Gynecologic Oncology

Our medical research library holds 13 studies published in Gynecologic Oncology (1975–2021). Each entry links to the study's record on PubMed and, where there is one, to the publisher's page and a free full text. 11 have an abstract, the authors' own summary as PubMed records it: open "Abstract" to read it. For 1 study PubMed has no abstract for, we give the abstract printed in the article or, where there is none, a summary we wrote from it, each labeled as such.

About the journal

• Publisher: Academic Press
• Published: 1972 to the present, United States
• Language: English
• ISSN: 0090-8258 (print), 1095-6859 (electronic)
• Its record in the NLM Catalog

2020s

• Talc, body powder, and ovarian cancer: A summary of the epidemiologic evidence. N. Wentzensen, K.M. O'Brien. 2021;163(1):199-208. Review PubMed · Publisher · Free full text

  Abstract

  Many women apply powder to the genital area as a drying agent. Talc, an inert mineral with a high capacity to absorb water, has historically been a major component of body powders. Due to its similarity and co-occurrence with asbestos, the association of body powder/talc use and gynecological cancer risk, specifically ovarian cancer risk, has been a long-standing research question. Retrospective case-control studies have shown associations between genital powder use and ovarian cancer risk, with summary relative risk estimates from meta-analyses and pooled analyses ranging from 1.24 to 1.35 for ever versus never use. In contrast, prospective cohort studies have not shown a statistically significant association until recently, when a pooled analysis of four large cohorts demonstrated a weak, but statistically significant association among women with patent reproductive tracts (hazard ratio 1.13). Taken together, the epidemiological data from case-control studies and cohort studies suggest that there may be a small, positive association between genital powder use and ovarian cancer. The causal factors underlying this association are not clear. Proposed factors include talc, other minerals, such as asbestos or quartz, that are known carcinogens and may contaminate talc products, or other powder ingredients that could cause inflammation of the reproductive tracts. Given the rarity of ovarian cancer in the general population, the small increase in relative risk translates to a very low increase in absolute risk. Further research is needed to understand the underpinnings of the observed association between genital powder use and ovarian cancer risk.

  Copyright © 2021. Published by Elsevier Inc.

2010s

• Soluble AXL is ubiquitously present in malignant serous effusions. K. Flem Karlsen, E. McFadden, V.A. Flørenes, et al. 2019;152(2):408-415. PubMed · Publisher

  Abstract

  Objective: The objective of this study was to analyze the expression level and clinical role of soluble AXL (sAXL) in cancers affecting the serosal surfaces, with focus on ovarian carcinoma.

  Methods: sAXL protein expression by ELISA was analyzed in 572 effusion supernatants, including 424 peritoneal, 147 pleural and 1 pericardial specimens.

  Results: sAXL was overexpressed in peritoneal effusions compared to pleural and pericardial specimens (p < 0.001). sAXL levels were additionally significantly higher in effusions from patients with ovarian carcinoma, malignant mesothelioma and breast carcinoma compared to specimens from patients with other cancers (predominantly carcinomas of lung, gastrointestinal or uterine corpus/cervix origin) or benign reactive effusions (p < 0.001). sAXL was further overexpressed in high-grade serous carcinoma (HGSC; n = 373) compared to low-grade serous carcinoma (LGSC; n = 32; p = 0.036). In HGSC, sAXL levels were significantly lower in post-chemotherapy effusions compared to primary diagnosis pre-chemotherapy specimens (p = 0.002). sAXL levels in HGSC were unrelated to chemoresponse at diagnosis, progression-free survival or overall survival. Levels were similarly unrelated to survival in LGSC and breast carcinoma.

  Conclusions: sAXL is widely expressed in malignant effusions, particularly in ovarian and breast carcinoma and in malignant mesothelioma. sAXL is overexpressed in HGSC compared to LGSC and its levels are lower following exposure to chemotherapy. However, sAXL levels are not informative of chemoresponse or survival.

