS: In this qualitative study, we found positive attitudes toward self-sampling among women living along the US border with Mexico. Further research is needed to evaluate interventions that address women's low levels of self-efficacy to perform the test and to evaluate the effectiveness of self-sampling in increasing cervical cancer screening rates.

Related: Cancer Screening and Early Detection USA Cervical Cancer

Kothari A
HPV vaccination: effects on cervical screening.
Nurs Times. 2014 Jun 11-17; 110(24):19-21 [PubMed] Related Publications
Uptake of cervical screening has declined slightly since the 1990s, and is generally lower among young women than older women. Although the human papillomavirus vaccination programme is successful, some girls are still not being vaccinated. In addition, the programme may have a negative impact on the uptake of cervical screening, as young women may not realise they are still vulnerable to cervical cancer after vaccination. Nurses should encourage girls and young women to take up both HPV vaccination and cervical screening.

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

Donovan KA, Donovan HS, Cella D, et al.
Recommended patient-reported core set of symptoms and quality-of-life domains to measure in ovarian cancer treatment trials.
J Natl Cancer Inst. 2014; 106(7) [PubMed] Article available free on PMC after 01/07/2015 Related Publications
There is no consensus as to what symptoms or quality-of-life (QOL) domains should be measured as patient-reported outcomes (PROs) in ovarian cancer clinical trials. A panel of experts convened by the National Cancer Institute reviewed studies published between January 2000 and August 2011. The results were included in and combined with an expert consensus-building process to identify the most salient PROs for ovarian cancer clinical trials. We identified a set of PROs specific to ovarian cancer: abdominal pain, bloating, cramping, fear of recurrence/disease progression, indigestion, sexual dysfunction, vomiting, weight gain, and weight loss. Additional PROs identified in parallel with a group charged with identifying the most important PROs across cancer types were anorexia, cognitive problems, constipation, diarrhea, dyspnea, fatigue, nausea, neuropathy, pain, and insomnia. Physical and emotional domains were considered to be the most salient domains of QOL. Findings of the review and consensus process provide good support for use of these ovarian cancer-specific PROs in ovarian cancer clinical trials.

Related: Ovarian Cancer USA

Reynolds D
Religiosity and parental acceptance of human papillomavirus (HPV) vaccine in 9-18 year-old girls.
J Christ Nurs. 2014 Jul-Sep; 31(3):172-7 [PubMed] Related Publications
The religious affiliation of parents/guardians may factor into the decision to accept human papillomavirus vaccine (HPV) vaccination for their 9- to 18-year-old girls but prior research findings are inconsistent on religious impact. This study assessed degree of religiosity and impact on HPV vaccination. No correlation was found between religiosity and vaccination status; however, significant correlations were found between religiosity and other assessed variables.

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

Kitaya K, Yasuo T, Nakamura Y
Recovery from endometrial thinning and successful pregnancy following vitamin E and C supplementation in infertile woman undergoing myomectomy for diffuse leiomyomatosis of the uterus: a case report.
Clin Exp Obstet Gynecol. 2014; 41(3):357-9 [PubMed] Related Publications
The authors here report a case of an infertile woman with diffuse leiomyomatosis of the uterus, which is a rare benign pathological condition in which the myometrium is occupied by innumerable small fibroid nodules. Due to the progressive abdominal distension of the patient and the desire for pregnancy of the couple, myomectomy was performed as a primary treatment. Urgent relaparotomy was required for hematoma debridement on the following day. Despite the evidence of the follicular growth and cyclic ovarian steroid secretion, the patient had postoperative endometrial thinning that was unresponsive to hormone replacement therapy. Supplementation of oral tocopherol nicotinate/vitamin E and ascorbic acid/vitamin C was effective for immediate recovery of withdrawal bleeding and gradual gain of endometrial thickness. The patient had a successful pregnancy in an in vitro fertilization-embryo transfer program and gave a birth to a healthy baby.

