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Quality of life in gynecologic cancer survivors compared to healthy check-up women.

Sarikapan WILAILAK ; Arb aroon LERTKHACHONSUK ; Nawaporn LOHACHAROENVANICH ; Suteera Chukkul LUENGSUKCHAROEN ; Manmana JIRAJARAS ; Puchong LIKITANASOMBAT ; Suwannee SIRILERTTRAKUL

Journal of Gynecologic Oncology.2011;22(2):103-109. doi:10.3802/jgo.2011.22.2.103

OBJECTIVE: The primary objective of this study was to compare quality of life of disease-free patients after therapy for gynecologic malignancies at follow-up in comparison with healthy check-up patients. Our second objective was to assess correlation between demographic data, disease and treatment factors and quality of life scores. METHODS: Patients completed the Functional Assessment of Cancer Therapy-General (FACT-G) quality of life questionnaire at least 6 months after treatment for a gynecologic malignancy. Responses were compared to unmatched healthy women who were seen for standard gynecologic screening examinations. Statistical calculation was done using chi-squared tests, Wilcoxon rank-sum, and Kruskal-Wallis one-way analysis and Spearman rank correlations. Factors associated with FACT-G scores were evaluated using univariate and multivariate analyses. RESULTS: Eight hundred and seventy patients were recruited. The median time since therapy was 61 months (range, 6 to 173 months). The overall FACT-G scores were higher in the patient group than in the healthy group (p<0.05). The scores of each subscale measuring physical, functional, social/family and emotional well-being were also higher in the patient group (p<0.05). Multivariate analysis revealed correlation between Eastern Cooperative Oncology Group performance status, educational level, care giver, presence of economic problems and FACT-G scores. CONCLUSION: The quality of life scores were higher in gynecologic cancer patients after treatment. And the factors that associated with the higher score in the patient group are having husband as a caregiver, no financial problem, Eastern Cooperative Oncology Group score 0 or 1 and having high school or higher education.
Caregivers ; Educational Status ; Female ; Follow-Up Studies ; Humans ; Mass Screening ; Multivariate Analysis ; Quality of Life ; Spouses ; Survivors ; Surveys and Questionnaires

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Major surgeries performed for gestational trophoblastic neoplasms in a teaching hospital in Tehran, Iran.

Fatemeh GHAEMMAGHAMI ; Tahereh ASHRAFGANGOOEI ; Mitra Modares GILLANI ; Asamosadat MOSAVI ; Nadereh BEHTASH

Journal of Gynecologic Oncology.2011;22(2):97-102. doi:10.3802/jgo.2011.22.2.97

OBJECTIVE: This study aim was to evaluate indications and outcomes of surgical interventions performed in patients with gestational trophoblastic neoplasm. METHODS: During January 1995 to December 2005, 110 patients with a diagnosis of persistent gestational trophoblastic neoplasm were treated in our Gynecologic Oncologic Department. Risk score calculation was carried out based on the revised FIGO 2000 scoring system for gestational trophoblastic neoplasm. Data from the patients' records and pathologic reports were analyzed by the chi-square and Fisher's exact tests and logistic regression. The Kaplan-Meier method including the log rank test was used to compare survival and recurrence. RESULTS: Eight patients did not complete their treatment and were excluded from the study. We evaluated treatment responses and outcomes in 102 patients. Seventy-nine patients (77.5%) responded fully to chemotherapy while 23 patients (22.5%) required surgery. Among 23 patients who underwent surgery, 10 cases (43.5%) had bleeding, and 13 cases (56.5%) had drug resistance. Several factors were found to be significantly different between the groups who responded to chemotherapy and those who needed surgery, including age (p=0.001), antecedent non-molar pregnancy (0.028), tumor stage (p=0.009), and pre-treatment risk scores (p=0.008). But, the total courses of chemotherapy (p=0.521), need to salvage chemotherapy (p=0.074), survival rates (p=0.714), and disease free survival rates (p=0.206) were not significantly different. CONCLUSION: The data suggest that age, antecedent non-molar pregnancy, tumor stage and the prognostic score are clinical predictors of need for surgery. But, it dose not seem that surgery have any effect on the total course of chemotherapy, need for salvage chemotherapy, and patient prognosis.
Disease-Free Survival ; Drug Resistance ; Gestational Trophoblastic Disease ; Hemorrhage ; Hospitals, Teaching ; Humans ; Iran ; Logistic Models ; Pregnancy ; Prognosis ; Survival Rate ; Trophoblasts

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Expression of matrix metalloproteinase-2 and survivin in endometrioid and nonendometrioid endometrial cancers and clinicopathologic significance.

