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Abramson Cancer CenterNCI CANCERLIT® Search: Diagnosis-Histopathology-Pathogenesis of Ovarian Cancer - April 2002
National Cancer Institute®
Last Modified: April 1, 2002
Table of Contents
1
UI - 11552325
AU - Frutuoso C; Silva MR; Amaral N; Martins I; De Oliveira C; De Oliveira HM
TI -
[Prognosis value of p53, C-erB-2 and Ki67 proteins in ovarian carcinoma]
SO - Acta Med Port 2001 May-Jun;14(3):277-83
AD - Servicos de Ginecologia e Anatomia Patologica, Hospitais da Universidade
de Coimbra, Coimbra.
The prognosis in ovarian carcinoma remains poor. We need to identify
patients who are less likely to respond to treatment. In order to
evaluate the prognostic value of C-erb-B2, p53 and Ki 67 expression and
correlate these markers with classic prognostic factors, we studied
paraffin-embedded tumor tissue from 81 patients with epithelial ovarian
cancer and made a quantitative evaluation of C-erb-B2, p53 and Ki 67
expression by immunohistochemistry. The results were: age 5.4 +/-
15(22-88); 66% with normal physical activity; 48.2% with residual
disease < 2 cm; initial stage--42% and advanced stage--58%. Age,
performance status, residual disease and stage were correlated with 2
and 5 years survival. Positive immunostaining: p53--87%, C-erb B-2--51%
and Ki67--100%. P53 and C-erb B-2 were associated with residual disease
and stage; patients with no C-erbB-2 staining had a significantly better
survival. A direct and significant correlation was found between p53 and
Ki67 and between C-erb B-2 and p53. We conclude that these markers have
a high expression in ovarian carcinoma and p53 and C-er B-2 correlate
with stage and residual disease. Although C-erb B-2 was associated with
better survival, it was not found to be an independent prognostic
factor.
2
UI - 11759816
AU - Chang J; Elledge RM
TI -
Clinical management of women with genomic BRCA1 and BRCA2 mutations.
SO - Breast Cancer Res Treat 2001 Sep;69(2):101-13
AD - Department of Medicine, Baylor-Methodist Breast Care Center, Baylor
College of Medicine, Houston, TX 77030, USA. jcchang@bcm.tmc.edu
PURPOSE: There is increasing evidence that BRCA1 and BRCA2 associated
tumors may differ from sporadic cancers. The purpose of this report is
to review the current state of knowledge of BRCA1 and BRCA2, the biology
of associated tumors, and possible risk reduction strategies in women
with these deleterious mutations. DESIGN AND METHODS: We conducted an
extensive literature search of all published articles (including
Medline) on preclinical data on the function of BRCA1 and BRCA2,
associated tumor pathology, and the clinical management for both
unaffected carriers and affected patients. RESULTS: BRCA1 and BRCA2 are
likely to act as tumor suppressor genes, and together with RAD51 operate
in a common DNA damage response pathway implicated in double-strand
repair. Breast cancers associated with BRCA1 are frequently of a higher
grade, steroid hormone receptor negative, and appear to have a higher
proportion of atypical or typical medullary subtype. Conversely, BRCA2
associated breast cancers do not differ significantly from sporadic
cancers. No special tumor phenotype has been ascribed to BRCA1 or BRCA2
associated ovarian cancers. Guidelines for risk reduction strategies for
the high risk unaffected carrier have been recommended by expert panels
in the USA and Europe. Lifestyle changes, multi-modality screening,
chemoprevention, and prophylactic oophorectomy and mastectomy, with
their possible benefits and attendant risks are described. Finally,
locoregional and systemic treatment in breast and ovarian cancers
associated with these mutations, and differences between these and
sporadic cancers are discussed. CONCLUSIONS: Although the incidence of
breast or ovarian cancers that can be attributed to BRCAI or BRCA2
mutations account for less than 5% of all cancers, these cancers may
differ from sporadic cases in terms of tumor biology and phenotype.
These differences may impact directly on clinical management of breast
and ovarian cancer patients, and their relatives. Further
recommendations of these patients are constantly changing as new
information emerges on the clinical behavior of these cancers.
3
UI - 11781518
AU - Baker PM; Rosai J; Young RH
TI -
Ovarian teratomas with florid benign vascular proliferation: a
distinctive finding associated with the neural component of teratomas
that may be confused with a vascular neoplasm.
SO - Int J Gynecol Pathol 2002 Jan;21(1):16-21
AD - Department of Pathology, Health Sciences Center, University of Manitoba,
Winnipeg, Manitoba, Canada.
Prominent benign vascular proliferations associated with neural tissue
in five cases of ovarian teratoma are described. The ages of the
patients ranged from 15 to 35 years. Three of the five had tumors
confined to the ovary, one had peritoneal implants, and one had
widespread metastatic immature teratoma. Two of the patients are alive
and well, 8 and 9 years postoperatively. Follow-up is unavailable in two
cases and the final case was recent. The tumor in three of the cases had
features of mature cystic teratoma including abundant mature neural
tissue and, in one instance, microscopic foci of primitive
neuroepithelium. The tumor in the fourth case was an immature teratoma
with abundant primitive neuroepithelium, and in the fifth case was a
mixed germ cell tumor, composed mostly of immature teratoma with a minor
component of yolk sac tumor. In all the tumors there was a prominent
vascular proliferation composed of long thin-walled, curved vessels or a
solid glomeruloid arrangement. Immunohistochemistry done in two cases
confirmed the vascular nature of the proliferation. Angiogenesis, likely
as an expression of vascular endothelial growth factors, is a well-known
phenomenon in a variety of neural and neuroendocrine neoplasms, in
particular high-grade gliomas. However, very few cases of this
phenomenon have been described in association with neural tissue in the
ovary. Recognition of this proliferation as a benign secondary one is
important to avoid misdiagnosis of a vascular neoplasm or an immature
teratoma, as happened in one of our cases.
