open access: The epidemiologic status of gynecologic cancer in Thailand

JGO :: Journal of Gynecologic Oncology
 
 Fig. 1.
Top ten cancers in Thailand (female) (estimated), 2011 [4].

2. Ovarian cancer

The mean ovarian cancer incidence per annum is 6.0 per 100,000 females in 2011. Bangkok, Lamphun and Krabi province had the highest number of incidence comparing to other provinces (ASR=7.3), while the Northeastern region had the lowest number of new cases of ovarian cancer (ASR=4.4). The incidence of ovarian cancer increased from the age of 55 years onward. This shows that there is a later onset of the cancer compared to 1999 where the peak incidence was in the age group 40–65 [2]. The incidence can occur since very young age. Interestingly, the most common histological types of ovarian cancer in 2011 were serous carcinoma followed by mucinous carcinoma and endometrioid carcinoma. This showed a larger variation from the data in 1999 as the two most prevalent histological types were serous and mucinous cystadenocarcinoma [2]. The most common stage of ovarian cancer was local, followed by regional stage.

open access: (review) Major clinical research advances in gynecologic cancer in 2015

JGO :: Journal of Gynecologic Oncology
 J Gynecol Oncol. 2016 Oct;27
In 2015, fourteen topics were selected as major research advances in gynecologic oncology. For ovarian cancer, high-level evidence for annual screening with multimodal strategy which could reduce ovarian cancer deaths was reported. The best preventive strategies with current status of evidence level were also summarized. Final report of chemotherapy or upfront surgery (CHORUS) trial of neoadjuvant chemotherapy in advanced stage ovarian cancer and individualized therapy based on gene characteristics followed. There was no sign of abating in great interest in immunotherapy as well as targeted therapies in various gynecologic cancers. The fifth ovarian cancer consensus conference which was held in November 7–9 in Tokyo was briefly introduced..... 

Table 1. Fourteen topics of major clinical research advances in gynecologic cancer in 2015

Site of cancer Topic Reference Ovary 1. Prevention and screening of ovarian cancer [2, 4, 5, 12] 2. Update of neoadjuvant chemotherapy in ovarian cancer: right therapy to right person [15] 3. Personalized therapy for the best possible chance of survival in ovarian cancer [21, 22, 23, 24] 4. Fifth Ovarian Cancer Consensus Conference in Tokyo 5. Immunotherapy update: anti-PD-1/PD-L1 antibody in ovarian cancer [25, 26] Uterine cervix 6. HPV vaccine update: two dose, 9-valent, therapeutic vaccine [28, 36, 42] Uterine corpus 7. Old age as a reason for abandoning power morcellation in presumed fibroids [43, 44, 45] 8. Hormone therapies and endometrial cancer risk [48, 49] 9. Trabectedin: another FDA-approved option for leiomyosarcoma [56] 10. Endometrial cancer and Lynch syndrome [58, 59] 11. Radiation therapy in endometrial cancer: ESMO-ESGO-ESTRO consensus conference guidelines [63, 64, 65] Others 12. Vulvar cancer adjuvant therapy [71] 13. Targeted therapy update in gynecologic cancer 1) Update of anti-angiogenic drugs in ovarian cancer [74, 75, 76] 2) Other promising targeting agents in ovarian cancer [81, 82, 84, 85] 3) Update of targeted therapy in cervical and endometrial cancer [88, 90, 91] Female breast 14. Breast cancer 1) Palbociclib in hormone-receptor-positive advanced breast cancer [93] 2) Oncotype DX Recurrence Score in low-risk breast cancer [97] 3) Regional nodal irradiation to internal mammary, supraclavicular, and axillary lymph nodes in breast cancer [98, 99] 4) Cavity shave margins in breast cancer [100]

ESGO, European Society of Gynecologic Oncology; ESMO, European Society of Medical Oncology; ESTRO, European Society for Radiotherapy and Oncology; FDA, the Food and Drug Administration; HPV, human papillomavirus; PD-1, programmed cell death protein-1; PD-L1, programmed cell death protein-ligand 1.

triage - definition (s) in practice or theory?

triage 

  tri·age trēˈäZH,ˈtrēˌäZH/

noun noun: triage

1. 1.

   (in medical use) the assignment of degrees of urgency to wounds or illnesses to decide the order of treatment of a large number of patients or casualties.

   • the process of determining the most important people or things from amongst a large number that require attention.

verb

verb: triage; 3rd person present: triages; past tense: triaged; past participle: triaged; gerund or present participle: triaging

1. 1.

   assign degrees of urgency to (wounded or ill patients).

New: Ovarian Cancer Research Fund Alliance + notice of 2017 conference

Ovarian Cancer Research Fund Alliance

 link to:

Associations of Premenopausal Hysterectomy and Oophorectomy With Breast Cancer Among Black and White Women (North Carolina)

Medscape
 Associations of Premenopausal Hysterectomy and Oophorectomy With Breast Cancer Among Black and White Women: The Carolina Breast Cancer Study, 1993–2001

 In the present study, our objective was to assess the association between premenopausal gynecologic surgeries and risk of breast cancer in a population-representative sample of black and white women living in the US South, a region in which hysterectomy rates are particularly high.^[1,13,21] We examined whether associations differed by race, breast cancer hormone-receptor status, or use of MHT.

  In summary, this research adds further evidence that premenopausal hysterectomy and oophorectomy may reduce the long-term risk of breast cancer. Further, the higher prevalence of premenopausal surgery among black women indicates that these surgeries could be an important contributor to race-specific trends in breast cancer incidence. Historically higher rates of premenopausal hysterectomy and oophorectomy may have transiently lowered breast cancer rates among black women. As hysterectomy rates decline, breast cancer incidence may increase among older black women and in the US South, a trend that has been observed in recent surveillance.^[34,37] Monitoring the long-term effects of changing clinical practice in gynecologic surgery may inform strategies to mitigate the growing breast cancer burden among US black women.

Review: Early Detection of Ovarian Cancer with Transvaginal Microbubble Sonography: Current and Potential Applications

pdf open access

Abstract
Contrast Enhanced microbubble Transvaginal Sonography (CE-TVS) can distinguish benign and malignant ovarian tumors. Initial results from several medical centers around the world have indicated that there are unique enhancement patterns in ovarian neoplasms. Challenges to the implementation of CE-TVS remain since some
aggressive ovarian tumors (type 2) that arise in the tubal epithelium and metastasize without producing a clinically detectable mass may be difficult to detect. This is being addressed through the use of labelled microbubbles which
can detect rapidly growing tumor vessels. As shown in an avian model, labelled microbubbles can be used to detect neoplastic vessels associated with tumor neoangiogenesis. This has been achieved in vitro by fabrication of microbubbles that have antibody attached to the lipid coat. In this manner, microscopic tumors that arise in the tubal epithelium might be detected in patients. This short communication describes the potential for contrast enhanced sonography to provide a means for early detection of ovarian cancer.

Summary
Whether the addition of CE-TVS in screening/early detection
programs could further the long-term survival of screened women
awaits further investigation. With that said, CE-US is probably best
suited as a secondary test after a "liquid biopsy" and/or an initial
morphologic assessment of the lesion with standard morphologic TVS
identifies women at risk. The basis for optimism concerning the use of
CE-TVS for the early detection of ovarian cancer is substantiated and
this author encourages further multicenter investigation.