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This was an age-stratified, retrospective, cohort study of patients between the ages of 65–69, 70–75 and ≥76 years diagnosed with high grade serous ovarian cancer of FIGO (2014) Stage 3a or higher between 01 January 2017 and April 2020. The study aimed to examine and compare patient characteristics, treatments and outcomes, including survival, of elderly patients within a single cancer centre in the south of England. Data collection began in January 2021 and concluded in March 2022. Ninety patients were eligible for the study. A correlation was observed between increasing age and worsening performance status (p = 0.044). Other variables assessed included age at diagnosis and time between decision to treatment, however, there was no evidence of correlations. The majority of patients studied received neoadjuvant chemotherapy followed by cytoreductive surgery as their primary treatment modality, however, 53% of our eldest cohort underwent treatment types that did not involve surgery. Of those who did undergo surgery, there was no observed correlation between age and the rates of complete cyto-reductive surgery, intra-operative complications, admission to High Dependency Unit, or length of hospital stay. Median length of stay across all age groups was 5 days. Patients ≥76 years were more likely to receive singleagent carboplatin (p = 0.009) than dual-agent chemotherapy. There was no increase in chemo-toxicity events with increasing age. While primary cytoreductive surgery is favoured by many gynaecological oncology teams, neoadjuvant chemotherapy still offers a viable treatment alternative for elderly and frail patients with advanced stage ovarian cancer by minimising operative times, reducing admissions to high dependency units and shortening lengths of hospital stay. Geriatric assessments, in combination with performance status, may aid treatment decisions made by the multi-disciplinary team. [ABSTRACT FROM AUTHOR]

Key Content: Cervical cancer is the commonest gynaecological malignancy diagnosed in pregnancy.Cancer symptoms may mimic complications of pregnancy, thus delaying diagnosis.Staging of cervical cancer in pregnancy is essential to determine an individual management plan.Treatment of cervical cancer in pregnancy is complex and depends on the stage of cancer and the gestation of the pregnancy.Involvement of a multidisciplinary team is essential in the care of a woman with cervical cancer in pregnancy. Learning Objectives: To understand how to diagnose, stage and treat cervical cancer in pregnancy.To know the risks to the fetus in each trimester, with regard to the various surgical and chemotherapeutic options available to treat cervical cancer in pregnancy.To understand the psychological effects on a woman of a cancer diagnosis in pregnancy. Ethical Issues: How should maternal and fetal risks be balanced while investigating and treating cervical cancer in pregnancy?Consideration of termination of pregnancy to allow timely treatment, alternatively risking delay in treatment and progression of disease. [ABSTRACT FROM AUTHOR]

Purpose: Trials of novel drugs used in advanced disease often show only progression-free survival or modest overall survival benefits. Hypothetical studies suggest that stabilisation of metastatic disease and/or symptom burden are worth treatment-related side effects. We examined this premise contemporaneously using qualitative and quantitative methods.Methods: Patients with metastatic cancers expected to live > 6 months and prescribed drugs aimed at cancer control were interviewed: at baseline, at 6 weeks, at progression, and if treatment was stopped for toxicity. They also completed Functional Assessment of Cancer Therapy (FACT-G) plus Anti-Angiogenesis (AA) subscale questionnaires at baseline then monthly for 6 months.Results: Ninety out of 120 (75%) eligible patients participated: 41 (45%) remained on study for 6 months, 36 progressed or died, 4 had treatment breaks, and 9 withdrew due to toxicity. By 6 weeks, 66/69 (96%) patients were experiencing side effects which impacted their activities. Low QoL scores at baseline did not predict a higher risk of death or dropout. At 6-week interviews, as the side effect severity increased, patients were significantly less inclined to view the benefit of cancer control as worthwhile (X2 = 50.7, P < 0.001). Emotional well-being initially improved from baseline by 10 weeks, then gradually returned to baseline levels.Conclusion: Maintaining QoL is vital to most patients with advanced cancer so minimising treatment-related side effects is essential. As side effect severity increased, drugs that controlled cancer for short periods were not viewed as worthwhile. Patients need to have the therapeutic aims of further anti-cancer treatment explained honestly and sensitively. [ABSTRACT FROM AUTHOR]

Aims Uterine tumour resembling ovarian sex cord tumour ( UTROSCT) is an uncommon mesenchymal neoplasm of uncertain histogenesis. While it is considered a neoplasm of uncertain but low malignant potential, there is limited evidence for this as there are no large studies with follow-up. We aimed to determine the clinical behaviour of this uncommon neoplasm and investigate clinicopathological parameters which predict behaviour. Methods and results From a series of 34 cases of UTROSCT, mainly from consultation practice, we obtained follow-up information which was obtained by contacting referring pathologists and clinicians. The follow-up periods ranged from 6 to 135 months (mean 39 months). Eight of 34 patients (23.5%) developed extrauterine metastasis to a variety of sites, including pelvic and abdominal peritoneum, ovary, lymph nodes, bone, liver and lung, and three patients (8.8%) died of tumour. Those neoplasms which exhibited malignant behaviour occurred on average in older patients, and were larger and more likely to exhibit necrosis, lymphovascular invasion, cervical involvement, significant nuclear atypia and significant mitotic activity. However, only the presence of necrosis and significant mitotic activity was statistically significant. Conclusions While our figure of 23.5% of cases exhibiting malignant behaviour may reflect some bias related to consultation practice our results show that, not uncommonly, these neoplasms have an aggressive clinical course with extrauterine metastasis. Given the overlap in pathological parameters between clinically benign and malignant neoplasms, UTROSCTs are all best regarded as potentially malignant. [ABSTRACT FROM AUTHOR]