The Mumbai Obstetric and Gynaecological Society www.mogsonline.org mogs
This section on women’s cancers is a rich source of information on every aspect on the subject. It is maintained by the National Institute of Health, USA and has links to updated data from ongoing trials. Topics such as cancer vaccines, statistics in cancer and other cancers are well covered.
This website is a compendium of weblinks to over 100 subtopics on gynecological cancers. It is vast resource but very comprehensive coverage about the smallest of topics.
The American Society for Colposcopy and Cervical Pathology covers subjects related to the vulva, vagnia, anus besides cervical pathology. The website has an atlas of colposcopy and various lesions. The Bethesda guidelines 2006 can be downloaded from here.
Fertility preservation in young women with epithelial ovarian cancer.
Cancer. 2009 Aug 10. [Epub ahead of print]
Wright JD, Shah M, Mathew L, Burke WM, Culhane J, Goldman N, Schiff PB, Herzog TJ.
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York.
BACKGROUND:: Surgical management of ovarian cancer consists of hysterectomy with bilateral oophorectomy. In young women, this results in the loss of reproductive function and estrogen deprivation. In the current study, the authors examined the safety of fertility-conserving surgery in premenopausal women with epithelial ovarian cancers.
METHODS:: Women aged
Patient-derived tumor-reactive antibodies as diagnostic markers for ovarian cancer.
Gynecol Oncol. 2009 Jul 30. [Epub ahead of print]
Taylor DD, Gercel-Taylor C, Parker LP.
Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Women's Health, University of Louisville School of Medicine, Louisville, KY 40292, USA.
OBJECTIVE: Most ovarian cancers are diagnosed at advanced stage (67%) and prospects for significant improvement in survival reside in early diagnosis. Our objective was to validate our array assay for the identification of ovarian cancer based on quantitation of tumor-reactive IgG.
METHODS: The diagnostic array utilizes specific exosome-derived antigens to detect reactive IgG in patients' sera. Specific protein targets were isolated by immunoaffinity from exosomes derived from ovarian tumor cell lines. Sera were obtained from age-matched female volunteers, women with benign ovarian disease and with ovarian cancer. Immunoreactivity was also compared between exosomal proteins and their recombinant counterparts.
RESULTS: Sera from ovarian cancer patients exhibited significantly greater immunoreactivities than either normal controls or women with benign disease (both considered negative to all antigens tested). Reactivities with nucleophosmin, cathepsin D, p53, and SSX common antigen for patients with all stages of ovarian cancer were significantly higher than for controls and women with benign ovarian disease. Reactivity with placental type alkaline phosphatase, TAG 72, survivin, NY-ESO-1, GRP78, and Muc16 (CA125) allowed the differentiation between Stage III/IV and early stage ovarian cancer.
CONCLUSIONS: The quantitation of circulating tumor-reactive IgG can be used to identify the presence of ovarian cancer. The analyses of IgG recognition of specific exosomal antigens allows for the differentiation of women with benign ovarian masses from ovarian cancer, as well as distinguishing early and late stage ovarian cancers. Thus, the quantitative assessment of IgG reactive with specific tumor-derived exosomal proteins can be used as diagnostic markers for ovarian cancer.
Pros and cons of intraperitoneal chemotherapy in the treatment of epithelial ovarian cancer.
Anticancer Res. 2009 Jul;29(7):2803-8.
Zeimet AG, Reimer D, Radl AC, Reinthaller A, Schauer C, Petru E, Concin N, Braun S, Marth C.
Department of Obstetrics and Gynecology, Innsbruck Medical University, Innsbruck, Austria. firstname.lastname@example.org
Development of the pros and cons of intraperitoneal (IP) chemotherapy in the treatment of epithelial ovarian cancer based on the most prominent data published on the evolution of IP chemotherapy and on experience with this therapeutic strategy in clinical routine. The literature published on IP chemotherapy in ovarian cancer between 1970 and 2008 was identified systematically by computer-based searches in MEDLINE and the Cochrane Library. Furthermore, a preliminary analysis of data recorded during an observational nationwide multicenter study of the Austrian AGO on IP-IV chemotherapy using the GOG-172 treatment regimen was performed. The literature review unequivocally revealed a significantly greater toxicity for IP than for intravenous (IV) cisplatin-based chemotherapy. However, according to a Cochrane meta-analysis, IP-IV administration of chemotherapy is associated with a 21.6% decrease in the risk for death. In agreement with earlier reports, the most frequently mentioned side-effects in the Austria-wide observational study were long-lasting neurotoxicity, abdominal pain, fatigue, gastrointestinal and metabolic toxicities, and catheter-related complications. Most of these toxicities were identified as mirroring the toxicity profile of high-dose IV cisplatin (>or=100 mg/m(2)). In some patients, the classic IP-IV regimen with cisplatin/paclitaxel was changed to an alternative schedule comprising carboplatin AUC 5 (d1) and weekly paclitaxel 60 mg/m(2) (d1, 8, 15) completely administered via the IP route. This treatment was better tolerated and quality of life was significantly less compromised. However, neutropenia and thrombocytopenia were the limiting side-effects of this IP regimen. In cases where optimal cytoreduction with residual disease
B152 Anti-hyperglycosylated Human Chorionic Gonadotropin Free b-Subunit: A New, Possible Treatment for Cancer
Laurence A. Cole, Ph.D., and Stephen A. Butler, Ph.D.
