Angiogenesis in ovarian cancer

Angiogenesis, the formation of new vessels from pre-existing vasculature, is critical to ascites development and metastasis in ovarian cancer. Many growth factors important to ovarian cancer invasion are also prominent in its associated angiogenesis. Deregulation of normal angiogenic processes occurs with the cancer's acquisition of the ability to secrete pro-angiogenic factors. The local imbalance of endogenous angio-stimulators and angio-inhibitors promotes vascularization and vascular leak. Assessment of these pro-angiogenic growth factors and enumeration of tumour-associated microvessels have been shown to be prognosticators of ovarian cancer outcome, and may also be surrogates of ovarian cancer tumour burden and/or ascites formation. The process of angiogenesis has been targeted for therapeutics development. Ovarian cancer is a primary cancer against which these new agents are being tested. Thus, further understanding of the molecular and cell biology of angiogenesis in the context of ovarian cancer offers important directions for estimation of patient outcome and for patient treatment.     

Hyperferritinemia in ovarian cancer

A prospective study was conducted on 50 women with ovarian cancer to determine the association of elevated serum ferritin and ovarian cancer and its potential as a tumor marker. The controls consisted of 116 healthy volunteers, 51 patients with benign gynecologic tumors and 15 patients with benign liver disease. The mean ferritin level in patients with ovarian cancer was 436.7 ng/mL, significantly higher than that in the controls. The effect of chronology on the serum ferritin was also investigated. Hyperferritinemia was observed in 25 (50.0%) of 50 patients with ovarian carcinoma. In patients with liver metastases a marked increase in ferritin was noted. The rate of ferritin elevation in patients with epithelial carcinoma and no hepatic involvement was 21.4%.     

Immunotherapy in ovarian cancer

In the last decade we have witnessed a stormy development in the field of molecular biology, immunology and genetics. Dramatic advances in laboratory and clinical procedures in cellular immunotherapy, along with the development of powerful immunomodulatory agents, created new conditions and opportunities in the treatment of ovarian cancer. The review article provides an overview of the current state of immunotherapy, outlines modern trends in the development of vaccines and immunomodulatory therapies available for immediate clinical testing in cases of advanced ovaria cancer.     

Lymphangiography in ovarian cancer

Lymphangiography (LAG) and retroperitoneal lymphadenectomy were performed in 30 patients with ovarian cancer from May 1985 to Oct. 1986. The results showed that preoperative radiologic-postoperative histologic correlation was 83.3%. There was no false negativity in lymphographic diagnosis of the pelvic node metastases but two false negatives in the para-aortic node. The single most reliable criterion for LAG diagnosis of metastases was a filling-defect in the nodes. The value of LAG as an aid in staging and planning therapy was discussed.     

Surgery in ovarian cancer.

The role of surgery in the management of primary and recurrent ovarian cancer is reviewed. The data to support primary and secondary cytoreduction are summarized. The role of second-look surgery and of surgery in the palliation of ovarian cancer is also discussed.     

Retroorbital metastases in ovarian cancer

We report a patient with unilateral metastasis to the posterior orbit from poorly differentiated ovarian carcinoma with neuroendocrine features. Ocular metastases from pelvic neoplasms have been reported infrequently; however, we report the first case of an ovarian cancer with orbital metastasis as the initial presenting symptom.     

Prognostic factors in ovarian cancer

The improvement in the treatment of ovarian cancer is based on the recognition of the prognostic factors. The 5-year survival rate of 174 patients with epithelial ovarian malignancies after primary operation at the University Department of Obstetrics and Gynecology in Ljubljana and treated with adjuvant therapy at the Institute of Oncology in Ljubljana in the period 1970-1980 was 29.3% (56% for stage I, 36% for stage II, 23% for stage III and 4.5% for stage IV). The amount of residual tumor after the primary operation was prognostically very important (5-year survival in stage III in cases of residual tumor less than 2 cm is 46.6%, in tumor greater than 2 cm only 18.6%). The histological type of tumor, considering the stage, was not important prognostically. On the contrary the grade of differentiation was prognostically very important even in advanced cases: 5 year survival for stage III in cases of well differentiated serous tumors was 61%, in moderately and poorly differentiated cases it was only 7%. Younger patients have better prognosis than older ones, because the tumors are better differentiated, too. Since ovarian cancers are diagnosed too late in 65% of cases in advanced stages, today all efforts should be focussed on early diagnosis, which is probably the only factors that can lead to the dramatic fall of the mortality rate.     

Computerized tomography in ovarian cancer

Sixteen women suffering from ovarian cancer were staged by clinical and pathological means and concomitantly scanned by computed tomographic means. Computed tomography (CT) was found accurate in nine patients. The staging of the disease was upgraded in three patients following the CT examination. CT examination in four patients was equivocal or failed to detect the true extent of the disease. It was not possible to accurately assess the true nature of the pelvic mass on CT following a partial debulking pelvic procedure, as the remnant pelvic bed tissue could be misinterpreted as recurrent cancer. Small peritoneal cancer seedings were not detected on CT. CT scanning despite certain limitations is a valuable noninvasive adjunct in the assessment of carcinoma of the ovary and its response to treatment.