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  1. Article ; Online: MDT practice determines treatment pathway for patients with advanced ovarian cancer: A multi-centre observational study.

    Khassan, T / Smitten, E / Wood, N / Fotopoulou, C / Morrison, J / MacDonald, M / Baxter, K / Edmondson, R J

    European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

    2023  Volume 49, Issue 8, Page(s) 1504–1510

    Abstract: Objective: To investigate decision making for patients with advanced ovarian cancer as a possible explanation of geographical variation in treatment patterns.: Methods: We carried out a multi-centre observational study in multidisciplinary teams ... ...

    Abstract Objective: To investigate decision making for patients with advanced ovarian cancer as a possible explanation of geographical variation in treatment patterns.
    Methods: We carried out a multi-centre observational study in multidisciplinary teams meetings for five major UK cancer centres. All patients presenting to five cancer centres with advanced ovarian cancer over a six-week period. The GO-MDT-MODe tool was used to provide a measure of participation and quality of case discussion for all cases of advanced ovarian cancer. MDT scores were correlated with surgical data extracted from national audit data. Data were recorded for overall MDT performance.
    Results: A total of 870 case discussions, including 145 cases of advanced ovarian cancer, were observed. MDTs varied in structure, format and time allocation between centres. Cluster analysis showed significant variation in quality and participation of discussion between centres (p < 0.0025) and this correlated with the proportion of patients in the wider cancer alliance undergoing surgery.
    Conclusions: We have shown that at least part of the variation in practice seen in the UK correlates with different behaviours within MDTs. Increasing time for discussion and encouraging participation from all staff groups may increase proportions of patients undergoing optimal treatment regimens.
    MeSH term(s) Male ; Humans ; Female ; Patient Care Team ; Genital Neoplasms, Male ; Carcinoma, Ovarian Epithelial ; Ovarian Neoplasms/surgery
    Language English
    Publishing date 2023-03-16
    Publishing country England
    Document type Observational Study ; Multicenter Study ; Journal Article
    ZDB-ID 632519-1
    ISSN 1532-2157 ; 0748-7983
    ISSN (online) 1532-2157
    ISSN 0748-7983
    DOI 10.1016/j.ejso.2023.03.210
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    Zs.A 1149: Show issues Location:
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  2. Article ; Online: Propensity score matching confirms that primary surgery or neoadjuvant chemotherapy result in equivalent survival within a comprehensive cohort of patients with high-grade serous ovarian cancer.

    Russell, B / Hawarden, A / Gee, M / Edmondson, R J

    Gynecologic oncology

    2020  Volume 160, Issue 1, Page(s) 24–31

    Abstract: Objective: Our objective was to investigate whether trial evidence showing that neoadjuvant chemotherapy is non inferior to primary surgery for the primary treatment of advanced ovarian cancer could be extrapolated to groups of patients that were not ... ...

    Abstract Objective: Our objective was to investigate whether trial evidence showing that neoadjuvant chemotherapy is non inferior to primary surgery for the primary treatment of advanced ovarian cancer could be extrapolated to groups of patients that were not included in the trials.
    Methods: Using a detailed retrospective cohort of all patients managed through a single tertiary hospital we carried out a propensity score analysis, principal component analysis, and cox proportional hazard analysis to compare survival in matched cohorts.
    Results: A propensity score analysis showed that for at least 41% of all patients with advanced high-grade serous cancer neoadjuvant chemotherapy is non inferior to primary surgery (median survival primary surgery: 38 months, neoadjuvant chemotherapy: 35 months. P = 0.39). However, principal component analysis, supported by cox modelling, suggests that for some subgroups, including patients with subdiaphragmatic nodal disease, primary surgery may be associated with improved survival (HR 0.11, CI 0.026-0.48).
    Conclusions: We have shown that the findings of previous trials can be extrapolated to a wider population and that statistical modelling can be used to identify groups or patients who benefit from specific modalities of treatment.
    MeSH term(s) Aged ; Carcinoma, Ovarian Epithelial/drug therapy ; Carcinoma, Ovarian Epithelial/mortality ; Carcinoma, Ovarian Epithelial/surgery ; Carcinoma, Ovarian Epithelial/therapy ; Cohort Studies ; England/epidemiology ; Female ; Humans ; Middle Aged ; Neoadjuvant Therapy ; Ovarian Neoplasms/drug therapy ; Ovarian Neoplasms/mortality ; Ovarian Neoplasms/surgery ; Ovarian Neoplasms/therapy ; Principal Component Analysis ; Propensity Score ; Proportional Hazards Models ; Retrospective Studies
    Language English
    Publishing date 2020-11-05
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 801461-9
    ISSN 1095-6859 ; 0090-8258
    ISSN (online) 1095-6859
    ISSN 0090-8258
    DOI 10.1016/j.ygyno.2020.10.035
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    Zs.A 885: Show issues Location:
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  3. Article ; Online: Should we worry about obesity in our ovarian cancer patients, too?

