National Cancer Institute®
Last Modified: April 1, 2002
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.
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. firstname.lastname@example.org
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.
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.
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. email@example.com
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.
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. firstname.lastname@example.org
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.
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
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
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
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.
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. email@example.com
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
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. firstname.lastname@example.org
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.
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. email@example.com
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.
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.
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. firstname.lastname@example.org
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.
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. email@example.com
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. firstname.lastname@example.org
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.
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. email@example.com
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.
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.
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. firstname.lastname@example.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.
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
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.
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.
UI - 11006746
AU - Trope C
TI - [Ovarian cancer screening of high risk groups]
SO - Tidsskr Nor Laegeforen 2000 Aug 10;120(18):2191
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.
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.
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. email@example.com
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.
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