摘要:

To reduce the mortality from ovarian cancer various studies by transvaginal color Doppler (TVCD) sonography and serum CA-125 tumor marker, alone or in combination, have been performed. Relatively poor specificities of CA-125 and transvaginal conventional sonography can be improved with the use of TVCD. Furthermore, high specificity can be achieved on screening asymptomatic postmenopausal women by combining serum CA-125 measurement with TVCD. Combining tests should not necessarily increase the overall cost of screening because of the expected decrease in the number of unnecessary surgical interventions. Until the results of large, prospective studies are available, the efficacy of potential tests for screening of ovarian cancer will remain unproven and they should not be used to screen apparently healthy women outside of scientific interest.

ISSN:1040-872X    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Endometrial cancer is the most common malignancy of the female genital tract. The prognosis of the endometrial carcinoma is strongly correlated with the myometrial infiltration depth. Therefore, it is of utmost clinical interest to detect the malignancies at the earliest stage or even as a precancer. All approaches, like cytologies and uterine smears, have failed to fulfil prerequisites for screening of endometrial cancer. Measurement of the endometrial thickness by transvaginosonography (TVS) can define a risk group for endometrial cancer in postmenopausal women. Further investigations have to clarify whether the combination of TVS and color Doppler can reduce the number of false-positive findings.

ISSN:1040-872X    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

The application of operative laparoscopy to patients with gynecologic malignancy is in its infancy, but promising findings have been demonstrated for surgical end staging after cytotoxic therapy for ovarian cancer, laparoscopic lymph node sampling for cervical cancer, and laparoscopic staging, vaginal hysterectomy and adnexectomy for corpus cancer. The most significant difficulty in integrating operative laparoscopy with gynecologic oncology, at this time, is the lack of controlled studies to demonstrate the ability of endoscopy to improve the contemporary management of these diseases. Further study will be necessary by subspecialists in gynecologic oncology to demonstrate the proper application of these new techniques.

ISSN:1040-872X    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

With heterosexual transmission of HIV becoming the primary mode of transmission to women in the USA, and a high rate of human papillomavirus (HPV) and cervical neoplasia in HIV-infected women, obstetrician-gynecologists have become primary care providers for HIV-infected women. Reports of a high rate of recurrence and progression of cervical neoplasia in this population suggest that gynecologists must strive to identify those women with cervical neoplasia who are HIV infected. Alterations in local immune response of the genital tract caused by HIV infection may be responsible for higher prevalence, recurrence rates, and progression rates of cervical neoplasms in these women. Since cervical cancer may have a more fulminant course in HIV-infected women and has become an AIDS-defining illness, the surveillance and treatment of cervical neoplasia may need to be more aggressive.

ISSN:1040-872X    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

In 1988, the International Federation of Gynecologists and Obstetricians' (FIGO) staging criteria for endometrial cancer were changed to require that surgical observations be included in the staging process. Staging now requires thorough intraperitoneal and retroperitoneal search and documentation of metastatic cancer; in addition, direct uterine inspection for tumor invasion and degree of cervical involvement replace length of uterine cavity and endocervical curettage. With change, there have naturally been questions regarding the method, benefit, and risk of surgical staging. The major concerns include: do all patients require surgical staging? what are the risk factors of endometrial cancer? what is gained from preoperative evaluation? what is the technique of surgical staging? what are the hazards to the patient? how is staging incorporated into treatment? and, what is the current experience with surgical staging? These questions are addressed in this review.

ISSN:1040-872X    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Ovarian germ cell malignancies are neoplasms derived from primitive germ cells of the embryonic gonad. These tumors are highly malignant, rapidly growing, and typically occur in young women. The prognosis for patients with ovarian non-dysgerminomatous germ cell malignancies was bleak before the introduction of modern combination chemotherapy. The evolution of modern chemotherapy transformed these virulent malignancies into highly curable ones. In the early 1970s, the combination of vincristine, actinomycin D, and cyclophosphamide (VAC) emerged as the first effective therapy. The efficacy of cisplatin, vinblastine, and bleomycin (PVB) was documented in treatment of men with testicular cancer and subsequently became standard treatment for women with ovarian germ cell malignancies. Bleomycin, etoposide, and cisplatin (BEP) are shown to have equal efficacy and less toxicity in the treatment of ovarian germ cell malignancies. Experience at Yale University suggested that patients with ovarian germ cell malignancies could be managed by using tumor histology to determine the type of chemotherapy, and determining treatment duration by serial assays of circulating tumor markers or by International Federation of Gynecologists and Obstetricians' staging. Preservation of reproductive function is appropriate for all patients with early stage disease and selected patients with more advanced disease.

ISSN:1040-872X    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:1040-872X    

出版商:OVID    

年代:1994

数据来源: OVID