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Friday, May 29, 2015

Explaining variation in cancer survival between 11 jurisdictions in the Intl Cancer Benchmarking Partnership: a primary care vignette survey

open access

Strengths and limitations of this study

  • A novel, large and logistically complicated study using a validated survey.
  • Data were analysed from 2795 primary care physicians (PCPs) across 11 jurisdictions.
  • Response rates were suboptimal (ranging from 5.5% in England and British Columbia to 45.6% in Manitoba) and respondents were not totally representative of the PCPs in all jurisdictions.
  • It is difficult to assess the effect of these weaknesses on the interpretation of results but sensitivity analyses and the literature suggest it would not be large. 

    Principal findings

    Using an online survey in 11 jurisdictions, we have demonstrated a correlation that suggests a relationship between the readiness of PCPs to investigate or refer for suspected cancer and cancer survival in each jurisdiction. This is the first time that readiness to investigate cancer—either directly or by referral to secondary care—has been shown to correlate with cancer survival. Evidence suggests that variations between healthcare systems have an impact on health outcomes.24 There is significant variation between jurisdictions in PCP's access to diagnostic tests. Whether greater access to tests improves outcomes depends on the sensitivity of the test and how the waiting time for test results compares with the waiting time if a referral is made. PCPs may not be aware of the fastest way to diagnose cancer: referral or primary care investigation. Our data indicate significantly long waits in some jurisdictions for the results of tests undertaken in primary care. However, access to tests was not associated with readiness to investigate or refer. Further research is required in this complex area.

Thursday, May 28, 2015

What Can You Do to Improve Your Odds Against Cancer? |

Dr. Robert A. Nagourney - Rational Therapeutics - Blog

I sometimes joke with my patients that a new diagnosis of cancer rarely provides them enough time to get an MD or PhD. Yet it is that level of preparation that may be required to answer the myriad questions that lie ahead.
Although it’s a joke, it is only partly in jest. Unlike buying a house or a car for which one’s life experiences can prepare you, medicine is opaque, complicated and ever changing. At the bleeding edge of medical complexity sits medical oncology and its dizzying array of genomics, transcriptomics, proteomics, epigenomics and metabolomics. Not only is it difficult for patients to keep up with all the changes, it is increasingly beyond the ken of their doctors who have spent entire careers training in the specialty, many of whom may have an MD and a PhD........

Anti-Angiogenesis Therapy in Gynecologic Malignancies - open access

open access

 The purpose of this paper is to provide a review of site-specific treatment options that involve the targeting of angiogenesis in gynecologic malignancies.

Canada has mixed wait time results in healthcare | Commentary

evidence network

Toxicities of Immunotherapy for the Practitioner

abstract and articles plus editorial

The toxicities of immunotherapy for cancer are as diverse as the type of treatments that have been devised. These range from cytokine therapies that induce capillary leakage to vaccines associated with low levels of autoimmunity to cell therapies that can induce damaging cross-reactivity with normal tissue to checkpoint protein inhibitors that induce immune-related adverse events that are autoinflammatory in nature. The thread that ties these toxicities together is their mechanism-based immune nature and the T-cell–mediated adverse events seen. The basis for the majority of these adverse events is a hyperactivated T-cell response with reactivity directed against normal tissue, resulting in the generation of high levels of CD4 T-helper cell cytokines or increased migration of cytolytic CD8 T cells within normal tissues. The T-cell immune response is not tissue specific and may reflect a diffuse expansion of the T-cell repertoire that induces cross-reactivity with normal tissue, effectively breaking tolerance that is active with cytokines, vaccines, and checkpoint protein inhibitors and passive in the case of adoptive cell therapy. Cytokines seem to generate diffuse and nonspecific T-cell reactivity, whereas checkpoint protein inhibition, vaccines, and adoptive cell therapy seem to activate more specific T cells that interact directly with normal tissues, potentially causing specific organ damage. In this review, we summarize the toxicities that are unique to immunotherapies, emphasizing the need to familiarize the oncology practitioner with the spectrum of adverse events seen with newly approved and emerging modalities.


Editorial: Recognizing the Financial Burden of Cancer Patients in Clinical Trials

 "Clinical trials often represent an increasingly important option for patients
with cancer, thus oncologists participating in clinical research need to consider and address the financial burden associated with trial participation."

Mutated Fanconi anemia pathway in non-Fanconi anemia cancers


 An extremely high cancer incidence and the hypersensitivity to DNA crosslinking agents associated with Fanconi Anemia (FA) have marked it to be a unique genetic model system to study human cancer etiology and treatment, which has emerged an intense area of investigation in cancer research. However, there is limited information about the relationship between the mutated FA pathway and the cancer development or/and treatment in patients without FA. Here we analyzed the mutation rates of the seventeen FA genes in 68 DNA sequence datasets. We found that the FA pathway is frequently mutated across a variety of human cancers, with a rate mostly in the range of 15 to 35 % in human lung, brain, bladder, ovarian, breast cancers, or others. Furthermore, we found a statistically significant correlation (p < 0.05) between the mutated FA pathway and the development of human bladder cancer that we only further analyzed. Together, our study demonstrates a previously unknown fact that the mutated FA pathway frequently occurs during the development of non-FA human cancers, holding profound implications directly in advancing our understanding of human tumorigenesis as well as tumor sensitivity/resistance to crosslinking drug-relevant chemotherapy.

