Gynecologic oncology
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Gynecologic oncology · Aug 2010
Multicenter StudyRisk factors for carcinoma of the fallopian tube in women with and without a germline BRCA mutation.
The purpose of this study was to identify risk factors for fallopian tube cancer in women with and without a BRCA mutation. ⋯ Parity and oral contraceptive use are associated with reduced risks of fallopian tube cancer. In contrast, hormone replacement therapy may be associated with an increase in the risk of fallopian tube cancer.
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Most collaborative studies for the treatment of primary and recurrent ovarian cancer have grouped all epithelial ovarian cancers together, leading to a common therapeutic approach to all the different subtypes. Emerging data, however, support the hypothesis that primary mucinous ovarian cancers are unique histologically, molecularly, and clinically from other epithelial subtypes. The objective of our review was to identify and synthesize the most current information on mucinous ovarian carcinoma with regard to pathologic, molecular, and clinical distinctions. ⋯ Primary mucinous ovarian cancer should be considered separate from the other epithelial ovarian cancers. Ongoing clinical trials in this disease will likely offer improvements in chemotherapeutic agents used to treat women with primary and recurrent mucinous ovarian cancer.
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Gynecologic oncology · May 2010
ReviewGlobal implementation of human papillomavirus (HPV) vaccine: lessons from hepatitis B vaccine.
Development of safe and effective vaccines against human papillomavirus (HPV)-the second vaccine against a major human cancer-is one of the most important medical and public health achievements of this century. As with all new vaccines, HPV is currently expensive and this cost precludes its use in the developing world, which has the greatest burden of disease from HPV-related cancers. Hepatitis B (HB) virus vaccine, which prevents chronic HB infection and related cirrhosis and liver cancer, has been successfully introduced as a routine vaccine for children in 89% of countries, including the poorest. ⋯ Global funding support will be needed to make control a reality for the poorest countries, and the program to accomplish this, the Global Alliance for Vaccines and Immunization (GAVI), has already expressed great interest in including HPV vaccine. For this to occur, the manufacturers will need to dramatically reduce the vaccine price for the poorest developing countries, and tier prices for wealthier developing countries not eligible for GAVI support. Countries will need to decide on the priority of HPV control in the context of other important new vaccines against pneumococcal pneumonia and rotavirus diarrhea.
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Gynecologic oncology · Apr 2010
Urinary angiostatin levels are elevated in patients with epithelial ovarian cancer.
The poor prognosis associated with epithelial ovarian cancer (EOC) is due to the lack of overt early symptoms and the absence of reliable diagnostic screening methods. Since many tumors over express angiogenic regulators, the purpose of this study was to determine whether elevated levels of the angiogenic or angiostatic molecules vascular endothelial growth factor (VEGF), hepatocyte growth factor (HGF), endostatin (ES), and angiostatin (AS) were elevated in plasma and urine from patients with EOC. ⋯ Levels of AS are elevated in the urine of patients with EOC and may be of diagnostic and/or prognostic clinical importance. Further studies of uAS as a biomarker for EOC alone or in combination with other markers are warranted.
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Gynecologic oncology · Mar 2010
Multicenter StudyThe clinical outcome of epithelial ovarian cancer patients with apparently isolated lymph node recurrence: a multicenter retrospective Italian study.
To assess the clinical outcome of epithelial ovarian cancer patients who developed an apparently isolated lymph node recurrence after primary therapy. ⋯ Patients who underwent surgery plus chemotherapy had a 72% reduction in the risk of death after recurrence and a 75% reduction in the risk of death after initial diagnosis when compared with those treated with chemotherapy alone. Secondary cytoreductive surgery appears to be able to prolong survival in epithelial ovarian cancer patients with apparently isolated lymph node recurrence.