Vol. XXVIII, n.2, 2007 ISSN: 0392-2936


european journal
of gynaecological oncology

an International Journal


Editors-in-Chief
A. Onnis
Montréal (CND)
P. Bösze
Budapest (Hungary)


Associate Editors
M. Marchetti
Montréal (CND)

Assistant Editor
J. Wilson
San Diego - CA (USA)
Editorial Board
Allen H.H., London, Ontario (Canada)
Anteby S.O., Jerusalem (Israel)
Audet-Lapointe P., Montreal (Canada)
Ayhan A., Ankara (Turkey)
Balat O., Graziantep (Turkey)
Barber H.K., New York, NY (USA)
Basta A., Krakow (Poland)
Bender H.C., Dusseldorf (Germany)
Benedetti Panici P.L., Rome (Italy)
Charkviani T., Tbilisi (Georgia)
De Oliveira C.F., Coimbra (Portugal)
Dexeus S. Jr., Barcelona (Spain)
Di Paola G.R.,Buenos Aires (Argentina)
Di Re F., Milan (Italy)
Di Saia P., Orange, CA (USA)
Fuller A.F. Jr., Boston, MA (USA)
Geisler H.E., Indianapolis, IN (USA)
Gerbaulet A., Villejuif (France)
Gorins A., Paris (France)
Heintz A.P.M., Utrecht (The Netherlands)
Ioannidou-Mouzaka L.,Athens (Greece)
Jordan J.A., Birmingham, England (UK)
Karseladze A.I., Moscow (Russia)
Klastersky J., Bruxelles (Belgium)
Kubista E., Vienna (Austria)
Kudelka A.P., Houston, TX (USA)
Maggino T., Padua (Italy)
Markowska J., Poznan (Poland)
Marth C., Innsbruck (Austria)
Massuger Leon F.A.G.,
Menczer J., Savyon (Israel)
Monsonego J., Paris (France)
Pinotti A., São Paulo (Brazil)
Piura B., Beer Sheva (Israel)
Piver S.M., Buffalo, NY (USA)
Rakar S., Ljubljana (Slovenia)
Raju K.S., London, England (UK)
Shepherd J.H., London, England (UK)
Stelmachów J., Warsaw (Poland)
Tjalma W., Antwerpen (Belgium)
Ungár L., Budapest (Hungary)
Vermorken J.B., Edegem (Belgium)
Vîrtej P., Bucharest (Romania)
Wang P.-H., Taipei (Taiwan)
Winter R., Graz (Austria)
Yokoyama Y., Hirosaki (Japan)

Publishing Organization (M. Morsani):
I.R.O.G. CANADA, Inc. - 4900 Côte St-Luc - Apt # 212 - Montréal, Qué. H3W 2H3 (Canada)
Tel. +514-4893242 - Fax +514-4854513 - E-mail: canlux@mgroup-online.com - www.irog.net

Editorial Office (M. Critelli):
Galleria Storione, 2/A - 35123 Padua (Italy) - Tel. (39) 049 8756900 - Fax (39) 049 8752018

 

EUROPEAN JOURNAL OF GYNAECOLOGICAL ONCOLOGY (ISSN 0392-2936) publishes original peer reviewed works in the fields of female genital cancers and related subjects and also proceedings of gynecologic oncology society meetings all over the world. The Journal is covered by CURRENT CONTENTS, SCISEARCH, RESEARCH ALERT, INDEX MEDICUS, MEDLINE, EMBASE/ Excerpta Medica, CURRENT ADVANCES IN CANCER RESEARCH, BIOSIS.

 

European Journal of Gynaecological Oncology
www.irog.net


General Information

The EUROPEAN JOURNAL OF GYNAECOLOGICAL ONCOLOGY (ISSN 0392-2936) publishes original peer reviewed work, preferably brief reports, in the fields of female genital cancers and related subjects – prevention, early detection, epidemiology, pathology, diagnosis, management – and also proceedings of Gynaecologic Oncology Society meetings all over the world.

The Journal is covered by CURRENT CONTENTS, SCISEARCH, RESEARCH ALERT, INDEX MEDICUS, MEDLINE,
EMBASE/ Excerpta Medica, CURRENT ADVANCES IN CANCER RESEARCH, BIOSIS.

AIMS AND SCOPE
The EUROPEAN JOURNAL OF GYNAECOLOGICAL ONCOLOGY is dedicated to publishing editorial articles in the “Distin-guished Expert Series” and original research papers, case reports, letters to the Editor, book reviews and newsletters.

