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PubMed1989

[A comparison between the dose distribution from 192Ir point and line sources in the afterloading therapy of gynecologic neoplasms].

For different fields of application in irradiation of gynecological tumors a comparison of isodose distribution is done with "point-shaped" and "line-shaped" 192Ir-source. With the oblateness of dose efficiency distribution towards the axis of source with the "line-shaped" 192Ir-source an improvement of dose distribution occurs in intracavitary irradiation with the lower and more balanced exposure of fundus uteri, especially in irradiation of the endometrial carcinoma. On the other hand the irradiation of vaginal stump renders problematic. In pure vaginal irradiation no differences are found in medically interesting range.

Brachytherapy↗

PubMed1981

Low-density lipoprotein as a potential vehicle for chemotherapeutic agents and radionucleotides in the management of gynecologic neoplasms.

Cholesterol metabolism was studied in cells from two established gynecologic cancer cell lines which were maintained in monolayer cultures. The cell lines were derived and established from poorly differentiated epidermoid cervical carcinoma (EC-50) and endometrial adenocarcinoma (AC-258). The specific activity of 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase, the rate-limiting enzyme of cholesterol de novo synthesis, in AC-258 cells (1,700 pmoles x mg-1 microsomal protein x min-1) was three times higher than that found in EC-50 cells (550 pmoles x mg-1 microsomal protein x min-1). However, epidermoid cervical cancer cells (EC-50) metabolized low-density lipoprotein (LDL), the major transport vehicle for cholesterol in plasma, at a very high rate (14,000 ng x mg-1 cell protein x 6 hours). This rate is fifteen times greater than the rate observed in fetal adrenal tissue and fifty times greater than the rate observed in nonneoplastic gynecologic tissue, each in organ culture. Both cancer cells (EC-50 and AC-258) in monolayer culture were shown to have specific receptors for LDL. These cancer cells demonstrate no defect in LDL metabolism, and lysosomal degradation of LDL was blocked by chloroquine. From the results of studies of specific binding of LDL in tissues obtained from nude mice it was demonstrated that membrane fractions prepared from EC-50 cells, after propagation in the mice, contained fifteen to thirty times more specific binding capacity for [125I]iodo-LDL than vital organs of the mouse, such as the liver, heart, lung, kidney, or brain. The results of these studies are suggestive that certain tumor cells might have a higher affinity for LDL than normal tissues and cytotoxic drugs or radionucleotides ligated to the LDL macromolecule may be utilized for the specific delivery of these agents.

Adenocarcinoma↗

PubMed1992

Computed tomography of gynecologic neoplasms.

Both CT and MR imaging have had a major impact on gynecologic oncologic imaging, and new technology and imaging techniques are still being introduced. CT maintains a role in gynecologic pelvic cancer imaging because of cost-effectiveness, high spatial resolution, fast examination time, and wide availability. CT is particularly advantageous for lymph node metastasis screening and guided-biopsy of metastases and recurrent tumor. CT currently is recommended for primary staging of ovarian cancer and advanced cancers of the cervix and endometrium, detection of persistent and metastatic gestational trophoblastic disease, and evaluation of recurrent gynecologic pelvic cancers.

Female↗

PubMed1987

[Gallium scintigraphy of gynecologic neoplasms].

67Gallium whole body scintigraphy was applied in 16 patients with gynecological malignomas and 2 patients with suspicion on a recurrent tumour as a supplement to usual diagnostic procedure. Aim of this study was the detection of metastases earlier than with the usual methods. Scintigraphy results have been interpreted average of 5 years after examination. Additional clinical informations were necessary in 6 cases. 3 out of these 6 cases have been shown in detail.

Female↗

PubMed1979

[Clinical and urological after care in gynecologic neoplasms].

