Change search
Refine search result
12 1 - 50 of 79
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the Create feeds function.
  • 1.
    Bergmark, K
    et al.
    Gynecological Oncology, Department of Oncology-Pathology, Radiumhemmet, Karolinska Institutet, Stockholm, Sweden. Clinical Cancerepidemiology, Department of Oncology–Pathology, Karolinska Institutet, Stockholm, Sweden .
    Åvall-Lundqvist, Elisabeth
    Gynecological Oncology, Department of Oncology-Pathology, Radiumhemmet, Karolinska Institutet, Stockholm, Sweden.
    Dickman, P W
    Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden .
    Henningsohn, L
    Clinical Cancerepidemiology, Department of Oncology–Pathology, Karolinska Institutet, Stockholm, Sweden . Department of Urology, Huddinge Hospital, Huddinge, Sweden .
    Steineck, G
    Clinical Cancerepidemiology, Department of Oncology–Pathology, Karolinska Institutet, Stockholm, Sweden. Clinical Cancerepidemiology, Stockholm City Council, Stockholm, Sweden .
    Lymphedema and bladder-emptying difficulties after radical hysterectomy for early cervical cancer and among population controls.2006In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 16, no 3, p. 1130-1139Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to acquire knowledge that can be used to refine radical hysterectomy to improve quality-of-life outcome. Data were collected in 1996-1997 by means of an anonymous postal questionnaire in a follow-up study of two cohorts (patients and population controls). We attempted to enroll all 332 patients with stage IB-IIA cervical cancer registered in 1991-1992 at the seven departments of gynecological oncology in Sweden and 489 population controls. Ninety three (37%) of the 256 women with a history of cervical cancer who answered the questionnaire (77%) were treated with surgery alone. Three-hundred fifty population controls answered the questionnaire (72%). Women treated with radical hysterectomy, as compared with controls, had an 8-fold increase in symptoms indicating lymphedema (25% reported distress due to lymphedema), a nearly 9-fold increase in difficult emptying of the bladder, and a 22-fold increase in the need to strain to initiate bladder evacuation. Ninety percent of the patients were not willing to trade off survival for freedom from symptoms. Avoiding to induce long-term lymphedema or bladder-emptying difficulties would probably improve quality of life after radical hysterectomy (to cure cervical cancer). Few women want to compromise survival to avoid long-term symptoms.

  • 2. Bjurberg, Maria
    et al.
    Kjellén, Elisabeth
    Umeå University, Faculty of Medicine, Department of Radiation Sciences. Department of Oncology, Lund University Hospital.
    Ohlsson, Tomas
    Bendahl, Pär-Ola
    Brun, Eva
    Prediction of patient outcome with 2-deoxy-2-[(18)F]fluoro-D-glucose-positron emission tomography early during radiotherapy for locally advanced cervical cancer2009In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 19, no 9, p. 1600-1605Article in journal (Refereed)
    Abstract [en]

    Introduction: It is difficult to assess the individual response of locally advanced cervical cancer to chemoradiation therapy during the course of treatment. We have investigated the predictive value of positron emission tomography (PET) with 2-deoxy-2-[(18)F]fluoro-D-glucose (FDG) early during treatment in relation to progression-free survival.

    Methods: This prospective single-center clinical trial included women with locally advanced cervical cancer from 2004 to 2008. 2-Deoxy-2-[(18)F]fluoro-D-glucose-PET/computed tomography was performed at baseline, during the third week of treatment and, finally, 3 months after the completion of treatment. The images were evaluated visually, semiquantitatively with the maximum standardized uptake value, and by calculating the metabolic rate of FDG. Thirty-two patients were eligible for full evaluation.

    Results: The median follow-up time was 28 months (range, 5-53 months). Visual metabolic complete response on FDG-PET, after a mean irradiation dose of 23 Gy (range, 16-27 Gy), was found in 7 patients, none of which relapsed. Eleven of the 25 patients with remaining malignant hypermetabolism on the second FDG-PET relapsed. Neither maximum standardized uptake value nor metabolic rate of FDG could further discriminate between patients with low risk and patients with high risk of relapse. The follow-up FDG-PET performed 3 months after the completion of treatment identified a group of patients with poor prognosis.

    Conclusions: In conclusion, FDG-PET early during chemoradiation therapy identified a small number of patients with an excellent prognosis. However, FDG-PET at this early point in time during treatment failed to predict the outcome for most patients. Future clinical trials to determine the optimal timing of predictive FDG-PET are thus warranted.

  • 3.
    Cibula, David
    et al.
    Charles Univ Prague, Czech Republic; Gen Univ Hosp, Czech Republic.
    Poetter, Richard
    Med Univ Vienna, Austria.
    Planchamp, Francois
    Inst Bergonie, France.
    Åvall-Lundqvist, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Oncology.
    Fischerova, Daniela
    Charles Univ Prague, Czech Republic; Gen Univ Hosp, Czech Republic.
    Meder, Christine Haie
    Inst Gustave Roussy, France.
    Koehler, Christhardt
    Asklepios Hambourg Altona, Germany; Univ Cologne, Germany.
    Landoni, Fabio
    Univ Milano Bicocca, Italy.
    Lax, Sigurd
    Gen Hosp Graz Sued West, Austria.
    Lindegaard, Jacob Christian
    Aarhus Univ, Denmark.
    Mahantshetty, Umesh
    Tata Mem Hosp, India.
    Mathevet, Patrice
    Lausanne Univ, Switzerland.
    McCluggage, W. Glenn
    Belfast Hlth and Social Care Trust, North Ireland.
    McCormack, Mary
    Univ Coll London Hosp, England.
    Naik, Raj
    Queen Elizabeth Hosp, England.
    Nout, Remi
    Leiden Univ, Netherlands.
    Pignata, Sandro
    Ist Nazl Studio and Cura Tumori, Italy.
    Ponce, Jordi
    Univ Hosp Bellvitge IDIBELL, Spain.
    Querleu, Denis
    Inst Bergonie, France.
    Raspagliesi, Francesco
    Not Found:[Cibula, David; Fischerova, Daniela] Charles Univ Prague, Fac Med 1, Gynecol Oncol Ctr, Dept Obstet and Gynecol, Prague, Czech Republic; [Cibula, David; Fischerova, Daniela] Gen Univ Hosp, Prague, Czech Republic; [Poetter, Richard] Med Univ Vienna, Dept Radiotherapy, Vienna, Austria; [Planchamp, Francois; Querleu, Denis] Inst Bergonie, Bordeaux, France; [Avall-Lundqvist, Elisabeth] Linkoping Univ, Linkoping, Sweden; [Meder, Christine Haie] Inst Gustave Roussy, Dept Radiotherapy, Villejuif, France; [Koehler, Christhardt] Asklepios Hambourg Altona, Hamburg, Germany; [Koehler, Christhardt] Univ Cologne, Med Fac, Dept Gynecol, Cologne, Germany; [Landoni, Fabio] Univ Milano Bicocca, Monza, Italy; [Lax, Sigurd] Gen Hosp Graz Sued West, Graz, Austria; [Lindegaard, Jacob Christian] Aarhus Univ, Dept Oncol, Aarhus, Denmark; [Mahantshetty, Umesh] Tata Mem Hosp, Dept Radiat Oncol, Mumbai, Maharashtra, India; [Mathevet, Patrice] Lausanne Univ, Lausanne, Switzerland; [McCluggage, W. Glenn] Belfast Hlth and Social Care Trust, Dept Pathol, Belfast, Antrim, North Ireland; [McCormack, Mary] Univ Coll London Hosp, London, England; [Naik, Raj] Queen Elizabeth Hosp, Gateshead, England; [Nout, Remi] Leiden Univ, Dept Radiat Oncol, Leiden, Netherlands; [Pignata, Sandro] Ist Nazl Studio and Cura Tumori, IRCCS, Fdn G Pascale, Naples, Italy; [Ponce, Jordi] Univ Hosp Bellvitge IDIBELL, Barcelona, Spain; [Rodolakis, Alexandros] Ist Nazl Tumori, Fdn IRCCS, Milan, Italy; [Tamussino, Karl] Univ Athens, Athens, Greece; [Wimberger, Pauline] Med Univ Graz, Graz, Austria; [Wimberger, Pauline] Dresden Univ, TU Dresden, Dresden, Germany; [Raspollini, Maria Rosaria] Univ Hosp, Florence, Italy;.
    Rodolakis, Alexandros
    Ist Nazl Tumori, Italy.
    Tamussino, Karl
    Univ Athens, Greece.
    Wimberger, Pauline
    Med Univ Graz, Austria; Dresden Univ, Germany.
    Raspollini, Maria Rosaria
    Univ Hosp, Italy.
    The European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology Guidelines for the Management of Patients With Cervical Cancer2018In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 28, no 4, p. 641-655Article in journal (Refereed)
    Abstract [en]

    Background Despite significant advances in the screening, detection, and treatment of preinvasive cervical lesions, invasive cervical cancer is the fifth most common cancer in European women. There are large disparities in Europe and worldwide in the incidence, management, and mortality of cervical cancer. Objective The European Society of Gynaecological Oncology (ESGO), the European Society for Radiotherapy and Oncology (ESTRO), and the European Society of Pathology (ESP) jointly develop clinically relevant and evidence-based guidelines in order to improve the quality of care for women with cervical cancer across Europe and worldwide. Methods The ESGO/ESTRO/ESP nominated an international multidisciplinary development group consisting of practicing clinicians and researchers who have demonstrated leadership and expertise in the care and research of cervical cancer (23 experts across Europe). To ensure that the guidelines are evidence based, the current literature identified from a systematic search was reviewed and critically appraised. In the absence of any clear scientific evidence, judgment was based on the professional experience and consensus of the development group. The guidelines are thus based on the best available evidence and expert agreement. Prior to publication, the guidelines were reviewed by 159 international reviewers, selected through ESGO/ESTRO/ESP and including patient representatives. Results The guidelines cover comprehensively staging, management, and follow-up for patients with cervical cancer. Management includes fertility sparing treatment; stage T1a, T1b1/T2a1, clinically occult cervical cancer diagnosed after simple hysterectomy; early and locally advanced cervical cancer; primary distant metastatic disease; cervical cancer in pregnancy; and recurrent disease. Principles of radiotherapy and pathological evaluation are defined.

  • 4.
    Dostalek, Lukas
    et al.
    Charles Univ Prague, Czech Republic.
    Åvall-Lundqvist, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Oncology.
    Creutzberg, Carien L.
    Leiden Univ, Netherlands.
    Kurdiani, Dina
    Tbilisi Canc Ctr, Rep of Georgia.
    Ponce, Jordi
    Univ Barcelona, Spain.
    Dostalkova, Iva
    Univ South Bohemia, Czech Republic.
    Cibula, David
    Charles Univ Prague, Czech Republic.
    ESGO Survey on Current Practice in the Management of Cervical Cancer2018In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 28, no 6, p. 1226-1231Article in journal (Refereed)
    Abstract [en]

    Objective The aim of this survey was to acquire an overview of the current management of cervical cancer with an emphasis on the early disease stages. Materials and Methods A hyperlink to the survey was sent to the European Society of Gynaecological Oncology Office database. The survey contained 6 groups of questions regarding the characteristics of respondents, pretreatment workup, management of the early stages of cervical cancer, adjuvant treatment, fertility-sparing treatment, and surveillance. Results In total, 566 responses were collected. The most frequent imaging method used in the workup was magnetic resonance imaging (74%), followed by computed tomography (54%) and positron emission tomography/computed tomography (25%). Conization or simple hysterectomy was a preferred procedure in stage T1a1 lymphovascular space invasion (LVSI)-positive for 79% of respondents, in stage T1a2 LVSI-negative for 58%, and in stage T1a2 LVSI-positive for 28%. Sentinel lymph node biopsy alone was reported in stage T1a1 by 17% and in stage T1b1 less than 2 cm by 9%, whereas systematic lymphadenectomy by 29% and 90% of respondents. Macrometastases, micrometastases, and isolated tumor cells in lymph nodes were considered indications for adjuvant treatment by 96%, 93%, and 68% of respondents, respectively. Neoadjuvant chemotherapy was reported by 28% and 19% of respondents in fertility-sparing and nonsparing management in stage T1b1. Over 60% of respondents recommend primary surgery for their patients with T1b2 N0 disease and 81% of them use a combination of adverse prognostic factors as indication for adjuvant radiotherapy in pN0 disease. Conclusions The results of this survey indicate considerable differences in the workup and treatment of cervical cancer in current clinical practice.

