A new prognostic model for FIGO stage 1 epithelial ovarian cancer.

Background: No consensus exists which patients with surgical stage 1 epithelial ovarian should receive postoperative chemotherapy. The purpose of this study was to evaluate the prognostic impact of preoperative CA-125 and to establish a prognostic index to identify patients in different risk categories.

Methods: Data of 600 surgically staged patients with FIGO stage 1 EOC treated in eleven gynecological cancer centers in Australia, the USA and Europe were analyzed.

Malnutrition among gynaecological cancer patients.

Objective: To assess the nutritional status of patients with gynaecological cancer.

Design: A prospective study assessing the nutritional status of gynaecological patients with suspected or proven gynaecological cancer.

Setting: Queensland Centre for Gynaecological Cancer, Brisbane, Australia; a tertiary referral centre for gynaecological cancer.

Wrigley forceps to deliver a bulky uterus following a total laparoscopic hysterectomy for endometrial cancer.

Morcellation of the uterus is contraindicated in endometrial cancer and a uterine size of 11 weeks or larger has been considered a contraindication for total laparoscopic hysterectomy (TLH) in endometrial cancer. We describe a new technique of removing a bulky uterus in a patient with endometrial cancer with the use of Wrigley forceps following a total laparoscopic hysterectomy.

Prognostic importance of preoperative CA-125 in International Federation of Gynecology and Obstetrics stage I epithelial ovarian cancer: an Australian multicenter study.

Purpose: To evaluate the prognostic significance of preoperative CA-125 levels on overall survival of patients with International Federation of Gynecology and Obstetrics (FIGO) stage I epithelial ovarian cancer (EOC).

Patients And Methods: Data from 518 patients with FIGO stage I EOC treated in seven gynecologic oncology centers throughout Australia between 1990 and 2002 were analyzed. Patients with borderline tumors and nonepithelial ovarian carcinomas were excluded, as were women in whom CA-125 had not been determined preoperatively.

The use of an overlay autogenous tissue (OAT) patch to control intra-operative haemorrhage of the spleen.

Background: During major abdomino-pelvic surgery, there is a risk of severe haemorrhage. When routine measures at haemostasis fail, the overlay autogenous tissue (OAT) patch may be useful to control bleeding.

Case: We present a case report of the use of the use of an OAT patch to control haemorrhage of the spleen incurred during tertiary cytoreduction.

Vulval Keratoacanthoma: a case report.

Background: Vulval Keratoacanthoma (KA) is very rare and its differential diagnosis from the commonly occurring Vulval Squamous Cell Carcinoma (SCC) is important to avoid overtreatment.

Case: A case of Vulval KA in a 79-year-old lady is reported. She presented with a 9-mm firm raised lesion on the antero-lateral left side of the clitoris of a few months' duration with no associated symptoms.

Postoperative analgesic requirements - total laparoscopic hysterectomy versus vaginal hysterectomy.

Background: There is limited information available on the requirement for postoperative analgesic drugs in patients submitted to total laparoscopic hysterectomy (TLH) compared with patients undergoing vaginal hysterectomy (VH).

Aim: To compare the postoperative analgesic requirements in patients who underwent a TLH with patients who had a VH.

Methods: Chart review of 53 patients who had TLH and 47 who had VH and were seen postoperatively by an acute pain management service in order to assess postoperative analgesic requirements.

Patterns of recurrence and disease-free survival in advanced squamous cell carcinoma of the vulva.

Objective: To compare patterns of recurrence and disease-free survival (DFS) of node-positive and node-negative patients with advanced vulval squamous cell carcinoma (SCC).

Methods: Fifty-five patients with FIGO stage III/IVA vulval SCC who had surgery at the Queensland Centre for Gynaecological Cancer from 1989 to 1999 were included. Patients were grouped as follows: Group A, pT3 N0; Group B, pT3 N1; Group C, pT4 N2.

The management of pre-invasive stage of cervical disease in a low-resource setting.

Cervical cancer is one of the commonest cancers in women. It is also the most preventable cancer. Numerous population based studies have shown that the development of a population based screening program can significantly reduce the incidence of and death rate from cervical cancer.

Management of borderline ovarian tumours.

Borderline ovarian tumours are known to occur in younger women than invasive cancers and to also have a better prognosis. However, there is also much disagreement about the best approaches to management. At the Queensland Centre for Gynaecological Cancer we have had a particular interest in this disease for some years.

Early-stage vaginal carcinoma--an analysis of 70 patients.

Objectives: The aims of this study were to assess outcomes and define prognostic factors for early-stage vaginal carcinoma.

Methods: A retrospective analysis was performed of women with FIGO stages I and II vaginal carcinoma identified from the database of the Queensland Centre for Gynaecological Cancer between January 1982 and December 1998.

Results: Seventy women were identified.

The place of bowel resection in initial debulking surgery for advanced ovarian cancer.

Objective: To evaluate the efficacy and morbidity associated with bowel resection at the initial debulking procedure for patients with advanced ovarian cancer.

Design: Retrospective medical record and computerised database review.

Setting: John Hunter Hospital, Newcastle, New South Wales.

Evaluation of restaging in clinical stage 1A low malignant potential ovarian tumours.

Objective: This study was undertaken to evaluate whether restaging clinical stage 1A low malignant potential (LMP) tumours previously incompletely staged in a non-gynaecology oncology centre yields useful information for management and prognosis.

