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  • 1
    Electronic Resource
    Electronic Resource
    Problems in the use of urinary hCG-beta-core as a tumor marker in gynecologic cancer (1995)
    Suite 500, 5th Floor, 238 Main Street, Cambridge, Massachusetts 02142, USA : Blackwell Science Inc.
    International journal of gynecological cancer 5 (1995), S. 0 
    Details
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Urinary human chorionic gonadotrophin beta-core (hCG-βC) was detected in 55–77% of gynecologic malignancies. The use of spot and early morning urine hCG-βC as a tumor marker was explored with regard to the stability of the hCG-βC level in serial spot urine samples collected within 24 hours and in early morning urine collected over 3 days. Thirteen patients with gynecologic malignancies were asked, before treatment, to collect serial urine samples voided within 24 hours. Nine of these 13 patients were also asked to save early morning urine for 2–3 consecutive days. Their urine was assayed for creatinine and hCG-βC using an immunoradiometric assay. Variation of urine concentration was corrected by using the hCG-βC/creatinine (βC/Cr) ratio expressed in pmolg−1. Wide fluctuations of βC/Cr ratios were found both in the serial spot urine within 24 hours and in early morning urine within 3 days. Eight per cent of the patients had one or more spot hCG-βC level double or half the median of their own serial urine samples. Neither spot urine nor early morning urine hCG-βC were suitable for use as a tumor marker for continuous monitoring because of the large fluctuation in hCG-βC levels. The reason for such a wide fluctuation is not clear.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1525-1438.1995.05010015.x
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  • 2
    Electronic Resource
    Electronic Resource
    Vaginal sarcoma: the Royal Marsden experience (1994)
    238 Main Street, Cambridge, MA 02142, USA : Blackwell Scientific Publications
    International journal of gynecological cancer 4 (1994), S. 0 
    Details
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Six patients with vaginal sarcoma are reported here. This clinicopathologic review confirms the poor prognosis of this disease. However, there were three 5-year survivors, all of whom had early stage disease and low to intermediate grade tumors. Apart from tumor grade, stage was of prognostic importance. Late recurrences at 5 and 21 years were noted in two of the three 5-year survivors. Neither chemotherapy nor radiotherapy were of use in the treatment of late stage or recurrent disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1525-1438.1994.04050337.x
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  • 3
    Electronic Resource
    Electronic Resource
    An evaluation of the prognostic factors in metastatic gestational trophoblastic disease (1994)
    238 Main Street, Cambridge, MA 02142, USA : Blackwell Scientific Publications
    International journal of gynecological cancer 4 (1994), S. 0 
    Details
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A retrospective evaluation of prognostic factors in 55 patients suffering from metastatic gestational trophoblastic disease (MGTD) treated by modified Bagshawe’s CHAMOCA regimen was done. The prognostic significance of the eight prognostic factors in the WHO scoring system, number of sites of metastasis and FIGO staging were evaluated by univariate analysis using Chi-square test with Yates’ correction and odds ratio and by multivariate analysis using Cox proportional hazard analysis and logistic regression analysis. In the univariate analysis, the intervals between antecedent pregnancy and the diagnosis of GTD, (P = 0.004) the level of hCG (P = 0.02) and the number of metastatic sites (P = 0.046) were significantly associated with death. In the multivariate analysis, only the interval between the antecedent pregnancy and the diagnosis and the level of hCG were significantly associated with death. Thus, it seems that the interval between antecedant pregnancy and the diagnosis and the level of hCG were the two most significant factors in predicting mortality in high risk MGTD. The WHO staging was more predictive of poor outcome than that of the FIGO staging in this group of patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1525-1438.1994.04010036.x
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  • 4
    Electronic Resource
    Electronic Resource
    Clinicopathologic study of 16 cases of primary tubal malignancy (1994)
    238 Main Street, Cambridge, Massachusetts 02142, USA : Blackwell Scientific Publications
    International journal of gynecological cancer 4 (1994), S. 0 
    Details
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Sixteen cases of primary carcinoma of the fallopian tube were diagnosed and treated at Queen Mary Hospital, Hong Kong from July 1972 to June 1992 constituting 0.26% of the total gynecologic malignancies seen during that period. The average age was 61 years and the most common presenting symptom was abnormal vaginal bleeding. Preoperative diagnosis is difficult; in only one case was a diagnosis of malignancy made by cervical smear. An adnexal mass was detected in 13 of the cases (81.3%) either by clinical examination and/or ultrasonography. Therapy consisted of surgical resection, usually followed by various combinations of adjuvant radiation therapy and chemotherapy. The cumulative survival was 62%. In addition to the typical form of adenocarcinoma, one case of squamous cell carcinoma and a case of multifocal endometrioid adenocarcinoma were observed. One case of an apparently usual form of adenocarcinoma recurred as a heterologous malignant mixed Müllerian tumor 2 years after diagnosis. This series further emphasises the wide range of differentiation possible in the Müllerian system and the variety of neoplasms which may arise from it.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1525-1438.1994.04020111.x
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  • 5
    Electronic Resource
    Electronic Resource
    The role of CT in predicting the surgical feasibility of exenteration in recurrent carcinoma of the cervix (1996)
    Suite 500, 5th Floor, 238 Main Street, Cambridge Massachusetts 02142, USA : Blackwell Science Inc.