  • 5.
    Dunberger, Gail
    et al.
    Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden.
    Lind, Helena
    Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden.
    Steineck, Gunnar
    Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden / Clinical Cancer Epidemiology, Sahlgrenska Academy, Gothenburg, Sweden.
    Waldenström, Ann-Charlotte
    Department of Gynecological Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Nyberg, Tommy
    Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden.
    al-Abany, Massoud
    Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden.
    Nyberg, Ullakarin
    Department of Clinical Neuroscience, Section of Psychiatry, St Gorans Hospital, Stockholm, Sweden.
    Åvall-Lundqvist, Elisabeth
    Department of Gynecological Oncology, Karolinska University Hospital, Stockholm, Sweden.
    Fecal incontinence affecting quality of life and social functioning among long-term gynecological cancer survivors.2010In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 20, no 3, p. 449-460Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Fecal incontinence is a symptom reported by cancer survivors after pelvic radiotherapy and is recognized to be one of the most troubling symptom-induced sources of distress to patients.

    OBJECTIVE: To investigate how fecal incontinence, patient-reported as emptying of all stools into clothing without forewarning, impact self-assessed quality of life from a social, psychological, sexual, and functional aspect among gynecological cancer survivors treated with pelvic radiotherapy.

    METHODS: We identified a cohort of 789 eligible women in the Stockholm and Gothenburg areas treated with pelvic radiotherapy alone or as combined treatment of gynecological cancer. From the Swedish Population Registry, we identified 478 control women. Data were collected using a study-specific, validated, postal questionnaire including questions covering symptoms from the pelvic region, demographics, social functioning, psychological, and quality-of-life issues.

    RESULTS: Participation was 78% for cancer survivors and 72% for control women. The fecal incontinence symptom emptying of all stools into clothing without forewarning was reported by 70 cancer survivors (12%), with lowered quality of life in 74% of the 70 cancer survivors. This symptom kept the survivors from going to parties (relative risk [RR], 11.8; 95% confidence interval [CI], 6.6-21.1), kept the survivors from traveling (RR, 9.3; 95% CI, 5.3-16.5), affected their work ability (RR, 7.9; 95% CI, 3.8-16.4), hindered their sexual life (RR, 9.2; 95% CI, 4.8-17.6), and changed them as persons (RR, 4.9; 95% CI, 2.9-8.1). The prevalence of the symptom emptying of all stools into clothing without forewarning among control women was 3 (1%) of 344.

    CONCLUSIONS: Among gynecological cancer survivors having undergone pelvic radiotherapy alone or as part of a combined treatment, fecal incontinence is associated with social, psychological, sexual, and functional consequences.

  • 6. Falconer, Henrik
    et al.
    Palsdottir, Kolbrun
    Stalberg, Karin
    Dahm-Kahler, Pernilla
    Ottander, Ulrika
    Umeå University, Faculty of Medicine, Department of Clinical Sciences.
    Lundin, Evelyn Serreyn
    Wijk, Lena
    Kimmig, Rainer
    Jensen, Pernille Tine
    Eriksson, Ane Gerda Zahl
    Maenpaa, Johanna
    Persson, Jan
    Salehi, Sahar
    Robot-assisted approach to cervical cancer (RACC): an international multi-center, open-label randomized controlled trial2019In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 29, no 6, p. 1072-1076Article in journal (Refereed)
    Abstract [en]

    Background Radical hysterectomy with pelvic lymphadenectomy represents the standard treatment for early-stage cervical cancer. Results from a recent randomized controlled trial demonstrate that minimally invasive surgery is inferior to laparotomy with regards to disease-free and overall survival. Primary Objective To investigate the oncologic safety of robot-assisted surgery for early-stage cervical cancer as compared with standard laparotomy. Study Hypothesis Robot-assisted laparoscopic radical hysterectomy is non-inferior to laparotomy in regards to recurrence-free survival with the advantage of fewer post-operative complications and superior patient-reported outcomes. Trial Design Prospective, multi-institutional, international, open-label randomized clinical trial. Consecutive women with early-stage cervical cancer will be assessed for eligibility and subsequently randomized 1:1 to either robot-assisted laparoscopic surgery or laparotomy. Institutional review board approval will be required from all participating institutions. The trial is coordinated from Karolinska University Hospital, Sweden. Major Inclusion/Exclusion Criteria Women over 18 with cervical cancer FIGO (2018) stages IB1, IB2, and IIA1 squamous, adenocarcinoma, or adenosquamous will be included. Women are not eligible if they have evidence of metastatic disease, serious co-morbidity, or a secondary invasive neoplasm in the past 5 years. Primary Endpoint Recurrence-free survival at 5 years between women who underwent robot-assisted laparoscopic surgery versus laparotomy for early-stage cervical cancer. Sample Size The clinical non-inferiority margin in this study is defined as a 5-year recurrence-free survival not worsened by >7.5%. With an expected recurrence-free survival of 85%, the study needs to observe 127 events with a one-sided level of significance (alpha) of 5% and a power (1-beta) of 80%. With 5 years of recruitment and 3 years of follow-up, the necessary number of events will be reached if the study can recruit a total of 768 patients. Estimated Dates for Completing Accrual and Presenting Results Trial launch is estimated to be May 2019 and the trial is estimated to close in May 2027 with presentation of data shortly thereafter.

  • 7.
    Falconer, Henrik
    et al.
    Karolinska Inst, Sweden.
    Palsdottir, Kolbrun
    Karolinska Inst, Sweden.
    Stalberg, Karin
    Uppsala Univ, Sweden.
    Dahm-Kahler, Pernilla
    Sahlgrens Acad, Sweden.
    Ottander, Ulrika
    Umea Univ, Sweden.
    Lundin, Evelyn
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Wijk, Lena
    Orebro Univ, Sweden.
    Kimmig, Rainer
    Univ Hosp Duisburg Essen, Germany.
    Jensen, Pernille Tine
    Aarhus Univ, Denmark.
    Eriksson, Ane Gerda Zahl
    Univ Oslo, Norway.
    Maenpaa, Johanna
    Tampere Univ, Finland.
    Persson, Jan
    Lund Univ Hosptial, Sweden.
    Salehi, Sahar
    Karolinska Inst, Sweden.
    Robot-assisted approach to cervical cancer (RACC): an international multi-center, open-label randomized controlled trial2019In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 29, no 6, p. 1072-1076Article in journal (Refereed)
    Abstract [en]

    Background Radical hysterectomy with pelvic lymphadenectomy represents the standard treatment for early-stage cervical cancer. Results from a recent randomized controlled trial demonstrate that minimally invasive surgery is inferior to laparotomy with regards to disease-free and overall survival. Primary Objective To investigate the oncologic safety of robot-assisted surgery for early-stage cervical cancer as compared with standard laparotomy. Study Hypothesis Robot-assisted laparoscopic radical hysterectomy is non-inferior to laparotomy in regards to recurrence-free survival with the advantage of fewer post-operative complications and superior patient-reported outcomes. Trial Design Prospective, multi-institutional, international, open-label randomized clinical trial. Consecutive women with early-stage cervical cancer will be assessed for eligibility and subsequently randomized 1:1 to either robot-assisted laparoscopic surgery or laparotomy. Institutional review board approval will be required from all participating institutions. The trial is coordinated from Karolinska University Hospital, Sweden. Major Inclusion/Exclusion Criteria Women over 18 with cervical cancer FIGO (2018) stages IB1, IB2, and IIA1 squamous, adenocarcinoma, or adenosquamous will be included. Women are not eligible if they have evidence of metastatic disease, serious co-morbidity, or a secondary invasive neoplasm in the past 5 years. Primary Endpoint Recurrence-free survival at 5 years between women who underwent robot-assisted laparoscopic surgery versus laparotomy for early-stage cervical cancer. Sample Size The clinical non-inferiority margin in this study is defined as a 5-year recurrence-free survival not worsened by amp;gt;7.5%. With an expected recurrence-free survival of 85%, the study needs to observe 127 events with a one-sided level of significance (alpha) of 5% and a power (1-beta) of 80%. With 5 years of recruitment and 3 years of follow-up, the necessary number of events will be reached if the study can recruit a total of 768 patients. Estimated Dates for Completing Accrual and Presenting Results Trial launch is estimated to be May 2019 and the trial is estimated to close in May 2027 with presentation of data shortly thereafter.

  • 8.
    Falconer, Henrik
    et al.
    Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
    Palsdottir, Kolbrun
    Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
    Stalberg, Karin
    Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
    Dahm-Kähler, Pernilla
    Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden.
    Ottander, Ulrika
    Department of Clinical Sciences, Umeå Universitet Medicinska fakulteten, Umea, Sweden.
    Lundin, Evelyn Serreyn
    Obstetrics and Gynecology, Linköpings universitet, Linköping, Sweden; Linköpings Universitet Institutionen for klinisk och experimentell medicin, Linköping, Sweden.
    Wijk, Lena
    Örebro University, School of Medical Sciences. Örebro University Hospital.
    Kimmig, Rainer
    Gynecology and Obstetrics, University Hospital of Duisburg-Essen, Essen, Germany.
    Jensen, Pernille Tine
    Faculty of Health Science, Aarhus University, Aarhus, Denmark.
    Eriksson, Ane Gerda Zahl
    Gynecologic Oncology, Universitetet i Oslo, Oslo, Norway.
    Mäenpää, Johanna
    Faculty of Medicine and Medical Technology, Tampere University, Tampere, Pirkanmaa, Finland.
    Persson, Jan
    Department of Obstetrics and Gynecology, Lund University Hosptial, Lund, Sweden.
    Salehi, Sahar
    Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
    Robot-assisted approach to cervical cancer (RACC): an international multi-center, open-label randomized controlled trial2019In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 29, no 6, p. 1072-1076Article in journal (Refereed)
    Abstract [en]

    Background: Radical hysterectomy with pelvic lymphadenectomy represents the standard treatment for early-stage cervical cancer. Results from a recent randomized controlled trial demonstrate that minimally invasive surgery is inferior to laparotomy with regards to disease-free and overall survival.

    Primary Objective: To investigate the oncologic safety of robot-assisted surgery for early-stage cervical cancer as compared with standard laparotomy.

    Study Hypothesis: Robot-assisted laparoscopic radical hysterectomy is non-inferior to laparotomy in regards to recurrence-free survival with the advantage of fewer post-operative complications and superior patient-reported outcomes.

    Trial Design: Prospective, multi-institutional, international, open-label randomized clinical trial. Consecutive women with early-stage cervical cancer will be assessed for eligibility and subsequently randomized 1:1 to either robot-assisted laparoscopic surgery or laparotomy. Institutional review board approval will be required from all participating institutions. The trial is coordinated from Karolinska University Hospital, Sweden.

    Major Inclusion/Exclusion Criteria: Women over 18 with cervical cancer FIGO (2018) stages IB1, IB2, and IIA1 squamous, adenocarcinoma, or adenosquamous will be included. Women are not eligible if they have evidence of metastatic disease, serious co-morbidity, or a secondary invasive neoplasm in the past 5 years.

    Primary Endpoint: Recurrence-free survival at 5 years between women who underwent robot-assisted laparoscopic surgery versus laparotomy for early-stage cervical cancer.

