Breast cancer consistently ranks fi rst in oncologic morbidity and mortality in women. On the other hand, with a steady increase in breast cancer incidence in a number of economically developed countries, there have been observations and reports showing the decline in death rates from this disease. The latter is associated both with success in early detection of cancer and improved systemic adjuvant treatment. Besides that, as a result of evolution of drug therapy the median life length of patients with metastatic breast cancer, who were included in randomised clinical studies, is also increasing. Thus, the regimen of weekly Paclitaxel administration is characterized by high effectiveness, good tolerability, and can be widely used in clinical practice both in patients with metastatic breast cancer and in adjuvant programmes with early stages of the disease.
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The article presents histologic and cytologic classifi cation of non-epithelial tumors of the body of the uterus. It focuses on the characteristic morphological features and cytologic criteria in the diagnosis of endometrial stromal tumors of different grades, smooth muscle tumors, rhabdomyosarcoma, mixed epithelial and mesenchymal tumors.
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Approximately 83,000 women were diagnosed in the United States with gynecologic malignancies in 2010 (Jemal et al., 2010). Treatment typically involves major abdominal surgery to remove the primary cancer. In addition to a hysterectomy, staging procedures such as pelvic and para-aortic dissection are often needed. In order to minimize the morbidity of surgery, a minimally invasive approach has been shown to provide numerable benefi ts to patients. These include shorter hospitalizations, reduced blood loss, faster recovery, and fewer postoperative complications.
The da Vinci Surgical System (Intuitive Surgical, Inc, Sunnyvale, California, USA) was approved by the FDA in 2005 for use in gynecology. This system has several advantages over traditional laparoscopy including 7 degrees of motion, 3-dimensional views and tremor fi ltration. Potential drawbacks of this system include lack of haptic feedback, cost, and the size of the system that often requires special operating rooms. In this chapter, we will focus on the outcomes, safety and feasibility reported on robotic assisted surgery in cervical, endometrial and ovarian cancer.
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Cervical cancer (CC) is the third most common malignancy in women. The treatment depends on the extent of disease, i.e on the stage of cancer. Staging is based on the FIGO classifi cation (2009) which has its own restrictions in the evaluation of tumor invasion in parametrium, pelvic walls, involvement of regional lymphnodes and establishment of the real dimensions of the tumor.
Ultrasound examination (USE) is the primary method for the diagnostics of female pelvic disorders. Restrictions of acoustic window sizes, level of radiologist manual skills, obesity, lead to limitations in staging. Nevertheless USE remains the primary method in establishing the tumor size and the involvement of pelvic & para-aortic lymph nodes.
As per FIGO (2009) recommendations, the computed tomography (CT) or MRI data has to be considered in planning treatment of CC patients. But CT has poor relative contrast of soft tissues. Lack of clear demarcation of borders between tumor and normal cervical tissues is a serious problem even in contrast enhanced CT.
Cervical Squamous cell carcinomas have active metabolism of glucose. That is why FDG-PET-CT is helpful in tumor staging, prognosis, treatment planning, effi cacy evaluation and detecting disease progression. 18-fl uthymidine PET-CT is useful in case of adenocarcinomas. But diagnostic value of PET-CT in patients with I–IIa stages CC is not clear.
Magnetic resonance imaging (MRI) is the method of choice in the staging of invasive CC. MRI is helpful in the evaluation of CC starting from stage Ib (FIGO 2009), to plan surgery or chemo-radiotherapy, to evaluate effi cacy of treatment and to detect local tumor recurrence.
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The review article examines the hypothesis on the role of fallopian tube epithelium in the etiopathogenesis of serous ovarian cancer which is based on morphological and molecular genetic studies. It has been traditionally assumed that ovarian cancer develops from ovarian surface epithelium (mesothelium) or so-called «inclusion cysts». Compelling evidence that have been obtained relatively recently confi rms the presence of serous intraepithelial carcinomas in fi mbriae of fallopian tubes in patients with serous ovarian cancer who had germinal BRCA1/2 mutations. Based on these fi ndings it appears reasonable to suggest that the fallopian tube epithelium is the true source of preneoplastic and neoplastic processes both in women who are not burdened with hereditary cancer and in patients with BRCA1/2 mutations.
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This review article presents a historical review of the development and implementation of the immunodiagnostic methods of malignant ovarian tumors in clinical oncology. The diagnostic value of the leading tumor markers for ovarian cancer and a new marker of epithelial ovarian cancer (protein-4 of human epidermis, HE4) have been described in the article. The biochemical and clinical characteristics of this marker, as well as information about its diagnostic and prognostic value in combination with the CA-125 marker, has been also analyzed. The risk assessment model (ROMA – Risk of Ovarian Malignancy Algorithm) for women with ovarian space-occupying process, depending on the concentrations CA-125 and HE4 in serum and reproductive status of a patient, has been described in details.
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The article focuses on the role of immunomorphological methods in the examination and diagnosis of primary and metastatic peritoneal neoplasms.
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The article is devoted to the existing measures for the prevention of thromboembolic complications and their effi cacy in surgical intervention in gynecologic oncology. Low-molecular-weight heparins have shown the best results for the treatment.
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Objective: The assessment of the effectivenes of Remestyp (Terlipressin) in patients with ovarian cancer.
Material and Methods: A prospective clinical research study on the assessment of the effectiveness of Terlipressin in 20 stage I to III ovarian cancer patients was conducted in the department of gynecologic oncology in the Federal State Budgetary Institution «N.N.Blokhin Russian Cancer Research Center» of the Russian Academy of Medical Sciences from 2013 to 2014.
Results: Therapy with Terlipressin provided an ooportunity to reduce the intensity of intraoperative bleeding by an average of 40% (p≤0,05) below the expected physiological blood loss (400 ml).
Conclusions: The use of Terlipressin in the prevention of intraoperative bleedings is highly effective and is optimal in combination with the agents of pathogenetic therapy, and it didn’t affect blood coagulation parameters.
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