DOCSLIB.ORG

Data Set for Reporting of Ovary, Fallopian Tube and Primary

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Data Set for Reporting of Ovary, Fallopian Tube and Primary Modern Pathology (2015) 28, 1101–1122 © 2015 USCAP, Inc All rights reserved 0893-3952/15 $32.00 1101 Data set for reporting of ovary, fallopian tube and primary peritoneal carcinoma: recommendations from the International Collaboration on Cancer Reporting (ICCR) W Glenn McCluggage1,15, Meagan J Judge2, Blaise A Clarke3, Ben Davidson4,5, C Blake Gilks6, Harry Hollema7, Jonathan A Ledermann8, Xavier Matias-Guiu9, Yoshiki Mikami10, Colin JR Stewart11,12, Russell Vang13 and Lynn Hirschowitz14,16 1Department of Pathology, Belfast Health and Social Care Trust, Belfast, UK; 2Royal College of Pathologists of Australasia, Sydney, NSW, Australia; 3Department of Pathology and Laboratory Medicine, University Health Network, University of Toronto, Toronto, ON, Canada; 4Department of Pathology, Oslo University Hospital, Norwegian Radium Hospital, Oslo, Norway; 5Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; 6Department of Pathology, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada; 7Department of Pathology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; 8Department of Oncology, UCL Cancer Institute, London, UK; 9Department of Pathology and Molecular Genetics and Research Laboratory, Hospital Universitari Arnau de Vilanova, University of Lleida, IRBLleida, Lleida, Spain; 10Department of Diagnostic Pathology, Kumamoto University Hospital, Kumamoto, Japan; 11Department of Histopathology, King Edward Memorial Hospital, Perth, WA, Australia; 12School for Women's and Infant's Health, University of Western Australia, Crawley, WA, Australia; 13Department of Pathology (Division of Gynecologic Pathology), The Johns Hopkins University School of Medicine, Baltimore, MD, USA and 14Department of Cellular Pathology, Birmingham Women’s Hospital, Birmingham, UK A comprehensive pathological report is essential for optimal patient management, cancer staging and prognostication. In many countries, proforma reports are used but these vary in their content. The International Collaboration on Cancer Reporting (ICCR) is an alliance formed by the Royal College of Pathologists of Australasia, the Royal College of Pathologists of the United Kingdom, the College of American Pathologists, the Canadian Partnership Against Cancer and the European Society of Pathology, with the aim of developing an evidence-based reporting data set for each cancer site. This will reduce the global burden of cancer data set development and reduplication of effort by different international institutions that commission, publish and maintain standardised cancer reporting data sets. The resultant standardisation of cancer reporting will benefit not only those countries directly involved in the collaboration but also others not in a position to develop their own data sets. We describe the development of a cancer data set by the ICCR expert panel for the reporting of primary ovarian, fallopian tube and peritoneal carcinoma and present the ‘required’ and ‘recommended’ elements to be included in the report with an explanatory commentary. This data set encompasses the recent International Federation of Obstetricians and Gynaecologists staging system for these neoplasms and the updated World Health Organisation Classification of Tumours of the Female Reproductive Organs. The data set also addresses issues about site assignment of the primary tumour in high-grade serous carcinomas and proposes a scoring system for the assessment of tumour response to neoadjuvant chemotherapy. The widespread implementation of this data set will facilitate consistent and accurate data collection, comparison of epidemiological and pathological parameters between different populations, facilitate research and hopefully will result in improved patient management. Modern Pathology (2015) 28, 1101–1122; doi:10.1038/modpathol.2015.77; published online 19 June 2015 Correspondence: Professor WG McCluggage, FRCPath, Department of Pathology, Royal Group of Hospitals Trust, Grosvenor Road, Belfast BT12 6BA, Northern Ireland. E-mail: [email protected] 15Chair of the ICCR Ovarian/Fallopian tube and Primary Peritoneal Site Cancer Panel. 16The ICCR Steering Group Representative. Received 13 January 2015; revised 24 February 2015; accepted 25 February 2015; published online 19 June 2015 www.modernpathology.org Ovary, tube and primary peritoneal data set 1102 WG McCluggage et al The Colleges of American, Australasian and United of standardised data sets is to ensure that histo- Kingdom Pathologists and the Canadian Partnership pathology reports include all relevant information Against Cancer formed the International Collabora- (based on current knowledge) and present it in a tion on Cancer Reporting (ICCR) in 2011 to reduce consistent, concise format that conforms to interna- the global burden of cancer data set development tional standards. Although much of the content of and reduplication of effort by different