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  • 1.
    Bergmark, K
    et al.
    Gynecological Oncology, Department of Oncology-Pathology, Radiumhemmet, Karolinska Institutet, Stockholm, Sweden. Clinical Cancerepidemiology, Department of Oncology–Pathology, Karolinska Institutet, Stockholm, Sweden .
    Åvall-Lundqvist, Elisabeth
    Gynecological Oncology, Department of Oncology-Pathology, Radiumhemmet, Karolinska Institutet, Stockholm, Sweden.
    Dickman, P W
    Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden .
    Henningsohn, L
    Clinical Cancerepidemiology, Department of Oncology–Pathology, Karolinska Institutet, Stockholm, Sweden . Department of Urology, Huddinge Hospital, Huddinge, Sweden .
    Steineck, G
    Clinical Cancerepidemiology, Department of Oncology–Pathology, Karolinska Institutet, Stockholm, Sweden. Clinical Cancerepidemiology, Stockholm City Council, Stockholm, Sweden .
    Lymphedema and bladder-emptying difficulties after radical hysterectomy for early cervical cancer and among population controls.2006In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 16, no 3, p. 1130-1139Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to acquire knowledge that can be used to refine radical hysterectomy to improve quality-of-life outcome. Data were collected in 1996-1997 by means of an anonymous postal questionnaire in a follow-up study of two cohorts (patients and population controls). We attempted to enroll all 332 patients with stage IB-IIA cervical cancer registered in 1991-1992 at the seven departments of gynecological oncology in Sweden and 489 population controls. Ninety three (37%) of the 256 women with a history of cervical cancer who answered the questionnaire (77%) were treated with surgery alone. Three-hundred fifty population controls answered the questionnaire (72%). Women treated with radical hysterectomy, as compared with controls, had an 8-fold increase in symptoms indicating lymphedema (25% reported distress due to lymphedema), a nearly 9-fold increase in difficult emptying of the bladder, and a 22-fold increase in the need to strain to initiate bladder evacuation. Ninety percent of the patients were not willing to trade off survival for freedom from symptoms. Avoiding to induce long-term lymphedema or bladder-emptying difficulties would probably improve quality of life after radical hysterectomy (to cure cervical cancer). Few women want to compromise survival to avoid long-term symptoms.

  • 2.
    Cibula, David
    et al.
    Charles Univ Prague, Czech Republic; Gen Univ Hosp, Czech Republic.
    Poetter, Richard
    Med Univ Vienna, Austria.
    Planchamp, Francois
    Inst Bergonie, France.
    Åvall Lundqvist, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences.
    Fischerova, Daniela
    Charles Univ Prague, Czech Republic; Gen Univ Hosp, Czech Republic.
    Meder, Christine Haie
    Inst Gustave Roussy, France.
    Koehler, Christhardt
    Asklepios Hambourg Altona, Germany; Univ Cologne, Germany.
    Landoni, Fabio
    Univ Milano Bicocca, Italy.
    Lax, Sigurd
    Gen Hosp Graz Sued West, Austria.
    Lindegaard, Jacob Christian
    Aarhus Univ, Denmark.
    Mahantshetty, Umesh
    Tata Mem Hosp, India.
    Mathevet, Patrice
    Lausanne Univ, Switzerland.
    McCluggage, W. Glenn
    Belfast Hlth and Social Care Trust, North Ireland.
    McCormack, Mary
    Univ Coll London Hosp, England.
    Naik, Raj
    Queen Elizabeth Hosp, England.
    Nout, Remi
    Leiden Univ, Netherlands.
    Pignata, Sandro
    Ist Nazl Studio and Cura Tumori, Italy.
    Ponce, Jordi
    Univ Hosp Bellvitge IDIBELL, Spain.
    Querleu, Denis
    Inst Bergonie, France.
    Raspagliesi, Francesco
    Not Found:[Cibula, David; Fischerova, Daniela] Charles Univ Prague, Fac Med 1, Gynecol Oncol Ctr, Dept Obstet and Gynecol, Prague, Czech Republic; [Cibula, David; Fischerova, Daniela] Gen Univ Hosp, Prague, Czech Republic; [Poetter, Richard] Med Univ Vienna, Dept Radiotherapy, Vienna, Austria; [Planchamp, Francois; Querleu, Denis] Inst Bergonie, Bordeaux, France; [Avall-Lundqvist, Elisabeth] Linkoping Univ, Linkoping, Sweden; [Meder, Christine Haie] Inst Gustave Roussy, Dept Radiotherapy, Villejuif, France; [Koehler, Christhardt] Asklepios Hambourg Altona, Hamburg, Germany; [Koehler, Christhardt] Univ Cologne, Med Fac, Dept Gynecol, Cologne, Germany; [Landoni, Fabio] Univ Milano Bicocca, Monza, Italy; [Lax, Sigurd] Gen Hosp Graz Sued West, Graz, Austria; [Lindegaard, Jacob Christian] Aarhus Univ, Dept Oncol, Aarhus, Denmark; [Mahantshetty, Umesh] Tata Mem Hosp, Dept Radiat Oncol, Mumbai, Maharashtra, India; [Mathevet, Patrice] Lausanne Univ, Lausanne, Switzerland; [McCluggage, W. Glenn] Belfast Hlth and Social Care Trust, Dept Pathol, Belfast, Antrim, North Ireland; [McCormack, Mary] Univ Coll London Hosp, London, England; [Naik, Raj] Queen Elizabeth Hosp, Gateshead, England; [Nout, Remi] Leiden Univ, Dept Radiat Oncol, Leiden, Netherlands; [Pignata, Sandro] Ist Nazl Studio and Cura Tumori, IRCCS, Fdn G Pascale, Naples, Italy; [Ponce, Jordi] Univ Hosp Bellvitge IDIBELL, Barcelona, Spain; [Rodolakis, Alexandros] Ist Nazl Tumori, Fdn IRCCS, Milan, Italy; [Tamussino, Karl] Univ Athens, Athens, Greece; [Wimberger, Pauline] Med Univ Graz, Graz, Austria; [Wimberger, Pauline] Dresden Univ, TU Dresden, Dresden, Germany; [Raspollini, Maria Rosaria] Univ Hosp, Florence, Italy;.
    Rodolakis, Alexandros
    Ist Nazl Tumori, Italy.
    Tamussino, Karl
    Univ Athens, Greece.
    Wimberger, Pauline
    Med Univ Graz, Austria; Dresden Univ, Germany.
    Raspollini, Maria Rosaria
    Univ Hosp, Italy.
    The European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology Guidelines for the Management of Patients With Cervical Cancer2018In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 28, no 4, p. 641-655Article in journal (Refereed)
    Abstract [en]

