摘要:

A review of available direct and indirect scientific reports strongly suggests that subspecialty training increases the likelihood that the appropriate surgical procedure will be completed in women operated on for gynecologic cancer. It is likely that specialty care lessens the costs associated with diagnosis, treatment and surveillance, and frequently improves survival.

ISSN:1040-872X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The incidence of the spread of ovarian cancer after laparoscopic surgery is difficult to establish from the current literature. The prognosis incidence of a trocar site metastasis without peritoneal dissemination is not known. Data from general surgeons in prospective studies from a single institution suggested that in colon cancer the risk is low, whereas it seems to be much higher in multicentric studies of undiagnosed gallbladder cancer. Experimental studies suggested that laparoscopy has advantages and disadvantages. However, the risk of dissemination is high when a large number of malignant cells and a carbon dioxide pneumoperitoneum are present, a situation encountered when managing adnexal tumours with large vegetations. Animal studies will allow the development of a peritoneal environment adapted to the treatment of cancer. The ovary is an intraperitoneal organ and ovarian cancer a peritoneal disease, so the risk of peritoneal spread may be higher in ovarian cancer than in other gynecological cancers. A careful preoperative evaluation appears to be the best way to prevent these risks. It should also be used to choose which patient should be operated by which surgical team. The second step is a careful and cautious laparoscopic diagnosis, so that more than 98% of ovarian cancers encountered can be treated immediately and effectively. The laparoscopic management of ovarian cancer remains controversial; it should be performed only in prospective clinical trials. Until the results of such studies become available, an immediate vertical midline laparotomy remains the gold standard if a cancer is encountered.

ISSN:1040-872X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Breast cancer is the most common female malignancy in the USA and second only to lung malignancy in cancer mortality. The only screening modality that effectively detects early breast cancer and decreases mortality is mammography. Because many females turn to obstetrician gynecologists for breast cancer screening, an understanding of the benefits and limitations of mammography and the breast imaging reporting and data system is imperative. Mammography remains the most cost effective and sensitive tool for early detection.

ISSN:1040-872X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Given the limitations regarding the impact of screening and the uncertainties concerning chemoprevention for women with significant genetic susceptibilities to breast, endometrial and ovarian cancers, recent research and publications on prophylactic surgery for cancer prevention and improved long-term survival for women at hereditary risk have increasing importance.

ISSN:1040-872X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Gynecologic oncology is a rapidly growing field due to constant advances in immunohistochemistry and molecular biology. This review serves as an overview of new studies promoting the use of tumor markers and molecular biological prognostic factors in malignancies affecting women. The majority of studies focus on either endometrial or ovarian carcinoma. Other gynecologic malignancies (cervical, vulvar, and vaginal carcinoma) have a much smaller representation in the world literature. Multiple new markers were examined over the last year. We conclude that although some markers show promise as potential new consensus prognostic indicators, more work is needed to confirm results and clarify any existing discrepancies.

ISSN:1040-872X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Quality of life has become a very important issue in deciding the extent of surgical procedures for patients affected with a variety of cancers. In recent years, more attention has been given to preserving organ function, cosmesis, and now reproductive function. As cancer treatment has improved survival in several neoplasias, cancer survivors are becoming more interested in preserving their fertility potential.We focus here on new surgical advances in the management of early stage cervical cancer, with emphasis on the radical trachelectomy technique to preserve fertility potential and the Saling procedure to prevent premature labor. We also discuss the issue of the sentinel node localization.

ISSN:1040-872X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The application of gene therapy strategies for ovarian cancer has employed various viral and nonviral vectors. Thus far, adenovirus has been the most promising vehicle for gene replacement but the use of non DNA-based viruses is also being explored. Recent novel advances in gene therapy approaches include refinement of vector targeting and the use of site-specific promoters and conditionally replicative adenoviral vectors. Although several clinical trials have documented the relative safety of gene therapy in ovarian cancer patients, few significant clinical responses have been effected. However, advances in the field are occurring rapidly and this strategy does appear promising for the treatment of ovarian cancer.

ISSN:1040-872X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The understanding of the pathogenesis and pathology of ovarian tumours is constantly evolving. Dominant themes in recent studies of ovarian tumours include prognostic features in borderline tumours, molecular events in the pathogenesis of ovarian tumours, the assessment of tumour features that may have prognostic or treatment implications, and the development of techniques that may enhance diagnostic accuracy. The literature has been reviewed with an aim to identifying those studies that can potentially impact practice and improve patient care. The most noteworthy developments include: the understanding that so-called ‘tumours of low malignant potential’ are virtually always benign, and that one can identify those rare cases with malignant potential; the importance of the recognition of micropapillary serous carcinomas; an improved understanding of early invasive carcinomas and their impact on screening practices; an understanding of the association of endometriosis with ovarian cancer; further awareness of factors in ovarian tumours that influence prognosis, such as refinements in grading and molecular markers such as P27; and refinements in diagnosis so as to distinguish primary from metastatic cancer and benign lesions from malignant tumours more effectively.

ISSN:1040-872X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

During the last year, population screening trials from the USA and Japan have reported on the effectiveness of transvaginal ultrasound screening in the early detection of ovarian cancer. Although the data are not from randomized trials, it is consistent with an impact of screening on mortality. A randomized control trial to definitively answer this question is now underway in the UK. This study also addresses the issues of target population, compliance, health economics and physical and psychological morbidity of screening.

ISSN:1040-872X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Cervical cancer is a tremendous health problem as the third most frequent cancer affecting women. Locally advanced disease, which exceeds that successfully treated with surgery, is a common presentation of unscreened women. The use of concurrent chemotherapy and radiation therapy has resulted in a significant increase in patient survival. Our understanding of cervical tumor biology has the potential for further improvements.

ISSN:1040-872X    

出版商:OVID    

年代:2001

数据来源: OVID