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OVARIAN CANCER –
CLINICAL AND
THERAPEUTIC
PERSPECTIVES
Edited by Samir A. Farghaly
Ovarian Cancer – Clinical and Therapeutic Perspectives
Edited by Samir A. Farghaly
Published by InTech
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First published February, 2012
Printed in Croatia
A free online edition of this book is available at www.intechopen.com
Additional hard copies can be obtained from orders@intechweb.org
Ovarian Cancer – Clinical and Therapeutic Perspectives, Edited by Samir A. Farghaly
p. cm.
ISBN 978-953-307-810-6
Contents
Preface IX
Chapter 1 Ovarian Cancer Incidence: Current
and Comprehensive Statistics 3
Sherri L. Stewart
Chapter 2 Preventive Strategies in Epithelial Ovarian Cancer 15
Gina M. Mantia-Smaldone and Nathalie Scholler
Chapter 3 Screening for Ovarian Cancer in Women 43
Duangmani Thanapprapasr and Sarikapan Wilailak
Chapter 4 Borderline and Malignant Surface Epithelial –
Stromal Tumors of the Ovary 55
Susanna Syriac, Faith Ough and Paulette Mhawech-Fauceglia
Chapter 5 Central Nervous System Involvement
from Epithelial Ovarian Cancer 87
Gennaro Cormio, Maddalena Falagario and Luigi E. Selvaggi
Chapter 6 Peripheral Neuropathy in Ovarian Cancer 109
Yi Pan
Chapter 7 Therapeutic Strategies in Ovarian Cancer 129
Dan Ancuşa, Octavian Neagoe, Răzvan Ilina, Adrian Carabineanu,
Corina Şerban and Marius Craina
Chapter 8 Combined Cytoreductive Surgery and
Perioperative Intraperitoneal Chemotherapy
for the Treatment of Advanced Ovarian Cancer 143
Antonios-Apostolos K. Tentes, Nicolaos Courcoutsakis
and Panos Prasopoulos
Chapter 9 Minimally Invasive Surgical Procedures for Patients
with Advanced and Recurrent Ovarian Cancer 167
Samir A. Farghaly
VI Contents
Chapter 10 Management of Recurrent or Persistent Ovarian Cancer 191
Constantine Gennatas
Chapter 11 Antiprogestins in Ovarian Cancer 207
Carlos M. Telleria and Alicia A. Goyeneche
Chapter 12 Intraperitoneal Radionuclide Therapy –
Clinical and Pre-Clinical Considerations 231
J. Elgqvist, S. Lindegren and P. Albertsson
Chapter 13 Vitamin K2 as a Chemotherapeutic
Agent for Treating Ovarian Cancer 259
K. Nakaya, Y. Masuda, T. Aiuchi and H. Itabe
Chapter 14 Second-Line Chemotherapy for Platinum- and
Taxane-Resistant Epithelial Ovarian Cancer:
Pegylated Liposomal Doxorubicin (PLD), Irinotecan,
and Combination Therapies at Lower Doses 275
Toru Sugiyama
Chapter 15 HER2 as a Therapeutic Target in Ovarian Cancer 289
Lukas C. Amler, Yulei Wang and Garret Hampton
Chapter 16 Sexuality After Ovarian Cancer Therapy 313
Juliane Farthmann and Annette Hasenburg
Chapter 17 Quality of Life of Patients with Ovarian Cancer 327
Wei-Chu Chie and Elfriede Greimel
Preface
204,449 new cases of ovarian cancer are diagnosed worldwide each year, with an
estimated 124,860 disease-related deaths. Ovarian cancer is the second most
gynecological cancer in the United States of America, but most common cause of
gynecological cancer related death, primarily because most patients present with
advanced disease. 65-70 % of patients are diagnosed at an advanced stage, conferring a
5-year survival rate of 30-55%. Ovarian cancer is associated with such a significant
burden of disease for the individual and for society. The ovarian cancer statistics for
incidence, indicate it is highest in the USA and Northern Europe and lowest in Africa
and Asia. The approach to women with ovarian cancer has become multidisciplinary,
with many professionals contributing to the excellent care and outcome that we wish
to see for those individuals we are privileged to look after.