    Background Despite significant advances in the screening, detection, and treatment of preinvasive cervical lesions, invasive cervical cancer is the fifth most common cancer in European women. There are large disparities in Europe and worldwide in the incidence, management, and mortality of cervical cancer. Objective The European Society of Gynaecological Oncology (ESGO), the European Society for Radiotherapy and Oncology (ESTRO), and the European Society of Pathology (ESP) jointly develop clinically relevant and evidence-based guidelines in order to improve the quality of care for women with cervical cancer across Europe and worldwide. Methods The ESGO/ESTRO/ESP nominated an international multidisciplinary development group consisting of practicing clinicians and researchers who have demonstrated leadership and expertise in the care and research of cervical cancer (23 experts across Europe). To ensure that the guidelines are evidence based, the current literature identified from a systematic search was reviewed and critically appraised. In the absence of any clear scientific evidence, judgment was based on the professional experience and consensus of the development group. The guidelines are thus based on the best available evidence and expert agreement. Prior to publication, the guidelines were reviewed by 159 international reviewers, selected through ESGO/ESTRO/ESP and including patient representatives. Results The guidelines cover comprehensively staging, management, and follow-up for patients with cervical cancer. Management includes fertility sparing treatment; stage T1a, T1b1/T2a1, clinically occult cervical cancer diagnosed after simple hysterectomy; early and locally advanced cervical cancer; primary distant metastatic disease; cervical cancer in pregnancy; and recurrent disease. Principles of radiotherapy and pathological evaluation are defined.

  • 3.
    Dostalek, Lukas
    et al.
    Charles Univ Prague, Czech Republic.
    Åvall Lundqvist, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences.
    Creutzberg, Carien L.
    Leiden Univ, Netherlands.
    Kurdiani, Dina
    Tbilisi Canc Ctr, Rep of Georgia.
    Ponce, Jordi
    Univ Barcelona, Spain.
    Dostalkova, Iva
    Univ South Bohemia, Czech Republic.
    Cibula, David
    Charles Univ Prague, Czech Republic.
    ESGO Survey on Current Practice in the Management of Cervical Cancer2018In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 28, no 6, p. 1226-1231Article in journal (Refereed)
    Abstract [en]

    Objective The aim of this survey was to acquire an overview of the current management of cervical cancer with an emphasis on the early disease stages. Materials and Methods A hyperlink to the survey was sent to the European Society of Gynaecological Oncology Office database. The survey contained 6 groups of questions regarding the characteristics of respondents, pretreatment workup, management of the early stages of cervical cancer, adjuvant treatment, fertility-sparing treatment, and surveillance. Results In total, 566 responses were collected. The most frequent imaging method used in the workup was magnetic resonance imaging (74%), followed by computed tomography (54%) and positron emission tomography/computed tomography (25%). Conization or simple hysterectomy was a preferred procedure in stage T1a1 lymphovascular space invasion (LVSI)-positive for 79% of respondents, in stage T1a2 LVSI-negative for 58%, and in stage T1a2 LVSI-positive for 28%. Sentinel lymph node biopsy alone was reported in stage T1a1 by 17% and in stage T1b1 less than 2 cm by 9%, whereas systematic lymphadenectomy by 29% and 90% of respondents. Macrometastases, micrometastases, and isolated tumor cells in lymph nodes were considered indications for adjuvant treatment by 96%, 93%, and 68% of respondents, respectively. Neoadjuvant chemotherapy was reported by 28% and 19% of respondents in fertility-sparing and nonsparing management in stage T1b1. Over 60% of respondents recommend primary surgery for their patients with T1b2 N0 disease and 81% of them use a combination of adverse prognostic factors as indication for adjuvant radiotherapy in pN0 disease. Conclusions The results of this survey indicate considerable differences in the workup and treatment of cervical cancer in current clinical practice.

  • 4.
    Dunberger, Gail
    et al.
    Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden.
    Lind, Helena
    Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden.
    Steineck, Gunnar
    Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden / Clinical Cancer Epidemiology, Sahlgrenska Academy, Gothenburg, Sweden.
    Waldenström, Ann-Charlotte
    Department of Gynecological Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Nyberg, Tommy
    Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden.
    al-Abany, Massoud
    Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden.
    Nyberg, Ullakarin
    Department of Clinical Neuroscience, Section of Psychiatry, St Gorans Hospital, Stockholm, Sweden.
    Åvall-Lundqvist, Elisabeth
    Department of Gynecological Oncology, Karolinska University Hospital, Stockholm, Sweden.
    Fecal incontinence affecting quality of life and social functioning among long-term gynecological cancer survivors.2010In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 20, no 3, p. 449-460Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Fecal incontinence is a symptom reported by cancer survivors after pelvic radiotherapy and is recognized to be one of the most troubling symptom-induced sources of distress to patients.

    OBJECTIVE: To investigate how fecal incontinence, patient-reported as emptying of all stools into clothing without forewarning, impact self-assessed quality of life from a social, psychological, sexual, and functional aspect among gynecological cancer survivors treated with pelvic radiotherapy.

    METHODS: We identified a cohort of 789 eligible women in the Stockholm and Gothenburg areas treated with pelvic radiotherapy alone or as combined treatment of gynecological cancer. From the Swedish Population Registry, we identified 478 control women. Data were collected using a study-specific, validated, postal questionnaire including questions covering symptoms from the pelvic region, demographics, social functioning, psychological, and quality-of-life issues.

    RESULTS: Participation was 78% for cancer survivors and 72% for control women. The fecal incontinence symptom emptying of all stools into clothing without forewarning was reported by 70 cancer survivors (12%), with lowered quality of life in 74% of the 70 cancer survivors. This symptom kept the survivors from going to parties (relative risk [RR], 11.8; 95% confidence interval [CI], 6.6-21.1), kept the survivors from traveling (RR, 9.3; 95% CI, 5.3-16.5), affected their work ability (RR, 7.9; 95% CI, 3.8-16.4), hindered their sexual life (RR, 9.2; 95% CI, 4.8-17.6), and changed them as persons (RR, 4.9; 95% CI, 2.9-8.1). The prevalence of the symptom emptying of all stools into clothing without forewarning among control women was 3 (1%) of 344.

    CONCLUSIONS: Among gynecological cancer survivors having undergone pelvic radiotherapy alone or as part of a combined treatment, fecal incontinence is associated with social, psychological, sexual, and functional consequences.

