Monday, December 15, 2014
(Lynch Syndrome etc) ASCO CPG Endorsement of the Familial Risk–Colorectal Cancer: ESMO CPG
open access
Hereditary Colorectal Cancer Syndromes: American Society of Clinical Oncology Clinical Practice Guideline Endorsement of the Familial Risk–Colorectal Cancer: European Society for Medical Oncology Clinical Practice Guidelines
Lynch syndrome
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Colon and rectum: Colonoscopy every 1 to 2 years, starting at age 20 to 25 or 5 years before the youngest case in the family. No upper limit is established.
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Endometrium and ovary: Gynecological examination, pelvic ultrasound (not CA-125), and aspiration biopsy every year, from age 30 to 35 years. Consider prophylactic hysterectomy and salpingoophorectomy when childbearing is completed.
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Gastric cancer: For gastric cancer, the search for the presence of Helicobacter pylori and subsequent eradication is recommended in mutation carriers. In case of a high incidence of gastric cancer in some populations, some experts recommend upper GI endoscopy every 1 to 3 years.
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Other Lynch-associated cancers: Surveillance is not recommended due to the low sensitivity and specificity. (Although there are insufficient data supporting surveillance for other target organs, it may be considered in the context of family history.)....... Unlike CRC, data to support the effectiveness of transvaginal ultrasound and endometrial biopsy for gynecologic surveillance are lacking, and only surgical removal of the uterus and ovaries (fallopian tubes???) has been shown to reduce incidence of endometrial and ovarian cancers.10 Individuals with LS also have an elevated risk of developing other cancers, specifically tumors of the urinary tract (lifetime risk, 5% to 12%), small intestine, ovary (lifetime risk, 4% to 12%), stomach (lifetime risk, 8% to 10%), pancreas (lifetime risk, 4%), biliary tract, brain, and skin.11,12 Comparisons of phenotype according to MMR gene mutation have shown that MLH1-mutation carriers tend to develop CRC at younger ages, whereas MSH2 carriers seem to be at higher risk for extracolonic cancers, and for women with MSH6 mutations, the risk for endometrial cancer may surpass the lifetime CRC risk.13–15 In contrast, the risks for CRC and endometrial cancer seem to be lower among individuals with mutations in PMS2 (15% to 20%) compared with carriers of other MMR gene mutations.16........
Saturday, December 13, 2014
Commentary on ‘Performance of ultrasound as a second line test to serum CA125 in ovarian cancer screening’
Commentary - open access
Conclusions
Thursday, December 11, 2014
Enhanced recovery pathways in gynecologic oncology
abstract
Highlights
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- Enhanced Recovery Pathways (ERP) are safe for patients undergoing complex gynecologic oncology operations, including colonic resection.
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- Incorporation of a comprehensive ERP is associated with reduced length of stay, excellent patient satisfaction, and lower costs.
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- Successful implementation of ERP requires standardization and cooperation within the care team.
Abstract
Objective
Methods
Results
Conclusion
Old drug, new trick: Repurposing metformin for gynecologic cancers?
abstract
Highlights
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- We summarize the molecular mechanisms of action mediating metformin's protective effect in cancer.
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- Review the preclinical and epidemiological evidences for metformin's potential role in gynecological cancers.
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- Description of ongoing prospective testing of metformin in gynecologic cancers and future directions.
Abstract
Objective
Methods
Results
Conclusions
Combining clinical assessment and the Risk of Ovarian Malignancy Algorithm for the prediction of ovarian cancer
abstract
Objectives
Methods
Results
Conclusions
CA125 kinetic parameters predict optimal cytoreduction in patients with advanced epithelial ovarian cancer treated with neoadjuvant chemotherapy
CA125
Highlights
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- This paper aims at determining the optimal CA125 cut-off value to accurately predict complete cytoreduction after NAC.
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- A CA125 level < 75 UI/ml after the 3rd NAC was an independent predictor factor for complete surgery.
Abstract
Objective
Methods
Results
Conclusion
Chemotherapy-induced peripheral neuropathy and its impact on health-related quality of life among ovarian cancer survivors PROFILES registry
abstract
Highlights
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- Neuropathy symptoms were experienced by 51% of women with ovarian cancer, especially tingling hands/feet and numbness in fingers/toes.
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- Even up to 12 years after the end of treatment some women experience neuropathy symptoms.
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- Neuropathy was associated with worse functioning, overall HRQoL, pain and insomnia.
Abstract
Objective
Methods
Results
Conclusion
Prognostic value of lymph node ratio in patients with advanced epithelial ovarian cancer
abstract
Highlights
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- Lymph node status is a prognostic factor in ovarian cancer.
