Major clinical research advances in gynecologic cancer in 2012

Abstract

Ten topics were chosen among major clinical research achievements in gynecologic oncology in 2012. For ovarian cancer, comprehensive review of the history of bevacizumab studies was followed by poly adenosine diphosphate [ADP]-ribose polymerase (PARP) inhibitors and other molecular targeted agents such as epidermal growth factor receptor tyrosine kinase inhibitor and AMG 386. For the development of genomic study in gynecologic cancers, BRCA and DICER1 mutations were covered in epithelial and nonepithelial ovarian cancer, respectively. For endometrial cancer, targeted agents including mammalian target of rapamycin (mTOR) inhibitors and bevacizumab were discussed. Radiation therapy "sandwiched" between combination chemotherapy schedules for the treatment of uterine papillary serous carcinoma was also reviewed. Preoperative prediction of lymph node metastasis, definition of low-risk group, and recurrence and survival outcomes of laparoscopic approaches were addressed. For cervical cancer, we reviewed long-term benefit of human papillomavirus test and efficacy of paclitaxel/carboplatin versus paclitaxel/cisplatin in stage IVB, persistent or recurrent disease. In addition, the effect of three dimensional image-based high-dose rate brachytherapy was also reviewed. For vulvar cancer, the diagnostic value of sentinel lymph node biopsy was discussed. For breast cancer, positive results of three outstanding phase III randomized clinical trials, CLEOPATRA, EMILIA, and BOLERO-2 were introduced. Lastly, updates of major practice guidelines were summarized.

Laparoendoscopic Single-Site Surgery for Extremely Large Ovarian Cysts: A Feasibility, Safety, and Patient Satisfaction Study

“…In the present study, we encountered 3 unexpected malignancies despite thorough preoperative evaluations including physical, laboratory and radiological examinations. Therefore, patients with large ovarian cysts should be counseled about the risks and benefits of LESS surgery as well as open surgery/conventional laparoscopy and should provide informed consent for the staging procedure in case of unexpected malignancy [14,15,16]. The availability of an experienced gyneco-oncological surgeon (alternatively, an expert laparoscopist and a gyneco-oncological surgeon on call) is mandatory.…”

Data set for reporting of ovary, fallopian tube and primary peritoneal carcinoma: recommendations from the International Collaboration on Cancer Reporting (ICCR)

“…7,8 According to the 2014 FIGO staging system for ovarian, tubal and primary peritoneal cancer, 5 ovarian capsular or tubal serosal rupture before surgery is considered stage IC2 while intra-operative rupture is 1C1. There is some controversy as to whether rupture during surgery worsens the prognosis in the absence of surface excrescences, ascites or positive washings.…”

Long non-coding RNA MALAT1 is upregulated and involved in cell proliferation, migration and apoptosis in ovarian cancer

“…In the United States in 2012, there were ~22,280 new cases of OC and 15,500 mortalities (2). There is a lack of definitive early symptoms and effective markers for OC diagnosis.…”