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Background: Gynaecologic cancers (GC) experience unintentional weight loss and inadequate oral intake even before treatment. Cancer patients are at risk of accessing inaccurate advice and misleading information due to the prevalence of misinformation regarding nutrition and cancer in the media. This study aimed to obtain a comprehensive understanding of the perception and belief of dietary intake among newly diagnosed with GC in Malaysia. Methods: We conducted in-depth qualitative interviews with 12 GC respondents from three major ethnicities and continued until the saturation point was reached. A semi-structured interview guide is employed. The interviews were audio recorded and verbally transcribed. Thematic analysis with theoretical saturation was applied to data analysis. Results: The majority of patients interviewed reported that they made dietary modifications following their GC diagnosis, such as healthy eating, and began taking supplements. Their belief and perception of dietary intake were influenced by the impact of diagnosis, uncertainty, and fear of cancer progression and empowerment through nutrition. The cultural influence and access to resources and information might affect their dietary intake. There was evidence of navigating information overload from various sources after newly diagnosed GC. They felt a dilemma in food choices, balancing emotional and nutritional needs. The multidisciplinary support systems and healthcare delivery approach were useful. Discussion and conclusion: The perception and belief of dietary intake among newly diagnosed with GC in Malaysia is diverse and can vary greatly depending on individual experiences, beliefs, and situations. They may attempt to restore some control over their health in the face of a cancer diagnosis. All respondents admitted that they changed to a healthy diet after being diagnosed with GC. The healthcare profession might benefit from current qualitative research to better understand more patients and increase the quality of oncology dietetic service and decision-making. Hence, effective dietary interventions and support strategies could be established for this population. [ABSTRACT FROM AUTHOR]

In this retrospective study, patients with epithelial gynaecologic cancer with pulmonary recurrence (PR) were evaluated from five national gynaecologic oncology clinics. Patients with a diagnosis of primary endometrial, ovarian/fallopian tube/peritoneal, cervical or vaginal/vulvar tumours who developed an initial PR were included in the study A total of 122 patients were included in the study. The median follow-up time after recurrence was 7.5 (range, 1–84) months. The 2-year PRS was 48% in the main cohort. The risk of death was more than seven times higher in patients who did not receive salvage chemotherapy compared with those who did (hazard ratio: 7.6, 95% CI: 3.0–18.9; p <.001). When squamous cell carcinoma was compared with the other tumour types, the risk of death increased more than three times (hazard ratio: 3.7, 95% CI: 1.4–9.6; p =.007). What is already known on this subject? Pulmonary recurrence (PR) from gynaecologic malignancies is rare and can cause major clinical problem. Therefore, defining the clinical and pathologic characteristics and recurrence patterns are essential. What the results of this study add? This study demonstrates non-squamous subtype and salvage chemotherapy at PR were associated with improved survival. What of these findings for clinical practice and/or further research? To the best of our knowledge, our study is the largest study to investigate the clinico-pathologic characteristics, recurrence patterns, treatment options, and post-recurrence survival (PRS) in patients with PR from epithelial gynaecologic cancers. Future research should examine the underlying causes of these findings. [ABSTRACT FROM AUTHOR]

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Gynaecologic and breast cancers share some similarities at the molecular level. The aims of our study are to highlight the similarities and differences about IDO1, an important immune‐related gene in female cancers. The NGS data from TCGA of cervical squamous cell carcinoma (CESC), ovarian serous cystadenocarcinoma (OV), uterine corpus endometrial carcinoma (UCEC), uterine carcinosarcoma (UCS) and breast invasive carcinoma (BRCA) were analysed to identify molecular features, and clinically significant and potential therapeutic targets of IDO1. We found IDO1 was significantly up‐regulated in four gynaecologic cancers and breast cancer. According to breast cancer PAM50 classification scheme, IDO1 expression was higher in tumours of basal than other subtypes and showed better survival prognosis in BRCA and OV. Through immune infiltration analysis, we found a strong correlation between IDO1 and immune cell populations especially for dendritic cells and T cells. In addition, we investigated the association between IDO1 and tumour mutation burden (TMB) and found that IDO1 was significantly correlated with TMB in BRCA and CESC. GSVA revealed that hallmarks significantly correlated with IDO1 were involved in interferon gamma response, allograft rejection and inflammatory response. We also found PD‐L1 and LAG3 were highly positive related to IDO1 in gynaecologic cancers when comparing with their corresponding normal tissues. Our results indicated that IDO1 participated in anti‐tumour immune process and is correlated with mutation burden. These findings may expand our outlook of potential anti‐IDO1 treatments. [ABSTRACT FROM AUTHOR]