Litta P, Leggieri C, Conte L, et al.
Monopolar versus bipolar device: safety, feasibility, limits and perioperative complications in performing hysteroscopic myomectomy.
Clin Exp Obstet Gynecol. 2014; 41(3):335-8 [PubMed] Related Publications
PURPOSE OF INVESTIGATION: The authors' aim is to compare surgical outcome of hysteroscopic G1 and G2 submucous myomectomy using bipolar resectoscope to those performed by monopolar device.
MATERIALS AND METHODS: a multicenter-observational-case-control study was conducted on premenopausal women affected by menorrhagia, pelvic pain or infertility because of submucous uterine myoma. The authors considered eligible: single G1 or G2 submucous uterine myoma, at least 0.5 cm ultrasound 'myometrial-free-margin' and two months GnRH pre-surgical treatment (myoma > three cm). Goup A patients were treated b y bipolar resectoscope and Group B by monopolar resectoscope. Primary endpoint was to compare the groups in term of complete or incomplete myomas resection ("second-step-procedure" rate). Secondary endpoint was to compare two treatments in term of surgical time and intraoperative complications rate.
RESULTS: Group A (60 patients) and Group B (216 patients) were homogeneous for general features and myomas location but they differed for G2 type prevalence (73.3% vs 50.5%), mean myomas diameter (33.17 +/- 11.93 vs 29.45 +/- 9.63), and surgical time (29.43 +/- 12.6 vs 23.2 +/- 8.2 minutes). In Group A patients both G1 and G2 myomas were completely removed in single step without intraoperative/postoperative complications; in Group B surgical outcomes of G1 myomas were similar to those of Group A, while G2 myomas required procedure termination in 12% of cases because of light electrolyte disturbance (22 cases) and severe iponatremia in four cases. All intraoperative complications occurred when procedure time exceeded 30 minutes and when myomas diameter was greater than 37.5 millimeters.
CONCLUSION: in the era ofmini-invasive surgery, hysteroscopic approach by bipolar device should be considered as a useful, safe, and large scale feasible procedure for submucosal myoma treatment, particularly when G2.

Oh NJ, Kim WY
Laparoendoscopic single-site surgery (LESS) for large benign adnexal tumors: one surgeon's experience over one-year period.
Clin Exp Obstet Gynecol. 2014; 41(3):319-22 [PubMed] Related Publications
OBJECTIVE: To present the authors' experience with laparoendoscopic single-site surgery (LESS) surgery for large benign adnexal tumors and to compare the removal time of resected specimen with that of conventional laparoscopy.
STUDY DESIGN: Ten consecutive patients underwent LESS for huge adnexal tumors at Myongjil Hospital, Korea between March 2011 and July 2012. A modified open Hasson technique was used to gain access to the abdominal cavity. The single-port device was inserted trans-umbilically into the wound opening. After suction of large amount of fluid content, LESS salpingo-oophorectomy was performed. The resected adnexal specimen was placed into a LapBag for removal out of the abdominal cavity. The authors compared the removal time of resected specimen between LESS and previously performed conventional laparoscopy for large benign adnexal tumors.
RESULTS: The adnexal tumors in this study were all very large cystic tumors reaching near or over the umbilicus. It took less than ten minutes for the removal of the resected adnexal tumors in all LESS cases (three to ten minutes), much less time than that of the conventional laparoscopy (usually ten to 17 minutes).
CONCLUSION: LESS for large benign adnexal tumors is feasible and removal of resected adnexal tumor is easier than conventional laparoscopic surgery.

Related: Ovarian Cancer

Djukic M, Stankovic Z, Vasiljevic M, et al.
Laparoscopic management of ovarian benign masses.
Clin Exp Obstet Gynecol. 2014; 41(3):296-9 [PubMed] Related Publications
PURPOSE: To determine whether the presence of normal ovarian tissue could assist in the diagnosis of large benign ovarian neoplasms in young females and in choosing the laparoscopic treatment.
MATERIALS AND METHODS: A prospective study of 25 patients treated surgically for a cystic ovarian neoplasm measuring diameter more than ten cm or volume more than 500 ml and having normal ovarian tissue or ovarian crescent sign (OCS). Ultrasonography was performed at six weeks, then at three, six, nine, and 12 months postoperatively.
RESULTS: The mean age of patients was 15.3 +/- 3.6 years, ranging between 6.5 and 19 years. The mean preoperative volume of the ovarian neoplasm was 1,686 +/- 1,380 cm3, ranging between 550 and 6,000 cm3. The presence of OCS was visualized by ultrasonography in all 25 patients and serum tumor markers were negative in 22. No borderline tumors or malignancies were identified. There was a statistically significant difference between the volume of the affected ovary and the contralateral ovary during the first six weeks follow-up, but without significant difference after three months.
CONCLUSIONS: Postoperative ultrasound revealed that the affected ovary resumed its normal volume within three months after surgery, despite the thinned appearance of the ovarian cortex present on ultrasound as the OCS. Laparoscopic ovarian preservation should be the preferred surgical approach for adolescents to ensure the conservation of the entire ovarian tissue.