Evren YILMAZ ; Meral KOYUNCUOGLU ; Ilknur Bilkay GORKEN ; Emre OKYAY ; Bahadir SAATLI ; Emine Cagnur ULUKUS ; Ugur SAYGILI

Journal of Gynecologic Oncology.2011;22(2):89-96. doi:10.3802/jgo.2011.22.2.89

OBJECTIVE: To determine matrix metalloproteinase-2 and survivin expressions in endometrial cancers, their relation to clinical and histologic parameters and to investigate any difference in the expression of these markers between endometrioid and nonendometrioid cancers. METHODS: Ninety-five patients with endometrial cancer, were included. Matrix metalloproteinase-2 and survivin expressions were analyzed immunohistochemically from paraffin-embedded tissues by using specific monoclonal antibodies. RESULTS: Survivin nuclear expression was higher in endometrioid cancer as compared to nonendometrioid cancer (p=0.040), but there was no difference for cytoplasmic survivin and matrix metalloproteinase-2 expressions between type I and type II carcinomas. Survivin cytoplasmic staining was significantly lower in patients with deep myometrial invasion (p=0.038). Nuclear expression of survivin is decreased in histologic grade 3 tumors compared to grade 1 and 2 tumors (p=0.013), but there is no difference between grade 1 and 2. We did not find any statistically significant difference between survivin or matrix metalloproteinase-2 expressions and survival. CONCLUSION: Survivin and matrix metalloproteinase-2 are present in endometrioid and nonendometrioid cancers. Grade 1 and 2 tumors and carcinomas having myometrial invasion less than 50% have higher survivin expression. These results supports that, survivin may play an important role in early stage tumors and early phases of tumor development. We did not find any association between matrix metalloproteinase-2 expression and classical prognostic factors in endometrial cancer and both proteins were not associated with survival.
Cytoplasm ; Endometrial Neoplasms ; Female ; Humans ; Matrix Metalloproteinase 2 ; Matrix Metalloproteinases ; Prognosis ; Proteins

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Which is worse: uterine papillary serous carcinomas or carcinosarcomas?.

Taejong SONG ; Chel Hun CHOI ; Yoo Young LEE ; Tae Joong KIM ; Jeong Won LEE ; Byoung Gie KIM ; Duk Soo BAE

Journal of Gynecologic Oncology.2011;22(2):83-88. doi:10.3802/jgo.2011.22.2.83

OBJECTIVE: It is clear that uterine carcinosarcomas and uterine papillary serous carcinomas (UPSC) have an adverse impact on outcome, but whether carcinosarcomas are worse than UPSC is unclear. The purpose of this study is to compare the pathology, survival, and disease recurrence of patients with carcinosarcomas to patients with UPSC. METHODS: The medical records of patients diagnosed with carcinosarcomas and UPSC between 1996 and 2009 at Samsung Medical Center were retrospectively analyzed. Information from pathology reports, site of relapse, time to recurrence, and death was obtained. The survival analysis was performed using the Kaplan-Meier method. RESULTS: Thirty seven patients with carcinosarcomas and 38 patients with UPSC were identified during the study period. There was no significant difference in clinical characteristics including age, body mass index, proportion with advanced stage disease, rate of optimal debulking, and adjuvant treatment used. In addition, the pathology showed no significant difference in tumor size, myometrial involvement, lymphovascular invasion, peritoneal cytology, cervical invasion, and lymph node involvement. Patients with carcinosarcomas had similar patterns of relapse as the patients with UPSC. There was no difference in the progression-free and overall survival between the carcinosarcomas and UPSC patients (p=0.804 and p=0.651, respectively). CONCLUSION: Patients with carcinosarcomas had similar clinicopathological features compared to the patients with UPSC.
Body Mass Index ; Carcinosarcoma ; Humans ; Lymph Nodes ; Medical Records ; Recurrence ; Retrospective Studies

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Cervical cancer in the screening era: who fell victim in spite of successful screening programs?.

B Folke PETTERSSON ; Kristina HELLMAN ; Roxane VAZIRI ; Sonia ANDERSSON ; Ann Cathrin HELLSTROM

Journal of Gynecologic Oncology.2011;22(2):76-82. doi:10.3802/jgo.2011.22.2.76

OBJECTIVE: To compare profiles of a prescreening and screening cohort of women with cervical cancer regarding histopathology and clinical variables in order to identify those remaining at risk despite successful screening programs. By analyzing these profiles we hope to improve future screening methods. METHODS: The prescreening and screening cohorts consisted of 5,046 and 1,174 women, respectively, treated for cervical cancer at the Department of Gynecological Oncology at Radiumhemmet, Karolinska University Hospital, during the periods 1944-1957 and 1990-2004. RESULTS: Mean age increased from 48.9 years to 55.3 years in the cohorts treated 1944-1957 and 1990-2004, respectively. The percentage of patients older than 69 years was 5.4% and 27.3% in the prescreening and screening period, respectively. A shift towards earlier stages at diagnosis, a reduction of squamous cervical cancer and an increase of adenocarcinoma were observed in the screening cohort. The percentage of adenocarcinoma was about 6 times higher among younger patients. Cases of stump cancer and cervical cancer associated with pregnancy have declined. Eighty-seven women in the screening cohort had a history of treatment for in situ carcinoma by conization; 28% of these cases developed cervical cancer within one year after conization. CONCLUSION: The profile changed in the screening era indicating a need to refine screening for improved detection of in older women. This study, one of the largest clinical series of cervical cancer, provides an important baseline with which later studies can be compared to evaluate the effects of human papillomavirus vaccine and other important changes in this field.
Adenocarcinoma ; Cohort Studies ; Female ; Humans ; Mass Screening ; Pregnancy ; Uterine Cervical Neoplasms

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Human papillomavirus 16/18 AS04-adjuvanted cervical cancer vaccine: immunogenicity and safety in 15-25 years old healthy Korean women.

Seung Cheol KIM ; Yong Sang SONG ; Young Tae KIM ; Young Tak KIM ; Ki Sung RYU ; Bhavyashree GUNAPALAIAH ; Dan BI ; Hans L BOCK ; Jong Sup PARK

Journal of Gynecologic Oncology.2011;22(2):67-75. doi:10.3802/jgo.2011.22.2.67

OBJECTIVE: The study assessed the immunogenicity and safety of human papillomavirus (HPV)-16/18 AS04-adjuvanted cervical cancer vaccine in healthy Korean women aged 15-25 years. METHODS: Phase IIIB, double-blind, randomised (2:1), multi-centre trial was conducted in Korea from June 2007 to March 2008. The study enrolled 225 women in the HPV (N=149) and placebo (N=76) groups who received three doses of HPV-16/18 AS04-adjuvanted vaccine or placebo (aluminium hydroxide) administered intramuscularly at 0, 1, and 6 months and were followed until one month post-dose 3. Serum samples were collected pre-vaccination and one month post-dose 3. Safety and reactogenicity data were collected throughout. RESULTS: In this trial, 208 women completed the study (141 in HPV group; 67 in placebo group). At month 7, all initially seronegative women had seroconverted for HPV-16 and HPV-18 antibodies with anti-HPV-16 and anti-HPV-18 geometric mean titres of 9,351.4 El.U/mL (95% CI, 8,145.5 to 10,735.8) and 4204.1 El.U/mL (95% CI, 3,626.5 to 4,873.6), respectively. Initially seropositive women showed similar increase in geometric mean titre levels. Compliance to the three dose vaccination course was 95.3% in HPV and 89.5% in placebo group. Solicited local (pain) and general (fatigue, myalgia or headache) symptoms were commonly reported in both groups. Three serious adverse events were reported (two in HPV group; one in placebo group), all unrelated to vaccination by the investigator; all recovered. CONCLUSION: The HPV-16/18 AS04-adjuvanted vaccine was highly immunogenic with a clinically acceptable safety profile in Korean women. This study was in line with previous global studies in Europe, North America, and Brazil. (ClinicalTrials.gov number, NCT 00485732.)
Aged ; Antibodies ; Brazil ; Compliance ; Europe ; Female ; Human papillomavirus 16 ; Human papillomavirus 18 ; Humans ; Korea ; North America ; Uterine Cervical Neoplasms ; Vaccination

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Robotic single-site surgery: from research to clinical practice?.

Pedro F ESCOBAR

Journal of Gynecologic Oncology.2011;22(2):65-66. doi:10.3802/jgo.2011.22.2.65

No abstract available.

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In reply: A large-scale study on the role of ovarian symptom index is necessary.

Kidong KIM ; Mi Kyung KIM ; Jae Weon KIM

Journal of Gynecologic Oncology.2010;21(1):66-66. doi:10.3802/jgo.2010.21.1.66

No abstract available.

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A hospital-based case-control study of identifying ovarian cancer using symptom index.

Young Tae KIM

Journal of Gynecologic Oncology.2010;21(1):65-65. doi:10.3802/jgo.2010.21.1.65

No abstract available.
Case-Control Studies ; Ovarian Neoplasms

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Lipoleiomyoma of broad ligament mimicking ovarian cancer in a postmenopausal patient: case report and literature review.

Mehmet Coskun SALMAN ; Zeliha ATAK ; Alp USUBUTUN ; Kunter YUCE

Journal of Gynecologic Oncology.2010;21(1):62-64. doi:10.3802/jgo.2010.21.1.62

Lipoleiomyoma is a very rare tumor which is composed of adipocytes and smooth muscle cells. It is most commonly located in uterine corpus although cervical, ovarian, and retroperitoneal locations were also reported. Lipoleiomyoma located in broad ligament is extremely uncommon and only five cases were reported to date. Here, we report the sixth case of lipoleiomyoma of broad ligament which was diagnosed in a postmenopausal woman who was subjected to exploratory laparotomy with a preoperative diagnosis of a solid adnexal mass suggesting an ovarian malignancy.
Adipocytes ; Broad Ligament ; Female ; Humans ; Laparotomy ; Myocytes, Smooth Muscle ; Ovarian Neoplasms

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