Pharmacoethnicity in Paclitaxel-Induced Sensory Peripheral Neuropathy

Sensory Peripheral Neuropathy


Paclitaxel is used worldwide in the treatment of breast, lung, ovarian and other cancers. Sensory peripheral neuropathy is an associated adverse effect that cannot be predicted, prevented or mitigated. To better understand the contribution of germline genetic variation to paclitaxel-induced peripheral neuropathy, we undertook an integrative approach that combines genome-wide association study (GWAS) data generated from HapMap lymphoblastoid cell lines (LCLs) and Asian patients.


GWAS was performed with paclitaxel-induced cytotoxicity generated in 363 LCLs and with paclitaxel-induced neuropathy from 145 Asian patients. A gene-based approach was used to identify overlapping genes and compare to a European clinical cohort of paclitaxel-induced neuropathy. Neurons derived from human induced pluripotent stem cells were used for functional validation of candidate genes.


SNPs near AIPL1 were significantly associated with paclitaxel-induced cytotoxicity in Asian LCLs (P < 10-6). Decreased expression of AIPL1 resulted in decreased sensitivity of neurons to paclitaxel by inducing neurite morphological changes as measured by increased relative total outgrowth, number of processes and mean process length. Using a gene-based analysis, there were 32 genes that overlapped between Asian LCL cytotoxicity and Asian patient neuropathy (P < 0.05) including BCR. Upon BCR knockdown, there was an increase in neuronal sensitivity to paclitaxel as measured by neurite morphological characteristics.


We identified genetic variants associated with Asian paclitaxel-induced cytotoxicity and functionally validated the AIPL1 and BCR in a neuronal cell model. Furthermore, the integrative pharmacogenomics approach of LCL/patient GWAS may help prioritize target genes associated with chemotherapeutic-induced peripheral neuropathy.

Pan-cancer analysis of genomic scar signatures associated with homologous recombination deficiency suggests novel indications....


 Pan-cancer analysis of genomic scar signatures associated with homologous recombination deficiency suggests novel indications for existing cancer drugs


Ovarian and triple-negative breast cancers with BRCA1 or BRCA2 loss are highly sensitive to treatment with PARP inhibitors and platinum-based cytotoxic agents and show an accumulation of genomic scars in the form of gross DNA copy number aberrations. Cancers without BRCA1 or BRCA2 loss but with accumulation of similar genomic scars also show increased sensitivity to platinum-based chemotherapy. Therefore, reliable biomarkers to identify DNA repair-deficient cancers prior to treatment may be useful for directing patients to platinum chemotherapy and possibly PARP inhibitors. Recently, three SNP array-based signatures of chromosomal instability were published that each quantitate a distinct type of genomic scar considered likely to be caused by improper DNA repair. They measure telomeric allelic imbalance (named NtAI), large scale transition (named LST), and loss of heterozygosity (named HRD-LOH), and it is suggested that these signatures may act as biomarkers for the state of DNA repair deficiency in a given cancer.


We explored the pan-cancer distribution of scores of the three signatures utilizing a panel of 5371 tumors representing 15 cancer types from The Cancer Genome Atlas, and found a good correlation between scores of the three signatures (Spearman's ρ 0.73-0.87). In addition we found that cancer types ordinarily receiving platinum as standard of care have higher median scores of all three signatures. Interestingly, we also found that smaller subpopulations of high-scoring tumors exist in most cancer types, including those for which platinum chemotherapy is not standard therapy.


Within several cancer types that are not ordinarily treated with platinum chemotherapy, we identified tumors with high levels of the three genomic biomarkers. These tumors represent identifiable subtypes of patients which may be strong candidates for clinical trials with PARP inhibitors or platinum-based chemotherapeutic regimens.


Cancer; Genomic scars; Homologous recombination deficiency

Wednesday, May 27, 2015

SGO outlines recommendations for ovarian cancer prevention

health news

Primary Chemo Good Option in Advanced Ovarian Cancer ?

Cancer Network

..... These results raise two questions, Kang wrote: whether the CHORUS findings apply to expert surgeons, and which patients would benefit most from this treatment strategy.
“Concerns are also increasing that neoadjuvant chemotherapy could be used as an excuse for neglecting maximum surgical efforts or improvement of competent surgical skills,” Kang wrote. “Despite these questions and concerns, Kehoe and colleagues are to be congratulated on their research showing that neoadjuvant chemotherapy lowers treatment-related morbidity without sacrificing treatment efficacy. However, efforts should now be directed towards identifying and resolving the remaining uncertainties.”

Olaparib not being funded by the NHS

Behind the headlines
Posted by Simon Newman, Head of Research on Tuesday 26 May 2015
As a scientist I have suffered the disappointment of seeing potential drugs I have worked on failing to make it into use. However, my frustrations as a scientist are nothing compared to the disappointment felt by women with ovarian cancer when drugs such as olaparib fail to get approved.
Olaparib is a treatment for women with relapsed platinum sensitive ovarian cancer with a BRCA gene mutation (around 400 women a year in England). It had been submitted for funding to the Cancer Drugs Fund, which announced on Friday that it won’t be funded by NHS England.....

Risk Factors for Surgical Complications in Ovarian Cancer | Cancer Network

Risk Factors

..... A woman’s preoperative albumin level and the number of extended cytoreductive procedures performed were found to be the strongest predictors of perioperative morbidity when undergoing surgery for ovarian cancer, according to the results of a retrospective analysis published in Gynecologic Oncology.....

