OBJECTIVE: The authors aim to evaluate the overall trends of this cancer including incidence rates, distribution of stage, pathologic results, and methods of treatment during the last 11 years. METHODS: We obtained the data from the Annual Report of Gynecologic Cancer Registry Program in Korean from 1991-2002. Incidence rates were calculated using the number of population registered since 1992 from the website of National Statistical Office. RESULTS: Age-standardized incidence rate of endometrial cancer increased markedly for 9 years (p<0.05). The peak age of endometrial cancer shifted from the seventh to the sixth decade starting from 1997. The majority of endometrial cancer was diagnosed as stage I. Stage I contributed the major proportion from 1992 and it became to 63.3% of endometrial cancer in 2002. Adenocarcinomas were the main histologic type. The trend of treatment did not change which surgery is the main therapy followed by surgery and adjuvant radiotherapy. CONCLUSION: Recently, the incidence of endometrial cancer in Korean women increased annually during the last 9 years. Therefore, endometrial cancer may be given much more weight in the field of gynecologic cancer in Korea.
Adenocarcinoma ; Endometrial Neoplasms* ; Female ; Humans ; Incidence ; Korea ; Radiotherapy, Adjuvant

OBJECTIVE: The purpose of this study was to determine whether carcinoma in situ (CIS) of the uterine cervix in pregnancy alters in the postpartum period and to evaluate the factors associated with this alteration. METHODS: In this retrospective study, we found 30 pregnant women with CIS of the uterine cervix between 1999 and 2003. All women had the diagnosis of CIS made on cervical biopsy performed during pregnancy at Samsung Cheil Hospital. All pathologic reports of initial cytology and biopsy were reviewed and compared to the same evaluations postpartum. Postpartum alteration of CIS was analyzed with respect to the mode of delivery, gravidity and parity. RESULTS: The incidence of CIS in pregnancy was 0.6 per 1000 pregnancies (30/44,807) in this study. The mean age was 31.2 years (20-40), the mean gravidity was 2.7 (1-6) and the mean parity was 0.3 (0-2). The prenatal cytology that initiated the referral to our colposcopy center was commonly discordant with the histologic diagnosis of CIS. Five (16.7%) had cytology of ASCUS, 3 (10.0%) had LSIL, and 22 (73.3%) had HSIL. The overall postpartum persistence and regression rates of CIS were 73.3% and 26.7% respectively. No lesion progressed to invasive carcinoma. There was no statistically difference in regression or persistence rates according to the delivery mode, gravidity and parity. CONCLUSION: According to the result of this study, postpartum persistence rate of CIS was high but progression rate was low. The mode of delivery, gravidity and parity did not influence the regression or persistence rates of CIS in pregnancy.
Biopsy ; Carcinoma in Situ* ; Cervix Uteri* ; Colposcopy ; Diagnosis ; Female ; Gravidity ; Humans ; Incidence ; Parity ; Postpartum Period ; Pregnancy* ; Pregnant Women ; Referral and Consultation ; Retrospective Studies

OBJECTIVE: To assess the ability of risk of malignancy index (RMI) based on ultrasound findings, serum levels of CA 125, and menopausal status to discriminate between benign and malignant ovarian masses for preoperative screening. METHODS: A retrospective study was conducted of 255 women with ovarian masses admitted for operation at the Department of Obstetrics and Gynecology, Hanyang University Hospital between 1999 and 2003. The sensitivity and specificity of serum levels of CA 125, ultrasound findings, and menopausal status were calculated both separately and combined into a RMI to diagnose malignancy. RESULTS: There were significant preoperative differences of ultrasound findings, serum CA 125 level, serum CA 19-9 level, platelet count and menopausal status between benign and malignant ovarian masses (P<0.05). Using a cut-off value of 100 to indicate malignancy, the RMI gave a sensitivity of 81.7%, specificity of 81.9%. The RMI was more accurate in predicting malignancy than each one of its components measured individually. CONCLUSION: The RMI is able to correctly discriminate between malignant and benign ovarian masses. This preoperative evaluation of women with ovarian masses is anticipated to help plan their management.
Female ; Gynecology ; Humans ; Mass Screening ; Menopause ; Obstetrics ; Ovarian Neoplasms ; Platelet Count ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography

OBJECTIVE: The treatment of intraepithelial neoplasia and microinvasive cervical cancer ranges from local destruvtive methods to total hysterectomy. The conservative treatment has increased as more lesions are being detected in young women. METHODS: This study was designed to compare the 112 microinvasive cervical cancer treatment reliability, efficacy, and safety of cold knife conization (23), electric conizer (31), and largr loop (58). RESULTS: The mean age for cold cone, conizer, and LEEP were 41.1, 41.4, and 42.2 years old. The parity for cold cone, conizer and LEEP were 3.1, 2.1, and 2.7 siblings. Resection margine involved pathologic finding were 47.8%, 54.8%, and 74.1% (P<0.05). After hysterectomy, residual disease for cold cone, conizer and LEEP were 1, 24, and 30 cases CONCLUSION: The results suggest that LEEP is quicker, safer, and lower cost than cold knife conization for the management of cervical intraepithelial neoplasia and micro invasive cancer.
Cervical Intraepithelial Neoplasia ; Conization* ; Female ; Humans ; Hysterectomy ; Parity ; Siblings ; Uterine Cervical Neoplasms

OBJECTIVE: To identify the clinical features, survival rate, and prognostic factors of the borderline ovarian tumor. METHODS: Data on 48 patients with borderline ovarian tumor were analyzed with regard to histologic type, age, staging, operation method, tumor size, preoperative CA 125 level, menopause status and presence of stromal microinvasion. Most informations were obtained from hospital record and were analyzed retrospectively. RESULTS: There were 43 patients with stage I and 5 with stage III by FIGO classification. The mean age was 47.3 years (range 17-84). The mean size of tumor between patients with serous tumor and patients with mucinous tumor was 12.3 cm and 17.8 cm, respectively, and there was statistical difference between the two groups (p<0.05). There was no statistical difference in preoperative elevated CA 125 levels between patients with serous tumor and patients with mucinous tumor (p>0.05), and no difference between premenopausal group and postmenopausal group (p>0.05), but difference between stage I patients and stage III patients (p<0.05). There was statistical difference in disease free survival between stage I patients and stage III patients (p<0.05). But, there was no difference in the disease free survival among stage I patients according to operation method (p>0.05), and no difference among stage III patients according to operation method (>0.05). There was no statistical difference in stage between patients with microinvasive tumor and patients without microinvasive tumor (p>0.05). And there was no difference in disease free survival between patients with microinvasive tumor and patients without microinvasive tumor (p>0.05). CONCLUSION: The FIGO stage is the prognostic factor in the borderline ovarian tumor. The implication of microinvasion may need to be evaluated further.
Classification ; Disease-Free Survival ; Female ; Hospital Records ; Humans ; Menopause ; Mucins ; Retrospective Studies ; Survival Rate

Recently, advances and complexity in the treatment of gynecologic cancer cause not only improvement of tumor response and survival but also increase of interest in quality of life (QOL). However, there were relatively few research studies that reported data on QOL in gynecologic cancer patients and the impact of various treatments on QOL in the patients. Considering high morbidity and severe risk of QOL in gynecologic cancer patients, more focus and researches have to be done in issues of QOL. Especially, comprehensive-physical, emotional, social, spiritual-assessments with valid QOL assessment tool should be taken into account in multi-center clinical trials and development of intervention programs for gynecologic cancer patients.
Humans ; Quality of Life*