Related: Ovarian Cancer

Boynukalin FK, Comunoglu C, Türkmen I, et al.
C-Met expression pattern in uterine leiomyoma.
Clin Exp Obstet Gynecol. 2014; 41(3):254-7 [PubMed] Related Publications
AIM: Growth factors take place in the formation and growth of uterine leiomyomas (LMs). Transforming growth factor beta (TGF-beta), epidermal growth factor (EGF), platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), fibroblast growth factor-2 (FGF-2), and insulin-like growth factor (IGF) contribute to the pathophysiology of LMs when they bind with a specific membrane receptor and transmit a signal into the cell. Little is known about hepatocyte growth factor (HGF) and its receptor system c-Met in formation and growth of uterine LMs. The aim of this study was to evaluate the c-Met receptor expression on human myometrium and uterine LMs.
MATERIALS AND METHODS: The study was performed on human myometrium and uterine LMs. Expression of c-Met receptor was evaluated by immunohistochemical analysis.
RESULTS: Overexpression of c-Met was found in all LM cases and in none of normal myometrium samples c-Met overexpression was seen.
CONCLUSION: HGF and c-Met receptor complex seem to have role in development of uterine LMs.

Porto MA, Habib PA
Viva Mulher: constructing a cervical cancer control program in Brazil.
Dynamis. 2014; 34(1):101-23 [PubMed] Related Publications
Through a number of isolated initiatives that began in the 1960s, Brazil accumulated knowledge and experience that in the late 1990s culminated in the implementation of the first nationwide public health action meant to coordinate health bodies and personnel from the federal, state, and municipal administrative levels to address a chronic degenerative disease. The main goal of this article is to analyze the process of construction of this public policy for cancer control in Brazil--more specifically, organized screening for the control of cervical cancer in the form of the Viva Mulher program. Our analytical approach relies on elements from the history of public policy and from the history of institutions, combining the use of documental sources, scientific literature, and interviews with managers involved in the process under study. Our analysis endeavors to show how and to what extent this national process incorporated the experiences of local projects and responded both to pressure from the social movement and to the country's political environment. It further shows how the new context, shaped by changes in the organization of the Brazilian health system, influenced this process.

Related: Cervical Cancer

Nappi L, Mele G, Angioni S, et al.
Uterine leiomyosarcoma: report of three cases and review of the literature.
Eur J Gynaecol Oncol. 2014; 35(3):328-31 [PubMed] Related Publications
This is the report of three cases of unsuspected uterine leiomyosarcoma diagnosed by pathologist after hysteroscopic resection. The literature on this issue has been reviewed. Mesenchymal uterine tumors are rare malignancies, occurring in only 17 per one million women annually. The three most common variants of uterine sarcoma are endometrial stromal sarcoma, leiomyosarcoma, and malignant mixed Müllerian tumour. Less than one percent of women believed to have a leiomyoma actually have a sarcoma at hysterectomy. According to the authors' experience and the available literature reviewed, the removal of the whole myomatosus lesion, even if its appearance suggests a typical submucosal myoma, represents the only method to definitively rule out the presence of sarcomatous tissue.

Barone A, Ambrosio MR, Rocca BJ, et al.
Myxoid leiomyosarcoma of the uterus: a case report.
Eur J Gynaecol Oncol. 2014; 35(3):322-4 [PubMed] Related Publications
Only 30 cases of myxoid leiomyosarcomas (MLMS) have been reported to date. The authors describe a further case in a 66-year-old woman. The main differential diagnoses include: myxoid inflammatory myofibroblastic tumours, mixoid leiomyoma, and endometrial stromal tumours. Surgery remains the appropriate treatment. However, in spite of an aggressive surgical approach and local and systemic control, recurrences and metastasis are frequent.

Wu PC, Yue CT, Huang SC
Complete response after MAID treatment for advanced primary ovarian angiosarcoma: case report and literature review.
Eur J Gynaecol Oncol. 2014; 35(3):318-21 [PubMed] Related Publications
The patient presented in this case report was a 45-year-old female, with a Stage IIIA ovarian angiosarcoma combined with mature teratoma, that underwent debulking surgery and achieved complete remission for 11 months after six cycles of MAID chemotherapy (mesna, adriamycin/doxorubicin, ifosfamide, and dacarbazine). Thereafter, she had tumor recurrence with peritoneal seeding and massive pleural effusion; hence she received chemotherapy again. Although she had been undergoing a series of chemotherapies, the tumor continued to progress. Hence, she refused further chemotherapy since September 2012. Unfortunately, she passed away in January 2013 due to severe dyspnea with wide spread tumor progression. She had the longest survival period (31 months) and complete remission period than the other advanced primary ovarian angiosarcoma cases ever reported in the literature.