Ovarian cancer's tricks discovered, new hope for better treatment


Simon Lauder reported this story on Thursday, May 28, 2015 08:24:41

comparison costs differing cancers-Clinical Oncology News - Lofty Goals Being Set For Reimbursement Reform

Clinical Oncology News

Figure. Trends in cancer costs.
Source:National Cancer Institute (http://costprojections.cancer.gov/​expenditures.html)

Tuesday, May 26, 2015

(EGFR) Pathway Biomarkers Phase III Trial of Erlotinib Vs Observation in Ovarian Cancer Patients


Epidermal Growth Factor Receptor (EGFR) Pathway Biomarkers in the Randomized Phase III Trial of Erlotinib Versus Observation in Ovarian Cancer Patients with No Evidence of Disease Progression after First-Line Platinum-Based Chemotherapy


In this work, we aimed to identify molecular epidermal growth factor receptor (EGFR) tissue biomarkers in patients with ovarian cancer who were treated within the phase III randomized European Organisation for Research and Treatment of Cancer-Gynaecological Cancer Group (EORTC-GCG) 55041 study comparing erlotinib with observation in patients with no evidence of disease progression after first-line platinum-based chemotherapy.


Somatic mutations in KRAS, BRAF, NRAS, PIK3CA, EGFR, and PTEN were determined in 318 (38 %) and expression of EGFR, pAkt, pMAPK, E-cadherin and Vimentin, and EGFR and HER2 gene copy numbers in 218 (26 %) of a total of 835 randomized patients. Biomarker data were correlated with progression-free survival (PFS) and overall survival (OS).


Only 28 mutations were observed among KRAS, BRAF, NRAS, PIK3CA, EGFR, and PTEN (in 7.5 % of patients), of which the most frequent were in KRAS and PIK3CA. EGFR mutations occurred in only three patients. When all mutations were pooled, patients with at least one mutation in KRAS, NRAS, BRAF, PIK3CA, or EGFR had longer PFS (33.1 versus 12.3 months; HR 0.57; 95 % CI 0.33 to 0.99; P = 0.042) compared to those with wild-type tumors. EGFR overexpression was detected in 93 of 218 patients (42.7 %), and 66 of 180 patients (36.7 %) had EGFR gene amplification or high levels of copy number gain. Fifty-eight of 128 patients had positive pMAPK expression (45.3 %), which was associated with inferior OS (38.9 versus 67.0 months; HR 1.81; 95 % CI 1.11 to 2.97; P = 0.016). Patients with positive EGFR fluorescence in situ hybridization (FISH) status had worse OS (46.1 months) than those with negative status (67.0 months; HR 1.56; 95 % CI 1.01 to 2.40; P = 0.044) and shorter PFS (9.6 versus 16.1 months; HR 1.57; 95 % CI 1.11 to 2.22; P = 0.010). None of the investigated biomarkers correlated with responsiveness to erlotinib.


In this phase III study, increased EGFR gene copy number was associated with worse OS and PFS in patients with ovarian cancer. It remains to be determined whether this association is purely prognostic or is also predictive.

Epidemiology in ovarian carcinoma: lessons from autopsy



We challenge epidemiologic knowledge regarding ovarian carcinoma (OC) by bridging the gap between clinical and autopsy data.


Autopsy reports, histological slides and clinical files from 660 patients in whom OC was diagnosed from 1975-2005 were studied (autopsy cohort, n=233; Clinical Cancer Registry from the local gyneco-oncologic center, n=427).


Out of the autopsy cohort, we identified four distinct subgroups of patients: 1) OC was diagnosed before autopsy, n=156 (67.0%). 2) OC was an incidental finding, n=16 (6.8%). 3) The ovarian tumors were not primary OC but rather metastases from other primary tumors; this revised diagnosis was first made by using current histopathological knowledge/techniques, n=24 (10.3%). 4) Death was directly due to OC in its final stage and OC was first diagnosed by autopsy, n=37 (15.9%); when these cases were added to the Clinical Cancer Registry to an adjusted OC incidence model, the autopsy cases comprised 8.8% of the adjusted cohort and almost doubled the percentage of oldest patients (≥80 years at diagnosis) from 4.9% to 9.3% (p=0.013).


Epidemiological data from the 1970s-1990s may overestimate true incidence because up to 10% of carcinomas in the ovary were not properly classified. Patients who were first diagnosed with OC by autopsy comprise a distinct subgroup. These are patients who have not been seen by specialized oncologists and thus play no role in their perception of the disease. Nevertheless, these cases have impact on prevalence and incidence data of OC and in an era of reduced autopsy rates will probably be overlooked.

Monday, May 25, 2015

special issue - call for abstracts Precision Medicine in Cancer and the Implications for Gyn Oncology

Gynecologic Oncology

Precision Medicine in Cancer and the Implications for Gynecologic Oncology: Special Issue of Gynecologic Oncology

Call for Abstracts
For this special issue of Gynecologic Oncology, we are inviting researchers who are engaged in precision medicine research and are thus investigating the genomics of gynecologic cancers and the implications and impact on early detection and prevention, etiology, treatment, and prognosis to submit an original manuscript reporting their results for peer review.

Please click here for details of the outline which provides general guidance on relevant topics for Gynecologic Oncology's forthcoming special issue on Precision Medicine in Cancer and the Implications for Gynecologic Oncology, which will be published in April 2016.

Please send your abstracts for review to Linda Brooks, Content Development Manager for Gynecologic Oncology via email: l.brooks@elsevier.com. All abstracts due Monday, 1st June 2015.

