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  • 1
    Electronic Resource
    Electronic Resource
    Prognostic factor analysis, for patients with no evidence of disease after initial chemotherapy for advanced epithelial ovarian carcinoma (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: Although the results from chemotherapy for advanced ovarian carcinoma have improved over the past 15 years with the introduction of platinum compounds, there are still a large number of patients who will relapse from complete response (clinical or pathological) to first line therapy, and there is little published data on prognostic factors for survival after relapse. A total of 270 patients from two randomized trials in ovarian carcinoma conducted in Scotland were reviewed and the data from 117 patients who were disease free after first line treatment were analyzed to determine prognostic factors associated with disease-free survival and survival after relapse respectively.The most important prognostic factors adversely influencing time to relapse were the presence of ascites at presentation and an advanced tumor stage. For time from relapse to death, the most important adverse features were: early relapse, no chemotherapy at relapse, histology other than serous and stage at diagnosis (either stage IC/II or stage III/IV with residual disease 〈inlineGraphic alt="geqslant R: gt-or-equal, slanted" extraInfo="nonStandardEntity" href="urn:x-wiley:1048891X:IJG06010008:ges" location="ges.gif"/〉2 cm). From our results, 26% of patients who achieve complete response are alive and disease-free after 5 years, while 56% relapsed within 2 years. Of the patients whose disease-free period following initial complete response extends beyond 600 days, 50% can expect a further period of at least 600 days following relapse and subsequent therapy. Patients with ascites and advanced stage may be suitable for consideration of a more aggressive approach (high dose chemotherapy) once complete response is confirmed, the aim being to improve the disease-free period.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1525-1438.1996.06010008.x
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  • 2
    Electronic Resource
    Electronic Resource
    Cervical carcinoma in the Grampian region (1980–1991): a population-based study of survival and cervical cytology history (1994)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 101 (1994), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives To study survival in women treated for cervical carcinoma in Grampian region, to identify clinical and pathological prognostic factors, and to correlate survival with cytology history.Design A retrospective study of all cases of cervical carcinoma using a prospectively gathered database. Data validated by 1 in 10 randomised retrospective case note sampling.Setting Aberdeen Royal Infirmary.Subjects Three hundred and sixty-three women resident within Grampian diagnosed as having cervical carcinoma between 1980 and 1991, with five-year survival data on the 206 diagnosed by the end of 1986.Main outcome measure Five-year survival rates.Results The mean annual incidence of cervical carcinoma in our population was 11.2 per 100 000 women, with an overall five-year survival of 67% in those under 40 years of age and 60% in those aged 40 years and over. On univariate analysis, survival was significantly adversely affected by tumour stage, grade and absence of previous smears. On multivariate analysis, the effect of previous smear history was lost, but stage and grade remained strong independent risk factors for survival. There was no significant difference in five-year survival by age or tumour type.Conclusions The prognosis of cervical carcinoma in Grampian region was independently affected only by stage of disease and tumour grading and cervical smear history.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1994.tb11949.x
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  • 3
    Electronic Resource
    Electronic Resource
    The 1993 British Society for Colposcopy and Cervical Pathology/National Coordinating Network United Kingdom Colposcopy Survey (1995)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 102 (1995), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To evaluate colposcopic practice over a 12-month period in the UK, April 1993 to March 1994, to compare this with 1988, and to test penetration and acceptance of previously introduced national guidelines.Design A nationwide survey of colposcopy practice by postal questionnaire, including referral criteria, diagnosis and treatment, follow up, waiting times and information and counselling.Setting All gynaecology clinics in the United Kingdom.Results Returns were obtained from 215 clinics (78%), that saw an average of 434 new women per year. Seventy percent of clinics follow the current national guideline for cytological referral criteria for colposcopy. Diathermy loop excision is now by far the most popular treatment method for CIN. The majority of clinics employ both colposcopy and cytology for follow up. A total of 103 invasive cancers following treatment for CIN were reported during the 12-month period of the survey. Most clinics provide new patients with both information and counselling.Conclusions Colposcopy practice has undergone considerable changes in the last five years. There has been a good response to the introduction of a national guideline for referral for colposcopy. While local audits are necessary to identify improvements that need to be made to individual clinical services, this national audit has shown some trends over the past five years, has highlighted the problem of invasive cancer following treatment for CIN and has assessed the impact of a national guideline.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1995.tb11359.x
