ISSN:8756-0437    

DOI:10.1002/ssu.2980060602

出版商:John Wiley&Sons, Inc.    

年代:1990

数据来源: WILEY

ISSN:8756-0437    

DOI:10.1002/ssu.2980060603

出版商:John Wiley&Sons, Inc.    

年代:1990

数据来源: WILEY

摘要:

AbstractThe advent of monoclonal technology has increased the potential utility of antibody‐dependent tumor marker assays in gynecologic oncology. The availability of unlimited quantities of several pure monoclonal antibodies directed against novel epitopes on tumor‐associated antigens has permitted development of highly sensitive assays for serum markers. Traditional assays for human chorionic gonadotropin (hCG), NB/70K and TA‐4 have been improved. CA 125 has provided a useful first‐generation marker for monitoring ovarian cancer and triaging patients with pelvic masses, despite limitations in sensitivity and specificity. In the next decade, the challenge is to identify new markers that will complement CA 125 in monitoring ovarian cancer and facilitate screening for occult early‐stage disease. Strategies involving multiple markers and modalities may be required. Some markers may emerge through a more fundamental knowledge of the biology of gynecologic neoplasms, including the expression of growth factors and their receptors. Finally, the application of monoclonal antibodies to immunohistochemistry and radionuclide imaging also may provide new areas of diagnostic application for monoclonal antibodies in gynecologic

ISSN:8756-0437    

DOI:10.1002/ssu.2980060604

出版商:John Wiley&Sons, Inc.    

年代:1990

数据来源: WILEY

摘要:

AbstractThis review encompasses advances in the pathology of female genital tract tumors that have been deemed to have clinical significance. A number of newly described neoplasms are discussed as are the results of analyses of large series of cases of previously described tumors. Recent revision in terminology and the application of newer techniques for evaluating neoplasms, such as flow cytometry, are also briefly reviewed.

ISSN:8756-0437    

DOI:10.1002/ssu.2980060605

出版商:John Wiley&Sons, Inc.    

年代:1990

数据来源: WILEY

摘要:

AbstractWe review, for their wider applicability, four advances in the radiotherapeutic management of the gynecologic malignancies. Attempts at improving upon results obtained with radiotherapy by the addition of chemotherapy have usually followed one of two temporal strategies: Sequential chemotherapy‐radiotherapy (so‐called neo‐adjuvant chemotherapy), or chemotherapy given concurrently with radiotherapy. The pros and cons of both models are discussed. Recent work suggests that there is a differential response between the acutely reacting normal tissues, as well as tumor, and the late‐reacting normal tissues, which is dependent upon the radiation fraction size. The rationale and some important clinical applications are reviewed.Advances in brachytherapy include the high dose rate treatment and the use of rigid templates to guide the accurate placement of the interstitial implant. The controversies surrounding these approaches require further study before the precise place of these techniques is known. Finally, in vulvar cancer, the addition of radiotherapy to surgery is being studied to permit less radical operations in early disease, and greater local tumor control in advanced

ISSN:8756-0437    

DOI:10.1002/ssu.2980060606

出版商:John Wiley&Sons, Inc.    

年代:1990

数据来源: WILEY

摘要:

AbstractEven though cisplatin‐based combination chemotherapy results in increased clinical and surgical complete remission rates and improved median survival compared with single‐agent alkylating agent chemotherapy, the 5 year survival rates for stages III and IV ovarian cancer have only improved to 25–30%. New methods being evaluated to improve response rates, median survival, and 5 year survival rates include the use of high‐dose carboplatin, dose intensity using platinum compounds, intraperitoneal chemotherapy, concomitant intravenous and intraperitoneal chemotherapy, and the recent discovery of new active agents against epithelial ovarian cancer—Taxol, and Ifosfamide p

ISSN:8756-0437    

DOI:10.1002/ssu.2980060607

出版商:John Wiley&Sons, Inc.    

年代:1990

数据来源: WILEY

摘要:

AbstractThere are well‐defined prognostic factors that identify patients with clinical stage I (confined to the uterus) endometrial adenocarcinoma and patients at high risk vs. low risk for recurrent disease and allow for treatment tailored to those specific prognostic indicators. This had led the International Federation of Gynecologists and Obstetricians (FIGO) in 1988 to revise the FIGO staging from a clinical to a surgical/histopathological evaluation. The use of these prognostic factors should lead to improved initial surgery and adjuvant therapy for patients considered at high risk for recurrenc

ISSN:8756-0437    

DOI:10.1002/ssu.2980060608

出版商:John Wiley&Sons, Inc.    

年代:1990

数据来源: WILEY

摘要:

AbstractIntrauterine diethylstilbestrol (DES) exposure is associated with an increased risk for the development of clear cell adenocarcinoma (CCA) of the vagina and cervix. The age of the DES‐exposed patients has varied from 7 to 34 years with the highest frequency from 14 to 22 years. The risk among the exposed is small and is on the order of 1 per 1,000. Factors that may increase the risk are maternal history of prior miscarriage, exposure to DES in early gestation, a fall season of birth, and prematurity. Pregnancy does not appear to influence adversely the tumor characteristics or prognosis of patients who have developed these malignancies. Criteria for appropriate local therapy of small clear cell adenocarcinomas of the vagina are presented. Recurrent CCA has been observed as long as 20 years after primary therapy emphasizing the importance of prolonged follow

ISSN:8756-0437    

DOI:10.1002/ssu.2980060609

出版商:John Wiley&Sons, Inc.    

年代:1990

数据来源: WILEY

摘要:

AbstractGestational trophoblastic tumor is a term applied to invasive mole, choriocarcinoma, and placental‐site trophoblastic tumor. The overall cure rate in the treatment of these gestational trophoblastic tumors now exceeds 90%. This high success rate is the result of (1) inherent sensitivity of trophoblastic tumors to chemotherapy, (2) ability to monitor therapy effectively with the use of human chorionic gonadotropin as a tumor marker, and (3) identification of prognostic factors which allows categorization of patients into high‐ and low‐risk groups for selection of treatment. Virtually all patients with nonmetastatic and low‐risk metastatic disease can be cured using single‐agent methotrexate or Actinomycin‐D chemotherapy. Intensive therapy with combination chemotherapy including etoposide, high‐dose methotrexate and Actinomycin D and, where indicated, adjuvant radiotherapy and surgery has resulted in cure rates of 80–90% in patients with high‐risk metastatic disease. The factors which are most important in determining response to treatment are: (1) clinicopathologic diagnosis of choriocarcinoma, (2) metastases to sites other than the lung or vagina, (3) number of metastases, (4) previous failed chemotherapy, and

ISSN:8756-0437    

DOI:10.1002/ssu.2980060610

出版商:John Wiley&Sons, Inc.    

年代:1990

数据来源: WILEY

摘要:

AbstractTreatment for squamous cell carcinoma of the vulva remains surgical, the standard procedure being radical vulvectomy and bilateral inguinal lymphadenectomy. There has been recent interest in refining histopathologic prognostic factors that would be highly predictive of regional lymph node metastases, recurrences, and survival. With such factors have come new innovative approaches to the management and treatment of minimally invasive carcinomas, regional nodal disease, and advanced lesions. These modifications from standard therapy could result in less morbidity, disfigurement, and hospitalization while not compromising survival.

ISSN:8756-0437    

DOI:10.1002/ssu.2980060611

出版商:John Wiley&Sons, Inc.    

年代:1990

数据来源: WILEY