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1. Goodheart MJ, Ritchie JM, Rose SL, Fruehauf JP, De Young BR, Buller RE: The relationship of molecular markers of p53 function and angiogenesis to prognosis of stage I epithelial ovarian cancer. Clin Cancer Res; 2005 May 15;11(10):3733-42
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The relationship of molecular markers of p53 function and angiogenesis to prognosis of stage I epithelial ovarian cancer.
  • We sought to identify molecular markers for high-risk stage I epithelial ovarian cancers.
  • EXPERIMENTAL DESIGN: Seventy-seven consecutive stage I epithelial ovarian cancers were evaluated for p53, CD31 microvessel density, thrombospondin-1, vascular endothelial growth factor (VEGF), p21 immunohistochemical staining, and p53 gene mutations.
  • Fesddration Internationale des Gynaecologistes et Obstetristes substage (IA/IB versus IC; P < 0.001) and VEGF staining (P = 0.02) were significant in bivariate models with relationship to disease-specific survival.
  • Stage (P = 0.0004), grade (P = 0.008), histology (P = 0.0025), p53 dysfunction (positive stain and/or mutation; P = 0.048), and microvessel density (P = 0.04) were significant in bivariate models with relationship to time to recurrence.
  • In multivariate analyses among stage IC patients, failure to receive chemotherapy and microvessel density were associated with disease-specific survival, time to recurrence, and time to distant recurrence with hazard ratios of 4.8 to 44.1.
  • CONCLUSIONS: The p53-dependent molecular markers of angiogenesis are of limited utility in developing a clinical strategy for postoperative management of stage I ovarian carcinoma.
  • Microvessel density impacts survival and metastasis for high-risk stage IC disease.
  • Adjuvant chemotherapy is necessary, but not sufficient, for cure of high-risk stage I epithelial ovarian cancers.
  • [MeSH-major] Genes, p53. Neoplasm Recurrence, Local / genetics. Neovascularization, Pathologic. Ovarian Neoplasms / genetics. Ovarian Neoplasms / pathology
  • [MeSH-minor] Chemotherapy, Adjuvant. DNA Mutational Analysis. Disease-Free Survival. Female. Humans. Immunohistochemistry. Middle Aged. Neoplasm Metastasis. Prognosis. Regression Analysis. Risk Factors


2. Bamias A, Papadimitriou C, Efstathiou E, Rodolakis A, Vlahos G, Voulgaris Z, Bozas G, Fountzilas G, Aravantinos G, Razis E, Gika D, Dimopoulos MA: Four cycles of paclitaxel and carboplatin as adjuvant treatment in early-stage ovarian cancer: a six-year experience of the Hellenic Cooperative Oncology Group. BMC Cancer; 2006;6:228
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  • [Title] Four cycles of paclitaxel and carboplatin as adjuvant treatment in early-stage ovarian cancer: a six-year experience of the Hellenic Cooperative Oncology Group.
  • BACKGROUND: Surgery can cure a significant percentage of ovarian carcinoma confined to the pelvis.
  • We administered paclitaxel/carboplatin as adjuvant treatment in early-stage ovarian carcinoma.
  • METHODS: Patients with stages Ia or Ib, Grade 2 or 3 and Ic to IIb (any grade) were included.
  • CONCLUSION: Paclitaxel/Carboplatin chemotherapy is a safe and effective adjuvant treatment in early-stage ovarian carcinoma.
  • Patients with stages Ic-IIb and tumor grade 2 or 3 may benefit from more extensive treatment.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carboplatin / therapeutic use. Ovarian Neoplasms / drug therapy. Paclitaxel / therapeutic use
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Disease-Free Survival. Female. Greece. Humans. Middle Aged. Neoplasm Staging. Retrospective Studies. Survival Rate

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  • (PMID = 16999858.001).
  • [ISSN] 1471-2407
  • [Journal-full-title] BMC cancer
  • [ISO-abbreviation] BMC Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel
  • [Other-IDs] NLM/ PMC1592509
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3. Reinartz S, Köhler S, Schlebusch H, Krista K, Giffels P, Renke K, Huober J, Möbus V, Kreienberg R, DuBois A, Sabbatini P, Wagner U: Vaccination of patients with advanced ovarian carcinoma with the anti-idiotype ACA125: immunological response and survival (phase Ib/II). Clin Cancer Res; 2004 Mar 1;10(5):1580-7
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  • [Title] Vaccination of patients with advanced ovarian carcinoma with the anti-idiotype ACA125: immunological response and survival (phase Ib/II).
  • PURPOSE: A Phase I/IIb multicenter study was conducted to evaluate the safety and immunogenicity of the anti-idiotypic antibody vaccine ACA125 that functionally imitates the tumor antigen CA125 in 119 patients with advanced ovarian carcinoma.
  • A positive Ab3 response remained associated with longer survival when controlling for other prognostic factors including FIGO (International Federation of Gynecologists and Obstetricians) stage, response to and type of first-line chemotherapy, number of previous treatments, or concomitant antitumor therapy.
  • CONCLUSIONS: Although the uncontrolled design of this study prevents definitive conclusions with respect to subgroups, the data support a relationship between Ab3 response and survival time.
  • [MeSH-major] CA-125 Antigen / immunology. Cancer Vaccines / toxicity. Ovarian Neoplasms / immunology

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  • (PMID = 15014007.001).
  • [ISSN] 1078-0432
  • [Journal-full-title] Clinical cancer research : an official journal of the American Association for Cancer Research
  • [ISO-abbreviation] Clin. Cancer Res.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase I; Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / CA-125 Antigen; 0 / Cancer Vaccines; 0 / Isoantibodies
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4. Vergote IB, De Wever I, Decloedt J, Tjalma W, Van Gramberen M, van Dam P: Neoadjuvant chemotherapy versus primary debulking surgery in advanced ovarian cancer. Semin Oncol; 2000 Jun;27(3 Suppl 7):31-6
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  • [Title] Neoadjuvant chemotherapy versus primary debulking surgery in advanced ovarian cancer.
  • Primary surgical cytoreduction followed by chemotherapy usually is the preferred management of advanced (stage III or IV) ovarian cancer.
  • Neoadjuvant chemotherapy has been proposed as an alternative approach to conventional surgery as initial management of bulky ovarian cancer, with the goal of improving surgical quality.
  • Since 1989, we have been treating advanced epithelial ovarian cancer with neoadjuvant chemotherapy instead of primary cytoreductive surgery in approximately half of the patients with stage III-IV disease.
  • Selection of neoadjuvant chemotherapy was based on disease-related characteristics (eg, metastatic tumor load, stage of disease, performance status).
  • A retrospective analysis of 338 patients was conducted to compare outcomes during 1989 to 1998, when neoadjuvant chemotherapy was used, with those observed during 1980 to 1988, when all patients underwent primary cytoreductive surgery.
  • Crude 3-year survival rates were higher and postoperative mortality rates were lower during the second time period compared with the first.
  • Overall, the results suggest that neoadjuvant chemotherapy results in survival rates in selected patients with advanced ovarian cancer that are comparable with those associated with primary cytoreductive surgery.
  • Patients with stage IV disease, total metastatic tumor load greater than 1,000 g, uncountable plaque-shaped peritoneal metastases, and/or a poor performance status are probably the best candidates for this alternative approach.
  • A prospective randomized study of neoadjuvant chemotherapy and primary cytoreductive surgery is ongoing.
  • [MeSH-major] Neoadjuvant Therapy. Ovarian Neoplasms / drug therapy. Ovarian Neoplasms / surgery

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  • (PMID = 10952124.001).
  • [ISSN] 0093-7754
  • [Journal-full-title] Seminars in oncology
  • [ISO-abbreviation] Semin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] UNITED STATES
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5. Shimada M, Kigawa J, Kanamori Y, Itamochi H, Oishi T, Minagawa Y, Ishihara K, Takeuchi Y, Okada M, Terakawa N: Outcome of patients with early ovarian cancer undergoing three courses of adjuvant chemotherapy following complete surgical staging. Int J Gynecol Cancer; 2005 Jul-Aug;15(4):601-5
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  • [Title] Outcome of patients with early ovarian cancer undergoing three courses of adjuvant chemotherapy following complete surgical staging.
  • We conducted the present study to determine the outcome of patients with early ovarian cancer who underwent three courses of adjuvant chemotherapy after complete surgical staging.
  • One hundred consecutive patients with stage I-II epithelial ovarian cancer who had undergone complete surgical staging and received three courses of platinum-based chemotherapy were entered in this study.
  • Twenty-one patients were low risk, defined as stage IA-B, grade 1 and histologic types except for clear cell adenocarcinoma, and remaining 79 were high risk.
  • All patients with stage IA or IB, whatever histologic type and histopathologic grade, were alive without disease.
  • The 5-year survival rate was 89.4% for patients with stage IC and 76.2% for those with stage II.
  • Multivariate analysis revealed that histologic grade was an independent prognostic factor in stage IC-II ovarian cancer.
  • The outcome of patients with early ovarian cancer undergoing three courses of chemotherapy after complete surgical staging was favorable even in high-risk patients.
  • [MeSH-major] Adenocarcinoma / drug therapy. Adenocarcinoma / surgery. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Ovarian Neoplasms / drug therapy. Ovarian Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Carboplatin / administration & dosage. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Combined Modality Therapy. Cyclophosphamide / administration & dosage. Doxorubicin / administration & dosage. Female. Humans. Middle Aged. Paclitaxel / administration & dosage. Prognosis. Survival Analysis