    Sample Size: The clinical non-inferiority margin in this study is defined as a 5-year recurrence-free survival not worsened by >7.5%. With an expected recurrence-free survival of 85%, the study needs to observe 127 events with a one-sided level of significance (alpha) of 5% and a power (1-beta) of 80%. With 5 years of recruitment and 3 years of follow-up, the necessary number of events will be reached if the study can recruit a total of 768 patients.

    Estimated Dates for Completing Accrual and Presenting Results: Trial launch is estimated to be May 2019 and the trial is estimated to close in May 2027 with presentation of data shortly thereafter.

  • 9.
    Falconer, Henrik
    et al.
    Karolinska Inst, Dept Womens & Childrens Hlth, S-17177 Stockholm, Sweden.
    Palsdottir, Kolbrun
    Karolinska Inst, Dept Womens & Childrens Hlth, S-17177 Stockholm, Sweden.
    Stålberg, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Reproductive Health.
    Dahm-Kähler, Pernilla
    Sahlgrens Acad, Inst Clin Sci, Gothenburg, Sweden.
    Ottander, Ulrika
    Umea Univ, Dept Clin Sci, Med Fak, Umea, Sweden.
    Lundin, Evelyn Serreyn
    Linkopings Univ, Obstet & Gynecol, Linkoping, Sweden;Linkopings Univ, Inst Klin & Expt Med, Linkoping, Sweden.
    Wijk, Lena
    Orebro Univ, Fac Med & Hlth, Orebro, Sweden.
    Kimmig, Rainer
    Univ Hosp Duisburg Essen, Gynecol & Obstet, Essen, Germany.
    Jensen, Pernille Tine
    Aarhus Univ, Fac Hlth Sci, Aarhus, Denmark.
    Eriksson, Ane Gerda Zahl
    Univ Oslo, Gynecol Oncol, Oslo, Norway.
    Mäenpää, Johanna
    Tampere Univ, Fac Med & Med Technol, Tampere, Finland.
    Persson, Jan
    Lund Univ Hosptial, Dept Obstet & Gynecol, Lund, Sweden.
    Salehi, Sahar
    Karolinska Inst, Dept Womens & Childrens Hlth, S-17177 Stockholm, Sweden.
    Robot-assisted approach to cervical cancer (RACC): an international multi-center, open-label randomized controlled trial2019In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 29, no 6, p. 1072-1076Article in journal (Refereed)
    Abstract [en]

    Background: Radical hysterectomy with pelvic lymphadenectomy represents the standard treatment for early-stage cervical cancer. Results from a recent randomized controlled trial demonstrate that minimally invasive surgery is inferior to laparotomy with regards to disease-free and overall survival.

    Primary Objective: To investigate the oncologic safety of robot-assisted surgery for early-stage cervical cancer as compared with standard laparotomy.

    Study Hypothesis: Robot-assisted laparoscopic radical hysterectomy is non-inferior to laparotomy in regards to recurrence-free survival with the advantage of fewer post-operative complications and superior patient-reported outcomes.

    Trial Design: Prospective, multi-institutional, international, open-label randomized clinical trial. Consecutive women with early-stage cervical cancer will be assessed for eligibility and subsequently randomized 1:1 to either robot-assisted laparoscopic surgery or laparotomy. Institutional review board approval will be required from all participating institutions. The trial is coordinated from Karolinska University Hospital, Sweden.

    Major Inclusion/Exclusion Criteria: Women over 18 with cervical cancer FIGO (2018) stages IB1, IB2, and IIA1 squamous, adenocarcinoma, or adenosquamous will be included. Women are not eligible if they have evidence of metastatic disease, serious co-morbidity, or a secondary invasive neoplasm in the past 5 years.

    Primary Endpoint: Recurrence-free survival at 5 years between women who underwent robot-assisted laparoscopic surgery versus laparotomy for early-stage cervical cancer.

    Sample Size: The clinical non-inferiority margin in this study is defined as a 5-year recurrence-free survival not worsened by >7.5%. With an expected recurrence-free survival of 85%, the study needs to observe 127 events with a one-sided level of significance (alpha) of 5% and a power (1-beta) of 80%. With 5 years of recruitment and 3 years of follow-up, the necessary number of events will be reached if the study can recruit a total of 768 patients.

    Estimated Dates for Completing Accrual and Presenting Results: Trial launch is estimated to be May 2019 and the trial is estimated to close in May 2027 with presentation of data shortly thereafter.

  • 10.
    Friedlander, Michael
    et al.
    ANZGOG, Australia-New Zealand.
    Trimble, Edward
    National Cancer Institute, USA.
    Tinker, Anna
    NCIC-CTG, Canada.
    Alberts, David
    SWOG.
    Åvall-Lundqvist, Elisabeth
    NSGO, Scandinavia.
    Brady, Mark
    GOG.
    Harter, Philipp
    AGO OVAR, Germany.
    Pignata, Sandro
    MITO, Italy.
    Pujade-Lauraine, Eric
    GINECO, France.
    Sehouli, Jalid
    AGO OVAR, Germany.
    Vergote, Ignace
    GINECO, France.
    Beale, Philip
    ANZGOG, Australia-New Zealand.
    Bekkers, Rudd
    DGOG, The Netherlands.
    Calvert, Paula
    ICORG, Ireland.
    Copeland, Lawrence
    SWOG.
    Glasspool, Ros
    ICORG, Ireland.
    Gonzalez-Martin, Antonio
    GEICO, Spain.
    Katsaros, Dionysis
    MANGO, Italy.
    Kim, Jae Won
    KGOG, Korea.
    Miller, Brigitte
    RTOG.
    Provencher, Diane
    GINECO, France.
    Rubinstein, Lawrence
    National Cancer Institute, USA.
    Atri, Mostafa
    ACRIN.
    Zeimet, Alain
    AGO-Au, Austria.
    Bacon, Monica
    Gynecologic Cancer InterGroup.
    Kitchener, Henry
    MRC/NCRI, UK.
    Stuart, Gavin C E
    NCIC-CTG, Canada, on behalf of the Gynecologic Cancer InterGroup.
    Clinical trials in recurrent ovarian cancer.2011In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 21, no 4, p. 771-775Article, review/survey (Refereed)
    Abstract [en]

    The 4th Ovarian Cancer Consensus Conference of the Gynecologic Cancer InterGroup was held in Vancouver, Canada, in June 2010. Representatives of 23 cooperative research groups studying gynecologic cancers gathered to establish international consensus on issues critical to the conduct of large randomized trials. Group C, 1 of the 3 discussion groups, examined recurrent ovarian cancer, and we report the consensus reached regarding 4 questions. These included the following: (1) What is the role of cytoreductive surgery for recurrent ovarian cancer? (2) How do we define distinct patient populations in need of specific therapeutic approaches? (3) Should end points for trials with recurrent disease vary from those of first-line trials? (4) Is CA-125 progression alone sufficient for entry/eligibility into clinical trials?

  • 11.
    Glasspool, Rosalind M
    et al.
    Beatson West of Scotland Cancer Centre, Glasgow, UK.
    González Martín, Antonio
    Medical Oncology Department, MD Anderson Cancer Centre, Madrid, Spain.
    Millan, David
    Southern General Hospital, Glasgow, UK.
    Lorusso, Domenica
    Gynecologic Oncology Unit, Fondazione IRCCS National Cancer institute of Milan (MITO), Milan, Italy.
    Åvall-Lundqvist, Elisabeth
    Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
    Hurteau, Jean A
    Division of Gynecologic Oncology, NorthShore University Health System, University of Chicago Pritzker School of Medicine, Evanston, IL, USA.
    Davis, Alison
    The Canberra Hospital, Canberra, Australia.
    Hilpert, Felix
    University Hospital of Schleswig-Holstein Campus, Kiel, Germany.
    Kim, Jae-Weon
    Department of Obstectrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea.
    Alexandre, Jérôme
    edical Oncology, Cochin-Hotel Dieu, Paris Descartes University, Paris, France.
    Ledermann, Jonathan A
    UCL Cancer Institute, London, UK.
    Gynecologic Cancer InterGroup (GCIG) consensus review for squamous cell carcinoma of the ovary.2014In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 24, no 9, p. S26-Article, review/survey (Refereed)
    Abstract [en]

    Squamous cell carcinoma of the ovary is a rare complication of mature cystic teratoma. The epidemiology, pathology, diagnosis, and management of this rare tumor are reviewed. Clinical characteristics, preoperative imaging, and tumor markers may help to predict malignancy preoperatively. Complete cytoreduction should be the aim of surgery. The prognosis for stage 1A disease is good, but for women with advanced or recurrent disease, it is very poor and has not improved in recent years. At present, there are insufficient data to provide clear guidance on the optimal management strategy for advanced disease, and there is a need to gain an understanding of the biology and to develop novel effective therapies. This will require coordinated international collaboration.

  • 12.
    Graflund, M.
    et al.
    Department of Gynecological Oncology, Örebro University Hospital, Örebro, Sweden.
    Sorbe, Bengt
    Department of Gynecological Oncology, Örebro University Hospital, Örebro, Sweden.
    Sigurdardóttir, S.
    Department of Pathology, Örebro University Hospital, Örebro, Sweden.
    Karlsson, Mats G.
    Department of Pathology, Örebro University Hospital, Örebro, Sweden.
    HPV-DNA, vascular space invasion, and their impact on the clinical outcome in early-stage cervical carcinomas2014In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 14, no 5, p. 896-902Article in journal (Refereed)
    Abstract [en]

    The present study was designed to analyze the relationship of human papillomavirus (HPV)-DNA, microvessel density, and their impact on clinical outcome in early cervical carcinoma. HPV-DNA was evaluated in 171 cases of cervical carcinoma treated from 1965 to 1990. In 110 cases, the analyses could be performed. A polymerase chain reaction technique was used on paraffin-embedded specimens obtained before the start of therapy. HPV-DNA of any type was detected in 78% (86/110) of all evaluable tumors. HPV16 was the predominant type and was detected in 56% (62/110), HPV18 in 8% (9/110), and HPV35 in 21% (23/110). Patients with tumors containing HPV16 or HPV18 were significantly (P = 0.011) younger than patients with tumors not containing either of these two subtypes. Vascular space invasion and lymph node metastases were observed more frequently in tumors expressing HPV16 and HPV18 (P = 0.002, P = 0.047) than in tumors negative for these HPV strains. Tumors containing HPV16 and HPV18 were significantly (P = 0.012) larger and more frequently (P = 0.005) associated with higher FIGO stages. The cancer-specific survival rate was lower for patients with HPV16- and HPV18-positive tumors, but the difference was not statistically significant. The microvessel density was a non-significant prognostic factor. The overall 5-year survival rate of the complete series was 91%. It was concluded that HPV-DNA was a prognostic factor in early-stage cervical cancer and was associated with the age of the patient, vascular space invasion, lymph node metastases, tumor size, and FIGO stage.

  • 13.
    Graflund, Marianne
    et al.
    Department of Gynecological Oncology, Örebro University Hospital, Örebro.
    Sorbe, B.
    Department of Gynecological Oncology, Örebro University Hospital, Örebro.
    Bryne, M.
    Department of Pathology, Institute of Cancer Research, Norwegian Radium Hospital, Oslo, Norway.
    Karlsson, M.
    Department of Pathology, Örebro University Hospital, Örebro.
    The prognostic value of a histologic grading system, DNA profile, and MIB-1 expression in early stages of cervical squamous cell carcinomas2002In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 12, no 2, p. 149-157Article in journal (Refereed)
    Abstract [en]

    This study evaluated the prognostic importance of a new grading system focusing on the invasive tumor front, DNA profile, and the proliferation marker MIB-1. A complete geographic series of 172 women treated with radical hysterectomy (Wertheim–Meigs) for FIGO stage I–II cervical carcinomas was the target population. The analyses were performed on 141 (82%) squamous cell carcinomas of the complete series. During the period of observation (mean 222 months), 17 recurrences (12.1%) were encountered. Prognostic factors for disease-free survival were lymph node status (P < 0.000001), radical surgical margins (P = 0.00004), and tumor size (P = 0.002). The complete score of the invasive front grading system (IFG), and the individual scores of two variables—pattern of invasion and host response—were all significantly (P = 0.002, P = 0.007, P = 0.0001) associated with pelvic lymph node metastases. Host response was the single most important factor in the IFG system, and it was superior to the complete score in predicting lymph node metastases. The total IFG score was also a significant (P = 0.003) prognostic factor for disease-free survival. DNA ploidy, S-phase fraction, and MIB-1 expression were nonsignificant factors in predicting pelvic lymph node metastases and disease-free survival of the patient. The IFG in the original or modified versions could predict low- and high-risk groups of tumors and therefore be of value in treatment planning for these patients.

