Prevalence of defective DNA mismatch repair and MSH6 mutation in an unselected series of endometrial cancers.

Endometrial cancer is the most common gynecologic malignancy in the United States and the most frequent extracolonic tumor in hereditary nonpolyposis colorectal cancer (HNPCC). HNPCC patients have inherited defects in DNA mismatch repair and the microsatellite instability (MSI) tumor phenotype. Sporadic endometrial cancers also exhibit MSI, usually associated with methylation of the MLH1 promoter.

Primary peritoneal carcinoma presenting as adenocarcinoma on a Pap smear. A case report.

Background: Primary peritoneal carcinoma is an uncommon malignancy that usually presents with gastrointestinal symptoms from abdominal carcinomatosis.

Case: A postmenopausal woman presented with vaginal bleeding and adenocarcinoma cells on a Pap smear. Colposcopy, endocervical and endometrial curettage, mammography, colonoscopy and pelvic ultrasound were all normal.

Phase I study of rubitecan and gemcitabine in patients with advanced malignancies.

Background: Rubitecan (9-nitrocamptothecin, 9-NC, Orathecin) and gemcitabine have single-agent activity in pancreatic and ovarian carcinoma. We conducted a phase I trial to evaluate the maximum tolerated dose (MTD) and toxicities of this combination in advanced malignancies.

Patients And Methods: Twenty-one patients with refractory or recurrent malignancies were enrolled in this dose escalation trial.

Folic acid intake from fortification in United States exceeds predictions.

In 1996, the U.S. Food and Drug Administration issued a regulation requiring that all enriched cereal-grain products be fortified with folic acid by January 1998.

Folic acid fortification, folate status and plasma homocysteine.

Folic acid fortification of enriched cereal-grain products (which became mandatory in the U.S. on January 1, 1998) was intended to increase folate intake among childbearing-aged women to reduce their risk of neural tube birth defect (NTD)-affected pregnancies.

MSI in endometrial carcinoma: absence of MLH1 promoter methylation is associated with increased familial risk for cancers.

Loss of DNA mismatch repair occurs in a variety of malignancies and is associated with genome-wide instability of microsatellite repeats, a molecular phenotype referred to as microsatellite instability (MSI). MSI is a consistent feature of colorectal and endometrial tumors from patients with hereditary non-polyposis colorectal cancer (HNPCC). Sporadic colorectal and endometrial cancers that exhibit MSI frequently have methylation of the MLH1 promoter.

Ribosomal DNA methylation in patients with endometrial carcinoma: an independent prognostic marker.

Background: Surgery is curative for the majority of patients with endometrial carcinoma: Consequently, the use of adjuvant therapy has been controversial. More effective methods to identify patients who are at risk for recurrence and who would benefit from adjuvant therapy are needed. The objective of this study was to investigate the prognostic significance of ribosomal DNA (rDNA) methylation in patients with endometrial carcinoma.

The significance of pneumatosis intestinalis or bowel perforation in patients with gynecologic malignancies.

Objectives: The objectives of this study were to evaluate the clinical significance and outcome of pneumatosis intestinalis or bowel perforation in patients with gynecologic malignancies.

Methods: A retrospective review of all gynecologic oncology patients at our institution from 1996 to the present was performed to identify computed tomography examinations showing pneumatosis, free air, or the presence of portal venous gas. Admission symptoms, laboratory testing, radiographic and operative findings, and overall survival were evaluated.

Microsatellite instability, MLH1 promoter methylation, and loss of mismatch repair in endometrial cancer and concomitant atypical hyperplasia.

Objective: MLH1 methylation is associated with the microsatellite instability (MSI) phenotype in endometrial cancer and atypical endometrial hyperplasia, a premalignant precursor to carcinoma. The observation that methylation is also seen in atypical endometrial hyperplasia without MSI suggests that methylation is an early event in endometrial tumorigenesis. Our objective was to determine if methylation is always present in MSI-positive atypical hyperplasia concomitant with MSI-positive, methylation-positive carcinoma.

Evaluation of the family history collection process and the accuracy of cancer reporting among a series of women with endometrial cancer.

Unlabelled: Family history data are critical in the study of hereditary cancer syndromes and the identification of cancer modifier genes.

Purpose: The purpose of this study was to analyze the process for collecting and verifying reported cancer family histories and identify reporting inaccuracies among a series of women with endometrial cancer.

Experimental Design: Detailed family histories were obtained from 80 women enrolled in a research study.

Mutation screening analysis of the retinoblastoma related gene RB2/p130 in sporadic ovarian cancer and head and neck squamous cell cancer.

Aims: To investigate the involvement of the RB2/p130 gene in the pathogenesis of sporadic ovarian cancer in addition to head and neck squamous cell carcinoma (HNSCC).

Methods: Paired tumour and patient matched normal DNA samples from 43 sporadic ovarian tumours and 39 normal/tumour HNSCC DNA samples were screened. The mutation screen used polymerase chain reaction (PCR) amplification followed by single strand conformation polymorphism analysis and direct sequencing of the PCR products.

Utility and cost-effectiveness of preoperative autologous blood donation in gynecologic and gynecologic oncology patients.

Objective: To evaluate utility and cost-effectiveness of preoperative autologous blood donation in gynecologic and gynecologic oncology patients.

Methods: Pheresis unit records were retrospectively reviewed to identify all women who performed autologous blood donation. Clinical charts were abstracted.