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  • (PMID = 16014112.001).
  • [ISSN] 1048-891X
  • [Journal-full-title] International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
  • [ISO-abbreviation] Int. J. Gynecol. Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin
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6. Chan JK, Tian C, Monk BJ, Herzog T, Kapp DS, Bell J, Young RC, Gynecologic Oncology Group: Prognostic factors for high-risk early-stage epithelial ovarian cancer: a Gynecologic Oncology Group study. Cancer; 2008 May 15;112(10):2202-10
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  • [Title] Prognostic factors for high-risk early-stage epithelial ovarian cancer: a Gynecologic Oncology Group study.
  • BACKGROUND: The purpose was to identify the factors predictive of recurrence and survival in patients with high-risk (stage I, grade 3; stage IC, stage II, or clear cell) epithelial ovarian cancer after adjuvant therapy.
  • METHODS: Data was extracted from patients who underwent primary surgery followed by adjuvant therapy in 2 randomized trials by the Gynecologic Oncology Group (Protocols 95 and 157).
  • RESULTS: Of 506 patients (median age = 56.2 years), 347 (68.6%) had stage I and 159 (31.4%) had stage II cancers.
  • On multivariate analysis, older age, higher stage, higher grade, and malignant cytology were independent prognostic factors predictive for recurrence and poorer survival.
  • The risk of recurrence was higher for those >/=60 versus < 60 years (hazards ratio [HR] = 1.57, 95% confidence interval [CI], 1.12-2.19), stage II (stage II: HR = 2.70, 95% CI, 1.41-5.16) versus stage IA or IB, grade 2 (HR = 1.84, 95% CI, 1.04-3.27) and grade 3 (HR = 2.47, 95% CI, 1.39-4.37) versus grade 1, and positive versus negative cytology (HR = 1.72, 95% CI, 1.21-2.45).
  • CONCLUSIONS: Age, stage, grade, and cytology are important prognostic factors in high-risk early-stage epithelial ovarian cancer.
  • [MeSH-major] Neoplasms, Glandular and Epithelial / pathology. Ovarian Neoplasms / pathology
  • [MeSH-minor] Adenocarcinoma, Clear Cell / drug therapy. Adenocarcinoma, Clear Cell / mortality. Adenocarcinoma, Clear Cell / pathology. Adenocarcinoma, Mucinous / drug therapy. Adenocarcinoma, Mucinous / mortality. Adenocarcinoma, Mucinous / pathology. Adult. Aged. Aged, 80 and over. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Endometrioid / drug therapy. Carcinoma, Endometrioid / mortality. Carcinoma, Endometrioid / pathology. Cystadenocarcinoma, Serous / drug therapy. Cystadenocarcinoma, Serous / mortality. Cystadenocarcinoma, Serous / pathology. Female. Follow-Up Studies. Humans. Middle Aged. Neoplasm Recurrence, Local / drug therapy. Neoplasm Recurrence, Local / mortality. Neoplasm Recurrence, Local / pathology. Neoplasm Staging. Prognosis. Risk Factors. Survival Rate

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  • [Copyright] (c) 2008 American Cancer Society.
  • (PMID = 18348296.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA27469; United States / NCI NIH HHS / CA / CA37517
  • [Publication-type] Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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7. Hanprasertpong J, Hanprasertpong T, Thammavichit T, Kongkabpan D, Tungsinmunkong K, Chandeying N: Primary non-Hodgkin,s lymphoma of the uterine cervix. Asian Pac J Cancer Prev; 2008 Apr-Jun;9(2):363-6
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  • Because the number of reports of this cancer is limited, there is no consensus on its management, prognosis or the efficacy of various treatments.
  • Primary malignant lymphoma of the cervix stage Ib was diagnosed in a 25-year-old woman.
  • The patient was treated with 6 courses of CHOP chemotherapy (cyclophosphamide, doxorubicin, vincristine, and prednisone).
  • This case supports current thinking in that, in selected young patients with primary malignant lymphoma of the cervix who desire to preserve fertility and ovarian functions, combination chemotherapy regimens such as CHOP are the treatment of choice.
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cyclophosphamide / therapeutic use. Doxorubicin / therapeutic use. Female. Humans. Prednisone / therapeutic use. Vincristine / therapeutic use


8. Cohen MH, Hirschfeld S, Flamm Honig S, Ibrahim A, Johnson JR, O'Leary JJ, White RM, Williams GA, Pazdur R: Drug approval summaries: arsenic trioxide, tamoxifen citrate, anastrazole, paclitaxel, bexarotene. Oncologist; 2001;6(1):4-11
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  • [Title] Drug approval summaries: arsenic trioxide, tamoxifen citrate, anastrazole, paclitaxel, bexarotene.
  • This report summarizes information on drugs recently approved by the Food and Drug Administration, Office of Drug Evaluation I, Division of Oncology Drug Products.
  • Five applications supporting new claims will be discussed: Trisenox (arsenic trioxide) for induction of remission and consolidation in patients with acute promyelocytic leukemia who are refractory to, or have relapsed from, retinoid and anthracycline chemotherapy, and whose disease is characterized by the presence of the t(15;17) translocation or PML/RAR-alpha gene expression; Nolvadex (tamoxifen citrate) in women with ductal carcinoma in situ, following breast surgery and radiation, to reduce the risk of invasive breast cancer; Arimidex (anastrazole) for first-line treatment of postmenopausal women with hormone receptor positive or hormone receptor unknown locally advanced or metastatic breast cancer; Taxol (paclitaxel), 175 mg/m(2) by 3 h infusion in combination with cisplatin for first-line treatment of advanced ovarian cancer; and Targretin gel (bexarotene) for the topical treatment of cutaneous lesions in patients with stage IA and IB cutaneous T-cell lymphoma who have not tolerated other therapies or who have refractory or persistent disease.
  • Information provided includes rationale for drug development, study design, efficacy and safety results, and pertinent literature references.
  • [MeSH-major] Anticarcinogenic Agents / therapeutic use. Antineoplastic Agents / therapeutic use. Antineoplastic Agents, Hormonal / therapeutic use. Antineoplastic Agents, Phytogenic / therapeutic use. Arsenicals / therapeutic use. Drug Approval. Nitriles / therapeutic use. Oxides / therapeutic use. Paclitaxel / therapeutic use. Tamoxifen / therapeutic use. Tetrahydronaphthalenes / therapeutic use. Triazoles / therapeutic use
  • [MeSH-minor] Breast Neoplasms / drug therapy. Female. Humans. Leukemia, Promyelocytic, Acute / drug therapy. Lymphoma, T-Cell, Cutaneous / drug therapy. United States. United States Food and Drug Administration

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  • (PMID = 11161223.001).
  • [ISSN] 1083-7159
  • [Journal-full-title] The oncologist
  • [ISO-abbreviation] Oncologist
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Anticarcinogenic Agents; 0 / Antineoplastic Agents; 0 / Antineoplastic Agents, Hormonal; 0 / Antineoplastic Agents, Phytogenic; 0 / Arsenicals; 0 / Nitriles; 0 / Oxides; 0 / Tetrahydronaphthalenes; 0 / Triazoles; 094ZI81Y45 / Tamoxifen; 2Z07MYW1AZ / anastrozole; A61RXM4375 / bexarotene; P88XT4IS4D / Paclitaxel; S7V92P67HO / arsenic trioxide
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9. Linghu H, Xu XR, Mei YY, Tang JY, Tang LD, Sun T: Response of early stage bulky cervical squamous carcinoma to preoperative adjuvant chemotherapy. Chin Med Sci J; 2004 Jun;19(2):116-9
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  • [Title] Response of early stage bulky cervical squamous carcinoma to preoperative adjuvant chemotherapy.
  • OBJECTIVE: To investigate the potential role of preoperative adjuvant chemotherapy on early stage cervical squamous carcinoma with bulky tumor.
  • METHODS: One hundred and forty-five patients with cervical squamous cancer stages Ib-IIa were investigated, among which 17 patients with bulky tumors (> or = 4 cm) were managed by cisplatin-based chemotherapy for 1-2 courses followed by radical hysterectomy and pelvic lymphadenectomy (BC group).
  • (1) The tumor size of 17 patients in BC group were decreased in various degrees after chemotherapy, with 13 patients of clinical effectiveness (76.47%).
  • And the responsiveness pertained to neither histological differentiation nor size of local tumors. (2) Post-operative histology has showed that patients in BC and BN group have higher incidence of lymph node metastasis and deep cervical infiltration (5/68 and 3/68, respectively) than in S group (1/77 and 1/77, respectively) while with no statistical significance. (3) Blood loss during operation in BC group was less than BN and S group. (4) Seventeen patients, including those underwent surgeries of vaginal prolongation and/or ovarian transposition, appeared disease-free survival within the follow-up time.
  • CONCLUSIONS: Most of patients with bulky early stage cervical squamous carcinoma are sensitive to cisplatin-based chemotherapy, which could greatly reduce local tumor size and in turn facilitate the following operation by well controlling blood loss.

