Gynecologic oncology
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Gynecologic oncology · Feb 2009
Whole-body hyperthermia (WBH) in combination with carboplatin in patients with recurrent ovarian cancer - a phase II study.
Despite considerable progress in the front-line treatment in patient with advanced ovarian cancer, the outcome of patients with recurrent or refractory disease is still poor. Based on promising results of a pilot study, we initiated a phase II study with WBH and carboplatin in pretreated patients with advanced ovarian cancer to investigate the toxicity and efficacy of WBH in combination with carboplatin. ⋯ This study confirms that WBH in combination with carboplatin is an active salvage treatment option in patients with advanced ovarian cancer. However, significant hematological toxicity has to be considered and renders this regimen less suitable for palliative care setting. There is no evidence yet, that whole-body hyperthermia contributes to any clinical improvement beyond chemotherapy alone. This question can only be addressed in a randomized phase III trial.
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Gynecologic oncology · Jan 2009
ReviewInterval debulking surgery for advanced epithelial ovarian cancer: a Cochrane systematic review.
To assess the effectiveness of interval debulking surgery (IDS) for patients with advanced stage epithelial ovarian cancer (EOC). ⋯ Our review could not conclude whether IDS would improve the survival of women with advanced EOC compared with conventional treatment. IDS appeared to yield benefit only in the patients whose primary surgery was not performed by expert surgeons.
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Gynecologic oncology · Jan 2009
Clinical TrialA feasibility study of topotecan with standard-dose cisplatin and concurrent primary radiation therapy in locally advanced cervical cancer.
Topotecan improves response rate (RR), progression-free survival (PFS) and overall survival (OS) when added to cisplatin in treating metastatic and recurrent cervical cancer. The objective of this study was to assess the feasibility of adding weekly topotecan to cisplatin in patients with primary, locally advanced carcinoma of the cervix receiving pelvic irradiation. ⋯ The addition of weekly topotecan to cisplatin at this dose and schedule during pelvic irradiation for locally advanced cervical cancer appears to be feasible. Based on this primary treatment data and the activity of cisplatin-topotecan in the recurrent disease setting, phase II and III studies of this combination are warranted.
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Gynecologic oncology · Dec 2008
Comparative StudyRobotically assisted laparoscopic hysterectomy versus total abdominal hysterectomy and lymphadenectomy for endometrial cancer.
To compare surgical morbidity and clinical-pathologic factors for patients with endometrial cancer (EC) undergoing robotic-assisted laparoscopic hysterectomy (RALH) versus total abdominal hysterectomy (TAH) with aortic and/or pelvic lymphadenectomy (LA). ⋯ Patients with EC who underwent RALH with LA during the first year of our robotics program were younger, thinner and had less cardio-pulmonary illness than patients previously treated with TAH and LA. LOS, EBL and peri-op complication rates were significantly lower for the robotic cohort.
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Gynecologic oncology · Nov 2008
Reducing ovarian cancer mortality through screening: Is it possible, and can we afford it?
Ovarian cancer is a leading cause of cancer-related deaths among women. Given the low prevalence of this disease, the effectiveness of screening strategies has not been established. We wished to estimate the clinical impact and cost-effectiveness of potential screening strategies for ovarian cancer using population-specific data. ⋯ Annual screening for ovarian cancer has the potential to be cost effective, particularly in high-risk populations. Clinically acceptable positive predictive values are achieved if specificity exceeds 99%. Mortality reduction above 50% may not be achievable without screening intervals less than 12 months.