  Copyright © 2018 Elsevier Inc. All rights reserved.

• Phase I combination study of the PARP inhibitor veliparib plus carboplatin and gemcitabine in patients with advanced ovarian cancer and other solid malignancies. H.J. Gray, K. Bell-McGuinn, G.F. Fleming, et al. 2018;148(3):507-514. PubMed · Publisher

  Abstract

  Objective: Determine the maximum tolerated dose (MTD) and recommended phase II dose (RP2D) of veliparib combined with carboplatin and gemcitabine in patients with advanced ovarian cancer and other nonhematologic malignancies.

  Methods: In this phase I study, patients with metastatic or unresectable solid tumors and ≤2 prior chemotherapy regimens received veliparib combined with carboplatin area under the curve (AUC) 4 on day 1 and gemcitabine 800mg/m2 on days 1 and 8 of a 21-day cycle for maximum 10cycles, followed by optional veliparib maintenance therapy. Veliparib dosing commenced twice-daily (BID) continuously on day 1 of cycle 2; granulocyte colony-stimulating factor was permitted. Dose escalation used a Bayesian continual reassessment method. Safety, tolerability, and efficacy were evaluated.

  Results: Seventy-five patients were enrolled (ovarian cancer, n=54; breast cancer, n=12). Thirty-six patients with ovarian cancer (67%) had known germline BRCA mutations. Most common treatment-related adverse events (TRAEs; ≥60%) were thrombocytopenia, neutropenia, nausea, and anemia. Most common grade 3/4 TRAEs (≥40%) were neutropenia and thrombocytopenia. Dose-limiting toxicities were thrombocytopenia and neutropenia. The MTD/RP2D was established at veliparib 250mg with carboplatin AUC 4 plus gemcitabine 800mg/m2. Responses were observed in 69% of patients with BRCA-deficient ovarian cancer (45% partial, 24% complete responses). Five patients remained on veliparib (80-310mg BID) for >34cycles.

  Conclusions: Veliparib plus carboplatin/gemcitabine is tolerated, with a safety profile similar to carboplatin and gemcitabine alone. Combination therapy demonstrated promising preliminary antitumor activity in platinum-sensitive ovarian cancer patients with germline BRCA mutations. Trial registration ID: NCT01063816.

  Copyright © 2018 Elsevier Inc. All rights reserved.

• Analyses of merlin/NF2 connection to FAK inhibitor responsiveness in serous ovarian cancer. N.R. Shah, I. Tancioni, K.K. Ward, et al. 2014;134(1):104-11. PubMed · Publisher · Free full text

  Abstract

  Objective: Focal adhesion kinase (FAK) is overexpressed in serous ovarian cancer. Loss of merlin, a product of the neurofibromatosis 2 tumor suppressor gene, is being evaluated as a biomarker for FAK inhibitor sensitivity in mesothelioma. Connections between merlin and FAK in ovarian cancer remain undefined.

  Methods: Nine human and two murine ovarian cancer cell lines were analyzed for growth in the presence of a small molecule FAK inhibitor (PF-271, also termed VS-6062) from 0.1 to 1 μM for 72 h. Merlin was evaluated by immunoblotting and immunostaining of a human ovarian tumor tissue array. Growth of cells was analyzed in an orthotopic tumor model and evaluated in vitro after stable shRNA-mediated merlin knockdown.

  Results: Greater than 50% inhibition of OVCAR8, HEY, and ID8-IP ovarian carcinoma cell growth occurred with 0.1 μM PF-271 in anchorage-independent (p<0.001) but not in adherent culture conditions. PF-271-mediated reduction in FAK Y397 phosphorylation occurred independently of growth inhibition. Suspended growth of OVCAR3, OVCAR10, IGROV1, IGROV1-IP, SKOV3, SKOV3-IP, A2780, and 5009-MOVCAR was not affected by 0.1 μM PF-271. Merlin expression did not correlate with serous ovarian tumor grade or stage. PF-271 (30 mg/kg, BID) did not inhibit 5009-MOVCAR tumor growth and merlin knockdown in SKOV3-IP and OVCAR10 cells did not alter suspended cell growth upon PF-271 addition.

