Risk factors for venous thromboembolism in patients undergoing neoadjuvant chemotherapy as treatment for ovarian cancer.

Objective: During the treatment of ovarian cancer, the risk of venous thromboembolism (VTE) post operatively is well established, however, patients may be at even greater risk during neoadjuvant chemotherapy (NACT). This study aimed to determine the incidence and timing of VTE amongst patients undergoing NACT, whether there was an association with survival, and examine risk factors associated with the development of VTE.

Study Design: This was a retrospective cohort study of patients diagnosed with ovarian, fallopian tube and primary peritoneal cancer receiving neoadjuvant chemotherapy betweenApril 2011 and April 2022 at a gynaecological cancer centre in England.

A meta-analysis evaluating the intra-operative use of collagen-fibrin sealants during inguino-femoral lymphadenectomy: A new direction in reducing post-operative morbidity or another disappointment?

Background: The intra-operative application of collagen-fibrin sealants (CFS) has emerged as a promising intervention to reduce post-operative morbidity associated with inguino-femoral lymph node dissection (IFLND).

Aim: The purpose of this systematic review was to ascertain the efficacy and safety of CFS to reduce lymphatic morbidity after IFLND.

Design: We systematically searched MEDLINE, SCOPUS, ClinicalTrials.

Sentinel lymph node biopsy alone in the management of early cervical carcinoma.

Objective: Sentinel lymph node (SLN) biopsy aims to assess lymph node status with reduced surgical morbidity. The aim of the study was to determine the accuracy and safety of SLN biopsy in the management of early cervical carcinoma using a double technique (technetium-99m (Tc-99m) nanocolloid and methylene blue dye injection).

Methods: This was a 10-year study from January 2009 to January 2019 that recruited 103 consecutive women undergoing surgery for early cervical carcinoma, FIGO 2009 stage IA1 (grade 3, and grade 2 with lymphovascular space invasion) to IB1 (<2 cm), at the West Kent Gynaecological Oncology Centre, Maidstone, UK.

Location of Sentinel Lymph Node in Cervical Carcinoma and Factors Associated With Unilateral Detection.

Objective: The aims of this study were to assess locality of the sentinel lymph node (SLN) in cervical carcinoma and examine factors affecting bilateral SLN detection.

Methods: This was a retrospective review of SLN data (anatomical location, count and laterality) in patients with early-stage cervical cancer (International Federation of Gynecology and Obstetrics stage IA1 with lymphovascular space invasion to stage IIA) using intraoperative gamma probe and blue dye. The preoperative single-photon emission computed tomography with computed tomography was used to detect laterality, number of the SLNs, and rare locations.

A prospective single-center study of sentinel lymph node detection in cervical carcinoma: is there a place in clinical practice?

Objective: To establish the accuracy of sentinel lymph node (SLN) detection in early cervical cancer.

Materials And Methods: Sentinel lymph node detection was performed prospectively over a 6-year period in 86 women undergoing surgery for cervical carcinoma by the combined method (Tc-99m and methylene blue dye). Further ultrastaging was performed on a subgroup of 26 patients who had benign SLNs on initial routine histological examination.

Fertility-sparing surgery for early cervical cancer-approach to less radical surgery.

Objective: To evaluate whether certain patients with early-stage cervical cancer are candidates for less radical surgery when considering fertility-sparing surgery.

Design: Prospective cohort study.

Setting: Two gynecologic cancer centers (St Thomas' Hospital, London; and West Kent Gynaecological Cancer Centre, Maidstone).

Laparoscopically assisted vaginal hysterectomy (LAVH) versus total abdominal hysterectomy (TAH) in endometrial carcinoma: prospective cohort study.

Objective: To determine the feasibility and safety of laparoscopically assisted vaginal hysterectomy in the treatment of presumed stage I endometrial cancer.

Study Design: This was a prospective cohort study without randomization of 182 consecutive patients who underwent surgery for early endometrial cancer or atypical hyperplasia at the West Kent Gynaecological Oncology Centre, UK. Seventy-four had laparoscopically assisted vaginal hysterectomy and bilateral salpingo-oophorectomy (BSO), and 108 had a total abdominal hysterectomy and bilateral salpingo-oophorectomy.

Well differentiated endometrioid adenocarcinoma of the uterus: a cancer unit or centre case?

Objective: The purpose of this study was to investigate what proportion of cases showing a well differentiated endometrioid endometrial adenocarcinoma in the hysterectomy specimen removed at two UK cancer centres had adverse pathological features or advanced stage disease at the time of presentation.

Study Design: Ninety-eight patients who were operated on at either the South East London Cancer Centre, London or the Kent Oncology Centre, Maidstone had a histological diagnosis of well differentiated (grade 1) endometrioid adenocarcinoma in their hysterectomy specimen. These were identified using the multidisciplinary meeting database as well as the respective pathology department databases.

Accuracy of frozen section diagnosis at surgery in pre- malignant and malignant lesions of the endometrium.

Objective: The purpose of this study was to correlate the histological diagnosis made during intraoperative frozen section examination of hysterectomies with atypical hyperplasia or carcinoma, with the definitive paraffin section histology.