4
UI - 11788818
AU - Baum RP; Przetak C
TI -
Evaluation of therapy response in breast and ovarian cancer patients by
positron emission tomography (PET).
SO - Q J Nucl Med 2001 Sep;45(3):257-68
AD - Zentralklinik Bad Berka Clinic of Nuclear Medicine, Center for PET, Bad
Berka, Germany. info@rpbaum.de
Positron emission tomography (PET) has the potential to contribute
significantly to treatment planning and to the evaluation of response to
therapy in patients with cancer. For disease recurrence PET imaging
provides information non-invasively. The final goal is to biologically
characterize an individual patient's tumor and to predict the response
to treatment at the earliest possible time. Since the development of
neoadjuvant chemotherapy, PET has been proved to be the most sensitive
and accurate imaging technique for early therapy response evaluation of
breast tumors. Quantitative and/or semi-quantitative PET studies yield
valuable information in breast cancer regarding prognosis and response
to chemohormontherapy in a timely fashion. In ovarian cancer, up to now
only few studies have been performed applying PET techniques for the
evaluation of treatment response. These preliminary studies indicate
that serial assessment of tumor metabolism by FDG-PET early during
effective chemotherapy may predict subsequent response to such therapy.
PET studies can be repeated without any side-effects and with low
radiation exposure and results can be directly correlated with clinical
laboratory data and histology. The role of PET in the context of patient
management and the cost-effectiveness of this approach needs further
evaluation. Therapy monitoring by PET could help to optimize neoadjuvant
therapy protocols and to avoid ineffective preoperative therapy in
non-responders, but this has to be proven in a larger number of patients
and in different neoadjuvant settings such as chemotherapy, radiation
therapy, hormone therapy or a combination of these.
5
UI - 11801872
AU - Narod SA; Boyd J
TI -
Current understanding of the epidemiology and clinical implications of
BRCA1 and BRCA2 mutations for ovarian cancer.
SO - Curr Opin Obstet Gynecol 2002 Feb;14(1):19-26
AD - The Centre for Research on Women's Health, Women's College Hospital,
University of Toronto, Toronto, Canada. steven.narod@swchsc.on.ca
Genetic testing for susceptibility to ovarian cancer is rapidly becoming
integrated into the clinical practice of oncology. Genetic testing for
BRCA1 and BRCA2 is now recommended to most women with invasive ovarian
cancer. Approximately 10% of these women will have a positive test,
including 4% of women without a family history of cancer. Currently, the
treatment of hereditary ovarian cancer is the same as for non-hereditary
ovarian cancer. It appears that women with ovarian cancer and a BRCA
mutation experience better survival than women without a mutation,
possibly due to enhanced susceptibility to chemotherapy. Strategies for
prevention of ovarian cancer among carriers include oral contraceptives,
tubal ligation and prophylactic oophorectomy.
6
UI - 11846741
AU - Oszurek O; Gorski B; Gronwald J; Prosolow Z; Uglanica K; Murinow A;
TI -
Bobko I; Downar O; Zlobicz M; Norik D; Byrski T; Jakubowska A; Lubinski
J
Founder mutations in the BRCA1 gene in west Belarusian breast-ovarian
cancer families.
SO - Clin Genet 2001 Dec;60(6):470-1
7
UI - 11875731
AU - Zhang M; Yang ZY; Binns CW; Lee AH
TI -
Diet and ovarian cancer risk: a case-control study in China.
SO - Br J Cancer 2002 Mar 4;86(5):712-7
AD - School of Public Health, Curtin University of Technology, GPO Box U1987,
Perth, WA 6845, Australia.
This case-control study, conducted in Zhejiang, China during 1999-2000,
investigated whether dietary factors have an aetiological association
with ovarian cancer. Cases were 254 patients with histologically
confirmed epithelial ovary cancer. The 652 controls comprised 340
hospital visitors, 261 non-neoplasm hospital outpatients without
long-term diet modifications and 51 women recruited from the community.
A validated food frequency questionnaire was used to measure the
habitual diet of cases and controls. The risks of ovarian cancer for the
dietary factors were assessed by adjusted odds ratios based on
multivariate logistic regression analysis, accounting for potential
confounding demographic, lifestyle, familial factors and hormonal
status, family ovarian cancer history and total energy intake. The
ovarian cancer risk declined with increasing consumption of vegetables
and fruits but vice versa with high intakes of animal fat and salted
vegetables. The adjusted upper quartile odds ratio compared to the lower
quartile was 0.24 (0.1-0.5) for vegetables, 0.36 (0.2-0.7) for fruits,
4.6 (2.2-9.3) for animal fat and 3.4 (2.0-5.8) for preserved (salted)
vegetables with significant dose-response relationship. The risk of
ovarian cancer also appeared to increase for those women preferring fat,
fried, cured and smoked food. Copyright 2002 Cancer Research UK
8
UI - 11875732
AU - Bennett KE; Howell A; Evans DG; Birch JM
TI -
A follow-up study of breast and other cancers in families of an
unselected series of breast cancer patients.