  • 14.
    Graflund, Marianne
    et al.
    Department of Gynecologic Oncology, Medical Center Hospital, Örebro, Sweden.
    Sorbe, B.
    Department of Gynecologic Oncology, Medical Center Hospital, Örebro, Sweden.
    Hussein, A.
    Department of Pathology, Medical Center Hospital, Örebro, Sweden.
    Bryne, M.
    Department of Pathology, Institute of Cancer Research, the Norwegian Radium Hospital, Oslo, Norway.
    Karlsson, M.
    Department of Pathology, Medical Center Hospital, Örebro, Sweden.
    The prognostic value of histopathologic grading parameters and microvessel density in patients with early squamous cell carcinoma of the uterine cervix2002In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 12, no 1, p. 32-41Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to investigate the prognostic importance of clinical and histopathologic factors, including malignancy grading systems (MGS), partial index (PI), invasive front grading (IFG), and microvessel density. A complete geographic series of 172 early stage (FIGO I–II) cervical carcinomas treated by Wertheim-Meigs surgery during the period 1965–1990 was studied. The patients were followed up for at least 10 years. Significant prognostic factors for disease-free survival were lymph node status (P < 0.0000001), radical surgical margins (P = 0.00003), and tumor size (P = 0.008). In a multivariate Cox analysis it was shown that lymph node status was the single most important prognostic factor with regard to disease-free survival. The total MGS and the PI scores were highly significantly (P = 0.0001) associated with pelvic lymph node metastases and disease-free survival rate in squamous cell carcinomas. The MGS and the PI systems were superior to the IFG system in predicting lymph node metastases. The total IFG score was also a statistically highly significant (P = 0.003) prognostic factor with regard to disease-free survival in both univariate and multivariate analyses. Microvessel density was a nonsignificant prognostic factor. There was a highly significant (P = 0.002) association between vascular space invasion of tumor cells and the presence of lymph node metastases. In conclusion, histopathologic malignancy grading systems provide valuable prognostic information in patients with early stage squamous cell carcinomas of the uterine cervix.

  • 15.
    Graflund, Marianne
    et al.
    Department of Gynecological Oncology, Örebro University Hospital, Örebro.
    Sorbe, B.
    Department of Gynecological Oncology, Örebro University Hospital, Örebro.
    Karlsson, M.
    Department of Pathology, Örebro University Hospital, Örebro.
    Immunohistochemical expression of p53, bcl-2, and p21WAF1/CIP1 in early cervical carcinoma: Correlation with clinical outcome2002In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 12, no 3, p. 290-298Article in journal (Refereed)
    Abstract [en]

    The objective of this study was to assess the value of p53, bcl-2, and p21WAF1/CIP1 immunoreactivity as predictors of pelvic lymph node metastases (LNM), recurrences, and death due to the disease in early stage (FIGO I-II) cervical carcinomas. FIGO stage, type of histopathology, and tumor grade were also evaluated in this series of patients treated by radical hysterectomy (Wertheim-Meigs) between 1965 and 1990. A total of 172 patients were included. A tumor was regarded as positive when more than 30% of the neoplastic cells exhibited immunoreactivity. Positive immunostaining was found in 8.9% for p53, in 43.5% for bcl-2, and in 25.0% for p21WAF1/CIP1. None of them was able to predict LNM or clinical outcome. Presence of LNM, tumor recurrence, and death from disease were significantly associated with the FIGO stage (P = 0.014, P = 0.009, and P = 0.001, respectively). The 5-year cancer-specific survival rate was 91.6% and the overall survival rate was 90.5%. It was concluded that immunohistochemically detected p53, bcl-2, and p21WAF1/CIP1 appeared to be of no predictive value with regard to LNM, tumor recurrences, or long-term survival in early cervical carcinomas.

  • 16.
    Graflund, Marianne
    et al.
    Departments of Gynecological Oncology, Örebro University Hospital, Örebro, Sweden.
    Sorbe, Bengt
    Departments of Gynecological Oncology, Örebro University Hospital, Örebro, Sweden.
    Bryne, M.
    Department of Pathology, Institute of Cancer Research, Norwegian Radium Hospital, Oslo, Norway.
    Karlsson, Mats G.
    Department of Pathology, Örebro University Hospital, Örebro, Sweden.
    The prognostic value of a histologic grading system, DNA profile, and MIB-1 expression in early stages of cervical squamous cell carcinomas2002In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 12, no 2, p. 149-157Article in journal (Refereed)
    Abstract [en]

    This study evaluated the prognostic importance of a new grading system focusing on the invasive tumor front, DNA profile, and the proliferation marker MIB-1. A complete geographic series of 172 women treated with radical hysterectomy (Wertheim-Meigs) for FIGO stage I-II cervical carcinomas was the target population. The analyses were performed on 141 (82%) squamous cell carcinomas of the complete series. During the period of observation (mean 222 months), 17 recurrences (12.1%) were encountered. Prognostic factors for disease-free survival were lymph node status (P < 0.000001), radical surgical margins (P = 0.00004), and tumor size (P = 0.002). The complete score of the invasive front grading system (IFG), and the individual scores of two variables-pattern of invasion and host response-were all significantly (P = 0.002, P = 0.007, P = 0.0001) associated with pelvic lymph node metastases. Host response was the single most important factor in the IFG system, and it was superior to the complete score in predicting lymph node metastases. The total IFG score was also a significant (P = 0.003) prognostic factor for disease-free survival. DNA ploidy, S-phase fraction, and MIB-1 expression were nonsignificant factors in predicting pelvic lymph node metastases and disease-free survival of the patient. The IFG in the original or modified versions could predict low- and high-risk groups of tumors and therefore be of value in treatment planning for these patients.

  • 17.
    Graflund, Marianne
    et al.
    Department of Gynecological Oncology, Örebro University Hospital, Örebro, Sweden .
    Sorbe, Bengt
    Department of Gynecological Oncology, Örebro University Hospital, Örebro, Sweden.
    Hussein, A.
    Department of Pathology, Medical Center Hospital, Örebro, Sweden.
    Bryne, M.
    Department of Pathology, Institute of Cancer Research, the Norwegian Radium Hospital, Oslo, Norway.
    Karlsson, Mats G.
    Department of Pathology, Medical Center Hospital, Örebro, Sweden.
    The prognostic value of histopathologic grading parameters and microvessel density in patients with early squamous cell carcinoma of the uterine cervix2002In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 12, no 1, p. 32-41Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to investigate the prognostic importance of clinical and histopathologic factors, including malignancy grading systems (MGS), partial index (PI), invasive front grading (IFG), and microvessel density. A complete geographic series of 172 early stage (FIGO I-II) cervical carcinomas treated by Wertheim-Meigs surgery during the period 1965-1990 was studied. The patients were followed up for at least 10 years. Significant prognostic factors for disease-free survival were lymph node status (P < 0.0000001), radical surgical margins (P = 0.00003), and tumor size (P = 0.008). In a multivariate Cox analysis it was shown that lymph node status was the single most important prognostic factor with regard to disease-free survival. The total MGS and the PI scores were highly significantly (P = 0.0001) associated with pelvic lymph node metastases and disease-free survival rate in squamous cell carcinomas. The MGS and the PI systems were superior to the IFG system in predicting lymph node metastases. The total IFG score was also a statistically highly significant (P = 0.003) prognostic factor with regard to disease-free survival in both univariate and multivariate analyses. Microvessel density was a nonsignificant prognostic factor. There was a highly significant (P = 0.002) association between vascular space invasion of tumor cells and the presence of lymph node metastases. In conclusion, histopathologic malignancy grading systems provide valuable prognostic information in patients with early stage squamous cell carcinomas of the uterine cervix.

  • 18.
    Graflund, Marianne
    et al.
    Department of Gynecological Oncology, Örebro University Hospital, Örebro, Sweden.
    Sorbe, Bengt
    Department of Gynecological Oncology, Örebro University Hospital, Örebro, Sweden.
    Karlsson, Mats G
    Department of Pathology, Örebro University Hospital, Örebro, Sweden.
    Immunohistochemical expression of p53, bcl-2, and p21(WAF1/CIP1) in early cervical carcinoma: correlation with clinical outcome2002In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 12, no 3, p. 290-298Article in journal (Refereed)
    Abstract [en]

    The objective of this study was to assess the value of p53, bcl-2, and p21(WAF1/CIP1) immunoreactivity as predictors of pelvic lymph node metastases (LNM), recurrences, and death due to the disease in early stage (FIGO I-II) cervical carcinomas. FIGO stage, type of histopathology, and tumor grade were also evaluated in this series of patients treated by radical hysterectomy (Wertheim-Meigs) between 1965 and 1990. A total of 172 patients were included. A tumor was regarded as positive when more than 30% of the neoplastic cells exhibited immunoreactivity. Positive immunostaining was found in 8.9% for p53, in 43.5% for bcl-2, and in 25.0% for p21(WAF1/CIP1). None of them was able to predict LNM or clinical outcome. Presence of LNM, tumor recurrence, and death from disease were significantly associated with the FIGO stage (P = 0.014, P = 0.009, and P = 0.001, respectively). The 5-year cancer-specific survival rate was 91.6% and the overall survival rate was 90.5%. It was concluded that immunohistochemically detected p53, bcl-2, and p21(WAF1/CIP1) appeared to be of no predictive value with regard to LNM, tumor recurrences, or long-term survival in early cervical carcinomas.

  • 19. Hellberg, D.
    et al.
    Sundström Poromaa, Inger
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Stålberg, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Billström, Emma
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Asplund, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Molecular and Morphological Pathology.
    Socioeconomic Characteristics, Housing Conditions and Criminal Behavior in Women with Cervical Intraepithelial Neoplasia (Cin) Between 1960 and 20062013In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 23, no 8Article in journal (Other academic)
  • 20.
    Hjerpe, Elisabet
    et al.
    Department of Oncology and Pathology, Cancer Center Karolinska CCK R8:03, Karolinska Institutet, Stockholm, Sweden.
    Brage, Suzanne Egyhazi
    Department of Oncologyand Pathology, Cancer Center Karolinska CCK R8:03, Karolinska Institutet, Stockholm, Sweden.
    Frostvik Stolt, Marianne
    Department of Oncologyand Pathology, Cancer Center Karolinska CCK R8:03, Karolinska Institutet, Stockholm, Sweden.
    Johansson, Hemming
    Department of Oncology and Pathology, Cancer Center Karolinska CCK R8:03, Karolinska Institutet, Stockholm, Sweden.
    Shoshan, Maria
    DepartmentDepartment of Oncologyand Pathology, Cancer Center Karolinska CCK R8:03, Karolinska Institutet, Stockholm, Sweden.
    Åvall-Lundqvist, Elisabeth
    Department of Oncology and Pathology, Cancer Center Karolinska CCK R8:03, Karolinska Institutet, Stockholm, Sweden.
    Metabolic markers and HSP60 in chemonaive serous solid ovarian cancer versus ascites.2014In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 24, no 8, p. 1389-1394Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Metabolic pathway alterations in cancer are thought to be dependent upon tumor type-specific oncogenic activation and local nutrient and oxygen supply during disease progression. In serous ovarian cancer, the typical peritoneal spread of disease is caused by shedding of tumor cells into the abdominal cavity, often along with ascites formation. Not much is known about the metabolic features of these detached serous tumor cells. In this study, we investigate the messenger RNA (mRNA) expression of GAPDH (glycolytic glyceraldehyde 3-phosphate dehydrogenase) and PKM2 (pyruvate kinase isoform M2), ATP5B (mitochondrial β-F1-ATPase), and heat shock protein 60 in matched serous solid tumor and corresponding ascites.