OBJECTIVE: To investigate the ability of B152 to block cancer growth in cell lines in vivo and in nude mice in vitro.
STUDY DESIGN: We examined JAR, JEG-3, and NTERA trophoblastic cancer cell lines and KLE, Hec-1A, SCaBER, and T24 nontrophoblastic cancer cell lines. JEG-3 cells were transplanted into 8 nude mice. Four nude mice were administered B152 antibody, and 4 were administered control nonspecific IgG. Two studies were completed: first with antibody treatment started 2 weeks after cancer transplantation, and second with antibody treatment started at the time of transplantation.
RESULTS: In 3 trophoblastic cancer lines and 4 nontrophoblastic cancer cell lines, B152 suppressed the growth of cancer cells, forcing cells into a state of regression. When B152 was administered to nude mice with tumor xenographs, the antibody blocked cancer cell growth and invoked oncostasis. When B152 was administered to nude mice starting at time of xenograph transplantation, the antibody prevented tumor growth completely.
CONCLUSION: B152 suppresses tumor growth by seemingly blocking hyperglycosylated human chorionic gonadotropin (hCG) free b-subunit effects. Thus, highly specific antibodies against hCG such as B152 may form part of a novel adjuvant treatment regimen against hCG-producing tumors in humans. This may form a new treatment for humans.
Comparison of Outcomes in Patients with Early-stage Mucinous Endometrial Cancer and Those with Endometrioid Endometrial Cancer, With and Without Adjuvant Therapy
Sharon Owusu-Darko, M.D., J. Alejandro Rauh-Hain, M.D., Neil S. Horowitz, M.D., Annekathryn Goodman, M.D., John O. Schorge, M.D., and Marcela G. del Carmen, M.D., M.P.H.
OBJECTIVE: To compare risk factors, treatment, and outcomes in patients with stage I/II mucinous endometrial cancer (MEC) relative to those of patients with endometrioid endometrial cancer (EEC).
STUDY DESIGN: We conducted a case-control study of patients with MEC and EEC. Patients with stage IA, IB, or II MEC treated at the 2 institutions between 01/01/ 1996 and 01/01/2007 were identified. Each MEC case was matched with 2 EEC controls by age, stage, grade, and year of diagnosis. The Kaplan-Meier method was used to generate overall survival (OS) data. Factors predictive of outcome were compared using the log-rank test and Cox proportional hazards model.
RESULTS: A total of 34 patients with MEC were compared to 68 controls with EEC. All patients were treated by hysterectomy and bilateral salpingo-oophorectomy. Use of adjuvant radiation therapy was similar between cases and controls. The 5-year disease-free survival (DFS) rates were not significantly different in patients with MEC when compared to those with EEC (89% vs. 92%, respectively, p=0.2). The 5-year OS rates for patients with MEC and the control group were 95% and 96%, respectively (p=0.1).
CONCLUSION: Patients with early-stage MEC and EEC have similar DFS and overall survival.
Endometrial Stromal Sarcoma: A Clinicopathologic Study of 29 Patients
J. Alejandro Rauh-Hain, M.D., Annekathryn Goodman, M.D., David M. Boruta, M.D., John O. Schorge, M.D., Neil S. Horowitz, M.D., and Marcela G. del Carmen, M.D., M.P.H.
OBJECTIVE: To analyze clinicopathological characteristics, treatment, and survival in patients with endometrial stromal sarcoma (ESS).
STUDY DESIGN: Patients with ESS were identified from the tumor registry of the two participating institutions. Categorical variables were evaluated by c2 analysis or Fisher’s exact test. Survival estimates were plotted utilizing the Kaplan–Meier method. The log-rank test was utilized to quantify survival differences on univariate analysis.
RESULTS: A total of 29 patients with ESS were included: 14 (48%) patients with stage I, 1 (3.4%) with stage II, 5 (17%) with stage III, and 9 (31%) with stage IV disease. Median age was 44 (range, 25–62). Most patients were treated by hysterectomy and salpingo-oophorectomy. Sixteen patients (55%) received adjuvant therapy after surgery. The most common type of adjuvant therapy was hormonal treatment. Median follow-up was 84 months (range, 1–382 months). Four patients with stage I (36%), 2 with stage III (18%), and 5 (46%) with stage IV developed disease recurrences. In 8 cases (73%) the recurrence site was the abdomen and pelvis, and in 3 cases (27%) the recurrence site was the lung.
CONCLUSION: ESS is an indolent tumor with propensity for late recurrence. Age, early tumor stage (stage I), lymph node dissection, and adjuvant therapy did not affect disease-free or overall survival.