The psychosocial impact of cervical cancer among affected women and their partners.

This study aimed to assess the range and intensity of psychosocial concerns experienced by women with cervical cancer and their male partners. A cross-sectional survey assessed 26 couples where the woman had invasive cervical cancer stage I-IV, up to 2 years posttreatment, using a concerns questionnaire and widely used psychosocial questionnaires. Respondents indicated their concerns about the impact of the disease and treatment as well as general psychosocial impact.

Pseudomyxoma peritonei: a case series and review of the literature.

The purpose of this study was to use descriptive methodology to study the management of patients with pseudomyxoma peritonei (PMP) at the Princess Margaret Hospital. This is a case series of patients with a diagnosis of PMP treated between January 1, 1995 and December 31, 2001. A health record search using the morphology code for PMP was done and identified 70 patients.

How important is removal of the parametrium at surgery for carcinoma of the cervix?

Objectives: The aims of this study were (1) to determine the incidence and factors predictive for pathologic parametrial involvement in clinical stage IA1/2 and IB1 cervical cancer after radical surgery and (2) to identify a population at low risk for pathologic parametrial involvement.

Methods: All patient information was collected prospectively and extracted from a cervical cancer radical surgery database. Selection criteria for surgery were generally based upon tumor size, with the cutoff for surgery between 3 and 4 cm.

Oncologists' use of quality of life information: results of a survey of Eastern Cooperative Oncology Group physicians.

Purpose: Objectives of this study were to obtain data from Eastern Cooperative Oncology Group (ECOG) oncologists regarding their views on quality of life (QOL) information; perform psychometric testing on the MD-QOL questionnaire, develop a model to describe oncologists' willingness to use QOL information and propose data-based interventions to facilitate use of QOL information in clinical decision-making.

Methods: A self-administered questionnaire, MD-QOL, designed to assess physician perspective on QOL information was mailed to a random sample of 500 oncologists, members of ECOG; 271 responded.

Results: Oncologists' attitude, current behaviour, knowledge of QOL data, and reported willingness to use QOL can be measured using MD-QOL.

Changes in the demographics and perioperative care of stage IA(2)/IB(1) cervical cancer over the past 16 years.

Objectives: The aim of this study was to determine whether there have been any significant changes in the demographics and perioperative care of FIGO stage IA(2)/IB(1) cervical cancer over the past 16 years and, if so, to quantify them.

Methods: Since July 1984, all patients with FIGO stage IA(2)/IB(1) cervical cancer undergoing radical surgery by members of our division have been entered into a prospective database. Selection for surgery has been unchanged over the past 16 years.

Quality-of-life information and clinical practice: the oncologist's perspective.

Objective: To collect information from a group of Canadian oncologists about their perspectives on quality of life (QOL) and QOL information.

Design: A self-administered questionnaire (MD-QOL) containing 75 items with a 4-point Likert categorical response scale was administered by mail using Dillman survey methodology to all staff oncologists at a single institution.

Setting: A large Canadian cancer care centre (Princess Margaret Hospital, Toronto).

A preliminary survey of oncologists' perceptions of quality of life information.

Quality of life (QOL) of cancer patients has become the focus of increasing research in oncology, and a frequently measured endpoint in clinical trials. Very little attention has been paid to the perspective of physicians on quality of life information, and its role in clinical decision-making. This report describes the findings of research focused on exploring the perspectives of physicians about quality of life information that is available for cancer patients.

Review of autologous and allogeneic blood transfusion practices in patients undergoing radical hysterectomy.

To review the practice and predictors of autologous (AUT) and allogeneic blood transfusion in patients undergoing radical hysterectomy (RH). All patients undergoing RH between April 1, 1991 and March 31, 1995 were identified by the hospital blood bank. Clinical and tumour characteristics were abstracted from the charts of endometrial cancer patients, and amalgamated with our cervical cancer RH database.

Physicians' perspective on quality of life: an exploratory study of oncologists.

There is an implicit assumption that physicians incorporate quality of life (QOL) information in clinical decision-making. However, very limited data exists on how physicians view QOL information and how they actually use it. To explore this issue, an in-depth study was conducted using a semi-structured interview guide, with 60 oncologists in Canada and the USA.

Laparoscopic ovarian transposition.

Preservation of ovarian function is both safe and feasible in many young women with pelvic malignancies. Techniques utilized to transpose the ovaries to date have uniformly required a laparotomy either at the time of surgical treatment or as a separate operation in patients about to undergo pelvic radiotherapy. We report our preliminary results in 3 patients who underwent laparoscopic ovarian transposition and pelvic lymphadenectomy as part of an experimental protocol using intracavitary radiation alone in patients with small node negative stage 1B cervical carcinoma desiring preservation of fertility.

Clinical review of adult granulosa cell tumors of the ovary.

Granulosa cell tumors are uncommon neoplasms that are characterized by their long natural history and for their tendency to recur years after an apparent clinical cure. As such they are difficult tumors to study. In the majority of cases, the initial therapy is surgical although the extent of the necessary procedure remains controversial.