Related: Dacarbazine Doxorubicin Ifosfamide Mesna Ovarian Cancer

Cossu A, Paliogiannis P, Tanda F, et al.
Uterine perivascular epithelioid cell neoplasms (PEComas): report of two cases and literature review.
Eur J Gynaecol Oncol. 2014; 35(3):309-12 [PubMed] Related Publications
Perivascular epithelioid cell tumors (PEComas) are rare tumors characterized by co-expression of melanocytic and smooth muscle markers. PEComas have been reported in a wide variety of anatomic sites. In the female genital tract, PEComas most frequently affect the uterus. PEComas which occur in non-classic anatomic distributions are known as perivascular epithelioid cell tumor-not otherwise specified (PEComa-NOS). PEComas have an unpredictable biologic behavior, with some tumors being unresectable or metastatic at the time of diagnosis. The risk of aggressive behavior of these tumors has been linked to a number of factors evaluable on histopathological review following initial surgical resection. The authors report two cases of PEComa-NOS of the uterus: one with disease confined to uterus and the other case with lung and liver metastasis.

Fan JT, Li MJ, Shen P, et al.
Serum and tissue level of YKL-40 in endometrial cancer.
Eur J Gynaecol Oncol. 2014; 35(3):304-8 [PubMed] Related Publications
OBJECTIVE: Serum YKL-40 level is elevated in patients with several malignancies. This study was designed to assess the correlation between serum YKL-40 and the corresponding tissue expression in endometrial cancer (EC).
MATERIALS AND METHODS: Preoperative serum levels of YKL-40 were measured by enzyme-linked immunosorbent assay (ELISA) from 41 patients with EC, 27 patients with uterine myoma, and 30 healthy women. YKL-40 protein expression in tissue was determined by immunohistochemistry for patients with EC and patients with uterine myoma.
RESULTS: Median preoperative serum YKL-40 level was 157.2 microg/l (range 76.0 - 301.2) in EC compared with 86.6 microg/l (range 69.3 - 191.1) in uterine myoma, and 86.2 microg/l (range 52.1 - 201.1) in healthy women (p < 0.05). Of 41 patients with EC, 26 patients with elevated serum YKL-40 level statistically differed from the remaining 15 patients with normal serum YKL-40 level with respect to FIGO Stage, tumor grade, washing cytology, and serum CA125 (p < 0.05). In multivariate analysis, elevated serum YKL-40 significantly correlated with FIGO stage (p < 0.05) and tumor grade (p < 0.01). The percentage of positive YKL-40 tissue staining was higher in EC patients (34.1%, 14/41) than in uterine myoma patients (11.1%, 3/27) (p < 0.05) and was lower than that of elevated serum levels in EC (26/41, 63.4%) (p < 0.05).
CONCLUSIONS: The elevated preoperative serum YKL-40 is related to stage and histologic grade of EC. The discordance between serum and tissue level of YKL-40 in EC indicates intrauterine tumor may not be the only source of serum YKL-40.

Related: Endometrial (Uterus) Cancer Endometrial Cancer

Togami S, Hori S, Kamio M, et al.
Clinical usefulness of concentrated ascites reinfusion therapy (CART) for gynecological cancer patients with refractory massive ascites due to cancerous peritonitis.
Eur J Gynaecol Oncol. 2014; 35(3):301-3 [PubMed] Related Publications
PURPOSE: Cell-free and concentrated ascites reinfusion therapy (CART) is intended to treat patients by ultrafiltration and reinfusion of their refractory ascites. In the CART system, bacteria and cancer cells in removed massive ascites are filtrated. Then, water is removed in the condenser, resulting in a higher protein concentration. The purpose of this study was to assess the clinical usefulness of CART in the treatment of refractory massive ascites in patients with cancerous peritonitis.
MATERIALS AND METHODS: CART was performed 13 times in four patients with ovarian and endometrial cancer.
RESULTS: Autologous protein with a higher concentration was intravenously administered. The amount of aspirated and condensed ascites was 3,190 +/- 1,086 ml (975 4,500 ml) and 538 +/- 249 ml (100 - 860 ml), respectively. Condensed albumin, albumin concentration, and concentration time were 43.2 +/- 25.8 g, 8.2 +/- 3.3 g/dl, and 73.3 +/- 24.8 min (28 - 122 min), respectively. CART was effective in maintaining serum albumin concentrations, and it is possible to repeat infusion. During CART, patients performance status was 1-2 and vital signs were stable except for mild elevations in body temperature. Daily life was maintained without serious side-effects.
CONCLUSIONS: The use of CART for gynecological cancer patients with refractory massive ascites due to cancerous peritonitis contributes to improvements in quality of life and relief of symptoms. With autologous infusion of condensed ascites, patients can avoid infection, allergic reactions, and administration of expensive blood products.

