Vol. XXXI, no. 3, 2010 ISSN: 0392-2936


european journal
of gynaecological oncology

an International Journal


Founding Editor
A. Onnis
Montréal (Canada)

Editors-in-Chief
M. Marchetti
Montréal (Canada)
P. Bösze
Budapest (Hungary)

Associate Editor
T. Maggino
Padua (Italy)

Assistant Editor
J. Wilson
San Diego - CA (USA)
Editorial Board
Allen H.H., London, Ontario (Canada)
Ayhan A., Ankara (Turkey)
Balat O., Graziantep (Turkey)
Ba˘nceanu G., Bucarest (Romania)
Basta A., Krakow (Poland)
Bender H.C., Dusseldorf (Germany)
Charkviani T., Tbilisi (Georgia)
Chiarelli S., Padua (Italy)
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)
Elit L., Hamilton (Canada)
Friedrich M., Hamburg (Germany)
Geisler H.E., Indianapolis, IN (USA)
Gorins A., Paris (France)
Heintz A.P.M.,
Utrecht (The Netherlands)
Ioannidou-Mouzaka L.,
Athens (Greece)
Jordan J.A.,
Birmingham, England (UK)
Klastersky J., Bruxelles (Belgium)
Kubista E., Vienna (Austria)
Lee Y.S., Daegu (South Korea)
Markowska J., Poznan (Poland)
Marth C., Innsbruck (Austria)
Massuger Leon F.A.G.,
Nijmegen (The Netherlands)
Menczer J., Savyon (Israel)
Monsonego J., Paris (France)
Pálfalvi L., Budapest, (Hungary)
Piura B., Beer Sheva (Israel)
Piver S.M., Buffalo, NY (USA)
Rakar S., Ljubljana (Slovenia)
Shepherd J.H.,
London, England (UK)
Smit B.J., Tygerberg (South Africa)
Stelmachów J., Warsaw (Poland)
Syrjänen K., Turku (Finland)
Tjalma W., Antwerpen (Belgium)
Ungár L., Budapest (Hungary)
Vermorken J.B., Edegem (Belgium)
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. XXXI, no. 3, 2010
 
   
CONTENTS  
DISTINGUISHED EXPERT SERIES  
Could the eventual results of the NSABP* 39/RTOG** 0413 trial for partial breast irradiation (PBI) be
improved by combining spherical applicators and whole breast irradiation? Radiobiology suggests it
may
241
B.J. Smit - Tygerber, SOUTH AFRICA
Combining spherical application and whole breast irradiation may improve outcome of partial breast irradiation.
 
 
EXPERT’S POINT OF VIEW  
Management of abnormal cytological findings 250
P. Bösze - Budapest, HUNGARY
Point of view of experts on management of abnormal cytological finginds is discussed.
 
REVIEW ARTICLES  
Hyperthermic intraperitoneal chemotherapy added to the treatment of ovarian cancer. A review of
achieved results and complications
256
E. Dovern, I.H.J.T. de Hingh, V.J. Verwaal, W.J. van Driel, S.W. Nienhuijs - Eindhoven, THE NETHERLANDS
A review of achieved results and complications of hyperthermic intraperitoneal chemotherapy added to the treatment of ovarian
cancer.
 
Hormone therapy/adjuvant chemotherapy induced deleterious effects on the bone mass of breast cancer
patients and the intervention of physiotherapy: a literature review
262
T. Tonezzer, C.M.A.P. Pereira, U.P. Filho, A. Marx - São Paulo, BRAZIL
The aim of this study was a literature review. Twenty four articles were selected to analyze the possible deleterious effects caused
by adjuvant chemotherapy and hormone therapy on the bone mass of patients diagnosed with breast cancer and the physiotherapy
intervention.
 
Molecular markers in epithelial ovarian cancer: Their role in prognosis and therapy 268
F. Zagouri, M.A. Dimopoulos, E. Bournakis, C.A. Papadimitriou - Athens, GREECE
The use of molecular markers in epithelial ovarian cancer in common clinical practice seems promising for the diagnosis and
prognostication. It is tempting to anticipate the gradual integration of molecular profiling in clinical practice.
 