This book discusses a range of diagnostic and therapeutic considerations, including
epidemiologic, pathologic, open surgical, minimally invasive surgical, and
chemotherapeutic aspects.
The most current and comprehensive statistics associated with ovarian cancer
incidence is detailed in Chapter 1. Screening for epithelial ovarian cancer (EOC), and
the development of novel diagnostic tests such as bead-based ELISA assays using
recombinant anti bodies produced by yeast is presented in Chapter 2. Screening for
ovarian cancer in the general and increased-risk population is reviewed in Chapter 3.
Macroscopic, histology grading, immunohistochemistry, and differential diagnosis of
malignant and borderline surface epithelial-stromal tumors of the ovary is discussed
in Chapter 4. Clinico-pathological features of the central nervous system involvement
in epithelial ovarian cancer and the different therapeutic approaches for such a disease
are discussed in Chapter 5. Comprehensive review of peripheral neuropathy relative
to ovarian cancer, including symptoms, pathogenesis, incidence, risk factors,
diagnosis, and management is covered in Chapter 6. A therapeutic strategy for the
treatment of primary and secondary ovarian cancer which involves surgery,
chemotherapy, radiation therapy, biological therapy, and hormones is presented in
Chapter 7. Cytoreductive surgery and perioperative intraperitoneal chemotherapy for
the treatment of locally advanced ovarian cancer is described in Chapter 8. Recent
advances and state-of-the-art minimally invasive surgical techniques for advanced and
recurrent ovarian cancer, in reference to involvement of lower urinary tract,
X Preface
gastrointestinal tract, spleen, and liver are presented in Chapter 9. The medical and
surgical management principals of recurrent and persistent ovarian cancer are
reviewed in Chapter 10. Feasibility of repositioning antiprogestins, originally designed
for contraceptive purposes, for ovarian cancer therapy is covered in Chapter 11.
Current status and aspects of intraperitoneal radioimmunotherapy (RIT) of ovarian
cancer is reviewed in Chapter 12. Efficacy and safety of Vitamin K2 as a chemotherapy
agent for the treatment of ovarian cancer is reviewed in Chapter 13. Second-line
combination therapy for platinum and taxane-resistant epithelial ovarian cancer is
described in Chapter 14. HER2 as a therapeutic target for ovarian cancer inidentifying
and treating the right patient is presented in Chapter 15. Sexual functions and body
image of patients with ovarian cancer following therapy is detailed in Chapter 16.
Finally, Scale structures, psychometric properties, and clinical validities of extrinsic
instruments for the assessment of health related quality of life of patients with ovarian
cancer is detailed in Chapter 17.
This book is intended for all clinicians caring for women with ovarian cancer,
including attending surgeons and physicians, fellows, and residents in the disciplines
of gynecologic oncology, surgical oncology, medical oncology, and primary care.
Allied medical staff, palliative services, and nurse specialists will also find it a useful
adjunct to getting current information on ovarian cancer.
I hope that you enjoy this book, and benefit from the extensive experience of the
contributors to this book from the USA, Europe, and Asia who have authored its
contents.