    MATERIALS/METHODS: Fresh samples from solid tumor and corresponding ascites were prospectively collected from 40 patients undergoing primary surgery for suspected advanced ovarian cancer. Of these, 25 met the study eligibility criteria, that is, stage IIC to IV disease of the serous (24) or endometrioid (1) subtype with solid and ascites specimens containing 50% or more tumor cells and with good quality and quantity mRNA yield. All but 2 patients (92%) had type II disease. GAPDH, PKM2, ATP5B, and HSP60 mRNA expressions were assessed by real-time polymerase chain reaction. For each marker, the mRNA expression in solid tumor was pairwise compared with the corresponding expression in ascites using the Wilcoxon matched pairs signed rank sum test.

    RESULTS: In contrast to our hypothesis, the mRNA expression of analyzed metabolic markers and HSP60 did not significantly differ between matched solid tumor and malignant ascites.

    CONCLUSIONS: Our results indicate that further expression changes in genes related to glycolysis or oxidative phosphorylation are not a prerequisite for serous cancer cell survival after detachment.

  • 21.
    Hjerpe, Elisabet
    et al.
    Department of Oncology, Karolinska University Hospital, Stockholm, Sweden.
    Egyhazi, Suzanne
    Department of Oncology and Pathology, Cancer Center Karolinska CCK R8:03, Karolinska Institutet, Stockholm, Sweden.
    Carlson, Joseph
    athology, Karolinska University Hospital, Stockholm, Sweden.
    Stolt, Marianne Frostvik
    Department of Oncology and Pathology, Cancer Center Karolinska CCK R8:03, Karolinska Institutet, Stockholm, Sweden.
    Schedvins, Kjell
    Obstetrics and Gynecology, Karolinska University Hospital, Stockholm, Sweden.
    Johansson, Hemming
    Department of Oncology, Karolinska University Hospital, Stockholm, Sweden.
    Shoshan, Maria
    Department of Oncology and Pathology, Cancer Center Karolinska CCK R8:03, Karolinska Institutet, Stockholm, Sweden.
    Åvall-Lundqvist, Elisabeth
    Department of Oncology, Karolinska University Hospital, Stockholm, Sweden.
    HSP60 predicts survival in advanced serous ovarian cancer.2013In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 23, no 3, p. 448-455Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Heat shock protein 60 (HSP60) plays an essential role in malignant cell survival. We evaluated the prognostic and treatment predictive value of HSP60 in advanced ovarian cancer.

    METHODS: Fresh tumor samples were prospectively collected from 123 patients undergoing primary surgery for suspected advanced ovarian cancer. Of these, 57 fulfilled the eligibility criteria, that is, International Federation of Gynecology and Obstetrics stage IIC-IV, serous/endometrioid tumors, platinum-based chemotherapy, and specimens with 50% tumor cells or greater. Heat shock protein 60 mRNA and protein expression was determined by real-time polymerase chain reaction and immunohistochemistry. We estimated the association between HSP60 and overall survival (OS) and platinum-free interval (PFI) by Cox proportional hazards models and its relationship with treatment response by Fisher's exact test. Median follow-up was 60 months.

    RESULTS: High HSP60 mRNA expression was associated with shorter OS (hazard ratio [HR], 3.4; 95% confidence interval [CI], 1.3-8.5) and PFI (HR, 3.3; 95% CI, 1.5-7.2). Likewise, high HSP60 protein expression was associated with shorter OS (HR, 3.2; 95% CI, 1.5-7.1) and PFI (HR, 2.6; 95% CI, 1.3-5.3). Median survival for patients with high HSP60 protein expression was 31 months compared with 55 months for low expression cases (P = 0.016). The impact on OS and PFI was even stronger in the subgroup of grade 3 serous tumors. All patients with low HSP60 levels responded to first-line chemotherapy.

    CONCLUSION: Heat shock protein 60 may identify groups of advanced serous ovarian cancer with different prognosis and treatment response.

  • 22. Hogberg, T.
    et al.
    Bangshoj, R.
    Bjurberg, M.
    Boman, K.
    Bulow, E.
    Dahm-Kahler, P.
    Holtenman, M.
    Rosenberg, P.
    Tholander, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Radiology, Oncology and Radiation Science, Oncology.
    Avall-Lundqvist, E.
    The Swedish Quality Registry for Gynecologic Oncology2013In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 23, no 8Article in journal (Other academic)
  • 23. Huvila, J.
    et al.
    Laajala, D.
    Edvist, P. H.
    Talve, L.
    Grenman, S.
    Ponten, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Molecular and Morphological Pathology.
    Aittokallio, T.
    Carpen, O.
    Auranen, A.
    Identifying Prognostically Relevant Subsets of Endometrial Cancer Using Unsupervised Clustering of Immunohistochemical Staining Data2013In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 23, no 8Article in journal (Other academic)
  • 24.
    Högberg, Thomas
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Oncology UHL.
    Fredstorp-Lidebring, M
    Alm, P
    Baldetorp, B
    Larsson, G
    Ottosen, C
    Svanberg, L
    Lindahl, B
    A prospective population-based management program including primary surgery and postoperative risk assessment by means of DNA ploidy and histopathology. Adjuvant radiotherapy is not necessary for the majority of patients with FIGO stage I-II endometrial cancer2004In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 14, no 3, p. 437-450Article in journal (Refereed)
    Abstract [en]

    A management program for FIGO stage I-II nonserous, nonclear-cell adenocarcinomas was evaluated. Histopathology and DNA ploidy were used to estimate postoperatively the risk of progression or death of disease and to tailor treatment. The patient material was a population-based consecutive cohort of all women with endometrial cancer in the Southern Swedish Health Care Region diagnosed between June 1993 and June 1996 (n=553). Of these, 335 were eligible for the management program. Patients estimated to be at low risk were treated by surgery only, while high-risk patients also received vaginal brachytherapy. A large low-risk group consisting of 84% (n=283) of the patients with an estimated disease-specific 5-year survival of 96% (95% CI=93-98%) was identified. The high-risk group (n=52, 16%) showed a worse outcome with an 80% 5-year disease-specific survival (95% CI=65-89%). The difference in survival between the groups was highly significant (P<0.0001). Half of the progressions were distant in the high-risk group. Although there is a clear indication for adjuvant therapy for this group, locoregional radiotherapy could be expected to fail in cases with distant progression. Thus, effective systemic treatments need to be developed. Low-risk patients, constituting the majority (84%) of the patients, can be safely treated by surgery only.

  • 25.
    Joly, Florence
    et al.
    Medical Oncology Department, Clinical Research Department, Centre Francois Baclesse, CHU Cote de Nacre, Inserm "cancer&preventions", University of Basse Normandie, Caen, France.
    McAlpine, Jessica
    Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University of British Columbia, Vancouver, British Columbia, Canada.
    Nout, Remi
    Department of Clinical Oncology, University Medical Center, Leiden, the Netherlands.
    Åvall-Lundqvist, Elisabeth
    Department of Gynaecologic Oncology, Karolinska University Hospital, Stockholm, Sweden.
    Shash, Emad
    ORTC, Brussells, Belgium.
    Friedlander, Michael
    Department of Medical Oncology, The Prince of Wales Hospital, University of New South Wales Clinical School, Sydney, Australia.
    Quality of life and patient-reported outcomes in endometrial cancer clinical trials: a call for action!2014In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 24, no 9, p. 1693-1699Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: There is increasing recognition that quality of life (QoL) and patient-reported outcomes (PROs) are of fundamental importance and particularly relevant given the relatively high likelihood of long-term survival in most women with endometrial cancer (EC). However, there has been relatively little research focused on this topic. Our objective was to analyze our current knowledge and identify research questions to be included in the design of next clinical trials.

    METHODS: Analyze and critically assess reported clinical trials in EC that have included QoL and PROs as primary or secondary end points.

    RESULTS: Surgery has a significant impact on physical and functional domains of QoL particularly in the first 6 months after diagnosis. Minimally invasive surgery is associated with less acute morbidity than open procedures and this persists over time. Lymphadenectomy is associated with increased incidence of lymphedema, important late effect. Adjuvant external irradiation may cause gastrointestinal and genitourinary symptoms that impact on physical functioning and which can persist over time. In contrast, vaginal brachytherapy has less toxicity and fewer late effects than external irradiation. The impact of treatment on sexuality has been poorly evaluated in EC survivors. There are few published data on QoL and PROs in patients treated with chemotherapy and the long-term impact has not been addressed. There is no evidence that palliative chemotherapy reduces symptoms and improves QoL. There are very few longitudinal studies on survivorship that is an important concern in EC survivors.

    CONCLUSIONS: Although there have been some studies addressing QoL and PROs in EC, we have identified deficiencies and gaps in our knowledge. Careful consideration of QoL and PROs end points and how to include them in clinical trials will result in a better appreciation of how treatments can impact on patients QoL and lead to conduct interventions to reduce late effects.

  • 26.
    Jonsdottir, Björg
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Reproductive Health.
    Ripoll, Montserrat Alemany
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Bergman, Antonina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Silins, Ilvars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Sundström Poromaa, Inger
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Reproductive Health.
    Ahlström, Håkan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Stålberg, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Reproductive Health.
    Comparison Of Pet-Mri And Mri Alone Predicting Carcinomatosis In Ovarian Cancer Using Peritoneal Cancer Index (Pci)2017In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 27, no Supplement: 4, p. 300-301Article in journal (Other academic)
  • 27. Koul, A
    et al.
    Bendahl, P-O
    Borg, Å
    Fernö, M
    Fredstorp Lidebring, M
    Högberg, Thomas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Oncology UHL.
    Långström Einarsson, M
    Ridderheim, M
    Willén, R
    TP53 protein expression analysis by luminometric immunoassay in comparison with gene mutation status and prognostic factors in early stage endometrial cancer2002In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 12, no 4, p. 362-371Article in journal (Refereed)
    Abstract [en]

    Mutations in the TP53 tumor suppressor gene have been shown to significantly correlate with poor prognosis in endometrial cancer. In the present study we have evaluated a luminometric immunoassay (LIA) for quantitative estimation of TP53 protein expression in 65 cytosol preparations from endometrial cancer, previously analyzed for mutations in TP53 exons 4-10. LIA showed high (= 0.6 ng/mg protein) expression of TP53 protein in all eight tumors with missense mutation, but high protein levels were also detected in 15 tumors with normal TP53 sequence. All four tumors with nonsense or frameshift mutations had low or no TP53 protein expression. LIA was further evaluated in a retrospective study of 201 cytosol samples from endometrial cancer. TP53 overexpression (>= 0.6 ng/mg protein) was observed in 22% of the tumors and correlated with nonendometrioid histology types (P = 0.005), poorly differentiated tumors (P = 0.001), higher FIGO grade (P = 0.001), DNA nondiploidy (P = 0.002), and high S-phase fraction (P = 0.03). After a median follow-up time of 6.8 years (range 0.7-9.9 years), 22 (13%) progressions were observed in the 175 patients with early stage (I-II) disease. TP53 overexpression (P = 0.04), FIGO grade 3 vs. 1 + 2 (P = 0.01), higher age (P = 0.02), and DNA nondiploidy (P < 0.001) showed significant correlation to shorter progression-free survival in these patients. We conclude that TP53 protein analysis by LIA provides an incomplete correlation to mutation status and cannot substitute for mutation analysis in assessment of prognosis in endometrial carcinoma. In comparison to TP53 overexpression and higher FIGO grades, DNA nonploidy status seems to be a better prognostic indicator to define a subset of early stage endometrial cancer patients who may benefit by adjuvant chemotherapy/radiotherapy.