international the independently developed cancer reporting pro- institutions that commission, publish and maintain tocols is similar, if cancer data are to be aggregated standardised cancer-reporting data sets. Many coun- across large populations, much closer harmonisation tries, including those involved in the ICCR, expend a of approach, uniformity of content and standardised great deal of time, effort and resources to commis- nomenclature to define the data items are needed; the sion, publish and maintain their own standardised data sets in different parts of the world should include cancer-reporting data sets. Other countries lack the same items of information, defined in the same sufficient pathologist manpower and other resources way and described using the same terms. Without this, to develop or implement standardised cancer- meaningful international comparison, benchmarking reporting protocols and will benefit from the avail- and epidemiological analysis are not possible. ability of internationally accredited data sets. The ICCR has developed and ratified a suite of The ICCR alliance has successfully developed four standard operating procedures for the process of data – data sets on prostatic, endometrial and lung cancers set development (described in earlier publications1 4) and malignant melanoma. All of the data sets are and also defined the selection process, roles and evidence-based, have been produced by a panel of responsibilities of the chair, expert panel members, internationally renowned expert pathologists and a the ICCR Steering Committee representative on the single clinician in a specific field, have been subject panel and the project manager. to international open consultation and are freely The scope of this data set was to cover resection available for worldwide use at the following website: specimens of primary borderline and malignant http://www.rcpa.edu.au/Library/Practising-Pathology/ epithelial tumours of the ovary, fallopian tube and ICCR/Cancer-Datasets. The process of production of peritoneum. After the expert panel was established, each of these data sets has been published in peer- the project manager collated existing international reviewed journals.1–4 data sets for these tumours and scheduled a series The ICCR is currently in the process of becoming of teleconferences to review and discuss each of incorporated that will facilitate financial support of the elements in the collated data set. As FIGO staging an expanded membership and allow the continued of ovarian, fallopian tube and primary peritoneal development of high-quality cancer data sets for carcinoma has now been revised and amalgamated international use. The founding members include into one unified staging system,5 the Chair of the the original quadripartite group together with the expert panel (WGM) took the decision to produce a European Society of Pathology. The ICCR has also single cancer data set for these tumours. formed strategic partnerships with the International The elements under discussion by the expert panel Agency for Research on Cancer (IARC) (the organisa- included REQUIRED elements, defined as those tion that is responsible for producing the World which are unanimously agreed by the panel to be Health Organisation (WHO) monographs, the ‘Blue essential for the histological diagnosis, clinical man- books’ on tumour classification), the organisations agement, staging or prognosis of ovarian, fallopian tube responsible for tumour staging—Union for Interna- and primary peritoneal cancer, and RECOMMENDED tional Cancer Control (UICC), American Joint Com- elements, defined as non-mandatory which are clini- mittee on Cancer (AJCC) and the International cally important and recommended as good practice Federation of Obstetricians and Gynaecologists and should ideally be included in the data set but (FIGO)—and other bodies such as European Organi- which are not yet validated or regularly used in patient sation for Research and Treatment of Cancer, which management. Evidentiary support at Level III-2 or develops, conducts, coordinates and promotes trans- above (based on prognostic factors in the NHMRC lational and clinical research in Europe to improve levels of evidence document and defined as ‘Analysis the management of cancer. These strategic partner- of prognostic factors amongst persons in a single arm of ships underpin the cancer data set development a randomised controlled trial’)6 is required to support process and facilitate the co-ordination of data set required (mandatory)
Load more

Recommended publications
  • Histological Tumour Type (Required)
