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Natural history of epithelial ovarian cancer and its relation to surgical and medical treatment

World Journal of Obstetrics and Gynecology 2013年第4期2卷 137-142页

作者： Pierandrea De Iaco Anna Myriam Perrone martina procaccini Alice Pellegrini Philippe Morice Gynecologic Oncology Unit Sant’Orsola Malpighi Hospital 40138 Bologna Italy Gynecologic Oncology Unit Gustave Roussy Institute 94805 Villejuif France

Epithelial ovarian cancer(EOC) represents approximately 90% of primary malignant ovarian tumors, the sixth most common cancer in women and the second most common gynecologic cancer. Approximately 80%-85% of all ovarian carcinomas in Western society are serous and up to 95% of patients are in advanced stages(FIGO stage Ⅲ-Ⅳ) at diagnosis. Treatment of ovarian cancer is mainly based on three key approaches: surgical removal of neoplasia; chemotherapy to kill cancer cells; direct chemotherapy on peritoneal surfaces. The application of hyperthermic chemotherapy to the peritoneal cavity(HIPEC) after radical surgery may also be an attractive option. We analyzed the natural history of EOC in the literature and identified various time-points where sensitivity to chemotherapy, freedom from disease and overall survival are different. We propose eight time-points in EOC history with homogeneous oncological fi ndings. The effectiveness of HIPEC in EOC treatment should be evaluated based on these eight time-points and we believe that retrospective and prospective studies of HIPEC should be evaluated according to these time-points.

关键词： Ovarian cancer Hyperthermic intraperitoneal chemotherapy Chemo-sensitivity Time-points Survival

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Gynecological malignancies and hormonal therapies: Clinical management and recommendations

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World Journal of Obstetrics and Gynecology 2014年第4期3卷 162-170页

作者： Anna Myriam Perrone Federica Pozzati Donatella Santini martina Rossi martina procaccini Lucia Casalini Erica Santi Marco Tesei Claudio Zamagni Pierandrea De Iaco Oncologic Gynecology Unit Sant’Orsola-Malpighi Hospital40138 BolognaItaly Pathology Unit Sant’Orsola-Malpighi University Hospital40138 BolognaItaly Medical Oncology Unit Sant’Orsola-Malpighi University Hospital40138 BolognaItaly

Every year in the world a large number of women receive a diagnosis of gynecological cancer and undergo a therapy such as surgery, chemotherapy and radiotherapy to the pelvic region. A large portion of these patients are already in menopause, but for younger patients therapies are responsible of early menopause. The physical and psychological symptoms due to iatrogenic menopause significantly reduce the quality of life; however hormone replacement therapy(HRT) has a high efficacy in reducing menopausal symptoms. The prescription of HRT in patients with story of gynecological cancer is debated because its safety has not been completely proven. The main criticism is based on the theory that the hormone replacement could stimulate growth of residual cancer cells increasing the risk of recurrence.

关键词： Iatrogenic menopause Gynecological cancer Hormone replacement therapy Risk of recurrence Climateric symptoms Cardiovascular benefits Clinical practice

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