  • 28.
    Kristensen, G B
    et al.
    Department of Gynecologic Oncology, The Norwegian Radium Hospital, Oslo, Norway.
    Vergote, I
    Department of Gynecologic Oncology, U.Z. Gasthuisberg, Leuven, Belgium .
    Stuart, G
    Department of Gynecologic Oncology, Tom Baker Cancer Center, Calgary, Canada .
    Del Campo, J M
    Department of Medical Oncology, Hospital General Vall d'Hebron, Barcelona, Spain .
    Kaern, J
    Department of Gynecologic Oncology, The Norwegian Radium Hospital, Oslo, Norway .
    Lopez, A B
    Department of Gynaecological Oncology, Gateshead Hospital, Gateshead, United Kingdom .
    Eisenhauer, E
    NCI Canada Clinical Trials Group, Kingston, Canada .
    Åvall-Lundquist, Elisabeth
    Department of Gynecologic Oncology, Karolinska Hospital, Stockholm, Sweden .
    Ridderheim, M
    Department of Gynecologic Oncology, Lund University Hospital, Lund, Sweden .
    Havsteen, H
    Department of Oncology, Aarhus University Hospital, Aarhus, Denmark .
    Mirza, M R
    Department of Oncology, Odense University Hospital, Odense, Denmark .
    Scheistroen, M
    Department of Gynecologic Oncology, The Norwegian Radium Hospital, Oslo, Norway .
    Vrdoljak, E
    Department of Oncology, University Hospital, Split, Croatia .
    First-line treatment of ovarian cancer FIGO stages IIb-IV with paclitaxel/epirubicin/carboplatin versus paclitaxel/carboplatin.2003In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 13, no s2, p. 172-177Article in journal (Refereed)
    Abstract [en]

    The objective of this study was to compare the safety and efficacy of carboplatin plus epirubicin and paclitaxel (TEC) to carboplatin and paclitaxel (TC), in the treatment of epithelial ovarian, peritoneal, or tubal carcinoma. Between March 1999 and August 2001, 887 patients were randomized to receive six to nine cycles of paclitaxel (175 mg/m2, 3 h intravenously) followed by carboplatin (AUC 5, Calvert formula) with or without epirubicin (75 mg/m2 intravenously prior to paclitaxel), on a 3-weekly schedule. The primary endpoint was progression-free survival. Demographic information: Residual disease <1 cm was reported on 41% of patients. At the end of treatment, 65% in the TEC and 55% in the TC arm had achieved a clinical complete response, and 18 and 25% a clinical partial response resulting in an overall response rate of 83% in the TEC and 80% in the TC arm, whereas 7 and 9% had progressive disease, respectively. The three-drug combination produced a markedly higher myelotoxicity, resulting in a higher frequency of febrile neutropenia (12.5% of the TEC and 1.5% of the TC patients) and a higher number of dose reductions and treatment delays. Cycle prolongation above seven days was seen in 7 and 5% of cycles in the TEC and TC arm, respectively. Stomatitis > or = grade 3 was also higher with TEC (4% TEC and 0.5% TC). Reductions in left ventricular ejection fraction of more than 15% after six courses were slightly more common with the TEC regimen (3% versus 1.5%), but the difference was not statistically significant (P = 0.2). In conclusion, treatment with the TEC combination produced a higher rate of complete responses than treatment with the TC combination. Toxicity was manageable. Long-term survival data are awaited.

  • 29. Larsson, Gabriella Lillsunde
    et al.
    Helenius, Gisela
    Andersson, Soren
    Elgh, Fredrik
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Virology.
    Sorbe, Bengt
    Karlsson, Mats G.
    Human Papillomavirus (HPV) and HPV 16-Variant Distribution in Vulvar Squamous Cell Carcinoma in Sweden2012In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 22, no 8, p. 1413-1419Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate the human papillomavirus (HPV) and HPV type 16-variant distribution in a series of vulvar squamous cell carcinomas (VSCC) and to evaluate the impact of HPV and HPV 16-variant on prognosis.

    Methods: A series of 133 patients who had a diagnosis of VSCC (1983-2008) was selected for the study. Detection of 11 high-risk HPV types (16, 18, 31, 33, 39, 45, 51, 52, 56, 58, and 59) and 2 low-risk HPV types (6 and 11) was performed with real-time polymerase chain reaction. Samples positive for HPV 16 were further analyzed for variant determination of 7 positions in the E6 gene with polymerase chain reaction and pyrosequencing.

    Results: Forty (30.8%) of 130 tumors were found to be HPV positive. Human papillomavirus type 16 was found in 31 cases, HPV 18 was found in 2 cases, HPV 33 was found in 5 cases, and HPV 56 and HPV 59 were found in one case each. All but one tumor harboring HPV 16 were of European linage, and the 3 most common variants were E-p (n = 13), E-G350 (n = 7), and E-G131 (n = 5). HPV positivity was associated with the basaloid tumor type and occurred in significantly younger patients. Overall and recurrence-free survival rates were better in HPV-positive cases, but after correction for age and tumor size, HPV status was no longer an independent and significant prognostic factor. The survival rates of the various HPV 16 variants were not significantly different, but there was a trend of worse outcome for the E-G131-variant group.

    Conclusions: Human papillomavirus positivity of 30.8% is similar to other reports on VSCC. To our knowledge, this first variant determination of HPV 16 in vulvar carcinoma in a Swedish cohort indicated that the variant E-G131 may have an increased oncogenic potential in patients with VSCC.

  • 30.
    Leitao, Mario M
    et al.
    Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
    Cheng, Xi
    Fudan University Shanghai Cancer Center, Shanghai, China.
    Hamilton, Anne L
    Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden / Royal Women's Hospital, Melbourne, Australia / University of Melbourne, Melbourne, Australia.
    Siddiqui, Nadeem A
    Glasgow Royal Infirmary, Gynaecology Administration Block, Glasgow, Scotland.
    Jurgenliemk-Schulz, Ina
    Department of Radiation Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands.
    Mahner, Sven
    Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
    Åvall-Lundqvist, Elisabeth
    Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden.
    Kim, Kidong
    Department of Obstetrics & Gynecology, Seoul National University Bundang Hospital, Seoul, Korea.
    Freyer, Gilles
    Service d'Oncologie Medicale, Centre Hospitalier Lyon-Sud, Lyon, France.
    Gynecologic Cancer InterGroup (GCIG) consensus review for vulvovaginal melanomas.2014In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 24, no 9, p. S117-S122Article, review/survey (Refereed)
    Abstract [en]

    Vulvovaginal melanomas are rare tumors that account for a small fraction of all vulvovaginal cancers. Biologically, they seem to be similar to mucosal and acral melanomas of other sites. There are limited data specific to vulvovaginal melanomas, especially regarding systemic therapies. Most treatment decisions are based on extrapolation from data regarding cutaneous melanomas of other sites. It is reasonable to follow already established guidelines from other professional groups and societies. Outcomes tend to be worse compared with cutaneous melanomas likely because of the later presentation and physical biological characteristics of these tumors.

  • 31.
    Li, Li
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Da, Jiping
    Landström, Marené
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Ludwig Institute for Cancer Research.
    Ulmsten, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Fu, Xin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Antiproliferative activity and toxicity of 2-Methoxyestradiol in cervical cancer xenograft mice2005In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 15, no 2, p. 301-307Article in journal (Refereed)
    Abstract [en]

    2-methoxyestradiol (2-ME) is considered to be an effective anticancer compound for many types of tumors. We have previously demonstrated that 2-ME inhibits the growth of human cervical cancer HeLaS3 cells in vitro. In this study, we investigated the antitumoral effects of 2-ME on human cervical carcinoma in severe combined immune deficient (SCID) mice. The potential side effects of 2-ME on the SCID mice were also investigated. SCID mice were injected with HeLaS3 cells (3 x 10(6) to 4 x 10(6)/mouse) and a 15-day administration of 2-ME followed after a 1-week cell implantation. Tumor weight, volume, body weight, and blood chemistry were determined. Tumor tissues were examined with an antibody against the proliferative cell nuclear antigen and terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) staining. Liver, spleen, kidney, heart, and lung were screened by pathologic examinations. 2-ME (75 mg/kg p.o.) inhibited growth of human cervical carcinoma by 34% (P < 0.05) as compared with control. Necrosis was found in both 2-ME-treated and untreated tumor tissues, but the necrotic area was larger in 2-ME-treated mice. A low expression of proliferative cell nuclear antigen and an increased number of apoptotic cells were found in 2-ME-treated tumor sections as compared to those in controls. No significant difference was detected in blood chemistry. In addition, the liver showed hyperplastic Kupffer cells, hydropic swelling of hepatocytes, and liquefactive necrosis. The spleen showed an increased number of megakaryocytes and apoptotic cells after 2-ME treatment. Thus, 2-ME has an antitumor effect on human cervical carcinoma, and it is toxic to liver and spleen in this mouse model.

  • 32.
    Lillsunde-Larsson, Gabriella
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital, Örebro, Sweden.
    Helenius, Gisela
    Örebro University, School of Medicine, Örebro University, Sweden. Örebro University Hospital, Örebro, Sweden.
    Andersson, Sören
    Örebro University Hospital, Örebro, Sweden.
    Elgh, Fredrik
    Umeå University Hospital, Umeå, Sweden.
    Sorbe, Bengt
    Örebro University, School of Health and Medical Sciences. Örebro University Hospital, Örebro, Sweden.
    Karlsson, Mats G.
    Örebro University Hospital, Örebro, Sweden.
    Human Papillomavirus (HPV) and HPV 16-Variant Distribution in Vulvar Squamous Cell Carcinoma in Sweden2012In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 22, no 8, p. 1413-1419Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate the human papillomavirus (HPV) and HPV type 16-variant distribution in a series of vulvar squamous cell carcinomas (VSCC) and to evaluate the impact of HPV and HPV 16-variant on prognosis.

    Methods: A series of 133 patients who had a diagnosis of VSCC (1983-2008) was selected for the study. Detection of 11 high-risk HPV types (16, 18, 31, 33, 39, 45, 51, 52, 56, 58, and 59) and 2 low-risk HPV types (6 and 11) was performed with real-time polymerase chain reaction. Samples positive for HPV 16 were further analyzed for variant determination of 7 positions in the E6 gene with polymerase chain reaction and pyrosequencing.

    Results: Forty (30.8%) of 130 tumors were found to be HPV positive. Human papillomavirus type 16 was found in 31 cases, HPV 18 was found in 2 cases, HPV 33 was found in 5 cases, and HPV 56 and HPV 59 were found in one case each. All but one tumor harboring HPV 16 were of European linage, and the 3 most common variants were E-p (n = 13), E-G350 (n = 7), and E-G131 (n = 5). HPV positivity was associated with the basaloid tumor type and occurred in significantly younger patients. Overall and recurrence-free survival rates were better in HPV-positive cases, but after correction for age and tumor size, HPV status was no longer an independent and significant prognostic factor. The survival rates of the various HPV 16 variants were not significantly different, but there was a trend of worse outcome for the E-G131-variant group.

    Conclusions: Human papillomavirus positivity of 30.8% is similar to other reports on VSCC. To our knowledge, this first variant determination of HPV 16 in vulvar carcinoma in a Swedish cohort indicated that the variant E-G131 may have an increased oncogenic potential in patients with VSCC.