SO - Br J Cancer 2002 Mar 4;86(5):718-22
AD - CRC Paediatric and Familial Cancer Research Group, Royal Manchester
Children's Hospital, Hospital Road, Manchester M27 4HA, UK.
The cancer experience among relatives of an unselected cohort of 402
breast cancer patients was previously reported. Cases and their first
degree relatives were flagged at the National Health Service Central
Register for continuous notification of cancer registrations and deaths.
More than 10 years of follow-up data have been analysed to update cancer
risks overall and to estimate breast cancer risk in relatives
prospectively according to family history at the time of breast cancer
diagnosis in the index case. Significant excesses of breast cancer (RR
2.24, P<0.0001), prostate cancer (RR 1.71, P=0.039) and bone sarcoma (RR
6.564, P=0.042) overall and soft tissue sarcoma in mothers only (RR
15.44, P=0.001) were found. There was no excess of any other cancer,
including ovarian. High breast cancer risk in relatives was associated
with young age at diagnosis in the index (index <40 years at diagnosis,
RR in relatives 3.76, P=0.004). Prospective risk of breast cancer was
higher in relatives of index patients who had an affected first degree
relative at the time of their diagnosis (no family history, RR 1.87,
P=0.012; with a family history, RR 3.72, P=0.015). These prospective
risk estimates are valuable in advising relatives of newly diagnosed
breast cancer patients. Copyright 2002 Cancer Research UK
9
UI - 11915744
AU - Komai K; Nishida T
TI -
[Tumor marker in ovarian cancer]
SO - Gan To Kagaku Ryoho 2002 Mar;29(3):481-6
AD - Dept. of Gynecology and Obstetrics, Kurume University School of
Medicine, 67 Asahi-machi, Krume 830-0011, Japan.
The current role of tumor markers in the management of ovarian cancer is
reviewed. The most useful tumor marker in epithelial ovarian cancer is
still the antigen CA125. However, the level of this marker is modified
by peritoneal irritation from endometriosis or inflammatory disease.
Furthermore, the level is not elevated in nearly half of patients with
the stage I disease, suggesting a limited value as a screening marker.
In CA125 positive cases, the marker determination is a sensitive
indicator in the early diagnosis of progressive disease in ovarian
cancer. The lack of an effective second-line regimen, however, limits
the value of the antigen as monitoring marker. Expectations for the new
tumor markers lysophosphatidic acid and inhibin are also briefly
discussed.
10
UI - 11834867
AU - Fujishita A; Khan KN; Masuzaki H; Ishimaru T
TI -
Influence of pelvic endometriosis and ovarian endometrioma on fertility.
SO - Gynecol Obstet Invest 2002;53 Suppl 1():40-5
AD - Department of Obstetrics and Gynecology, Nagasaki University School of
Medicine, Nagasaki, Japan. fujishita@net.nagasaki-u.ac.jp
We investigated the influence of pelvic endometriosis and ovarian
endometrioma on pregnancy outcome in women associated with infertility.
A total of 237 women with endometriosis were reviewed, and their
fertility rate was assessed by both r-AFS staging and TOP classification
as previously proposed by our group. There was no significant difference
in pregnancy rate among r-AFS stages. However, the pregnancy rate was
mostly affected by the tubal condition according to the TOP
classification as follows: no adhesive lesion (T0), 53% (69/129);
unilateral lesion (T1), 46% (18/39); bilateral lesion with at least one
tube patent, (T2), 37% (10/27); bilateral tubal occlusion (T3), 0% (0/8)
(p < 0.05, Mantel-Extension test). The absence (O0-O1) or co-existence
(O2-O3) of ovarian endometrioma and different gradings of cul-de-sac
obliteration (P2-P3) showed no significant differences in pregnancy
rate. The resulting conception rate was also not affected by the size or
location of ovarian endometrioma. In addition, the higher adhesion score
of ovarian endometrioma involving the fallopian tube and as described in
r-AFS classification had a significant detrimental effect on fertility.
These observations suggest that our TOP classification describing
individual tubal condition has a clinically predictive value in
assessing the reproductive outcome of women with endometriosis.
Copyright 2002 S. Karger AG, Basel
11
UI - 11695227
AU - Huncharek M; Klassen H; Kupelnick B
TI -
Dietary beta-carotene intake and the risk of epithelial ovarian cancer:
a meta-analysis of 3,782 subjects from five observational studies.