  Conclusions: Differential responsiveness to FAK inhibitor treatment was observed. Intrinsic low merlin protein level correlated with PF-271-mediated anchorage-independent growth inhibition, but reduction in merlin expression did not induce sensitivity to FAK inhibition. Merlin levels may be useful for patient stratification in FAK inhibitor trials.

  Copyright © 2014 Elsevier Inc. All rights reserved.

• Pre-diagnostic serum levels of inflammation markers and risk of ovarian cancer in the prostate, lung, colorectal and ovarian cancer (PLCO) screening trial. B. Trabert, L. Pinto, P. Hartge, et al. 2014;135(2):297-304. PubMed · Publisher · Free full text

  Abstract

  Objective: Pro-inflammatory mechanisms may explain the increased ovarian cancer risk linked to more lifetime ovulations, endometriosis, and exposure to talc and asbestos, as well as decreased risk with non-steroidal anti-inflammatory drugs. Limited data are available to estimate ovarian cancer risk associated with levels of circulating inflammatory markers.

  Methods: We conducted a nested case-control study within the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Pre-diagnostic serum levels of 46 inflammation-related biomarkers (11 with a priori hypotheses; 35 agnostic) were measured in 149 incident ovarian cancer cases and 149 matched controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using conditional logistic regression and adjusted for identified covariates.

  Results: Increased ovarian cancer risk was associated with elevated levels of C-reactive protein (CRP) [tertile (T)3 vs. T1: OR (95% CI) 2.04 (1.06-3.93), p-trend=0.03], interleukin (IL)-1α [detectable vs. undetectable: 2.23 (1.14-4.34)] and tumor necrosis factor alpha (TNF-α) [T3 vs. T1: 2.21 (1.06-4.63), p-trend=0.04]. Elevated IL-8 was non-significantly associated with risk [T3 vs. T1: 1.86 (0.96-3.61), p-trend=0.05]. In analyses restricted to serous ovarian cancer (n=83), the associations with CRP and IL-8 remained or strengthened [CRP T3 vs. T1: 3.96 (1.14-11.14), p-trend=0.008; IL-8 T3 vs. T1: 3.05 (1.09-8.51), p-trend=0.03]. Elevated levels of CRP and TNF-α remained positively associated with ovarian cancer risk in analysis restricted to specimens collected at least 5years before diagnosis (n=56).

  Conclusion: These results suggest that CRP, IL-1α, IL-8, and TNF-α are associated with increased risk of subsequently developing ovarian cancer.

  Published by Elsevier Inc.

• Ovarian surface epithelium as a source of ovarian cancers: unwarranted speculation or evidence-based hypothesis?. N. Auersperg. 2013;130(1):246-51. Review PubMed · Publisher

  Abstract

  Objectives: There has been increasing evidence that high grade serous ovarian carcinomas (HGSOCs), the most common and most lethal of all ovarian cancers, originate in oviductal fimbriae and metastasize to the ovary. The alternate hypothesis, that ovarian carcinomas may originate within the ovarian stroma in inclusion cysts lined by ovarian surface epithelium (OSE), has been criticized and often dismissed on the basis of the OSE's embryonic origin, mesothelial phenotype, tissue-specific markers, questionable ability to undergo metaplasia, and the lack of identifiable precursor lesions. This review analyzes these criticisms and summarizes evidence indicating that OSE as a source of ovarian cancers cannot be ruled out.

  Methods: The literature was reviewed and representative reports were chosen to evaluate the current criticisms of, and evidence in favor of, the OSE hypothesis.

