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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. -
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. -
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. -
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. -
Clinical Radiation Oncology Review
Clinical Radiation Oncology Review Daniel M. Trifiletti University of Virginia Disclaimer: The following is meant to serve as a brief review of information in preparation for board examinations in Radiation Oncology and allow for an open-access, printable, updatable resource for trainees. Recommendations are briefly summarized, vary by institution, and there may be errors. NCCN guidelines are taken from 2014 and may be out-dated. This should be taken into consideration when reading. 1 Table of Contents 1) Pediatrics 6) Gastrointestinal a) Rhabdomyosarcoma a) Esophageal Cancer b) Ewings Sarcoma b) Gastric Cancer c) Wilms Tumor c) Pancreatic Cancer d) Neuroblastoma d) Hepatocellular Carcinoma e) Retinoblastoma e) Colorectal cancer f) Medulloblastoma f) Anal Cancer g) Epndymoma h) Germ cell, Non-Germ cell tumors, Pineal tumors 7) Genitourinary i) Craniopharyngioma a) Prostate Cancer j) Brainstem Glioma i) Low Risk Prostate Cancer & Brachytherapy ii) Intermediate/High Risk Prostate Cancer 2) Central Nervous System iii) Adjuvant/Salvage & Metastatic Prostate Cancer a) Low Grade Glioma b) Bladder Cancer b) High Grade Glioma c) Renal Cell Cancer c) Primary CNS lymphoma d) Urethral Cancer d) Meningioma e) Testicular Cancer e) Pituitary Tumor f) Penile Cancer 3) Head and Neck 8) Gynecologic a) Ocular Melanoma a) Cervical Cancer b) Nasopharyngeal Cancer b) Endometrial Cancer c) Paranasal Sinus Cancer c) Uterine Sarcoma d) Oral Cavity Cancer d) Vulvar Cancer e) Oropharyngeal Cancer e) Vaginal Cancer f) Salivary Gland Cancer f) Ovarian Cancer & Fallopian -
Urinary Bladder Neoplasia
Canine Urinary Tract Neoplasia Phyllis C Glawe DVM, MS The principal organs of the urinary tract are the kidneys, ureters, urinary bladder and urethra. The urinary bladder and urethra are the most commonly affected by cancer in the dog and the majority of cancers in these locations are malignant. The most common type of cancer is Transitional Cell Carcinoma (TCC). This handout reviews the facts about clinical symptoms, diagnosis and treatment of urinary tract cancer in the dog. Clinical Features More common in female dogs, urinary bladder and urethral cancer are typically associated with advanced age (9-10 years). Frequent urination, blood in the urine, and straining to urinate are typical symptoms. These signs are also similar to those of urinary tract infections, thus a cancer diagnosis can be missed early in the course of the disease. If the flow of urine is obstructed, abdominal pain, vomiting, depression and loss of appetite can occur. More rarely, dogs can present with back pain and weakness of the hind limbs due to metastases (spread) of the cancer to the spine and lymph nodes. Diagnosis Abdominal radiographs and abdominal ultrasound can be utilized to detect cancer in the lower urinary tract. Abdominal ultrasound is particularly helpful to assess whether other organs in the abdomen region are affected, such as the kidneys and ureters. Hydronephrosis and hydroureter are terms describing a back-up of urine flow due to the obstructive effects of a tumor. Regional lymph node enlargement and possible prostate enlargement in male dogs can be assessed quickly and accurately with ultrasound. Urine analysis is not very helpful as a diagnostic tool in most cases. -
Primary Urethral Carcinoma
EAU Guidelines on Primary Urethral Carcinoma G. Gakis, J.A. Witjes, E. Compérat, N.C. Cowan, V. Hernàndez, T. Lebret, A. Lorch, M.J. Ribal, A.G. van der Heijden Guidelines Associates: M. Bruins, E. Linares Espinós, M. Rouanne, Y. Neuzillet, E. Veskimäe © European Association of Urology 2017 TABLE OF CONTENTS PAGE 1. INTRODUCTION 3 1.1 Aims and scope 3 1.2 Panel composition 3 1.3 Publication history and summary of changes 3 1.3.1 Summary of changes 3 2. METHODS 3 2.1 Data identification 3 2.2 Review 3 2.3 Future goals 4 3. EPIDEMIOLOGY, AETIOLOGY AND PATHOLOGY 4 3.1 Epidemiology 4 3.2 Aetiology 4 3.3 Histopathology 4 4. STAGING AND CLASSIFICATION SYSTEMS 5 4.1 Tumour, Node, Metastasis (TNM) staging system 5 4.2 Tumour grade 5 5. DIAGNOSTIC EVALUATION AND STAGING 6 5.1 History 6 