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  • 4
    Electronic Resource
    Electronic Resource
    Fertility and pregnancy outcome following large loop excision of the cervical transformation zone (1995)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 102 (1995), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To determine if large loop excision of the transformation zone affects subsequent fertility and pregnancy outcome.Design A case-control study.Setting A teaching hospital serving a regional population.Subjects One thousand women who had undergone large loop excision of the transformation zone (LLETZ) for the treatment of cervical intraepithelial neoplasia (CIN) between 1989 and 1991. Two controls were matched for each of the 149 women who had a singleton pregnancy progressing beyond 20 weeks of gestation following treatment, with regard to age, parity, height, husband's or partner's social class and smoking habits to account for common independent risk factors for adverse obstetric outcome and cervical intraepithelial neoplasia.Main outcome measures Intention to conceive, number of pregnancies, gestation, low birthweight, mean birthweight, mode of delivery, and duration of labour.Results Out of a cohort of 1000 women who underwent LLETZ for the treatment of CIN, 653 women replied to a postal questionnaire. When asked up to 54 months after treatment, 130 women (19.9%) had become pregnant and 47 (7.2%) had tried to become pregnant. A total of 199 pregnancies from 178 women was identified from the cohort of women.For the 149 women from the case cohort, the mean birthweight was 3380 g compared with 3373 g in the control group (P= 0.88). The incidence of low birthweight in pregnancies progressing to at least 37 weeks of gestation was 3.1% in the treated group, compared with 3.2% in the control group (P= 098). Following LLETZ, 94% of deliveries were preterm (〈 37 weeks of gestation), compared with 50% in the control group (P= 0.12). There was no significant difference in mean gestation, mode of delivery, indication for caesarean section or duration of labour between the women who had undergone LLETZ and the controls.Conclusion When socio-epidemiological factors associated with the development of cervical intraepithelial neoplasia are controlled for, LLETZ does not appear to exert an independent adverse effect on subsequent pregnancy outcome.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1995.tb11319.x
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  • 5
    Electronic Resource
    Electronic Resource
    Prospective serial study of viral change in the cervix and correlation with human papillomavirus genome status (1991)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 98 (1991), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective— To observe in serial fashion the histological changes of human papilloma virus (HPV) infection of the cervix and to correlate these with the detection of HPV genomes.Design— A prospective longitudinal study to perform colposcopy and at 0,9 and 18 months to obtain a smear, a biopsy for histology and HPV-16 genome detection by DNA/DNA hybridization.Setting— Glasgow Family Planning Centre.Subjects— Eighty-two women recruited on the basis of a routine smear showing viral change without dyskaryosis.Interventions— Women found to have CIN 3 were treated with laser.Main outcome measures— Cytology and cervical biopsy results and HPV-16 DNA detection by Southern blotting obtained serially from individual subjects.Results— Of 82 women recruited, 10% were positive for HPV-16 detection by Southern blotting. Detection of HPV-16 genomes did not correlate with either CIN or viral infection assessed histologically and serial hybridizations in a given individual showed fluctuation in HPV-16 detection. Polymerase chain reaction in a subset of samples revealed 46% positive for HPV DNA.Conclusion— No clear correlation exists between HPV genome detection and the histological appearance. HPV-16 genome detection alone may not be a useful predictor of precancerous progression.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1991.tb15344.x
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  • 6
    Electronic Resource
    Electronic Resource
