ISSN:1040-8746    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

In this review, current basic and clinical literature that describes innovative strategies for staging diagnosis and management of cancers of the cervix, vulva, and vagina are reviewed. The reviewed literature includes investigations of viral oncogenesis, the role of angiogenesis in tumor development, pretreatment staging, and the emerging role of chemotherapy in the treatment of locally advanced disease.

ISSN:1040-8746    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Endometrial cancer is the most common gynecologic malignancy in the United States, with 37,400 new cases and 6400 deaths estimated to occur in 1999. The epidemiology of endometrial cancer has been widely characterized; nevertheless, efforts continue to more precisely define risk factors for the disease. Accurate epidemiologic risk factor profiles or focused screening efforts may ultimately facilitate the primary prevention of endometrial cancer. Currently, standard management of women with endometrial cancer includes surgical exploration with total hysterectomy and bilateral salpingo-oophorectomy. Uterine histopathologic characteristics and intraoperative findings continue to provide the primary indications for surgical staging in endometrial cancer. The addition of serum CA125 and selected imaging techniques (eg,transvaginal sonography with color Doppler and MR imaging) to the preoperative assessment may ultimately improve the sensitivity and specificity with which patients are selected for pathologic nodal evaluation. Various clinicopathologic factors have been evaluated as predictors of the clinical course of endometrial cancer and as selection criteria for patients most likely to benefit from adjuvant therapy. Histologic measurement of the tumor microvessel density is a promising technique for identifying patients at high risk for recurrence. Although uterine papillary serous carcinoma of the endometrium represents only 3% to 4% of endometrial cancer cases, it is of particular interest because of the aggressive clinical course and poor prognosis associated with this disease.

ISSN:1040-8746    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Cancer is a genetic disease, and inherited or acquired genetic defects contribute to the initiation and progression of cancer. Improved molecular techniques have lead to the identification of many of these genetic mutations in gynecologic malignancies. The molecular characterization of cancer has provided a better understanding of tumor formation and the clinical behavior of different tumor types, with important implications for developing screening tests and prognostic markers. Applications of these findings have led to novel targeted gene therapies that correct the critical genetic defects seen in gynecologic cancers. Future research will focus on the clinical translation of these genetic alterations as targets of cancer prevention, screening, and treatment.

ISSN:1040-8746    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:1040-8746    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Although variation in diet may account for approximately one third of the variation in cancer incidence worldwide, epidemiologic studies have proven to be a blunt instrument for identifying causal relationships between intakes of specific food constituents and cancer risk at specific sites. Diets rich in fruits and vegetables seem to be protective, but the adverse effects of beta carotene supplementation trials on lung cancer incidence in smokers caution against the attribution of benefit to single substances. Important diet–gene interactions may exist, as illustrated by differential responses to variation in folate status in those with methylenetetrahydrofolate reductase polymorphisms. Targeting initial intervention studies in those with explicit genetic predisposition to cancer may have both greater cost-effectiveness and fewer ethical difficulties than do similar studies in the general public.

ISSN:1040-8746    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Over the past 2 years, new insights into mutator and stromal epithelial cell interactions have enhanced the understanding of the carcinogenesis process and have identified potential new approaches to chemoprevention in diverse epithelial sites. Data testing the efficacy of chemopreventive agents in genetically mutated animal carcinogenesis models as screening tools for chemopreventive agents remain immature and point to a continued need for chemical carcinogenesis models to screen for the potential efficacy of chemopreventive agents. The Breast Cancer Prevention Trial is a published, risk-reduction trial that demonstrated a tamoxifen-induced reduction of the risk for breast cancer and focused attention on the clinical use of chemopreventive agents in healthy women. This trial highlighted the potential chemopreventive activity of selective estrogen-receptor antagonists as chemopreventives for breast cancer. New data from animal and human models continue to support the development of nonsteroidal anti-inflammatory agents as chemopreventives for colorectal cancer. Micronutrient-and diet-intervention trials for colorectal chemoprevention present a mixed picture. Although calcium and vitamin supplements, including folate, reduce the recurrence of adenomatous polyps in humans, the effect is small. Fiber supplementation does not reduce the incidence of polyps or colorectal cancer. New approaches for the chemoprevention of esophageal adenocarcinomas, hepatomas, and squamous cell skin cancers represent promising new approaches to the chemoprevention of epithelial cancers.

ISSN:1040-8746    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Screening mammography has been shown to reduce breast cancer mortality by detecting small, nonpalpable, early-stage breast cancers. In 1998, several studies were published, reinforcing the value of screening mammography in women aged 40 years and older. Some studies focused on when screening should begin (age 40 years), while others analyzed the process of screening mammography, with particular attention to recall rates and false-positive studies. Other reports emphasized the limitations of mammographic interpretation, the use of computers to aid in mammographic diagnosis, and screening with ultrasound.

ISSN:1040-8746    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Recent research has revealed the existence of specific mutations in cancer. These mutations are being investigated as targets to find subjects at high risk for cancer, to detect early cancer, to detect the early recurrence of established cancer, and to find micrometastasis. These mutations are reviewed for the major anatomic sites. Some of the clinical issues related to the application of these mutations and the limitations of using molecular targets are also considered. Current methods for determining the risk of cancer are reviewed. Risk assessment is essential for defining cohorts for chemoprevention and other interventions. The concept of using surrogate anatomic and functional sites for estimating risk is introduced. Finally, the increasing complexity of molecular genetic analysis and the biologic heterogeneity of cancer are discussed in relation to early detection.

ISSN:1040-8746    

出版商:OVID    

年代:1999

数据来源: OVID