  Results: The close developmental relationship between the oviduct and OSE, both of which originate in the mesothelial coelomic epithelium, accounts for their capacity to produce similar tumors. Histopathologic and experimental data show that OSE does undergo serous metaplasia, and that transformation of pure OSE cultures produces aggressive neoplasms resembling high- and low-grade serous carcinomas, but never mesotheliomas. There is evidence of premalignant changes (e.g. p53 inactivation) in morphologically normal OSE and of rare but definitive dysplastic and early preinvasive lesions in OSE-lined inclusion cysts. Conclusions based on tissue-specific markers to identify origins of inclusion cysts usually disregard the changes in differentiation occurring when OSE is displaced to the stroma. Lastly, an explanation is offered for the rare detection of precursor lesions in OSE-lined cysts, based on the likelihood that the duration from initiation of malignant transformation to invasive growth is minimal and thus difficult to detect.

  Conclusion: The likelihood that HGSOCs originate both in fimbriae and in OSE should be considered in clinical decisions involving choices between prophylactic salpingo-oophorectomies and salpingectomies.

  Copyright © 2013 Elsevier Inc. All rights reserved.

2000s

• Case report: malignant peritoneal mesothelioma in two siblings. A.H. Picklesimer, V. Zanagnolo, T.H. Niemann, et al. 2005;99(2):512-6. Case report PubMed · Publisher

  Abstract

  Background: Mesothelioma is a rare tumor, linked with occupational asbestos exposure. This association has been used to explain clustering of cases within families. Newer evidence, however, supports a possible genetic predisposition for this tumor.

  Case: Our patient's brother was diagnosed with advanced stage malignant peritoneal mesothelioma in August 1995 at age of 42, he underwent tumor-reductive surgery followed by chemotherapy. He underwent a repeat cytoreductive surgery in September 1996 and further chemotherapy. He died of disease in December 1996. Our patient underwent cytoreductive surgery in May 1999 at age of 49 for advanced stage malignant peritoneal mesothelioma with suboptimal debulking. She received multiple chemotherapy regimens, including most recently experimental targeted agents, for slow progressing disease. She is presently alive with clinical disease 6 years from diagnosis.

  Conclusion: This is the first report of two siblings of different gender with malignant peritoneal mesothelioma and only average environmental asbestos exposure. It is highly likely that the family described in this case report has some form of inherited susceptibility to malignancy cancer gene, HLA type, or tumor suppressor gene mutation.

• Well-differentiated papillary mesothelioma of the peritoneum: a pathological analysis and review of the literature. A.V. Hoekstra, M.W. Riben, M. Frumovitz, et al. 2005;98(1):161-7. Case report · Review PubMed · Publisher

  Abstract

  Background: Well-differentiated papillary mesothelioma (WDPM) of the peritoneum is a rare subtype of peritoneal epithelioid mesothelioma which typically has low malignant potential. It most commonly occurs in young women lacking a history of asbestos exposure. Only 38 female patients with peritoneal WPDM have been reported in the literature, and no uniform treatment recommendation has been established.

  Case Report: A 74-year-old asymptomatic woman without significant past medical history underwent workup and subsequent surgery for an adnexal mass with a normal serum CA-125 level. Exploratory laparotomy identified an ovarian serous cystadenoma and an incidental multifocal peritoneal neoplasm with extensive calcifications. Histology and cytology confirmed WDPM with extensive, intimately associated mesothelial cystic inclusions and zonal calcifications with osseous metaplasia. Our patient did not receive adjuvant therapy and was without clinical or radiologic evidence of disease 12 months after diagnosis.

  Conclusion: WDPM of the peritoneum in women is frequently asymptomatic and associated with an indolent course. Patient outcomes are usually favorable after tumor-debulking surgery without adjuvant therapy.