SO - In Vivo 2001 Jul-Aug;15(4):339-43
AD - Department of Clinical Oncology, Marshfield Clinic Cancer Center,
Marshfield, WI, USA. metaresearch@hotmail.com
OBJECTIVE: The etiology of epithelial ovarian cancer is unknown. Prior
work suggests that high dietary beta-carotene intake is associated with
a decreased risk of this tumor although this association remains
speculative. A meta-analysis was performed to evaluate this suspected
relationship. METHODS: Using previously described methods, a protocol
was developed for a meta-analysis examining the association between high
dietary beta-carotene intake versus low intake and the risk of
epithelial ovarian cancer. Literature search techniques, study inclusion
criteria and statistical procedures were prospectively defined. Data
from observational studies were pooled using a general variance based
meta-analytic method employing confidence intervals previously described
by Greenland. The outcome of interest was a summary relative risk (RRs)
reflecting the risk of ovarian cancer associated with high beta-carotene
intake versus low dietary intake. Sensitivity analyses were performed
when necessary to evaluate any observed statistical heterogeneity.
RESULTS: Five observational studies enrolling 3,782 subjects were
initially pooled in a meta-analysis subsequent to an analysis showing a
lack of statistical heterogeneity. The meta-analysis showed a summary
relative risk of 0.84 with a 95% confidence interval of 0.75-0.94, a
statistically significant result. These data suggest that high (versus
low) dietary intake of beta-carotene is associated with a sixteen
percent decrease in ovarian cancer risk. Sensitivity analyses showed no
impact of study design or differences in quantitative measure of
beta-carotene intake across studies on the summary relative risk.
CONCLUSIONS: High dietary intake of beta-carotene appears to represent a
protective factor for the development of ovarian cancer although its
magnitude is modest. Further work is needed to clarify factors that may
modify the effects of beta-carotene in vivo.
12
UI - 11870167
AU - Bristow RE; Tomacruz RS; Armstrong DK; Trimble EL; Montz FJ
TI -
Survival effect of maximal cytoreductive surgery for advanced ovarian
carcinoma during the platinum era: a meta-analysis.
SO - J Clin Oncol 2002 Mar 1;20(5):1248-59
AD - Kelly Gynecologic Oncology Service, Department of Gynecology and
Obstetrics, Johns Hopkins Medical Institutions, Baltimore, MD
21287-1248, USA. rbristo@jhmi.edu
PURPOSE: To evaluate the relative effect of percent maximal
cytoreductive surgery and other prognostic variables on survival among
cohorts of patients with advanced-stage ovarian carcinoma treated with
platinum-based chemotherapy. MATERIALS AND METHODS: Eighty-one cohorts
of patients with stage III or IV ovarian carcinoma (6,885 patients) were
identified from articles in MEDLINE (1989 through 1998). Linear
regression models, with weighted correlation calculations, were used to
assess the effects on log median survival time of the proportion of each
cohort undergoing maximal cytoreduction, dose-intensity of the platinum
compound administered, proportion of patients with stage IV disease,
median age, and year of publication. RESULTS: There was a statistically
significant positive correlation between percent maximal cytoreduction
and log median survival time, and this correlation remained significant
after controlling for all other variables (P <.001). Each 10% increase
in maximal cytoreduction was associated with a 5.5% increase in median
survival time. When actuarial survival was estimated, cohorts with < or
= 25% maximal cytoreduction had a mean weighted median survival time of
22.7 months, whereas cohorts with more than 75% maximal cytoreduction
had a mean weighted median survival time of 33.9 months--an increase of
50%. The relationship between platinum dose-intensity and log median
survival time was not statistically significant. CONCLUSION: During the
platinum era, maximal cytoreduction was one of the most powerful
determinants of cohort survival among patients with stage III or IV
ovarian carcinoma. Consistent referral of patients with apparent
advanced ovarian cancer to expert centers for primary surgery may be the
best means currently available for improving overall survival.
13
UI - 11870168
AU - Scheuer L; Kauff N; Robson M; Kelly B; Barakat R; Satagopan J; Ellis N;
TI -
Hensley M; Boyd J; Borgen P; Norton L; Offit K
Outcome of preventive surgery and screening for breast and ovarian
cancer in BRCA mutation carriers.
SO - J Clin Oncol 2002 Mar 1;20(5):1260-8
AD - Clinical Genetics, Breast Cancer Medicine, and Developmental
Chemotherapy Services, Department of Medicine, Memorial Sloan-Kettering
Cancer Center, New york, NY 10021, USA.
PURPOSE: To prospectively determine the impact of genetic counseling and
testing on risk-reduction strategies and cancer incidence in a cohort of
individuals at hereditary risk for breast and ovarian cancer. PATIENTS
AND METHODS: Two hundred fifty-one individuals with BRCA mutations were
identified at a single comprehensive cancer center from May 1, 1995,
through October 31, 2000. Uniform recommendations regarding screening
and preventive surgery were provided in the context of genetic
counseling. Patients were followed for a mean of 24.8 months (range, 1.6
to 66.0 months) using standardized questionnaires, chart reviews, and
contact with primary physicians. RESULTS: Frequency of cancer
surveillance by physical examinations and imaging studies increased
after genetic counseling and testing. Twenty-one breast, ovarian,
primary peritoneal, or fallopian tube cancers were detected after
receipt of genetic test results. Among 29 individuals choosing
risk-reducing mastectomy after testing, two were found to have occult
intraductal breast cancers. Among 90 individuals who underwent
risk-reducing salpingo-oophorectomy, one early-stage ovarian neoplasm
and one early-stage fallopian tube neoplasm were found. Radiographic or
tumor marker-based screening detected six breast cancers, five of which
were stage 0/I, one early-stage primary peritoneal cancer, and three
stage I or II ovarian cancers. Six additional breast cancers were
detected by physical examination between radiographic screening
intervals; four of these six tumors were stage I. No stage III or stage
IV malignancies were detected after genetic testing. CONCLUSION: This
study provides prospective evidence that genetic counseling and testing
increased surveillance and led to risk-reducing operations, which
resulted in diagnosis of early-stage tumors in patients with BRCA1 and
BRCA2 mutations.