The Journal was founded in 1980 – the second gynaecologic oncology hyperspecialization journal in the world. Its aim is the dif-fusion of scientific, clinical and practical progress and knowledge in female neoplastic diseases in an interdisciplinary approach among gynaecologists, oncologists, radiotherapists, surgeons, chemotherapists, pathologists, epidemiologists and so on.

ANNOUNCEMENTS regarding meetings, postgraduate courses and symposia will be accepted 6 months before publication and will be published free of charge.
BOOK SAMPLES for review should be sent to the Editorial offices in Montréal or in Padova.
COPYRIGHT: the Journal has been registered with the Copyright Clearance Center, Inc. Reproductions are not allowed without the written consent of the Publisher. All photocopy fees should be paid to the Copyright Clearance Center, Inc., 21 Congress Street, Salem, MA 01970, USA stating the ISSN number, the volume and the first and last page numbers of each article copied.
ADVERTISING INFORMATION: advertising orders and inquiries may be sent to: I.R.O.G. CANADA Inc., Publisher, 4900 Côte St. Luc, Apt. 212, Montréal (Quebec) Canada H3W 2HS, Tél. 514.4893242-4893640 - Fax 514.4854513 - E-mail: canlux@mgroup-online.com - www.irog.net
RESPONSIBILITY: although every effort is made by the editorial staff and the printer to eliminate misleading or inaccurate infor-mation, the publisher accepts no responsibility for the consequences of faultful or incorrect information. The authors recognize that the editor and publisher have no responsibility and are indemnified against any liability or claim that may result from the publication of misleading or incorrect data.


SUBSCRIPTION INFORMATION
The Journal is published bimonthly (January, March, May, July, September and November); one volume per year. Subscriptions start from January and are automatically renewed if not cancelled by the end of September.

Subscriptions include six issues per year plus supplements, monographs and all official communications of Meetings, Courses, Symposia and all scientific activities of Gynaecologic Oncology Societies all over the world.

Subscriptions are entered with prepayment only. The annual subscription is $390 US for Institutions, $200 US for Individuals. For airmail add $30, for receipt add $10 US. Single copy prepaid cost $95 US.

Send subscription requests with cheque or credit card payment (Amex - Visa - Diner’s - Master Card) to I.R.O.G. CANADA Inc., 4900 Côte St. Luc, Apt. 212, Montréal, Québec H3W 2H3 Canada. Only US Funds are accepted. No bank transfers.

Claims for missing issues can be honoured up to six months. Changes of address: allow six weeks for all changes to become effec-tive. All communications should include both old and new addresses (with postal codes) – better if accompanied by a mailing label from a recent issue – and should be sent to the printer: La Garangola, Via E. Dalla Costa 6, 35129 Padova (Italy) or by Fax +39.049.7806580. Claims should be made within six months of publication date.

Duplicate copies will not be sent to replace those undelivered through failure to notify of change of address.

Single copies and back issue and volume information is available from the printer, La Garangola, Padova, Tel. +39.049.8075557, Fax +39.049.7806580. Certain back issues may only be available as photocopies of the originals.

All other business correspondence including orders for offprints and advertising space and any communication and requests should be addressed to I.R.O.G. CANADA Inc., 4900 Côte St. Luc, Apt. 212, MONTRÉAL, QUÉBEC H3W 2H3 (Canada), tel. (514) 4893242, fax (514) 4854513.

IN ALL LEGAL MATTERS THE COURT OF MONTREAL IS COMPETENT

 

European Journal of Gynaecological Oncology
www.irog.net


Instructions to Authors

SUBMISSION OF MANUSCRIPTS
Papers should be submitted to A. ONNIS Editor-in-Chief of the EUROPEAN JOURNAL OF GYNAECOLOGICAL ONCOLOGY, 4900 Côte St. Luc, Apt. 212 MONTREAL, QUÉBEC H3W 2H3 (Canada) - Tel. +514-4893242 - Fax +514-4854513, or Galleria Sto-rione 2/A - 35123 PADOVA (Italy) - Fax +39-049-8752018.

Editorial articles for publication in the “Distinguished Expert Series” should be submitted to P. Bösze, Editor-in-Chief of this section, Department of Gynecology, Saint Stephan Hospital, 1096 Budapest, Nagyvárad tér 1, Telephone (36-1) 275 2172, Fax (36-1)
275 2172, E-mail: bosze@axelero.hu

When a manuscript is submitted, an acknowledgement card is sent to the corresponding author within two or three weeks.