  • 5.
    Friedlander, Michael
    et al.
    ANZGOG, Australia-New Zealand.
    Trimble, Edward
    National Cancer Institute, USA.
    Tinker, Anna
    NCIC-CTG, Canada.
    Alberts, David
    SWOG.
    Åvall-Lundqvist, Elisabeth
    NSGO, Scandinavia.
    Brady, Mark
    GOG.
    Harter, Philipp
    AGO OVAR, Germany.
    Pignata, Sandro
    MITO, Italy.
    Pujade-Lauraine, Eric
    GINECO, France.
    Sehouli, Jalid
    AGO OVAR, Germany.
    Vergote, Ignace
    GINECO, France.
    Beale, Philip
    ANZGOG, Australia-New Zealand.
    Bekkers, Rudd
    DGOG, The Netherlands.
    Calvert, Paula
    ICORG, Ireland.
    Copeland, Lawrence
    SWOG.
    Glasspool, Ros
    ICORG, Ireland.
    Gonzalez-Martin, Antonio
    GEICO, Spain.
    Katsaros, Dionysis
    MANGO, Italy.
    Kim, Jae Won
    KGOG, Korea.
    Miller, Brigitte
    RTOG.
    Provencher, Diane
    GINECO, France.
    Rubinstein, Lawrence
    National Cancer Institute, USA.
    Atri, Mostafa
    ACRIN.
    Zeimet, Alain
    AGO-Au, Austria.
    Bacon, Monica
    Gynecologic Cancer InterGroup.
    Kitchener, Henry
    MRC/NCRI, UK.
    Stuart, Gavin C E
    NCIC-CTG, Canada, on behalf of the Gynecologic Cancer InterGroup.
    Clinical trials in recurrent ovarian cancer.2011In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 21, no 4, p. 771-775Article, review/survey (Refereed)
    Abstract [en]

    The 4th Ovarian Cancer Consensus Conference of the Gynecologic Cancer InterGroup was held in Vancouver, Canada, in June 2010. Representatives of 23 cooperative research groups studying gynecologic cancers gathered to establish international consensus on issues critical to the conduct of large randomized trials. Group C, 1 of the 3 discussion groups, examined recurrent ovarian cancer, and we report the consensus reached regarding 4 questions. These included the following: (1) What is the role of cytoreductive surgery for recurrent ovarian cancer? (2) How do we define distinct patient populations in need of specific therapeutic approaches? (3) Should end points for trials with recurrent disease vary from those of first-line trials? (4) Is CA-125 progression alone sufficient for entry/eligibility into clinical trials?

  • 6.
    Glasspool, Rosalind M
    et al.
    Beatson West of Scotland Cancer Centre, Glasgow, UK.
    González Martín, Antonio
    Medical Oncology Department, MD Anderson Cancer Centre, Madrid, Spain.
    Millan, David
    Southern General Hospital, Glasgow, UK.
    Lorusso, Domenica
    Gynecologic Oncology Unit, Fondazione IRCCS National Cancer institute of Milan (MITO), Milan, Italy.
    Åvall-Lundqvist, Elisabeth
    Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
    Hurteau, Jean A
    Division of Gynecologic Oncology, NorthShore University Health System, University of Chicago Pritzker School of Medicine, Evanston, IL, USA.
    Davis, Alison
    The Canberra Hospital, Canberra, Australia.
    Hilpert, Felix
    University Hospital of Schleswig-Holstein Campus, Kiel, Germany.
    Kim, Jae-Weon
    Department of Obstectrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea.
    Alexandre, Jérôme
    edical Oncology, Cochin-Hotel Dieu, Paris Descartes University, Paris, France.
    Ledermann, Jonathan A
    UCL Cancer Institute, London, UK.
    Gynecologic Cancer InterGroup (GCIG) consensus review for squamous cell carcinoma of the ovary.2014In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 24, no 9, p. S26-Article, review/survey (Refereed)
    Abstract [en]

    Squamous cell carcinoma of the ovary is a rare complication of mature cystic teratoma. The epidemiology, pathology, diagnosis, and management of this rare tumor are reviewed. Clinical characteristics, preoperative imaging, and tumor markers may help to predict malignancy preoperatively. Complete cytoreduction should be the aim of surgery. The prognosis for stage 1A disease is good, but for women with advanced or recurrent disease, it is very poor and has not improved in recent years. At present, there are insufficient data to provide clear guidance on the optimal management strategy for advanced disease, and there is a need to gain an understanding of the biology and to develop novel effective therapies. This will require coordinated international collaboration.

  • 7.
    Graflund, Marianne
    et al.
    Department of Gynecological Oncology, Örebro University Hospital, Örebro.
    Sorbe, B.
    Department of Gynecological Oncology, Örebro University Hospital, Örebro.
    Bryne, M.
    Department of Pathology, Institute of Cancer Research, Norwegian Radium Hospital, Oslo, Norway.
    Karlsson, M.
    Department of Pathology, Örebro University Hospital, Örebro.
    The prognostic value of a histologic grading system, DNA profile, and MIB-1 expression in early stages of cervical squamous cell carcinomas2002In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 12, no 2, p. 149-157Article in journal (Refereed)
    Abstract [en]

    This study evaluated the prognostic importance of a new grading system focusing on the invasive tumor front, DNA profile, and the proliferation marker MIB-1. A complete geographic series of 172 women treated with radical hysterectomy (Wertheim–Meigs) for FIGO stage I–II cervical carcinomas was the target population. The analyses were performed on 141 (82%) squamous cell carcinomas of the complete series. During the period of observation (mean 222 months), 17 recurrences (12.1%) were encountered. Prognostic factors for disease-free survival were lymph node status (P < 0.000001), radical surgical margins (P = 0.00004), and tumor size (P = 0.002). The complete score of the invasive front grading system (IFG), and the individual scores of two variables—pattern of invasion and host response—were all significantly (P = 0.002, P = 0.007, P = 0.0001) associated with pelvic lymph node metastases. Host response was the single most important factor in the IFG system, and it was superior to the complete score in predicting lymph node metastases. The total IFG score was also a significant (P = 0.003) prognostic factor for disease-free survival. DNA ploidy, S-phase fraction, and MIB-1 expression were nonsignificant factors in predicting pelvic lymph node metastases and disease-free survival of the patient. The IFG in the original or modified versions could predict low- and high-risk groups of tumors and therefore be of value in treatment planning for these patients.