    Sawan, S / Edmondson, R J

    BJOG : an international journal of obstetrics and gynaecology

    2016  Volume 123, Issue 2, Page(s) 309

    MeSH term(s) Female ; Humans ; Obesity/surgery ; Ovarian Neoplasms/surgery ; Postoperative Complications/surgery
    Language English
    Publishing date 2016-01
    Publishing country England
    Document type Comment ; Journal Article
    ZDB-ID 2000931-8
    ISSN 1471-0528 ; 0306-5456 ; 1470-0328
    ISSN (online) 1471-0528
    ISSN 0306-5456 ; 1470-0328
    DOI 10.1111/1471-0528.13773
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  4. Article ; Online: Detection of MCM5 as a novel non-invasive aid for the diagnosis of endometrial and ovarian tumours.

    Stockley, J / Akhand, R / Kennedy, A / Nyberg, C / Crosbie, E J / Edmondson, R J

    BMC cancer

    2020  Volume 20, Issue 1, Page(s) 1000

    Abstract: Background: MCM5 is a protein involved in DNA replication, facilitating cell proliferation. In normal epithelium MCM5 expression is restricted to the cells in the basal proliferative compartments, however in the presence of a tumour MCM5 positive cells ... ...

    Abstract Background: MCM5 is a protein involved in DNA replication, facilitating cell proliferation. In normal epithelium MCM5 expression is restricted to the cells in the basal proliferative compartments, however in the presence of a tumour MCM5 positive cells are present at the surface epithelium and are shed into bodily fluids. The aim of this study was to determine the sensitivity of MCM5 as a biomarker for the detection of endometrial and ovarian cancer.
    Methods: Patients with known ovarian or endometrial cancers, or known benign gynaecological conditions, were enrolled. Informed consent was obtained prior to the collection of full void urine, and either a vaginal tampon (worn for 6-8 h), or a vaginal swab. Vaginal secretions were extracted from the tampon or swab, centrifuged and lysed. Urine samples were centrifuged and lysed. MCM5 levels were determined by MCM5-ELISA (Arquer Diagnostics Ltd).
    Results: 125 patients completed the study protocol, 41 patients had endometrial cancer, 26 ovarian cancer, and 58 benign controls. All patients provided a urine sample and either a tampon or vaginal swab sample. Urine MCM5 levels were higher in cancer patients than controls (p < 0.0001), there was no significant difference in levels between tampon samples or vaginal swab samples in cancer patients when compared to controls. Performance of MCM5 to discriminate cancer from benign disease was high with an area under the ROC curve of 0.83 for endometrial cancer and 0.68 for ovarian cancer. Using a cut off of 12 pg/mL, overall sensitivity for endometrial cancer was 87.8, and 61.5% for ovarian cancer with a specificity of 75.9%.
    Conclusions: MCM5 is a novel sensitive and specific biomarker for the detection of ovarian and endometrial tumours in urine samples, which is likely to have clinical utility as a diagnostic aid.
    MeSH term(s) Aged ; Biomarkers, Tumor/metabolism ; Cell Cycle Proteins/metabolism ; Early Detection of Cancer ; Endometrial Neoplasms/diagnosis ; Female ; Humans ; Middle Aged ; Ovarian Neoplasms/diagnosis
    Chemical Substances Biomarkers, Tumor ; Cell Cycle Proteins ; MCM5 protein, human
    Language English
    Publishing date 2020-10-15
    Publishing country England
    Document type Journal Article
    ISSN 1471-2407
    ISSN (online) 1471-2407
    DOI 10.1186/s12885-020-07468-y
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  5. Article ; Online: Artificial Intelligence Systems as Prognostic and Predictive Tools in Ovarian Cancer.