Committee Opinion No. 634: Hereditary Cancer Syndromes & Risk Assessment

open access 


A hereditary cancer syndrome is a genetic predisposition to certain types of cancer, often with onset at an early age, caused by inherited mutations in one or more genes. Cases of cancer commonly encountered by obstetrician–gynecologists or other obstetric–gynecologic providers––such as breast cancer, ovarian cancer, and endometrial cancer––are features of specific hereditary cancer syndromes. The most common hereditary cancer syndromes related to gynecologic cancer include hereditary breast and ovarian cancer syndrome, Lynch syndrome, Li–Fraumeni syndrome, Cowden syndrome, and Peutz–Jeghers syndrome. A hereditary cancer risk assessment is the key to identifying patients and families who may be at increased risk of developing certain types of cancer. Screening should include, at minimum, a personal cancer history and a first- and second-degree relative cancer history that includes a description of the type of primary cancer, the age of onset, and the lineage (paternal versus maternal) of the family member. In addition, a patient’s ethnic background can influence her genetic risk. If a hereditary cancer risk assessment suggests an increased risk of a hereditary cancer syndrome, referral to a specialist in cancer genetics or a health care provider with expertise in genetics is recommended for expanded gathering of family history information, risk assessment, education, and counseling, which may lead to genetic testing.

Effectiveness of the RMI & ROMA Algorithm - Cohort of Women With OC: Does Histotype and Stage Matter?


Objective: To examine the performance of the Risk of Malignancy Index (RMI) and Risk of Ovarian Malignancy Algorithm (ROMA) by histologic subtype and stage of disease in a cohort of women with ovarian cancer.

Methods: All patients with confirmed ovarian cancer at the Princess Margaret Hospital between February 2011 and January 2013 were eligible for study inclusion. Preoperative cancer antigen 125, human epididymis protein 4, and ultrasound findings were reviewed, and the sensitivity and false-negative rates of the RMI and ROMA were determined by stage of disease and tumor histology.

Results: A total of 131 patients with ovarian cancer were identified. High-grade serous (HGS) histology was most frequently associated with stage III/IV disease (n = 46 [72% of stage III/IV]) vs stage I (n = 5 [11% of stage I]; P < 0.0001). Clear cell (CC) and endometrioid (EC) histology presented most commonly with stage I disease (n = 9 [20%] and n = 13 [29% of stage I cases], respectively). Median cancer antigen 125 and human epididymis protein 4 values were significantly higher for HGS than for EC or CC histology. Risk of Malignancy Index II demonstrated the highest sensitivity of the 3 RMI algorithms. All RMIs and ROMA were significantly more sensitive in predicting malignancy in patients with HGS than EC or CC histology. Risk of Malignancy Index II (n = 38) and ROMA (n = 35) exhibited sensitivities of 68% and 54% and false-negative rates of 32% and 46%, respectively, for patients with stage I disease vs sensitivities of 94% and 93% and false-negative rates of 6% and 7% for patients with stage III/IV disease.

Conclusion: Both RMI and ROMA performed well for the detection of advanced ovarian cancer and HGS histology. These triaging algorithms do not perform well in patients with stage I disease where EC and CC histologies predominate. Clinicians should be cautious using RMI or ROMA scoring tools to triage isolated adnexal masses because many patients with stage I malignancies would be missed.

Index: Intl Journal of Gynecological Cancer June 2015

Current Issue


Purchase Access

Table of Contents Outline

Letter to the Editor

Basic Science

Outcomes of Ovarian Germ Cell Tumors: Ten Years of Experience at the Brazilian National Cancer Institute

A Series of Malignant Ovarian Cancers Arising From Within a Mature Cystic Teratoma: A Single Institution Experience

Does a Standardized Preoperative Algorithm of Clinical Data Improve Outcomes in Patients With Ovarian Cancer? A Quality Improvement Project

Percutaneous Cryoablation of Ovarian Cancer Metastasis to the Liver: Initial Experience in 13 Patients

Effectiveness of the Risk of Malignancy Index and the Risk of Ovarian Malignancy Algorithm in a Cohort of Women With Ovarian Cancer: Does Histotype and Stage Matter?

Prognostic Factors for Ovarian Epithelial Cancer in the Elderly: A Case-Control Study

The Impact of Percent Reduction in CA-125 Levels on Prediction of the Extent of Interval Cytoreduction and Outcome in Patients With Advanced-Stage Cancer of Müllerian Origin...

Outcome of Patients With Advanced-Stage Borderline Ovarian Tumors After a First Peritoneal Noninvasive Recurrence: Impact on Further Management

Uterine Cancer

Magnetic Resonance Imaging in the Assessment of High-Risk Features of Endometrial Carcinoma: A Meta-Analysis

Purchase Access

Role of SUVmax and GLUT-1 Expression in Determining Tumor Aggressiveness in Patients With Clinical Stage I Endometrioid Endometrial Cancer

Incidence and Survival of Gynecologic Sarcomas in England

The Use of Transvaginal Ultrasound in Type II Endometrial Cancer

Strong Correlation Between Molecular Changes in Endometrial Carcinomas and Concomitant Hyperplasia

Isolated Port-Site Metastases After Minimally Invasive Hysterectomy for Endometrial Cancer: Outcomes of Patients Treated With Radiotherapy

Incidence of Nodal Metastasis and Isolated Aortic Metastases in Patients With Surgically Staged Endometrioid Endometrial Cancer

Stage I Granulosa Cell Tumors: A management conundrum? Results of long-term follow up. - PubMed - NCBI


Optimal management of women with early stage GCT presents a management conundrum - they have excellent prognosis but a third will relapse. Advances uncovering the molecular characteristics of GCTs have not been matched by improvements in our understanding and treatment.


