Management of squamous cell vulvar cancer: a review.

Squamous cell vulvar cancer is a rare gynecologic malignancy. Standard treatment for early stage disease consists of wide radical excision of the primary tumor with inguinal-femoral lymphadenectomy or sentinel lymph node mapping/biopsy. Because of the general paucity of patients with advanced vulvar cancer, there is no standard therapy for advanced disease and therefore treatment should be individualized.

Chemotherapy of vulvar cancer: a review.

Squamous cell carcinoma of the vulva is a rare disease with good prognosis if diagnosed early. The standard primary therapy is surgery. Neoadjuvant radiation or chemotherapy has been used to achieve resectability of the tumor and to decrease the radicality of the surgery.

Platinum-based combination chemotherapy for the treatment of advanced-stage squamous cell carcinoma of the vulva.

Background: Chemoradiation is an alternative to radical vulvectomy with en bloc node dissection for advanced vulvar cancer. We report a case of complete clinical and pathologic response with chemotherapy alone in a patient with advanced vulvar cancer.

Case: A middle-aged woman known to have had human immunodeficiency virus (HIV) for 10 years was newly diagnosed with advanced-stage squamous carcinoma of the vulva.

Merkel cell carcinoma in a patient with noninvasive vulvar Paget's disease.

We present the first case of inguinal Merkel cell carcinoma of unknown primary origin in a patient with vulvar Paget's disease. Correlation with immune suppression of both entities warrants further investigation. Additionally, this case highlights the value of ultrasound scanning in the detection of inguinal metastasis.

Stage III uterine carcinosarcoma: 2009 International Federation of Gynecology and Obstetrics Staging System and Prognostic Determinants.

Objectives: (1) To determine the significance of positive peritoneal cytology and pelvic versus para-aortic lymph node involvement in uterine carcinosarcoma. (2) To evaluate the impact of isolated retroperitoneal lymph node involvement (IIIC-N) versus retroperitoneal lymph node involvement plus other evidence of extrauterine disease spread (IIIC-N+) on survival in patients with stage IIIC uterine carcinosarcoma.

Methods: Data were extracted from the Surveillance, Epidemiology, and End Results database between 1988 and 2005.

Stage IIA1 versus stage IIA2 cervical cancer: does the new staging criteria predict survival?

Objective: (1) To determine the correlation of 2008 International Federation of Gynecology and Obstetrics staging system with survival in patients with stage IIA cervical cancer, (2) to elucidate the treatment patterns in stage IIA1 and stage IIA2 cervical cancer, and (3) to investigate whether radical hysterectomy or radiation influenced overall survival.

Methods: Data were extracted from the Surveillance, Epidemiology and End Results database between 1988 and 2005. Statistical analysis used χ test, Kaplan-Meier method, Cox regression, and logistic regression.

Life-threatening clostridial sepsis in a postmenopausal patient with degenerating uterine leiomyoma.

Clostridium perfringens is a fulminant infection that affects patients with a high rate of morbidity and mortality. Fortunately, C. perfringens-associated sepsis and death in the gynecologic patient is rarely encountered.

Feasibility of extension of platinum-free interval with weekly bolus topotecan and subsequent platinum retreatment outcomes in recurrent ovarian cancer.

Purpose: The goal of this study was to evaluate the outcomes and response in a cohort of patients with presumed platinum-sensitive disease who were subsequently retreated with platinum after receiving weekly bolus topotecan at the time of initial recurrence.

Methods: A retrospective review of our institutional databases identified a cohort of platinum-sensitive women with recurrent ovarian and peritoneal carcinoma. Antitumor responses and toxicities were assessed for patients retreated with platinum-based chemotherapy following weekly bolus topotecan (4 mg/m²).

Racial disparities in survival among patients with germ cell tumors of the ovary--United States.

Objective(s): To compare the survival of African American (AA) and white (W) patients with malignant germ cell tumors of the ovary (OGCT).

Methods: Patients with a diagnosis of OGCT were identified from Surveillance, Epidemiology, and End Results Program (SEER) from 1988 to 2004, and were divided into African American (AA) and white (W) subgroups. Only surgically treated patients were included.