  • 33. Lindemann, Kristina
    et al.
    Zalewski, Kamil
    Halaska, Michael J.
    Lindquist, David
    Umeå University.
    Life - Literature for ENYGO2016In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 26, p. 2-73Article in journal (Refereed)
    Abstract [en]

    Reviews covering publications from February 15, 2016 – September 15, 2016

  • 34.
    Lindquist, David
    Umeå University.
    Medical (chemo and radiotherapy) treatment of primary uterine cancer2016In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 26, p. 28-28Article in journal (Refereed)
  • 35.
    Lindquist, David
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Ranhem, C.
    Stefansson, Kristina
    Hellman, K.
    Andersson, S.
    PREVALENCE OF HPV-POSITIVE VAGINAL AND VULVAR CANCER OVER TIME IN TWO SWEDISH COHORTS2014In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 24, no 9 suppl 4, p. 892-892Article in journal (Other academic)
  • 36.
    Lindquist, David
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Öfverman, Charlotte
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Stefansson, Kristina
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Aglund, Kristina
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Survival-data for endometrial cancer patients in northern Sweden 2010-20112015In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 25, no 9, p. 1100-1100Article in journal (Other academic)
  • 37. Lindström, A K
    et al.
    Ekman, K
    Stendahl, U
    Tot, T
    Henriksson, R
    Hedman, H
    Hellberg, D
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    LRIG1 and squamous epithelial uterine cervical cancer: correlation to prognosis, other tumor markers, sex steroid hormones, and smoking2008In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 18, no 2, p. 312-317Article in journal (Refereed)
    Abstract [en]

    The aim is to evaluate LRIG1 as a prognosis predictor and correlations to cofactors in squamous cell cervical cancer. LRIG1 expression was studied in 128 cervical carcinomas and was compared with expression of nine other tumor markers. Smoking history was registered and pretreatment serum estradiol and progesterone levels were evaluated in 79 women. At clinical stage IB, 58% of the tumors showed LRIG1 expression, but there was a decline by increasing stage (33% in stage IV). Ninety percent of women with stage IB cancer and LRIG1 positivity survived, as compared to 64% without expression (P = 0.02). LRIG1 expression did not predict prognosis in advanced stages, but in stage IIA there was a marked relative difference, with 75% survival in tumors expressing LRIG1, as compared to 43% in those without. No correlation was found between LRIG1 and the other nine tumor markers studied. A high serum progesterone and smoking correlated to absent LRIG1 expression. We conclude that LRIG1 appears to be a significant prognosis predictor in early-stage cervical cancer, independent of the other tumor markers that were studied. Diminished expression in advanced stages and the inverse correlation to serum progesterone and smoking indicates that LRIG1 is a tumor suppressor in cervix.

  • 38.
    Lindström, Annika
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Ekman, K
    Stendahl, Ulf
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Tot, Tibor
    Henriksson, Roger
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Hedman, Håkan
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Hellberg, Dan
    LRIG1 and squamous epithelial uterine cervical cancer: correlation to prognosis, other tumor markers, sex steroid hormones, and smoking2008In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 18, no 2, p. 312-317Article in journal (Refereed)
    Abstract [en]

    The aim is to evaluate LRIG1 as a prognosis predictor and correlations to cofactors in squamous cell cervical cancer. LRIG1 expression was studied in 128 cervical carcinomas and was compared with expression of nine other tumor markers. Smoking history was registered and pretreatment serum estradiol and progesterone levels were evaluated in 79 women. At clinical stage IB, 58% of the tumors showed LRIG1 expression, but there was a decline by increasing stage (33% in stage IV). Ninety percent of women with stage IB cancer and LRIG1 positivity survived, as compared to 64% without expression (P = 0.02). LRIG1 expression did not predict prognosis in advanced stages, but in stage IIA there was a marked relative difference, with 75% survival in tumors expressing LRIG1, as compared to 43% in those without. No correlation was found between LRIG1 and the other nine tumor markers studied. A high serum progesterone and smoking correlated to absent LRIG1 expression. We conclude that LRIG1 appears to be a significant prognosis predictor in early-stage cervical cancer, independent of the other tumor markers that were studied. Diminished expression in advanced stages and the inverse correlation to serum progesterone and smoking indicates that LRIG1 is a tumor suppressor in cervix.

  • 39.
    Lomnytska, M.
    et al.
    Karolinska Inst, Womens & Childrens Hlth, Karolinska Univ Hosp, Obstet & Gynaecol, Stockholm, Sweden..
    Stalberg, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology. Akademiska Hosp, Uppsala, Sweden..
    Birgisson, Helgi
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Colorectal Surgery. Akademiska Hosp, Uppsala, Sweden..
    Silins, Ilvars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences. Akademiska, Uppsala, Sweden..
    Graf, Wilhelm
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Colorectal Surgery. Akademiska Hosp, Uppsala, Sweden..
    Complications Related To Surgery For Ovarian Cancer With Intestinal Involvement2015In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 25, no 9, p. 492-492Article in journal (Other academic)
  • 40.
    Lundin, Evelyn
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Borendal Wodlin, Ninnie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Nilsson, Lena
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Linköping (ANOPIVA).
    Kjölhede, Preben
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    A prospective randomized assessment of quality of life between open and robotic hysterectomy in early endometrial cancer2019In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 29, no 4, p. 721-727Article in journal (Refereed)
    Abstract [en]

    Objective There are limited prospective data on the evaluation of quality of life in patients undergoing robotic hysterectomy for endometrial cancer. Our objective was to determine whether post-operative recovery differs between robotic and abdominal hysterectomy.

    Methods At a Swedish tertiary referral university hospital, 50 women with low-risk endometrial cancer scheduled for surgery between February 2012 and May 2016 were included in a randomized trial. Surgery was performed according to principles for minimal invasive surgery. Anesthesia and peri-operative care followed a standardized enhanced recovery after surgery program in both groups. The EuroQol Group form EQ-5D and the Short Form-36 were used to evaluate patients' health-related quality of life. The Swedish Postoperative Symptoms Questionnaire assessed symptoms pre-operatively, daily for 7 days from the day of surgery, and then weekly until 6 weeks post-operatively. Data were analyzed by means of non-parametric tests and repeated measures ANOVA. To evaluate the time-dependent occurrence of complications, Kaplan-Meier survival and Cox proportional-hazard models were used.

    Results A total of 50 women were enrolled in the study (25 robotic and 25 abdominal hysterectomy). Median age (68 years vs 67 years), estimated blood loss (50 mL vs 50 mL), length of hospital stay de facto (53 hours vs 51 hours), and time to meet discharge criteria (36 hours vs 36 hours) in the robotic and abdominal groups, respectively, did not differ significantly (p>0.05) Women in the robotic hysterectomy group recovered significantly faster (p=0.01) in the EQ-5D health index, and reached their pre-operative level after approximately 3 weeks, nearly 2 weeks earlier than the abdominal group. Differences regarding improvement in health-related quality of life (Short Form-36) were statistically significant in general health and social functioning only, and were in favor of robotic hysterectomy. Consumption of analgesics, pain intensity, and symptom sum score post-operatively were equal. Occurrence of complications was an independent risk factor and influenced significantly the EQ-5D health index, length of hospital stay, pain intensity, opioid consumption, and symptom sum score adversely.

    Conclusion Robotic hysterectomy in the setting of an enhanced recovery after surgery program led to faster recovery in health-related quality of life compared with abdominal hysterectomy.

  • 41.
    McAlpine, Jessica N
    et al.
    Department of Gynecology and Obstetrics, University of British Columbia, Vancouver, British Columbia, Canada.
    Greimel, Elfriede
    Department of Medical Psychology and Psychotherapy, Medical University of Graz, Graz, Austria.
    Brotto, Lori A
    Department of Gynecology and Obstetrics, University of British Columbia, Vancouver, British Columbia, Canada.
    Nout, Remy A
    Department of Clinical Oncology, Leiden UniversityMedical Center, Leiden, the Netherlands.
    Shash, Emad
    EORTC, Brussels, Belgium.
    Åvall-Lundqvist, Elisabeth
    Department of Gynecologic Oncology, Karolinska University Hospital, Stockholm, Sweden.
    Friedlander, Michael L
    Department of Medical Oncology, The Prince of Wales Hospital, University of New South Wales Clinical School, Sydney, Australia.
    Joly, Florence
    Departments of Medical Oncology and Clinical Research, Centre Francois Baclesse, CHU Cote de Nacre, University of Basse Normandie, Caen, France.
    Quality of life research in endometrial cancer: what is needed to advance progress in this disease site? Methodological considerations from the Gynecologic Cancer InterGroup Symptom Benefit Working Group brainstorming session, Leiden 2012.2014In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 24, no 9, p. 1686-1692Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Quality of life (QoL) in endometrial cancer (EC) is understudied. Incorporation of QoL questionnaires and patient-reported outcomes in clinical trials has been inconsistent, and the tools and interpretation of these measures are unfamiliar to most practitioners. In 2012, the Gynecologic Cancer InterGroup Symptom Benefit Working Group convened for a brainstorming collaborative session to address deficiencies and work toward improving the quality and quantity of QoL research in women with EC.

    METHODS: Through literature review and international expert contributions, we compiled a comprehensive appraisal of current generic and disease site-specific QoL assessment tools, strengths and weaknesses of these measures, assessment of sexual health, statistical considerations, and an exploration of the unique array of histopathologic and clinical factors that may influence QoL outcomes in women with EC.

    RESULTS: This collaborative composition is the first publication specific to EC that addresses methodology in QoL research and the components necessary to achieve high quality QoL data in clinical trials. Future recommendations regarding (1) the incorporation of patient-reported outcomes in all clinical trials in EC, (2) definition of an a priori hypothesis, (3) utilization of validated tools and consideration of new tools corresponding to new therapies or specific symptoms, (4) publication within the same time frame as clinical outcome data, and (5) attempt to correct for disease site-specific potential confounders are presented.

    CONCLUSIONS: Improved understanding of methodology in QoL research and an increased undertaking of EC-specific QoL research in clinical trials are imperative if we are to improve outcomes in women with EC.

  • 42.
    Mints, M.
    et al.
    Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden..
    Tzortzatos, G.
    Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden..
    Andersson, E.
    Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden..
    Soller, M.
    Skane Univ Hosp, Dept Clin Genet, Malmo, Sweden..
    Askmalm, M. Stenmark
    Linkoping Univ, Fac Hlth Sci, Dept Clin Pathol & Clin Genet, Linkoping, Sweden.;Linkoping Univ, Fac Hlth Sci, Dept Clin & Expt Med, Linkoping, Sweden..
    Zagoras, T.
    Sahlgrens Acad, Clin Genet Inst Biomed, Gothenburg, Sweden..
    Georgii-Hemming, Patrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology.
    Lindblom, A.
    Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden..
    Tham, E.
    Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden..
    The Gynecological Surveillance Of Women With Lynch Syndrome In Sweden2015In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 25, no 9, p. 1111-1111Article in journal (Other academic)
  • 43.
    Molassiotis, A.
    et al.
    School of Nursing, University of Manchester, United Kingdom.
    Browall, Maria
    Sahlgrenska University Hospital, Gothenburg, Sweden.
    Milovics, L.
    Department of Education, Institute for Oncology and Radiology, Belgrade, Serbia.
    Panteli, V.
    Greek Oncology Nursing Society, Athens, Greece.
    Patiraki, E.
    Greek Oncology Nursing Society, Athens, Greece.
    Fernandez-Ortega, P.
    Institut Català Oncologia ICO, Barcelona, Spain.
    Complementary and alternative medicine use in patients with gynecological cancers in Europe2006In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 16, no Suppl. 1, p. 219-224Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to assess the use of complementary and alternative medicine (CAM) specifically in women with gynecological cancer. The design of the study was of a descriptive cross-sectional survey using a 27-item questionnaire. The study was conducted in 11 countries in Europe as part of a larger project. Data were available from 72 gynecological cancer patients. Among the participants, 40.3% used CAM after the diagnosis with cancer. The most popular CAM modalities used were herbal medicine (34.5%), relaxation techniques (21.4%), and vitamins/minerals (20.7%). A very high level of satisfaction with CAM use was reported. Patients used CAM to increase the body's ability to fight the cancer or to improve physical and emotional well-being. The main sources of information about CAM were informal (friends/ family or the media). It is important to discuss CAM use with gynecological cancer patients, as they frequently use it and such use may have implications for clinical practice.