Study Design: Frozen section pathology results of patients with a preoperative biopsy showing atypical hyperplasia or endometrial carcinoma (87 patients) were compared retrospectively with paraffin section pathology findings. Those patients with curettage specimens showing atypical hyperplasia or curettings suspicious of endometrioid carcinoma had intraoperative frozen section to determine whether an invasive lesion was present and whether they required pelvic lymphadenectomy.

Tumour M2-PK as a predictor of surgical outcome in ovarian cancer, a prospective cohort study.

Background: Optimal cytoreduction is a major prognostic factor in ovarian cancer; several clinical, radiological and biochemical predictors have been studied. Tumour M2-PK (TU M2-PK) is over-expressed in tumour cells and can be detected in plasma samples but its role in ovarian cancer has not yet been evaluated.

Objectives: To assess the potential clinical applications of TU M2-PK in ovarian cancer particularly in relation to surgical cytoreduction.

M2-PK as a novel marker in ovarian cancer. A prospective cohort study.

Background: Pyruvate kinase isoenzyme M2-PK is instrumental to tumour metabolism and hence over-expressed in tumour cells leading to detectable plasma concentrations.

Objectives: To assess the degree of association between M2-PK plasma concentrations and ovarian cancer and to determine the cut-off values for its sensitivity and specificity for differentiating between benign and malignant ovarian disease.

Settings: The Gynaecological Cancer Centre at both King's College and St.

Development of an evidence-based algorithm for the management of cervical cancer.

Objective: To develop a description of the management of cervical cancer to support locally developed, regional guidelines and to identify the level of primary research evidence to support it.

Design: Development of a flow-charted algorithm, using regional guidelines and clinician consensus. A Medline literature search for primary research was done to validate the algorithm and selection of papers, to verify if they were valid according to pre-defined criteria and to compare algorithm management with an alternative.

Development of an evidence-based algorithm for the management of ovarian cancer.

Objective: To describe the management of ovarian cancer to be undertaken by a gynaecologist and to describe the highest level of primary research evidence supporting it.

Design: Use of regional guidelines and semi-structured interviews with gynaecological oncologists to devise a flow-chart algorithm for management. Use of an algorithm to identify the key research questions and to define search strategies for primary research, which was assessed using pre-defined criteria for validity.

Cholera toxin-induced alteration of the phenotype and behaviour of an ovarian carcinoma cell line, SR8.

Cholera toxin (CT) has been reported to cause a variety of effects on several different cell types. Recently, CT has been shown to increase the susceptibility of ovarian carcinoma cells to cytotoxicity mediated by a variety of effector cells (natural killer, lymphokine-activated killer cells and tumour-associated lymphocytes derived from ascites of ovarian cancer patients) of both autologous and allogenic background. In the present study, CT demonstrated several effects on a newly established ovarian carcinoma line (SR8)1 when added to the culture medium at a concentration of 12.

IL-2 enhances standard IFNgamma/LPS activation of macrophage cytotoxicity to human ovarian carcinoma in vitro: a potential for adoptive cellular immunotherapy.

Objective: The objective was to evaluate the enhancement of human peritoneal macrophage cytotoxic in vitro activity by the addition of interleukin-2 (IL-2) to the standard interferon gama (IFNgamma) and lipopolysaccharide (LPS) activation procedure used for cellular adoptive immunotherapy in a human ovarian cancer system. This cytotoxic effect of these activated macrophages was tested on cells from ovarian cancers of various stages, histology type, and grade, both prior to chemotherapy and at recurrence, in ovarian carcinoma cells lines and normal cells. Increased activation of the macrophage may make it a better candidate for intraperitoneal cellular adoptive immunotherapy as a component of ovarian cancer therapy.

Malignant potential of gigantic condylomatous lesions of the vulva.

A diagnostic and therapeutic approach in the identification of malignant lesions and the types of HPV in 11 patients with gigantic condylomatous vulvar protuberances is presented. Different histological types of squamous cell vulvar carcinoma have been found in 8 (72.7%) cases: condylomatous (4), verrucous (3) and basaloid type of the carcinoma (1).

Tumor lymphocytes in patients with advanced ovarian cancer: changes during in vitro culture and implications for immunotherapy.

Tumor specimens and ascites of patients with advanced ovarian cancer were utilized to obtain both primary ovarian carcinoma cell cultures and lymphocytes: tumor-infiltrating lymphocytes (TILs) from solid tumor tissue and tumor-associated lymphocytes (TALs) from peritoneal fluid. Tumor lymphocytes were grown in coculture with autologous tumor cells and recombinant human IL-2 (rhIL-2) for up to 4 weeks and at weekly intervals these were examined with respect to phenotype and cytotoxicity. The phenotype was studied using flow cytometry for a variety of human immunocompetent cell surface markers (CD3, CD4 CD8, CD16, CD56, TCR alphabeta, TCRgammadelta).

Heat-shock protein 27 (HSP27) and its role in female reproductive organs.

Heat shock, other environmental and pathophysiological stress stimulate synthesis of heat shock proteins (HSP) family. These proteins enable the cell to survive and recover from stressful conditions but as yet incompletely understood mechanisms. Beside its role in thermotolerance, it plays a role in cell proliferation and drug resistance which makes this protein of special clinical interest.