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  • (PMID = 15250247.001).
  • [ISSN] 1001-9294
  • [Journal-full-title] Chinese medical sciences journal = Chung-kuo i hsueh k'o hsueh tsa chih
  • [ISO-abbreviation] Chin. Med. Sci. J.
  • [Language] ENG
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
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10. Chen X, Feng Y: Effect of progesterone combined with chemotherapy on epithelial ovarian cancer. Chin Med J (Engl); 2003 Mar;116(3):388-91
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  • [Title] Effect of progesterone combined with chemotherapy on epithelial ovarian cancer.
  • OBJECTIVE: To identify an effective auxiliary therapy for epithelial ovarian cancer.
  • METHODS: Progesterone acetate given at 250 mg intramuscularly twice a week for 1 month followed by increased administration to 500 mg intramuscularly every two weeks for 3 years was used in combination with platinum based chemotherapy to treat patients with epithelial ovarian cancer as a first-line therapy.
  • Prognoses of the patients receiving progesterone combined with chemotherapy (progesterone group) and those receiving chemotherapy only (control group) were compared.
  • Stage Ia: no patient relapsed or died in either group.
  • Stage Ib-Ic: three-year recurrence rates were 14.2% and 37.5%, respectively (P = 0.2845); three-year survival rates were 92.3% and 87.5% (P = 0.7221).
  • Stage II: 1 patient relapsed and died among the 3 patients in the progesterone group; among the 4 patients in the control group, 1 patient relapsed, none died.
  • Stage III: three-year recurrence rates were 30.8% and 64.3%, respectively (P = 0.1170); three-year survival rates were 85.7% and 42.9%, respectively (P = 0.005).
  • Stage IV: 4 patients relapsed and 1 patient died among the 7 patients in the progesterone group; both the patients in the control group relapsed and died.
  • CONCLUSIONS: The results indicated that progesterone combined with platinum based chemotherapy as a first-line therapy may improve the prognosis of advanced epithelial ovarian cancer, but would not change the prognosis of early stage epithelial ovarian cancer.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Neoplasms, Glandular and Epithelial / drug therapy. Ovarian Neoplasms / drug therapy. Progesterone / administration & dosage


11. Kojs Z, Glinski B, Reinfuss M, Pudelek J, Urbanski K, Kowalska T, Kulpa J: [Results of a randomized prospective trial comparing postoperative abdominopelvic radiotherapy with postoperative chemotherapy in early ovarian cancer]. Cancer Radiother; 2001 Jan-Feb;5(1):5-11
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  • [Title] [Results of a randomized prospective trial comparing postoperative abdominopelvic radiotherapy with postoperative chemotherapy in early ovarian cancer].
  • PURPOSE: In a prospective randomized trial, our aim was to evaluate and compare the tolerance and efficacy of postoperative radiotherapy and chemotherapy in the treatment of early ovarian cancer.
  • MATERIAL AND METHODS: Between 1990 and 1996, 150 patients with ovarian cancer stage IA, IB grades G2-3, and all patients classified IC and IIA, who did not have evidence of residual disease after surgery, were randomized to two treatment branches: radiotherapy or chemotherapy (CH).
  • In the radiotherapy branch (76 patients), a whole abdomen irradiation of 30 Gy in 24 fractions over 5 weeks, with a pelvic boost to 50 Gy, was delivered.
  • In the chemotherapy branch (74 patients), there were six series of polychemotherapy separated with 3-weeks interval.
  • RESULTS: The tolerance of the treatment was good and comparable in both groups.
  • CONCLUSION: These data suggest that efficacy of postoperative radiotherapy and chemotherapy administered to our patients with early ovarian cancer gave approximately identical results.
  • [MeSH-major] Ovarian Neoplasms / drug therapy. Ovarian Neoplasms / radiotherapy
  • [MeSH-minor] Combined Modality Therapy. Female. Humans. Middle Aged. Postoperative Care. Prospective Studies

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  • (PMID = 11236537.001).
  • [ISSN] 1278-3218
  • [Journal-full-title] Cancer radiothérapie : journal de la Société française de radiothérapie oncologique
  • [ISO-abbreviation] Cancer Radiother
  • [Language] fre
  • [Publication-type] Clinical Trial; Comparative Study; English Abstract; Journal Article; Randomized Controlled Trial
  • [Publication-country] France
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12. Högberg T, Glimelius B, Nygren P, SBU-group. Swedish Council of Technology Assessment in Health Care: A systematic overview of chemotherapy effects in ovarian cancer. Acta Oncol; 2001;40(2-3):340-60
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  • [Title] A systematic overview of chemotherapy effects in ovarian cancer.
  • A systematic review of chemotherapy trials in several tumour types was performed by The Swedish Council of Technology Assessment in Health Care (SBU).
  • This overview on chemotherapy for epithelial ovarian cancer is based on a total of 176 scientific reports.
  • The conclusions reached can be summarized into the following points: Radically operated patients with low-risk early ovarian cancer (stage IA or IB non-clear-cell well-differentiated carcinomas or borderline tumours) have a very good prognosis and there is no indication for adjuvant therapy.
  • Radically operated patients with high-risk early ovarian cancer (clear cell carcinomas or FIGO stage IA or IB moderately or poorly differentiated carcinomas or stage IC) have a substantial risk for micrometastatic disease.
  • However, the role of adjuvant chemotherapy is unclear and such therapy should, thus, only be used within clinical trials.
  • The median overall survival for patients with advanced (FIGO stages II-IV) ovarian cancer randomised to paclitaxel/platinum-containing chemotherapy in three large studies ranged between 36-39 months.
  • Compared with historical data, this represents a six to seven times longer median survival time than after surgery only.
  • In two prospective randomised trials in advanced ovarian cancer, paclitaxel in combination with cisplatin has provided a survival benefit over cyclophosphamide/cisplatin.
  • Based on these trials, paclitaxel/cisplatin is considered to be the standard treatment.
  • This choice of standard therapy might, however, be questioned based on the results of the hitherto largest randomised study in advanced ovarian cancer, ICON3, which is, as yet only available in abstract form.
  • The drug regimen in the control arms of the previous studies showing superiority of the paclitaxel-cisplatin combination may not have been the optimal non-paclitaxel platinum-containing regimen.
  • Intraperitoneal therapy with cisplatin caused improved survival compared with intravenous therapy in one ramdomised study.
  • Further studies have shown trends to better survival and longer progression-free interval with intraperitoneal therapy.
  • The accrual to studies on intraperitoneal chemotherapy has been poor reflecting that it is a cumbersome and not easily accepted treatment.
  • In advanced ovarian cancer, no convincing advantage has been shown from more dose-intensive chemotherapy, without cytokines or bone marrow stem cell support, compared with standard doses.
  • High response rates are achieved with high-dose chemotherapy with stem cell support in the salvage situation but response duration is short.
  • Phase III studies evaluating high-dose chemotherapy in the first-line situation are ongoing.
  • Until supportive controlled clinical trials are presented, high-dose chemotherapy should be confined to clinical trials.
  • Tumour response is frequently observed on re-treatment with the same drugs as given first-line in patients sensitive to first-line platinum-based chemotherapy with a long progression-free interval.
  • Thus, in these patients treatment with a platinum/paclitaxel combination might be recommended. albeit based on limited data.
  • In patients resistant to first-line therapy, a number of single agents induce tumour responses in the range of 10-30%.
  • The literature does not permit general treatment recommendations in these patients, which are recommended to be included in controlled clinical trials.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Ovarian Neoplasms / drug therapy
  • [MeSH-minor] Carboplatin / administration & dosage. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Cyclophosphamide / administration & dosage. Female. Humans. Infusions, Parenteral. Neoplasm Staging. Paclitaxel / administration & dosage. Prognosis. Quality of Life. Randomized Controlled Trials as Topic. Salvage Therapy. Survival Analysis