Stage I GCT patients referred to Auckland City Hospital (1955-2012) and Princess Margaret Cancer Centre (1992-2012) were identified. Baseline characteristics, histopathology and outcomes were recorded retrospectively.


One hundred and sixty stage I GCT patients were identified with median age of 49 years. Median follow-up was 7.0 years (range 0.1-44.2 years). Fifty-one patients (32%) relapsed with a median time to relapse (TTR) of 12.0 years (1.3-17.7 years) - 20 initial relapses occurred 10 years post-diagnosis. Higher relapse rates (43% vs. 24% p=0.02) and shorter TTR (10.2 vs. 16.2 years p=0.007) were seen with stage Ic versus stage Ia disease. Cyst rupture was associated with increased relapse (p=0.03). Surgery was the main therapeutic modality at relapse. Eighty six percent of patients received non-surgical management at least once post-relapse. Clinical benefit rate was 43% with chemotherapy, 61% with hormonal therapy and 86% with radiation. Five- and 10-year overall survival (OS) were 98.5 and 91.6%, respectively. Median OS was similar in patients with (24.3 years) and without relapse (22.3 years).


Surgery remains fundamental at diagnosis and relapse. Caution should be exercised in recommending adjuvant chemotherapy at initial diagnosis given OS was greater than 20 years even with relapse. Hormonal therapy at relapse appears encouraging but needs further assessment. Novel treatment strategies need exploration with international collaboration essential for this.

Does ovarian stimulation for IVF increase gynaecological cancer risk? A systematic review and meta-analysis


 The aim of this study was to evaluate whether ovarian stimulation for IVF increases the risk of gynaecological cancer, including ovarian, endometrial, cervical and breast cancers, as an independent risk factor. A systematic review and meta-analysis was conducted. Clinical trials that examined the association between ovarian stimulation for IVF and gynaecologic cancers were included. The outcomes of interest were incidence rate of gynaecologic cancers. Twelve cohort studies with 178,396 women exposed to IVF were included; 10 studies were used to analyse ovarian (167,640 women) and breast (151,702 women) cancers, and six studies were identified in the analysis of endometrial (116,672 women) and cervical cancer (114,799 women). Among these studies, 175 ovarian, 48 endometrial, 502 cervical and 866 cases of breast cancer were reported. The meta-analysis found no significant association between ovarian stimulation for IVF and increased ovarian, endometrial, cervical and breast cancer risk (odds ratio [OR] 1.06, 95% confidence interval [CI] 0.85 to 1.32; OR 0.97, 95% CI 0.58 to 1.63; OR 0.43, 95% CI 0.30 to 0.60; OR 0.69, 95% CI 0.63 to 0.76, respectively). Ovarian stimulation for IVF, therefore, does not increase the gynaecologic cancer risk, whether hormone-dependent endometrial and breast cancer or non-hormone-dependent ovarian and cervical cancer.

Sunday, May 24, 2015

Index: Vol 137 issue 3 June 2015 Gynecologic Oncology (journal) - not open access

Gynecologic OncologyGynecologic Oncology
Volume 137, Issue 3 ,  Pages 363-600, June 2015

Editorial Board   

The ideal adjuvant treatment in node positive vulvar cancer is (fill in your best guess here)   
Pages 363-364
Mitchell Kamrava

  Original Research Reports

  Lead Article
Impact of adjuvant chemotherapy with radiation for node-positive vulvar cancer: A National Cancer Data Base (NCDB) analysis   Original Research Article
Pages 365-372
Beant S. Gill, Mark E. Bernard, Jeff F. Lin, Goundappa K. Balasubramani, Malolan S. Rajagopalan, Paniti Sukumvanich, Thomas C. Krivak, Alexander B. Olawaiye, Joseph L. Kelley, Sushil Beriwal

  Vulvar Cancer
Prognostic role of inguinal lymphadenectomy in vulvar squamous carcinoma: younger and older patients should be equally treated. A prospective study and literature review   Original Research Article
Pages 373-379
Pierluigi Benedetti Panici, Federica Tomao, Lavinia Domenici, Andrea Giannini, Diana Giannarelli, Innocenza Palaia, Violante Di Donato, Angela Musella, Roberto Angioli, Ludovico Muzii
Vulvar and vaginal reconstruction using the “angel wing” perforator-based island flap   Original Research Article
Pages 380-385
Sang Wha Kim, Won Moo Lee, Jeong Tae Kim, Youn Hwan Kim