5.2 Clinical examination 6 5.3 Urinary cytology 6 5.4 Diagnostic urethrocystoscopy and biopsy 6 5.5 Radiological imaging 7 5.6 Regional lymph nodes 7 6. PROGNOSIS 7 6.1 Long-term survival after primary urethral carcinoma 7 6.2 Predictors of survival in primary urethral carcinoma 7 7. DISEASE MANAGEMENT 8 7.1 Treatment of localised primary urethral carcinoma in males 8 7.2 Treatment of localised urethral carcinoma in females 8 7.2.1 Urethrectomy and urethra-sparing surgery 8 7.2.2 Radiotherapy 8 7.3 Multimodal treatment in advanced urethral carcinoma in both genders 9 7.3.1 Preoperative platinum-based chemotherapy 9 7.3.2 Preoperative chemoradiotherapy in locally advanced squamous cell carcinoma of the urethra 9 7.4 Treatment of urothelial carcinoma of the prostate 9 8. -
Sarcomatoid Urothelial Carcinoma Arising in the Female Urethral Diverticulum
Journal of Pathology and Translational Medicine 2021; 55: 298-302 https://doi.org/10.4132/jptm.2021.04.23 CASE STUDY Sarcomatoid urothelial carcinoma arising in the female urethral diverticulum Heae Surng Park Department of Pathology, Ewha Womans University Seoul Hospital, Seoul, Korea A sarcomatoid variant of urothelial carcinoma in the female urethral diverticulum has not been reported previously. A 66-year-old woman suffering from dysuria presented with a huge urethral mass invading the urinary bladder and vagina. Histopathological examination of the resected specimen revealed predominantly undifferentiated pleomorphic sarcoma with sclerosis. Only a small portion of conven- tional urothelial carcinoma was identified around the urethral diverticulum, which contained glandular epithelium and villous adenoma. The patient showed rapid systemic recurrence and resistance to immune checkpoint inhibitor therapy despite high expression of pro- grammed cell death ligand-1. We report the first case of urethral diverticular carcinoma with sarcomatoid features. Key Words: Sarcomatoid carcinoma; Urothelial carcinoma; Urethral diverticulum Received: March 9, 2021 Revised: April 16, 2021 Accepted: April 23, 2021 Corresponding Author: Heae Surng Park, MD, PhD, Department of Pathology, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, 260 Gonghang-daero, Gangseo-gu, Seoul 07804, Korea Tel: +82-2-6986-5253, Fax: +82-2-6986-3423, E-mail: [email protected] Urethral diverticular carcinoma (UDC) is extremely rare; the urinary bladder, and vagina with enlarged lymph nodes at both most common histological subtype is adenocarcinoma [1,2]. femoral, both inguinal, and both internal and external iliac areas Sarcomatoid urothelial carcinoma (UC) is also unusual. Due to (Fig. 1B). -
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. -
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 -
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. -
Clinical Curriculum: Gynecologic Oncology
Reviewed July 2014 Clinical Curriculum: Gynecologic Oncology Goal: The primary goal of the gynecologic oncology rotation at the University of Alabama at Birmingham is to train residents to have a general understanding of the evaluation and treatment of women with suspected gynecologic malignancies. At the completion of four years of training, our residents will be capable of appropriate workup and referral of patients with gynecologic malignancies. Organization: Four residents are assigned to the UAB inpatient rotation (Green: PGY2 & 3; Gold: PGY1 & 4). One intern will be assigned to the outpatient clinic rotation. Junior residents (PGY1, 2) will also attend the Colposcopy Clinic on Friday mornings. Supervision: Residents are directly supervised by faculty members at all times. Gynecologic oncology faculty are in attendance in the operating rooms during the critical portion of all procedures. All admitted inpatients are seen by a faculty daily. By the end of the rotation, 1st and 2nd year residents should be able to perform: Workup and management of patients with suspected gynecologic malignancies Minor gynecologic procedures such as D&C, cold knife cone, and CO2 laser ablations Basic laparoscopy Routine open hysterectomy and salpingo-oophorectomy By the end of the rotation, 3rd and 4th year residents should be able to perform: Critical care of postoperative patients Robotic hysterectomy and salpingo-oophorectomy Complicated abdominal and pelvic surgery such as endometriosis and adhesions Reviewed July 2014 By the end of the rotation,