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  • (PMID = 11441940.001).
  • [ISSN] 0284-186X
  • [Journal-full-title] Acta oncologica (Stockholm, Sweden)
  • [ISO-abbreviation] Acta Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Norway
  • [Chemical-registry-number] 8N3DW7272P / Cyclophosphamide; BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin
  • [Number-of-references] 176
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13. Mangili G, Scarfone G, Gadducci A, Sigismondi C, Ferrandina G, Scibilia G, Viganò R, Tateo S, Villa A, Lorusso D: Is adjuvant chemotherapy indicated in stage I pure immature ovarian teratoma (IT)? A multicentre Italian trial in ovarian cancer (MITO-9). Gynecol Oncol; 2010 Oct;119(1):48-52
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  • [Title] Is adjuvant chemotherapy indicated in stage I pure immature ovarian teratoma (IT)? A multicentre Italian trial in ovarian cancer (MITO-9).
  • OBJECTIVE: Conservative surgery followed by platinum-based chemotherapy is considered the standard approach for stage I immature ovarian teratoma (IT), except for stage IA G1.
  • Nevertheless the use of chemotherapy in stage IA G2-3 and IB-IC is controversial.
  • The aim of this study was to evaluate the outcome of patients with IT in order to define the role of chemotherapy in stage I disease.
  • METHODS: Twenty-eight patients with stage I IT treated in MITO centers were retrospectively reviewed.
  • Grade, stage, age, surgical and postoperative treatment were analyzed using χ(2) test and T test looking for association with recurrence.
  • FIGO stages were 19 IA, 2 IB, and 7 IC.
  • Nine patients received adjuvant chemotherapy.
  • Overall recurrence rate was 21.4% (2 in chemotherapy group and 4 in the group without treatment).
  • Recurrence rate was not significantly different according to stage, grade or adjuvant chemotherapy, whereas it was greater in the group not operated in a MITO center, not staged and of age lower than 20 years, with statistical significance.
  • At recurrence 4 patients presenting with mature teratoma were treated with surgery alone, whereas 2 recurring with IT were treated with surgery plus chemotherapy.
  • CONCLUSIONS: Our study suggests that chemotherapy may be withheld for primary therapy and utilized only for recurrence.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Ovarian Neoplasms / drug therapy. Teratoma / drug therapy
  • [MeSH-minor] Adolescent. Adult. Bleomycin / administration & dosage. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Etoposide / administration & dosage. Female. Follow-Up Studies. Humans. Middle Aged. Neoplasm Staging. Retrospective Studies. Treatment Outcome. Young Adult

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  • [Copyright] Copyright © 2010 Elsevier Inc. All rights reserved.
  • (PMID = 20599258.001).
  • [ISSN] 1095-6859
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] United States
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
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14. Hirte H, Vergote IB, Jeffrey JR, Grimshaw RN, Coppieters S, Schwartz B, Tu D, Sadura A, Brundage M, Seymour L: A phase III randomized trial of BAY 12-9566 (tanomastat) as maintenance therapy in patients with advanced ovarian cancer responsive to primary surgery and paclitaxel/platinum containing chemotherapy: a National Cancer Institute of Canada Clinical Trials Group Study. Gynecol Oncol; 2006 Aug;102(2):300-8
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  • [Title] A phase III randomized trial of BAY 12-9566 (tanomastat) as maintenance therapy in patients with advanced ovarian cancer responsive to primary surgery and paclitaxel/platinum containing chemotherapy: a National Cancer Institute of Canada Clinical Trials Group Study.
  • The objective of the study was to determine whether the addition of BAY 12-9566 after optimal response to chemotherapy could improve time to progression (TTP).
  • PATIENTS AND METHODS: Patients enrolled in the study had received 6-9 cycles of platinum/paclitaxel containing chemotherapy for stage III or IV ovarian carcinoma, with a response of no evidence of disease, or complete or partial response with residual disease < 2 cm.
  • RESULTS: The study was closed after 243 patients had been randomized because of Bayer's decision to close all ongoing trials due to negative results from other phase III trials in pancreatic and small cell lung cancer.
  • PATIENT CHARACTERISTICS: performance status was ECOG 0/1/2 in 65/33/2%; median age 57 years; 79% of patients were FIGO stage III; 41% were optimally debulked; 76% had serous histology, and 67% had > or = grade 3 histology.
  • Median time to progression (TTP) was 10.4 months (8.5-11.5) for BAY 12-9566 and 9.2 months (7.2-13.9) for placebo (P = 0.67).
  • CONCLUSION: We conclude that BAY 12-9566 was generally well tolerated and at the time of the final analysis, there was no evidence of an impact of BAY 12-9566 on PFS or OS.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Organic Chemicals / therapeutic use. Ovarian Neoplasms / drug therapy. Ovarian Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Biphenyl Compounds. Combined Modality Therapy. Disease-Free Survival. Double-Blind Method. Female. Humans. Matrix Metalloproteinase Inhibitors. Middle Aged. Organoplatinum Compounds / administration & dosage. Paclitaxel / administration & dosage. Phenylbutyrates. Placebos. Protease Inhibitors / administration & dosage. Protease Inhibitors / therapeutic use. Quality of Life

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  • (PMID = 16442153.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase III; Journal Article; Multicenter Study; Randomized Controlled Trial
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Bay 12-9566; 0 / Biphenyl Compounds; 0 / Matrix Metalloproteinase Inhibitors; 0 / Organic Chemicals; 0 / Organoplatinum Compounds; 0 / Phenylbutyrates; 0 / Placebos; 0 / Protease Inhibitors; P88XT4IS4D / Paclitaxel
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15. Vasey P, Kaye S, Paul J, Rustin G, Wilson R, Guastalla JP, Pujade-Lauraine E, Gore M, Gabra H, Carty K, Scottish Gyn Cancer Trials Group: A phase Ib trial of erlotinib (E) in combination with docetaxel (D) and carboplatin (C) in untreated ovarian, fallopian tube and primary peritoneal cancers. J Clin Oncol; 2004 Jul 15;22(14_suppl):5017

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  • [Title] A phase Ib trial of erlotinib (E) in combination with docetaxel (D) and carboplatin (C) in untreated ovarian, fallopian tube and primary peritoneal cancers.
  • : 5017 Background: Epidermal growth factor receptor (HER1/EGFR) overexpression occurs in over 50% of advanced epithelial ovarian carcinomas (EOC) and is associated with poor prognosis.
  • Erlotinib (Tarceva™, a highly potent reversible HER1/EGFR tyrosine-kinase inhibitor) has exhibited additive antitumor activity in combination with platinum and taxane chemotherapy preclinically, and single agent activity in heavily pretreated patients (pts).
  • In pts with EOC, D with C has a tolerable safety profile, similar efficacy as paclitaxel with C, and is an acceptable first-line option (Vasey ASCO 2002).
  • RESULTS: 39 pts (median age 59 years; stage III/IV EOC) have been treated (median 5 cycles).
  • 1/12 pts in Cohort 1 (50mg E + DC) had a drug-related DLT (plantar-palmar erythrodysethesia [PPE]).
  • In Cohort 2, 4/12 pts on 100mg E with DC had significant skin toxicity (intolerable grade 2 or 3 rash) and 1 pt had grade 3 diarrhea despite loperamide treatment.

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  • (PMID = 28015481.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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16. Coukos G, Rubin SC: Early ovarian cancer. Curr Treat Options Oncol; 2000 Jun;1(2):129-37
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  • [Title] Early ovarian cancer.
  • Epithelial ovarian cancer may appear to be confined to the ovaries or pelvis in approximately one-third of patients at exploration, but up to 30% of them will be upstaged following surgical staging.
  • Substage and histotype are the most important prognostic factors that determine the need for adjuvant treatment.
  • Patients with stage Ia or Ib and well-differentiated (other than clear cell) tumors do not require adjuvant treatment.
  • Patients with stage Ia or Ib grade 3 or clear cell histology, as well as any stage Ic and II disease, are at high risk for recurrence.
  • Platinum-based chemotherapy is the mainstay of treatment.
  • Four to six courses are probably adequate, although grade 3 tumors may require further treatment.
  • Preservation of the uterus and the uninvolved contralateral ovary is a viable option in young women with unilateral early disease.
  • [MeSH-major] Ovarian Neoplasms / therapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Female. Humans. Survival Rate. Urogenital Surgical Procedures

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  • (PMID = 12057050.001).
  • [ISSN] 1527-2729
  • [Journal-full-title] Current treatment options in oncology
  • [ISO-abbreviation] Curr Treat Options Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 23
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17. Bell J, Brady MF, Young RC, Lage J, Walker JL, Look KY, Rose GS, Spirtos NM, Gynecologic Oncology Group: Randomized phase III trial of three versus six cycles of adjuvant carboplatin and paclitaxel in early stage epithelial ovarian carcinoma: a Gynecologic Oncology Group study. Gynecol Oncol; 2006 Sep;102(3):432-9
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  • [Title] Randomized phase III trial of three versus six cycles of adjuvant carboplatin and paclitaxel in early stage epithelial ovarian carcinoma: a Gynecologic Oncology Group study.
  • OBJECTIVE: Compared to 3 cycles, to determine if 6 cycles of adjuvant carboplatin (C) and paclitaxel (P) significantly lower the rate of recurrence in surgically staged patients with stage IA grade 3, IB grade 3, clear cell, IC, and completely resected stage II epithelial ovarian cancer (EOC); and to compare toxicities.
  • METHODS: Postoperatively, randomization was to either 3 or 6 cycles of chemotherapy consisting of P (175 mg/m2 over 3 h) and C (7.5 AUC over 30 min) every 21 days.
  • Median age was 55.5 years; 69% of patients had stage I disease.
  • CONCLUSIONS: Compared to 3 cycles, 6 cycles of C and P do not significantly alter the recurrence rate in high risk early stage EOC but are associated with more toxicity.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carboplatin / administration & dosage. Carcinoma / drug therapy. Ovarian Neoplasms / drug therapy. Paclitaxel / administration & dosage
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Drug Administration Schedule. Female. Humans. Middle Aged. Neoplasm Recurrence, Local. Proportional Hazards Models. Survival Analysis

