Gynecologic oncology
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Gynecologic oncology · Dec 2009
ReviewApplication of proteomics in ovarian cancer: which sample should be used?
In the last decade several studies have been published using proteomics to unravel molecular pathways and to find biomarkers which can be used for diagnosis and/or prognostication in ovarian cancer. This review gives an overview of proteomic studies performed in ovarian cancer focusing on the nature of samples that have been used. ⋯ To date no biomarkers for early diagnosis or prognostication in ovarian cancer have been found using proteomics. We speculate that it would be interesting to investigate the tissue proteome in an attempt to overcome acute phase reactants and to facilitate the discovery of real tumor-specific biomarkers instead of the identification of secondary protein changes.
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Gynecologic oncology · Dec 2009
Comparative Study Clinical TrialPerioperative outcomes comparing patient controlled epidural versus intravenous analgesia in gynecologic oncology surgery.
Our aim was to compare perioperative patient controlled epidural analgesia (PCEA) versus patient controlled intravenous analgesia (PCA) after gynecologic oncology laparotomy. ⋯ In this nonrandomized prospective study, selection of a PCEA for perioperative pain management did not improve pain management for patients undergoing gynecologic oncology surgery.
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Gynecologic oncology · Dec 2009
Long-term persistence of anti-HPV-16 and -18 antibodies induced by vaccination with the AS04-adjuvanted cervical cancer vaccine: modeling of sustained antibody responses.
Strong and sustained HPV-16 and -18 antibody responses have been observed in previously unexposed women aged 15-25 years vaccinated with the AS04-adjuvanted HPV-16/18 L1 virus-like particle vaccine. While awaiting the extended results of ongoing trials, our objective was to predict the long-term persistence of anti-HPV-16/18 antibodies in vaccinees by applying three statistical models using immunogenicity data from vaccinated women with serum samples collected up to 6.4 years after first vaccination. Two different data lock-points (up to 5.5 years and up to 6.4 years) were used to assess the robustness of the models. ⋯ Vaccination with the AS04-adjuvanted HPV-16/18 vaccine is predicted to provide long-term persistence for both HPV-16 and -18 antibodies, independent of the statistical model applied. Model predictions are based on conservative mathematical assumptions. Since the input of longer term data of up to 6.4 years showed an improved profile compared with that for data up to 5.5 years, the predictions of antibody persistence based on population means are conservative when predicting that antibody levels will remain well above levels induced by natural infection for 20 years.
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Gynecologic oncology · Dec 2009
HPV vaccination against cervical cancer in women above 25 years of age: key considerations and current perspectives.
Vaccination of young women (15-25 years of age) against human papillomavirus (HPV) has been shown to be very efficacious in preventing the development of moderate or severe cervical precancerous lesions associated with HPV-16 or -18. As the highest rates of new infections with high-risk (i.e., oncogenic) HPV types occur in the first years following sexual debut, most existing guidelines and recommendations advise on vaccinating young girls. We consider oncogenic HPV infection and the risk of developing cervical cancer in women over 25 years of age and whether they would also benefit from vaccination against HPV. ⋯ The priority of routine vaccination programmes must be to target girls and young women, with catch-up programmes that extend to age 25/26 when resources allow. For sexually active women over the age of 25, HPV vaccination can be considered on an individual basis, as most will have the potential to benefit from vaccination.
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Gynecologic oncology · Dec 2009
The combination of monthly carboplatin and weekly paclitaxel is highly active for the treatment of recurrent ovarian cancer.
To evaluate the response rate and toxicity of a regimen comprised of monthly carboplatin and weekly paclitaxel for recurrent ovarian cancer. ⋯ A monthly carboplatin and weekly paclitaxel regimen is highly active for women with recurrent platinum-sensitive and platinum-resistant epithelial ovarian cancer. The regimen is well tolerated. This pilot series demonstrates the potential for this regimen as treatment of choice among doublet first salvage regimens for patients with recurrent epithelial ovarian cancer, thus warranting multi-institutional study.