    Enshaei, A / Robson, C N / Edmondson, R J

    Annals of surgical oncology

    2015  Volume 22, Issue 12, Page(s) 3970–3975

    Abstract: Background: The ability to provide accurate prognostic and predictive information to patients is becoming increasingly important as clinicians enter an era of personalized medicine. For a disease as heterogeneous as epithelial ovarian cancer, ... ...

    Abstract Background: The ability to provide accurate prognostic and predictive information to patients is becoming increasingly important as clinicians enter an era of personalized medicine. For a disease as heterogeneous as epithelial ovarian cancer, conventional algorithms become too complex for routine clinical use. This study therefore investigated the potential for an artificial intelligence model to provide this information and compared it with conventional statistical approaches.
    Methods: The authors created a database comprising 668 cases of epithelial ovarian cancer during a 10-year period and collected data routinely available in a clinical environment. They also collected survival data for all the patients, then constructed an artificial intelligence model capable of comparing a variety of algorithms and classifiers alongside conventional statistical approaches such as logistic regression.
    Results: The model was used to predict overall survival and demonstrated that an artificial neural network (ANN) algorithm was capable of predicting survival with high accuracy (93 %) and an area under the curve (AUC) of 0.74 and that this outperformed logistic regression. The model also was used to predict the outcome of surgery and again showed that ANN could predict outcome (complete/optimal cytoreduction vs. suboptimal cytoreduction) with 77 % accuracy and an AUC of 0.73.
    Conclusions: These data are encouraging and demonstrate that artificial intelligence systems may have a role in providing prognostic and predictive data for patients. The performance of these systems likely will improve with increasing data set size, and this needs further investigation.
    MeSH term(s) Algorithms ; Area Under Curve ; Bayes Theorem ; Carcinoma, Ovarian Epithelial ; Cytoreduction Surgical Procedures ; Decision Trees ; Female ; Humans ; Neoplasms, Glandular and Epithelial/surgery ; Neural Networks (Computer) ; Ovarian Neoplasms/surgery ; Predictive Value of Tests ; Prognosis ; Proportional Hazards Models ; ROC Curve ; Support Vector Machine ; Survival Rate
    Language English
    Publishing date 2015-03-10
    Publishing country United States
    Document type Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1200469-8
    ISSN 1534-4681 ; 1068-9265
    ISSN (online) 1534-4681
    ISSN 1068-9265
    DOI 10.1245/s10434-015-4475-6
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    Zs.A 4042: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (2.OG)
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  6. Article: Uterine corpus metastasis in stage IA1 squamous carcinoma of the cervix.

    McCormick, A / Cross, P / Edmondson, R J

    Gynecologic oncology case reports

    2013  Volume 6, Page(s) 31–33

    Abstract: Treatment of stage 1A1 cancer of the cervix often involves preservation of the corpus.•Rarely metastasis to the corpus can occur in these cases. ...

    Abstract •Treatment of stage 1A1 cancer of the cervix often involves preservation of the corpus.•Rarely metastasis to the corpus can occur in these cases.
    Language English
    Publishing date 2013-07-27
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2634831-7
    ISSN 2211-338X
    ISSN 2211-338X
    DOI 10.1016/j.gynor.2013.07.006
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  7. Article ; Online: Phase 2 study of anastrozole in rare cohorts of patients with estrogen receptor/progesterone receptor positive leiomyosarcomas and carcinosarcomas of the uterine corpus: The PARAGON trial (ANZGOG 0903).