Image-guided percutaneous cryotherapy for the management of gynecologic cancer metastases.

Objective: To report the clinical response to image-guided percutaneous cryotherapy (IPC) for the palliative management of localized metastases in patients with gynecologic malignancies.

Methods: Institutional review board approval and patient consent were obtained. Gynecologic oncology patients were identified from our institution's cryotherapy database from August 2003 to August 2007.

A population-based analysis of 788 cases of yolk sac tumors: A comparison of males and females.

Yolk sac tumors (YST) are a rare and aggressive germ cell tumor. The objective of this study is to compare the patient characteristics and survival of YST in males and females. Demographic and clinicopathologic information were obtained from the Surveillance, Epidemiology, and End Results Program from 1973 to 2003.

Long-term follow-up of a randomized trial comparing concurrent single agent cisplatin, cisplatin-based combination chemotherapy, or hydroxyurea during pelvic irradiation for locally advanced cervical cancer: a Gynecologic Oncology Group Study.

Purpose: We report the long-term survival and toxicity of a randomized phase III study comparing cisplatin alone with cisplatin, flurouracil, and hydroxyurea versus hydroxyurea concurrent with pelvic irradiation for patients with locally advanced cervical cancer with pathologically negative para-aortic nodes.

Patients And Methods: Comparisons of progression-free (PFS) and overall survival (OS) between treatment arms utilized Kaplan-Meier and log-rank statistics. Relative risk estimates adjusting for prognostic factors were determined using the Cox proportional hazards regression model.

Ultrasonography-guided transvaginal endometrial biopsy: a useful technique in patients with cervical stenosis.

Background: In patients with failed dilatation and curettage due to stenotic cervix, options for endometrial sampling are limited. We propose the ultrasonography-guided transvaginal endometrial biopsy.

Cases: Two postmenopausal women presented with bleeding and failed dilatation and curettage due to a stenotic cervix.

[Treatment strategies for endometrial cancer].

This paper focuses on the controversies surrounding management of endometrial cancer, the most common carcinoma of the female genital tract. We discuss current management strategies, especially the importance of surgical staging and briefly describe ongoing prospective randomized trials. Actual treatment suggestions are attached as tables.

Hypoxia up-regulates the effects of prostaglandin E2 on tumor angiogenesis in ovarian cancer cells.

Objective: Emerging evidence supports a role for prostaglandins (PG) and their synthesizing enzyme, cyclooxygenase (COX), in tumor angiogenesis. The objective of this study was to investigate the effects of prostaglandin E(2) (PGE(2)) on the expression of vascular endothelial growth factor (VEGF) and hypoxia-inducible transcription factor-1 alpha (HIF-1alpha) genes in epithelial ovarian cancer (EOC) cells.

Methods: Two human EOC cell lines, MDAH-2774 and SKOV-3, were treated with exogenous dimethyl prostaglandin E(2) (dmPGE(2)) at two doses of 10 and 50 microg/ml and cultured for 24 h under both normoxic and hypoxic conditions.

Radiation therapy with or without chemotherapy for cervical cancer with periaortic lymph node metastasis.

The purpose of this article is to evaluate the efficacy of chemoradiation therapy (CRT) and radiation therapy (RT) alone for cervical cancer with periaortic nodal metastasis (PANM). Twenty-one patients with cervical cancer with PANM were identified. Eleven patients received concomitant CRT with cisplatin-based chemotherapy and 10 received RT alone.

Upper extremity deep vein thrombosis associated with indwelling peripheral venous catheters in gynecology oncology patients.

Objective: The goal of this study was to review the clinical presentation, management, and outcome of upper extremity deep vein thrombosis (UEDVT) in women with gynecologic malignancies who had indwelling peripheral venous access catheters.

Methods: From a retrospective review of medical records, we identified 13 patients with various gynecologic malignancies who were diagnosed with UEDVT during their disease course. We obtained tumor data, detailed information regarding the indwelling catheters used, and the diagnosis and management of UEDVT.

Inhibition of paclitaxel-induced apoptosis by the specific COX-2 inhibitor, NS398, in epithelial ovarian cancer cells.