ORIGINAL ARTICLES  
Human papillomavirus (HPV)-type distribution in relation to oral contraceptive use in women with
cervical intraepithelial neoplasia, Durban, South Africa
278
M. Moodley, G. Lindeque, C. Connolly - Durban, SOUTH AFRICA
Unusual HPV types with contraceptive usage in a South African context.
 
A comparison of outcome in patients with Stage 1 clear cell and grade 3 endometrioid adenocarcinoma
of the endometrium with and without adjuvant therapy
284
J.A. Rauh-Hain, I. Costaaggini, A.B. Olawaiye, W.B. Growdon, N.S. Horowitz, M.G. del Carmen -
Pittsburgh, USA
In surgical Stage I uterine clear cell carcinoma there is no clear benefit to adjuvant radiation given the absence of improvement
in recurrence risk or any survival benefit.
 
Liquid based cytology improves the positive predictive value of glandular smears compared to
conventional cytology
288
R.J. Edmondson, C.A. Errington, D.J.A. Mansour - Newcastle upon Tyne, UK
A database review suggests that LBC increases the positive predictive value of cervical sampling to detect preinvasive and
invasive cancer.
 
Increase of Mcm3 and Mcm4 expression in cervical squamous cell carcinomas 291
N. Gan, Y. Du, W. Zhang, J. Zhou - Zhejiang Province, CHINA
Mcm3 and Mcm4 were highly expressed in cervical squamous carcinoma and these two proteins might be useful as biomarkers
in clinical diagnosis.
 
Repeated chemosensitivity testing in patients with epithelial ovarian carcinoma 295
M. Pospíšková, M. Špenerová, R. Pilka, M. Kudela, M. Hajdúch, V. Šrámek, B. Melichar, K. Cwiertka -
Olomouc, CZECH REPUBLIC
Changes of chemosensitivity were repeatedly evaluated in a cohort of patients with epithelial ovarian carcinoma. Limited, but
statistical increase in chemoresistance was observed for paclitaxel and carboplatin.
 
Non-hormonal treatment of vasomotor symptoms in gynecological cancer patients 299
L. Del Pup, T. Maggino - Mestre-Venice, ITALY
Non-hormonal therapies such as venlafaxine, paroxetine, gabapentin and clonidine have been shown to reduce hot flashes in
randomized trials compared to placebo.
 
Analysis of clinical and molecular associations of triple negative breast cancers in node-negative patients 304
N. Koronakis, G. Karanikas, E.E. Lagoudianakis, D. Grosomanidis, A. Pappas, J. Chrysikos, G. Xepapadakis,
A. Manouras - Athens, GREECE
Immunohistochemical expression of patients with node-negative invasive breast carcinomas was compared. The TN phenotype
is associated with aggressive histology.
 
Bevacizumab, paclitaxel and carboplatin for advanced ovarian cancer: low risk of gastrointestinal and
cardiovascular toxicity
308
L.N. Abaid, K.L. Lopez, J.P. Micha, M.A. Rettenmaier, J.V. Brown III, B.H. Goldstein - Newport Beach,
CA (USA)
Despite concerns for hypertension and bowel perforations, bevacizumab can be safely administered during induction therapy for
ovarian carcinoma.
 
Expression of p16 in serous ovarian neoplasms 312
H.O. Nazlioglu, I · . Ercan, T. Bilgin, S. Ozuysal - Bursa, TURKEY
P16 expression of benign, borderline and malignant serous ovarian neoplasms was immunohistochemically evaluated, and was
found to be strong in serous ovarian carcinomas.
 
Distribution of HPV genotypes in uterine cervical lesions among the Uighur women in Xinjiang province
of China
315
A. Abudukadeer, Y. Ding, M. Niyazi, A. Ababaikeli, A. Abudula - Urumqi, P.R. CHINA
HPV16 was the most common type found in Uighur patients with cervical cancer while HPV18 and 58 types were relatively
low and other types were absent.
 