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- Lymph node ratio reflects lymph node spread and surgical extent.
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- Lymph node ratio predicts overall survival more concisely.
Abstract
Objective
Methods
Results
Conclusion
Laparoscopic staging of apparent early stage ovarian cancer: Results of a large, retrospective, multi-institutional series
abstract
Highlights
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- Stage of disease is still the most important prognostic factor in early ovarian cancer.
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- Among early ovarian cancer patients there is a non-negligible percentage of upstaged patients.
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- A complete and accurate surgical staging can be safely achieved through laparoscopic surgery, when performed in referral centers.
Abstract
Objective
Patients and methods
Results
Conclusion
Endometriosis and ovarian cancer - World Journal of Clinical Oncology
open access
..........In addition, we know about the possible links between endometriosis and cancer for almost 100 years. Despite clear evidence revealing that endometriosis increases ovarian cancer risks, it is possible that it may not affect disease progression after the appearance of ovarian cancer. However, despite clear evidence revealing that endometriosis increases ovarian cancer risk, our knowledge of the risk factors is far from established. In our review, we focused on the most recent approaches including possible biomarkers and genetic approaches....
Enteroenterostomy - emedicine
emedicine
Background
Tuesday, December 09, 2014
New Downloadable Slides: Adding Precision and Power to Progress in Ovarian Cancer Management
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Subject: New Downloadable Slides: Adding Precision and Power to Progress in Ovarian Cancer Management
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Longwoods eLetter December 9, 2014 | If We Had a Magic Wand
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Saturday, November 29, 2014
Estrogen Biosynthesis and Action in Ovarian Cancer | Experimental Endocrinology
open access
The review explains the role of estrogen in ovarian cancer and it gives an overview on ovarian cancer subtypes. Furthermore, enzymes active to synthesize and metabolize estrogens as well as estrogen signaling pathways are described. Strategies to target these pathways are discussed.
Training randomized trial recruiters to facilitate recruitment and informed consent by exploring patients' treatment preferences
Full text
........Several previous studies have tended to assume that patients’ treatment preferences are simple and static entities that can be easily defined and measured [4,10]. However, there is also a small body of research that shows that preferences are complex, multifaceted, and changeable entities that can be based on incomplete or inaccurate information [11-16]. .....
Friday, November 28, 2014
Up-to-dateness of reviews is often neglected in overviews: a systematic review
open access
1. Introduction
Key findings
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- The mean publication lag per review was more than 5 years.
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- Only one in four overviews considered up-to-dateness.
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- No overview systematically investigated whether an update was necessary.
What this adds to what was known?
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- This is the first systematic analysis of up-to-dateness in overviews.
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- We developed recommendations to produce up-to-date overviews.
What is the implication and what should change now?
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- Authors should analyze whether the underlying evidence of systematic reviews (SRs) is still up-to-date when conducting overviews.
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- Authors should search for primary studies not included in SRs, if needed
New concepts of biomarkers and clinical outcomes for therapeutic cancer vaccines in clinical trials, Immunotherapy
abstract
Aim: This study aimed to derive meaningful parameters for immune monitoring during cancer vaccine development by analysis of the literature.
Methods: This retrospective study was based on analysis of clinical trials registered at ClinicalTrials.gov and published data available on PubMed.
Results: The most common sample evaluated in immune monitoring was peripheral blood. All trials employed ELISA for detecting a humoral immune response; however, cellular immune assays were not used across trials. Most cellular immune assays failed to correlate with clinical outcome, although results of other methods did. Conclusion: Standardization of the cellular immune assays across trials is important for predicting the effects of therapeutic cancer vaccines when considering the reliability and characteristics of the methods. Currently, assays mostly target detection of T-cell function, such as proliferation and cytokine release; however, T-cell phenotype analysis in peripheral blood and/or tumor sites may also be considered in the future.
Wednesday, November 26, 2014
Prognostic Significance of Sugarbaker's Peritoneal Cancer Index for the operability of ovarian carcinoma
abstract
INTRODUCTION:
This study aimed to investigate Sugarbaker's peritoneal cancer index (PCI) as a prognostic indicator for the resectability of ovarian carcinoma (OC), as depicted in the study using the completeness of cytoreduction score (CCS).Currently, the intraoperative assessment of operability in OC surgery is primarily a subjective measurement that is dependent on the surgeon.METHODS:
The retrospective data from 98 patients with OC International Federation of Gynecology and Obstetrics (FIGO) III to IV who had received surgery between January 2010 and December 2011 were analyzed. The PCI and the CCS were determined retrospectively using surgical reports, histological findings, and intraoperative photographic documentation. Receiver operating characteristic curves and ordinal regression were applied to evaluate the predictability of CCS using the PCI.RESULTS:
Of 98 patients, 80 (81.6%) were staged FIGO III and 18 (18.4%) FIGO IV. A statistically significant correlation was demonstrated between the PCI and CCS (P < 0.01).......CONCLUSIONS:
The PCI more precisely defined the heterogeneous group of patients with OC FIGO III. The PCI provided objectivity and reproducibility, and it seems to be a possible prognostic indicator for OC resectability.worth reading: Looking For Light in a Dark Room - note references to YAC/clinical trials/Canada....