Prospective evaluation of positron emission tomography for the detection of groin node metastases from vulvar cancer.

Objective: We set out to determine the ability of positron emission tomography with fluorodeoxyglucose to detect groin lymph node metastases from vulvar cancer.

Methods: From January 2000 to August 2001, patients with squamous cell cancer of the vulva undergoing radical excision and lymphadenectomy were offered preoperative positron emission tomography. The imaging and pathologic status of each patient and groin were compared, and the sensitivity, specificity, and predictive value of positron emission tomography in predicting nodal metastasis were determined.

Qualitative Evaluation of Medical Information Processing Needs of 60 Women Choosing Ovarian Cancer Surveillance or Prophylactic Oophorectomy.

Thirty women who had prophylactic oophorectomy (PO) and thirty women undergoing ovarian cancer surveillance (OCS) completed a one-time in-depth telephone interview exploring information gathering and decision-making processes. There were close similarities between groups, including age, race, marital status, education, menopausal status, number undergoing genetic testing for BRCA mutations, and number of prophylactic mastectomies. The majority of participants indicated overall satisfaction with their final decision.

Randomized trial of cisplatin and ifosfamide with or without bleomycin in squamous carcinoma of the cervix: a gynecologic oncology group study.

Purpose: Phase II trial reports have suggested that the addition of bleomycin to the combination of cisplatin and ifosfamide may improve response rates and possible survival in squamous carcinoma of the cervix. This study prospectively evaluates the combination of bleomycin to this regimen in women with histologically proven advanced recurrent or persistent squamous cell carcinoma of the cervix.

Patients And Methods: Eligible women were randomized to receive either cisplatin (50 mg/m(2)), ifosfamide (5 g/m(2) over 24 hours), and mesna (6 g/m(2) during ifosfamide infusion and the following 12 hours) (CI) versus bleomycin 30 units over 24 hours on day 1 followed by cisplatin (50 mg/m(2)), ifosfamide (5 g/m(2) over 24 hours), and mesna (6 g/m(2) during ifosfamide infusion and the following 12 hours) (CIB).

Gas chromatographic analysis of infant formulas for total fatty acids, including trans fatty acids.

Twelve powdered and 13 liquid infant formulas were analyzed by using an extension of AOAC Official Method 996.01 for fat analysis in cereal products. Samples were hydrolyzed with 8 N HCl and extracted with ethyl and petroleum ethers.

Use of complementary and alternative medicine among women with gynecologic cancers.

Objective: The aim of this study was to determine the prevalence and types of complementary and alternative medicine (CAM) usage by women with gynecologic cancer in an outpatient midwestern university practice.

Methods: Any patient with a gynecologic cancer seen in the outpatient clinic of the gynecologic oncology division at Washington University over a 3-month period was eligible, excluding those patients with a new cancer diagnosis. Subjects completed a questionnaire anonymously.

Phase II trial of pyrazoloacridine in patients with persistent or recurrent endometrial carcinoma: a Gynecologic Oncology Group Study.

Objectives: The aims of this study were to determine the response rate of pyrazoloacridine (PZA) in patients with recurrent or persistent endometrial carcinoma and to describe the nature and degree of toxicity in this population.

Methods: PZA was initially administered at a dose of 750 mg/m(2) intravenously over 3 h every 3 weeks but, due to toxicity, was subsequently reduced to 560 mg/m(2) at the same schedule.

Results: Among 23 evaluable patients, 11 of whom had had prior chemotherapy, there was 1 (4.

Epithelial ovarian tumors of low malignant potential: the role of microinvasion.

Objective: To identify prognostic factors that may be used to predict an aggressive disease course and poor outcome in patients with epithelial ovarian tumors of low malignant potential (borderline tumors).

Methods: Data on 126 patients with ovarian borderline tumors were analyzed with regard to demographic characteristics, staging, presence of microinvasion, duration of follow-up, recurrence rate, rate of recurrence as invasive disease, mortality rate, preoperative and postoperative CA-125, and treatment. Chi-square and Fisher exact tests were used to evaluate proportions for statistical significance.

Role of the ultrasonic surgical aspirator in gynecology.

As is true in neurosurgery and general surgery, the ultrasonic surgical aspirator is a powerful tool for the general gynecologist and gynecologic oncologist in assisting in the treatment and management of benign and malignant diseases. The physical properties of ultrasonic sound waves along with the composition of the tissues in question allow for safe, selective, and precise tissue resection. Although the ultrasonic surgical aspirator has had favorable results to date and future applications seem promising, the ultimate role of this device needs to be established with clinical trials.

Genotypic and phenotypic progression in endometrial tumorigenesis: determining when defects in DNA mismatch repair and KRAS2 occur.

We set out to determine the relative timing of loss of DNA mismatch repair and KRAS2 mutation in endometrial tumorigenesis. We studied endometrial carcinoma (CA) and synchronous atypical endometrial hyperplasia (AEH), the premalignant precursor of endometrial cancer. Carcinoma and hyperplasia were investigated for loss of mismatch repair as evidenced by microsatellite instability (MSI) and for KRAS2 mutations.

Factors predicting subcutaneous implanted central venous port function: the relationship between catheter tip location and port failure in patients with gynecologic malignancies.

Objective: We set out to determine the factors that predict subcutaneous implanted central venous port function. Specifically, we sought to determine whether the location of the catheter tip is correlated with port failure.

Methods: A review of all gynecologic oncology patients who underwent initial port placement between 1993 and 1998 was undertaken.