  • 8.
    Graflund, Marianne
    et al.
    Department of Gynecologic Oncology, Medical Center Hospital, Örebro, Sweden.
    Sorbe, B.
    Department of Gynecologic Oncology, Medical Center Hospital, Örebro, Sweden.
    Hussein, A.
    Department of Pathology, Medical Center Hospital, Örebro, Sweden.
    Bryne, M.
    Department of Pathology, Institute of Cancer Research, the Norwegian Radium Hospital, Oslo, Norway.
    Karlsson, M.
    Department of Pathology, Medical Center Hospital, Örebro, Sweden.
    The prognostic value of histopathologic grading parameters and microvessel density in patients with early squamous cell carcinoma of the uterine cervix2002In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 12, no 1, p. 32-41Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to investigate the prognostic importance of clinical and histopathologic factors, including malignancy grading systems (MGS), partial index (PI), invasive front grading (IFG), and microvessel density. A complete geographic series of 172 early stage (FIGO I–II) cervical carcinomas treated by Wertheim-Meigs surgery during the period 1965–1990 was studied. The patients were followed up for at least 10 years. Significant prognostic factors for disease-free survival were lymph node status (P < 0.0000001), radical surgical margins (P = 0.00003), and tumor size (P = 0.008). In a multivariate Cox analysis it was shown that lymph node status was the single most important prognostic factor with regard to disease-free survival. The total MGS and the PI scores were highly significantly (P = 0.0001) associated with pelvic lymph node metastases and disease-free survival rate in squamous cell carcinomas. The MGS and the PI systems were superior to the IFG system in predicting lymph node metastases. The total IFG score was also a statistically highly significant (P = 0.003) prognostic factor with regard to disease-free survival in both univariate and multivariate analyses. Microvessel density was a nonsignificant prognostic factor. There was a highly significant (P = 0.002) association between vascular space invasion of tumor cells and the presence of lymph node metastases. In conclusion, histopathologic malignancy grading systems provide valuable prognostic information in patients with early stage squamous cell carcinomas of the uterine cervix.

  • 9.
    Graflund, Marianne
    et al.
    Department of Gynecological Oncology, Örebro University Hospital, Örebro.
    Sorbe, B.
    Department of Gynecological Oncology, Örebro University Hospital, Örebro.
    Karlsson, M.
    Department of Pathology, Örebro University Hospital, Örebro.
    Immunohistochemical expression of p53, bcl-2, and p21WAF1/CIP1 in early cervical carcinoma: Correlation with clinical outcome2002In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 12, no 3, p. 290-298Article in journal (Refereed)
    Abstract [en]

    The objective of this study was to assess the value of p53, bcl-2, and p21WAF1/CIP1 immunoreactivity as predictors of pelvic lymph node metastases (LNM), recurrences, and death due to the disease in early stage (FIGO I-II) cervical carcinomas. FIGO stage, type of histopathology, and tumor grade were also evaluated in this series of patients treated by radical hysterectomy (Wertheim-Meigs) between 1965 and 1990. A total of 172 patients were included. A tumor was regarded as positive when more than 30% of the neoplastic cells exhibited immunoreactivity. Positive immunostaining was found in 8.9% for p53, in 43.5% for bcl-2, and in 25.0% for p21WAF1/CIP1. None of them was able to predict LNM or clinical outcome. Presence of LNM, tumor recurrence, and death from disease were significantly associated with the FIGO stage (P = 0.014, P = 0.009, and P = 0.001, respectively). The 5-year cancer-specific survival rate was 91.6% and the overall survival rate was 90.5%. It was concluded that immunohistochemically detected p53, bcl-2, and p21WAF1/CIP1 appeared to be of no predictive value with regard to LNM, tumor recurrences, or long-term survival in early cervical carcinomas.

  • 10.
    Hjerpe, Elisabet
    et al.
    Department of Oncology and Pathology, Cancer Center Karolinska CCK R8:03, Karolinska Institutet, Stockholm, Sweden.
    Brage, Suzanne Egyhazi
    Department of Oncologyand Pathology, Cancer Center Karolinska CCK R8:03, Karolinska Institutet, Stockholm, Sweden.
    Frostvik Stolt, Marianne
    Department of Oncologyand Pathology, Cancer Center Karolinska CCK R8:03, Karolinska Institutet, Stockholm, Sweden.
    Johansson, Hemming
    Department of Oncology and Pathology, Cancer Center Karolinska CCK R8:03, Karolinska Institutet, Stockholm, Sweden.
    Shoshan, Maria
    DepartmentDepartment of Oncologyand Pathology, Cancer Center Karolinska CCK R8:03, Karolinska Institutet, Stockholm, Sweden.
    Åvall-Lundqvist, Elisabeth
    Department of Oncology and Pathology, Cancer Center Karolinska CCK R8:03, Karolinska Institutet, Stockholm, Sweden.
    Metabolic markers and HSP60 in chemonaive serous solid ovarian cancer versus ascites.2014In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 24, no 8, p. 1389-1394Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Metabolic pathway alterations in cancer are thought to be dependent upon tumor type-specific oncogenic activation and local nutrient and oxygen supply during disease progression. In serous ovarian cancer, the typical peritoneal spread of disease is caused by shedding of tumor cells into the abdominal cavity, often along with ascites formation. Not much is known about the metabolic features of these detached serous tumor cells. In this study, we investigate the messenger RNA (mRNA) expression of GAPDH (glycolytic glyceraldehyde 3-phosphate dehydrogenase) and PKM2 (pyruvate kinase isoform M2), ATP5B (mitochondrial β-F1-ATPase), and heat shock protein 60 in matched serous solid tumor and corresponding ascites.

    MATERIALS/METHODS: Fresh samples from solid tumor and corresponding ascites were prospectively collected from 40 patients undergoing primary surgery for suspected advanced ovarian cancer. Of these, 25 met the study eligibility criteria, that is, stage IIC to IV disease of the serous (24) or endometrioid (1) subtype with solid and ascites specimens containing 50% or more tumor cells and with good quality and quantity mRNA yield. All but 2 patients (92%) had type II disease. GAPDH, PKM2, ATP5B, and HSP60 mRNA expressions were assessed by real-time polymerase chain reaction. For each marker, the mRNA expression in solid tumor was pairwise compared with the corresponding expression in ascites using the Wilcoxon matched pairs signed rank sum test.

    RESULTS: In contrast to our hypothesis, the mRNA expression of analyzed metabolic markers and HSP60 did not significantly differ between matched solid tumor and malignant ascites.