14
UI - 11889215
AU - Fuller PJ; Zumpe ET; Chu S; Mamers P; Burger HG
TI -
Inhibin-activin receptor subunit gene expression in ovarian tumors.
SO - J Clin Endocrinol Metab 2002 Mar;87(3):1395-401
AD - Prince Henry's Institute of Medical Research and Monash University,
Department of Obstetrics and Gynecology, Monash Medical Center, Clayton,
Victoria 3168, Australia. peter.fuller@med.monash.edu.au
Granulosa cell tumors of the ovary (GCT) express the inhibin subunit
genes and secrete dimeric inhibin. Transgenic mice null for the
alpha-inhibin gene develop GCT. It has been suggested that this apparent
contradiction may be reconciled if the human GCT are resistant to the
tumor-suppressive effects of inhibin. Inhibin receptors have recently
been characterized as consisting of either betaglycan or p120 in
association with the type II or type I activin receptor subunits (ActR),
respectively. To test the hypothesis that GCT may exhibit loss of
inhibin receptor expression we have examined the expression of the
receptor subunits in a cohort of GCT and in mucinous and serous
cystadenocarcinomas and normal ovary. Expression was determined by
RT-PCR using gene-specific primers and probes combined with Southern
blot analysis of the PCR products. The ActRI subunits and ActRIIA
exhibited widespread albeit variable expression across tissues, with the
highest levels in the serous tumors. ActRIIB expression was relatively
low in the mucinous tumors and high in the GCT. Betaglycan expression
was abundant, widespread, and variable across all tissues; highest mean
levels occurred in the GCT and normal ovary. p120 expression was low or
absent in all tissues except the GCT. Within the GCT there was parallel
expression of the ActR subunits, betaglycan and p120; the levels,
however, varied considerably between tumors. Expression of betaglycan
and p120 in most GCT argues against the hypothesis, but does not exclude
the possibility that low or absent expression of p120 might be
significant in a subset of these tumors.
15
UI - 11818122
AU - Satoh S; Takashima T; Nakano H
TI -
Role of imaging modalities in ovarian tumors.
SO - Int J Gynaecol Obstet 2002 Feb;76(2):195-7
AD - Maternity and Perinatal Care Unit, Kyushu University Hospital, Maidashi
3-1-1, Higashi-ku, Fukuoka 812-8582, Japan.
satoh@gynob.med.kyushu-u.ac.jp
16
UI - 11880767
AU - McGuire V; Herrinton L; Whittemore AS
TI -
Race, epithelial ovarian cancer survival, and membership in a large
health maintenance organization.
SO - Epidemiology 2002 Mar;13(2):231-4
AD - Department of Health Research and Policy, Stanford University School of
Medicine, Stanford, CA 94305-5405, USA. vmcguire@leland.stanford.edu
BACKGROUND: African-American ovarian cancer patients present with more
advanced disease and have poorer survival than do white patients.
METHODS: To determine whether these differences occur among
African-American and white patients who have equal access to medical
care, we analyzed ovarian cancer patient characteristics separately for
1,587 members of the Kaiser Permanente Medical Plan of Northern
California and 5,757 non-members. RESULTS: The distributions of disease
stage at diagnosis were similar among African-American and white
patients, both in the Kaiser plan and elsewhere. However, ovarian cancer
death rates, adjusted for disease stage and age at diagnosis and for
histology, were higher for African-American patients compared with white
patients, regardless of Kaiser membership status. The death rate ratios
for African-Americans compared with whites were 1.32 (95% CI =
1.02-1.70) for Kaiser members and 1.20 (95% CI = 1.04-1.40) for Kaiser
non-members. CONCLUSION: Further research within an equal-access care
system is needed to evaluate other important factors such as specialty
of surgeon, extent of residual tumor after surgery, chemotherapy
treatment, and postoperative management to determine whether these
factors are contributing to the differences in survival between
African-American and white ovarian cancer patients.
17
UI - 11884782
AU - Katayama M; Masui T; Kobayashi S; Ito T; Sakahara H; Nozaki A; Kabasawa
TI -
H
Diffusion-weighted echo planar imaging of ovarian tumors: is it useful
to measure apparent diffusion coefficients?
SO - J Comput Assist Tomogr 2002 Mar-Apr;26(2):250-6
AD - Department of Radiology, Seirei Hamamatsu General Hospital, Japan.
mkataya@sis.seirei.or.jp
PURPOSE: Our goal was to test the hypothesis, as previously reported in
other studies, that apparent diffusion coefficients (ADCs) provide
specific information to diagnose ovarian tumors, especially to
discriminate between benign and malignant lesions. METHOD: T1-and
T2-weighted spin echo imaging and diffusion-weighted echo planar imaging
were performed in 31 women with 61 cystic components of ovarian tumors.