Related: Endometrial (Uterus) Cancer Endometrial Cancer Ovarian Cancer

Du CX, Li SQ, Wang AH, Wang Y
Significance of combined detection of p53 and FHIT in cervical carcinoma diagnosis.
Eur J Gynaecol Oncol. 2014; 35(3):298-300 [PubMed] Related Publications
PURPOSE: To explore the significance of combined detection of p53 genes and fragile histidine triad (FHIT) genes in cervical carcinoma.
MATERIALS AND METHODS: Specimens taken from 161 cases invasive carcinoma, 23 cases carcinoma in situ or cervical intraepithelial neoplasia III (CIN III), 74 cases CIN I - II, 25 cases normal cervical tissue, and 32 cases tumor-adjacent tissues were processed by immunohistochemistry to determine the expression of p53 and FHIT genes. The results of the combined detection were compared for clinical diagnostic value of cervical carcinoma diagnosis.
RESULTS: The p53 gene, FHIT gene and the two genes combined examination of cervical carcinoma diagnostic sensitivity were: 65.8% (121/184), 66.3% (122/184), 90.2% (166/184), respectively. There were no significant differences between the p53 gene and the FHIT gene detected (p > 0.05). Combined detection of the two gene were more sensitivity than single detection, the difference was significant (p < 0.001). Although diagnosis specificity had dropped somewhat, no significant statistical appeared (chi2 = 0.022, p > 0.05).
CONCLUSION: Combined detection of p53 genes and FHIT genes can increase the sensitivity diagnosis and specificity diagnosis for early cervical carcinoma and precancerous lesions has a positive meaning.

Related: Cervical Cancer

Tibúrcio MG, Pinheiro NM, Carboni Sde S, et al.
GTPases Rho distribution in intraepithelial and invasive neoplasias of the uterine cervix.
Eur J Gynaecol Oncol. 2014; 35(3):284-8 [PubMed] Related Publications
PURPOSE OF INVESTIGATION: To evaluate the distribution of GTPases RhoA, RhoB, and Cdc42 in cervical intraepithelial neoplasias (CIN) and invasive neoplasias of the uterine cervix.
MATERIALS AND METHODS: samples of neoplastic lesions of the uterine cervix of 44 patients were classified in: CIN I (n = 10), CIN II (n = 10), CIN III (n = 09), and invasive carcinoma (n = 15). Antibodies anti-RhoA, anti-RhoB, and anti-Cdc42 were used and staining was classified as: negative, mild, moderate, and intense positive.
RESULTS: When compared with dysplastic cells, superficial cells showed: higher expression of RhoB in CIN I (p = 0.0018), and lower expression of Cdc42 in CIN I (p = 0.0225). The authors observed higher expression of RhoA (p = 0.0002) and RhoB (p = 0.0046) in CIN dysplastic cells when compared with invasive carcinoma cells.
CONCLUSIONS: GTPases Rho may be involved with the regulation of biological processes, important to the progression of cervical neoplasias. Probably, RhoA is important for maintenance of cell differentiation and RhoB protects cells from malignant cervical neoplasia.