Patients after operative and/or radiological therapy for cervical cancer should have gynecological follow-up examinations every two months in the first year. In cases of urological complications after irradiation therapy, radionephrography, infusion urogram, blood count, cystoscopy, and cystometry should also be carried out after two months. Depending on the clinical picture, radionephrography, blood count and urinalysis are to be repeated in regular intervals. After lymphography with positive findings, x-ray controls are necessary after two and four months. In cases of increasing hydronephrosis and hydroureter due to fibrostenosis of the ureter plastic surgery is recommended. Most urological complications are to be expected after radical operation and postoperative irradiation. In patients with endometrial uterine cancer, metastases mostly occur paraurethrally and in the lungs. Chest x-ray is to be taken every six months. Suspicious paraurethral hardening is cytologically diagnosed by needle biopsy. In ovarian carcinoma stage III and IV repeated x-ray controls of the lungs during longterm polychemotherapy are advisable. Prior to second look operations after combined treatment a second look laparoscopy is particularly important. Urological complications are more frequent after therapy of cervical cancer while ovarian carcinoma is more likely to develop complications of the small bowel.

Adult↗

PubMed2002

An optimization method for reference dose point of rectum in brachytherapy of gynecological neoplasms.

Rectum reference dose points have a direct impact on the morbidity seen in gynecological intracavitaty radiotherapy. The aim of this study is to obtain less morbidity by marking rectum with radio opaque solution. Fourteen patients with gynecological cancer who underwent external radiotherapy received 15 Gray (Gy) intracavitary radiotherapy. During the internal radiotherapy planning, radio opaque solution has been administered into the rectum to observe it on lateral radiogram. Thus rectum reference dose point and five points were marked at sites nearest to the sources. Nucletron Planning system was used for obtaining three-dimensional planning. After therapy patients were followed at every three months. Median follow-up was 18 months. Most frequently observed morbidities were grade 1-2 rectitis and cystitis in six patients. As a result, more accurate rectum dose values and less factors causing dose changing can provide better results for gynecological intracavitary brachytherapy.

Brachytherapy↗

PubMedDate not supplied

Peritoneal washing cytology. Uses and diagnostic criteria in gynecologic neoplasms.

Review of a 20-month experience with 241 peritoneal washes performed on 191 patients showed that the use of these specimens has expanded greatly. Of the 19 patients with neoplastic cells in their peritoneal washing cytology specimens, 12 had primary ovarian neoplasms, 4 had primary uterine cervical neoplasms, 2 had primary endometrial neoplasms, and 1 had mammary carcinoma metastatic to the ovary. Gynecologic oncologists at this institution are now routinely obtaining peritoneal washing cytology specimens whenever there is intraabdominal surgery on patients known to have or suspected of having a pelvic neoplasm. The following criteria were found to be essential to the accurate evaluation of these specimens: (1) cells considered to be malignant should be present both singly and in groups and should be malignant by the usual cytologic criteria, (2) the patients must have or be known to have had a neoplasm whose cells are similar to those in the washing specimen, and (3) the cells considered to be neoplastic must be different from and not confused with reactive mesothelial cells. The last criterion is important because the peritoneal lavage traumatically removes mesothelium, which can appear atypical. These criteria make the cytologic interpretation of most peritoneal washing specimens straightforward; interesting diagnostic problems occur, however, including the evaluation of neoplasms of borderline malignancy, those "spilled" during surgery and second neoplasms found by peritoneal washing cytology.

Ascitic Fluid↗

PubMed2005

The role of sonographic examination in the follow-up of gynecological neoplasms.

OBJECTIVE: The role and type of procedures of follow-up in patients with gynecological tumors are still a debatable issue. We prospectively analyzed the role of routine transabdominal and transvaginal ultrasound examination (US) in the detection of recurrent disease in gynecologic cancer patients. METHODS: Among 552 patients who underwent surgery for gynecological cancer, 385 were available for the analysis. Follow-up examinations included clinical examination, serum tumor marker assay, transvaginal and transabdominal sonography and CT scan/MRI. RESULTS: Positive US examination was documented in 83/385 patients (21.5%). In the overall series, the positive predictive value (PPV) of US examination was 100%, while the negative predictive value (NPV) was 92.7% failing to identify 22 cases of recurrences. When considering the subgroup of patients with positive clinical examination or abnormal tumor marker, positive US analysis was able to identify 66/66 cases of recurrence (PPV=100%), but exhibited an NPV of 22.2%, with 21/27 (77.8%) false negative cases. Conversely, in cases without clinical/serological signs of disease, positive US recognized all cases of recurrences (17/17, PPV=100%), and exhibited a very high NPV, with only 1 false negative case out of 275 (0.4%). The US detected recurrences appeared as a solitary lesion in 38/75 (50.6%) patients and in 28/75 (37%) appeared located centrally in the pelvis. The sonographic pattern of the ovarian recurrences was a solid lesion in most (33/40, 82%) cases. In the other gynecological tumors, the lesions appeared as solid masses in 33/35 (94%) cases. CONCLUSIONS: We showed that routine US might play a role in the follow-up of gynecologic malignancies, especially in the group of asymptomatic patients, while CT/MRI imaging might be more properly applied to patients with clinical or serological signs of disease.

