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1. Tanaka H, Masuda H, Komai Y, Yokoyama M, Iwai A, Numao N, Sakai Y, Saito K, Fujii Y, Kobayashi T, Kawakami S, Kihara K: [Primary adenocarcinoma of the female urethra treated by multimodal therapy]. Hinyokika Kiyo; 2009 Jan;55(1):43-6

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  • [Title] [Primary adenocarcinoma of the female urethra treated by multimodal therapy].
  • Physical examination revealed a firm mass on the anterior vaginal wall.
  • Magnetic resonance imaging showed a tumor surrounding the urethra, which invaded to the vesical triangle and the anterior vaginal wall.
  • Serum levels of carcinoembryonic antigen and carbohydrate antigen 19-9 were elevated, but squamous cell carcinoma antigen and prostate specific antigen were within normal limits.
  • First, the patient received local chemoradiotherapy and systemic chemotherapy using a fluoropyrimidine drug TS-1 and cisplatin.
  • The tumor markers declined to within normal limits after this preoperative therapy.
  • Then she underwent total cysto-urethrectomy with anterior vaginal wall resection, pelvic lymphadenectomy, and urinary diversion with ureterocutaneous fistula.
  • Histopathological examination of the surgical specimen showed mutinous adenocarcinoma invading to the vesical triangle and the anterior vaginal wall.
  • The final diagnosis was urethral adenocarcinoma, pT4N0, Stage IV.
  • [MeSH-major] Adenocarcinoma, Mucinous / therapy. Urethral Neoplasms / therapy
  • [MeSH-minor] Combined Modality Therapy. Fatal Outcome. Female. Humans. Middle Aged. Neoplasm Invasiveness. Urinary Bladder Neoplasms / pathology. Urinary Bladder Neoplasms / therapy. Vaginal Neoplasms / pathology. Vaginal Neoplasms / therapy

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  • (PMID = 19227213.001).
  • [ISSN] 0018-1994
  • [Journal-full-title] Hinyokika kiyo. Acta urologica Japonica
  • [ISO-abbreviation] Hinyokika Kiyo
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
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2. Missaoui N, Hmissa S, Trabelsi A, Frappart L, Mokni M, Korbi S: Cervix cancer in Tunisia: clinical and pathological study. Asian Pac J Cancer Prev; 2010;11(1):235-8
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  • [Title] Cervix cancer in Tunisia: clinical and pathological study.
  • INTRODUCTION: Uterine cervix cancer is the second most commonly diagnosed cancer among women worldwide.
  • DESIGN: In order to review the clinical and pathological features of cervix cancer in the center of Tunisia, a retrospective study was carried out on 410 cancer cases diagnosed in the Pathology Department, Farhet Hached University Hospital, Sousse, Tunisia (1993-2006).
  • Of the 410 patients, 90.5% had squamous cell carcinoma and 7.3% had adenocarcinoma.
  • One hundred thirty-eight patients were identified as being in early stages (0 and I) (33.6%) and 58.2% in advanced stages (II-IV).
  • Therapy consisted mainly in combination of radiotherapy and surgery in early stages (28.8%), and radiotherapy alone or associated with the chemotherapy in advanced stage (29.7%).
  • Surgery was the only treatment in 29.5% of cases.
  • CONCLUSION: A relatively large proportion of patients presented in stages II to IV, as compared to only 36% with early stages, emphasizing the need to reinforce the early detection of this cancer and its precursor lesions in the center of Tunisia.
  • [MeSH-major] Adenocarcinoma / diagnosis. Carcinoma, Squamous Cell / diagnosis. Uterine Cervical Neoplasms / diagnosis
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Middle Aged. Retrospective Studies. Tunisia / epidemiology. Vaginal Smears. Young Adult

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  • (PMID = 20593963.001).
  • [ISSN] 2476-762X
  • [Journal-full-title] Asian Pacific journal of cancer prevention : APJCP
  • [ISO-abbreviation] Asian Pac. J. Cancer Prev.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Thailand
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3. Mundt AJ, McBride R, Rotmensch J, Waggoner SE, Yamada SD, Connell PP: Significant pelvic recurrence in high-risk pathologic stage I--IV endometrial carcinoma patients after adjuvant chemotherapy alone: implications for adjuvant radiation therapy. Int J Radiat Oncol Biol Phys; 2001 Aug 1;50(5):1145-53
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  • [Title] Significant pelvic recurrence in high-risk pathologic stage I--IV endometrial carcinoma patients after adjuvant chemotherapy alone: implications for adjuvant radiation therapy.
  • OBJECTIVE: To evaluate the risk of pelvic recurrence (PVR) in high-risk pathologic Stage I--IV endometrial carcinoma patients after adjuvant chemotherapy alone.
  • METHODS: Between 1992 and 1998, 43 high-risk endometrial cancer patients received adjuvant chemotherapy.
  • No patients received preoperative radiation therapy (RT).
  • Most patients had Stage III--IV disease (83.7%) or unfavorable histology tumors (74.4%).
  • All patients received 4-6 cycles of chemotherapy as the sole adjuvant therapy, consisting primarily of cisplatin and doxorubicin.
  • Recurrent disease sites were divided into pelvic (vaginal, nonvaginal) and extrapelvic (para-aortic, upper abdomen, liver, and extra-abdominal).
  • Of the 17 women who developed a PVR, 8 relapsed in the vagina, 3 in the nonvaginal pelvis, and 6 in both.
  • The 3-year vaginal and nonvaginal PVR rates were 37.8% and 26%, respectively.
  • The most significant factor correlated with vaginal PVR was CI (p = 0.0007).
  • Nine of the 29 relapsed patients (31%) developed PVR as their only (6) or first site (3) of recurrence.
  • Factors associated with a higher rate of PVR (as the first or only site) were CI and Stage I--II disease.
  • CONCLUSIONS: PVR is common in high-risk pathologic Stage I-IV endometrial cancer patients after adjuvant chemotherapy alone.
  • These results support the continued use of locoregional RT in patients undergoing adjuvant chemotherapy.
  • Further studies are needed to test the addition of chemotherapy to locoregional RT.
  • [MeSH-major] Adenocarcinoma / secondary. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chemotherapy, Adjuvant. Endometrial Neoplasms / drug therapy. Pelvic Neoplasms / secondary
  • [MeSH-minor] Adenocarcinoma, Clear Cell / epidemiology. Adenocarcinoma, Clear Cell / prevention & control. Adenocarcinoma, Clear Cell / secondary. Adenocarcinoma, Clear Cell / therapy. Adult. Aged. Carcinoma, Adenosquamous / epidemiology. Carcinoma, Adenosquamous / prevention & control. Carcinoma, Adenosquamous / secondary. Carcinoma, Adenosquamous / therapy. Chicago / epidemiology. Cisplatin / administration & dosage. Combined Modality Therapy. Cystadenocarcinoma, Papillary / epidemiology. Cystadenocarcinoma, Papillary / prevention & control. Cystadenocarcinoma, Papillary / secondary. Cystadenocarcinoma, Papillary / therapy. Doxorubicin / administration & dosage. Female. Follow-Up Studies. Humans. Hysterectomy. Life Tables. Lymphatic Metastasis. Middle Aged. Neoplasm Invasiveness. Neoplasm Staging. Ovariectomy. Radiotherapy, Adjuvant. Retrospective Studies. Risk. Treatment Outcome. Vaginal Neoplasms / epidemiology. Vaginal Neoplasms / prevention & control. Vaginal Neoplasms / secondary