  Ovarian Cancer
A phase II evaluation of the potent, highly selective PARP inhibitor veliparib in the treatment of persistent or recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer in patients who carry a germline BRCA1 or BRCA2 mutation — An NRG Oncology/Gynecologic Oncology Group study   Original Research Article
Pages 386-391
Robert L. Coleman, Michael W. Sill, Katherine Bell-McGuinn, Carol Aghajanian, Heidi J. Gray, Krishnansu S. Tewari, Steven C. Rubin, Thomas J. Rutherford, John K. Chan, Alice Chen, Elizabeth M. Swisher
Weekly ixabepilone with or without biweekly bevacizumab in the treatment of recurrent or persistent uterine and ovarian/primary peritoneal/fallopian tube cancers: A retrospective review   Original Research Article
Pages 392-400
Dana M. Roque, Elena S. Ratner, Dan-Arin Silasi, Masoud Azodi, Thomas J. Rutherford, Peter E. Schwartz, Wendelin K. Nelson, Alessandro D. Santin
Delay in chemotherapy administration impacts survival in elderly patients with epithelial ovarian cancer   Original Research Article
Pages 401-405
Naima Joseph, Rachel M. Clark, Don S. Dizon, Malinda S. Lee, Annekathryn Goodman, David Boruta, John O. Schorge, Marcela G. del Carmen, Whitfield B. Growdon
Predictors of postoperative morbidity after cytoreduction for advanced ovarian cancer: Analysis and management of complications in upper abdominal surgery   Original Research Article
Pages 406-411
Pierluigi Benedetti Panici, Violante Di Donato, Margherita Fischetti, Assunta Casorelli, Giorgia Perniola, Angela Musella, Claudia Marchetti, Innocenza Palaia, Pasquale Berloco, Ludovico Muzii
The clinical value of surgeons' efforts of preventing intraoperative tumor rupture in stage I clear cell carcinoma of the ovary: A Korean multicenter study   Original Research Article
Pages 412-417
Dong Hoon Suh, Jeong-Yeol Park, Jung-Yun Lee, Byoung-Gie Kim, Myong Cheol Lim, Jae-Weon Kim, Duk-Soo Bae, Sang-Yoon Park, Joo-Hyun Nam, Kidong Kim, Jae Hong No, Yong-Beom Kim

  Ovarian Germ Cell Tumors
Outcomes of pediatric and adolescent girls with malignant ovarian germ cell tumors   Original Research Article
Pages 418-422
Jeong-Yeol Park, Dae-Yeon Kim, Dae-Shik Suh, Jong-Hyeok Kim, Yong-Man Kim, Young-Tak Kim, Joo-Hyun Nam

  Cancer Genetics and Biomarkers
The sooner the better: Genetic testing following ovarian cancer diagnosis   Original Research Article
Pages 423-429
E. Fox, J. McCuaig, R. Demsky, C. Shuman, D. Chitayat, M. Maganti, J. Murphy, B. Rosen, S. Ferguson, S. Randall Armel
Detection of the HE4 protein in urine as a biomarker for ovarian neoplasms: Clinical correlates   Original Research Article
Pages 430-435
John B. Liao, Yuen Yee Yip, Elizabeth M. Swisher, Kathy Agnew, Karl Erik Hellstrom, Ingegerd Hellstrom

  Uterine Cancer
Comparing indocyanine green, technetium, and blue dye for sentinel lymph node mapping in endometrial cancer   Original Research Article
Pages 436-442
J. How, W.H. Gotlieb, J.Z. Press, J. Abitbol, M. Pelmus, A. Ferenczy, S. Probst, R. Gotlieb, S. Brin, S. Lau

Graphical abstract

Sentinel node mapping with indocyanine green and endoscopic near-infrared fluorescence imaging in endometrial cancer. A pilot study and review of the literature   Original Research Article
Pages 443-447
Marie Plante, Omar Touhami, Xuan-Bich Trinh, Marie-Claude Renaud, Alexandra Sebastianelli, Katherine Grondin, Jean Gregoire
Circadian actigraphic rest–activity rhythms following surgery for endometrial cancer: A prospective, longitudinal study   Original Research Article
Pages 448-455
Meredith E. Rumble, Stephen L. Rose, Kaitlin Hanley White, A. Holliston Moore, Philip Gehrman, Ruth M. Benca, Erin S. Costanzo
Epithelioid trophoblastic tumor: A single institution case series at the New England Trophoblastic Disease Center   Original Research Article
Pages 456-461
M.R. Davis, B.E. Howitt, B.J. Quade, C.P. Crum, N.S. Horowitz, D.P. Goldstein, R.S. Berkowitz

  Cervical Cancer
A randomized trial comparing concurrent chemoradiotherapy with single-agent cisplatin versus cisplatin plus gemcitabine in patients with advanced cervical cancer: An Asian Gynecologic Oncology Group study   Original Research Article
Pages 462-467
Chun-Chieh Wang, Hung-Hsueh Chou, Lan-Yan Yang, Hao Lin, Wen-Shiung Liou, Chih-Wen Tseng, Feng-Yuan Liu, Jui-Der Liou, Kuan-Gen Huang, Huei-Jean Huang, Eng-Yen Huang, Chien-Hsun Chen, Ting-Chang Chang, Chee-Jen Chang, Ji-Hong Hong, Chyong-Huey Lai
Primary surgery versus primary radiation therapy for FIGO stages I–II small cell carcinoma of the uterine cervix: A retrospective Taiwanese Gynecologic Oncology Group study   Original Research Article
Pages 468-473
Tze-Chien Chen, Huei-Jean Huang, Tao-Yeuan Wang, Lan-Yan Yang, Chi-Hau Chen, Ya-Min Cheng, Wen-Hsiung Liou, Shih-Tien Hsu, Kuo-Chang Wen, Yu-Che Ou, Yao-Ching Hung, Hung-Cheng Lai, Chih-Ming Ho, Ting-Chang Chang
The prognostic significance of histologic type in early stage cervical cancer – A multi-institutional study   Original Research Article
Pages 474-478
Ira Winer, Isabel Alvarado-Cabrero, Oudai Hassan, Quratulain F. Ahmed, Baraa Alosh, Sudeshna Bandyopadhyay, Sumi Thomas, Samet Albayrak, Shobhana Talukdar, Zaid Al-Wahab, Mohamed A. Elshaikh, Adnan Munkarah, Robert Morris, Rouba Ali-Fehmi