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  • [CommentIn] Gynecol Oncol. 2006 Sep;102(3):415-7 [16979430.001]
  • [CommentIn] Gynecol Oncol. 2007 May;105(2):555-6; author reply 556 [17306342.001]
  • [CommentIn] Gynecol Oncol. 2007 Apr;105(1):279-80; author reply 280-1 [17291570.001]
  • (PMID = 16860852.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA 27469; United States / NCI NIH HHS / CA / CA 37517
  • [Publication-type] Clinical Trial, Phase III; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Chemical-registry-number] BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel
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18. Ishii K, Aoki Y, Takakuwa K, Tanaka K: Ovarian function after radical hysterectomy with ovarian preservation for cervical cancer. J Reprod Med; 2001 Apr;46(4):347-52
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  • [Title] Ovarian function after radical hysterectomy with ovarian preservation for cervical cancer.
  • OBJECTIVE: To investigate the function of preserved ovaries following radical hysterectomy in premenopausal women with cervical carcinoma and to attempt to identify clinical factors influencing ovarian function.
  • STUDY DESIGN: Between 1991 and 1998, 33 premenopausal patients with International Federation of Gynecology and Obstetrics stage IB and II cervical cancer underwent radical hysterectomy with ovarian preservation, including lateral ovarian transposition in 20 patients.
  • In 12 cases of squamous cell carcinoma with deep stromal invasion or a suspicious, positive node, neoadjuvant chemotherapy was performed.
  • Ovarian function was evaluated by serum FSH level during the follow-up period, 12 months to 9 years.
  • RESULTS: Fifteen of 33 patients became climacteric after treatment.
  • Using multiple regression analysis, a significant correlation between ovarian dysfunction and age (under 40) was observed (P = .0286).
  • No ovarian recurrence or symptomatic ovarian cyst was observed in preserved ovaries during the study period.
  • CONCLUSION: Ovarian preservation is safe in patients under 40 years old undergoing radical hysterectomy even if they received additional treatment, such as neoadjuvant chemotherapy or postoperative radiotherapy with ovarian transposition.
  • [MeSH-major] Adenocarcinoma / surgery. Carcinoma, Squamous Cell / surgery. Follicle Stimulating Hormone / blood. Hysterectomy. Ovary / physiology. Uterine Cervical Neoplasms / surgery


19. Vergote I, Trimbos BJ: Treatment of patients with early epithelial ovarian cancer. Curr Opin Oncol; 2003 Nov;15(6):452-5
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  • [Title] Treatment of patients with early epithelial ovarian cancer.
  • PURPOSE OF REVIEW: During 2003, the first randomized trials were published comparing adjuvant platin-based chemotherapy versus no treatment in early epithelial ovarian cancer.
  • RECENT FINDINGS: Recent findings of the European Organisation for Research and Treatment of Cancer Adjuvant ChemoTherapy In Ovarian Neoplasm and International Collaborative Ovarian Neoplasm-1 trials showed an improvement of overall survival of 8% in patients treated with adjuvant platin-based chemotherapy compared with observation.
  • In a subgroup analysis, in 150 optimally surgically staged patients of the European Organisation for Research and Treatment of Cancer Adjuvant ChemoTherapy In Ovarian Neoplasm trial, there appears to be no benefit of adjuvant chemotherapy.
  • In past years, it has been shown that degree of differentiation is a much stronger predictor of recurrence in early ovarian cancer than International Federation of Gynaecology and Obstetrics subclassification (Ia, Ib, Ic).
  • It has also been shown that patients with bilateral tumors (Ib) have the same prognosis as International Federation of Gynaecology and Obstetrics stage Ic patients.
  • SUMMARY: During the past year, it has been shown that platin-based adjuvant chemotherapy improves recurrence-free and overall survival in early epithelial ovarian cancer.
  • It should be emphasized, however, that this was demonstrated in patients in whom the true nature of early stage disease was doubtful in many patients due to incomplete surgical staging.
  • In a subgroup of patients who are optimally surgically staged, adjuvant chemotherapy may be less effective.
  • Theoretically, only a future trial randomizing optimal surgical staging versus adjuvant chemotherapy may be able to provide definitive conclusions, but such a trial would be almost impossible to conduct.
  • In the meantime, optimal staging is advocated in all patients who are fit enough to undergo this procedure.
  • Degree of differentiation should be incorporated in a new International Federation of Gynaecology and Obstetrics classification for stage I disease and in clinical decision making.
  • [MeSH-major] Neoplasms, Glandular and Epithelial / therapy. Ovarian Neoplasms / therapy
  • [MeSH-minor] Clinical Trials as Topic. Female. Gynecologic Surgical Procedures. Humans. Prognosis. Time Factors


20. Sivanesaratnam V: Third S. S. Ratnam memorial lecture 2007. Ovarian cancer: Is there hope for women? J Obstet Gynaecol Res; 2009 Jun;35(3):393-404
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  • [Title] Third S. S. Ratnam memorial lecture 2007. Ovarian cancer: Is there hope for women?
  • Ovarian cancer is today the most lethal female cancer with an overall survival of only 49.9%.
  • The currently available screening modalities are disappointing in detecting highly curable early stage ovarian cancer.
  • Natural history of ovarian cancer is unknown; it appears it can develop quickly from normal looking ovaries.
  • Patients with Stage IA or IB disease with grade 1 tumors have a cure rate of >90%; this is likely to be compromised by laparoscopic surgery.
  • However, the relapse rate in 'high risk' early stage ovarian cancers is 40-45%; adjuvant chemotherapy is needed.
  • Only 20-25% of those with stage III and IV disease are cured.
  • Optimal debulking surgery followed by adjuvant chemotherapy are needed for stages III and IV disease; the outcome is superior if managed by gynecologic oncologists.
  • Where cost of drugs is an important consideration, an alternative is carboplatin (an affordable and equally effective drug).
  • [MeSH-major] Ovarian Neoplasms / diagnosis. Ovarian Neoplasms / surgery
  • [MeSH-minor] Adult. CA-125 Antigen / blood. Carboplatin / therapeutic use. Chemotherapy, Adjuvant. Female. Humans. Laparoscopy / adverse effects. Mass Screening. Neoplasm Metastasis. Neoplasm Recurrence, Local. Neoplasm Staging. Paclitaxel / therapeutic use. Prognosis. Survival Rate. Ultrasonography

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  • (PMID = 19527374.001).
  • [ISSN] 1341-8076
  • [Journal-full-title] The journal of obstetrics and gynaecology research
  • [ISO-abbreviation] J. Obstet. Gynaecol. Res.
  • [Language] eng
  • [Publication-type] Lectures
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / CA-125 Antigen; BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel
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21. de Poncheville L, Perrotin F, Lefrancq T, Lansac J, Body G: Does paraaortic lymphadenectomy have a benefit in the treatment of ovarian cancer that is apparently confined to the ovaries? Eur J Cancer; 2001 Jan;37(2):210-5
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  • [Title] Does paraaortic lymphadenectomy have a benefit in the treatment of ovarian cancer that is apparently confined to the ovaries?
  • We conducted a retrospective review of all epithelial ovarian carcinoma patients with disease that is apparently confined to the ovaries who were treated in the Obstetric and Gynecologic Hospital of the University of Tours.
  • In our hospital, no lymphadenectomies for such epithelial ovarian carcinoma patients are carried out.
  • 43 epithelial ovarian carcinoma patients were studied; 22 were stage Ia, 1 was stage Ib and 20 were stage Ic.
  • 5% (2/43) developed recurrent disease and the rates of disease-free and overall survival after 5 years were 83% and 90.3% respectively.
  • As no series to date has demonstrated the benefit of paraaortic lymphadenectomy on survival and we know that paraaortic lymphadenectomy increases morbidity, we think it reasonable to propose surgery without lymphadenectomy for the treatment of early ovarian epithelial cancer patients whose disease is apparently confined to the ovaries.
  • [MeSH-major] Lymph Node Excision / methods. Ovarian Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Chemotherapy, Adjuvant. Disease-Free Survival. Female. Follow-Up Studies. Humans. Lymphatic Metastasis. Middle Aged. Neoplasm Recurrence, Local / drug therapy. Neoplasm Recurrence, Local / radiotherapy. Neoplasm Staging. Retrospective Studies. Survival Analysis