    CONCLUSIONS: Our results indicate that further expression changes in genes related to glycolysis or oxidative phosphorylation are not a prerequisite for serous cancer cell survival after detachment.

  • 11.
    Hjerpe, Elisabet
    et al.
    Department of Oncology, Karolinska University Hospital, Stockholm, Sweden.
    Egyhazi, Suzanne
    Department of Oncology and Pathology, Cancer Center Karolinska CCK R8:03, Karolinska Institutet, Stockholm, Sweden.
    Carlson, Joseph
    athology, Karolinska University Hospital, Stockholm, Sweden.
    Stolt, Marianne Frostvik
    Department of Oncology and Pathology, Cancer Center Karolinska CCK R8:03, Karolinska Institutet, Stockholm, Sweden.
    Schedvins, Kjell
    Obstetrics and Gynecology, Karolinska University Hospital, Stockholm, Sweden.
    Johansson, Hemming
    Department of Oncology, Karolinska University Hospital, Stockholm, Sweden.
    Shoshan, Maria
    Department of Oncology and Pathology, Cancer Center Karolinska CCK R8:03, Karolinska Institutet, Stockholm, Sweden.
    Åvall-Lundqvist, Elisabeth
    Department of Oncology, Karolinska University Hospital, Stockholm, Sweden.
    HSP60 predicts survival in advanced serous ovarian cancer.2013In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 23, no 3, p. 448-455Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Heat shock protein 60 (HSP60) plays an essential role in malignant cell survival. We evaluated the prognostic and treatment predictive value of HSP60 in advanced ovarian cancer.

    METHODS: Fresh tumor samples were prospectively collected from 123 patients undergoing primary surgery for suspected advanced ovarian cancer. Of these, 57 fulfilled the eligibility criteria, that is, International Federation of Gynecology and Obstetrics stage IIC-IV, serous/endometrioid tumors, platinum-based chemotherapy, and specimens with 50% tumor cells or greater. Heat shock protein 60 mRNA and protein expression was determined by real-time polymerase chain reaction and immunohistochemistry. We estimated the association between HSP60 and overall survival (OS) and platinum-free interval (PFI) by Cox proportional hazards models and its relationship with treatment response by Fisher's exact test. Median follow-up was 60 months.

    RESULTS: High HSP60 mRNA expression was associated with shorter OS (hazard ratio [HR], 3.4; 95% confidence interval [CI], 1.3-8.5) and PFI (HR, 3.3; 95% CI, 1.5-7.2). Likewise, high HSP60 protein expression was associated with shorter OS (HR, 3.2; 95% CI, 1.5-7.1) and PFI (HR, 2.6; 95% CI, 1.3-5.3). Median survival for patients with high HSP60 protein expression was 31 months compared with 55 months for low expression cases (P = 0.016). The impact on OS and PFI was even stronger in the subgroup of grade 3 serous tumors. All patients with low HSP60 levels responded to first-line chemotherapy.

    CONCLUSION: Heat shock protein 60 may identify groups of advanced serous ovarian cancer with different prognosis and treatment response.

  • 12.
    Högberg, Thomas
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Oncology UHL.
    Fredstorp-Lidebring, M
    Alm, P
    Baldetorp, B
    Larsson, G
    Ottosen, C
    Svanberg, L
    Lindahl, B
    A prospective population-based management program including primary surgery and postoperative risk assessment by means of DNA ploidy and histopathology. Adjuvant radiotherapy is not necessary for the majority of patients with FIGO stage I-II endometrial cancer2004In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 14, no 3, p. 437-450Article in journal (Refereed)
    Abstract [en]

    A management program for FIGO stage I-II nonserous, nonclear-cell adenocarcinomas was evaluated. Histopathology and DNA ploidy were used to estimate postoperatively the risk of progression or death of disease and to tailor treatment. The patient material was a population-based consecutive cohort of all women with endometrial cancer in the Southern Swedish Health Care Region diagnosed between June 1993 and June 1996 (n=553). Of these, 335 were eligible for the management program. Patients estimated to be at low risk were treated by surgery only, while high-risk patients also received vaginal brachytherapy. A large low-risk group consisting of 84% (n=283) of the patients with an estimated disease-specific 5-year survival of 96% (95% CI=93-98%) was identified. The high-risk group (n=52, 16%) showed a worse outcome with an 80% 5-year disease-specific survival (95% CI=65-89%). The difference in survival between the groups was highly significant (P<0.0001). Half of the progressions were distant in the high-risk group. Although there is a clear indication for adjuvant therapy for this group, locoregional radiotherapy could be expected to fail in cases with distant progression. Thus, effective systemic treatments need to be developed. Low-risk patients, constituting the majority (84%) of the patients, can be safely treated by surgery only.

  • 13.
    Joly, Florence
    et al.
    Medical Oncology Department, Clinical Research Department, Centre Francois Baclesse, CHU Cote de Nacre, Inserm "cancer&preventions", University of Basse Normandie, Caen, France.
    McAlpine, Jessica
    Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University of British Columbia, Vancouver, British Columbia, Canada.
    Nout, Remi
    Department of Clinical Oncology, University Medical Center, Leiden, the Netherlands.
    Åvall-Lundqvist, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Shash, Emad
    ORTC, Brussells, Belgium.
    Friedlander, Michael
    Department of Medical Oncology, The Prince of Wales Hospital, University of New South Wales Clinical School, Sydney, Australia.
    Quality of life and patient-reported outcomes in endometrial cancer clinical trials: a call for action!2014In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 24, no 9, p. 1693-1699Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: There is increasing recognition that quality of life (QoL) and patient-reported outcomes (PROs) are of fundamental importance and particularly relevant given the relatively high likelihood of long-term survival in most women with endometrial cancer (EC). However, there has been relatively little research focused on this topic. Our objective was to analyze our current knowledge and identify research questions to be included in the design of next clinical trials.

    METHODS: Analyze and critically assess reported clinical trials in EC that have included QoL and PROs as primary or secondary end points.

    RESULTS: Surgery has a significant impact on physical and functional domains of QoL particularly in the first 6 months after diagnosis. Minimally invasive surgery is associated with less acute morbidity than open procedures and this persists over time. Lymphadenectomy is associated with increased incidence of lymphedema, important late effect. Adjuvant external irradiation may cause gastrointestinal and genitourinary symptoms that impact on physical functioning and which can persist over time. In contrast, vaginal brachytherapy has less toxicity and fewer late effects than external irradiation. The impact of treatment on sexuality has been poorly evaluated in EC survivors. There are few published data on QoL and PROs in patients treated with chemotherapy and the long-term impact has not been addressed. There is no evidence that palliative chemotherapy reduces symptoms and improves QoL. There are very few longitudinal studies on survivorship that is an important concern in EC survivors.