RESULTS: The lesions that showed typical watery intensity, hypointensity
in T1-weighted imaging, and hyperintensity in T2-weighted imaging had
similar ADCs, ranging from 1.54 to 1.84 x 10(-3) mm2 /s. The lesions
that showed signal intensity different from typical watery intensity in
conventional MRI tended to have low ADCs. In endometrial cysts, the mean
ADC of the subgroup that showed typical watery intensity was higher than
that of other subgroups. CONCLUSION: With conventional MRI, a tendency
of ADCs could be predicted. ADCs may not provide additional information,
especially to discriminate benign from malignant lesions.
18
UI - 11920551
AU - Lee SC; Bernhardt BA; Helzlsouer KJ
TI -
Utilization of BRCA1/2 genetic testing in the clinical setting: report
from a single institution.
SO - Cancer 2002 Mar 15;94(6):1876-85
AD - Department of Oncology, Johns Hopkins Medical Institution, Baltimore, MD
21205, USA.
BACKGROUND: Clinical testing for BRCA1/2 has been available since 1996.
Interest in testing in the research and hypothetical situations has been
consistently high, but there have been limited reports on its clinical
utilization. METHODS: This is a retrospective study of BRCA1/2 test
utilization by high-risk patients who were seen at the Johns Hopkins
carrying a BRCA1/2 mutation were offered genetic testing. Of these, 26
testing. Overall, 68 of 258 (26%) underwent genetic testing. Educational
level, number of children or daughters, breast carcinoma screening
behavior, smoking and drinking behavior, perceived risk of breast
carcinoma, and family history was not associated with test utilization.
Eligibility for free testing, prior history of breast or ovarian
carcinoma, Ashkenazi Jewish versus non-Ashkenazi Jewish heritage,
genetic risk category, and age category were associated with test
utilization, and in multivariate analysis, the first three remained
statistically significant factors associated with genetic testing. Only
26% of the 50 patients who did not have access to free testing sought
insurance reimbursement, of which greater than 50% (7 of 13) had a prior
diagnosis of breast or ovarian carcinoma. CONCLUSIONS: The actual
utilization of BRCA1/2 genetic testing in a clinical setting is lower
than in the research and hypothetical settings. Potential obstacles
include cost, fear of insurance discrimination, and need to involve an
affected family member in the testing process. Copyright 2002 American
Cancer Society.
19
UI - 11920552
AU - Barnholtz-Sloan JS; Tainsky MA; Abrams J; Severson RK; Qureshi F;
TI -
Jacques SM; Levin N; Schwartz AG
Ethnic differences in survival among women with ovarian carcinoma.
SO - Cancer 2002 Mar 15;94(6):1886-93
AD - Epidemiology Section, Population Studies and Prevention Program,
Karmanos Cancer Institute, Detroit, Michigan 48201, USA.
barnholz@karmanos.org
BACKGROUND: Ovarian carcinoma is the leading cause of death among all
female reproductive malignancies. There are substantial differences in
age-adjusted incidence rates and survival rates between Caucasian women
and African-American women. The objective of this study was to examine
ethnic differences in survival after ovarian carcinoma in a
population-based sample of women. METHODS: Thirteen thousand
eighty-three patients (12285 Caucasian women and 798 African-American
women) who were diagnosed with primary ovarian carcinoma from the
population-based Surveillance, Epidemiology, and End Results (SEER)
Program were used for analysis. Odds ratios were used to estimate the
association between prognostic variables and ethnicity. Chi-square tests
were used to determine the statistical significance of these
associations (using two-sided P values). Univariable and multivariable
Cox proportional hazards models were used to assess survival
differences. RESULTS: African-American women were significantly younger
at the time of diagnosis, were more likely to be single, and were less
likely to undergo site specific surgery compared with Caucasian women.
In addition, the crude median survival for African-American women was
nearly 1 year less than for Caucasian women (22 months vs. 32 months,
respectively; P < 0.0001). African-American women were at a 30%
increased risk of death from any cause when adjusting for all other
prognostic variables that differed between the two ethnic groups.
CONCLUSIONS: African-American women who are diagnosed with ovarian
carcinoma are at a significant increased risk of death from any cause
compared with Caucasian women who are diagnosed with ovarian carcinoma.
Copyright 2002 American Cancer Society.
20
UI - 10925628
AU - Apold J; Heimdal K; Moller P
TI -
[Screening for ovarian cancer]
SO - Tidsskr Nor Laegeforen 2000 Jun 20;120(16):1913-4
21
UI - 10600311
AU - Eltabbakh GH; Yadav PR; Morgan A; Yadev PR
TI -
Clinical picture of women with early stage ovarian cancer.
SO - Gynecol Oncol 1999 Dec;75(3):476-9
AD - Division of Gynecologic Oncology, University of Vermont, Burlington,
Vermont 05401, USA.
OBJECTIVE: The objective of this study was to review the clinical
picture of women with early stage ovarian cancer, to examine the
difference between women with borderline ovarian tumors (BLOT) and those
with ovarian cancer (OC), and to estimate the average time interval
between the onset of symptoms and diagnosis. METHODS: A retrospective
review of all women with surgical stage I and II OC or BLOT was
performed and the following information abstracted: age, parity, family
history of cancer, personal history of previous malignancies, symptoms,
signs, date of start of symptoms, imaging studies, CA-125 values, date
of diagnosis at surgery, tumor stage, histology, grade, date of last
follow-up, and condition at last follow-up. Comparison between patients
with BLOT and OC was performed using chi(2) and two-sample t tests.