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  • (PMID = 11166148.001).
  • [ISSN] 0959-8049
  • [Journal-full-title] European journal of cancer (Oxford, England : 1990)
  • [ISO-abbreviation] Eur. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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22. Gershenson DM: Fertility-sparing surgery for malignancies in women. J Natl Cancer Inst Monogr; 2005;(34):43-7
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  • Girls or women of childbearing age with several ovarian cancer subtypes have a high probability of unilateral ovarian involvement, and, thus, may be candidates for fertility-sparing surgery with preservation of a contralateral normal ovary and uterus.
  • These subtypes include ovarian tumors of low malignant potential, malignant ovarian germ cell tumors, and ovarian sex cord-stromal tumors.
  • For women with invasive epithelial ovarian cancer who have early-stage disease, fertility-sparing surgery may be an option.
  • In some cases, fertility-sparing surgery may be followed by postoperative chemotherapy.
  • For women with invasive cervical cancer, fertility-sparing surgery may be possible.
  • Options include conization alone for stage IA1 or IA2 disease, radical trachelectomy with stage IA2 or IB disease, or ovarian transposition for women undergoing chemoradiation.
  • Non-operative options, such as hormonal therapy, may be considered for women with early-stage, low-grade endometrial cancer.
  • For all women of childbearing age with gynecologic malignancies, in vitro fertilization techniques or cryopreservation of ovarian tissue may be an option prior to definitive treatment.
  • [MeSH-major] Endometrial Neoplasms / surgery. Infertility, Female / prevention & control. Ovarian Neoplasms / surgery. Uterine Cervical Neoplasms / surgery
  • [MeSH-minor] Adult. Antineoplastic Agents / adverse effects. Antineoplastic Agents / therapeutic use. Endometrial Hyperplasia / drug therapy. Endometrial Hyperplasia / surgery. Female. Humans. Ovary / physiology. Uterus / physiology

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  • (PMID = 15784822.001).
  • [ISSN] 1052-6773
  • [Journal-full-title] Journal of the National Cancer Institute. Monographs
  • [ISO-abbreviation] J. Natl. Cancer Inst. Monographs
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 44
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23. Ma SK, Zhang HT, Sun YC, Wu LY: [Synchronous primary cancers of the endometrium and ovary: review of 43 cases]. Zhonghua Zhong Liu Za Zhi; 2008 Sep;30(9):690-4
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  • [Title] [Synchronous primary cancers of the endometrium and ovary: review of 43 cases].
  • OBJECTIVE: To investigate the clinical and pathological characteristics, treatment methods, and prognosis of synchronous primary cancers of the endometrium and ovary.
  • METHODS: The clinical data of 43 patients with synchronous primary cancers of the endometrium and ovary were retrospectively reviewed.
  • FIGO stages of endometrial carcinomas: IA 18 cases, IB 20 cases, IC 2 cases, IIA 3 cases; Stages of ovarian carcinomas: IA 19 cases, IB 4 cases, IC 7 cases, II 4 cases, III C 9 cases.
  • Twenty-four patients (55.8%) were in stage I both endometrial and ovarian carcinomas.
  • The predominant ovarian histology was endometrioid or mixed tumor with endometrioid components (30/43, 69.8%).
  • Postoperatively, 26 patients (60.5%) received adjuvant chemotherapy alone, 12 had chemotherapy plus radiotherapy, only one patient had radiation alone and the remaining 4 cases received no adjuvant treatment.
  • The 3- and 5-year survival rates of patients with both endometrioid and ovarian carcinomas were higher than that of those with non-endometrioid or mixed subtypes (93.8%, 82.0% vs. 79.7%, 69.0%).
  • The 3-year and 5-year survival rates of patients with early stage disease were better than those of the other patients (93.3%, 93.3% vs. 69.7%, 36.7%).
  • Recurrence developed in 15 patients (34.9%).
  • It was showed by univariate analysis that lower CA125 level, early FIGO stage, and adjuvant chemotherapy plus radiotherapy significantly and positively affect the 5-year survival rates, while only early FIGO stage and chemotherapy plus radiotherapy were revealed by multivariate analysis as independent prognostic factors.
  • CONCLUSION: Synchronous primary cancers of the endometrium and ovary are different from either primary endometrial carcinoma or ovarian cancer, while it can usually be detected in early stage and with a good prognosis.
  • Surgical treatment alone may be enough for early stage patients.
  • Chemotherapy plus radiotherapy may be necessary for advanced stage patients.
  • [MeSH-major] Carcinoma, Endometrioid. Endometrial Neoplasms. Hysterectomy / methods. Neoplasms, Multiple Primary. Ovarian Neoplasms
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Female. Humans. Lymph Node Excision. Lymphatic Metastasis. Middle Aged. Neoplasm Recurrence, Local. Neoplasm Staging. Proportional Hazards Models. Proteins / metabolism. Radiotherapy, Adjuvant. Retrospective Studies. Survival Rate

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  • (PMID = 19173912.001).
  • [ISSN] 0253-3766
  • [Journal-full-title] Zhonghua zhong liu za zhi [Chinese journal of oncology]
  • [ISO-abbreviation] Zhonghua Zhong Liu Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0 / NBR1 protein, human; 0 / Proteins
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24. Yamazawa K, Matsui H, Ishikura H, Seki K, Mitsuhashi A, Sekiya S: Significance of perivascular lymphocytic infiltrates on survival of patients with invasive cervical cancer. J Immunother; 2003 Mar-Apr;26(2):149-55
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  • [Title] Significance of perivascular lymphocytic infiltrates on survival of patients with invasive cervical cancer.
  • The authors retrospectively reviewed the medical records of 129 patients with stage IB and II cervical cancer (93 squamous cell carcinomas, 30 adenocarcinomas, and 6 adenosquamous carcinomas) who underwent primary surgery between 1989 and 2000.
  • Vascular invasion is the predictor of recurrence, and lymphocytic infiltrates within the tumor is associated with favorable outcome in cervical cancer.
  • Age, clinical stage, histology, tumor grade, depth of stromal invasion, VI and PLI, tumor size, ovarian metastasis, pelvic lymph node metastasis, postoperative irradiation, and chemotherapy were assessed statistically for recurrence of the disease by Cox regression analysis.
  • [MeSH-minor] Adenocarcinoma / mortality. Adenocarcinoma / pathology. Adenocarcinoma / surgery. Adult. Aged. Biopsy, Needle. Carcinoma, Adenosquamous / mortality. Carcinoma, Adenosquamous / pathology. Carcinoma, Adenosquamous / surgery. Carcinoma, Squamous Cell / mortality. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / surgery. Disease-Free Survival. Female. Humans. Hysterectomy / methods. Immunohistochemistry. Japan. Lymph Node Excision. Middle Aged. Multivariate Analysis. Probability. Prognosis. Proportional Hazards Models. Retrospective Studies. Risk Assessment. Survival Analysis


25. Moore DH: Treatment of stage IB2 (bulky) cervical carcinoma. Cancer Treat Rev; 2003 Oct;29(5):401-6
International Agency for Research on Cancer - Screening Group. diagnostics - Histopathology and cytopathology of the uterine cervix - digital atlas .

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  • [Title] Treatment of stage IB2 (bulky) cervical carcinoma.
  • Tumour size is an important prognostic factor in patients with stage IB cervical cancer.
  • The patient with stage IB2 (bulky) cervical cancer represents a therapeutic challenge.
  • Neither radical hysterectomy nor primary radiation therapy are sufficiently effective and are associated with significant treatment-related complications including ovarian failure and psychosexual deficits.
  • It appears that extrafascial hysterectomy following radiation therapy does not improve overall survival relative to radiation therapy alone.
  • Consistent with results seen in locally advanced cervical carcinoma, chemoradiation therapy is superior to radiation therapy alone as primary treatment for stage IB2 cervical cancer and as adjuvant therapy for surgically treated patients with high-risk factors for recurrence.
  • Neoadjuvant chemotherapy has resulted in high clinical response rates and operability rates.
  • There are two phase III trials suggesting an improvement in survival with neoadjuvant chemotherapy followed by radical hysterectomy versus either surgery (and selected postoperative radiation) or radiation therapy alone.
  • These emerging treatments should be scrutinized in prospective controlled trials.
  • [MeSH-major] Hysterectomy / methods. Uterine Cervical Neoplasms / pathology. Uterine Cervical Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Biopsy, Needle. Chemotherapy, Adjuvant. Combined Modality Therapy. Female. Humans. Middle Aged. Neoadjuvant Therapy / methods. Neoplasm Staging. Prognosis. Radiotherapy, Adjuvant. Randomized Controlled Trials as Topic. Risk Assessment. Survival Analysis. Treatment Outcome