    CONCLUSIONS: Although there have been some studies addressing QoL and PROs in EC, we have identified deficiencies and gaps in our knowledge. Careful consideration of QoL and PROs end points and how to include them in clinical trials will result in a better appreciation of how treatments can impact on patients QoL and lead to conduct interventions to reduce late effects.

  • 14. Koul, A
    et al.
    Bendahl, P-O
    Borg, Å
    Fernö, M
    Fredstorp Lidebring, M
    Högberg, Thomas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Oncology UHL.
    Långström Einarsson, M
    Ridderheim, M
    Willén, R
    TP53 protein expression analysis by luminometric immunoassay in comparison with gene mutation status and prognostic factors in early stage endometrial cancer2002In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 12, no 4, p. 362-371Article in journal (Refereed)
    Abstract [en]

    Mutations in the TP53 tumor suppressor gene have been shown to significantly correlate with poor prognosis in endometrial cancer. In the present study we have evaluated a luminometric immunoassay (LIA) for quantitative estimation of TP53 protein expression in 65 cytosol preparations from endometrial cancer, previously analyzed for mutations in TP53 exons 4-10. LIA showed high (= 0.6 ng/mg protein) expression of TP53 protein in all eight tumors with missense mutation, but high protein levels were also detected in 15 tumors with normal TP53 sequence. All four tumors with nonsense or frameshift mutations had low or no TP53 protein expression. LIA was further evaluated in a retrospective study of 201 cytosol samples from endometrial cancer. TP53 overexpression (>= 0.6 ng/mg protein) was observed in 22% of the tumors and correlated with nonendometrioid histology types (P = 0.005), poorly differentiated tumors (P = 0.001), higher FIGO grade (P = 0.001), DNA nondiploidy (P = 0.002), and high S-phase fraction (P = 0.03). After a median follow-up time of 6.8 years (range 0.7-9.9 years), 22 (13%) progressions were observed in the 175 patients with early stage (I-II) disease. TP53 overexpression (P = 0.04), FIGO grade 3 vs. 1 + 2 (P = 0.01), higher age (P = 0.02), and DNA nondiploidy (P < 0.001) showed significant correlation to shorter progression-free survival in these patients. We conclude that TP53 protein analysis by LIA provides an incomplete correlation to mutation status and cannot substitute for mutation analysis in assessment of prognosis in endometrial carcinoma. In comparison to TP53 overexpression and higher FIGO grades, DNA nonploidy status seems to be a better prognostic indicator to define a subset of early stage endometrial cancer patients who may benefit by adjuvant chemotherapy/radiotherapy.

  • 15.
    Kristensen, G B
    et al.
    Department of Gynecologic Oncology, The Norwegian Radium Hospital, Oslo, Norway.
    Vergote, I
    Department of Gynecologic Oncology, U.Z. Gasthuisberg, Leuven, Belgium .
    Stuart, G
    Department of Gynecologic Oncology, Tom Baker Cancer Center, Calgary, Canada .
    Del Campo, J M
    Department of Medical Oncology, Hospital General Vall d'Hebron, Barcelona, Spain .
    Kaern, J
    Department of Gynecologic Oncology, The Norwegian Radium Hospital, Oslo, Norway .
    Lopez, A B
    Department of Gynaecological Oncology, Gateshead Hospital, Gateshead, United Kingdom .
    Eisenhauer, E
    NCI Canada Clinical Trials Group, Kingston, Canada .
    Åvall-Lundquist, Elisabeth
    Department of Gynecologic Oncology, Karolinska Hospital, Stockholm, Sweden .
    Ridderheim, M
    Department of Gynecologic Oncology, Lund University Hospital, Lund, Sweden .
    Havsteen, H
    Department of Oncology, Aarhus University Hospital, Aarhus, Denmark .
    Mirza, M R
    Department of Oncology, Odense University Hospital, Odense, Denmark .
    Scheistroen, M
    Department of Gynecologic Oncology, The Norwegian Radium Hospital, Oslo, Norway .
    Vrdoljak, E
    Department of Oncology, University Hospital, Split, Croatia .
    First-line treatment of ovarian cancer FIGO stages IIb-IV with paclitaxel/epirubicin/carboplatin versus paclitaxel/carboplatin.2003In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 13, no s2, p. 172-177Article in journal (Refereed)
    Abstract [en]

    The objective of this study was to compare the safety and efficacy of carboplatin plus epirubicin and paclitaxel (TEC) to carboplatin and paclitaxel (TC), in the treatment of epithelial ovarian, peritoneal, or tubal carcinoma. Between March 1999 and August 2001, 887 patients were randomized to receive six to nine cycles of paclitaxel (175 mg/m2, 3 h intravenously) followed by carboplatin (AUC 5, Calvert formula) with or without epirubicin (75 mg/m2 intravenously prior to paclitaxel), on a 3-weekly schedule. The primary endpoint was progression-free survival. Demographic information: Residual disease <1 cm was reported on 41% of patients. At the end of treatment, 65% in the TEC and 55% in the TC arm had achieved a clinical complete response, and 18 and 25% a clinical partial response resulting in an overall response rate of 83% in the TEC and 80% in the TC arm, whereas 7 and 9% had progressive disease, respectively. The three-drug combination produced a markedly higher myelotoxicity, resulting in a higher frequency of febrile neutropenia (12.5% of the TEC and 1.5% of the TC patients) and a higher number of dose reductions and treatment delays. Cycle prolongation above seven days was seen in 7 and 5% of cycles in the TEC and TC arm, respectively. Stomatitis > or = grade 3 was also higher with TEC (4% TEC and 0.5% TC). Reductions in left ventricular ejection fraction of more than 15% after six courses were slightly more common with the TEC regimen (3% versus 1.5%), but the difference was not statistically significant (P = 0.2). In conclusion, treatment with the TEC combination produced a higher rate of complete responses than treatment with the TC combination. Toxicity was manageable. Long-term survival data are awaited.