Related: Cervical Cancer CDC42 RHOA RHOB

Gulec UK, Paydas S, Guzel AB, et al.
The relationship between ovarian volume and serum CA-125 levels.
Eur J Gynaecol Oncol. 2014; 35(3):280-3 [PubMed] Related Publications
PURPOSE: The aim of this study was to investigate the relationship between ovarian volume and serum CA-125 levels.
MATERIALS AND METHODS: Serum CA-125 levels and ovarian volume were compared among the cases with benign ovarian neoplasms, primary epithelial ovarian cancer (EOC), controlled ovarian hyperstimulation, and ovarian hyperstimulation syndrome (OHSS). Also, the correlation between CA-125 levels and ovarian volume were evaluated in the presence of peritoneal fluid and/or peritoneal carcinomatosis.
RESULTS: Although ovarian volume was not different among the groups, CA-125 levels were higher in the cases with EOC than with benign ovarian tumors (p = 0.001). Baseline CA-125 levels were not found to have increased while ovarian volume went up with controlled hyperstimulation in the infertile group (p = 0.555). However, uncontrolled hyperstimulation of the ovaries and the presence of peritoneal fluid caused an increase in the levels of CA-125 (p = 0.001). There was no correlation between ovarian volume and CA-125 levels in the cases with malignant ovarian tumors (r = 0.083).
CONCLUSIONS: The results of this study have confirmed that CA-125 is a peritoneal marker and increased ovarian volume with benign ovarian neoplasms or controlled hyperstimulation does not increase CA-125 levels in the same way. The presence of peritoneal carcinomatosis and/or peritoneal fluid seems to be an important factor for high CA-125 levels in patients with epithelial ovarian cancer (EOC).

Related: Ovarian Cancer

Choi SD, Kim TH, Bae DH
Cervical intraepithelial neoplasia based on array comparative genomic hybridization.
Eur J Gynaecol Oncol. 2014; 35(3):270-3 [PubMed] Related Publications
Uterine cervical cancer is one of the most frequently observed malignant gynaecologic tumors. Carcinoma in situ or invasive cervical carcinoma develops from a low-grade intraepithelial lesion of the cervix over time. Human papillomavirus (HPV) is known to be a major contributing factor. With improvements in molecular genetic technologies, the authors attempted to identify the genomic changes associated with cervical precancerous lesions. In this study, changes in gene copy numbers were evaluated in five cases of severe uterine cervical dysplasia (HPV negative, two cases; HPV 16 and 18 positive only, three cases) by array comparative genomic hybridization (array CGH), and genes with copy number changes were compared between the two groups. Between the HPV positive and negative groups, only one gene was found to be upregulated more than 1.5 fold (3q23-q24), and no downregulated genes were identified. In conclusion, it is useful to evaluate genomic aberrations in cervical cancer using array CGH.

Related: CGH Cervical Cancer

Yin ZM, Yu AJ, Wu MJ, et al.
Prognostic factors and treatment comparison in small cell neuroendocrine cervical carcinoma.
Eur J Gynaecol Oncol. 2014; 35(3):259-63 [PubMed] Related Publications
OBJECTIVE: To determine the clinicopathologic factors associated with survival in small cell neuroendocrine cervical cancer (SCNEC) patients.
MATERIALS AND METHODS: The study was approved by the ethics committee of the hospital. The records of 64 SCNEC patients from 9,474 Chinese patients with cervical cancer at the Zhejiang Cancer Hospital were reviewed. Kaplan-Meier and Cox regression methods were used for analyses.
RESULTS: Of 64 patients, 47 had Stages I-IIA, 12 had Stages IIB-IVA, and five had Stage IV-B disease. A total of 81.25% underwent surgery, 89.1% received chemotherapy, 62.5% received radiation, 34.4% received neoadjuvant chemotherapy (NACT), and 34.4% received concurrent chemoradiation (CCRT). The median follow-up for surviving patients was 35.7 months (range: 0.5-160), and 29 (50%) of the 58 patients with Stages I-III had either disease recurrence or progression. The median time to first relapse was 10.5 months (range: 0-88.2). The five-year overall survival of patients in Stages I-IIA and IIB-IVB disease was 54.4% and 9.8%, respectively (p = 0.001). Women with early-stage (Stages IIBIIA) disease had median survival rates of 94 months compared with 21.4 months in the advanced-stage (Stages IIB-IVB) group. In univariate analysis, advanced-stage (p = 0.001), without radical surgery (p = 0.002) and deep stromal invasion (DSI) (p = 0.000) were considered poor prognostic factors. In a multivariable analysis, tumor size > four cm (p = 0.048), postoperative radiation (p = 0.038) for early-stage patients and the FIGO stage (p = 0.040) of disease in the overall population remained as independent prognostic factor of survival.
CONCLUSION: The FIGO stage was found to be an independent prognostic factor of SCNEC. In addition, tumor size > four cm and DSI was associated with poor survival. Postoperative radiation for early-stage patients may not improve survival. The role of primary and postoperative NACT or CCRT is unclear. Clinical trials are needed.