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  • (PMID = 11483323.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 80168379AG / Doxorubicin; Q20Q21Q62J / Cisplatin
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4. Murphy KT, Rotmensch J, Yamada SD, Mundt AJ: Outcome and patterns of failure in pathologic stages I-IV clear-cell carcinoma of the endometrium: implications for adjuvant radiation therapy. Int J Radiat Oncol Biol Phys; 2003 Apr 1;55(5):1272-6
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  • [Title] Outcome and patterns of failure in pathologic stages I-IV clear-cell carcinoma of the endometrium: implications for adjuvant radiation therapy.
  • PURPOSE: To evaluate the outcome and patterns of failure in women with uterine clear-cell carcinoma and discuss implications for adjuvant radiation therapy (RT).
  • METHODS: Between 1980 and 2000, 686 endometrial carcinoma patients underwent primary surgery at our institution.
  • FIGO stages were as follows: 3 IA, 4 IB, 5 IC, 4 IIA, 6 IIB, 8 IIIA, 2 IIIB, 3 IIIC, and 6 IV.
  • Adjuvant therapies included the following: 5 none, 22 RT (13 pelvic RT, 2 vaginal brachytherapy, 7 both), 11 chemotherapy (8 alone, 3 after pelvic RT), and 3 hormones.
  • No correlation was seen between relapse and stage, myometrial invasion, cytology, cervical extension, or involvement of extrauterine sites.
  • Corresponding pelvic failure rates in the Stage IA-IIB patients with and without RT were 0/16 (0%) and 5/6 (83%) (p < 0.0001).
  • Only 1 (2%) patient developed an isolated abdominal failure (This patient had a mixed clear-cell/papillary serous tumor).
  • CONCLUSION: Clear-cell carcinoma comprises a small percentage of endometrial cancers, frequently presents as a mixed histology, and has a poor overall outcome.
  • Unlike papillary serous tumors, clear-cell carcinoma does not seem to have a high propensity for abdominal failure.
  • Future protocols should focus instead on combinations of locoregional RT and chemotherapy to reduce the risk of local and systemic recurrence.
  • [MeSH-minor] Abdominal Neoplasms / secondary. Adenocarcinoma / drug therapy. Adenocarcinoma / mortality. Adenocarcinoma / pathology. Adenocarcinoma / radiotherapy. Adenocarcinoma / secondary. Adenocarcinoma / surgery. Adult. Aged. Aged, 80 and over. Bone Neoplasms / secondary. Brachytherapy. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Combined Modality Therapy. Cystadenocarcinoma / pathology. Disease-Free Survival. Female. Follow-Up Studies. Humans. Hysterectomy. Life Tables. Lung Neoplasms / secondary. Lymphatic Metastasis. Middle Aged. Neoplasm Staging. Neoplasms, Multiple Primary / drug therapy. Neoplasms, Multiple Primary / mortality. Neoplasms, Multiple Primary / pathology. Neoplasms, Multiple Primary / radiotherapy. Neoplasms, Multiple Primary / surgery. Pelvic Neoplasms / secondary. Prognosis. Sarcoma / pathology. Treatment Failure. Treatment Outcome. Uterine Neoplasms / pathology. Vaginal Neoplasms / secondary

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  • (PMID = 12654437.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin
  • [Number-of-references] 30
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5. Ashman JB, Connell PP, Yamada D, Rotmensch J, Waggoner SE, Mundt AJ: Outcome of endometrial carcinoma patients with involvement of the uterine serosa. Gynecol Oncol; 2001 Aug;82(2):338-43
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  • [Title] Outcome of endometrial carcinoma patients with involvement of the uterine serosa.
  • OBJECTIVE: The goal of this work was to evaluate the outcome of endometrial carcinoma patients undergoing primary surgery who have serosal involvement (SI).
  • METHODS: Between 1980 and 1998, 562 women underwent primary surgery for endometrial cancer at the University of Chicago.
  • FIGO stages were IIIA (19), IIIB (1), IIIC (7), and IV (12).
  • Twenty-six patients received pelvic radiation therapy (RT) with or without vaginal brachytherapy (VB).
  • One patient received whole-abdomen radiation therapy, and 13, adjuvant chemotherapy.
  • Solitary SI patients received pelvic RT with or without VB as their sole adjuvant therapy.
  • Factors correlated with disease recurrence included tumor stage (P = 0.003) and lymph node involvement (P = 0.04).
  • CONCLUSION: Endometrial carcinoma patients with SI have a high rate of relapse and a poor outcome.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Disease-Free Survival. Female. Humans. Middle Aged. Neoplasm Recurrence, Local / pathology. Neoplasm Staging. Radiotherapy, Adjuvant. Retrospective Studies. Treatment Outcome

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  • [Copyright] Copyright 2001 Academic Press.
  • (PMID = 11531290.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Grant] United States / NIGMS NIH HHS / GM / 5 T32 GM07281
  • [Publication-type] Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
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6. Low JS, Wong EH, Tan HS, Yap SP, Chua EJ, Sethi VK, Soh LT, Low J, Tay EH, Chew SH: Adjuvant sequential chemotherapy and radiotherapy in uterine papillary serous carcinoma. Gynecol Oncol; 2005 Apr;97(1):171-7
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  • [Title] Adjuvant sequential chemotherapy and radiotherapy in uterine papillary serous carcinoma.
  • PURPOSE: To evaluate the efficacy and toxicity of adjuvant combination of sequential chemotherapy followed by radiotherapy in uterine papillary serous carcinoma (UPSC).
  • METHODS AND MATERIALS: From April 1994 to June 2003, 26 patients (median age 61.7 years, range 46.9-78.4) with UPSC were treated with a platinum-based chemoradiation protocol after definitive surgery.
  • 9 patients were assigned as stage I (35%), 4 were stage II (15%), 11 were stage III (42%), and 2 were stage IV (8%) according to the FIGO staging for gynecological cancers.
  • The adjuvant chemoradiation protocol consists of 4 cycles of platinum-based chemotherapy followed by pelvic irradiation and vaginal vault brachytherapy.
  • In selected stage I patients with no or minimal myometrial invasion, only vault brachytherapy was given after adjuvant chemotherapy.
  • 12 out of these 14 patients were FIGO stage I/II.
  • None of the patients developed local vault recurrence.
  • The treatment was well tolerated, only 1 patient developed congestive cardiac failure from the chemotherapy and 6 patients had grade 2 peripheral neuropathy on follow-up.
  • CONCLUSION: In our series of UPSC patients treated with adjuvant chemotherapy followed by radiotherapy, local control can be achieved in a majority of patients.
  • Further investigations into finding a more effective systemic therapy are required if improvement in outcome for this form of uterine cancer is to be achieved.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Papillary / drug therapy. Carcinoma, Papillary / radiotherapy. Cystadenocarcinoma, Serous / drug therapy. Cystadenocarcinoma, Serous / radiotherapy. Uterine Neoplasms / drug therapy. Uterine Neoplasms / radiotherapy
  • [MeSH-minor] Aged. Carboplatin / administration & dosage. Carboplatin / adverse effects. Chemotherapy, Adjuvant. Female. Humans. Middle Aged. Paclitaxel / administration & dosage. Paclitaxel / adverse effects. Radiotherapy, Adjuvant. Treatment Outcome

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  • (PMID = 15790454.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel
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7. Hamilton CA, Cheung MK, Osann K, Balzer B, Berman ML, Husain A, Teng NN, Kapp DS, Chan JK: The effect of adjuvant chemotherapy versus whole abdominopelvic radiation on the survival of patients with advanced stage uterine papillary serous carcinoma. Gynecol Oncol; 2006 Nov;103(2):679-83
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  • [Title] The effect of adjuvant chemotherapy versus whole abdominopelvic radiation on the survival of patients with advanced stage uterine papillary serous carcinoma.
  • OBJECTIVES: To compare the outcomes of stage III and IV uterine papillary serous carcinoma (UPSC) patients treated with platinum-based chemotherapy (PC) versus whole abdominopelvic irradiation (WAPI) after optimal cytoreductive surgery.
  • METHODS: Surgically staged patients with advanced stage UPSC diagnosed between 1981 and 2002 were identified from tumor registry databases at four hospitals.
  • The majority of patients (85%) presented with vaginal bleeding.
  • Twenty-seven had stage III and 13 had stage IV disease.
  • The 3-year overall survival (OS) and progression-free survival (PFS) for the patients with stage III disease were 49% and 37% compared to 37% and 31% in those with stage IV disease (P = 0.23 for OS; P = 0.41 for PFS).
  • CONCLUSION: Platinum-based chemotherapy or whole abdominopelvic irradiation resulted in similar survival in this series of women with optimally cytoreduced UPSC.
  • Given the overall poor prognosis of these patients, new treatment modalities are warranted.
  • [MeSH-major] Cystadenocarcinoma, Papillary / drug therapy. Cystadenocarcinoma, Papillary / radiotherapy. Cystadenocarcinoma, Serous / drug therapy. Cystadenocarcinoma, Serous / radiotherapy. Uterine Neoplasms / drug therapy. Uterine Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Chemotherapy, Adjuvant. Female. Humans. Middle Aged. Neoplasm Staging. Radiotherapy, Adjuvant. Retrospective Studies. Survival Rate

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  • (PMID = 16793126.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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8. Sinha B, Stehman F, Schilder J, Clark L, Cardenes H: Indiana University experience in the management of vaginal cancer. Int J Gynecol Cancer; 2009 May;19(4):686-93
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  • [Title] Indiana University experience in the management of vaginal cancer.
  • PURPOSE: To review our institutional experience in the treatment of primary vaginal cancer and identify predictors for outcome, in particular, recurrence rate.
  • MATERIALS AND METHODS: We retrospectively reviewed the charts of 45 patients identified as having primary squamous cell cancer and adenocarcinoma of the vagina and recorded information regarding both patient and tumor characteristics and treatment modalities.
  • Treatment modalities included surgery and radiation with or without chemotherapy (6 patients), radiation alone (30 patients), and chemoradiation (9 patients).
  • RESULTS: The median follow-up time for all surviving patients was 5.8 years (range, 9-146 months).
  • The 5-year overall survival rates by stage were carcinoma in situ with microinvasion and stage I, 92%; stage II, 82%; and stages III and IVA, 20% (P = 0.0005).
  • The 5-year progression-free survival rates by stage were carcinoma in situ and stage I, 92%; stage II, 88%; and stages III and IVA, 30% (P = 0.00049).
  • Of the factors analyzed, only stage predicted for a statistically significant increased risk for recurrence (P = 2.23E-0.05).
  • CONCLUSIONS: Early-stage vaginal cancer can be successfully managed with radiation therapy with excellent rates of local control and survival.
  • Patients with stages III and IV disease have a very poor outcome, and more aggressive therapies need to be investigated.
  • Given the limited number of patients treated with chemotherapy and radiation, no definitive conclusions can be made regarding the impact of combined therapy in the management of this disease.
  • [MeSH-major] Adenocarcinoma / therapy. Carcinoma, Squamous Cell / therapy. Vaginal Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Brachytherapy. Combined Modality Therapy. Female. Humans. Middle Aged. Retrospective Studies. Treatment Outcome

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  • (PMID = 19509572.001).
  • [ISSN] 1525-1438
  • [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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9. Mizuno K, Kidokoro K, Miyazaki K, Yoshida K, Nakagawa A, Mizuno M, Suzuki S, Kuno N, Furuhashi M, Ishizuka T, Ishikawa K: [Neoadjuvant chemotherapy with intra-arterial infusion in the treatment of advanced cervical cancer]. Gan To Kagaku Ryoho; 2005 Jun;32(6):815-9
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  • [Title] [Neoadjuvant chemotherapy with intra-arterial infusion in the treatment of advanced cervical cancer].
  • Neoadjuvant chemotherapy (NAC) with intra-arterial infusion was performed in the treatment for 53 patients with advanced cervical squamous cell carcinoma.
  • The response to therapy was observed in 45 of all patients (84.9%) clinically, and 36 of 42 patients (85.7%) pathologically.
  • Cancer cells disappeared in 11.9% of patients with cervical invasion, 69.2% with vaginal wall invasion and 39.4% with parametrium invasion after NAG.
  • Five-year survival rates were 100% in stage I, 71.5% in stage II, 52.2% in stage II and 0% in stage IV.
  • The group of patients without cancer in the parametrium after NAC showed a significantly better 5-year survival rate than the group with residual cancer in the parametrium.
  • According to the results, the elimination of cancer invasion to the parametrium by NAC is thought to be important for improvement of the prognosis in advanced cervical cancer.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Hysterectomy. Lymph Node Excision. Uterine Cervical Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Bleomycin / administration & dosage. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Drug Administration Schedule. Female. Humans. Ifosfamide / administration & dosage. Infusions, Intra-Arterial. Middle Aged. Mitomycin / administration & dosage. Neoadjuvant Therapy. Neoplasm Staging. Prognosis. Survival Rate. Vincristine / administration & dosage


10. Sood BM, Jones J, Gupta S, Khabele D, Guha C, Runowicz C, Goldberg G, Fields A, Anderson P, Vikram B: Patterns of failure after the multimodality treatment of uterine papillary serous carcinoma. Int J Radiat Oncol Biol Phys; 2003 Sep 1;57(1):208-16
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  • [Title] Patterns of failure after the multimodality treatment of uterine papillary serous carcinoma.
  • PURPOSE: Uterine papillary serous carcinoma (UPSC) is an aggressive variant of endometrial carcinoma.
  • The majority of patients with clinical Stage I UPSC are found to have extrauterine disease at the time of surgery.
  • Most authors report survival rates of 35-50% for Stage I-II and 0-15% for Stage III and IV UPSC.
  • Surgical treatment as the sole therapy for patients with Stage I-IV UPSC is unacceptable because of high recurrence rates.
  • Chemotherapy, radiotherapy, or both have been added after surgery in an attempt to improve survival.
  • However, the survival benefit to patients from such multimodality therapy remains uncertain.
  • This study analyzes the patterns of failure in patients with FIGO Stages I-IV UPSC treated by multimodality therapy.
  • METHODS AND MATERIALS: Forty-two women with FIGO Stages I-IV UPSC who were treated by multimodality therapy were analyzed retrospectively between 1988 and 1998.
  • Data were obtained from tumor registry, hospital, and radiotherapy chart reviews, operative notes, pathology, and chemotherapy flow sheets.
  • All the patients underwent staging laparotomy, peritoneal cytology, total abdominal hysterectomy and salpingo oophorectomy, pelvic and para-aortic lymph node sampling, omentectomy, and cytoreductive surgery, when indicated followed by radiotherapy and/or chemotherapy.
  • Therapy consisted of external beam radiation therapy in 11 patients (26%), systemic chemotherapy in 20 (48%), and both radiotherapy and chemotherapy in 11 (26%).
  • The treatments were not assigned in a randomized fashion.
  • The dose of external beam radiation therapy ranged from 45-50.40 Gy (median 45).
  • Of the 31 patients (74%) who received chemotherapy, 18 received single-agent (58%), whereas 13 received multiagent chemotherapy (42%).
  • Six patients (14%) had Stage I, 8 patients (19%) had Stage II, 10 (24%) had Stage III, and 18 (43%) had Stage IV disease.
  • Twenty-nine patients (69%) had suffered recurrence at the time of last follow-up.
  • Twenty-five patients (60%) had died at the time of reporting; the observed survival rate at 2 years and 5 years was 52% and 43%, respectively.
  • CONCLUSIONS: Our data suggest that, after multimodality therapy of FIGO Stage I-IV UPSC, most patients developed abdominopelvic (locoregional) failure, and the great majority of the failures occurred in the abdomen, vagina, and pelvis (66%).
  • Distant failure alone occurred in 17% of the patients.We propose that future studies should combine whole abdominal radiotherapy (WART) with pelvic and vaginal boosts, in addition to chemotherapy for FIGO Stage I-IV UPSC, especially in patients with minimal residual disease, to attempt to improve the dismal prognosis of patients with UPSC.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Cystadenocarcinoma, Papillary / mortality. Cystadenocarcinoma, Papillary / therapy. Neoplasm Recurrence, Local / diagnosis. Uterine Neoplasms / mortality. Uterine Neoplasms / therapy
  • [MeSH-minor] Aged. Aged, 80 and over. Cisplatin / administration & dosage. Combined Modality Therapy / methods. Disease-Free Survival. Doxorubicin / administration & dosage. Female. Follow-Up Studies. Humans. Middle Aged. Neoplasm Staging / methods. Paclitaxel / administration & dosage. Retrospective Studies. Shiga Toxins / administration & dosage. Survival Analysis. Treatment Failure

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  • (PMID = 12909235.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Shiga Toxins; 80168379AG / Doxorubicin; P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin
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11. Nguyen NP, Sallah S, Karlsson U, Vos P, Ludin A, Semer D, Tait D, Salehpour M, Jendrasiak G, Robiou C: Prognosis for papillary serous carcinoma of the endometrium after surgical staging. Int J Gynecol Cancer; 2001 Jul-Aug;11(4):305-11
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  • [Title] Prognosis for papillary serous carcinoma of the endometrium after surgical staging.
  • BACKGROUND: To investigate the pattern of failure and the prognosis following pathological staging for uterine papillary serous carcinoma (UPSC).
  • Two patients with advanced disease received chemotherapy only.
  • Two patients with early-stage disease were followed without further treatment.
  • In addition, seven of these patients received vaginal cuff irradiation with low-dose-rate or high-dose-rate brachytherapy.
  • RESULTS: Seven patients (32%) developed distant metastases, three out of seven (42%) after WART.
  • Four out of seven patients who had distant metastases died from disease progression during subsequent chemotherapy.
  • All patients with distant metastases had locally advanced-stage disease at presentation (six stage III, one stage IV).
  • Four patients with pelvic recurrences developed concurrent (2) and subsequent (2) distant metastases.
  • No patient with early stage-disease (stage I and II) died from disease progression.
  • CONCLUSION: Pathological staging should be performed for all patients with UPSC to determine the prognosis as well as to tailor the treatment.
  • The role of abdominal irradiation in the treatment of UPSC is yet to be determined; however, such an approach may not be necessary for the control of disease for patients with early-stage (I and II) disease.
  • Patients with locally advanced-stage (stage III) disease are at risk of local regional failures and distant metastases despite WART.
  • Therefore, the benefit of WART for advanced-stage disease is also questionable.
  • Paclitaxel-based chemotherapy is currently being investigated in this setting.
  • [MeSH-major] Carcinoma, Papillary / mortality. Carcinoma, Papillary / pathology. Endometrial Neoplasms / mortality. Endometrial Neoplasms / pathology
  • [MeSH-minor] Aged. Aged, 80 and over. Female. Humans. Middle Aged. Neoplasm Staging. North Carolina. Prognosis. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • (PMID = 11520370.001).
  • [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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12. Tan YT, Zhang X, Lin ZQ, Chen Q, Wang LJ, Zhang BZ: [Primary clear cell carcinoma of the cervix: report of five cases and review of the literature]. Zhonghua Fu Chan Ke Za Zhi; 2008 Feb;43(2):120-3
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  • [Title] [Primary clear cell carcinoma of the cervix: report of five cases and review of the literature].
  • OBJECTIVE: To explore the clinical diagnostic and therapeutic characteristics, prognostic factors of patients with primary clear cell carcinoma of the cervix.
  • METHODS: The clinical, pathologic and follow-up data of patients with primary clear cell carcinoma of the cervix treated in our hospital from Jan 2003 to Dec 2006 were collected and analyzed retrospectively.
  • RESULTS: Five patients with primary clear cell carcinoma of the cervix were treated (1 case stage I b1, 2 of stage I b2, 1 of stage IIa, 1 of stage IVa).
  • The primary symptom was mostly irregularly vaginal bleeding (3/5) and clinical type was predominantly (4/5) endophytic growth.
  • All of four patients underwent four courses of chemotherapy with fluorouracil (5-FU) and carboplatin, one patient (stage II a) was added with intracavitary brachytherapy.
  • The patient with stage IV a underwent firstly hysterectomy and prerectum mass removal.
  • Pelvic relapse occurred three months after operation and the patient then underwent the second operation, external beam radiotherapy and intracavitary brachytherapy and 8 courses of chemotherapy with paclitaxel (taxol) and carboplatin.
  • CONCLUSIONS: Primary clear cell carcinoma of the cervix may be unrelated to HPV infection.
  • Operation combined with chemotherapy with carboplatin and 5-FU or taxol may lead to relatively perfect short-term therapeutical effect.
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carboplatin / administration & dosage. Cervix Uteri / pathology. Female. Fluorouracil / administration & dosage. Humans. Hysterectomy. Lymph Node Excision. Middle Aged. Neoplasm Invasiveness. Neoplasm Staging. Paclitaxel / administration & dosage. Prognosis. Retrospective Studies


13. Xue DB, Ding LJ, Xia AL, Chen D, Xia HP, Teng XD, Xu ST, Zhang SJ, Ren XC: [Clinicopathologic study on 61 cases of uterine papillary serous carcinoma with or without adjuvant therapy]. Zhonghua Bing Li Xue Za Zhi; 2010 Oct;39(10):671-4
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  • [Title] [Clinicopathologic study on 61 cases of uterine papillary serous carcinoma with or without adjuvant therapy].
  • OBJECTIVE: To study the clinicopathologic features of uterine papillary serous carcinoma (UPSC) and the roles of adjuvant therapy.
  • The clinical presentations included abnormal vaginal bleeding, abdominal symptoms and abnormal Pap smears.
  • There were 27.9% cases in FIGO stage I (8.2% in stage IA, 14.8% in stage IB and 4.9% in stage IC), 9.8% in stage II, 32.8% in stage III and 29.5% in FIGO stage IV.
  • Fifty-six patients received adjuvant therapy.
  • The number of patients receiving adjuvant chemotherapy alone, adjuvant radiotherapy alone and combined adjuvant chemotherapy/radiotherapy were 42, 24 and 10, respectively.
  • The median survivals of the chemotherapy group and non-chemotherapy group (with or without radiotherapy) were 66.4 months and 32.8 months, respectively.
  • The tumor stage, lymph node status, lymphovascular permeation and depth of myometrial invasion were important prognostic factors.
  • Adjuvant chemotherapy for stage III/IV tumors or recurrent UPSC may have survival benefit.
  • [MeSH-major] Carcinoma, Papillary. Cystadenocarcinoma, Serous. Uterine Neoplasms
  • [MeSH-minor] Aged. Aged, 80 and over. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Female. Follow-Up Studies. Humans. Lymphatic Metastasis. Menopause. Middle Aged. Neoplasm Invasiveness. Neoplasm Staging. Paclitaxel / administration & dosage. Radiotherapy, Adjuvant. Survival Rate

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  • (PMID = 21176532.001).
  • [ISSN] 0529-5807
  • [Journal-full-title] Zhonghua bing li xue za zhi = Chinese journal of pathology
  • [ISO-abbreviation] Zhonghua Bing Li Xue Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] China
  • [Chemical-registry-number] P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin
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14. Eltabbakh GH, Mount SL: Laparoscopic surgery does not increase the positive peritoneal cytology among women with endometrial carcinoma. Gynecol Oncol; 2006 Feb;100(2):361-4

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  • [Title] Laparoscopic surgery does not increase the positive peritoneal cytology among women with endometrial carcinoma.
  • OBJECTIVE: The purpose of our study was to find if uterine manipulation at the time of laparoscopic hysterectomy among women with endometrial carcinoma increases the incidence of malignant cells in the peritoneal washings.
  • MATERIAL AND METHODS: We conducted a prospective study including women with clinical stage I endometrioid endometrial carcinoma undergoing laparoscopic surgery between 07/01/2000 and 07/01/2004.
  • The procedure was converted to laparotomy in 3 (7.6%) patients after obtaining the two sets of washings.
  • All patients underwent laparoscopically assisted vaginal hysterectomy with bilateral salpingo-oophorectomy, 30 patients had bilateral pelvic lymphadenectomy, and 5 patients had bilateral pelvic and para-aortic lymphadenectomy.
  • The surgical stages were: IA: 14 (33.3%), IB: 12 (28.6%), IC: 7 (16.7%), IIA: 1 (2.4%), IIB: 1 (2.4%), IIIA: 4 (9.5%), IIIB: 1 (2.4%), IIIC: 1 (2.4%), and IV: 1 (2.4%).
  • Twenty-nine patients received no postoperative treatment, 2 received chemotherapy, 3 received Megace, and 9 received radiation therapy.
  • CONCLUSIONS: We conclude that uterine manipulation at the time of laparoscopic hysterectomy does not increase the incidence of positive peritoneal cytology among women with endometrial carcinoma.
  • [MeSH-major] Carcinoma, Endometrioid / secondary. Carcinoma, Endometrioid / surgery. Endometrial Neoplasms / pathology. Endometrial Neoplasms / surgery. Neoplasm Seeding. Peritoneal Neoplasms / secondary

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  • (PMID = 16185754.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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15. Watari H, Mitamura T, Moriwaki M, Hosaka M, Ohba Y, Sudo S, Todo Y, Takeda M, Ebina Y, Sakuragi N: Survival and failure pattern of patients with endometrial cancer after extensive surgery including systematic pelvic and para-aortic lymphadenectomy followed by adjuvant chemotherapy. Int J Gynecol Cancer; 2009 Dec;19(9):1585-90
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  • [Title] Survival and failure pattern of patients with endometrial cancer after extensive surgery including systematic pelvic and para-aortic lymphadenectomy followed by adjuvant chemotherapy.
  • We investigated the survival and the failure pattern of 288 patients with endometrial cancer treated with extensive surgery including systematic pelvic and para-aortic lymphadenectomy followed by cisplatin-based chemotherapy from 1982 to 2002.
  • The 5-year overall survival rates were 97.5% for stage I, 87.5% for stage II, 85.2% for stage III, and 12.5% for stage IV.
  • Notably, the 5-year survival rate was 76.5% for patients with stage IIIC disease.
  • Among patients with a low risk (n = 92) for recurrence who received no adjuvant chemotherapy, 2 (2.2%) showed recurrent disease.
  • Among those with intermediate (n = 98) and high (n = 98) risks for recurrence who received adjuvant chemotherapy, 9 (9.2%) and 20 (20.4%) showed recurrent disease, respectively.
  • The recurrence sites were described as follows: distant (n = 12), vaginal (n = 8), peritoneal (n = 7), pelvic (n = 2), and lymphatic (n = 2).
  • Cervical invasion and lymph node metastasis were predictors of vaginal failure.
  • For patients with stage I/II cancer, the architectural and nuclear grades were related to distant failure.
  • We conclude that we need to further test the efficacy of systemic adjuvant therapy using new chemotherapeutic regimens to prevent distant failure and to improve the survival of patients with endometrial cancer.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Carcinoma, Endometrioid / drug therapy. Carcinoma, Endometrioid / surgery. Endometrial Neoplasms / drug therapy. Endometrial Neoplasms / surgery
  • [MeSH-minor] Aorta, Abdominal / surgery. Chemotherapy, Adjuvant. Female. Follow-Up Studies. Gynecologic Surgical Procedures / methods. Humans. Lymph Node Excision. Pelvis / surgery. Recurrence. Retrospective Studies. Survival Analysis. Treatment Failure

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  • (PMID = 19955942.001).
  • [ISSN] 1525-1438
  • [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] Evaluation Studies; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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16. Singhal P, Odunsi K, Rodabaugh K, Driscoll D, Lele S: Primary fallopian tube carcinoma: a retrospective clinicopathologic study. Eur J Gynaecol Oncol; 2006;27(1):16-8

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  • [Title] Primary fallopian tube carcinoma: a retrospective clinicopathologic study.
  • INTRODUCTION: Primary fallopian tube carcinoma is a rare tumor.
  • The aim of this study was to evaluate clinical characteristics and management of fallopian tube malignancies at a large tertiary care cancer institute.
  • RESULTS: Thirty-five patients had histology consistent with fallopian tube carcinoma.
  • The most common signs or symptoms were abnormal vaginal bleeding (29%) and abdominal/pelvic mass (26%).
  • Five patients (14%) were Stage I, seven patients (20%) Stage II, 17 patients (49%) Stage III and six patients (17%) Stage IV.
  • Thirty-two (91%) patients received adjuvant chemotherapy and 77% received platinum-based chemotherapy.
  • The 5-year survival rate was 64% for Stage I, 42% for Stage II, 32% for Stage III, and 17% for Stage IV.
  • More extensive research needs to be performed to have definitive etiologic, diagnostic and treatment guidelines.
  • [MeSH-major] Carcinoma / mortality. Carcinoma / pathology. Cause of Death. Fallopian Tube Neoplasms / mortality. Fallopian Tube Neoplasms / pathology. Second-Look Surgery / trends
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Biopsy, Needle. Combined Modality Therapy. Female. Gynecologic Surgical Procedures / methods. Humans. Immunohistochemistry. Middle Aged. Neoplasm Staging. Probability. Prognosis. Registries. Retrospective Studies. Risk Assessment. Survival Analysis. Treatment Outcome

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  • (PMID = 16550961.001).
  • [ISSN] 0392-2936
  • [Journal-full-title] European journal of gynaecological oncology
  • [ISO-abbreviation] Eur. J. Gynaecol. Oncol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Italy
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17. Bafna UD, Devi UM, Naik KA, Hazra S, Sushma N, Babu N: Carcinoma of the vulva: a retrospective review of 37 cases at a regional cancer centre in South India. J Obstet Gynaecol; 2004 Jun;24(4):403-7
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  • [Title] Carcinoma of the vulva: a retrospective review of 37 cases at a regional cancer centre in South India.
  • A retrospective review of 37 cases of carcinoma of the vulva presenting between 1996 and 2000 has been carried out.
  • The surgical treatment consisted of wide excision in one case, radical vulvectomy (RV) in six cases, radical vulvectomy and bilateral groin node dissection (RV+BGND) in 25 cases and radical vulvectomy and unilateral groin node dissection in one case.
  • Nine of these 33 women also received adjuvant chemotherapy preoperatively in the hope of achieving better tumour-free surgical margins.
  • Thirteen of these 26 patients (50%) had inguinal node metastases (Stage III, four patients; Stage IV, nine patients).
  • All the patients with negative nodes were free of disease while three of four patients with Stage III and two of nine patients with Stage IV with nodal metastases remained free of disease.
  • The only patient with Stage III disease plus inguinal node metastases who recurred had multiple positive nodes with extracapsular spread.
  • It appears that although bilateral involvement of the inguinal lymph nodes carries a worse prognosis, unilateral involvement with or without vaginal involvement carries an excellent prognosis provided multiple nodes are not involved.
  • The role of neoadjuvant chemotherapy as compared to neoadjuvant radiotherapy, in locally advanced tumours, needs to be explored further.
  • [MeSH-minor] Adenocarcinoma / epidemiology. Adenocarcinoma / etiology. Adenocarcinoma / pathology. Adenocarcinoma / therapy. Adult. Aged. Carcinoma, Squamous Cell / epidemiology. Carcinoma, Squamous Cell / etiology. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / therapy. Combined Modality Therapy. Female. Humans. India / epidemiology. Lymphatic Metastasis. Medical Records. Medically Underserved Area. Middle Aged. Neoplasm Metastasis. Neoplasm Staging. Palliative Care. Regional Medical Programs. Retrospective Studies

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  • (PMID = 15203581.001).
  • [ISSN] 0144-3615
  • [Journal-full-title] Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology
  • [ISO-abbreviation] J Obstet Gynaecol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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18. Veras E, Deavers MT, Silva EG, Malpica A: Ovarian nonsmall cell neuroendocrine carcinoma: a clinicopathologic and immunohistochemical study of 11 cases. Am J Surg Pathol; 2007 May;31(5):774-82
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  • [Title] Ovarian nonsmall cell neuroendocrine carcinoma: a clinicopathologic and immunohistochemical study of 11 cases.
  • Nonsmall cell neuroendocrine carcinoma (NSCNEC) of the ovary is a rare and aggressive tumor commonly associated with other surface epithelial and germ cell neoplasms.
  • Anderson Cancer Center in a 16-year period (1990 to 2005).
  • The most common presentation was abdominal/pelvic pain (6 cases), followed by ascites (2 cases), pelvic mass, vaginal bleeding, and abdominal bloating (1 case each).
  • In 8 cases, NSCNEC was associated with other epithelial neoplasms, including mucinous neoplasms of low malignant potential, mucinous carcinoma, endometrioid carcinoma, mixed endometrioid and mucinous carcinoma, and a high-grade carcinoma, not otherwise specified.
  • According to the International Federation of Gynecology and Obstetrics staging system, 4 cases were stage I tumors, 3 cases were stage III tumors, and 4 cases were stage IV tumors.
  • Seven patients were treated with total abdominal hysterectomy and bilateral salpingo-oophorectomy followed by chemotherapy.
  • One patient had a bilateral salpingo-oophorectomy with omentectomy and appendectomy followed by chemotherapy; 1 patient had a total abdominal hysterectomy with right salpingo-oophorectomy followed by chemotherapy; one had a bilateral salpingo-oophorectomy followed by chemotherapy, and one had a right salpingo-oophorectomy with appendectomy followed by chemotherapy.
  • Four of 5 patients who died of disease had either stage III or IV tumors and 3 of 5 patients who are alive without evidence of disease have stage I tumors.
  • In summary, ovarian NSCNEC is an aggressive tumor with a tendency to present at advanced stage and cause death within a mean of 17 months after diagnosis; however, some patients, particularly those with stage I disease and/or those who have received platinum-based therapy, may have a more favorable prognosis.
  • [MeSH-major] Biomarkers, Tumor. Carcinoma, Neuroendocrine / pathology. Immunoenzyme Techniques. Ovarian Neoplasms / pathology
  • [MeSH-minor] Adult. Combined Modality Therapy. Fatal Outcome. Female. Humans. Middle Aged. Neoplasm Proteins / analysis. Neoplasm Staging. Neoplasms, Multiple Primary. Remission Induction. Treatment Outcome

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  • (PMID = 17460463.001).
  • [ISSN] 0147-5185
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Neoplasm Proteins
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19. Morice P, Viala J, Pautier P, Lhommé C, Duvillard P, Castaigne D: Port-site metastasis after laparoscopic surgery for gynecologic cancer. A report of six cases. J Reprod Med; 2000 Oct;45(10):837-40
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  • [Title] Port-site metastasis after laparoscopic surgery for gynecologic cancer. A report of six cases.
  • BACKGROUND: Port-site metastasis after laparoscopic surgery for gynecologic cancer is a recognized entity.
  • CASES: Five patients underwent laparoscopic peritoneal biopsies for a stage III (n = 4) or IV (n = 1) ovarian cancer with moderate or poor differentiation.
  • The sixth patient underwent a laparoscopic lymphadenectomy for vaginal carcinoma with bulky metastatic pelvic lymph nodes.
  • If a malignant ovarian tumor is discovered during laparoscopy, the interval between initial surgery and complete cytoreductive surgery (with resection of laparoscopic ports) followed by chemotherapy should be as short as possible.
  • For patients with uterine cancer and bulky nodes, laparoscopic lymphadenectomy should be avoided to avoid trocar implantation metastasis.
  • [MeSH-major] Adenocarcinoma / secondary. Laparoscopy / adverse effects. Neoplasm Seeding. Ovarian Neoplasms / pathology. Skin Neoplasms / secondary. Vaginal Neoplasms / pathology

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  • (PMID = 11077634.001).
  • [ISSN] 0024-7758
  • [Journal-full-title] The Journal of reproductive medicine
  • [ISO-abbreviation] J Reprod Med
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] UNITED STATES
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20. Luo LM, Huang HF, Pan LY, Shen K, Wu M, Xu L: [Clinical analysis of 42 cases of primary malignant tumor in vagina]. Zhonghua Fu Chan Ke Za Zhi; 2008 Dec;43(12):923-7
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  • OBJECTIVE: To analyze the clinical characters, treatment and prognosis of primary malignant tumor in vagina.
  • According to the International Federation of Gynecology and Obstetrics (FIGO) staging system, 19 cases were at stage I, 12 cases at stage II, 5 cases at stage III, and 6 cases at stage IV.
  • Thirteen cases were squamous carcinoma, 13 cases were malignant melanoma, 8 cases were adenocarcinoma, 3 cases were yolk sac tumor and 5 cases were other types.
  • The majority of patients were treated with surgery combined with radiotherapy and chemotherapy.
  • The longest follow up was 10 years, with the median time of 2 years.
  • For stage I, stage II and stage III - IV, the 2-year survival rates were 71.3%, 58.3% and 29.6% respectively.
  • The 2-year survival rate of patients with squamous carcinoma was 46.8%, malignant melanoma 72.9%, adenocarcinoma 20.0% and patients with yolk sac tumor were all alive tumor-free after 6 - 10 years' follow up.
  • CONCLUSIONS: The prognosis of primary malignant tumor in vagina is affected by clinical stage and histological type.
  • As to malignant melanoma, radical surgery combined with chemotherapy and immunotherapy produce good effects.
  • Patients with yolk sac tumor can be cured only with chemotherapy.
  • As to other types, more treatment experiences are needed.
  • [MeSH-major] Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / therapy. Vaginal Neoplasms / pathology. Vaginal Neoplasms / therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chemotherapy, Adjuvant. Child. Child, Preschool. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Hysterectomy / methods. Infant. Melanoma / mortality. Melanoma / pathology. Melanoma / surgery. Melanoma / therapy. Middle Aged. Neoplasm Staging. Prognosis. Retrospective Studies. Survival Rate. Vagina / pathology. Vagina / surgery. Young Adult

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  • (PMID = 19134332.001).
  • [ISSN] 0529-567X
  • [Journal-full-title] Zhonghua fu chan ke za zhi
  • [ISO-abbreviation] Zhonghua Fu Chan Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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21. Thomas L, Bataillard A, Brémond A, Fondrinier E, Fervers B, Achard JL, Lansac J, Bailly C, Hoffstetter S, Basuyau JP, d'Anjou J, Descamps P, Farsi F, Guastalla JP, Laffargue F, Rodier JF, Vincent P, Pigneux J: [Standards, options, and recommendations for the radiotherapy of patients with endometrial cancer. FNCLCC (National Federation of Cancer Campaign Centers) and CRLCC (Regional Cancer Campaign Centers)]. Cancer Radiother; 2001 Apr;5(2):163-92
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  • [Title] [Standards, options, and recommendations for the radiotherapy of patients with endometrial cancer. FNCLCC (National Federation of Cancer Campaign Centers) and CRLCC (Regional Cancer Campaign Centers)].
  • [Transliterated title] Standards, Options et Recommandations pour la radiothérapie des patientes atteintes de cancer de l'endomètre.
  • OBJECTIVES: To develop clinical practice guidelines according to the definitions of the Standards, Options and Recommendations project for the radiotherapy of carcinoma of the endometrium.
  • Once the guidelines were defined, the document was submitted for review to independent reviewers, and to the medical committees of the 20 French Cancer Centres.
  • RESULTS: The main recommendations for the radiotherapy of carcinoma of the endometrium are:.
  • 1) For grade 1 and 2 stage IA tumours, follow-up alone is standard as additional treatment.
  • For grade 1 and 2 stage IB tumours, vaginal brachytherapy or follow-up alone are options.
  • For grade 3, stage IB tumours and stage IC disease, there are two treatment options: external pelvic radiotherapy with a brachytherapy boost or vaginal brachytherapy.
  • 2) Treatment for stage II disease can be preoperative when stage II disease has been suggested by a positive endometrial curettage.
  • Postoperative vaginal brachytherapy is given for stage IIA tumours if the penetration of the myometrium is less than 50% or if the tumour is grade 1 or 2.
  • In the case of deep penetration, or higher grade disease, or for stage IIB external radiotherapy with brachytherapy boosting must be undertaken routinely.
  • 3) After surgery, for stage IIIA disease, either external pelvic radiotherapy or abdomino-pelvic radiotherapy is indicated, along with medical treatment in certain patients.
  • For stage IIIB tumours, postoperative external radiotherapy with brachytherapy (if possible) should be undertaken.
  • For stage IIIC tumours, standard treatment is external (pelvic or pelvic and para-aortic) radiotherapy followed or not by a brachytherapy boost.
  • 4) Standard treatment for inoperable stage I and II disease is external radiotherapy and brachytherapy.
  • For patients with inoperable stage III or IV disease, treatment is often symptomatic, combining external radiotherapy and medical treatment.
  • [MeSH-minor] Brachytherapy / adverse effects. Carcinoma / drug therapy. Carcinoma / pathology. Carcinoma / radiotherapy. Carcinoma / surgery. Cesium Radioisotopes / therapeutic use. Chemotherapy, Adjuvant. Combined Modality Therapy. Female. Humans. Hysterectomy. Indium Radioisotopes / therapeutic use. Lymphatic Irradiation / adverse effects. Lymphatic Metastasis / radiotherapy. Neoplasm Staging. Pelvic Neoplasms / radiotherapy. Pelvic Neoplasms / secondary. Peritoneal Neoplasms / radiotherapy. Peritoneal Neoplasms / secondary. Postoperative Period. Preoperative Care. Radiation Injuries / etiology. Radiotherapy Dosage. Radiotherapy, Adjuvant / adverse effects. Radiotherapy, High-Energy / adverse effects. Radium / therapeutic use

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  • (PMID = 11355582.001).
  • [ISSN] 1278-3218
  • [Journal-full-title] Cancer radiothérapie : journal de la Société française de radiothérapie oncologique
  • [ISO-abbreviation] Cancer Radiother
  • [Language] fre
  • [Publication-type] Comparative Study; English Abstract; Guideline; Journal Article; Practice Guideline; Research Support, Non-U.S. Gov't
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Cesium Radioisotopes; 0 / Indium Radioisotopes; W90AYD6R3Q / Radium
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22. Gonzalez Bosquet J, Terstriep SA, Cliby WA, Brown-Jones M, Kaur JS, Podratz KC, Keeney GL: The impact of multi-modal therapy on survival for uterine carcinosarcomas. Gynecol Oncol; 2010 Mar;116(3):419-23
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  • [Title] The impact of multi-modal therapy on survival for uterine carcinosarcomas.
  • OBJECTIVES: To investigate treatment outcomes of patients with carcinosarcoma of the uterus and to identify parameters predictive of survival.
  • Secondary objectives included (a) the assessment of treatment failures as a function of histologic subtypes and (b) the impact of the new FIGO staging classification system.
  • Clinical, surgical and pathological data were reviewed and patients were classified according to the new 2009 FIGO staging system for endometrial carcinoma.
  • RESULTS: In the multivariate analyses for disease-specific survival (DSS) and disease-free survival (DFS), the only independent factors were FIGO stage, adjuvant chemotherapy after surgery and the presence of clear cell histology in the tumor.
  • The 5-year DSS for stages I-II, III and IV was 59%, 22% and 9%, respectively.
  • The administration of platin-based chemotherapy provided a significant benefit with regard to both DFS (OR=0.28; p=0.001) and DSS (OR=0.35; p=0.01).
  • While radiotherapy (RT) appeared to control vaginal failures in all stages, pelvic RT did not impact DSS.
  • CONCLUSIONS: This highly aggressive uterine malignancy warrants comprehensive surgical staging to assess tumor dissemination followed by systemic therapy in patients with both early and advanced stage disease.
  • [MeSH-major] Carcinosarcoma / therapy. Uterine Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Carcinoma, Endometrioid / pathology. Carcinoma, Endometrioid / therapy. Combined Modality Therapy. Disease-Free Survival. Female. Humans. Middle Aged. Neoplasm Staging. Retrospective Studies. Treatment Outcome. Young Adult

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  • (PMID = 19896181.001).
  • [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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23. Kelly MG, O'Malley D, Hui P, McAlpine J, Dziura J, Rutherford TJ, Azodi M, Chambers SK, Schwartz PE: Patients with uterine papillary serous cancers may benefit from adjuvant platinum-based chemoradiation. Gynecol Oncol; 2004 Dec;95(3):469-73
Hazardous Substances Data Bank. CARBOPLATIN .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • OBJECTIVE: The coexistence of minimal uterine disease and extrauterine metastases is common in patients with uterine papillary serous carcinoma (UPSC).
  • The purpose of this study was to evaluate different therapeutic options in surgically staged patients.
  • RESULTS: Twenty-three (45%) cases were International Federation of Gynecology and Obstetrics (FIGO) stage IA, seven (15%) were stage IIIA, one (2%) was stage IIIC, and nine (18%) stage IV.
  • Additionally, 11 of these 51 patients (21%) were diagnosed with two cancers: a stage IA UPSC and concomitant advanced stage serous cancer of the ovary, fallopian tube, or peritoneum.
  • Stage IA patients with no cancer in the hysterectomy specimen (defined as no residual uterine disease) had no recurrences (n = 10) regardless of treatment.
  • There was a trend toward increased survival in stage IA patients with residual uterine disease who were treated with chemoradiation (concomitant vaginal brachytherapy and platinum-based chemotherapy).
  • All patients with advanced stage UPSC (stage IIIC or IV or two primary cancers) did poorly regardless of treatment.
  • CONCLUSION: Our findings suggest that stage IA patients with no residual uterine disease may be observed.
  • Stage IA patients with residual uterine disease may benefit from chemoradiation.
  • More effective treatment needs to be identified for advanced stage UPSC.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cystadenocarcinoma, Papillary / therapy. Cystadenocarcinoma, Serous / therapy. Uterine Neoplasms / therapy
  • [MeSH-minor] Aged. Aged, 80 and over. Brachytherapy. Carboplatin / administration & dosage. Chemotherapy, Adjuvant. Female. Humans. Hysterectomy. Middle Aged. Neoplasm Staging. Radiotherapy, Adjuvant. Retrospective Studies

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  • (PMID = 15581948.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] BG3F62OND5 / Carboplatin
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24. Dhar KK, NeedhiRajan T, Koslowski M, Woolas RP: Is levonorgestrel intrauterine system effective for treatment of early endometrial cancer? Report of four cases and review of the literature. Gynecol Oncol; 2005 Jun;97(3):924-7
Hazardous Substances Data Bank. LEVONORGESTREL .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Is levonorgestrel intrauterine system effective for treatment of early endometrial cancer? Report of four cases and review of the literature.
  • BACKGROUND: Intrauterine progesterone therapy potentially provides a simple alternative treatment for women with Stage I Grade I endometrial cancers who are at high risk for surgery.
  • The case histories of four women with early endometrial cancer primarily treated with levonorgestrel intrauterine system (Mirena) are reported and the literature reviewed.
  • CASES: Four women had Stage I grade 1 endometrial adenocarcinoma with positive progesterone receptor.
  • All were assessed to be in American Society of anaesthesiologists risk class IV.
  • One of three women who did not respond to treatment subsequently had a vaginal hysterectomy, which showed endometrial cancer with superficial myometrial invasion.
  • CONCLUSION: This report raises doubts about the effectiveness of intrauterine progesterone therapy as a definitive alternative for the treatment of early endometrial cancer.
  • [MeSH-major] Antineoplastic Agents, Hormonal / administration & dosage. Carcinoma, Endometrioid / drug therapy. Endometrial Neoplasms / drug therapy. Levonorgestrel / administration & dosage
  • [MeSH-minor] Aged. Aged, 80 and over. Drug Administration Routes. Female. Humans. Middle Aged. Uterus

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  • (PMID = 15943993.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 5W7SIA7YZW / Levonorgestrel
  • [Number-of-references] 13
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25. Sorbe B, Bohr L, Karlsson L, Bermark B: Combined external and intracavitary irradiation in treatment of advanced cervical carcinomas: predictive factors for local tumor control and early recurrences. Int J Oncol; 2010 Feb;36(2):371-8
International Agency for Research on Cancer - Screening Group. diagnostics - Histopathology and cytopathology of the uterine cervix - digital atlas .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Combined external and intracavitary irradiation in treatment of advanced cervical carcinomas: predictive factors for local tumor control and early recurrences.
  • In a series of 131 primary cervical carcinomas in FIGO stages I-IV suitable for combined external pelvic and intraluminal cervical-vaginal brachytherapy predictive and prognostic factors were analyzed with regard to locoregional tumor control, recurrences and survival data.
  • Patients with prior surgery or patients treated with external beam therapy alone were excluded from this series.
  • Concomitant chemotherapy was given to 47 patients (36%).
  • The external beam therapy was given with a four-field technique (50-60 Gy) and brachytherapy with high dose-rate (Ir-192) using a ring applicator set.
  • The dose (18-30 Gy) was specified according to the rules in ICRU 38 (a minimum dose to the surface of the target volume).
  • A CT-based 3-D dose-planning system (TMS) was used for the external beam therapy and for the brachytherapy planning (PLATO).
  • One hundred and eight tumors were in FIGO stages I-II and 23 tumors in stages III-IV.
  • A lower FIGO stage, chemoradiotherapy, squamous cell histology, diploid DNA-profile, a higher brachytherapy dose, more brachytherapy fractions and a higher total combined irradiation dose were favorable factors with regard to the risk of tumor recurrences.
  • The overall survival rate was 50% and the cancer-specific survival rate 65%.
  • Chemoradiotherapy therapy versus radiotherapy alone and squamous cell carcinomas versus adenocarcinomas were associated with improved survival rates.
  • [MeSH-major] Brachytherapy / methods. Carcinoma / radiotherapy. Neoplasm Recurrence, Local / radiotherapy. Radiotherapy / methods. Uterine Cervical Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Antineoplastic Agents / therapeutic use. Combined Modality Therapy. Female. Humans. Kaplan-Meier Estimate. Middle Aged. Neoplasm Staging. Radiotherapy Dosage

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  • (PMID = 20043071.001).
  • [ISSN] 1791-2423
  • [Journal-full-title] International journal of oncology
  • [ISO-abbreviation] Int. J. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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