Due to substantial improvement in the diagnosis and treatment of gynaecologic cancers, a better understanding of patient care needs to be revised. We reviewed the literature related to fertility preservation strategies in gynaecological cancer and discussed current general management approaches. New technical modalities and patients' own desire for motherhood should be integral and paramount in the clinical evaluation to significantly contribute to preserving fertility in those women diagnosed with gynaecologic cancers during the reproductive years. [ABSTRACT FROM AUTHOR]

Uterine malignancies account for the majority of gynaecologic cancers. Different treatment options are available depending on histology, disease grade and stage. Hysterectomy is the most frequent surgical procedure. Chemotherapy and radiation therapy (CRT) represents the preferred therapeutic choice for locally advanced uterine and cervical malignancies. Imaging of the female pelvis following these treatments is particularly challenging due to alteration of the normal anatomy. Radiologists should be familiar with both the expected post-treatment imaging findings and the imaging features of possible complications to make the correct interpretation and avoid possible pitfalls. The purpose of this review is to show the expected computed tomography (CT) and Magnetic Resonance Imaging (MRI) appearances of the female pelvis following surgery and CRT for uterine and cervical cancer, to illustrate the imaging findings of early and delayed most common complications after surgery and CRT, describing the suitable imaging modalities and protocols for evaluation of patients treated for gynaecologic malignancies. [ABSTRACT FROM AUTHOR]

Uterine sarcomas are rare, highly malignant tumours comprising < 1 % of all gynaecologic malignancies. To evaluate clinical presentation, histolopathologic pattern and outcome of uterine sarcomas presenting to a tertiary referral centre over an 8 year period (2004-2012). All histologically proven uterine sarcomas were retrospectively analysed. Clinical presentation, histology, treatment and outcome were analysed. Mean age was 42 years. Predominant histopathology was endometrial stromal sarcoma ( n = 13); 9 were low grade, carcinosarcoma ( n = 8) and leiomyosarcoma ( n = 2). Fourteen patients had Stage I disease, 3 Stage II, 4 Stage III and 2 were Stage IV at presentation. Patients with disease confined to uterus received no adjuvant treatment (61 %). Of these, 11 were endometrial stromal sarcoma (7 were low grade) and 3 were carcinosarcomas. Four patients received adjuvant EBRT following hysterectomy (17 %). Two patients who presented with metastases received palliative chemotherapy. Mean follow-up period was 46 months (0-86 months). Eleven patients (47 %) developed disease recurrence. Seven (30 %) had local recurrence, while 4 (17 %) developed pulmonary metastases. A total of eight patients died and all deaths were within 1 year of recurrence. The only prognostic factor that correlated with survival was the stage of disease at diagnosis. [ABSTRACT FROM AUTHOR]

BACKGROUND: Aim ot the study was to assess the role of planar lymphoscintigraphy and fusion imaging of SPECT/CT in sentinel lymph node (SLN) detection in patients with various types of tumours and to estimate some factors influencing detection success -- age and body mass index. MATERIAL AND METHODS: Planar scintigraphy and hybrid modality SPECT/CT were performed in 550 consecutive patients (mean age 58.1 ± 13.1 years): 69 pts with gynaecological tumours (37 pts with cervical cancer, 25 pts with endometrial cancer, 7 pts with vulvar carcinoma; mean age 54.4 ± 13.2 years), 161 consecutive patients with melanomas (mean age 57.1 ± 14.8 years), and 320 consecutive women with breast cancer (mean age 59.4 ± 12.0 years). The radiopharmaceutical was injected around the tumour (gynaecologic and breast cancers, melanomas), subareolarly (in some breast cancers), or around the scar (in melanomas after their removal). Planar and SPECT/CT images were interpreted separately by two nuclear medicine physicians. RESULTS: Planar scintigraphy did not show SLN in 77 patients (14.0%): in 8 pts with gynaecologic tumours, in 23 pts with mela¬nomas and in 46 pts with breast cancer. SPECT/CT was negative in 49 patients (8.9%): in 4 pts with gynaecologic tumours, in 12 pts with melanomas and in 33 pts with breast cancer. In 199 (36.2%) patients the number of SLNs captured on SPECT/CT was higher than on planar imaging. 35 foci of uptake (3.1% from totally visible 1134 foci on planar images) interpreted on planar images as hot LNs were found to be false positive non-nodal sites of uptake when further assessed on SPECT/CT. SPECT/CT showed the exact anatomical location of all visualized sentinel nodes. Influence of the age and BMI: The group of patients with higher number of detected SLN on SPECT/CT than on planar scintigraphy had lower average age than the group of patients with the same number of detected SLN on SPECT/CT and on planar scintigraphy, the difference was statistically significant (P=0.008). BMI did not differ between the two groups. CONCLUSION: In some patients with gynaecologic and breast cancers and melanomas, SPECT/CT improves detection of sentinel lymph nodes. It can image nodes not visible on planar scintigrams, exclude false positive uptake and exactly local¬ize axillary, inguinal, pelvic and paraaortic SLNs. It improves anatomical localization of SLNs. We have found the influence of the age on the difference in the number of SLNs detected by the fusion of SPECT/CT and planar lymphoscintigraphy. On the other hand, this difference was not influenced by BMI. [ABSTRACT FROM AUTHOR]

