Advertisement
Research Article| Volume 15, ISSUE 3, P743-770, September 1995

New Therapeutic Approaches in Gynecologic Oncology

  • Paul R. Kucera
    Correspondence
    Address reprint requests to Paul R. Kucera, MD Division of Gynecologic Oncology Department of Obstetrics and Gynecology Oregon Health Sciences University 3181 SW Sam Jackson Park Road, L-466 Portland, OR 97201-3098
    Affiliations
    From the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Oregon Health Sciences University, Portland, Oregon
    Search for articles by this author
DOI:https://doi.org/10.1016/S0272-2712(18)30327-5
New Therapeutic Approaches in Gynecologic Oncology
Previous ArticleImmunohistochemical Approaches to Diagnosis in Gynecologic Pathology
Next ArticleIndex
      This paper is only available as a PDF. To read, Please Download here.
      Early-stage epithelial ovarian cancer, although elusive in screening programs, is readily controlled by resection and limited duration chemotherapy. Extensive cytoreductive surgery and multiagent chemotherapy, now including paclitaxel, show significant, although still modest, improvement in the survival of advanced-stage epithelial cancer. The role of radiation therapy for intermediate risk and advanced-stage endometrial cancer is debatable. Tailored hysterectomy for early-stage cervical cancer is replacing radiation therapy in many instances, whereas advanced cancer is being treated with combination chemoradiation. Smaller, less disfiguring procedures are being used successfully for vulvar squamous cell cancers and melanomas.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribers receive full online access to your subscription and archive of back issues up to and including 2002.

      Content published before 2002 is available via pay-per-view purchase only.

      Subscribe:

      Subscribe to Clinics in Laboratory Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Register: Create an account
      Institutional Access: Sign in to ScienceDirect

      References

        • Abeier V.
        • Holm R.
        • Nesland J.
        • et al.
        Small cell carcinoma of the cervix. A clinical pathologic study of 26 patients.
        Cancer. 1994; 73: 672
        • Alvarez R.
        • Gelder M.
        • Gore H.
        • et al.
        Radical hysterectomy in the treatment of patients with bulky early stage carcinoma of the cervix uteri.
        Surg Gynecol Obstet. 1993; 176: 539
        • Amos C.
        • Struewing J.
        Genetic epidemiology of epithelial ovarian cancer.
        Cancer. 1993; 71: 566
        • Arbuck S.
        • Strauss H.
        • Rowinsky E.
        • et al.
        A reassessment of cardiac toxicity associated with taxol.
        Monogr Natl Cancer Inst. 1993; 15: 117

      5. Barnhill D, Kurman R, Brady M, et al: The behavior of stage I ovarian serous tumors of low malignant potential. J Clin Oncol, submitted