    Histological tumour type (Required) Reason/Evidentiary Support All ovarian epithelial malignancies and borderline tumours should be typed according to the WHO classification.1 There are 5 major subtypes of primary ovarian carcinoma, high‐grade serous, clear cell, endometrioid, mucinous and low‐ grade serous.2‐5 There are also other uncommon minor subtypes, those listed by the WHO including malignant Brenner tumour, seromucinous carcinoma and undifferentiated carcinoma.1 Carcinosarcoma is a mixed epithelial and mesenchymal malignancy but is included in the category of epithelial malignancies in this dataset since most are of epithelial origin and histogenesis.6 Although management of ovarian carcinoma is, at present, largely dependent on tumour stage and grade, accurate typing will almost certainly become more important in the future with the introduction of targeted therapies and specific treatments for different tumour types. This is in part because, although clinically often considered as one disease, there is an increasing realisation that the different morphological subtypes of ovarian carcinoma have a different pathogenesis, are associated with distinct molecular alterations and have a different natural history, response to traditional chemotherapy and prognosis.2‐5 Tumour typing may also be important in identifying or initiating testing for an underlying genetic predisposition; for example, high‐grade serous carcinoma may be associated with underlying BRCA1/2 mutation while endometrioid and clear cell carcinomas can occur in patients with Lynch syndrome.7 The most common ovarian carcinoma is high‐grade serous carcinoma (approximately 70%) followed by clear cell and endometrioid.8,9 Mucinous and low‐grade serous are less common. Approximately 90% of advanced stage ovarian carcinomas (stage III/IV) are high‐grade serous in type.8,9 Most primary tubal carcinomas are high‐grade serous or endometrioid and most primary peritoneal carcinomas are of high‐grade serous type.
    [Show full text]
  • About Ovarian Cancer Overview and Types
    cancer.org | 1.800.227.2345 About Ovarian Cancer Overview and Types If you have been diagnosed with ovarian cancer or are worried about it, you likely have a lot of questions. Learning some basics is a good place to start. ● What Is Ovarian Cancer? Research and Statistics See the latest estimates for new cases of ovarian cancer and deaths in the US and what research is currently being done. ● Key Statistics for Ovarian Cancer ● What's New in Ovarian Cancer Research? What Is Ovarian Cancer? Cancer starts when cells in the body begin to grow out of control. Cells in nearly any part of the body can become cancer and can spread. To learn more about how cancers start and spread, see What Is Cancer?1 Ovarian cancers were previously believed to begin only in the ovaries, but recent evidence suggests that many ovarian cancers may actually start in the cells in the far (distal) end of the fallopian tubes. 1 ____________________________________________________________________________________American Cancer Society cancer.org | 1.800.227.2345 What are the ovaries? Ovaries are reproductive glands found only in females (women). The ovaries produce eggs (ova) for reproduction. The eggs travel from the ovaries through the fallopian tubes into the uterus where the fertilized egg settles in and develops into a fetus. The ovaries are also the main source of the female hormones estrogen and progesterone. One ovary is on each side of the uterus. The ovaries are mainly made up of 3 kinds of cells. Each type of cell can develop into a different type of tumor: ● Epithelial tumors start from the cells that cover the outer surface of the ovary.
    [Show full text]
  • Primary Peritoneal Serous Papillary Carcinoma: a Case Series
    Archives of Gynecology and Obstetrics (2019) 300:1023–1028 https://doi.org/10.1007/s00404-019-05280-z GYNECOLOGIC ONCOLOGY Primary peritoneal serous papillary carcinoma: a case series Nikolaos Blontzos1 · Evangelos Vafas1 · George Vorgias1 · Nikolaos Kalinoglou1 · Christos Iavazzo1 Received: 27 May 2018 / Accepted: 22 August 2019 / Published online: 5 September 2019 © Springer-Verlag GmbH Germany, part of Springer Nature 2019 Abstract Purpose To present the clinical and laboratory characteristics, as well as the management, of patients with primary peritoneal serous papillary carcinoma (PPSPC). Methods This is a retrospective study of 19 patients with PPSPC who underwent debulking surgery followed by frst line chemotherapy and were managed in Metaxa Memorial Cancer Hospital between January 2002 and December 2017. Results The median age of the patients was found to be 66 years (range 44–76 years). Clinical presentation of PPSPC included abdominal distention and pain, constipation, as well as loss of appetite and weight gain. Two of the patients did not mention any symptomatology and the disease was suspected by an abnormal cervical smear and elevated CA125 levels respectively. Biomarkers measurement during the initial management of the patients revealed abnormal values of CA125 for all the participants (median value 565 U/ml). Human epididymis secretory protein 4 (HE4) and ratios of blood count were also measured. Perioperative Peritoneal Cancer Index ranged from 6 to 20. Optimal debulking was achieved in 5 cases. All patients were staged as IIIC and IVA PPSPC and received standard chemotherapy with paclitaxel and carboplatin, whereas bevacizumab was added in the 5 most recent cases. Median overall survival was 29 months.