RESULTS: Our search identified 72 women with surgical stage I and II
BLOT (n = 22) or OC (n = 50). Seventy-eight percent of the patients had
presenting symptoms, the most common of which were abdominal or pelvic
pain (34. 7%), bloatedness (31.9%), and vaginal bleeding (19.4%).
Symptoms were similar among women with BLOT and those with OC, with a
higher proportion of BLOT patients reporting no symptoms (31.8% versus
18. 0%, respectively). Abdominal and/or pelvic masses were palpable in
72.2% of the patients and ascites was present in 12.5%. Ovarian masses
were most commonly complex in appearance and CA-125 was elevated in
52.2% of the patients in whom CA-125 values were known. The average time
interval between onset of symptoms and diagnosis was 4.6 months (range
0.1-24.4 months). Women with BLOT had a significantly longer average
time interval than women with OC (8.0 +/- 7.7 versus 3.4 +/- 3.7 months,
respectively, P = 0.03). CONCLUSIONS: The majority of women with early
stage ovarian cancer have nonspecific symptoms. The array of symptoms is
similar between women with BLOT and those with OC. However, women with
BLOT tend to have a longer time interval from onset of symptoms to
diagnosis. Copyright 1999 Academic Press.
22
UI - 10851943
AU - Bjorge T; Dorum A; Trope CG
TI -
[Screening for ovarian cancer]
SO - Tidsskr Nor Laegeforen 2000 May 10;120(12):1444-8
AD - Avdeling for gynekologisk onkologi, Det Norske Radiumhospital, Oslo.
BACKGROUND: Ovarian cancer is a common malignant neoplasm in affluent
societies. Although the prognosis has continuously improved since the
1950s, it is still poor, with five-year relative survival rates of about
40%. MATERIAL AND METHODS: The paper discusses the potential use of
screening for early ovarian cancer detection. RESULTS: The disease is a
suitable candidate for screening because the prognosis is strongly
dependent on the stage of disease at the time of diagnosis. Ovarian
cancer does not, however, meet all the prerequisites for successful
screening; there is no preclinical stage that can be detected, and the
tests are not sensitive and specific enough to be effective.
Furthermore, there is so far no direct evidence that screening would
decrease mortality from ovarian cancer, though recent data suggest that
screening may increase survival. INTERPRETATION: Screening women at
higher risk of developing ovarian cancer might be beneficial.
23
UI - 11006746
AU - Trope C
TI -
[Ovarian cancer screening of high risk groups]
SO - Tidsskr Nor Laegeforen 2000 Aug 10;120(18):2191
24
UI - 11801560
AU - Rodriguez-Burford C; Barnes MN; Oelschlager DK; Myers RB; Talley LI;
TI -
Partridge EE; Grizzle WE
Effects of nonsteroidal anti-inflammatory agents (NSAIDs) on ovarian
carcinoma cell lines: preclinical evaluation of NSAIDs as
chemopreventive agents.
SO - Clin Cancer Res 2002 Jan;8(1):202-9
AD - Department of Obstetrics and Gynecology, Comprehensive Cancer Center,
Biostatistics Unit, The University of Alabama at Birmingham, Birmingham,
Alabama 35213, USA.
PURPOSE: Nonsteroidal anti-inflammatory agents may inhibit
carcinogenesis in specific tissues including the colon, breast, and
pancreas, and, hence, may prove to be effective chemopreventive agents.
The purpose of this study was to investigate the cellular effects of
acetylsalicylic acid (ASA), acetaminophen, and a COX-2 inhibitor
(NS-398) on the growth of cell lines of human ovarian cancer in vitro.
EXPERIMENTAL DESIGN: SK-OV-3, Caov-3, and NIH:OVCAR-3 ovarian carcinoma
cell lines were treated with ASA (10(-6) M-10(-2) M), acetaminophen
(10(-6) M-10(-2) M), and a COX-2 inhibitor (10(-6) M-10(-4) M) for 96 h.
The number of viable cells was determined using a tetrazolium conversion
assay. Immunohistochemical assessment was performed for alterations in
expression of Ki-67, erbB-2, COX enzyme, and apoptosis in primary
ovarian cancer cells using terminal deoxynucleotidyl transferase
(Tdt)-mediated nick end labeling assay. RESULTS: A decrease in cell
number compared with controls was observed for all of the cell lines
treated with ASA, acetaminophen, and COX-2 inhibitor by cell count and
tetrazolium conversion assay. A significant decrease in Ki-67 compared
with controls in the OVCAR-3 (P = 0.005) and SK-OV-3 (P = 0.007) cell
lines after treatment with the COX-2 inhibitor was observed. We observed
a decrease in mitotic activity compared with controls in each cell line
after treatment with the COX-2 inhibitor. Apoptosis was observed in
primary ovarian cancer cell culture treated with COX-2 inhibitor.
CONCLUSION: Our results suggest additional study for the use of
nonsteroidal anti-inflammatory agents, specifically COX-2 inhibitors, as
a strategy of chemoprevention for ovarian cancer.
