The following articles appeared in the October 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: Outcome of Reproductive Age Women with Stage IA or IC Invasive Epithelial Ovarian Cancer Treated with Fertility-Sparing Therapy

Authors: Jeanne M. Schilder, M.D.,Amy M. Thompson, M.D., Paul D. DePriest, M.D.,1Frederick R. Ueland, M.D.,Michael L. Cibull, M.D.,3Richard J. Kryscio, Ph.D.,Susan C. Modesitt, M.D.,Karen H. Lu, M.D.,John P. Geisler, M.D.,Robert V. Higgins, M.D.,Paul M. Magtibay, M.D., David E. Cohn, M.D.,Matthew A. Powell, M.D., Christina Chu, M.D.,Frederick B. Stehman, M.D.,and John van Nagell, M.D.,William E. Winter, III , Paul R. Kucera, William Rodgers, John W. McBroom, Cara Olsen and G. Larry Maxwell

Source: Gynecologic Oncology, Volume 87, Issue 1, October 2002, Pages 1-7.

Summary: This is a retrospective review of 52 patients with stage IA or IC epithelial invasive ovarian carcinoma treated with USO and surgical staging at eight different institutions.  There were 5 recurrences and 2 deaths.  The 5- and 10-year estimated survival was 98% and 93%, respectively. 24 patients attempted pregnancy and 17 (71%) of these conceived with no congenital anomalies.  The authors conclude that conservative therapy may be appropriate in a select group of women desiring fertility.

Click here for abstract from Gynecologic Oncology

Return to top of page

Journal of Clinical Oncology - Bhavana Pothuri

Nothing of interest this month

Journal of the National Cancer Institute – Rami Eitan

Nothing of interest this month

Obstetrics and Gynecology – Alan Schlaerth

Title: Surgical Staging in Patients with Ovarian Tumors of Low Malignant Potential.

Authors: William E. Winter, III , Paul R. Kucera, William Rodgers, John W. McBroom, Cara Olsen and G. Larry Maxwell

Source: Obstetrics & Gynecology, Volume 100, Issue 4, October 2002, Pages 671-676.

Summary: This retrospective review compares patients with ovarian tumors of low malignant potential who had complete surgical staging (n=48) with those who were unstaged (n=45) to determine if recurrence or survival was affected by the staging.  In 17% of patients their stage was upgraded on the basis of surgical staging, as a result of retroperitoneal involvement in only 6% of those cases (three of 48 staged patients).  There were three recurrences and two deaths in both the staged and unstaged groups.  As expected, the overall 5-year survival was approximately 93% for all stages and not different for patients staged or unstaged. 

Click here for abstract from Obstetrics & Gynecology

Return to top of page

Title: Outcomes of Endometrial Cancer Patients Undergoing Surgery With Gynecologic Oncology Involvement.

Authors: Michael L. Pearl, Jeannine A. Villella, Fidel A. Valea, Paul A. DiSilvestro and Eva Chalas

Source: Obstetrics & Gynecology, Volume 100, Issue 4, October 2002, Pages 724-729

Summary: This study compared the outcomes patients who had primary surgery for endometrial cancer with gynecologic oncology involvement performed at a university hospital versus a community hospital.  Their were no differences between the two groups regarding Quetelet index, EBL, operative or peri-operative complications, frequency of staging, stage distribution, histology and grade of tumor, or length of stay.  The patients at a university setting were significantly older, had more comorbid conditions, were more likely to have a vaginal hysterectomy and participate in a research protocol. Involvement of a gynecologic oncologist was associated with comparable outcomes in both settings.

Click here for abstract from Obstetrics & Gynecology

Return to top of page

Title: Ovarian and Extraovarian Endometriosis-Associated Cancer. 

Authors: Susan C. Modesitt, Guillermo Tortolero-Luna, Jubilee B. Robinson, David M. Gershenson and Judith K. Wolf

Source: Obstetrics & Gynecology, Volume 100, Issue 4, October 2002, Pages 788-795

Summary: This retrospective study analyzed the clinical characteristics of women with endometriosis-associated intraperitoneal cancer.  115 patients were identified with either an endometriosis-associated ovarian cancer (94 patients) or a cancer arising in extra-ovarian endometriosis (21 patients).  Of significance, patients with endometriosis-associated cancers more often were premenopausal, had early stage disease, and had an increased incidence of clear cell and endometrioid histologies. Independent predictors of survival were stage and gravidity.  The use of HRT in the 21 patients with cancer arising in extra-ovarian endometriosis did not impact survival.

Click here for abstract from Obstetrics & Gynecology

Return to top of page

American Journal of Obstetrics and Gynecology – Chris Awtrey

Nothing of interest this month

New England Journal of Medicine – Bhavana Pothuri

Title: Outcomes after total versus subtotal abdominal hysterectomy

Authors: Ranee Thakar, Susan Ayers, Peter Clarkson, Stuart Stanton, and Isaac Manyonda

Source: NEJM, Volume 347,Number 17,October 2002, 1318-1325

Summary: This is a randomized trial comparing 279 women undergoing total vs subtotal hysterectomy in terms of bladder, bowel, and sexual function at 12 months. Neither subtotal or total abdominal hysterectomy adversely affected pelvic organ function at 12 months. Subtotal hysterectomy resulted in more rapid recovery and fewer short term complications, but infrequently causes cyclical bleeding or cervical prolapse.

Click here for abstract from the New England Journal of Medicine

Return to top of page

Journal of the American Medical Association – Rami Eitan

Cancer – Mario Leitao

Nothing of interest this month

Lancet – Chris Awtrey

Nothing of interest this month

Cancer Research – Sarah Ferguson

Nothing of interest this month