        • Barnhill D.
        • Heller P.
        • Brzozowski P.
        • et al.
        Epithelial ovarian carcinoma of low malignant potential.
        Obstet Gynecol. 1985; 65: 53
        • Bloss J.
        • Berman M.
        • Mukhererjee J.
        • et al.
        Bulky stage IB cervical carcinoma managed by primary radical hysterectomy followed by tailored radiotherapy.
        Gynecol Oncol. 1992; 47: 21
        • Buller R.
        • Berman M.
        • Bloss J.
        • et al.
        CA 125 regression: A model for epithelial ovarian cancer response.
        Am J Obstet Gynecol. 1991; 165: 360
        • Caldas C.
        • McGuire III, W.
        Taxol in epithelial ovarian cancer.
        Mongr Natl Cancer Inst. 1993; 15: 155
        • Canis M.
        • Mage G.
        • Pouly J.
        • et al.
        Laparoscopic diagnosis of adnexal cystic masses: A 12-year experience with long-term follow-up.
        Obstet Gynecol. 1994; 83: 707
        • Chapman J.
        • Mannel R.
        • Disaia P.
        • et al.
        Surgical treatment of unexpected invasive cervical cancer found at total hysterectomy.
        Obstet Gynecol. 1992; 80: 931
        • Childers J.
        • Spirtos N.
        • Brainard P.
        • et al.
        Laparoscopic staging of the patient with incompletely staged early adenocarcinoma of the endometrium.
        Obstet Gynecol. 1994; 83: 597
        • Cohen C.
        • Jennings T.
        Screening for ovarian cancer: The role of noninvasive imaging techniques.
        Am J Obstet Gynecol. 1994; 170: 1088
        • Creasman W.
        • DiSaia P.
        Screening in ovarian cancer.
        Am J Obstet Gynecol. 1991; 165: 7
        • Cullimore J.
        • Luesley D.
        • Rollason T.
        • et al.
        A prospective study of conization of the cervix in the management of cervical intraepithelial glandular neoplasia (CIGN)—a preliminary report.
        Br J Obstet Gynaecol. 1992; 99: 314
        • Curry S.
        • Blessing J.
        • DiSaia P.
        • et al.
        A prospective randomized comparison of methotrexate, dactinomycin, and chlorambucil versus methotrexate, dactinomycin, cyclophosphamide, doxorubicin, melphalan, hydroxyurea, and vincristine in “poor prognosis” metastatic gestational trophoblastic disease: A gynecologic oncology group study.
        Obstet Gynecol. 1989; 73: 357
        • Dembo A.
        • Davy M.
        • Stenwig A.
        • et al.
        Prognostic factors in patients with stage I epithelial ovarian cancer.
        Obstet Gynecol. 1990; 75: 263
        • Doering D.
        • Barnhill D.
        • Weiser E.
        • et al.
        Intraoperative evaluation of depth of myometrial invasion in stage I endometrial adenocarcinoma.
        Obstet Gynecol. 1989; 74: 930
        • Droegemueller W.
        Screening for ovarian carcinoma: Hopeful and wishful thinking.
        Am J Obstet Gynecol. 1994; 170: 1095
        • Einhorn N.
        • Sjövall K.
        • Knapp R.
        • et al.
        Prospective evaluation of serum CA 125 levels for early detection of ovarian cancer.
        Obstet Gynecol. 1992; 80: 14-18
        • Farias-Eisner R.
        • Cirisano F.
        • Grouse D.
        • et al.
        Conservative and individualized surgery for early squamous carcinoma of the vulva: The treatment of choice for stage I and II (T1-2N0-1M0) disease.
        Gynecol Oncol. 1994; 53: 55
        • Fayers P.
        • Rustin G.
        • Wood R.
        • et al.
        The prognostic value of serum CA 125 in patients with advanced ovarian carcinoma: A analysis of 573 patients by the Medical Research Council Working Party on Gynaecological Cancer.
        Int J Gynecol Cancer. 1993; 3: 285
        • Fort M.
        • Pierce V.
        • Saigo P.
        • et al.
        Evidence for the efficacy of adjuvant therapy in epithelial ovarian tumors of low malignant potential.
        Gynecol Oncol. 1989; 32: 269
        • Frank A.
        • Tseng P.
        • Haffty B.
        • et al.
        Adjuvant whole-abdominal radiation therapy in uterine papillary serous carcinoma.
        Cancer. 1991; 66: 1516
        • Hacker N.
        • Van der Velden J.
        Conservative management of early vulvar cancer.
        Cancer. 1993; 71: 1673
        • Harrison T.
        • Sevin B.
        • Koechli O.
        • et al.
        Adenosquamous carcinoma of the cervix: Prognosis in early stage disease treated by radical hysterectomy.
        Gynecol Oncol. 1993; 50: 310
        • Herbst A.
        The epidemiology of ovarian carcinoma and the current status of tumor markers to detect disease.
        Am J Obstet Gynecol. 1994; 170: 1099
        • Hoskins W.
        • Bundy B.
        • Thigpen J.
        • et al.
        The influence of cytoreductive surgery on recurrence-free interval and survival in small-volume stage III epithelial ovarian cancer: A Gynecologic Oncology Group study.
        Gynecol Oncol. 1992; 47: 159
        • Hoskins W.
        • McGuire W.
        • Brady M.
        • et al.
        The effect of diameter of largest residual disease on survival after primary cytoreductive surgery in patients with suboptimal residual epithelial ovarian carcinoma.
        Am J Obstet Gynecol. 1994; 170: 974
        • Hricak H.
        • Rubinstein L.
        • Gherman G.
        • et al.
        MR imaging evaluation of endometrial carcinoma: Results of an NCI cooperative study.
        Radiology. 1991; 179: 829
        • Hunter R.
        • Alexander N.
        • Soutter W.
        Meta-analysis of surgery in advanced ovarian carcinoma: Is maximum cytoreductive surgery an independent determinant of prognosis?.
        Am J Obstet Gynecol. 1992; 166: 504
        • Jacobs I.
        • Kohler M.
        • Wiseman R.
        • et al.
        Clonal origin of epithelial ovarian carcinoma: Analysis by loss of heterozygosity, p53 mutation, and X-chromosome inactivation.
        J Natl Cancer Inst. 1992; 84: 1793
        • Kerlikowske K.
        • Brown J.
        • Grady D.
        Should women with familial ovarian cancer undergo prophylactic oophorectomy?.
        Obstet Gynecol. 1992; 80: 700
        • Keys H.
        Gynecologic Oncology Group randomized trials of combined technique therapy for vulvar cancer.
        Cancer. 1993; 71: 1691
        • Kim D.
        • Moon H.
        • Kim K.
        • et al.
        Effects of prophylactic chemotherapy for persistent trophoblastic disease in patients with complete hydatidiform mole.
        Obstet Gynecol. 1986; 67: 690
        • Kosary C.
        FIGO stage, histology, histologic grade, age and race as prognostic factors in determining survival for cancers of the female gynecological system: An analysis of 1973-87 SEER cases of cancers of the endometrium, cervix, ovary, vulva, and vagina.
        Semin Surg Oncol. 1994; 10: 31
        • Kurjak A.
        • Shalan H.
        • Sosic A.
        • et al.
        Endometrial carcinoma in postmenopausal women: Evaluation by transvaginal color Doppler ultrasonography.
        Am J Obstet Gynecol. 1993; 169: 1597
        • Levenback C.
        • Burke T.
        • Silva E.
        • et al.
        Uterine papillary serous carcinoma (UPSC) treated with cisplatin, doxorubicin, and cyclophosphamide (PAC).
        Gynecol Oncol. 1992; 46: 317
        • Look K.
        • Roth L.
        • Sutton G.
        Vulvar melanoma reconsidered.
        Cancer. 1993; 72: 143
        • Mallipeddi P.
        • Kapp D.
        • Teng N.
        Long-term survival with adjuvant whole abdominopelvic irradiation for uterine papillary serous carcinoma.
        Cancer. 1993; 71: 3076
        • Mann W.
        • Patsner B.
        • Cohen H.
        • et al.
        Preoperative serum CA-125 levels in patients with surgical stage I invasive ovarian adenocarcinoma.
        J Natl Cancer Inst. 1988; 80: 208
        • Markman M.
        • Berek J.
        • Blessing J.
        • et al.
        Characteristics of patients with small-volume residual ovarian cancer unresponsive to cisplatin-based ip chemotherapy: Lessons learned from a Gynecologic Oncology Group phase II trial of ip cisplatin and recombinant a-interferon.