Related: Cervical Cancer

Gungor T, Altinkaya SO, Baser E, et al.
Rare ovarian tumors: a single center experience of 15 years.
Eur J Gynaecol Oncol. 2014; 35(3):250-8 [PubMed] Related Publications
OBJECTIVE: The present study aims to review cases of extremely rare primary ovarian tumors and thus, to evaluate the distribution of rare primary ovarian pathologies. Various aspects of the presentation, diagnosis, and treatment of these tumors are discussed.
MATERIALS AND METHODS: A retrospective review of women with final pathology of rare primary ovarian tumors, which were managed at the Gynecologic Oncology Department of Zekai Tahir Burak Women's Health Education and Research Hospital, from 1995 to 2010 was undertaken.
RESULTS: Among the 2,210 women treated during the study period, extremely rare ovarian tumors accounted for 1.62% (36/2210) of all cases.
CONCLUSION: It is important to be aware of these rare entities in the pathological diagnosis of ovarian tumors. Intraoperative frozen examination should be performed because rare benign conditions that mimic malignancy may not require radical surgery. The rarity of these tumors renders basic scientific advances more challenging.

Related: Ovarian Cancer

Kozakiewicz B, Dmoch-Gajzlerska E, Roszkowska-Purska K
Carcinomas and sarcomas of Bartholin gland. A report of nine cases and review of the literature.
Eur J Gynaecol Oncol. 2014; 35(3):243-9 [PubMed] Related Publications
UNLABELLED: The greater vestibular gland, also called Bartholin's gland after the Danish anatomist Caspar Bartholin the Younger who first described it in the 17th century, is the site of tumours arising from different types of epithelium and characterized by a different clinical course. In the years 1980-2009, 1,296 patients with vulvar carcinoma were treated at the Oncology Centre in Warsaw, Poland and nine of them had carcinoma of Bartholin's gland, including three patients with squamous cell carcinoma (SCC), three patients with adenoid cystic carcinoma (ACC) and three patients with sarcoma. In this paper the authors present the signs and symptoms, clinical course, treatment outcomes, and recurrence of these three malignant tumours of different histopathology. Own observations and evaluation of treatment results are compared with published reports from other centres. Interestingly, there is no consensus regarding diagnostic criteria or a uniform approach to management. Relatively poor knowledge of malignant tumours of Bartholin's gland seems to be responsible for delays in proper diagnosis and hence optimal management. When instituted, the treatment is usually aggressive and involves adjuvant radio- and chemotherapy, while the chances of longer disease-free survival after treatment may be compromised.
CONCLUSION: Bartholin sarcomas grow fast and invasive, SCC, and ACC infiltrate slowly and systematic. All types are curable at high interest rates if they are originally from the surgically removed lymph nodes on both sides and irradiated.

Related: Soft Tissue Sarcomas Vulva Cancer

Sheng XJ, Zhou DM, Liu Q, et al.
BRMS1 inhibits expression of NF-kappaB subunit p65, uPA and OPN in ovarian cancer cells.
Eur J Gynaecol Oncol. 2014; 35(3):236-42 [PubMed] Related Publications
BACKGROUND: Breast cancer metastasis suppressor 1 (BRMS1) is a potent metastasis suppressor of various types of malignancies, including melanoma and ovarian cancer. Unfortunately, the clinical data regarding its role as a true metastatic suppressor and its efficacy as a prognostic marker and therapeutic target remain controversial. This study was designed to investigate the effect of BRMS1 on the invasion and metastasis of human ovarian cancer cells and its potential underlying mechanisms.
MATERIALS AND METHODS: BRMS1 small interfering RNAs (siRNAs) or control siRNAs were transfected into the OVCAR3 human ovarian cancer cell line. Invasion and migration activities were assessed using the Transwell invasion and migration assay. Protein levels of nuclear factor-kappaB (NF-kappaB) subunit p65, osteopontin (OPN) and urokinase-type plasminogen activator (uPA) were evaluated by Western blot, immunofluorescence and immunocytochemistry methods.
RESULTS: Successful knockdown of BRMS1 was verified by quantitative real-time RT-PCR and Western blot. The invasion and migration capacities of OVCAR3 cells were significantly enhanced in the BRMS1-silenced group, compared to controls (p < 0.05). Silencing of BRMS 1 significantly induced the expression of NF-kappaB subunit, p65, uPA, and OPN proteins.
CONCLUSIONS: BRMS1 inhibits expression of p65, uPA and OPN protein. In turn, this leads to inhibition of ovarian cancer cell invasion and metastasis. This study unveils a potential novel mechanism by which BRMS1 inhibits metastasis of ovarian cancer cells.

