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Volume 1, Number 3 – November, 2002 |
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The following articles appeared in the November issues of the surveyed journals. Articles that seem to be of most interest to the practicing gynecologic oncologist are included. The journals that are surveyed are New England Journal of Medicine, Journal of Clinical Oncology, Gynecologic Oncology, Cancer, American Journal of Obstetrics and Gynecology, Lancet, Cancer Research, Obstetrics and Gynecology, Journal of the National Cancer Institute, Journal of the American Medical Association. The participants in this program are the active clinical fellows at Memorial Hospital: Bhavana Pothuri, Mario Leitao, Christopher Awtrey, Sarah Ferguson, Alan Schlaerth and Rami Eitan. The managing editor is Douglas Levine. Comments, questions, complaints and suggestions are always welcome, please E-mail us at: VJC@smgo.org or click here. To subscribe or unsubscribe to the VJC, click here. Gynecologic Oncology – Mario Leitao Title: Management of Invasive Carcinoma of the Uterine Cervix Associated with Pregnancy: Outcome of Intentional Delay in Treatment Authors: Minako Takushi, M.D., Hidehiko Moromizato, M.D., Ph.D., Kaoru Sakumoto, M.D., Ph.D., Koji Kanazawa, M.D., Ph.D. Source: Gynecologic Oncology Vol. 87, No. 2, November 2002, Pages 185-189. Summary: 28 patients with invasive cervical carcinoma diagnosed during pregnancy or within 1 month of delivery were retrospectively identified over a 19-year period. 16 underwent immediate definitive therapy. Treatment was intentionally delayed in 12 patients. 8 were stage IA1, 1 IA2, 2 IB1 and 1 IB2. The disease was diagnosed at 16-27 weeks of gestation and treatment was delayed 6-25 weeks. All 12 patients were alive and without evidence of disease with follow-up of 52-156 months. This is a small retrospective review that highlights the consideration of conservative management to term in highly select and motivated patients. Click here for abstract from Gynecologic Oncology Journal of Clinical Oncology - Bhavana Pothuri Nothing of interest this month Journal of the National Cancer Institute – Rami Eitan Title: Herpes Simplex Virus-2 as a Human Papillomavirus Cofactor in the Etiology of Invasive Cervical Cancer Authors: Jennifer S. Smith, Rolando Herrero, Cristina Bosetti, Nubia Muñoz, F. Xavier Bosch, José Eluf-Neto, Xavier Castellsagué, Chris J. L. M. Meijer, Adriaan J. C. Van den Brule, Silvia Franceschi, and Rhoda Ashley Source: J Natl Cancer Inst 2002; 94: 1604-1613. Summary: Blood and exfoliated cervical specimens were obtained from 1263 case patients with invasive cervical cancer and 1117 age-matched control subjects. Assay were used to detect serum antibodies to HSV-2 and HSV-1. HPV DNA was detected using a PCR assay. Overall, HSV-2 seropositivity was higher among case patients with squamous-cell carcinoma (44.4%, 95% CI = 41.5% to 47.3%) or adeno- or adenosquamous-cell carcinoma (43.8%, 95% CI = 34.2% to 53.5%) than among control subjects (25.6%, 95% CI = 23.0% to 28.2%). Among the HPV-positive women, HSV-2 seropositivity was associated with increased risks of squamous-cell carcinoma (OR = 2.19, 95% CI = 1.41 to 3.40) and adeno- or adenosquamous-cell carcinoma (OR = 3.37, 95% CI = 1.47 to 7.74) after adjustment for potential confounders. HSV-2 infection may act in conjunction with HPV infection to increase the risk of invasive cervical carcinoma. Click here for abstract from JNCI Obstetrics and Gynecology – Alan Schlaerth Title: Rate of Human Papillomavirus Clearance After Treatment of Cervical Intraepithelial Neoplasia. Authors: Kristina Elfgren, Marcel Jacobs, Jan M. M. Walboomers, Chris J. L. M. Meijer and Joakim Dillner. Source: Obstetrics & Gynecology, Volume 100, Issue 5, November 2002, Pages 965-971. Summary: The rate of clearance of HPV infection in 109 patients was examined after surgical treatment. 38 patients had cryotherapy and 71 patients underwent conization. At 12 months post-treatment, only 7 patients were persistently HPV positive. The authors conclude that effective treatment of CIN will facilitate clearance of HPV. Click here for abstract from Obstetrics & Gynecology American Journal of Obstetrics and Gynecology – Chris Awtrey Nothing of interest this month New England Journal of Medicine – Bhavana Pothuri