1990s

• The antiestrogen tamoxifen in the treatment of recurrent benign cystic mesothelioma. G.S. Letterie, J.L. Yon. 1998;70(1):131-3. Case report PubMed · Publisher

  Abstract

  Benign cystic mesothelioma is a tumor characteristically found in women during the reproductive years. These tumors are infrequently found after castration or menopause, suggesting some degree of hormonal sensitivity. Such aspects of the tumor suggest a potential role for antiestrogens as medical management and an alternative to radical surgery. We treated a 19-year-old woman with a symptomatic pelvic mass secondary to a recurrent benign cystic mesothelioma 2 years after radical surgery with the antiestrogen tamoxifen. An initial reduction in volume and arrest of growth was followed by stabilization in size and disappearance of symptoms. Therapy was continued for 18 months with no change in the volume of the cystic structure. The patient continued to be asymptomatic. Periodic surveillance with quantitative digital radiography for bone density showed no change in bone mineral density. Serum testing for liver function studies was normal throughout treatment. This case suggests that antiestrogens may have a role in the medical management of these rare estrogen-dependent neoplasms. The initial reduction in size and arrest in growth further suggest extreme sensitivity of this tumor to manipulation of the hormonal milieu. Therapy with the antiestrogen tamoxifen in this setting may provide an option for long-term medical management in cases of symptomatic recurrent cystic mesotheliomas.

• An autopsy case of serous papillary carcinoma of peritoneum with distant metastases but no peritoneal dissemination. O. Miyaishi, K. Iida, S. Saga, et al. 1994;55(3 Pt 1):448-52. Case report PubMed · Publisher

  Abstract

  A case of a 61-year-old woman who had a serous papillary carcinoma of probable peritoneal or surface ovarian origin, which formed a single tumor mass in the pelvis but did not metastasize throughout the abdominal cavity but only to the pleura and then the hilar lymph nodes over a protracted period lasting more than 7 years, is reported. This unusually behaving tumor was well differentiated and at least partially responded to therapy, as witnessed by its histologic appearance at autopsy. This type of neoplasm usually shows diffuse peritoneal dissemination and no distant metastasis.

1980s

• Peritoneal papillary carcinoma. S.B. Lele, M.S. Piver, J. Matharu, et al. 1988;31(2):315-20. Review PubMed · Publisher

  Abstract

  Between 1977 and 1986, 325 patients with a diagnosis of ovarian carcinoma, peritoneal cancer, or malignant mesothelioma were reviewed with identification of 23 patients (7%) having peritoneal papillary cancer. Only 2 patients had disease confined to the pelvis and the rest had widespread abdominal disease. Various combination chemotherapeutic agents were used with over a 65% response rate to first-line chemotherapy. Twenty of the 23 patients received cisplatin combination chemotherapy with an overall response rate of 65%.

1970s

• Soft tissue sarcomas of vulva. I. Davos, M.R. Abell. 1976;4(1):70-86. PubMed · Publisher

  Abstract

  Fifteen cases of vulvar sarcomas were studied. The most common neoplasm was leiomyosarcoma, which also had the least favorable prognosis with a tendency to develop local recurrences and disseminated hematogenous metastases. The second most frequent sarcoma belonged to the fibrous histiocytoma group. Although they are unpredictable, they tended to be less aggressive than the leiomyosarcomas. Other sarcomas encountered were fibrosarcoma, hemangiosarcoma, malignant hemangiopericytoma, epithelioid sarcoma, neurogenous sarcoma, malignant mesothelioma, and embryonal stromal sarcoma. Local recurrences were common in the series due in part to inadequate initial treatment. It was evident from the study that wide local excision or radical vulvectomy early in the disease with bilateral lymph node resection for those sarcomas that have a potential for lymphogenous metastases is the treatment of choice and gives the most favorable results. In the presence of local recurrences, aggressive surgical treatment is indicated and increases the survival rate significantly.

  PubMed has no abstract for this study. This is the authors' abstract, copied from the article.

• Mesothelioma of the abdomen in women. Monitoring of therapy by peritoneal fluid study. L. McGowan, B. Bunnag, L.F. Arias. 1975;3(1):10-4. PubMed · Publisher

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