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  • (PMID = 12972358.001).
  • [ISSN] 0305-7372
  • [Journal-full-title] Cancer treatment reviews
  • [ISO-abbreviation] Cancer Treat. Rev.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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26. Adis International Ltd: Erlotinib: CP 358774, NSC 718781, OSI 774, R 1415. Drugs R D; 2003;4(4):243-8
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  • It is one of a class of anticancer drugs that target the underlying molecular mechanism involving oncogenes and tumour suppressor genes, which play critical roles in the conversion of normal cells into a cancerous state.
  • OSI will keep certain co-promotion rights in the US and Genentech will be responsible for commercialising the drug in the US should the FDA approve it.
  • Initially, the alliance partners intend to pursue development of erlotinib in all the major tumour markets, particularly for non-small cell lung cancer (NSCLC) in which the group will focus on front-line combination approaches.
  • Pfizer and OSI Pharmaceuticals in the US were developing erlotinib as a treatment for solid tumours.
  • This divestiture of the erlotinib portfolio, in effect, gave OSI a royalty-free, cashless license to the drug.
  • The partnership will enable OSI to heighten awareness of its clinical trials and shorten patient accrual times.
  • OSI has also entered into an agreement with Therradex, a contract research organisation (CRO) to monitor phase II trials for erlotinib in NSCLC, ovarian and head and neck cancer.
  • The multicentre study is being conducted by Genentech in 1000 patients in the US, and will determine whether the addition of erlotinib to carboplatin chemotherapy is able to improve the duration of patient survival.
  • However, the DMC did recommend stopping erlotinib at the time of disease progression or at the start of second-line therapy.
  • A front-line phase III study of erlotinib in NSCLC (TALENT) in combination with gemcitabine and cisplatin chemotherapy was initiated by Roche in Europe in November 2001.
  • Roche has confirmed that the study woulde has confirmed that the study would be included in the alliance's potential regulatory submission for front-line therapy in chemotherapy-naive patients in the US.
  • OSI has opened two additional phase Ib studies to examine the potential of erlotinib in combination with carboplatin and paclitaxel in one study and gemcitabine and cisplatin in the other.
  • A phase I study of erlotinib is also being conducted in patients with lung cancer in Japan.
  • OSI received fast-track status from the US FDA in September 2002 for erlotinib as a second- or third-line treatment for patients with incurable stage IIIB/IV NSCLC who have failed to respond to standard therapy for advanced metastatic disease.
  • Fast-track status was also granted to erlotinib in May 2002 for the treatment of chemotherapy-naive stage III/IV NSCLC.
  • There are important differences between phase III studies of erlotinib and AstraZeneca's direct competitor drug gefitinib, which recently returned disappointing results in a frontline NSCLC trial with combination chemotherapy.
  • In assessing the survival benefit of erlotinib with chemotherapy, the dose employed of 150 mg/day is the maximum tolerated dose (MTD), whereas the gefitinib trials were conducted at relatively lower doses than the MTD determined in earlier phase I studies.
  • Patient size of the NSCLC trial was increased from 330 to 700 as OSI shifted emphasis from its pancreatic cancer trials.
  • The NCI is developing erlotinib through its CTEP programme for multiple tumour types including epithelial malignancies, gastrointestinal and genitourinary tracts, gynaecological malignancies and brain tumours.
  • A series of approximately ten phase Ib trials are already underway or were set to start in the US in 2001 to determine safety, tolerance and pharmacokinetic parameters of erlotinib in combination with a number of commonly used chemotherapeutic agents.
  • In an earlier report by the Financial Times on 10 May 2001, it was stated that approximately 12 new anticancer agents are expected to be approved by the FDA through to the end of 2002.
  • Goldman Sachs have forecast Tarceva to reach peak sales of $US250 million for the indication of head and neck cancer alone.
  • Previously in January 2001, the Financial Times claimed that OSI Pharmaceuticals, one of the development partners for Tarceva, stood to gain $US187 million pending regulatory approval.
  • Tarceva is facing competition by two similar compounds, developed by AstraZeneca and ImClone, respectively.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Neoplasms / drug therapy. Quinazolines / therapeutic use
  • [MeSH-minor] Administration, Oral. Clinical Trials as Topic. Costs and Cost Analysis. Drug Industry / economics. Erlotinib Hydrochloride. Humans. Receptor, Epidermal Growth Factor / antagonists & inhibitors. Treatment Outcome

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  • (PMID = 12848590.001).
  • [ISSN] 1174-5886
  • [Journal-full-title] Drugs in R&D
  • [ISO-abbreviation] Drugs R D
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] New Zealand
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Quinazolines; DA87705X9K / Erlotinib Hydrochloride; EC 2.7.10.1 / Receptor, Epidermal Growth Factor
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27. Williams SD, Kauderer J, Burnett AF, Lentz SS, Aghajanian C, Armstrong DK: Adjuvant therapy of completely resected dysgerminoma with carboplatin and etoposide: a trial of the Gynecologic Oncology Group. Gynecol Oncol; 2004 Dec;95(3):496-9
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  • [Title] Adjuvant therapy of completely resected dysgerminoma with carboplatin and etoposide: a trial of the Gynecologic Oncology Group.
  • OBJECTIVE: This study was designed to evaluate the effect of adjuvant chemotherapy with carboplatin and etoposide in patients with completely resected stage IB-III dysgerminoma.
  • One patient was excluded on pathology review (elements of endodermal sinus tumor were present) developed recurrent tumor and died despite further therapy.
  • CONCLUSION: The regimen used in this study is an alternative to cisplatin, etoposide, and bleomycin (BEP) for selected patients for whom minimizing toxicity (particularly neuropathy) is critical or for whom reduction in the number of treatment days is important.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Dysgerminoma / drug therapy. Ovarian Neoplasms / drug therapy
  • [MeSH-minor] Adolescent. Adult. Carboplatin / administration & dosage. Carboplatin / adverse effects. Chemotherapy, Adjuvant. Child. Etoposide / administration & dosage. Etoposide / adverse effects. Female. Humans. Neoplasm Staging

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  • (PMID = 15581952.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA 27469; United States / NCI NIH HHS / CA / CA 37517
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; BG3F62OND5 / Carboplatin
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28. Park JY, Kim DY, Suh DS, Kim JH, Kim YM, Kim YT, Nam JH: Outcomes of fertility-sparing surgery for invasive epithelial ovarian cancer: oncologic safety and reproductive outcomes. Gynecol Oncol; 2008 Sep;110(3):345-53
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  • [Title] Outcomes of fertility-sparing surgery for invasive epithelial ovarian cancer: oncologic safety and reproductive outcomes.
  • OBJECTIVE: Younger patients with invasive epithelial ovarian cancer (EOC) frequently want to preserve their fertility, but the role of fertility-sparing surgery in EOC has not been well defined.
  • METHODS: Records of 62 patients with invasive EOC who underwent fertility-sparing surgery, defined as the preservation of ovarian tissue in one or both adnexa and the uterus, between May 1990 and October 2006, were retrospectively reviewed.
  • RESULTS: Of the 62 EOCs, 36 were stage IA, 2 were stage IB, 21 were stage IC, and 1 each was stage IIB, IIIA, and IIIC; 48 were grade I, 5 were grade II, and 9 were grade III.
  • Forty-eight patients received platinum-based adjuvant chemotherapy (mean 4.6 cycles, range 1-9 cycles).
  • Patients with stage >IC (p=0.0014) or grade III (p=0.0002) tumors had significantly poorer survival.
  • [MeSH-major] Fertility. Ovarian Neoplasms / surgery
  • [MeSH-minor] Adenocarcinoma, Clear Cell / pathology. Adenocarcinoma, Clear Cell / surgery. Adenocarcinoma, Mucinous / pathology. Adenocarcinoma, Mucinous / surgery. Adult. Carcinoma, Endometrioid / pathology. Carcinoma, Endometrioid / surgery. Disease-Free Survival. Female. Gynecologic Surgical Procedures / adverse effects. Gynecologic Surgical Procedures / methods. Humans. Neoplasm Invasiveness. Neoplasm Staging. Pregnancy. Pregnancy Outcome. Retrospective Studies. Treatment Outcome

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  • [CommentIn] Gynecol Oncol. 2009 Mar;112(3):673-4; author reply 674 [18986689.001]
  • (PMID = 18586310.001).
  • [ISSN] 1095-6859
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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29. Wong HF, Low JJ, Chua Y, Busmanis I, Tay EH, Ho TH: Ovarian tumors of borderline malignancy: a review of 247 patients from 1991 to 2004. Int J Gynecol Cancer; 2007 Mar-Apr;17(2):342-9
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  • [Title] Ovarian tumors of borderline malignancy: a review of 247 patients from 1991 to 2004.
  • Borderline ovarian tumors account for 15% of epithelial ovarian cancers and are different from invasive malignant carcinoma.
  • Majority are early stage, occurring in women in the reproductive age group, where fertility is important.
  • Majority of the cases (92%) were FIGO stage I (Ia, 75%; Ib, 1%; and Ic, 16%).
  • Seven (3.5%) patients were diagnosed as having stage II disease, six (2.5%) as stage IIIa, two (1%) as stage IIIb, and four (2%) as stage IIIc.
  • Primary surgical procedures undertaken were as follows: hysterectomy with bilateral salpingo-oophorectomy (52%), unilateral salpingo-oophorectomy (33%), or ovarian cystectomy (15%).
  • Adjuvant chemotherapy was administered in 13 patients (5.2% of cases), of which 4 patients were given chemotherapy only because of synchronous malignancies.
  • Overall mean time to recurrence was 59 months.
  • There were a total of five deaths (2.8%): three (1.5%) from invasive ovarian/peritoneal carcinoma and two from synchronous uterine malignancies.
  • It appears that surgical resection is the mainstay of treatment, with conservative surgery where fertility is desired or pelvic clearance if the family is complete.
  • The role of adjuvant chemotherapy is not established.
  • [MeSH-major] Neoplasms, Glandular and Epithelial / pathology. Ovarian Neoplasms / pathology