25
UI - 11895489
AU - Attanoos RL; Webb R; Dojcinov SD; Gibbs AR
TI -
Value of mesothelial and epithelial antibodies in distinguishing diffuse
peritoneal mesothelioma in females from serous papillary carcinoma of
the ovary and peritoneum.
SO - Histopathology 2002 Mar;40(3):237-44
AD - Department of Histopathology, Llandough Hospital, Cardiff & Vale NHS
Trust, Penarth, Vale of Glamoran, UK.
AIMS: To evaluate the role of mesothelial markers (calretinin,
thrombomodulin, cytokeratin 5/6, and CD44H) and carcinoma markers
(polyclonal and monoclonal carcinoembryonic antigen, Leu-M1, CA-125 and
Ber-EP4) in distinguishing diffuse peritoneal malignant mesothelioma
from primary serous papillary adenocarcinoma of the ovary and
peritoneum. METHODS AND RESULTS: Paraffin-embedded formalin-fixed blocks
from 32 diffuse peritoneal mesotheliomas of epithelial subtype (all
females), 20 serous papillary ovarian carcinomas and three primary
peritoneal serous papillary carcinomas were studied. Calretinin and
Ber-EP4 appeared to be the best positive mesothelial and carcinoma
marker, respectively. Nuclear calretinin expression was identified in 28
of 32 malignant mesotheliomas with no nuclear immunoreactivity in the
cohorts of serous papillary ovarian and peritoneal carcinomas, thus
yielding 88% sensitivity and 100% specificity. Ber-EP4 showed 95%
sensitivity and 91% specificity for serous papillary ovarian carcinoma.
Thrombomodulin, cytokeratin 5/6 and CD44H immunoreactivities were seen
in 18 (56%), 17 (53%) and 15 (47%) of peritoneal mesotheliomas,
respectively, and in six (30%), five (25%) and five (25%) of the ovarian
tumours, respectively. None of the three primary peritoneal serous
papillary carcinomas expressed calretinin, thrombomodulin, cytokeratin
5/6 or CD44H. Polyclonal and monoclonal CEA, and Leu-M1 were expressed
by two (10%), one (5%) and seven (35%) serous papillary ovarian
carcinomas, respectively. None of the serous papillary peritoneal
carcinomas expressed polyclonal CEA, monoclonal CEA or Leu-M1. CA-125
was positive in 19 (95%) and two (67%) ovarian and peritoneal
carcinomas, respectively, and in eight (25%) peritoneal mesotheliomas.
CONCLUSIONS: Calretinin and Ber-EP4 are useful discriminant markers in
distinguishing peritoneal mesothelioma in women from serous papillary
ovarian and peritoneal carcinoma. The other mesothelial markers
(thrombomodulin, cytokeratin 5/6, and CD44H) and carcinoma markers
(polyclonal and monoclonal CEA, and Leu-M1) yielded a too low
sensitivity for practical use.
26
UI - 11906897
AU - Laking GR; Price PM
TI -
Clinical value of positron emission tomography.
SO - AJR Am J Roentgenol 2002 Apr;178(4):1030
27
UI - 11821246
AU - Ness RB; Cramer DW; Goodman MT; Kjaer SK; Mallin K; Mosgaard BJ; Purdie
TI -
DM; Risch HA; Vergona R; Wu AH
Infertility, fertility drugs, and ovarian cancer: a pooled analysis of
case-control studies.
SO - Am J Epidemiol 2002 Feb 1;155(3):217-24
AD - University of Pittsburgh School of Public Health, Pittsburgh, PA 15261,
USA. repro@vms.cis.pitt.edu
Controversy surrounds the relations among infertility, fertility drug
use, and the risk of ovarian cancer. The authors pooled interview data
on infertility and fertility drug use from eight case-control studies
conducted between 1989 and 1999 in the United States, Denmark, Canada,
and Australia. Odds ratios and 95% confidence intervals were calculated,
adjusting for age, race, family history of ovarian cancer, duration of
oral contraception use, tubal ligation, gravidity, education, and site.
Included in the analysis were 5,207 cases and 7,705 controls. Among
nulligravid women, attempts for more than 5 years to become pregnant
compared with attempts for less than 1 year increased the risk of
ovarian cancer 2.67-fold (95% confidence interval (CI): 1.91, 3.74).
Among nulliparous, subfertile women, neither any fertility drug use
(odds ratio (OR) = 1.60, 95% CI: 0.90, 2.87) nor more than 12 months of
use (OR = 1.54, 95% CI: 0.45, 5.27) was associated with ovarian cancer.
Fertility drug use in nulligravid women was associated with borderline
serous tumors (OR = 2.43, 95% CI: 1.01, 5.88) but not with any invasive
histologic subtypes. Endometriosis (OR = 1.73, 95% CI: 1.10, 2.71) and
unknown cause of infertility (OR = 1.19, 95% CI: 1.00, 1.40) increased
cancer risk. These data suggest a role for specific biologic causes of
infertility, but not for fertility drugs in overall risk for ovarian
cancer.
28
UI - 11920478
AU - Kalir T; Wang BY; Goldfischer M; Haber RS; Reder I; Demopoulos R; Cohen
TI -
CJ; Burstein DE
Immunohistochemical staining of GLUT1 in benign, borderline, and
malignant ovarian epithelia.
SO - Cancer 2002 Feb 15;94(4
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