History Of Gynecologic Cancer Research Articles

Lack of Association between −460 C/T and 936 C/T of the Vascular Endothelial Growth Factor and Angiopoietin-2 Exon 4 G/A Polymorphisms and Ovarian, Cervical, and Endometrial Cancers

Tumor growth, which employs a number of regulators, requires the formation of new blood vessels. The most important regulators are vascular endothelial growth factor (VEGF) and angiopoietin-2 (ANGPT-2). DNA sequence variations in VEGF and ANGPT-2 genes may lead to altered productions and/or activities of these genes. In this study, we aimed to determine the polymorphic effects of the changes in the VEGF -460 C/T, VEGF 936 C/T, and ANGPT-2 exon 4 G/A, which we perceive as risk factors in the progress and metastasis of cancer, on the gynecologic cancer patients in the Turkish population. Forty-seven ovarian, 32 cervical, and 21 endometrial cancer patients and 106 healthy controls were studied. The genomic DNA was extracted from the whole blood by using DNA extraction techniques. DNA samples were analyzed by polymerase chain reaction and restriction fragment length polymorphism. There were no significant differences between any of the three types of gynecologic cancer patients and controls in terms of the distribution of VEGF -460, VEGF 936, and ANGPT-2 genotypes and alleles (p > 0.05). Odds ratios (ORs) were calculated by logistic regression analysis in comparison with the most common homozygote genotype observed in the studied population. No evidence of a relationship that would constitute a risk factor (p > 0.05) was found between genotype and allele frequencies of patients and controls for VEGF -460, VEGF 936, and ANGPT-2 genes. A multivariable logistic regression analysis with the involvement of covariant factors, such as the history of gynecologic cancer and/or other cancer types in the family, stages of tumor, smoking habits, and existence of other diseases, did not change the results. The present study is the first case-control study of VEGF and ANGPT-2 polymorphisms in relation to ovarian, cervical, and endometrial cancers.

Gynecologic cancer treatment and the impact of cancer-related infertility

Objective The objective of this study was to empirically assess the emotional and sexual impact of cancer-related infertility in women with a history of gynecologic cancer. Method Women with a history of gynecologic cancer were approached during their gynecologic oncology clinic appointment; they were provided a description of the study and asked to participate. All participants completed a one-time self-report survey. We present data acquired via the following methods: Center for Epidemiologic Studies-Depression Scale (CES-D), Impact of Events Scale (IES), Modified Inventory of Traumatic Grief (M-ITG), Female Sexual Function Index (FSFI), and the Menopausal Symptom Checklist. Results The study sample consisted of 20 women, ages 27 to 49 years (mean, ∼40 years), who had undergone treatment for cervical (40%), ovarian (20%), or uterine (40%) cancer. Forty percent of the sample reported depressive symptoms as measured by the CES-D, with 35% of the women experiencing moderate to severe levels of distress as measured by the IES. The women in this sample experienced dissatisfaction with their overall sex lives (67%), pain during vaginal penetration (62%), and low levels of sexual desire (56%). Conclusions The preliminary findings of this study indicated that feelings of depression, grief, stress, and sexual dysfunction are being experienced by women with a history of gynecologic cancer who have lost their fertility as a result of their cancer treatment.

Brief report: total pelvic exenteration--A retrospective clinical needs assessment.

This clinical needs assessment retrospectively identified 11 women with a history of gynecologic cancer who had undergone pelvic exenteration within the last 4 years, of whom six were available for interview. All patients agreed to telephone interviews, which lasted approximately 45-60 min and addressed their surgical experience. Seven themes emerged from the interviews: concerns about recovery, complications, ostomies, social support, sexuality, disclosure, and fear. The findings of our needs assessment concur with the existing literature noting decreased sexual interest/activity and difficulties with body image. An improvement in mood and an increase in activities over time postoperatively were noted. We also found reluctance by participants to disclose information about their exenterative procedure.

Breast Cancer Risk Assessment in Indigent Women at a Public Hospital

Objectives. The aims of this study were to estimate the 5-year breast cancer risk in indigent women presenting to the gynecology clinic at a public hospital and to determine whether routine use of the computerized Gail model for screening in this population identifies individuals at increased risk.Methods. A prospective study was performed over 1-year period (7/99–7/00) of women presenting to the gynecology and gynecologic oncology clinics at a public hospital. All women ages 35–60 years with no personal history of breast cancer were offered testing utilizing the computerized Gail model provided by the National Cancer Institute. Age, race, age at menarche, age at first live birth, number of first-degree relatives with breast cancer, number of breast biopsies, and number of breast biopsies diagnosed as atypical hyperplasia were documented. A calculated 5-year risk ≥1.67% was considered high-risk.Results. In all, 319 women enrolled, 121 (38%) with a history of gynecologic cancer and 198 (62%) without. The mean age was 46.9 years (range 35–60), and 28 (8.8%) patients had at least one first-degree relative with breast cancer. Ethnicity included 206 (65%) African American, 52 (16%) Caucasian, 45 (14%) Hispanic, and 16 (5%) oriental. Eight (2.5%) women had a 5-year risk ≥1.67%. The mean 5-year risk for all patients was 0.68% (0.55% for African American versus 0.90% for Caucasian/other, P < 0.001).Conclusion. Estimating 5-year breast cancer risk using the Gail model in indigent women may identify individuals at increased risk. Compared to other patients, African American women appeared to have a lower estimated 5-year risk according to the currently available model. The routine utilization of the Gail model deserves further investigation in the indigent minority population.

Are women with a history of gynecologic cancer at increased risk for colorectal neoplasia?

Are women with a history of gynecologic cancer at increased risk for colorectal neoplasia?

Are women with a history of gynecologic cancer at increased risk for colorectal neoplasia?

Are women with a history of gynecologic cancer at increased risk for colorectal neoplasia?

Colorectal cancer screening in women with a past history of gynecologic cancer

Colorectal cancer screening in women with a past history of gynecologic cancer

Colorectal cancer screening in women with a past history of gynecologic cancer

Colorectal cancer screening in women with a past history of gynecologic cancer

A New Portal for Gynecologic Laparoscopy

We used the middle upper abdomen as a primary port insertion as an alternative portal for laparoscopy and multiport operative pelviscopy in 188 women who were at high risk for subumbilical adhesions because of previous abdominal surgeries or history of gynecologic cancer. Primary cannula insertion was in the middle upper abdomen between xyphoid process and umbilicus (Lee-Huang point). This was the single entry site for the Veress needle and primary laparoscopy port. In 184 (98.4%) of 188 women surgery was performed without complications. No procedure was converted to laparotomy due to visceral or vascular injuries. Two omentum injuries from primary port insertion were repaired with bipolar electrocoagulation; a colon injury was repaired with laparoscopic sutures. In our experience, this laparoscopic port is effective in women who have had abdominal surgery or gynecologic malignancy.

Abdominal Sacral Colpopexy in Patients with Gynecologic Cancer: Report of 25 Cases with Long-Term Follow-Up and Literature Review

Objective.The aim of this study was to evaluate abdominal sacral colpopexy performed in conjunction with radical pelvic surgery for gynecologic cancer.Methods. Over a 9-year period from 1990 to 1999 25 patients with invasive gynecologic cancer and concomitant uterovaginal or vaginal vault prolapse underwent surgery. These patients were compared to a series of 50 patients with no history of gynecologic cancer who underwent abdominal sacral colpopexy during the same period.Results. All surgeries were performed without intraoperative complication. There was one failed vault suspension in each group and no postoperative mesh complications as a result of radical pelvic surgery or postoperative radiation or chemotherapy.Conclusion. Abdominal sacral colpopexy may be safely performed along with radical pelvic surgery for gynecologic cancer without an increase in intra- or postoperative morbidity even if patients require chemotherapy or radiation therapy after surgery.

Laparoscopy using the left upper quadrant approach

To describe a technique of laparoscopy and multiport operative pelviscopy using left upper quadrant primary port insertion. Retrospective evaluation (Canadian Task Force classification II-2). Private gynecologic oncology practice. Ninety women with a history of gynecologic cancer and at least one laparotomy. Laparoscopy and operative pelviscopy. The procedure was performed using the left upper quadrant as a single entry site for the Veress needle and primary laparoscopy port. In 88 women it was performed without complication. One woman experienced transverse colon injury from primary port insertion, which was repaired immediately by laparotomy. A second patient had a rectosigmoid injury that required temporary colostomy at laparotomy. Operative laparoscopy using the left upper quadrant approach seems to be safe in patients with advanced gynecologic malignancy. (J Am Assoc Gynecol Laparosc 6(3):323-325, 1999)

Gynecologic cancers metastatic to the breast

Background: We report a series of gynecologic cancers metastatic to the breast, illustrating the diagnostic and prognostic implications of this rare event. Study Design: By reviewing the gynecologic oncology data base, we identified 10 women with gynecologic cancer metastatic to the breast who were treated at Indiana University School of Medicine between August 1978 and February 1995. Medical records were reviewed for pertinent data concerning the presentation, evaluation, and treatment of the primary gynecologic malignancy and the metastatic breast tumor. Results: The mean patient age was 56.8 years (range, 30–80 years). The most common gynecologic malignancy was ovarian cancer (five patients), followed by cervical cancer (two patients) and cancers of the vagina, endometrium, or peritoneum (one patient each). A palpable solitary breast mass was found in 8 of 10 patients (80%), and the upper outer quadrant of the breast was the most common site of tumor involvement. One woman presented with examination findings resembling inflammatory breast cancer, and one patient presented with multiple firm subcutaneous nodules. Despite further treatment, which in all cases consisted of systemic chemotherapy, 83% of the patients died with a breast metastasis within 1 year of presentation. Conclusions: Secondary breast malignancy should be suspected in any patient with a breast tumor and a known history of gynecologic cancer. A breast metastasis implies widespread tumor dissemination and a poor prognosis. Radical breast surgery should be avoided.