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  • (PMID = 17343573.001).
  • [ISSN] 1048-891X
  • [Journal-full-title] International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
  • [ISO-abbreviation] Int. J. Gynecol. Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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30. Lu KH, Burke TW: Early cervical cancer. Curr Treat Options Oncol; 2000 Jun;1(2):147-55
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  • [Title] Early cervical cancer.
  • Early cervical cancer includes a broad range of disease, from clinically undetectable microinvasive cancer to large, bulky tumors that replace the entire cervix.
  • Further subgrouping of this category is therefore necessary to define the optimal treatment approach for individual cases.
  • The International Federation of Gynecology and Obstetrics (FIGO) staging system stratifies stage I tumors into two broad categories, stage IA (microinvasive) and stage IB (gross tumor).
  • Management of women with stage IA disease is controversial.
  • Stage IB1 cervical cancer is managed by either radical surgery or radiotherapy with equivalent recurrence and survival rates.
  • In patients with tumors less than 4 cm in diameter, the decision between radical surgery and radiotherapy is guided by patients' overall health and treatment preferences.
  • For younger women, radical surgery is preferred because ovarian function can be preserved and vaginal stenosis secondary to radiation can be avoided.
  • Radiation therapy is preferred for women who may not tolerate radical surgery.
  • We always prefer primary radiation therapy for patients with tumors larger than 4 cm in diameter.
  • Recent data convincingly demonstrate that the addition of cisplatin-based chemotherapy significantly improves overall survival rates in cervical cancer patients who undergo radiation therapy.
  • [MeSH-major] Uterine Cervical Neoplasms / therapy
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Clinical Trials as Topic. Combined Modality Therapy. Female. Humans. Hysterectomy. Immunotherapy, Active. Neoplasm Staging. Prognosis. Radiotherapy

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  • [Cites] Gynecol Oncol. 1993 Nov;51(2):193-6 [8276293.001]
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  • (PMID = 12057052.001).
  • [ISSN] 1527-2729
  • [Journal-full-title] Current treatment options in oncology
  • [ISO-abbreviation] Curr Treat Options Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 10
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31. Ma SK, Zhang HT, Wu LY, Liu LY: [Prognostic analysis of 88 patients with ovarian clear cell carcinoma]. Zhonghua Zhong Liu Za Zhi; 2007 Oct;29(10):784-8
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  • [Title] [Prognostic analysis of 88 patients with ovarian clear cell carcinoma].
  • OBJECTIVE: To investigate the clinical characteristics of clear cell carcinoma of the ovary and to compare the survival of the patients treated by three different chemotherapy regimens.
  • METHODS: Between 1984 and 2005, the clinical data of 88 surgically treated patients with clear cell carcinoma of the ovary were retrospectively analyzed.
  • Of the 88 patients, 55 (62.5%) had tumor in stage I, 2 in stage II, 22 in stage II, 3 in stage IV and 6 in indefinite stage.
  • Of 55 stage I patients, 20 received pelvic lymohadenectomy.
  • All patients were given postoperative chemotherapy, 43 patients received CAP/CP, 33 paclitaxel combination with carboplatinum/cisplatin (TC/TP) and 12 CPT-11 plus MMC.
  • During follow-up, 47 (53.4%) patients were found to have recurrence, it was 45.4% (25/55) in stage I patients including 29.6% (8/27) in stage I a + I b and 60.7% (17/28) in stage I c, 75.0% (18/24) in stage II + III and 4/6 in the indefinite FIGO stage.
  • The recurrences rate was 27.8% (5/18) in stage I patients with pelvic lymphadenectomy vs. 51.3% (19/37) in those without.
  • The overall 3- and 5-year survival rate of 88 patients was 48.7% and 40.9% , respectively, with 72.5% and 66.8% in stage I, 100.0% and 70.5% in stage Ia + Ib, 68.5% and 60.3% in stage Ic, 41.8% and 20.8% in stage II + III, 0 in stage IV (P < 0.05).
  • The 3- and 5-year survival in stage I with pelvic lymphadenectomy was 88.5% and 75.8% vs. 70.3% and 65.1% in those without (P < 0.05).
  • CONCLUSION: Our data show that ovarian clear cell cancer patient have a poor response to CAP/CP and may have a better response to TC/TP, especially to CPT-11 plus MMC.
  • [MeSH-major] Adenocarcinoma, Clear Cell. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Ovarian Neoplasms. Ovariectomy / methods

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  • (PMID = 18396695.001).
  • [ISSN] 0253-3766
  • [Journal-full-title] Zhonghua zhong liu za zhi [Chinese journal of oncology]
  • [ISO-abbreviation] Zhonghua Zhong Liu Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0 / CA-125 Antigen
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32. Kesic V: Fertility after the treatment of gynecologic tumors. Recent Results Cancer Res; 2008;178:79-95
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  • [Title] Fertility after the treatment of gynecologic tumors.
  • In a young woman with gynecologic cancer, preservation of fertility is possible.
  • Fertility-sparing surgery may be safe in early ovarian cancer of certain histological subtypes such as ovarian tumors of low malignant potential, malignant ovarian germ cell tumors, and ovarian sex cord stromal tumors.
  • For women with invasive epithelial ovarian cancer who have early-stage disease, fertility-sparing surgery may be an option.
  • In some cases, fertility-sparing surgery may be followed by postoperative chemotherapy.
  • The concept of fertility-preserving surgery in early cervical cancer has been adopted by several leading centers worldwide as an option for stage Ia and small Ib disease without the presence of lymphovascular involvement.
  • Nonsurgical options such as hormonal therapy may be considered for women with early-stage, low-grade endometrial cancer.
  • Improvements in cancer cure rates and the development of conservative treatments mean that many young women with early gynecologic cancer can hope to start a new pregnancy after the treatment.
  • Patients are generally advised to wait 2 years after treatment for any malignancy before attempting pregnancy, but the optimal interval between cure and conception must be carefully determined by a multidisciplinary team including oncologist and obstetrician.
  • Management of young women diagnosed with gynecologic cancer should be individualized, with the risk of conservative therapy balanced against the disadvantages of more radical treatment.
  • The alternatives to the traditional and standard radical procedures should be discussed, and the limitation of data regarding many conservative treatment options should be explained.
  • The patients should be aware that by accepting fertility-sparing treatment they are assuming a small but undefined risk for recurrence of the disease.
  • They need to know that these conservative therapeutic approaches are yet not considered "standard."
  • They may also consider ovarian tissue, oocyte, or embryo cryopreservation before definitive cancer therapies.
  • [MeSH-major] Fertility / physiology. Infertility, Female / prevention & control. Ovarian Neoplasms / therapy. Pregnancy Complications, Neoplastic. Pregnancy Outcome

  • MedlinePlus Health Information. consumer health - Female Infertility.
  • MedlinePlus Health Information. consumer health - Ovarian Cancer.
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  • (PMID = 18080446.001).
  • [ISSN] 0080-0015
  • [Journal-full-title] Recent results in cancer research. Fortschritte der Krebsforschung. Progrès dans les recherches sur le cancer
  • [ISO-abbreviation] Recent Results Cancer Res.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Germany
  • [Number-of-references] 64
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33. Sebastian M, Passlick B, Friccius-Quecke H, Jäger M, Lindhofer H, Kanniess F, Wiewrodt R, Thiel E, Buhl R, Schmittel A: Treatment of non-small cell lung cancer patients with the trifunctional monoclonal antibody catumaxomab (anti-EpCAM x anti-CD3): a phase I study. Cancer Immunol Immunother; 2007 Oct;56(10):1637-44
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Treatment of non-small cell lung cancer patients with the trifunctional monoclonal antibody catumaxomab (anti-EpCAM x anti-CD3): a phase I study.
  • Catumaxomab demonstrated efficacy when administered intraperitoneally in patients with EpCAM positive malignant ascites from ovarian cancer in terms of tumor cell killing and reduction of ascites generation.
  • As EpCAM is also overexpressed in NSCLC, the present study was conducted in order to evaluate safety and tolerability of intravenous treatment with catumaxomab.
  • PATIENTS AND METHODS: UICC stage IB-IV NSCLC patients were eligible, if they had at least one prior therapy.
  • CONCLUSIONS: Five micrograms of catumaxomab with a pre-medication of 40 mg dexamethasone and antihistamines can be recommended as first dose for i.v. therapy consisting of multiple catumaxomab infusions for patients with NSCLC.
  • [MeSH-major] Antibodies, Bispecific / therapeutic use. Antibodies, Monoclonal / therapeutic use. Antineoplastic Agents / therapeutic use. Carcinoma, Non-Small-Cell Lung / drug therapy. Lung Neoplasms / drug therapy






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