    [Show full text]
  • Capecitabine)
    Reference number(s) 1993-A SPECIALTY GUIDELINE MANAGEMENT XELODA (capecitabine) POLICY I. INDICATIONS The indications below including FDA-approved indications and compendial uses are considered a covered benefit provided that all the approval criteria are met and the member has no exclusions to the prescribed therapy. A. FDA-Approved Indications 1. Colorectal Cancer a. Xeloda is indicated as a single agent for adjuvant treatment in patients with Dukes’ C colon cancer who have undergone complete resection of the primary tumor when treatment with fluoropyrimidine therapy alone is preferred. b. Xeloda is indicated as first-line treatment in patients with metastatic colorectal carcinoma when treatment with fluoropyrimidine therapy alone is preferred. 2. Breast Cancer a. Xeloda in combination with docetaxel is indicated for the treatment of patients with metastatic breast cancer after failure of prior anthracycline-containing chemotherapy. b. Xeloda monotherapy is also indicated for the treatment of patients with metastatic breast cancer resistant to both paclitaxel and an anthracycline-containing chemotherapy regimen or resistant to paclitaxel and for whom further anthracycline therapy is not indicated, for example, patients who have received cumulative doses of 400 mg/m2 of doxorubicin or doxorubicin equivalents. B. Compendial Uses 1. Anal cancer 2. Breast cancer 3. Central nervous system (CNS) metastases from breast cancer 4. Colorectal Cancer 5. Esophageal and esophagogastric junction cancer 6. Gastric cancer 7. Head and neck cancer 8. Hepatobiliary cancers (extra-/intra-hepatic cholangiocarcinoma and gallbladder cancer) 9. Occult primary tumors (cancer of unknown primary) 10. Ovarian cancer (Epithelial ovarian cancer/fallopian tube cancer/primary peritoneal cancer/mucinous cancer) 11.
    [Show full text]
  • Mechanisms of High-Grade Serous Carcinogenesis in the Fallopian Tube and Ovary: Current Hypotheses, Etiologic Factors, and Molecular Alterations
    International Journal of Molecular Sciences Review Mechanisms of High-Grade Serous Carcinogenesis in the Fallopian Tube and Ovary: Current Hypotheses, Etiologic Factors, and Molecular Alterations Isao Otsuka Kameda Medical Center, Department of Obstetrics and Gynecology, Kamogawa 296-8602, Japan; [email protected] Abstract: Ovarian high-grade serous carcinomas (HGSCs) are a heterogeneous group of diseases. They include fallopian-tube-epithelium (FTE)-derived and ovarian-surface-epithelium (OSE)-derived tumors. The risk/protective factors suggest that the etiology of HGSCs is multifactorial. Inflammation caused by ovulation and retrograde bleeding may play a major role. HGSCs are among the most genetically altered cancers, and TP53 mutations are ubiquitous. Key driving events other than TP53 mutations include homologous recombination (HR) deficiency, such as BRCA 1/2 dysfunction, and activation of the CCNE1 pathway. HR deficiency and the CCNE1 amplification appear to be mutually exclusive. Intratumor heterogeneity resulting from genomic instability can be observed at the early stage of tumorigenesis. In this review, I discuss current carcinogenic hypotheses, sites of origin, etiologic factors, and molecular alterations of HGSCs. Keywords: ovarian cancer; high-grade serous carcinoma; carcinogenesis; molecular alterations Citation: Otsuka, I. Mechanisms of High-Grade Serous Carcinogenesis in the Fallopian Tube and Ovary: Current Hypotheses, Etiologic 1. Introduction Factors, and Molecular Alterations. Ovarian cancer is the most lethal gynecological malignancy. Epithelial ovarian cancers Int. J. Mol. Sci. 2021, 22, 4409. (EOCs) are a heterogeneous group of diseases and can be divided into five main types, https://doi.org/10.3390/ijms based on histopathology and molecular genetics [1]: high-grade serous, low-grade serous, 22094409 endometrioid, clear cell, and mucinous tumors.