Methods: A retrospective chart review was undertaken of all patients with LMP tumours treated at the Queensland Centre for Gynaecological Cancer (QCGC) from 1982-2000.

Results: Fifty-six (69%) of the 81 patients referred with a provisional stage 1A diagnosis underwent a second operation for staging purposes.

Expression of MUC1 splice variants in benign and malignant ovarian tumours.

MUC1 is expressed on the surface of ovarian cancer cells. Nine different splice variants of MUC1 have been described, but no study has reported on the expression of MUC1 isoforms in human ovarian cancer. Our study compares patterns of expression of MUC1 splice variants of malignant and benign ovarian tumours.

Novel MUC1 splice variants are expressed in cervical carcinoma.

Objectives: The MUC1 antigen can be used to identify epithelial cells from the background of hemopoietic cells. The present investigation describes patterns of overexpression of two novel MUC1 splice variants in human cervical carcinoma cell lines.

Methods: RT-PCR was carried out to determine MUC1 splice variants in the cervical cancer cell lines C-4 II, C-33A, DoTc 2 4510, C-4 I, SiHa, HT3, Hs 636 T (C4-I), and HeLa.

Safety and efficacy of low anterior en bloc resection as part of cytoreductive surgery for patients with ovarian cancer.

Objective: To examine the feasibility and safety of a low anterior resection of the rectosigmoid plus adjacent pelvic tumour as part of primary cytoreduction for ovarian cancer.

Methods: This study included 65 consecutive patients with primary ovarian cancer who had debulking surgery from 1996 through 2000. All patients underwent an en bloc resection of ovarian cancer and a rectosigmoid resection followed by an end-to-end anastomosis.

Postoperative vaginal vault brachytherapy for node-negative Stage II (occult) endometrial carcinoma.

Objective: The aim of this study is to look at the efficacy of extended surgical staging and postoperative vaginal vault brachytherapy in patients with Stage II (occult) endometrial carcinoma.

Methods: Between January 1989 and December 1997, there were 30 patients with Stage II (occult) endometrial carcinoma who received postoperative vaginal vault brachytherapy as the only adjuvant treatment. The study group consisted of 15 of these patients who had extended surgical staging (including lymphadenectomy).

Primary Bartholin gland carcinoma: a report of seven cases.

This study reviews our experience with 7 patients with primary Bartholin gland cancer (BGC) treated at the Queensland Gynaecological Cancer Centre (QCGC) and compares this with previously published data. A retrospective clinicopathologic review of all patients with primary BGC treated at QCGC from 1988 to 2000 was performed. Of the 7 patients treated, all underwent primary surgery and 5 of the 7 patients received radiotherapy postoperatively.

Peritoneal cytology: impact on disease-free survival in clinical stage I endometrioid adenocarcinoma of the uterus.

The prognostic significance of positive peritoneal cytology in endometrial carcinoma has led to the incorporation of peritoneal cytology into the current FIGO staging system. While cytology was shown to be prognostically relevant in patients with stage II and III disease, conflicting data exists about its significance in patients who would have been stage I but were classified as stage III solely and exclusively on the basis of positive peritoneal cytology (clinical stage I). Analysis was based on the data of 369 consecutive patients with clinical stage I endometrioid adenocarcinoma of the endometrium.

Fertility and ovarian function after conservative surgery for germ cell tumours of the ovary.

Malignant ovarian germ cell tumours (MOGCT) principally occur in girls and young women and are generally unilateral. Effective combination chemotherapy with conservative surgery has seen a dramatic improvement in survival rates. This increase has shifted the focus to long-term fertility and reproductive outcome.

Local recurrence in high-risk node-negative stage I endometrial carcinoma treated with postoperative vaginal vault brachytherapy.

Objectives: The aim of this study is to examine the patterns of failure after extended surgical staging and postoperative vaginal vault brachytherapy as the only adjuvant treatment in high-risk surgical Stage I patients with endometrial carcinoma.

Methods: The records of all patients with endometrial carcinoma (adenocarcinoma or adenosquamous) receiving vaginal vault brachytherapy as the only adjuvant treatment from January 1989 to December 1997 were examined. A total of 489 patients were found.

Low malignant potential ovarian tumours: a review of 175 consecutive cases.

Epithelial ovarian tumours of low malignant potential (LMP) are known to have a generally good prognosis, although there is not universal agreement on all aspects of treatment. We report a series of 175 patients with LMP ovarian tumours referred to the Queensland Centre for Gynaecological Cancer between January, 1982 and December, 1993. Stage I disease accounted for 142 cases, with only 1 patient dead from disease at 293 months.

Small cell carcinoma of the cervix of neuroendocrine origin causing obstructed labour.

Small cell carcinoma of the cervix complicating pregnancy is rare, only 4 cases having been reported. This is the first case in which the tumour is reported as causing obstructed labour.

Small cell carcinoma of the cervix.

Small cell carcinoma of the cervix is an uncommon aggressive variety of cervical cancer. Between 1982 and 1993, eight cases of this disease were diagnosed at the Queensland Centre for Gynaecological Cancer among 1586 cervical cancers. Treatment results have been poor with one long-term survivor.

The treatment of recurrent pelvic lymphocysts with marsupialization and functioning omental flap.

A new treatment for recurrent pelvic lymphocysts is reviewed. Nine women with recurrent symptomatic lymphocyst were treated by marsupialization of the lymphocyst to the peritoneal cavity and functioning omental flap. The omental flap was dissected off the greater curve of the stomach maintaining its blood supply from the appropriate gastroepiploic vessels.