Intestinal-type metaplasia in the original squamous epithelium of the cervix 319
E. Sivridis, G. Karpathiou, V. Malamou-Mitsi, A. Giatromanolaki - Ioannina, GREECE
The expression of mucin-distended goblet cells in the normal/original squamous epithelium of the cervix is described for the
first time.
 
Evaluation of preoperative diagnosis with results of histopathological examinations of ovarian tumors in
women of reproductive age
323
D. Samulak, S. Sajdak, M. Wilczak, M. Michalska, B. Pi ta, M. Englert-Golon - Poznan, POLAND
Gynecological, ultrasonographic and Doppler examinations as well as determination of CA-125 antigen provide an efficient
research panel in the preoperative diagnosis of ovarian tumors.
 
 
CASE REPORTS  
Management of recurrence from a retroperitoneal xanthogranuloma: case report 326
D. Salehin, C. Haugk, A. Stricker, R. Triefenbach, M. Friedrich - Krefeld, GERMANY
A rare case of a xanthogranuloma from the retroperitoneal space diagnosed in a 24-year-old woman is presented.
 
A benign metastasizing leiomyoma involving a nodule in the pulmonary artery: case and literature
review
329
O. Poujade, A.S. Genin, M. Dhouha, D. Luton - Paris, FRANCE
A benign metastasizing leiomyoma with local recurrence and metastasis growing into the left pulmonary artery was managed by
surgery.
 
Metastatic and recurrent adenocarcinoma of the uterine cervix: a long-term survival of 16 years 333
I. Peregrin-Alvarez, M.N. Akl, C.P. Morrow, J.F. Magrina - Seville, SPAIN
A multi-modal salvage approach may achieve long-term survival in rare cases of recurrent metastatic cervical adenocarcinoma.
 
Three-dimensional power Doppler color ultrasonographic features of a minimal deviation adenocarcinoma
of the uterine cervix
336
L. Hereter, F. Tresserra, B. Graupera, M.A. Pascual, M.A. Martinez, A. Úbeda - Barcelona, SPAIN
A case of minimal deviation adenocarcinoma of the cervix in a 34-year-old female is presented.
 
Ovarian metastasis of a primary renal cell carcinoma: case report and review of literature 339
S. Guney, N. Guney, D. Özcan, T. Sayılgan, E. Özakın - Istanbul, TURKEY
A case of ovarian metastasis of a primary renal cell carcinoma in a 29-year-old patient is reported.
 
Liver resection for metastases arising from recurrent granulosa cell tumour of the ovary - a case series 342
T.K. Madhuri, S. Butler-Manuel, N. Karanjia, A. Tailor - Guildford, UK
This series discusses three recurrent cases of GCT of the ovary successfully managed with resection of hepatic metastases
improving patient quality of life.
 
Ovarian carcinomatosis presenting as bilateral inguinal hernia: a brief report 345
Y.H. Hung, C.T. Hsu, C.C. Chang - Taiwan, R.O.C.
Gynecologists should be aware of the difficulties associated with a delay in diagnosis of ovarian carcinomatosis presenting as
inguinal hernias.
 
Serous ovarian cystadenocarcinoma incidentally discovered in a 29-year-old patient: case report 347
N. Cutura, V. Soldo, M. Vasiljevic - Belgrade, SERBIA
A case report of a serous ovarian cystadenocarcinoma incidentally discovered in a 29-year-old women is presented.
 
Chemotherapy with low-dose bevacizumab and carboplatin in the treatment of a patient with recurrent
cervical cancer
350
S.J. Tan, Y.H. Juan, P.T. Fu, M.H. Yu, H.C. Lai - Taipei, TAIWAN
The case of patient with platinum-resistant recurrent cervical cancer treated with low-dose bevacizumab and carboplatin with
resultant improved disease progression is presented.
 
Groin recurrence following Stage IA squamous cell carcinoma of the vulva with negative nodes on
superficial inguinal lymphadenectomy
354
A.C. Iyibozkurt, O.C. Dural, S. Topuz, S. Berkman, E. Bengisu - Istanbul, TURKEY
Stage 1A vulvar cancer may recur in the groin despite finding negative nodes in superficial inguinal lymph node dissection.