Female↗

PubMed1976

[Fibrinogen degradation products in gynecologic neoplasms].

Concentration of fibrinogen degradation products in sera of 12 healthy women and 163 patients with gynecological tumors was determined by Staphylococcal-clumping-test. In sera of healthy women and patients with benign tumors the highest titer was 8. On the other hand in 53 of 97 cases with malign tumors higher concentrations were evaluated.

Endometriosis↗

PubMedDate not supplied

[Tumor markers in the early diagnosis of recurrence in gynecologic neoplasms: combined determination of CA-125, CA 15-3, CA 72.4, SCC, 90 K].

In 156 patients with gynecologic neoplasia the sieric levels of tumor markers (CA 125, CA 15-3, CA 72.4, SCC and 90 K) before the primary treatment and during the follow-up have been evaluated. In the patients with ovarian cancer elevated levels of CA 125 (80%), CA 72.4 (62%), 90 K (49%) and CA 15-3 (16.6) were found. The integrated evaluation of CA 125 and 90 K sieric levels was positive in the 86% of cases. The evaluation of CA 125 in combination with 90 K seems to facilitate the earlier detection of ovarian cancer recurrences. Elevated levels of SCC (89%) were found in the patients with cervical cancer. In the patients with endometrial or vulvar cancer the evaluation of these tumor markers was not significant.

Antigens, Neoplasm↗

PubMed1991

Fine-needle aspiration cytology accuracy with palpable gynecologic neoplasms.

From 1984 to 1988, 62 fine-needle aspirations (FNA) were performed on palpable lesions in 59 gynecologic oncology patients at the UCLA Medical Center. Sites of aspiration included abdomen, cervix, vagina, superficial lymph nodes, and pelvic masses. Confirmatory open biopsy (41) or adequate clinical follow-up (17) was obtained in 55 patients (58 aspirates). FNA correctly established the diagnosis of malignancy in 19 of 26 (73%) biopsied patients. The predictive value for a positive test was 100%, and the predictive value for a negative test was 82%. Initial surgical biopsy had been incorrectly benign in 4 of these patients who were shown subsequently to have malignant tumors by FNA and clinical findings. In 7 patients, FNA failed to diagnose the malignancy found by open biopsy. Two of the false-negative FNAs were insufficient and five were in masses where palpation was inadequate. In 17 patients who were followed clinically without open biopsy, FNA correctly predicted the subsequent clinical course in 15 (88%). There were no false-positive FNA diagnoses obtained when cytologic results were correlated with both clinical outcome and surgical biopsy. Aspiration cytology has a specificity of 100% and a sensitivity of 65%. A negative FNA obtained from a clinically suspicious lesion should be followed by a repeat aspiration or surgical biopsy.

Abdominal Neoplasms↗

PubMed1985

[Immediate results of the surgical treatment of gynecologic neoplasm patients over 60].

Surgery was carried out in 1,229 cases (346 (28.1%) aged 60 and older) at the gynecological department of the Dispensary in 1976-1983. The operability rate in the aged and old-age bracket was 55.2%. Malignancies were registered in 239 benign tumors--in 107 cases. 16 patients died (4.6%), thromboembolism of the lung artery being the most frequent cause of postoperative mortality. A combination of neuroleptanalgetics, barbiturates and nitrous oxide is recommended for anesthesia.

Adult↗

PubMed1994

[A controlled study of chemiluminescent enzyme immunoassay for the measurement of estrogen receptor in tissue of gynecological neoplasms].

