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  • 1
    Electronic Resource
    Electronic Resource
    Treatment of advanced carcinoma of the vulva with chemoradiotherapy — can exenterative surgery be avoided? (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: Thirty-seven patients with advanced FIGO stage (17 stage III, 20 stage IV) carcinoma of the vulva whose extent of disease would have required extenterative surgery were treated with chemoradiotherapy (CRT). Radiotherapy was given as a split course (2500 cGy mid-plane dose in 10 daily fractions, repeated 1 month later) to the first seven patients. Subsequently radiotherapy was given as a continuous course (4500 cGy mid-plane dose in 20–25 daily fractions). Chemotherapy included mitomycin c as an intravenous bolus and 5 fluorouracil as a continuous intra-venous infusion over 4–5 days, with variations in timing and dose according to the type of radiotherapy course. Fifteen (47%) complete and 11 (34%) partial responses were seen at 3 months after completion of treatment. Of the 15 patients with complete response, 10 remained disease-free for a median of 24 months (range 6–36 months). The median sur-vival for complete and partial responding patients was 15 and 11 months, respectively (range 2–37 months). Acute toxicity included moist perineal desquamation, diarrhea and myelosupression. One death secondary to neutropaenic sepsis occurred in the split course group. WHO grade 3 radiation enteritis occurred in one patient (14%) in the split course and two patients (6%) in the continuous CRT groups. Using CRT, very high response rates have been obtained with relatively low toxicity. There is a useful role for CRT in the treatment of patients with locally advanced recurrent disease although its place in the management of extensive primary disease requires further evaluation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1525-1438.1994.04030150.x
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  • 2
    Electronic Resource
    Electronic Resource
    Multiparameter flow cytometric measurement of epidermal growth factor receptor and c-erbB-2 oncoprotein in cultured cells and in fresh and preserved solid tumor cells (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: We developed a multiparameter flow cytometric technique for the simultaneous measurement of cellular DNA content and c-erbB-2 or epidermal growth factor receptor (EGFR) expression. The method provides a high resolution of DNA content and well preserved c-erbB-2 and EGFR immunostaining under saturated antibody conditions, allowing good control for background fluorescence and satisfactory cell morphology. Four different protocols for the short-term preservation of cells used for multiparameter flow cytometric assay of EGFR and c-erbB-2 were assessed in cell suspensions prepared by mechanical disaggregation in 10 gynecologic tumors. The protocols at 4°C were: storage in 50% methanol, and storage in buffer after formalin fixation. Tissues were also cryopreserved as cell suspensions and tissue blocks. When the oncoprotein expression and DNA histograms were compared with those in fresh suspensions, cryopreservation was found to be the best method: oncoprotein expression was well preserved and there was a good correlation between oncoprotein expression and the quality of the DNA histograms. The currently developed methods for cell preservation make the technique generally available for clinical cancer studies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1525-1438.1995.05010020.x
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  • 3
    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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  • 4
    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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  • 5
    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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  • 6
    Electronic Resource
    Electronic Resource
    Flow cytometric DNA analysis in gynecological oncology (1992)
    Three Cambridge Center, Massachusetts 02142, USA : Blackwell Scientific Publications Inc.
    International journal of gynecological cancer 2 (1992), S. 0 
    Details
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The relevance of flow cytometric DNA analysis in neoplasia of the female genital tract is reviewed. The virtues and limitations of the technique are discussed. There is good evidence, mainly from retrospective studies, that DNA ploidy and/or the tumor S-phase fraction are valuable prognostic indicators in patients with carcinoma of the ovary and endometrium. Further prospective studies are needed, however, to establish the precise value of flow cytometric DNA analysis before it can be used safely for stratification of therapeutic regimes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1525-1438.1992.02020057.x
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  • 7
    Electronic Resource
    Electronic Resource
    Malignant melanoma of the vulva and vagina: a report of 23 cases presenting in a 10-year period (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: In the 10-year period ending December 1991, 14 patients with primary melanoma of the vulva and nine with primary melanoma of the vagina were diagnosed and treated. Of the patients with vulval melanoma, three were treated surgically with wide local excision of the tumor alone, six had wide local excision with inguinal node dissection, and five had radical vulvectomy with inguinal node dissection. Four of the patients with vaginal melanoma had wide local excision; two had wide local excision with inguinal and or pelvic node dissection; and three had surgery that was more radical than this. Two years after diagnosis, all of the patients whose tumors were 2 mm thick or more had died, or were alive but had distant metastases. This was independent of the apparent surgical success of local excision of the disease. We consider that conservative procedures in the management of invasive melanoma of the lower female genital tract should be the rule, and that radical procedures should be reserved for palliation rather than cure.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1525-1438.1994.04060379.x
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  • 8
    Electronic Resource
    Electronic Resource
    Actinomyces on a papanicolaou smear following a radical trachelectomy (2003)
    Oxford, UK : Blackwell Science Ltd
    BJOG 110 (2003), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.2003.02031.x
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