    International journal of gynecological cancer 6 (1996), S. 0 
    Details
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In women with recurrent cervical cancer, there is a 52% 5-year survival rate when exenteration of the centrally placed tumor is performed. If not exenterated, the 2-year survival rate is less than 2%. The purpose of this study is to ascertain whether CT can predict inoperability reliably leading to a reduction in operations which do not have a curative outcome. The records of patients with recurrence of cervical cancer who underwent laparotomies for exenteration over the last 10 years under the care of one surgeon were reviewed. The CT scans were retrospectively assessed by two radiologists without knowledge of the subsequent outcome of the laparotomy. CT scans on 31 patients were reviewed, 21 of whom underwent a radical surgical procedure. Using CT criteria, 9 cases were felt to be operable with a curative intent and the remaining 22 cases were deemed to be inoperable. The sensitivity of CT prediction of inoperability is 93% (95%Cl:66–100%) and the specificity is 47% (95%Cl:23–72%). In three cases ascites was the only abnormal finding other than the central pelvic mass and in all of these cases a radical procedure with clear resection margins was possible. When the group with ascites alone was not considered to have peritoneal disease underlying the ascites, the sensitivity of CT prediction of inoperability is 93% (95%Cl:66–100%) and the specificity of 65% (95%Cl:38–86%). If, in addition, lymphadenopathy is not taken as definite evidence of inoperability, the specificity rises to 82% (95%Cl:57–96%). A high quality CT scan is highly specific for predicting inoperability based on extension of the tumor to the pelvic side walls, encasement of adjacent vessels or ureteric dilatation and so should be a major tool in assessing women for radical surgical treatment of recurrent cervical cancer. If ascites is the only abnormal finding other than the central pelvic mass then exploration should be undertaken.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1525-1438.1996.06030231.x
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  • 6
    Electronic Resource
    Electronic Resource
    Multivariate analysis of factors affecting survival in pelvic exenteration (1994)
    238 Main Street, Cambridge, Massachusetts 02142, USA : Blackwell Scientific Publications
    International journal of gynecological cancer 4 (1994), S. 0 
    Details
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Of 153 patients with primary or recurrent pelvic malignancy referred for consideration of exenteration, only 40.6% (62 patients) were found to be suitable for exenteration after full assessment. Thirty percent (46 patients) were found to be inoperable on examination under anesthesia. Of the remaining 107 patients, 33% (35 patients) were found to be inoperable at laparotomy, 9% (10 patients) underwent radical hysterectomy and 58% (62 patients) had an exenterative procedure. One patient had no active disease found on final histologic review of the exenteration surgical specimen and was excluded, as the aim of this study was to look at the prognostic factors affecting survival. There remained 61 patients in the exenteration group who were analyzed. The 2-year survival rate was less than 2% for patients with inoperable disease, 48% for patients who underwent radical hysterectomy and 54.1% for patients who underwent exenteration. The 5-year survival rate for all patients undergoing exenteration for pelvic malignancies was 44% and that for cervical cancer only was 52%. Multivariate analysis of patients who had undergone exenteration showed four significantly poor prognostic factors influencing survival. They were: (a) aged older than 69 years, (b) recurrence of the tumor within 3 years, (c) persistent recurrence, and (d) positive resection margins.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1525-1438.1994.04060361.x
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  • 7
    Electronic Resource
    Electronic Resource
    The prognostic significance of positive peritoneal cytology in endometrial cancer (1996)
    Suite 500, 5th Floor, 238 Main Street, Cambridge, Massachusetts 02142, USA : Blackwell Science Inc.