Submitted papers are reviewed by the Editor-in-Chief and his Peer Referees. Authors may be required to modify the manuscript according to the reviewers’ suggestions.

Manuscripts accepted for publication will be copyedited by the editorial staff for typographical and grammatical mistakes and to guarantee clarity and conciseness.

Publication time will be the shortest possible based on scientific and publishing needs. Manuscripts submitted for publi-cation cannot be returned.

Published papers will become property of the Journal and copyrighted under I.R.O.G. CANADA Inc.

After six months no grievances will be accepted regarding published articles.

All statements are the responsibility of the authors. Product dosages, indications and methods referred to in the papers reflect the author’s experience. No responsibility is assumed by the Editor-in-Chief or the Publisher for any damage from use of any products, operation methods or instructions contained in the published materials.

Trade names, trademarks, etc. are protected by the law and regulations. The Editor-in-Chief and the Publisher cannot accept any legal responsibility for any errors or omissions that may be made in press, particularly for information about drug dosage and appli-cation thereof contained in the Journal. Consult the prescribing information before administering any drug.

MANUSCRIPT REQUIREMENTS
The Journal follows the “Uniform requirements for manuscripts submitted to biomedical journals” published in the New England Journal of Medicine 1991, 324, 424-8 and in the British Medical Journal 1991, 302.

Three manuscripts, typed and double spaced should be submitted with an electronic disk, formatted in Word for Macintosh or Windows, version 6.0. Manuscripts without an electronic disk will not be accepted. A cover letter signed by all authors must state that all authors who have participated in the work take responsibility for the manuscript which has never been pub lished or submitted for publication elsewhere. Without a cover letter the publication will not be possible. Name, address and phone/fax numbers of the Corresponding Author, responsible for revision and approval of the proofs, should be indicated. Full-length articles should not exceed 8 printed pages including tables and references.

After the title page (full title and names of authors, institutions, eventual acknowledgement for financial support, running title of no more than 60 characters or spaces), original works should be arranged in the conventional order: Summary (purpose of investiga-tion, methods, results, conclusion - about 150 words), Key words, Content (a 20-word summary), Introduction, Materials and Methods, Results, Discussion, Conclusion, Acknowledgement (if any), References, Tables, Legends.

Authors should supply a complete address for reprint requests.

In the text only standard abbreviations can be used and must be avoided in the title. The full term for which an abbreviation stands should precede its first use in the summary and text unless it is a standard unit of measurement.

Authors must give their complete professional identifications and affiliations, including all academic titles and positions.

Letters to the editor should be brief (500 words or less) and offer objective, constructive and educational criticism of published material. The editor reserves the right to publish.

Figures: Two original copies (not negatives) of each figure are requested. Each figure should have a label on the back indicating its number, author’s name and top of the figure. Do not write on the back of the figures and do not mount them on cardboard. If sending colour pictures advise if they must be printed in colour or black and white (colour costs ten times more).

Legends should be typed on a separate page with Arabic numerals corresponding to the illustrations.

Tables should be titled, typed in double space on separate pages and numbered in Arabic numerals in the order of their first cita-tion
in the text. Do not use internal rules. Only standard, universally understood abbreviations should be used.

References should be numbered consecutively in the order in which they are first mentioned in the text. Identify references in the text, tables, and legends by Arabic numerals in parentheses.

Use the style of the examples below, which are based with slight modifications on the format used by the U.S. National Library of Medicine in Index Medicus. The titles of journals should be abbreviated according to the style used in Index Medicus.

References must be verified by the Author(s) against the original documents.

Examples of correct forms of references are given below:

Articles in Journals: Authors’ surname and initials (if more than six names, give six followed by “et al.”), Title, Abbreviated Journal Title, Year of Publication, Volume, Issue and first page.

Books: Authors’ surname and initials, title of the book and title of chapter, in: Title, Editor(s), Place, Publisher, Year, Page.

Acknowledgments
will be limited to appropriate professionals who were contributors to the paper.

PROOFS revised by the editorial staff will be sent to the corresponding author and should be checked and returned within ten days. The corresponding author is responsible for detecting typesetting errors. After this deadline the proofs will be considered approved. Only essential corrections should be made; extensive changes will be charged to the authors.

BUSINESS MATTERS
The Journal has no commercial advertisements.

Authors will be expected to contribute to the printing expenses, tables, figures and postage. For every published article a copy of the Journal will be provided free of charge. Only payments in US dollars will be accepted. No bank transfers.

Reprints should be requested with the form enclosed with the acceptance letter. No free reprints will be supplied.