UNLABELLED: In this study, chemiluminescent enzyme immunoassay (CLEIA) has been developed for the measurement of estrogen receptor (ER) in 34 gynecological oncological tissues from 15 cases of endometrial carcinoma, 15 cases of ovarian tumors and 4 cases of other gynecological tumors. The accuracy, specificity and sensitivity of CLEIA for ER were compared with that of dextran-coated charcoal (DCC) and enzyme immunoassay (EIA). RESULTS: (1) the standard curve of ER-CLEIA showed a significant linear correlation between the luminosity and ER concentration (r = 0.9786, P < 0.001); (2) The results of CLEIA and that of the other two methods were compared; the correlation coefficients were > 0.8 and their corresponding rates were > 90%; (3) the positive rate of ER determined by these three methods showed no significant differences, however, the mean value of ER-CLEIA was the highest among them. It is concluded that the CLEIA has a higher sensitivity than that of the other two methods for the measurement of ER.

Adenocarcinoma↗

PubMedDate not supplied

[Bacterial vaginosis during chemotherapy for gynecological neoplasms. A therapeutic proposal].

Bacterial vaginosis (BV) is a well characterized disease, defined Amsel's criteria, whose incidence is significantly increased during chemotherapy for gynecologic malignancies, as previously reported by the authors. Nine patients out of 14 (64%) who were receiving adjuvant chemotherapy for gynecologic tumors showed a clinical and laboratory evidence of bacterial vaginosis and were treated with cetyltrimethilammonium naproxenate vaginal douches. Results were analyzed up to the completion of oncologic chemotherapy: a high efficacy and tolerability for the topical treatment was demonstrated in all cases.

Adult↗

PubMedDate not supplied

[Ultrasound in the study of gynecologic neoplasms].

The authors discuss the state-of-the-art of ultrasound diagnosis for pelvic swellings, with special reference to uterine and ovarian cancer. They review the applications of Eco colour Doppler in gynecological oncology and discuss the protocols for the prevention and/or early diagnosis of gynecological tumours.

Adenocarcinoma↗

PubMed1991

[High dose brachytherapy in gynecologic neoplasms. Review of the literature].

The paper reports the historical origins of remote afterloading systems in intracavitary radiotherapy, together with the results and complications of high dose rate brachytherapy in gynecological tumours. High dose rate therapy achieves the same results as low dose rate therapy but has the advantage of making treatment more comfortable for patients.

Brachytherapy↗

PubMed2000

[Malignant gynecologic neoplasms in the Czech Republic 1986-1995].

OBJECTIVE: The incidence and mortality of malignant tumours of the uterine cervix, uterine body and ovary are analysed. DESIGN: Retrospective study. SETTING: Department of Obstetrics and Gynecology, Medical Faculty and Faculty Hospital, Charles University, Plzen. METHODS: Analysis of relevant dates from the National Oncological Registry 1986-1995. RESULTS: The incidence of the cervical carcinoma oscilated around 22 (22.7-21.6), the mortality slightly decreased (9.6-8.4). The incidence of the corpus carcinoma rose again (25.9-28.9), its mortality declined (7.4-6.9). The incidence of malignant ovarian tumours significantly increased (16.3-23.4), the mortality became slightly higher (14.8-16.2). The incidence of the ovarian carcinoma got ahead the incidence of the cervical carcinoma (23.4:21.6) and it occupied the second place after the corpus carcinoma. CONCLUSIONS: It is necessary to screen systematically gynecological malignant tumours and concentrate its treatment to specialized centers. Correct reports of these tumours and their precise staging is needed, too.

Czech Republic↗

PubMed1976

The ultrastructural morphology of gynecologic neoplasms.

Our knowledge of the morphology and pathogenesis of malignant neoplasms of the female genital tract has traditionally depended heavily on their light microscopic characteristics. The introduction of transmission, and most recently, scanning electron microscopy, into the field of gynecologic pathology has resulted in a considerable improvement in the diagnosis of genital cancers that are difficult to classify and has provided valuable information for a better understanding of their subcellular dynamics and pathogenetic development. This paper describes and illustrates the ultrastructural alterations that are considered specific for the most common malignant and potentially malignant neoplasms of the genital system in this context. The value of electron microscopy in the morphologic study of genital cancers warrants its increased use in routine diagnostic pathology, as well as further evaluation of it in basic research in this challenging area of investigation.

Adenocarcinoma↗