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To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ajog.2005.04.044 Byline: John K. Chan (a), Vera Loizzi (b), Alessandra Magistris (b), Mark I. Hunter (b), Joanne Rutgers (c), Philip J. DiSaia (b), Michael L. Berman (b) Abstract: Primary lymphoma of the uterine cervix is rare, with less than 60 cases reported. We present a series of 6 patients with cervical lymphoma and review the literature. Author Affiliation: (a) Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Stanford Cancer Center, Stanford University School of Medicine, Stanford, CA (b) Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Chao Family Comprehensive Cancer Center, University of California, Irvine Medical Center, Orange, CA (c) Department of Pathology, Long Beach Memorial Medical Center, Long Beach, CA Article History: Received 17 December 2004; Revised 13 March 2005

Interstitial brachytherapy may be effective in women with cancer of the vulva. This form of radiation treatment is delivered through needles that can be inserted into the skin and tissues. This allows the radiation to be delivered to a smaller area, with fewer side effects.

Estrogen replacement therapy may not be contraindicated in women who have survived stage I or II endometrial cancer. The endometrium is the inner layer of the uterus. Researchers reviewed the outcomes of 123 women treated for stage I and II endometrial cancer, 62 of whom took estrogen replacement therapy after cancer treatment. Women who took estrogen had a similar death rate from recurrences of endometrial cancer (1.6%) as women who did not take estrogen. Estrogen therapy lowers the risk of cardiovascular disease and osteoporosis, both of which may outweigh the risk of cancer recurrence.

Pelvic adhesions, a common complication of pelvic surgery, are the most common cause of intestinal obstruction in the industrialized world, and the more extensive the pelvic surgery, the more likely the development of adhesions. Pelvic adhesions form when the peritoneal membrane, which lines the pelvic cavity and covers organs, attempts to heal in the face of an insufficient blood supply. To minimize adhesion formation, surgeons should handle tissues gently, control bleeding, copiously wash the operating field, treat with antibiotics to prevent infection, limit foreign body reaction, and minimize heat injury from the cautery instruments used to control bleeding. Several techniques, including anti-inflammatory medication, dissolving adhesions once they have formed, and fabric barriers, are under investigation in animal models, but more research is needed before any can be recommended.

Cancer of the ovary ranks fourth as a cause of death among women in the US. Surgical removal of the tumor and treatment with the anticancer agent cisplatin have increased the survival time of women with ovarian cancer. CA 125 is a substance released by the epithelial form of ovarian cancer and can be used to assess the progression of disease and response to treatment. Increased levels of CA 125 suggest progression of the cancer or lack of response to chemotherapy. However, in most cases, the effectiveness of chemotherapy is assessed by surgery, in which the abdomen is examined for any residual cancer cells following treatment. Measurement of CA 125 levels before repeat surgery is not very effective in predicting disease progression in advanced cases of epithelial ovarian cancer. However, CA 125 levels may be useful in evaluating the initial response of tumor cells to chemotherapy and to compare the effectiveness of different drug regimens. A model was developed in which CA 125 levels decline with decreasing numbers of tumor cells. The average time for initial CA 125 levels to decrease by 50 percent following surgery to remove the tumor was 10.4 days. It was predicted that the response of tumor cells to drug therapy was greater with high doses of cisplatin compared with lower doses. This initial response of tumor cells as indicated by CA 125 may be used to predict the outcome of repeat surgery and overall survival. (Consumer Summary produced by Reliance Medical Information, Inc.)