  Health Services Research
Costs of treatment for elderly women with advanced ovarian cancer in a Medicare population   Original Research Article
Pages 479-484
G.K. Forde, J. Chang, A. Ziogas, K. Tewari, R.E. Bristow
Patterns and utility of routine surveillance in high grade endometrial cancer   Original Research Article
Pages 485-489
Jessica Hunn, Meaghan E. Tenney, Ana I. Tergas, Erin A. Bishop, Kathleen Moore, William Watkin, Carolyn Kirschner, Jean Hurteau, Gustavo C. Rodriguez, Ernst Lengyel, Nita K. Lee, S. Diane Yamada
A Markov model to evaluate cost-effectiveness of antiangiogenesis therapy using bevacizumab in advanced cervical cancer   Original Research Article
Pages 490-496
Lindsey E. Minion, Jiaru Bai, Bradley J. Monk, L. Robin Keller, Eskander N. Ramez, Gareth K. Forde, John K. Chan, Krishnansu S. Tewari
Geographic disparities amongst patients with gynecologic malignancies at an urban NCI-designated cancer center   Original Research Article
Pages 497-502
Sarah M. Temkin, Saroj A. Fleming, Selma Amrane, Nicholas Schluterman, Mishka Terplan
Selective cardiac surveillance in patients with gynecologic cancer undergoing treatment with pegylated liposomal doxorubicin (PLD)   Original Research Article
Pages 503-507
C.L. Kushnir, A.M. Angarita, L.J. Havrilesky, S. Thompson, D. Spahlinger, A.K. Sinno, E.J. Tanner, A.A. Secord, K.L. Roche, R.L. Stone, A.N. Fader

  Quality of Life
Feasibility of a lifestyle intervention for overweight/obese endometrial and breast cancer survivors using an interactive mobile application   Original Research Article
Pages 508-515
Michele L. McCarroll, Shannon Armbruster, Rachael J. Pohle-Krauza, Amy M. Lyzen, Sarah Min, David W. Nash, G. Dante Roulette, Stephen J. Andrews, Vivian E. von Gruenigen
Quality of life after early enteral feeding versus standard care for proven or suspected advanced epithelial ovarian cancer: Results from a randomised trial   Original Research Article
Pages 516-522
Jannah Baker, Monika Janda, Nick Graves, Judy Bauer, Merrilyn Banks, Andrea Garrett, Naven Chetty, Alex J. Crandon, Russell Land, Marcelo Nascimento, James L. Nicklin, Lewis C. Perrin, Andreas Obermair
Post-operative enteral immunonutrition for gynecologic oncology patients undergoing laparotomy decreases wound complications   Original Research Article
Pages 523-528
J.S. Chapman, E. Roddy, G. Westhoff, E. Simons, R. Brooks, S. Ueda, L. Chen

  Translational Science
Loss of ASRGL1 expression is an independent biomarker for disease-specific survival in endometrioid endometrial carcinoma   Original Research Article
Pages 529-537
Per-Henrik D. Edqvist, Jutta Huvila, Bjorn Forsstrom, Lauri Talve, Olli Carpen, Helga B. Salvesen, Camilla Krakstad, Seija Grenman, Henrik Johannesson, Oscar Ljungqvist, Mathias Uhlen, Fredrik Ponten, Annika Auranen
The anti-malarial chloroquine suppresses proliferation and overcomes cisplatin resistance of endometrial cancer cells via autophagy inhibition   Original Research Article
Pages 538-545
Tomohiko Fukuda, Katsutoshi Oda, Osamu Wada-Hiraike, Kenbun Sone, Kanako Inaba, Yuji Ikeda, Aki Miyasaka, Tomoko Kashiyama, Michihiro Tanikawa, Takahide Arimoto, Hiroyuki Kuramoto, Tetsu Yano, Kei Kawana, Yutaka Osuga, Tomoyuki Fujii
PRSS3 expression is associated with tumor progression and poor prognosis in epithelial ovarian cancer   Original Research Article
Pages 546-552
Ruiqiong Ma, Xue Ye, Hongyan Cheng, Yu Ma, Heng Cui, Xiaohong Chang

Predictors of optimal cytoreduction in patients with newly diagnosed advanced-stage epithelial ovarian cancer: Time to incorporate laparoscopic assessment into the standard of care   Review Article
Pages 553-558
Natalia Rodriguez Gomez-Hidalgo, Bertha Alejandra Martinez-Cannon, Alpa M. Nick, Karen H. Lu, Anil K. Sood, Robert L. Coleman, Pedro T. Ramirez
Epithelial ovarian cancer and recreational physical activity: A review of the epidemiological literature and implications for exercise prescription   Review Article
Pages 559-573
Rikki A. Cannioto, Kirsten B. Moysich
Immediate radical trachelectomy versus neoadjuvant chemotherapy followed by conservative surgery for patients with stage IB1 cervical cancer with tumors 2 cm or larger: A literature review and analysis of oncological and obstetrical outcomes   Review Article
Pages 574-580
Rene Pareja, Gabriel J. Rendon, Monica Vasquez, Lina Echeverri, Carlos Millan Sanz-Lomana, Pedro T. Ramirez
Uterine carcinosarcoma: A review of the literature   Review Article
Pages 581-588
Leigh A. Cantrell, Stephanie V. Blank, Linda R. Duska

  Surgical Film
Controlled removal of a large uterus within a bowel bag and morcellation in the bowel bag from the vagina   
Pages 589-590
Diana English, Gulden Menderes, Masoud Azodi