    [Show full text]
  • BSOG-FOGSI Quiz Preliminary Round Conducted on 24Th April at API
    BSOG-FOGSI quiz preliminary round conducted on 24th April at API Bhavana South Zone Yuva Fogsi 2016 Quiz – BSOG round Topic- Gynecological Oncology 24th April, 2016 (60 marks) Name: Institution: Dear participants, Welcome to the FOGSI Quiz 2016 Thirty questions are to be answered in 30 minutes. Circle the right answer. Scratching and overwriting will get a negative marking even if the final answer is right. Each correct answer gets 2 marks and a wrong one gets a negative marking of minus 1.The top 2 scorers will represent BSOG in South Zone Yuva FOGSI 2016 in Madurai on 22nd May 2016. The decision of the Quiz Master is final. Happy Quizzing!!! 1. With regards to the staging of endometrial cancer, pick the wrong answer a. Stage 1a Endometrial Adenocarcinoma is confined to the uterus and involves less than half of the myometrium b. Stage 4a Endometrial Adenocarcinoma invades bladder mucosa c. Stage 4b Endometrial Adenocarcinoma involves inguinal lymph nodes d. Stage 3c2 Endometrial Adenocarcinoma involves more than half of myometrium and pelvic lymph nodes Ans: Stage 3c1 is involvement of pelvic nodes, Stage 3c2 is involvement of paraaortic nodes 2. The average time between HPV infection and pre-cancer is a. 2-5 years b. 15-20 years c. 7-10 years d. 20-25 years Novak 3. What factor does not contribute to persistence and progression of HPV infection? a. Smoking b. Contraceptive use c. STDs d. Drinking alcohol Novak 4. On Colposcopy, Adenocarcinoma has the following features a. Mosaic pattern b. Punctate lesions c. Abnormal vasculature d.
    [Show full text]
  • SNOMED CT Codes for Gynaecological Neoplasms
    SNOMED CT codes for gynaecological neoplasms Authors: Brian Rous1 and Naveena Singh2 1Cambridge University Hospitals NHS Trust and 2Barts Health NHS Trusts Background (summarised from NHS Digital): • SNOMED CT is a structured clinical vocabulary for use in an electronic health record. It forms an integral part of the electronic care record, and serves to represent care information in a clear, consistent, and comprehensive manner. • The move to a single terminology, SNOMED CT, for the direct management of care of an individual, across all care settings in England, is recommended by the National Information Board (NIB), in “Personalised Health and Care 2020: A Framework for Action”. • SNOMED CT is owned, managed and licensed by SNOMED International. NHS Digital is the UK Member's National Release Centre for the creation of, and delegated authority to licence the SNOMED CT Edition and derivatives. • The benefits of using SNOMED CT in electronic care records are that it: • enables sharing of vital information consistently within and across health and care settings • allows comprehensive coverage and greater depth of details and content for all clinical specialities and professionals • includes diagnosis and procedures, symptoms, family history, allergies, assessment tools, observations, devices • supports clinical decision making • facilitates analysis to support clinical audit and research • reduces risk of misinterpretations of the record in different care settings • Implementation plans for England: • SNOMED CT must be implemented across primary care and deployed to GP practices in a phased approach from April 2018. • Secondary care, acute care, mental health, community systems, dentistry and other systems used in direct patient care must use SNOMED CT as the clinical terminology, before 1 April 2020.