Differences in the morbidity of radical hysterectomy between gynecological oncologists.

A multivariate analysis was performed on 405 patients who underwent radical hysterectomy and pelvic lymphadenectomy by eight surgeons for stage IB cervical carcinoma, to determine the influence of primary surgeon on morbidity. Patient characteristics analyzed (mean/proportion) were age (41 years), quetelet index (25.4), American Society of Anesthesiologists classification of physical status (0.

Etiology, epidemiology, risk and prognostic factors, screening, and imaging of gynecologic cancers.

This review presents some of the articles published over the past year pertaining to the etiology, epidemiology, risk and prognostic factors, screening, and imaging techniques of gynecologic cancer. The most significant advances in this period were made in the area of the genetics of gynecologic cancers and the factors that control tumor growth. New technologies are being developed in this area, which may eventually produce therapies aimed at controlling gynecologic cancers at the genetic or cellular level.

The prognostic importance of site and type of radiation-induced bowel injury in patients requiring surgical management.

A multivariate analysis was performed to determine the outcome, and factors prognostic for outcome, in 57 patients requiring surgical intervention for radiation bowel injury. The actuarial 2- and 5-year cause-specific survival (CSS) was 76 and 74%, respectively, with a median follow-up of 62 months for the survivors. The median time from surgery to death from complications was 4 months.

Changing concepts in the management of vulvar cancer.

Vulvar carcinoma varies widely in its clinical presentations and prognosis. The reviewed literature outlines the achievements of conventional surgery, radiation, or chemoradiation therapy in its management. Currently therapeutic concepts are evolving.

Concurrent radiation and chemotherapy in vulvar carcinoma.

Between June 1984 and February 1988 the role of radiation with concurrent infusional 5-fluorouracil with or without mitomycin C (CT-RT) was examined in 33 patients with vulvar cancer. The median duration of follow-up is 16 months (range 5 to 45 months). Nine received adjuvant postsurgical CT-RT and none has relapsed in the radiation field.

Current therapy for dysgerminoma of the ovary.

It is important that therapy of ovarian dysgerminoma be optimized because of the young age of women affected and the threat that therapy may pose to fertility. Our understanding of dysgerminoma has improved, so that treatment schemes with better therapeutic ratio may now be used. Approximately 65% of patients present with stage IA disease.

Pelvic exenteration.

Exenteration, or complete excision of the pelvic viscera, is an ultra-radical surgical procedure intended for curative treatment of the patient with advanced pelvic malignancy--primary or recurrent. At the time of introduction of this procedure, enthusiasm for its use was marred by the high incidence of serious surgical morbidity and mortality, which approached the five-year survival rate. With more careful physiological and psychological selection of patients, concentration of this kind of procedure in centres familiar with its use, improved urinary conduit techniques and careful attention to covering the pelvic floor with omentum and/or synthetic materials, the morbidity and mortality rate has been significantly reduced thus making exenteration a more acceptable treatment option to a wider spectrum of patients.

Vinblastine, bleomycin, and cisplatin in malignant germ cell tumors of the ovary.

Fourteen patients with malignant ovarian germ cell tumors were treated with vinblastine, bleomycin, and cisplatin. A complete clinical response was achieved in all 14 patients; however, 1 patient had small macroscopic disease present at second-look laparotomy. One patient died of bleomycin pulmonary toxicity.

Adenocarcinoma in a cecal neovagina--complication of irradiation: report of a case and review of literature.

A 42-year-old woman is presented with her fifth primary pelvic carcinoma, occurring in an irradiated cecal neovagina. Previously reported neovaginal carcinomas are reviewed. The possible etiologies are examined.

Appendicitis masking as recurrent squamous cell carcinoma of the cervix.

The diagnosis of pelvic recurrent squamous cell carcinoma of the cervix is made on the basis of clinical assessment and radiologic confirmation. Occasionally the diagnosis is confused with sequelae of radiation therapy. The authors describe the symptoms and signs of appendicitis mimicking recurrent squamous cell carcinoma in a 43-year-old female.

Stage I endometrial adenocarcinoma: treatment results in 835 patients.

A 16-year review of 835 patients with Stage I adenocarcinoma of the uterus revealed histologic grade and depth of myometrial invasion to be salient prognostic factors. Sixteen percent of patients developed recurrent disease and despite aggressive treatment, only 10% of these survived. Preoperative or postoperative radium decreased the incidence of vault recurrence.

An analysis of "long-term" follow-up results in patients with cervical intraepithelial neoplasia treated by cryotherapy.

Two thousand eight hundred thirty-nine patients who had been treated by cryotherapy for cervical intraepithelial neoplasia (CIN) in nine different institutions were followed longitudinally after three negative Papanicolaou smears to ascertain the risk of recurrence. The cumulative risk of developing CIN after successful cryotherapeutic management of CIN was 0.41% at year 5, 0.