  Winter Meeting Abstracts
Abstract 1: Gynecologic oncologists as benign gynecologic surgeons   
Pages 591
W. Baker, E. Chang, E. Pelkofski, L. Duska
Abstract 2: Prognostic significance of POLE exonuclease domain mutations in high grade endometrioid endometrial cancer on survival and recurrence   
Pages 591-592
C.C. Billingsley, E.M. Hade, D.E. Cohn, D.G. Mutch, P.J. Goodfellow
Abstract 3: Inhibition of STAT3 in ovarian clear cell carcinoma results in decreased cell proliferation and induction of apoptosis   
Pages 592
K. Bixel, U. Saini, J. Fowler, S. Rajendiran, R. Wanner, K. Hideg, D.E. Cohn, S. Karuppaiyah
Abstract 4: Differential gene expression associated with Lynch syndrome in patients less than and over 60 years of age with endometrial adenocarcinoma   
Pages 592
O. Dziadek, B. Shoup, K. Williams
Abstract 5: Evaluation of universal immunohistochemistry screening for diagnosing Lynch syndrome in endometrial cancer patients at a tertiary care center   
Pages 592-593
E.G. Hartnett, A. Stuckey, C. McCourt
Abstract 6: Proposed algorithm for the management of age 21 and older undergoing primary cervical cancer screening using primary HPV testing with cytology or colposcopy triage: A decision analysis   
Pages 593
N. Joseph, R. Pilliod, R. Clark, A. Goodman, W. Growdon
Abstract 7: Impact of age on 30-day mortality and morbidity in patients undergoing surgery for endometrial cancer   
Pages 593
K. Maurer, H. Mahdi
Abstract 8: The effects of obesity on oncologic outcomes in patients with ovarian cancer   
Pages 593-594
M. McDonald, A. O’Shea, M. Goodheart, D. Bender, J. Gonzalez Bosquet, A. Button, J. Stephan
Abstract 9: Low utility of cytology screening for other lower genital tract neoplasia (LGTN) following chemoradiation (CRT) for cervical cancer (CxCA)   
Pages 594
S. Park, C. Holschneider, M. Amneus
Abstract 10: Does routine post-treatment PET/CT add value to the care of women with locally advanced cervical cancer?   
Pages 594-595
N.T. Phippen, L.J. Havrilesky, J.C. Barnett, C.A. Hamilton, M. Stany, W.J. Lowery
Abstract 11: Morcellation and the incidence of occult malignancy: a dual-institution review   
Pages 595
T. Picerno, M. Wasson, M. Hoffman, M.E. Borowsky
Abstract 12: Perioperative blood transfusion in gynecologic surgery   
Pages 595
L. Prescott, T. Aloia, A. Brown, J. Taylor, C. Sun, C. Levenback, K. Schmeler, D. Bodurka
Abstract 13: Trends in treatment of uterine serous cancer in the medicare population   
Pages 595-596
JA Rauh-Hain, S. Connor, J.B. Clemmer, R.M. Clark, T. Hall, W.B. Growdon, A.K. Goodman, D. Boruta, J.O. Schorge, M.G. del Carmen
Abstract 14: Glutamine supports ovarian cancer cell proliferation through modulation of the mTOR/S6 pathway   
Pages 596
D.R. Roque, L. Yuan, W.Z. Wysham, C. Zhou, V. Bae-Jump
Abstract 15: Cancer-related fatigue in gynecologic oncology patients undergoing chemotherapy   
Pages 596
K. Shields, C. Craig, L. Baxter, L. Renda, J. Pipe, B. Monk, D. Chase
Abstract 16: Multimodal pain control is associated with reduced hospital stay following open abdominal hysterectomy   
Pages 596
M. Ulm, J. Santoso, B. Jennings, J. Wan
Abstract 17: Knowledge of risk factors associated with endometrial cancer in a general gynecologic population   
Pages 597
C. Washington, W. Ronner, P. Neff, A. Haggerty, E. Ko
Abstract 18: Overa: a prediction tool using serum calcium to discriminate malignant from benign pelvic masses   
Pages 597
S.S. Winkler, M.G. Kelly, S.S. Lentz, S.H. Berliner, M.F. Swain, H.G. Skinner, G.G. Schwartz
Evaluation of three predictive models assessing debulkability of patients with advanced ovarian, fallopian tube, or primary peritoneal cancer   
Pages 597-598
C. Stashwick, L. Cory, M. Kelly
Making the case for salpingectomy as the elective sterilization procedure: A decision analysis   
Pages 598
S. Dilley, A. Allen, C. Lessard-Anderson, J. Bakkum-Gamez, Koenraad De Geest, A.B. Caughey, M.I. Rodriguez
Effect of preoperative chemotherapy on postoperative morbidity and mortality in patients undergoing surgery for ovarian cancer   
Pages 598-599
D. Doo, M. Guy, K. Behbakht, S. Davidson, J. Sheeder, S. Guntupalli
Lymphocyte nadir and reconstitution during chemotherapy predicts survival in ovarian cancer patients   
Pages 599
R. Brightwell, K. Eng, S. Lele, P. Frederick, S. Akers, A. Odunsi
Impact of age on 30-day mortality and morbidity in patients undergoing surgery for ovarian cancer   
Pages 599
A. Wiechert, P. Rose, H. Mahdi

Erratum to “Should ovaries be removed or not in (early-stage) adenocarcinoma of the uterine cervix: A review” [Gynecol. Oncol. 136 (2015) 384–388]   
Pages 600
Omar Touhami, Marie Plante