    A pragmatic randomised comparison of transcervical resection of the endometrium with endometrial laser ablation for the treatment of menorrhagia (1997)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 104 (1997), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To compare endometrial laser ablation (ELA) with transcervical resection of the endometrium (TCRE) in the treatment of menorrhagia.Design Randomised controlled trial.Setting Gynaecology department of a large teaching hospital.Participants Women with menorrhagia due to dysfunctional uterine bleeding (n= 372) were randomly allocated to ELA (n= 188) or TCRE (n= 184).Main outcome measures Operative complications, post-operative recovery, relief of menstrual and other symptoms, need for further surgical treatment, satisfaction with treatment after 6 and 12 months, and differential resource use.Results TCRE was significantly quicker, with lower rates of fluid overload. Perioperative morbidity was low and similar hi both groups. Outcome at 12 months was also similar: 72 women (45%) had either amenorrhoea or brown discharge in the ELA group compared with 71 (49%) in the TCRE group; 79 (49%) versus 68 (46%) had lighter periods. Thirty (16%) versus36 (20%) had received further surgical treatment: 9 (5%) compared with 25 (14%) had had a hysterectomy, and 21 (11%) versus 11 (6%) had received repeat ablation. Anxiety and depression, dysmenorrhoea and pre-menstrual symptoms were improved by both procedures and bladder symptoms were affected by neither. At 12 months 148 (90%) women in the ELA group and 140 (91%) women in the TCRE group were satisfied with their treatment. The estimated additional cost of ELA was £145 per procedure.Conclusions At one year there was no clear difference in clinical outcome between ELA and TCRE.Both procedures were associated with low morbidity. ELA was the more costly procedure. Despite the need for further surgery for about one in six women, satisfaction rates were high following both ELA and TCRE.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1997.tb11540.x
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  • 7
    Electronic Resource
    Electronic Resource
    Patlent selection for hysteroscopic endometrial resection (1991)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 98 (1991), 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.1471-0528.1991.tb13495.x
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  • 8
    Electronic Resource
    Electronic Resource
    An out-patient approach to the management of post-menopausal bleeding (1991)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 98 (1991), 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.1471-0528.1991.tb10348.x
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  • 9
    Electronic Resource
    Electronic Resource
    The presence of RNA complementary to HSV-2 (herpes simplex virus) DNA in cervical intraepithelial neoplasia after laser therapy (1984)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 91 (1984), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In-situ hybridization of radiolabelled DNA probes to tissue sections detected RNA complementary to HSV-2 (herpes simplex virus) DNA in 65% (22 of 34) biopsies from cervical intraepithelial neoplasia (CIN) and in none of internally paired benign epithelia from individuals before treatment by laser vaporization cone. Laser therapy did not produce an increase in clinical or subclinical HSV infections of the cervix. Of 18 patients with RNA complementary to HSV-2 DNA in CIN biopsies before treatment, in whom treatment was successful, virus transcripts were detected at follow-up in only two of them.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1984.tb04765.x
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  • 10
    Electronic Resource
    Electronic Resource
    Uterine activity during spontaneous labour after previous lower-segment caesarean section (1989)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 96 (1989), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. Uterine activity was measured in three groups of labouring women who previously had a caesarean section (CS): group A included women with a previous elective CS before labour or in the early latent phase of labour and no previous vaginal delivery; group B included women with a CS in the active phase of labour and no previous vaginal delivery; group C included women with a CS and a vaginal delivery either before or after the abdominal delivery. The active contraction area profiles in the three groups were compared with those of matched control groups of nulliparae and multiparac without a uterine scar. Group A had a uterine activity profile similar to that in control nulliparae and significantly higher than that in control multiparae. The uterine activity in group B was less than that in matched nulliparae but was similar to that in matched multiparae. Group C had significantly less uterine activity than matched nulliparae but a similar profile to that in the matched multiparae. Progress of labour into the active phase in the previous pregnancy reduces the uterine activity profile in subsequent labour. Women who had had a vaginal delivery either before or after the CS (group C) exhibited uterine activity profiles similar to multiparae, suggesting that an intact scar did not affect the uterine function.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1989.tb03348.x
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