Title: A Controlled Trial of a Human Papillomavirus Type 16 Vaccine. Source: NEJM Volume 347, Number 21:1645-1651 November 21, 2002 Summary: This is a randomized double blinded study of 2392 women receiving 3 doses of placebo or HPV 16 virus-like- particle vaccine. HPV 16 DNA testing from genital samples were obtained sequentially and biopsy tissue was evaluated for cervical intraepithelial neoplasia. Follow-up was 17.4 months after vaccination. The incidence of HPV infection was 3.8 per 100 woman-years risk in placebo vs 0 per 100 woman-years-risk in the vaccine group, p=0.001. All nine cases of HPV related CIN occurred in placebo recipients. Immunizing with HPV 16 (noted in 50% of cervix cancers) may reduce the incidence of cervix cancer. Click here for abstract from the New England Journal of Medicine Journal of the American Medical Association – Rami Eitan Title: Hormone Replacement Therapy and Incidence of Alzheimer Disease in Older Women - The Cache County Study. Authors: Peter P. Zandi, PhD; Michelle C. Carlson, PhD; Brenda L. Plassman, PhD; Kathleen A. Welsh-Bohmer, PhD; Lawrence S. Mayer, MD; David C. Steffens, MD; John C. S. Breitner, MD; for the Cache County Memory Study Investigators. Source: JAMA. November 2002;288:2123-2129. Summary: 1889 women (mean age, 74.5 years) were followed prospectively for the development of Alzheimer disease (AD). History of use of HRT was ascertained at the initial contact. Incidence among women increased after age 80 years and exceeded the risk among men of similar age (HR, 2.11). Women who used HRT had a reduced risk of AD compared with non-HRT users (adjusted HR, 0.59; 95% CI, 0.36-0.96). Risk varied with duration of HRT use, so that a woman's sex-specific increase in risk disappeared entirely with more than 10 years of treatment. Almost all of the HRT-related reduction in incidence reflected former use of HRT. There was no effect with current HRT use. Prior HRT use is associated with reduced risk of AD, but there is no apparent benefit with current HRT use. Click here for abstract from JAMA Cancer – Sarah Ferguson Title: Absolute risk of a subsequent abnormal pap among oncogenic human papillomavirus DNA-positive, cytologically negative women. Authors: Philip E. Castle, Ph.D., M.P.H., Sholom Wacholder, Ph.D., Mark E. Sherman, M.D., Attila T. Lorincz, Ph.D., Andrew G. Glass, M.D., David R. Scott, M.D., Brenda B. Rush, R.N., Franklin Demuth, B.S., Mark Schiffman, M.D., M.P.H. Source: Cancer Volume 95, Issue 10, 2002. Pages: 2145-2151 Summary: 2020 women with negative Pap test but positive for oncogenic HPV DNA type were followed for the incidence of abnormality on Pap smears for 57 months. Risk of Pap with ASCUS or greater was 16.8%. 6.4% for LGSIL and 2.2% for HGSIL. A higher viral load was associated with a greater risk of abnormality on followup Pap. Click here for abstract from Cancer Lancet – Chris Awtrey Nothing of interest this month Cancer Research – Sarah Ferguson Title: Growth Inhibition of Cervix Carcinoma Cells in Vivo by Endothelin A Receptor Blockade
Authors: Source: Cancer Res 2002 62: 6381-6384. Summary: Endothelin A receptor (ETaR) may represent a target for antitumor therapy in HPV positive cervical cells. The authors describe the complete inhibition of human cervix carcinoma growth by blocking the ETaR. In nude mice, ETaR-antagonist called atrasentan inhibited the growth and the neoangiogenesis of cervical carcinoma cell xenografts. There appears to be an additive effect when administered with paclitaxel. This small molecule may help to control cervical cancer by either monotherapy or combination therapy. |
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