Cancer Knowledge Network
.....The AIDS movement, which changed the fates of thousands of dying people was not built from positive thinking. Change happened because people were angry. Access to drugs came about because people stood up and said “this is not acceptable”. It is not acceptable that those of us with advanced disease cannot access the drugs we need because of bureaucracy and the screwed up drug trial system. It is not acceptable that many provinces do not cover drugs like oral chemo. It is not acceptable that as an act to save our lives some of us have to go out of country to access up and coming drug trials. It is not acceptable that we are dying. Empowerment and positive thinking is important but so is addressing the dark side of cancer. Young adult organizations need to decide whether or not they will take a stand with those of us who are dying and living chronically. They need to explore how they can contribute to the empowerment of those of us who cannot get past our cancer experience. They need to help end isolation and take affirmative action towards change.
Genetics of Skin Cancer (references to BRCA (BAP1) and BRCA2
National Cancer Institute
BRCA-Associated Protein 1 (BAP1) BRCA-associated protein 1 (BAP1) has recently emerged as a gene implicated both in sporadic and hereditary melanomas......
BRCA2
Google and Women's Health-Related Issues: What Does the Search Engine Data Reveal?
abstract
pdf (requires registration - free - to view full text)
OBJECTIVES:
Identifying the gaps in public knowledge of women's health related issues has always been difficult. With the increasing number of Internet users in the United States, we sought to use the Internet as a tool to help us identify such gaps and to estimate women's most prevalent health concerns by examining commonly searched health-related keywords in Google search engine.METHODS:
We collected a large pool of possible search keywords from two independent practicing obstetrician/gynecologists and classified them into five main categories (obstetrics, gynecology, infertility, urogynecology/menopause and oncology), and measured the monthly average search volume within the United States for each keyword with all its possible combinations using Google AdWords tool.RESULTS:
We found that pregnancy related keywords were less frequently searched in general compared to other categories with an average of 145,400 hits per month for the top twenty keywords. Among the most common pregnancy-related keywords was "pregnancy and sex' while pregnancy-related diseases were uncommonly searched. HPV alone was searched 305,400 times per month. Of the cancers affecting women, breast cancer was the most commonly searched with an average of 247,190 times per month, followed by cervical cancer then ovarian cancer.CONCLUSION:
The commonly searched keywords are often issues that are not discussed in our daily practice as well as in public health messages. The search volume is relatively related to disease prevalence with the exception of ovarian cancer which could signify a public fear.Amgen Ends Gastric Cancer Drug Studies on Safety Review - Amgen/Trebananib/ovarian
Analyst Blog
....We note that Amgen stumbled with its oncology pipeline earlier this month as well when its experimental ovarian cancer treatment, trebananib, failed to meet the secondary endpoint of overall survival in a late-stage study. Although trebananib had achieved the primary endpoint of the study, overall survival is an important criterion for gaining FDA approval. Moreover, the rate of discontinuation due to adverse events was much higher in the trebananib arm compared to the control arm (20% versus 7%).....
Tuesday, November 25, 2014
On vitamin D, the so-called experts have it wrong, U.K. researcher says (re: the Lancet)
media
.....However, The Lancet, the world’s best-known medical journal, recently suggested in an editorial that most of the benefits of vitamin D advanced by scientific studies are a “myth.” It says people tend to have low vitamin D when they are ill because they do not go outdoors very much.
Most of The Lancet’s trials have used low doses of vitamin DThis was also the view presented in papers published in The Lancet by two teams, Philippe Autier of the International Prevention Research Institute, Lyon, and Mark Bolland of the Department of Medicine, University of Auckland.
They argue that clinical trials of vitamin D have failed to show any clear benefit. However, most of the trials have used low doses of the vitamin. Professor Michael Holick, pioneer of vitamin D research at Boston University, says 4,000 units per day is required to give an optimum level of the vitamin in the blood, enough to prevent disease. A number of clinical trials relied on by The Lancet editorial and its authors used a daily dose of just 400 units.....
Blurring of boundaries in the doctor–patient relationship : The Lancet Oncology
Note: too bad open access is not available on this one
extract only