    Edmondson, R J / O'Connell, R L / Banerjee, S / Mileshkin, L / Sykes, P / Beale, P / Fisher, A / Bonaventura, A / Millan, D / Nottley, S / Benson, C / Hamilton, A / Sjoquist, K / Alexander, L / Kelly, C / Carty, K / Divers, L / Bradshaw, N / Friedlander, M

    Gynecologic oncology

    2021  Volume 163, Issue 3, Page(s) 524–530

    Abstract: Background: Aromatase inhibitors have been used empirically to treat a subset of patients with hormone receptor positive uterine leiomyosarcomas(LMS) and carcinosarcomas (UCS) mainly supported by retrospective data. We evaluated the activity of ... ...

    Abstract Background: Aromatase inhibitors have been used empirically to treat a subset of patients with hormone receptor positive uterine leiomyosarcomas(LMS) and carcinosarcomas (UCS) mainly supported by retrospective data. We evaluated the activity of anastrozole in two rare cohorts; patients with recurrent/metastatic LMS and UCS enrolled in PARAGON, a basket trial of anastrozole in estrogen receptor (ER+)/progesterone receptor positive (PR+) gynecological cancers.
    Method: An investigator-initiated, single-arm, prospective open-label trial of anastrozole 1 mg/day in patients with ER &/or PR + ve LMS or UCS with measurable disease, treated until progression or unacceptable toxicity. Primary endpoint was clinical benefit (complete/partial response + stable disease) rate (CBR) at 3 months. Secondary endpoints include progression-free survival (PFS), quality of life and toxicity.
    Results: 39 eligible patients were enrolled, 32 with LMS and 7 with UCS. For the LMS cohort CBR at 3 months was 35% (95% CI: 21-53%) with a median duration of clinical benefit of 5.8 months. Best response was a partial response in one patient. Two patients remained on treatment for more than one year. The median progression-free survival was 2.8 months (95% CI: 2.6-4.9). For the UCS cohort CBR at 3 months was 43% (95% CI: 16-75%) with a median duration of clinical benefit of 5.6 months. Stable disease was seen in 3 patients but no objective responses were seen. The median progression-free survival was 2.7 months (95% CI, 1.1-8.2). Safety was acceptable with 5/39 evaluable patients showing grade 3 toxicities.
    Conclusion: Whilst objective response rates with anastrozole are low, the clinical benefit rate and good tolerance suggests that aromatase inhibitor therapy may have a role in a subset of patients with metastatic LMS and UCS.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Anastrozole/adverse effects ; Anastrozole/therapeutic use ; Aromatase Inhibitors/adverse effects ; Aromatase Inhibitors/therapeutic use ; Carcinosarcoma/drug therapy ; Carcinosarcoma/metabolism ; Carcinosarcoma/pathology ; Female ; Humans ; Leiomyosarcoma/drug therapy ; Leiomyosarcoma/metabolism ; Leiomyosarcoma/pathology ; Middle Aged ; Neoplasm Metastasis ; Prospective Studies ; Quality of Life ; Receptors, Estrogen/metabolism ; Receptors, Progesterone/metabolism ; Uterine Neoplasms/drug therapy ; Uterine Neoplasms/metabolism ; Uterine Neoplasms/pathology
    Chemical Substances Aromatase Inhibitors ; Receptors, Estrogen ; Receptors, Progesterone ; Anastrozole (2Z07MYW1AZ)
    Language English
    Publishing date 2021-10-05
    Publishing country United States
    Document type Clinical Trial, Phase II ; Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 801461-9
    ISSN 1095-6859 ; 0090-8258
    ISSN (online) 1095-6859
    ISSN 0090-8258
    DOI 10.1016/j.ygyno.2021.09.010
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    Zs.A 885: Show issues Location:
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  8. Article ; Online: Are rigid management protocols stifling innovation in cancer treatment?