Please cite this paper as: Dey S, Hablas A, Seifeldin I, Ismail K, Ramadan M, El-Hamzawy H, Wilson M, Banerjee M, Boffetta P, Harford J, Merajver S, Soliman A. Urban–rural differences of gynaecological malignancies in Egypt (1999–2002). BJOG 2010;117:348–355. Objective In previous studies, we have shown a three to four times higher urban incidence of breast cancer and estrogen receptor-positive breast cancers in the Gharbiah Province of Egypt. We investigated the urban–rural incidence differences of gynaecologic malignancies (uterine, ovarian and cervical cancers) to explore if they show the same trend that we found for breast cancer. Design Cancer registry-based incidence comparison. Setting Gharbiah population-based cancer registry (GPCR), Tanta, Egypt. Sample All patients with uterine, ovarian and cervical cancer in GPCR from 1999 to 2002. Methods We calculated uterine, ovarian and cervical cancer incidence from 1999 to 2002. For each of the three cancers, we calculated the overall and age-specific rates for the province as a whole, and by urban–rural status, as well as for the eight districts of the province. Results Incidence of all three cancer sites was higher in urban than in rural areas. Uterine cancer showed the highest urban–rural incidence rate ratio (IRR = 6.07, 95% CI = 4.17, 8.85). Uterine cancer also showed the highest urban incidence in the oldest age group (70+ age category, IRR = 14.39, 95% CI = 4.24, 48.87) and in developed districts (Tanta, IRR = 4.14, 95% CI = 0.41, 42.04). Incidence rates by groups of cancer sites showed an increasing gradient of urban incidence for cancers related to hormonal aetiology, mainly of the breast and uterus (IRR = 4.96, 95% CI = 2.86, 8.61). Conclusions The higher urban incidence of uterine cancer, coupled with our previous findings of higher incidence of breast cancer and estrogen receptor positive breast cancer in urban areas in this region, may be suggestive of possible higher exposure to environmental estrogenic compounds, such as xenoestrogens, in urban areas. [ABSTRACT FROM AUTHOR]

Abstract: Revealing a diagnosis of gynaecologic cancer generates various psychosocial and emotional responses: anxiety, denial, passivity, annihilation of long-term projects and personal responsibilities, worries about the near future and of death. In gynaecological cancer, alterations of sexuality and of representation of femininity can seriously complicate the psychic representation of disease and impair family life of the patients. The prevalence of depression among cancer increases with the severity of the disease and with the intensity of the symptoms such as pain and fatigue. Conversely, depression may interfere with the course of cancer in altering the adherence to medical treatment and in affecting the patient''s endocrine and immune functions. Thus, serious medical and psychiatric comorbidities may be underestimated. Depression in patients with gynaecological cancers has been under-diagnosed and under-treated, partly because of the belief that depression is a normal and universal reaction to serious diseases and partly, because the neurovegetative signs or emotional and cognitive symptoms of depression are often attributed to the medical illness itself. Many recent studies have shown a decrease of depression by chemotherapy, psychotherapy or relaxation interventions. The complexity of psychological reactions of such patients, however, requires that a psycho-oncologist be included in the treatment team. These studies point to the importance of detecting depression and of treating the substantial minority of gynaecological cancer patients suffering from depression with therapies designed to improve their quality of life and their ability to cope with the cancer at every stage of their disease. [Copyright &y& Elsevier]