  • 44.
    Molassiotis, A.
    et al.
    School of Nursing, University of Manchester, United Kingdom.
    Browall, Maria
    Sahlgrenska University Hospital, Gothenburg, Sweden.
    Milovics, L.
    Department of Education, Institute for Oncology and Radiology, Belgrade, Serbia.
    Panteli, V.
    Greek Oncology Nursing Society, Athens, Greece.
    Patiraki, E.
    Greek Oncology Nursing Society, Athens, Greece.
    Fernandez-Ortega, P.
    Institut Català Oncologia ICO, Barcelona, Spain.
    Complementary and alternative medicine use in patients with gynecological cancers in Europe2006In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 16, no Suppl. 1, p. 219-224Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to assess the use of complementary and alternative medicine (CAM) specifically in women with gynecological cancer. The design of the study was of a descriptive cross-sectional survey using a 27-item questionnaire. The study was conducted in 11 countries in Europe as part of a larger project. Data were available from 72 gynecological cancer patients. Among the participants, 40.3% used CAM after the diagnosis with cancer. The most popular CAM modalities used were herbal medicine (34.5%), relaxation techniques (21.4%), and vitamins/minerals (20.7%). A very high level of satisfaction with CAM use was reported. Patients used CAM to increase the body's ability to fight the cancer or to improve physical and emotional well-being. The main sources of information about CAM were informal (friends/ family or the media). It is important to discuss CAM use with gynecological cancer patients, as they frequently use it and such use may have implications for clinical practice.

  • 45.
    Mordhorst, Louise Bohr
    et al.
    Department of Oncology, Örebro University Hospital, Örebro, Sweden.
    Karlsson, Leif
    Department of Radiation Physics, Örebro University Hospital, Örebro, Sweden.
    Bärmark, Berit
    Department of Oncology, Örebro University Hospital, Örebro, Sweden.
    Sorbe, Bengt
    Örebro University Hospital. Department of Oncology, Örebro University Hospital, Örebro, Sweden.
    Combined External and Intracavitary Irradiation in Treatment of Advanced Cervical Carcinomas Predictive Factors for Treatment Outcome and Early and Late Radiation Reactions2014In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 24, no 7, p. 1268-1275Article in journal (Refereed)
    Abstract [en]

    Objective: The objective of this study was to find out predictive factors of tumor control as well as acute and late radiation reactions in treatment of advanced cervical carcinomas.

    Methods: In a series of 134 primary cervical carcinomas in International Federation of Gynecology and Obstetrics stages I to IV treated with combined external pelvic and intraluminal cervical-vaginal brachytherapy, predictive and prognostic factors were analyzed with regard to tumor control, recurrences, survival data, and adverse effects. Concomitant chemotherapy was given to 48 patients (35.8%). The external beam therapy was given with a 4-field technique (50-60 Gy) and brachytherapy was given with a high-dose rate (iridium-192) afterloading technique using a ring applicator set. A computed tomographically based 3-dimensional dose-planning system was used for the external beam therapy and for the brachytherapy planning. The mean age of the patients was 65 years. A total of 110 tumors were squamous cell carcinomas and 24 were adenocarcinomas or adenosquamous carcinomas. A total of 111 tumors were in International Federation of Gynecology and Obstetrics stages I to II; 23 tumors, in stages III to IV.

    Results: The primary control rate of the complete series was 92.5%. Tumor size, the brachytherapy dose, the combined external and brachytherapy dose, as well as the number of days of interruption (delay) of irradiation were all significant predictive factors for local tumor control. Forty recurrences (30%) were recorded. Early radiation reactions were recorded in 67% (mostly grade 1) and were associated with the widths of the anterior-posterior and lateral pelvic fields. Serious late radiations reactions (grade 3-4) were noted in 11%.

    Conclusions: The width of the lateral pelvic fields, left point A and B doses, dose to the rectal reference point, as well as asymmetry of the dose distribution were associated with late severe reactions. Prior abdominal and pelvic surgery was also a high-risk factor for late tissue reactions. Concomitant chemotherapy did not increase the risk for acute or late toxicity.

  • 46.
    Nelson, Gregg
    et al.
    Division of Gynecologic Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada .
    Bakkum-Gamez, Jamie
    Division of Gynecologic Oncology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
    Kalogera, Eleftheria
    Division of Gynecologic Oncology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
    Glaser, Gretchen
    Division of Gynecologic Oncology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
    Altman, Alon
    Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
    Meyer, Larissa A.
    Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
    Taylor, Jolyn S.
    Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
    Iniesta, Maria
    Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
    Lasala, Javier
    Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
    Mena, Gabriel
    Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
    Scott, Michael
    Department of Anesthesia, Virginia Commonwealth University Hospital, Richmond, Virginia, USA.
    Gillis, Chelsia
    Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
    Elias, Kevin
    Division of Gynecologic Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA.
    Wijk, Lena
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Obstetrics and Gynecology.
    Huang, Jeffrey
    Department of Anesthesiology, Oak Hill Hospital, Brooksville, Florida, USA.
    Nygren, Jonas
    Departments of Surgery and Clinical Sciences, Ersta Hospital and Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
    Ljungqvist, Olle
    Örebro University, School of Medical Sciences. Department of Surgery.
    Ramirez, Pedro T.
    Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
    Dowdy, Sean C.
    Division of Gynecologic Oncology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
    Guidelines for perioperative care in gynecologic/oncology: Enhanced Recovery After Surgery (ERAS) Society recommendations-2019 update2019In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 29, no 4, p. 651-668Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: This is the first updated Enhanced Recovery After Surgery (ERAS) Society guideline presenting a consensus for optimal perioperative care in gynecologic/oncology surgery.

    METHODS: A database search of publications using Embase and PubMed was performed. Studies on each item within the ERAS gynecologic/oncology protocol were selected with emphasis on meta-analyses, randomized controlled trials, and large prospective cohort studies. These studies were then reviewed and graded according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system.

    RESULTS: All recommendations on ERAS protocol items are based on best available evidence. The level of evidence for each item is presented accordingly.

    CONCLUSIONS: The updated evidence base and recommendation for items within the ERAS gynecologic/oncology perioperative care pathway are presented by the ERAS® Society in this consensus review.

  • 47.
    Ofverman, Charlotte
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Stefansson, Kristina
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Ottander, Ulrika
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynecology.
    Lindquist, David
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    CASE SERIES OF PATIENTS WITH LEIOMYOSARCOMA OF THE UTERUS TREATED WITH TRABECTEDIN IN NORTHERN SWEDEN2016In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 26, no Supplement 3, p. 1046-1046, article id IGCS-0142Article in journal (Refereed)
  • 48. Phongsavan, Keokedthong
    et al.
    Gustavsson, Inger
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Genomics.
    Marions, Lena
    Phengsavanh, Alongkone
    Wahlstrom, Rolf
    Gyllensten, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Genomics.
    Detection of Human Papillomavirus Among Women in Laos Feasibility of Using Filter Paper Card and Prevalence of High-Risk Types2012In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 22, no 8, p. 1398-1406Article in journal (Refereed)
    Abstract [en]

    Background: Persistent infection with high-risk (HR) human papillomavirus (HPV) is a well-recognized cause of cervical cancer, but little is known about the situation in Laos. The aims of the study were to determine the prevalence of HR-HPV among Lao women and to evaluate the use of a filter paper card (FTA Elute Micro Card) for collection of cervical cells in the humid tropical climate. Methods: This is a cross-sectional study including 1922 women from 3 provinces in Laos. During a gynecological examination, cervical cells were collected and applied to the FTA card followed by HPV typing using a real-time polymerase chain reaction (PCR)-based assay. Results: Overall, 213 of the 1922 women were positive for HR-HPV (11%). The most common type was the group HPV33/52/58 (3%), followed by the single type 16 (2%) and the group 18/45 (1%), respectively. Only 11 cards (0.6%) did not contain a sufficient amount of genomic DNA for polymerase chain reaction-based analysis. Conclusions: The prevalence of HR-HPV infections in Laos is similar to other Asian countries, and 40% of the women with an HR-HPV infection will be target of the present HPV vaccines. The FTA card is suitable for collection of cervical cells for HR-HPV typing in tropical conditions. This information is important for planning and establishing primary and secondary prevention of cervical cancer in Laos.

  • 49. Rauvala, M
    et al.
    Aglund, Kristina
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Puistola, U
    Turpeenniemi-Hujanen, T
    Horvath, G
    Willén, R
    Stendahl, Ulf
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Matrix metalloproteinases-2 and -9 in cervical cancer: different roles in tumor progression.2006In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 16, no 3, p. 1297-1302Article in journal (Refereed)
    Abstract [en]

    The incidence of uterine cervical cancer has increased slightly in Western countries, with an increase in relatively young women. Overexpression of matrix metalloproteinases (MMPs)-2 and -9 has turned out as a prognostic factor in many cancers. We compared the expression of the proteins MMP-2 and MMP-9 in cervical primary tumors with clinical outcome and risk factors of cervical cancer. One hundred sixty-one patients with cervical cancer treated in Umeå University Hospital or Sahlgrenska University Hospital, Sweden, between 1991 and 1995 were included in the study. Paraffin-embedded tissue samples obtained prior to treatment were examined immunohistochemically by specific antibodies for MMP-2 and MMP-9. Forty-two percent of the tumors were intensively positive for MMP-2 and 31% for MMP-9. Nineteen percent of the samples were intensively positive for both proteinases and 47% negative or weak for both. Overexpression of MMP-2 seemed to predict unfavorable survival under Kaplan-Meier analysis and in the multivariate analysis. Early sexual activity and low parity seemed to correlate to overexpression of MMP-2. MMP-9 was not associated with survival or sexual behavior. Intensive MMP-9 was noted in grade 1 tumors. We conclude that MMP-2 and MMP-9 have different roles in uterine cervical cancer. MMP-2 could be associated with aggressive behavior, but MMP-9 expression diminishes in high-grade tumors.

  • 50.
    Reed, Nicholas Simon
    et al.
    Beatson Oncology Centre, Glasgow, UK.
    Pautier, Patricia
    Institut Gustave Roussy, Villejuif, France.
    Åvall-Lundqvist, Elisabeth
    Karolinska Intitute, Stockholm, Sweden.
    Choi, Chel-Hun
    Samsung Medical Centre, Sung Kyun Kwan University Medical Centre, Seoul, South Korea.
    du Bois, Andreas
    University of Duisberg, Essen, Germany.
    Friedlander, Michael
    National Health and Medical Research Council, Clinical Trials Centre, New South Wales, Australia.
    Fyles, Anthony
    Princess Margaret Hospital, Toronto, Canada.
    Kichenadasse, Ganessan
    Flinders Centre for Innovation in Cancer, South Australia, Australia.
    Provencher, Diane M
    Centre hospitalier de l'Universite de Montreal, Montreal, Canada.
    Ray-Coquard, Isabelle
    Centre Leon Berard, Lyon, France.
    Gynecologic Cancer InterGroup (GCIG) consensus review for ovarian small cell cancers.2014In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 24, no 9, p. S30-S34Article, review/survey (Refereed)
    Abstract [en]

    Small cell carcinomas of the ovary are uncommon and account for less than 1% of ovarian cancers. They were first recognized in 1979, and a number of reports appeared during the next 2 decades. They are highly aggressive tumors and usually carry a poor prognosis, although this may reflect that most are diagnosed at advanced stage; however, those diagnosed as stage 1A have only 30% to 40% of long-term survivors. More reports followed extending our experience in the diagnosis and management of these rare cancers. The classification is described below and shown in Table 1, but a revision is expected to be published from the World Health Organization in 2014.

12 1 - 50 of 79
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf