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Trends in gynecologic cancer mortality in East Asian regions.

Jung Yun LEE ; Eun Yang KIM ; Kyu Won JUNG ; Aesun SHIN ; Karen K L CHAN ; Daisuke AOKI ; Jae Weon KIM ; Jeffrey J H LOW ; Young Joo WON

Journal of Gynecologic Oncology.2014;25(3):174-182. doi:10.3802/jgo.2014.25.3.174

OBJECTIVE: To evaluate uterine and ovarian cancer mortality trends in East Asian countries. METHODS: For three Asian countries and one region (Japan, Korea, Singapore, and Hong Kong), we extracted number of deaths for each year from the World Health Organization (WHO) mortality database, focusing on women > or =20 years old. The WHO population data were used to estimate person-years at risk for women. The annual age-standardized, truncated rates were evaluated for four age groups. We also compared age-specific mortality rates during three calendar periods (1979 to 1988, 1989 to 1998, and 1999 to 2010). Joinpoint regression was used to determine secular trends in mortality. To obtain cervical and uterine corpus cancer mortality rates in Korea, we re-allocated the cases with uterine cancer of unspecified subsite according to the proportion in the National Cancer Incidence Databases. RESULTS: Overall, uterine cancer mortality has decreased in each of the Asian regions. In Korea, corrected cervical cancer mortality has declined since 1993, at an annual percentage change (APC) of -4.8% (95% confidence interval [CI], -5.3 to -4.4). On the other hand, corrected uterine corpus cancer mortality has abruptly increased since 1995 (APC, 6.7; 95% CI, 5.4 to 8.0). Ovarian cancer mortality was stable, except in Korea, where mortality rates steadily increased at an APC of 6.2% (95% CI, 3.4 to 9.0) during 1995 to 2000, and subsequently stabilized. CONCLUSION: Although uterine cancer mortality rates are declining in East Asia, additional effort is warranted to reduce the burden of gynecologic cancer in the future, through the implementation of early detection programs and the use of optimal therapeutic strategies.
Adult ; Age Distribution ; Aged ; Databases, Factual ; Far East/epidemiology ; Female ; Genital Neoplasms, Female/*mortality ; Humans ; Middle Aged ; Mortality/trends ; Ovarian Neoplasms/mortality ; Uterine Neoplasms/mortality ; Young Adult

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New frontiers in cancer therapy: the 11th International Meeting of the Asian Clinical Oncology Society (ACOS).

Hung Hsueh CHOU

Journal of Gynecologic Oncology.2014;25(3):172-173. doi:10.3802/jgo.2014.25.3.172

No abstract available.

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Comprehensive cervical cancer prevention and control in the Asia Pacific region: the 6th Biennial Conference of the Asia Oceania Research Organization on Genital Infections & Neoplasia (AOGIN).

Fang Hui ZHAO ; You Lin QIAO

Journal of Gynecologic Oncology.2014;25(3):170-171. doi:10.3802/jgo.2014.25.3.170

No abstract available.

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Laparoscopic surgery for early ovarian cancer.

Daisuke AOKI

Journal of Gynecologic Oncology.2014;25(3):168-169. doi:10.3802/jgo.2014.25.3.168

No abstract available.
Female ; Humans ; Laparoscopy/adverse effects/*methods ; Neoplasm Staging ; Ovarian Neoplasms/pathology/*surgery

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Conservative treatment for atypical endometrial hyperplasia: what is the most effective therapeutic method?.

Mi Kyoung KIM ; Seok Ju SEONG

Journal of Gynecologic Oncology.2014;25(3):164-165. doi:10.3802/jgo.2014.25.3.164

No abstract available.
Antineoplastic Agents, Hormonal/*therapeutic use ; Endometrial Hyperplasia/*drug therapy ; Female ; Humans ; Hypoglycemic Agents/*therapeutic use ; Megestrol Acetate/*therapeutic use ; Metformin/*therapeutic use

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Shall we settle for low-level evidence?.

Mansoor Raza MIRZA

Journal of Gynecologic Oncology.2014;25(3):162-163. doi:10.3802/jgo.2014.25.3.162

No abstract available.
Brachytherapy/*methods ; Female ; Humans ; Radiotherapy, Conformal/*methods ; Ultrasonography, Interventional/*methods ; Uterine Cervical Neoplasms/*radiography

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Urodynamic study of bladder function following nerve sparing radical hysterectomy.

Francesco MANESCHI

Journal of Gynecologic Oncology.2014;25(3):159-161. doi:10.3802/jgo.2014.25.3.159

No abstract available.
Female ; Humans ; Hysterectomy/adverse effects/*methods ; Postoperative Complications/*prevention & control ; Urinary Bladder/*innervation/physiopathology ; Urodynamics/*physiology

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Performance of a low cost magnifying device, magnivisualizer, versus colposcope for detection of pre-cancer and cancerous lesions of uterine cervix.

Veena SINGH ; Aditya PARASHARI ; Sanjay GUPTA ; Pushpa SODHANI ; Ashok SEHGAL

Journal of Gynecologic Oncology.2014;25(4):282-286. doi:10.3802/jgo.2014.25.4.282

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

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Role of lymphadenectomy for ovarian cancer.

Mikio MIKAMI

Journal of Gynecologic Oncology.2014;25(4):279-281. doi:10.3802/jgo.2014.25.4.279

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

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Defining the concept of locally advanced squamous cell carcinoma of the vulva: a new perspective based on standardization of criteria and current evidence.

Alejandro M ARAGONA ; Alejandro H SODERINI ; Nicasio A CUNEO

Journal of Gynecologic Oncology.2014;25(4):272-278. doi:10.3802/jgo.2014.25.4.272

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

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