    Crosbie, E J / Edmondson, R J / McNeish, I A / Sasieni, P

    BJOG : an international journal of obstetrics and gynaecology

    2015  Volume 122, Issue 11, Page(s) 1432–1434

    MeSH term(s) Health Services Accessibility/legislation & jurisprudence ; Humans ; Liability, Legal ; Neoplasms/therapy ; Therapies, Investigational
    Language English
    Publishing date 2015-05-29
    Publishing country England
    Document type Journal Article ; Comment
    ZDB-ID 2000931-8
    ISSN 1471-0528 ; 0306-5456 ; 1470-0328
    ISSN (online) 1471-0528
    ISSN 0306-5456 ; 1470-0328
    DOI 10.1111/1471-0528.13449
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  9. Article: Liquid based cytology improves the positive predictive value of glandular smears compared to conventional cytology.

    Edmondson, R J / Errington, C A / Mansour, D J A

    European journal of gynaecological oncology

    2010  Volume 31, Issue 3, Page(s) 288–290

    Abstract: Purpose: To investigate whether the introduction of liquid-based cytology (LBC) in an urban setting decreases the diagnosis of glandular neoplasia (grade 6) and improves the positive predictive value (PPV) of cervical cytological screening.: Methods: ...

    Abstract Purpose: To investigate whether the introduction of liquid-based cytology (LBC) in an urban setting decreases the diagnosis of glandular neoplasia (grade 6) and improves the positive predictive value (PPV) of cervical cytological screening.
    Methods: A retrospective database review was conducted identifying women with cervical cytological abnormalities including glandular neoplasia (grade 6) before and after the introduction of LBC.
    Results: Following the introduction of LBC the rate of glandular neoplasia (grade 6) referrals fell from 1.08% to 0.69% of all cervical cytological abnormalities. There was a significant reduction in 'abnormal' cytological samples subsequently found to be associated with no invasive or preinvasive disease but no decrease in the number showing preinvasive or invasive disease. A significant decrease in number of patients having a final diagnosis of normal/inflammatory or wart changes was seen in those patients referred during the LBC period (p < 0.01).
    Conclusion: The introduction of LBC in an urban setting decreased cytological glandular neoplasia referrals but not at the expense of missing preinvasive and invasive cancers. It has also increased the PPV of cervical sampling to detect preinvasive and invasive cancer from 59.6% to 76.0%.
    MeSH term(s) Cervical Intraepithelial Neoplasia/pathology ; Cytological Techniques ; Female ; Humans ; Neoplasms, Glandular and Epithelial/pathology ; Predictive Value of Tests ; Uterine Cervical Neoplasms/pathology
    Language English
    Publishing date 2010-07-28
    Publishing country China
    Document type Comparative Study ; Journal Article
    ZDB-ID 604589-3
    ISSN 0392-2936
    ISSN 0392-2936
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  10. Article: Gastric-type adenocarcinoma of the cervix in a patient with Lynch syndrome: A case report.

    Moat, M / O'Donnell, R L / McCluggage, W G / Ralte, A / Edmondson, R J

    Gynecologic oncology reports

    2014  Volume 10, Page(s) 41–43

    Abstract: Lynch syndrome (LS) is an uncommon, genetic disorder which predisposes affected individuals to colorectal, endometrial and ovarian malignancies.•We report a case of cervical gastric-type adenocarcinoma in a patient with LS.•Immunohistochemistry for ... ...

    Abstract •Lynch syndrome (LS) is an uncommon, genetic disorder which predisposes affected individuals to colorectal, endometrial and ovarian malignancies.•We report a case of cervical gastric-type adenocarcinoma in a patient with LS.•Immunohistochemistry for mismatch repair proteins is a useful screening tool in tumours suspected to be associated with LS.
    Language English
    Publishing date 2014-03-13
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2818505-5
    ISSN 2352-5789
    ISSN 2352-5789
    DOI 10.1016/j.gynor.2014.03.002
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