Samir A. Farghaly, MD, PhD
The Joan and Sanford Weill Medical College of Cornell University
The New York Presbyterian Hospital
Cornell University Medical Center New York
USA
[...]... spread Although there is limited 18 Ovarian Cancer – Clinical and Therapeutic Perspectives data to support symptomatology as a sole screening modality for ovarian cancer, recognition of ovarian cancer symptoms by both patients and caregivers may help to identify individuals with early stage disease 29 and in 2007 the Gynecologic Cancer Foundation, American Cancer Society and Society of Gynecologic Oncologists... 10 Ovarian Cancer – Clinical and Therapeutic Perspectives reduction in the misclassification of PPC and PFTC as ovarian cancer (Stewart et al., 2007, Goodman & Shvetsov, 2009b) 5 Discussion Ovarian cancer incidence rates reported from countries with nationwide cancer registration and those from more developed countries are generally similar to each other In less developed countries and regions, ovarian. .. Table 2 Ovarian cancer incidence counts and rates for selected regions and continents worldwide Rates are per 100,000 women and age-standardized to the 1960 world standard population Source: Ferlay et al., 2011 Ovarian Cancer Incidence: Current and Comprehensive Statistics 5 Fig 1 Map of ovarian cancer rates worldwide Rates are per 100,000 women and are agestandardized to the 1960 world standard population... Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology, 9th Edition., DeVita, V.T.; Lawrence, T.S & 12 Ovarian Cancer – Clinical and Therapeutic Perspectives Rosenberg, S.A.pp (1368-1391) Lippincott, Williams, & Wilkins, ISBN 978-1-45110545-2, Philadelphia, PA, USA Chen, V.W.; Ruiz, B.; Killeen, J.L.; Cote, T.R.; Wu, X.C & Correa, C.N.(2003) Pathology and classification of ovarian tumors Cancer, ... Program NR=not reported Source: (U.S .Cancer Statistics Working Group, 2010) 8 Ovarian Cancer – Clinical and Therapeutic Perspectives 3.1 Clinical factors (histology, stage, laterality) and ovarian cancer incidence Ovarian cancers are classified into three main histologic groups: epithelial tumors, sex cord-stromal tumors, and germ cell tumors (Cannistra et al., 2011) Epithelial tumors are believed to... cervical cancer and its immediate precursors worldwide 23, the exact etiology for ovarian cancer remains largely debated Precursors for ovarian cancer should be “morphologically recognizable lesions that are reproducible thereby permitting early clinical intervention” 24 It has been 17 Preventive Strategies in Epithelial Ovarian Cancer generally accepted that ovarian cancer originates from the ovarian. .. biomarker overexpressed by both serous and endometrioid ovarian cancers 78 and is expressed by 32% of ovarian cancers lacking CA125 expression 76 HE4 has been FDA approved to monitor for disease recurrence (June 2008) and was recently incorporated into the clinical evaluation of ovarian cancer patients Studies have also indicated that HE4 may also improve prediction of malignancy in ovarian masses when... relative with ovarian cancer have a three- 24 Ovarian Cancer – Clinical and Therapeutic Perspectives fold increase in risk 104 Hereditary ovarian cancers are commonly attributed to genetic mutations which are transmitted in families in an autosomal dominant fashion Germline mutations in BRCA1 and BRCA2, tumor suppressors which participate in homologous recombination repair of double-stranded DNA breaks,... women with ovarian cancer and 87, 303 controls.Lancet, Vol 371, No 9609, (2008), pp (303-14) Biesma, R.G.; Schouten, L.J.; Dirx, M.J.; Goldbohm, R.A & van den Brandt, P .A.( 2006) Physical activity and risk of ovarian cancer: results from the Netherlands Cohort Study (The Netherlands) Cancer Causes Contro, Vol 17, No 1 (2006), pp (109-15) Boger-Megiddo, I & Weiss, N.S (2005) Histologic subtypes and laterality... 1 Ovarian Cancer Incidence: Current and Comprehensive Statistics Sherri L Stewart Division of Cancer Prevention and Control, Centers for Disease Control and Prevention USA 1 Introduction Ovarian cancer is a commonly diagnosed and particularly deadly gynecologic malignancy worldwide It ranks among the top ten diagnosed cancers and top five deadliest cancers in most countries . OVARIAN CANCER –
CLINICAL AND
THERAPEUTIC
PERSPECTIVES
Edited by Samir A. Farghaly
Ovarian Cancer – Clinical and Therapeutic.
Chapter 7 Therapeutic Strategies in Ovarian Cancer 129
Dan Ancu a, Octavian Neagoe, Răzvan Ilina, Adrian Carabineanu,
Corina Şerban and Marius Craina
Chapter
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