    [Show full text]
  • Brenner Tumor with Serous Cystadenoma- an Unusual Combination: a Case Report
    DOI: 10.5958/2319-5886.2015.00045.4 International Journal of Medical Research & Health Sciences www.ijmrhs.com Volume 4 Issue 1 Coden: IJMRHS Copyright @2014 ISSN: 2319-5886 Received: 6th Nov 2014 Revised: 28th Nov 2014 Accepted: 31st Dec 2014 Case report BRENNER TUMOR WITH SEROUS CYSTADENOMA- AN UNUSUAL COMBINATION: A CASE REPORT *Syam Sundar B1, Shanthi V1, Mohan Rao N1, Bhavana Grandhi2, Chidananda Reddy V 2, Swathi S2 1Associate Professor, 2Assistant professor, Department of Pathology, Narayana Medical College, Nellore, A.P, India *Corresponding author email: syam.byna&gmail.com ABSTRACT Surface epithelial tumors are most common, which comprise 58% of all ovarian tumors. Serous and mucinous cystadenoma are the most common epithelial tumors which accounts for about 35% of ovarian tumors. Different combinations of epithelial tumors can occur in ovary most common among them is Mucinous cystadenoma and Brenner tumor. We report a case of an ovarian tumor with rare combination Brenner tumor with serous cyst adenoma of ovary in 56 year old female patient. Only a few cases with this combination are very rarely reported in the literature. Keywords: Brenner Tumor, Serous cystadenoma. INTRODUCTION Surface epithelial tumors are the most important CASE REPORT group of neoplasm of ovary which are namely serous, mucinous, endometroid, clear cell and Brenner along A 56 year old female patient presented with a with combinations of these types1. Surface epithelial swelling in the lower abdomen with intermittent tumors occur at all ages with a peak incidence in 2nd abdominal pain over a period of 1 year. Clinically, to 5th decade of life.
    [Show full text]
  • XELODA (Capecitabine)
    Reference number(s) 1993-A SPECIALTY GUIDELINE MANAGEMENT XELODA (capecitabine) POLICY I. INDICATIONS The indications below including FDA-approved indications and compendial uses are considered a covered benefit provided that all the approval criteria are met and the member has no exclusions to the prescribed therapy. A. FDA-Approved Indications 1. Colorectal Cancer a. Xeloda is indicated as a single agent for adjuvant treatment in patients with Dukes’ C colon cancer who have undergone complete resection of the primary tumor when treatment with fluoropyrimidine therapy alone is preferred. b. Xeloda is indicated as first-line treatment in patients with metastatic colorectal carcinoma when treatment with fluoropyrimidine therapy alone is preferred. 2. Breast Cancer a. Xeloda in combination with docetaxel is indicated for the treatment of patients with metastatic breast cancer after failure of prior anthracycline-containing chemotherapy. b. Xeloda monotherapy is also indicated for the treatment of patients with metastatic breast cancer resistant to both paclitaxel and an anthracycline-containing chemotherapy regimen or resistant to paclitaxel and for whom further anthracycline therapy is not indicated, for example, patients who have received cumulative doses of 400 mg/m2 of doxorubicin or doxorubicin equivalents. B. Compendial Uses 1. Anal cancer 2. Breast cancer 3. Central nervous system (CNS) metastases from breast cancer 4. Colorectal Cancer 5. Esophageal and esophagogastric junction cancer 6. Gastric cancer 7. Head and neck cancers (including very advanced head and neck cancer) 8. Hepatobiliary cancers (including extrahepatic and intra-hepatic cholangiocarcinoma and gallbladder cancer) 9. Occult primary tumors (cancer of unknown primary) 10. Ovarian cancer, fallopian tube cancer, and primary peritoneal cancer: Epithelial ovarian cancer, fallopian tube cancer, primary peritoneal cancer, and mucinous cancer) 11.