  • 16.
    Leitao, Mario M
    et al.
    Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
    Cheng, Xi
    Fudan University Shanghai Cancer Center, Shanghai, China.
    Hamilton, Anne L
    Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden / Royal Women's Hospital, Melbourne, Australia / University of Melbourne, Melbourne, Australia.
    Siddiqui, Nadeem A
    Glasgow Royal Infirmary, Gynaecology Administration Block, Glasgow, Scotland.
    Jurgenliemk-Schulz, Ina
    Department of Radiation Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands.
    Mahner, Sven
    Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
    Åvall-Lundqvist, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden.
    Kim, Kidong
    Department of Obstetrics & Gynecology, Seoul National University Bundang Hospital, Seoul, Korea.
    Freyer, Gilles
    Service d'Oncologie Medicale, Centre Hospitalier Lyon-Sud, Lyon, France.
    Gynecologic Cancer InterGroup (GCIG) consensus review for vulvovaginal melanomas.2014In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 24, no 9, p. S117-S122Article, review/survey (Refereed)
    Abstract [en]

    Vulvovaginal melanomas are rare tumors that account for a small fraction of all vulvovaginal cancers. Biologically, they seem to be similar to mucosal and acral melanomas of other sites. There are limited data specific to vulvovaginal melanomas, especially regarding systemic therapies. Most treatment decisions are based on extrapolation from data regarding cutaneous melanomas of other sites. It is reasonable to follow already established guidelines from other professional groups and societies. Outcomes tend to be worse compared with cutaneous melanomas likely because of the later presentation and physical biological characteristics of these tumors.

  • 17.
    McAlpine, Jessica N
    et al.
    Department of Gynecology and Obstetrics, University of British Columbia, Vancouver, British Columbia, Canada.
    Greimel, Elfriede
    Department of Medical Psychology and Psychotherapy, Medical University of Graz, Graz, Austria.
    Brotto, Lori A
    Department of Gynecology and Obstetrics, University of British Columbia, Vancouver, British Columbia, Canada.
    Nout, Remy A
    Department of Clinical Oncology, Leiden UniversityMedical Center, Leiden, the Netherlands.
    Shash, Emad
    EORTC, Brussels, Belgium.
    Åvall-Lundqvist, Elisabeth
    Department of Gynecologic Oncology, Karolinska University Hospital, Stockholm, Sweden.
    Friedlander, Michael L
    Department of Medical Oncology, The Prince of Wales Hospital, University of New South Wales Clinical School, Sydney, Australia.
    Joly, Florence
    Departments of Medical Oncology and Clinical Research, Centre Francois Baclesse, CHU Cote de Nacre, University of Basse Normandie, Caen, France.
    Quality of life research in endometrial cancer: what is needed to advance progress in this disease site? Methodological considerations from the Gynecologic Cancer InterGroup Symptom Benefit Working Group brainstorming session, Leiden 2012.2014In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 24, no 9, p. 1686-1692Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Quality of life (QoL) in endometrial cancer (EC) is understudied. Incorporation of QoL questionnaires and patient-reported outcomes in clinical trials has been inconsistent, and the tools and interpretation of these measures are unfamiliar to most practitioners. In 2012, the Gynecologic Cancer InterGroup Symptom Benefit Working Group convened for a brainstorming collaborative session to address deficiencies and work toward improving the quality and quantity of QoL research in women with EC.

    METHODS: Through literature review and international expert contributions, we compiled a comprehensive appraisal of current generic and disease site-specific QoL assessment tools, strengths and weaknesses of these measures, assessment of sexual health, statistical considerations, and an exploration of the unique array of histopathologic and clinical factors that may influence QoL outcomes in women with EC.

    RESULTS: This collaborative composition is the first publication specific to EC that addresses methodology in QoL research and the components necessary to achieve high quality QoL data in clinical trials. Future recommendations regarding (1) the incorporation of patient-reported outcomes in all clinical trials in EC, (2) definition of an a priori hypothesis, (3) utilization of validated tools and consideration of new tools corresponding to new therapies or specific symptoms, (4) publication within the same time frame as clinical outcome data, and (5) attempt to correct for disease site-specific potential confounders are presented.

    CONCLUSIONS: Improved understanding of methodology in QoL research and an increased undertaking of EC-specific QoL research in clinical trials are imperative if we are to improve outcomes in women with EC.

  • 18.
    Reed, Nicholas Simon
    et al.
    Beatson Oncology Centre, Glasgow, UK.
    Pautier, Patricia
    Institut Gustave Roussy, Villejuif, France.
    Åvall-Lundqvist, Elisabeth
    Karolinska Intitute, Stockholm, Sweden.
    Choi, Chel-Hun
    Samsung Medical Centre, Sung Kyun Kwan University Medical Centre, Seoul, South Korea.
    du Bois, Andreas
    University of Duisberg, Essen, Germany.
    Friedlander, Michael
    National Health and Medical Research Council, Clinical Trials Centre, New South Wales, Australia.
    Fyles, Anthony
    Princess Margaret Hospital, Toronto, Canada.
    Kichenadasse, Ganessan
    Flinders Centre for Innovation in Cancer, South Australia, Australia.
    Provencher, Diane M
    Centre hospitalier de l'Universite de Montreal, Montreal, Canada.
    Ray-Coquard, Isabelle
    Centre Leon Berard, Lyon, France.
    Gynecologic Cancer InterGroup (GCIG) consensus review for ovarian small cell cancers.2014In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 24, no 9, p. S30-S34Article, review/survey (Refereed)
    Abstract [en]

    Small cell carcinomas of the ovary are uncommon and account for less than 1% of ovarian cancers. They were first recognized in 1979, and a number of reports appeared during the next 2 decades. They are highly aggressive tumors and usually carry a poor prognosis, although this may reflect that most are diagnosed at advanced stage; however, those diagnosed as stage 1A have only 30% to 40% of long-term survivors. More reports followed extending our experience in the diagnosis and management of these rare cancers. The classification is described below and shown in Table 1, but a revision is expected to be published from the World Health Organization in 2014.