Related: Ovarian Cancer

Kamran MW, O'Toole F, Meghen K, et al.
Whole-body [18F]fluoro-2-deoxyglucose positron emission tomography scan as combined PET-CT staging prior to planned radical vulvectomy and inguinofemoral lymphadenectomy for squamous vulvar cancer: a correlation with groin node metastasis.
Eur J Gynaecol Oncol. 2014; 35(3):230-5 [PubMed] Related Publications
Surgery is the mainstay of treatment for vulvar cancer. FIGO staging requires histopathological detail of the primary tumor and inguinofemoral lymph nodes but groin node dissection carries a substantial risk of short and long-term morbidity. The trend in current practice is towards sentinel lymphadenectomy for cancers with a low risk of metastases. Full lymphadenectomy is undertaken if the sentinel lymph node contains metastasis. The predictive value of 18F-FDG-PET in preoperative assessment of the groin in vulvar squamous cancer was assessed in retrospect at a single institution. A period of three years prior to the introduction of sentinel lymph node mapping was chosen in order to have full histopathological assessment of inguinal and femoral lymph nodes available as the gold standard for correlation with positron emission tomography-computerized tomography (PET-CT) to determine the accuracy of the enhanced radiological technique. In patients with histologically proven metastases to groin nodes, comparisons between PET-CT positive (True-positive/TP) and negative (False-negative/FN) groups vis-à-vis histology showed a tendency towards higher FDG avidity in the vulvar lesions, more bilateral nodes, multiple metastases, larger metastases and more extra-capsular extension in the TP group. Calculations per patient for PET-CT yielded a sensitivity of 50% and specificity at 100%. The positive predictive value (PPV) was 100% and the negative predictive value (NPV) was 57.1%. The test accuracy was 70% per patient. The high positive predictive value of PET-CT can be used to advance treatment planning prior to surgical staging of patients identified with Stage III disease. The poor sensitivity makes it unsuitable as a substitute for staging lymphadenectomy.

Related: Vulva Cancer

Matoda M, Omatsu K, Yamamoto A, et al.
Importance of platinum-free interval in second-line chemotherapy for advanced or recurrent endometrial cancer.
Eur J Gynaecol Oncol. 2014; 35(3):224-9 [PubMed] Related Publications
PURPOSE: To investigate the effectiveness of platinum-based combination chemotherapy as second-line chemotherapy for patients with advanced or recurrent endometrial cancer treated initially by platinum-based combination chemotherapy.
MATERIALS AND METHODS: Subjects were patients who had received platinum-based combination chemotherapy as second-line chemotherapy: 56 patients with recurrent disease who had previously received postoperative adjuvant platinum-based combination chemotherapy (Category 1) and 21 patients who had received first-line chemotherapy but not adjuvant chemotherapy for advanced or recurrent disease (Category 2). Patients' records were searched for the response to second-line chemotherapy and survival, particularly in relation to the platinum-free interval (PFI).
RESULTS: APFI over 12 months was a predictor of response (64.7%) and overall survival time (23 months) in Category 1 patients. A PFI of less than three months was a negative predictor of response (0%) and overall survival (nine months) in Category 2 patients.
CONCLUSION: Platinum-based combination chemotherapy appears to be effective as second-line chemotherapy for endometrial cancer if the PFI is sufficiently long.

Related: Endometrial (Uterus) Cancer Endometrial Cancer

Tjalma WA
The ideal cervical cancer screening recommendation for Belgium, an industrialized country in Europe.
Eur J Gynaecol Oncol. 2014; 35(3):211-8 [PubMed] Related Publications
Cervical cancer should be a historical disease, why are we not succeeding! The prophylactic vaccination will reduce cervical cancer by almost 80% in Belgium. Cervical cancer screening should therefore remain in order to prevent the remaining 20%. The current used Pap cytology test misses 50% of all clinically significant precancers and cancers at the time of testing. The test should remain but the analysis should be altered. The screening should be modified based on our knowledge of human papillomavirus (HPV) as causal factor. Instead of looking for a cell abnormality, one should look for the presence of HPV. Then depending on the test, only two to ten percent of all relevant lesions are missed. The introduction of the vaccination should lead to the re-introduction of the screening based on HPV. This will not only lead to a considerable reduction in morbidity and mortality, allow longer screening intervals, but it will also be more cost-effective. More for less should be the driving force in cervical cancer screening if we want to be successful.

Related: Cancer Screening and Early Detection Cervical Cancer

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