OBJECTIVE: To assess the performance of a low cost magnifying device (Magnivisualizer) compared to a standard optical colposcope for detection of precancerous and cancerous lesions of the uterine cervix. METHODS: A total of 659 consecutive symptomatic women attending a gynecologic outpatient clinic underwent unaided visual inspection followed by cytology, visual inspection of the cervix using 5% acetic acid (VIA), and VIA under magnification (VIAM) with the Magnivisualizer. All women, independently of test results, were referred for colposcopic examination. Colposcopic-directed biopsies were obtained from all positive lesions and compared to positive VIAM cases. RESULTS: The detection rate for VIA positive lesions was 12% (134/659), while it was 29% for VIAM positive lesions (191/659). The sensitivities of detection of cervical intraepithelial neoplasia (CIN) 2 and higher lesions were 61.7% for VIA, 88.3% for VIAM, and 86.7% for colposcopy, with a specificity of 58.5% for VIA, 55.8% for VIAM, and 90.4% for colposcopy. The performance of colposcopy and VIAM was moderate (kappa, 0.48; 95% confidence interval [CI], 0.41 to 0.54) for detection of CIN 1 and higher lesions and excellent (kappa, 0.87; 95% CI, 0.82 to 0.94) for detection of CIN 2 and higher lesions. CONCLUSION: In low resource settings, where colposcopic facilities are not available at the community level, a simple low-cost, handheld Magnivisualizer can be considered a valid option for detection of cervical precancerous and cancerous lesions. However, it cannot replace traditional colposcopy because it has a low specificity that results in many unnecessary biopsies.
Acetic Acid/diagnostic use ; Adult ; Aged ; Biopsy/methods ; *Colposcopes ; Colposcopy ; Early Detection of Cancer/*instrumentation/methods ; Equipment Design ; Female ; Humans ; Middle Aged ; Neoplasm Grading ; Optical Imaging/*instrumentation/methods ; Outpatient Clinics, Hospital ; Reproducibility of Results ; Uterine Cervical Dysplasia/*diagnosis/pathology ; Uterine Cervical Neoplasms/*diagnosis/pathology

Japan Society of Gynecologic Oncology (JSGO) recently revised its Ovarian Cancer Treatment Guidelines and the 4th edition will be released next year. This Guidelines state that lymphadenectomy is essential to allow accurate assessment of the clinical stage in early ovarian cancer, but there is no randomized controlled trial that shows any therapeutic efficacy of lymphadenectomy. In patients with advanced stage tumors, lymphadenectomy should be considered if optimal debulking has been performed. I fully agree with this recommendation of the JSGO and I would like to discuss the role of lymphadenectomy in the management of ovarian cancer.
Cytoreduction Surgical Procedures/methods ; Female ; Humans ; Lymph Node Excision/*methods ; Lymphatic Metastasis ; Neoplasm Staging ; Ovarian Neoplasms/*pathology/therapy ; Practice Guidelines as Topic

The phrase "locally advanced carcinoma of the vulva" has often been mentioned in the literature, though not accurately defined, or even leading to the interpretation overlapping. Grounded on cervical cancer experience, we are able to state that designing a tailored primary strategy based on clinically measurable adverse prognostic factors represents the cornerstone of therapy. This fact urged us to rethink about the real usefulness of the concept of locally advanced squamous cell carcinoma of the vulva. We will refer to this concept as a clinical entity emerging from a rigorous workup which is a valuable guiding tool in the context of a thorough debate about the best primary treatment approach to be used. Furthermore, bulky tumors of the vulva have been associated with a worse prognosis on several occasions. Some authors have questioned the fact that tumor size has not been considered in the staging system. Finally, a standardized definition will help us compare the results obtained, which is extremely necessary given the worldwide low prevalence of this disease.
Carcinoma, Squamous Cell/*pathology/therapy ; Combined Modality Therapy ; Evidence-Based Medicine/methods ; Female ; Humans ; Neoplasm Staging ; Prognosis ; *Terminology as Topic ; Vulvar Neoplasms/*pathology/therapy

No abstract available.
Female ; Fertility Preservation/*methods ; Humans ; Neoplasms, Glandular and Epithelial/*surgery ; Ovarian Neoplasms/*surgery ; Pregnancy