  • 19.
    Satoh, Toyomi
    et al.
    University of Tsukuba, Tsukuba-City, Japan.
    Takei, Yuji
    Jichi Medical University, Shimono-City, Japan.
    Treilleux, Isabelle
    Centre Leon Berard, Lyon, France.
    Devouassoux-Shisheboran, Mojgan
    Hospices Civils de Lyon, France.
    Ledermann, Jonathan
    University College of London, London, UK.
    Viswanathan, Akila N
    Harvard Medical School, Boston, MA, USA.
    Mahner, Sven
    Universtatsklinikum Hamburg-Eppendorf, Hamburg, Germany.
    Provencher, Diane M
    University of Montreal, Montreal, Quebec, Canada.
    Mileshkin, Linda
    Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
    Åvall-Lundqvist, Elisabeth
    Karolinska Institute, Stockholm, Sweden.
    Pautier, Patricia
    Insitut Gustave Roussy, Villejuif, France.
    Reed, Nicholas Simon
    Beatson Oncology Centre, Glasgow, UK.
    Fujiwara, Keiichi
    Saitama Medical University International Medical Center, Hidaka-City, Japan.
    Gynecologic Cancer InterGroup (GCIG) consensus review for small cell carcinoma of the cervix.2014In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 24, no 9, p. S102-S108Article, review/survey (Refereed)
    Abstract [en]

    Small cell carcinoma of the cervix (SCCC) is a rare histological entity of uterine cervical cancer. Compared with other common histological types, squamous cell carcinoma or adenocarcinoma, the outcome of SCCC is poor because of the high incidence of nodal or distant metastasis even with early stage. In this review, current consensus of epidemiology, pathology, and initial treatment for SCCC will be discussed.

  • 20.
    Sorbe, B.
    et al.
    Department of Gynecological Oncology, University Hospital, Örebro, Sweden, Department of Gynecological Oncology, University Hospital, SE-701 85 Örebro, Sweden.
    Andersson, H.
    Department of Gynecological Oncology, University Hospital, Gothenburg, Sweden.
    Boman, K.
    Department of Gynecological Oncology, University Hospital, Umeå, Sweden.
    Rosenberg, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Oncology . Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Oncology UHL.
    Kalling, M.
    Department of Gynecologic Oncology, University Hospital, Lund, Sweden.
    Treatment of primary advanced and recurrent endometrial carcinoma with a combination of carboplatin and paclitaxel - Long-term follow-up2008In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 18, no 4, p. 803-808Article in journal (Refereed)
    Abstract [en]

    There is no generally accepted standard chemotherapy in treatment of advanced and recurrent endometrial carcinoma. Cisplatin and doxorubicin with or without cyclophosphamide are widely used. Response rates have improved with combination chemotherapy compared with single-agent therapy. A platinum analog seems to be an important part of the chemotherapy regimen. Since few patients are cured from their disease and since the duration of response is short, further improvement of this therapy is warranted. During the past years, the taxanes (paclitaxel) are being added to prior evaluated regimens and not only improved response rates are reported but also increased toxicity is observed. In a prospective, phase II, multicenter study, carboplatin (area under the curve = 5) and paclitaxel (175 mg/m2) were evaluated in treatment of primary advanced and recurrent endometrial carcinoma. In total, 66 patients were recruited during the years 2000-2004. Eighteen primary advanced tumors and 48 recurrences were treated. All histologic types and tumor grades were allowed. The median follow-up was 57 months (range 37-69 months). The overall response rate was 67% (95% CI 55-78). The complete response rate was 29% and the partial response rate 38%. Primary advanced and recurrent tumors as well as endometrioid and nonendometrioid tumors showed similar response rates. The median response duration was 14 months. The 1- and 3-year survival rates were 82% and 33%, respectively. The main toxicities were hematologic and neurologic (sensory neuropathy). The response rates were encouraging, superior to prior platinum-containing regimens, but response duration and the long-term survival rate were still short. The neurologic toxicity was frequent and was a substantial problem in this series of patients. Further research is highly needed to improve the treatment of advanced and recurrent endometrial cancer. © 2007, Copyright the Authors.

  • 21.
    Sorbe, Bengt
    et al.
    University Hospital, Örebro.
    Graflund, Marianne
    University Hospital, Örebro.
    Horvath, Gyorgy
    Sahlgrenska University Hospital.
    Swahn, Marie
    Sahlgrenska University Hospital.
    Boman, Karin
    University Hospital, Umeå.
    Bangshöj, Rene
    Central Hospital Karlstad.
    Lood, Margareta
    Central Hospital Karlstad.
    Malmström, Henric
    Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Oncology UHL.
    Phase II Study of Docetaxel Weekly in Combination With Carboplatin Every 3 Weeks as First-Line Chemotherapy in Stage IIB to Stage IV Epithelial Ovarian Cancer2012In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 22, no 1, p. 47-53Article in journal (Refereed)
    Abstract [en]

    Objectives: The purpose of this study was to assess the response rate, toxicity, progression-free survival, and overall survival in a series of patients with advanced-stage ovarian carcinoma treated with a first-line weekly docetaxel and 3 weekly carboplatin regimen. less thanbrgreater than less thanbrgreater thanMethods: All eligible patients were treated with intravenous docetaxel (30 mg/m(2)) on days 1, 8, and 15, and carboplatin (area under the curve, 5) on day 1; every 21 days for at least 6 cycles. less thanbrgreater than less thanbrgreater thanResults: One hundred six patients received at least one cycle of primary chemotherapy (median, 6.0; range, 1-9), and they were evaluable for toxicity assessment. Eighty-five patients had evaluable (measurable) disease and received at least 3 courses of chemotherapy and were evaluable for clinical response rate. The overall response rate was 78.8% (95% confidence interval, 70.1%-87.5%), and the biochemical response 92.8% (95% confidence interval, 87.2%-98.4%). The median progression-free survival was 12.0 months and the median overall survival was 35.3 months. Thirty-six patients (34.0%) experienced grades 3 and 4 neutropenia, which resulted in the removal of 3 patients. Six patients (5.7%) experienced grades 3 or 4 thrombocytopenia. No patients experienced grade 3 to grade 4 sensory neuropathy. Epiphora, nail changes, and fatigue were frequently recorded nonhematologic adverse effects. less thanbrgreater than less thanbrgreater thanConclusions: The tolerable hematologic toxicity (no need for colony-stimulating factors) and the low rate of neurotoxicity (only grades 1-2) and response rates in line with the standard 3-week paclitaxel-carboplatin regimen for advanced primary ovarian carcinoma after suboptimal cytoreductive surgerymake this regimen an interesting alternative in selected patients.

  • 22. Tropé, C
    et al.
    Nordal, R
    Himmelmann, A
    Kjörstad, K
    Onsrud, M
    Simonsen, E
    Högberg, Thomas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Oncology UHL.
    Einhorn, N
    Pettersson, F
    Frankendal, B
    Pettersson, B
    Tholander, B
    Svanberg, L
    Consolidation treatment of advanced (FIGO stage III) ovarian carcinoma in complete surgical remission after induction chemotherapy: A randomized, controlled, clinical trial comparing whole abdominal radiotherapy, chemotherapy, and no further treatment2003In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 13, p. 278-286Article in journal (Refereed)
1 - 22 of 22
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