© By I.R.O.G. CANADA INC. - Publisher - Editorial office 4900 Côte St. Luc - Apt. 212 - Montréal Québec H3W 2H3 (Canada) - Tel. (514) 4893242-4893640 - Fax (514) 4854513 - Printed in Italy by “La Garangola” - Via E. Dalla Costa, 6 - 35129 Padua (Italy) - Responsible Director: Prof. Antonio Onnis M.D. - Authorization of Padua’s Court n. 633 - 28-6-1979
   
European Journal of Gynaecological Oncology - Vol. XXVIII, n. 2, 2007
 
   
CONTENTS  
DISTINGUISHED EXPERT SERIES  
Robotic surgery in gynecology 77
J.F. Magrina - Scottsdale, AZ (USA)
Robotic surgery constitutes a major improvement in the efficiency, accuracy, case and comfort associated with the performance of laparoscopic operations.
 
 
ORIGINAL ARTICLES  
M2-PK as a novel marker in ovarian cancer. A prospective cohort study 83
A.S. Ahmed, T. Dew, F.G. Lawton, A.J. Papadopoulos, O. Devaja, K.S. Raju, R.A. Sherwood - Kent, UK
Tumour marker M2-PK was significantly raised in ovarian cancer patients with comparable efficacy to CA-125; however further evaluation is needed.
 
Effects of selective estrogen receptor modulators and genistein on the expression of ERα/β and COX-1/2 in ovarectomized mouse uteri 89
Y. Wu, K. Niwa, K. Onogi, L. Tang, H. Mori, T. Tamaya - Gifu-city, JAPAN
Genistein significantly decreased c-jun, Cox-2 and ERα. Toremifene significantly increased ERβ. Toremifene and genistein might prevent E2-related endometrial carcinogenesis.
 
Diabetes mellitus is a multivariate independent prognostic factor in endometrial carcinoma: A clinicopathologic study on 313 patients 95
E. Steiner, K. Plata, C. Interthal, M. Schmidt, A. Faldum, J.G. Hengstler, N. Sakuragi, H. Watari, R. Yamamoto, H. Kölbl - Sapporo, JAPAN
This retrospective multivariate analysis revealed that diabetes mellitus, FIGO stage and depth of myometrial invasion were significantly associated with overall survival.
 
Is aortic lymphadenectomy necessary in the management of endometrial carcinoma? 98

S.S.N. Siu, K.W.K. Lo, T.H. Cheung, S.F. Yim, T.K.H. Chung - Shatin, HONG KONG
Aortic lymphadenectomy provides diagnostic and therapeutic value in the management of endometrial carcinoma. It should be considered in cases with high metastatic risk.

 
Tumour M2-PK as a predictor of surgical outcome in ovarian cancer, a prospective cohort study 103
A.S. Ahmed, T. Dew, F.G. Lawton, A.J. Papadopoulos, O. Devaja, K.S. Raju, R.A. Sherwood - Kent, UK
Tumour M2-PK predicted suboptimal cytoreduction in advanced stage disease with 69% sensitivity, 60% specificity and 61% overall efficacy (CI: 44-75%).
 
Anthracycline-based adjuvant chemotherapy in early-stage uterine sarcomas: Long-term results of a single institution experience 109
C.A. Papadimitriou, M.P. Zorzou, S. Markaki, A. Rodolakis, Z. Voulgaris, G. Bozas, E. Kastritis, A. Bamias, D. Gika, M.A. Dimopoulos - Athens, GREECE
A retrospective study of patients with early-stage uterine sarcomas treated with anthracycline-based regimens revealed that the addition of ifosfamide improved overall survival.
 
Could epithelial ovarian cancer be associated with chlamydial infection? 117
A. Wong, A.B. Maclean, S.J. Furrows, G.L. Ridgway, P.J. Hardiman, C.W. Perrett - London, UK
Higher IgA chlamydia seropositivity and lower IgG seropositivity occur in EOC patients compared to patients with benign cystadenomas and controls.
 
Evaluation of anxiety levels during intracavitary brachytherapy applications in women with gynecological malignancies 121
S. Kamer, Z. Özsaran, Ö. Çelik, O. Bildik, D. Yalman,Y. Bölükbas¸ı, A. Haydarog˘lu - Manisa, TURKEY
Anxiety levels of women treated for gynecological malignancies using intracavitary brachytherapy were evaluated.
 