    [Show full text]
  • Rotana Alsaggaf, MS
    Neoplasms and Factors Associated with Their Development in Patients Diagnosed with Myotonic Dystrophy Type I Item Type dissertation Authors Alsaggaf, Rotana Publication Date 2018 Abstract Background. Recent epidemiological studies have provided evidence that myotonic dystrophy type I (DM1) patients are at excess risk of cancer, but inconsistencies in reported cancer sites exist. The risk of benign tumors and contributing factors to tu... Keywords Cancer; Tumors; Cataract; Comorbidity; Diabetes Mellitus; Myotonic Dystrophy; Neoplasms; Thyroid Diseases Download date 07/10/2021 07:06:48 Link to Item http://hdl.handle.net/10713/7926 Rotana Alsaggaf, M.S. Pre-doctoral Fellow - Clinical Genetics Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, NIH PhD Candidate – Department of Epidemiology & Public Health, University of Maryland, Baltimore Contact Information Business Address 9609 Medical Center Drive, 6E530 Rockville, MD 20850 Business Phone 240-276-6402 Emails [email protected] [email protected] Education University of Maryland – Baltimore, Baltimore, MD Ongoing Ph.D. Epidemiology Expected graduation: May 2018 2015 M.S. Epidemiology & Preventive Medicine Concentration: Human Genetics 2014 GradCert. Research Ethics Colorado State University, Fort Collins, CO 2009 B.S. Biological Science Minor: Biomedical Sciences 2009 Cert. Biomedical Engineering Interdisciplinary studies program Professional Experience Research Experience 2016 – present Pre-doctoral Fellow National Cancer Institute, National Institutes
    [Show full text]
  • Ovarian Cancer: the New Paradigm (And What You Need to Know Clinically)
    Ovarian Cancer: The New Paradigm (and what you need to know clinically) Dianne Miller, M.D., FRCSC University of British Columbia and the British Columbia Cancer Agency Ovarian Cancer y Germ Cell: y Stromal tumors y Dysgerminoma y Lymphoma y Endodermal sinus y Sarcoma etc. y Teratoma etc. y Epithelial Tumors y Sex cord stromal y Serous y Granulosa cell y Mucinous y FOX L2 y Endometriod y Sertoli leydig etc y Clear cell etc. Objectives y To discuss why epithelial ovarian cancer is becoming vanishingly rare! y To discuss our new insights into ovarian cancer y Epithelial Ovarian Cancer is a least five distinct diseases y High Grade Serous* y Endometriod* y Clear cell* y Mucinous y Low Grade Serous y (and possibly transitional cell) y To discuss the clinical implications of the changes in our understanding of the origin of “Ovarian Cancers” “Ovarian” Cancer in Canada y modest lifetime risk of 1/70, but: y major public health issue: y 2500 new cases/annum: 1750 deaths y potential years of life lost from cancer: y breast 94,400 = 1.0 y ovary 28,600 0.3 y uterus 11,400 y cervix 10,100 International Benchmarking y The Lancet, Volume 377, Issue 9760, Pages 127 ‐ 138, 8 January 2011 y Published Online: 22 December 2010 y Cancer survival in Australia, Canada, Denmark, Norway, Sweden, and the UK, 1995—2007 (the International Cancer Benchmarking Partnership): an analysis of population‐based cancer registry data “Ovarian Cancer” y Screening ineffective y Survival rates low & stable “Ovarian Cancer” Presentation y 1/3 gradual intrapelvic growth → y lower
    [Show full text]
  • Specialty Guideline Management
    Reference number(s) 2040-A SPECIALTY GUIDELINE MANAGEMENT GEMZAR (gemcitabine) gemcitabine POLICY I. INDICATIONS The indications below including FDA-approved indications and compendial uses are considered a covered benefit provided that all the approval criteria are met and the member has no exclusions to the prescribed therapy. A. FDA-Approved Indications 1. Ovarian cancer In combination with carboplatin for the treatment of patients with advanced ovarian cancer that has relapsed at least 6 months after completion of platinum-based therapy 2. Breast cancer In combination with paclitaxel for the first-line treatment of patients with metastatic breast cancer after failure of prior anthracycline-containing adjuvant chemotherapy, unless anthracyclines were clinically contraindicated 3. Non-small cell lung cancer In combination with cisplatin for the first-line treatment of patients with inoperable, locally advanced (Stage IIIA or IIIB), or metastatic (Stage IV) non-small cell lung cancer (NSCLC) 4. Pancreatic cancer As first-line treatment for patients with locally advanced (nonresectable Stage II or Stage III) or metastatic (Stage IV) adenocarcinoma of the pancreas. Gemzar or gemcitabine is indicated for patients previously treated with fluorouracil. B. Compendial Uses 1. Bladder cancer, primary carcinoma of the urethra, upper genitourinary tract tumors, transitional cell carcinoma of the urinary tract, urothelial carcinoma of the prostate, non-urothelial and urothelial cancer with variant histology 2. Bone cancer a. Ewing’s sarcoma b. Osteosarcoma 3. Breast cancer 4. Head and neck cancers (including very advanced head and neck cancer and cancer of the nasopharynx) 5. Hepatobiliary and biliary tract cancer a. Extrahepatic cholangiocarcinoma b. Intrahepatic cholangiocarcinoma c.
    [Show full text]