Objective: In vitro studies have revealed that treatment of various human cancer cell lines with specific cyclo-oxygenase 2 (COX-2) inhibitors induces apoptotic cell death. It is currently proposed that the combination of COX-2 inhibitors with chemotherapeutic agents improves the efficacy of cancer treatment.

Materials And Methods: In this study we sought to determine the effects of combining paclitaxel and the COX-2 inhibitor NS398 on apoptosis of epithelial ovarian cancer (EOC) cells.

Effects of prostaglandin E(2) on proliferation and apoptosis of epithelial ovarian cancer cells.

Objective: There is strong evidence indicating that prostaglandins (PG) and their synthesizing enzyme cyclooxygenase-2 (COX-2) play an important role in tumorigenesis. The purposes of the present study were to determine the pattern of expression of COX-2 and the effect of PG treatment on proliferation and apoptosis in epithelial ovarian cancer cells.

Methods: Two epithelial ovarian cancer cell lines, MDAH-2774 and SKOV3, were grown in flasks to confluence.

Advances in ovarian cancer chemotherapy.

Traditionally, surgery and radiation represented the pillars of cancer therapy. In contrast to the European approach, in the United States chemotherapy for ovarian cancer has replaced radiation for a long time. Nevertheless, with the aim being cure of the patient, both approaches result in a sometimes severely diminished quality of life for the woman.

[Chemotherapy in metastatic or recurrent endometrial carcinoma].

Endometrial cancer is the fourth most common malignancy in women with an estimated 36,100 new cases diagnosed in the United States. The major treatment is surgical staging with hysterectomy, lymph node assessment and possible adjuvant irradiation. Systemic hormonal and chemotherapy has been reserved for women with disseminated primary disease or extrapelvic recurrence.

Combined low-dose-rate brachytherapy and external beam radiation for cervical cancer: experience over ten years.

Cervical cancer was treated with a combination of external beam and intracavitary radiation during a 10-year period at Wayne State University. Data were collected for 216 patients treated radically with external beam radiation (EBRT) and low-dose-rate brachytherapy for cervical cancer between 1980 and 1991 at Wayne State University. Patient distribution by stage was IB, 20.

Conservative surgery in a young patient with peritoneal psammocarcinoma.

Psammocarcinoma is a rare epithelial neoplasm of the ovary and peritoneum. The reported management of patients with this tumor includes radical surgery and chemotherapy. We report the case of a young woman with metastatic psammocarcinoma treated with conservative surgery who is alive 6.

Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cervical cancer.

Background And Methods: On behalf of the Gynecologic Oncology Group, we performed a randomized trial of radiotherapy in combination with three concurrent chemotherapy regimens -- cisplatin alone; cisplatin, fluorouracil, and hydroxyurea; and hydroxyurea alone -- in patients with locally advanced cervical cancer. Women with primary untreated invasive squamous-cell carcinoma, adenosquamous carcinoma, or adenocarcinoma of the cervix of stage IIB, III, or IVA, without involvement of the para-aortic lymph nodes, were enrolled. The patients had to have a leukocyte count of at least 3000 per cubic millimeter, a platelet count of at least 100,000 per cubic millimeter, a serum creatinine level no higher than 2 mg per deciliter (177 micromol per liter), and adequate hepatic function.

Cervical carcinoma metastatic to para-aortic nodes: extended field radiation therapy with concomitant 5-fluorouracil and cisplatin chemotherapy: a Gynecologic Oncology Group study.

Purpose: A multicenter trial of chemoradiation therapy to evaluate the feasibility of extended field radiation therapy (ERT) with 5-fluorouracil (5-FU) and cisplatin, and to determine the progression-free interval (PFI), overall survival (OS), and recurrence sites in patients with biopsy-confirmed para-aortic node metastases (PAN) from cervical carcinoma.

Methods And Materials: Ninety-five patients with cervical carcinoma and PAN metastases were entered and 86 were evaluable: Stage I--14, Stage II--40, Stage III--27, Stage IVA--5. Seventy-nine percent of the patients were followed for 5 or more years or died.