Postoperative complications - massive transfusions in radical malignant gynecological surgeries 125
Lj. Arsenijevic, M. Gojnic, D. Filimonovic, N. Popovic, V. Dugalic - Belgrade, SERBIA AND MONTENEGRO
Of 24 women who underwent radical surgery and received massive transfusions during the intraoperative and postoperative period, 12 developed massive transfusion complications. Early recognition is the key to the optimal care of such patients.
 
Combination of intraperitoneal hyperthermic perfusion chemotherapy (IHPC) with intraperitoneal chemotherapy as a treatment modality for persistent ovarian cancer 128
D. Wydra, S. Sawicki, K. Ciach, A. Marciniak, J. Emerich - Gdan´sk, POLAND
Combining IHPC with intraperitoneal chemotherapy was effective as a second-line treatment in a patient with persistent disease.
 
 
CASE REPORTS  
Cancer of the vulva in a 25-year-old woman with VIN III and high-grade cervical SIL - case report 131
E. González-Bosquet, M. Sun¯ol, A. Hernandez, J. Callejo, J.M. Lailla - Barcelona, SPAIN
An unusual case of vulvar carcinoma in a 25-year-old woman with a VIN III and high-grade cervical SIL is presented.
 
Bizarre big belly ball: intraabdominal abscess mimicking Stauffer syndrome secondary to uterine leiomyosarcoma 134
A. Bardia, C.A. Thompson, K.C. Podratz, S.H. Okuno - Rochester, MN (USA)
A rare case of uterine leiomyosarcoma and abdominal abscess mimicking Stauffer syndrome is presented.
 
Endometrial carcinoma with ovarian metastases incidentally detected in a 30-year-old infertile patient - case report 137
M. Vasiljevic, M. Prorocic, N. Vasiljevic, L. Tasic - Belgrade, SERBIA
A case of invasive endometrial carcinoma with ovarian metastases in a 30-year-old infertile woman is presented.
 
“Occult” neuroendocrine component and rare metastatic pattern in cervical cancer: Report of a case and brief review of the literature 139
K. Rhiem, M. Possover, A. Gossmann, K. Drebber, P. Mallmann, U. Ulrich - Düsseldorf, GERMANY
A “mixed” squamous cell cervical cancer FIGO Stage IB1 with a small neuroendocrine component exhibited a rare pattern of distant metastases.
 
Small cell carcinoma of the breast: case report 142
R. Shaco-Levy, V. Dyomin, L. Kachko, N. Sion-Vardy, D.B. Geffen, M. Koretz - Beer-Sheva, ISRAEL
A case of primary small cell carcinoma of the breast in a young woman is reported with a discussion of the clinical and pathological aspects.
 
Pseudomyxoma peritonei and mucinous pyometral fluid arising from an ovarian borderline mucinous tumor: case report 145
K. Niwa, R. Hirose, T. Mizuno,Y. Hirose, T. Tamaya - Gifu, JAPAN
A case of a pseudomyxoma peritonei and mucinous pyometral fluid possibly arising from an ovarian borderline mucinous tumor is reported.
 
Diffuse malignant peritoneal mesothelioma in a 31-year-old patient - case report 147
M. Prorocic, M. Vasiljevic, S. Jankovic, O. Dzatic - Belgrade, SERBIA
A case of diffuse malignant peritoneal mesothelioma is reported. Radical surgery combined with chemotherapy is the treatment of choice.
 
Malignant paraganglioma of the urinary bladder in a 44-year-old female: clinicopathological and immunohistochemical study of a rare entity and literature review 149
E. Kairi-Vassilatou, J. Argeitis, H. Nika, D. Grapsa, V. Smyrniotis, A. Kondi-Pafiti - Athens, GREECE
Histological and immunohistochemical characteristics of a malignant paraganglioma of the urinary bladder in a 44-year-old female were analyzed.
 
Brain metastasis and carcinomatous meningitis from vulvar squamous cell carcinoma: case report 152
J. Puente Vázquez, S. López-Tarruella Cobo, F.M. Antón, A.C. Asado, J.A. Vidart, P. Coronado, E. Díaz- Rubio - Madrid, SPAIN
A case of a 74-year-old woman diagnosed with locally advanced vulvar squamous carcinoma is presented. Initial therapy consisted of multiagent chemotherapy and vulvar, pelvis and groin irradiation.
 
A case of endodermal sinus tumor associated with the first pregnancy and successful management of the second pregnancy: a case report and review of the literature 155
S. Ayas, I·. Aköz, E. Eskicirak, A. Karateke, Ö. Bozoklu - Istanbul, TURKEY
Successful outcome of a second pregnancy in a patient treated for an endodermal sinus tumor during the first pregnancy.
 
Letter to the Editor 160