    International journal of gynecological cancer 6 (1996), S. 0 
    Details
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A retrospective analysis of clinical data extracted from hospital records of 145 patients who had had primary surgical treatment for endometrial cancer in Queen Mary Hospital, Hong Kong, from 1987 to 1993 was performed to study the prognostic significance of positive peritoneal cytology. Positive peritoneal cytology was found to be associated with poor prognostic factors such as deep myometrial invasion, high grade tumor, extrauterine spread and lymphovascular permeation. By univariate analysis, all the poor prognostic factors were found to be significant in affecting survival. These included age above 65, nonadenocarcinoma histology, deep myometrial invasion, positive cytology, extrauterine involvement and lymphovascular involvement. By multivariate analysis, only histology and extrauterine involvement remained significant. In patients with positive cytology, 61.1% had extrauterine involvement at initial presentation. Patients who had positive cytology and extrauterine disease had the shortest survival. The survival was independent of cytology result when the tumor was confined to the uterus.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1525-1438.1996.06060473.x
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  • 8
    Electronic Resource
    Electronic Resource
    Post-treatment serial serum squamous cell carcinoma antigen (SCC) in the monitoring of squamous cell carcinoma of the cervix (1996)
    Suite 500, 5th Floor, 238 Main Street, Cambridge, Massachussets 02142, USA : Blackwell Science Inc.
    International journal of gynecological cancer 6 (1996), S. 0 
    Details
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Serum squamous cell carcinoma antigen (SCC) was raised in 62% of 308 patients with squamous cell carcinoma of the cervix before treatment. Post-treatment SCC levels were raised in 69 patients (22.4%). Retrospective review showed that persistently raised SCC level after treatment was significantly associated with persistent or recurrent disease in squamous cell carcinoma of the cervix. The specificity of persistently raised SCC level in association with recurrent disease was 98.2%. The sensitivity in association with recurrent disease was 74.7%. The positive predictive values was 94.2%. The median lead time for recurrence was 4 months. SCC was raised in 38% of patients with clinical evidence of disease in the vagina. One patient had raised SCC one month prior to clinical detection of vaginal metastasis and was salvaged by an exenterative procedure. SCC was raised in 71–91% of patients with metastatic disease in the lung, lymph nodes or other distant sites. Thus, persistently raised SCC level after treatment of squamous cell carcinoma should alert the clinician to look for recurrent disease especially in distant metastatic sites. Post-treatment raised SCC level was associated with less than 5% 5-year survival rate whereas in patients with normal SCC level, the 5-year survival rate was 87%.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1525-1438.1996.06020115.x
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  • 9
    Electronic Resource
    Electronic Resource
    The expression of cathepsin D, oestrogen receptor and progestogen receptor in hydatidiform mole—an immunohistochemical study (1995)
    Oxford, UK : Blackwell Publishing Ltd
    Histopathology 27 (1995), S. 0 
    Details
    ISSN: 1365-2559
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The expression of oestrogen and progestogen receptors, as well as Cathepsin D, an oestrogen-induced protease, in trophoblastic cells of 12 cases of complete hydatidiform mole, 12 cases of partial mole and nine cases of spontaneous abortions, were studied in an attempt to elucidate their possible roles in the pathogenesis of the diseases. The immunohistochemical studies were performed on formalin-fixed paraffin-embedded tissue using the ABC immunoperoxidase method. The intensity of staining and proportion of cells stained were assessed and compared in the three categories of lesions. Immunoreactivity for Cathepsin D was noted in both the syncytio- and cytotrophoblastic cells in all three lesions. Statistical analysis showed consistently stronger and more extensive staining for Cathepsin D in complete moles when compared with abortions. Staining for oestrogen and progestogen receptors was found to be weak in the tissues studied. The strong expression of Cathepsin D in trophoblastic cells of all three lesions, especially in complete mole, suggests that it might be important in the control of trophoblastic cell activities and involved in the pathogenesis of hydatidiform mole. The associated weak expression of sex hormone receptors also suggests that the expression of Cathepsin D in trophoblastic cells may be controlled by modes of regulation other than sex hormones.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2559.1995.tb01524.x
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  • 10
    Electronic Resource
    Electronic Resource
    The significance of proliferating cell nuclear antigen in human trophobiastic disease: an immunohistochemical study (1993)
    Oxford, UK : Blackwell Publishing Ltd
    Histopathology 22 (1993), S. 0 
    Details
    ISSN: 1365-2559
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The expression of proliferating cell nuclear antigen (PCNA) in human trophobiastic disease was assessed immunohistochemically in tissue from 29 spontaneous abortions, 33 partial moles, 40 complete moles and 23 chorio carcinomas using the monoclonal antibody PC ID. PCNA immunoreactivity occurred predominantly in the cytotrophoblasts in each of the four types of tissues. Quantitative analysis showed that the choriocarcinoma group gave a statistically significant higher PCNA index than the other three. There was no significant difference between the groups of spontaneous abortion, partial or complete mole. Sixteen of the 73 patients with partial and complete moles developed persistent gestational trophobiastic disease and there was no significant difference between the patients requiring chemotherapy and those who did not. We conclude that choriocarcinoma has a significantly higher PCNA proliferative index whilst hydatidiform moles cannot be distinguished from abortions by such analysis. The PCNA index does not appear to be useful in predicting the progression of molar pregnancies to persistent trophobiastic diseases.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2559.1993.tb00177.x
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