        Gynecol Oncol. 1992; 45: 3
        • Markman M.
        • Reichman B.
        • Hakes T.
        • et al.
        Responses to second-line cisplatin-based intraperitoneal therapy in ovarian cancer: Influence of a prior response to intravenous cisplatin.
        J Clin Oncol. 1991; 9: 1801
        • McGuire W.P.
        • Hoskins W.J.
        • Brady M.F.
        • et al.
        A phase III trial comparing cisplatin/cytoxan and cisplatin/taxol in advanced ovarian cancer. ASCO Annual Meeting, Orlando and Los Angeles1993
        • McLellan R.
        • Dillon M.
        • Woodruff J.
        • et al.
        Long-term follow-up of stage I cervical adenocarcinoma treated by radical surgery.
        Gynecol Oncol. 1994; 52: 253
        • Morris M.
        • Gershenson D.
        • Eifel P.
        • et al.
        Treatment of small cell carcinoma of the cervix with cisplatin, doxorubicin, and etoposide.
        Gynecol Oncol. 1992; 47: 62
        • Muntz H.
        • Bell D.
        • Lage J.
        • et al.
        Adenocarcinoma in situ of the uterine cervix.
        Obstet Gynecol. 1992; 80: 935
        • National Institutes of Health
        Ovarian cancer: Screening, treatment and followup. National Institutes of Health Consensus Development Conference, Bethesda1994
        • Orr J.
        • Ball G.
        • Soong S.
        • et al.
        Surgical treatment of women found to have invasive cervix cancer at the time of total hysterectomy.
        Obstet Gynecol. 1986; 68: 353
        • Patsner B.
        • Mann W.
        • Cohen H.
        • et al.
        Predictive value of preoperative serum CA 125 levels in clinically localized and advanced endometrial carcinoma.
        Am J Obstet. 1988; 158: 399
        • Phillips G.
        • Bundy B.
        • Okagaki T.
        • et al.
        Malignant melanoma of the vulva treated by radical hemivulvectomy.
        Cancer. 1994; 73: 2626
        • Piver M.
        • Recio F.
        • Baker T.
        • et al.
        Evaluation of survival after second-line intraperitoneal cisplatin-based chemotherapy for advanced ovarian cancer.
        Cancer. 1994; 73: 1693
        • Piver M.
        • Malfetano J.
        • Baker T.
        • et al.
        Five-year survival for stage IC or stage I grade 3 epithelial ovarian cancer treated with cisplatin-based chemotherapy.
        Gynecol Oncol. 1992; 46: 357
        • Podczaski E.
        • Palombo C.
        • Manetta A.
        • et al.
        Assessment of pretreatment laparotomy in patients with cervical carcinoma prior to radiotherapy.
        Gynecol Oncol. 1989; 33: 71
        • Potish R.
        • Twiggs L.
        On the lack of demonstrated clinical benefit of neoadjuvant cisplatinum therapy for cervical cancer.
        Int J Radiat Oncol Biol Phys. 1993; 27: 975
        • Potter M.
        • Spencer S.
        • Soong S.
        • et al.
        The influence of staging laparotomy for cervical cancer on patterns of recurrence and survival.
        Int J Gynecol Cancer. 1993; 3: 169
        • Potter M.
        • Partridge E.
        • Hatch K.
        • et al.
        Primary surgical therapy of ovarian cancer: How much and when?.
        Gynecol Oncol. 1991; 40: 195
        • Price F.
        • Chambers S.
        • Carcangiu M.
        • et al.
        Intravenous cisplatin, doxorubicin, and cyclophosphamide in the treatment of uterine papillary serous carcinoma (UPSC).
        Gynecol Oncol. 1993; 51: 383
        • Rosman M.
        • Hayden C.
        • Thiel R.
        • et al.
        Prognostic indicators for poor risk epithelial ovarian carcinoma.
        Cancer. 1994; 74: 1323
        • Sainz de la Cuesta R.
        • Goff B.
        • Fuller A.
        • et al.
        Prognostic importance of intraoperative rupture of malignant ovarian epithelial neoplasms.
        Obstet Gynecol. 1994; 84: 1
        • Schink J.
        • Singh D.
        • Rademaker A.
        • et al.
        Etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine for the treatment of metastatic, high-risk gestational trophoblastic disease.
        Obstet Gynecol. 1992; 80: 817
        • Schueler J.
        • Comelisse C.
        • Hermans J.
        • et al.
        Prognostic factors in well-differentiated early-stage epithelial ovarian cancer.
        Cancer. 1993; 71: 787
        • Schutter E.
        • Kenemans P.
        • Sohn C.
        • et al.
        Diagnostic value of pelvic examination, ultrasound, and serum CA 125 in postmenopausal women with a pelvic mass.
        Cancer. 1994; 74: 1398
        • Schwartz P.
        • Chambers J.
        • Makuch R.
        Neoadjuvant chemotherapy for advanced ovarian cancer.
        Gynecol Oncol. 1994; 53: 33
        • Sevelda P.
        • Dittrich C.
        • Salzer H.
        Prognostic value of the rupture of the capsule in stage I epithelial ovarian carcinoma.
        Gynecol Oncol. 1989; 35: 321
        • Shalev E.
        • Eliyahu S.
        • Peleg
        • et al.
        Laparoscopic management of adnexal cystic masses in postmenopausal women.
        Obstet Gynecol. 1994; 83: 594
        • Shim J.
        • Rose P.
        • Reale F.
        • et al.
        Accuracy of frozen-section diagnosis at surgery in clinical stage I and II endometrial carcinoma.
        Am J Obstet Gynecol. 1992; 166: 1335
        • Soper J.
        • Berchuck A.
        • Dodge R.
        • et al.
        Adjuvant therapy with intraperitoneal chromic phosphate (32P) in women with early ovarian carcinoma after comprehensive surgical staging.
        Obstet Gynecol. 1992; 79: 993
        • Stehman F.
        • Bundy B.
        • Dvoretsky P.
        • et al.
        Early stage I carcinoma of the vulva treated with ipsilateral superficial inguinal lymphadenectomy and modified radical hemivul-vectomy: A prospective study of the Gynecologic Oncology Group.
        Obstet Gynecol. 1992; 79: 490
        • Stehman F.
        • Bundy B.
        Carcinoma of the cervix treated with chemotherapy and radiation therapy.
        Cancer. 1993; 71: 1697
        • Tropé C.
        • Vergote I.
        • Kristensen G.
        • et al.
        Are borderline tumors of the ovary overtreated both surgically and systemically? A review of four prospective randomized trials including 253 patients with borderline tumors.
        Gynecol Oncol. 1993; 51: 236
        • Tsao S.
        • Mok C-H
        • Knapp R.
        • et al.
        Molecular genetic evidence of a unifocal origin for human serous ovarian carcinomas.
        Gynecol Oncol. 1993; 48: 5
        • Williams S.
        • Blessing J.
        • Hatch K.
        • et al.
        Chemotherapy of advanced dysgerminoma: Trials of the Gynecologic Oncology Group.
        J Clin Oncol. 1991; 9: 1950
        • Williams S.
        • Blessing J.
        • Liao S.
        • et al.
        Adjuvant therapy of ovarian germ cell tumors with cisplatin, etoposide, and bleomycin: A trial of the Gynecologic Oncology Group.
        Clin Oncol. 1994; 12: 701
        • Yazigi R.
        • Munoz A.
        • Sandstad J.
        • et al.
        Cisplatin based combination chemotherapy in the treatment of stage III ovarian epithelial tumors of low malignant potential.
        Eur J Gynaec Oncol. 1991; 12: 451
        • Young R.
        • Walton L.
        • Ellenberg S.
        • et al.
        Adjuvant therapy in stage I and stage II epithelial ovarian cancer.
        N Engl J Med. 1990; 322: 1021

      Article info

      Identification

      DOI: https://doi.org/10.1016/S0272-2712(18)30327-5

      Copyright

      © 1995 Elsevier Inc. Published by Elsevier Inc. All rights reserved.

      ScienceDirect

      Access this article on ScienceDirect

      The content on this site is intended for healthcare professionals.


      We use cookies to help provide and enhance our service and tailor content. To update your cookie settings, please visit the Cookie Preference Center for this site.
      Copyright © 2023 Elsevier Inc. except certain content provided by third parties.


      RELX