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  1. Article ; Online: Repeat extraperitoneal cesarean section on a woman with pseudomyxoma peritonei.

    Mukhopadhyay, Debjani / Gada, Ruta / Rufford, Barnaby

    Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology

    2017  Volume 37, Issue 3, Page(s) 370–372

    MeSH term(s) Adult ; Cesarean Section, Repeat/methods ; Female ; Fertilization in Vitro ; Humans ; Male ; Peritoneal Neoplasms/complications ; Peritoneal Neoplasms/diagnosis ; Peritoneal Neoplasms/surgery ; Pregnancy ; Pregnancy Complications, Neoplastic/surgery ; Pregnancy Outcome ; Pseudomyxoma Peritonei/complications ; Pseudomyxoma Peritonei/diagnosis ; Pseudomyxoma Peritonei/surgery
    Language English
    Publishing date 2017-02-13
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 604639-3
    ISSN 1364-6893 ; 0144-3615
    ISSN (online) 1364-6893
    ISSN 0144-3615
    DOI 10.1080/01443615.2016.1205557
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Risk factors for HPV persistence and cytology anomalies at follow-up after treatment for cervical dysplasia.

    Rizzuto, Ivana / Nalam, Mythili / Jiang, Jason / Linder, Anders / Rufford, Barnaby

    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

    2018  Volume 141, Issue 2, Page(s) 240–244

    Abstract: Objective: To evaluate predictor factors of persistent cytologic dysplasia and/or high-risk human papillomavirus (hrHPV) infection at 6-month follow-up and at 3-5 years during routine cervical smear testing.: Methods: The present retrospective study ... ...

    Abstract Objective: To evaluate predictor factors of persistent cytologic dysplasia and/or high-risk human papillomavirus (hrHPV) infection at 6-month follow-up and at 3-5 years during routine cervical smear testing.
    Methods: The present retrospective study included data from women treated for cervical dysplasia by large loop excision of the transformation zone (LLETZ) at Ipswich Hospital, UK, between January 1 and December 31, 2012. Age, parity, smoking, status of resection margins, and previous LLETZ treatment were evaluated by multivariate analyses.
    Results: There were 192 patients included in the study. There was no association between age (relative risk [RR] 1.0, 95% confidence interval [CI] 0.80-1.23; P>0.99), smoking (RR 1.12, 95% CI 0.79-1.59; P=0.516), or parity (RR 1.10, 95% CI 0.88-1.38; P=0.382) and abnormal cytology and/or persistent hrHPV infection at 6 months. There was an association between positive margins (RR 1.64, 95% CI 1.20-2.24; P=0.003), previous LLETZ (RR 3.48, 95% CI 1.69-7.15; P<0.001), and dyskaryosis and/or hrHPV infection at 6 months. Only previous LLETZ treatment remained associated with abnormal cytology and persistent hrHPV infection at 3-5 years (RR 6.37, 95% CI 3.56-11.3; P<0.001).
    Conclusion: Clinical factors, including age, smoking, treatment history, and status of surgical margins, could help to determine the risk of dysplasia recurrence and facilitate patient follow-up based on risk stratification.
    MeSH term(s) Adult ; Aged ; Cervical Intraepithelial Neoplasia/pathology ; Cervical Intraepithelial Neoplasia/virology ; Cytodiagnosis ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Neoplasm Recurrence, Local ; Papillomavirus Infections/epidemiology ; Papillomavirus Infections/virology ; Retrospective Studies ; Risk Factors ; Smoking/epidemiology ; Trachelectomy ; Uterine Cervical Dysplasia/surgery ; Uterine Cervical Dysplasia/virology ; Uterine Cervical Neoplasms/pathology ; Uterine Cervical Neoplasms/virology ; Young Adult
    Language English
    Publishing date 2018-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80149-5
    ISSN 1879-3479 ; 0020-7292
    ISSN (online) 1879-3479
    ISSN 0020-7292
    DOI 10.1002/ijgo.12431
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  3. Article: Risk factors and sonographic endometrial thickness as predictors of tumour stage and histological subtype of endometrial cancer.

    Rizzuto, Ivana / Nicholson, Rachel / MacNab, Wendy S / Nalam, Mythili / Sharma, Rohit / Rufford, Barnaby

    Gynecologic oncology reports

    2019  Volume 30, Page(s) 100491

    Abstract: We evaluated the association between risk factors for endometrial cancer (EC) and sonographic endometrial thickness (ET) with FIGO stages at diagnosis. We also reported our experience in reliability of sonographic ET as screening tool for either ... ...

    Abstract We evaluated the association between risk factors for endometrial cancer (EC) and sonographic endometrial thickness (ET) with FIGO stages at diagnosis. We also reported our experience in reliability of sonographic ET as screening tool for either histologic subtype I and II of EC. It was a case series study including 339 patients diagnosed with EC from 2010 to 2017 at the Ipswich Hospital, UK. Women with higher body mass index (BMI) presented at earlier stages when compared to women with lower BMIs (
    Language English
    Publishing date 2019-08-27
    Publishing country Netherlands
    Document type Case Reports
    ZDB-ID 2818505-5
    ISSN 2352-5789
    ISSN 2352-5789
    DOI 10.1016/j.gore.2019.100491
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  4. Article ; Online: Diagnostic performance of urgent referrals for suspected gynaecological malignancies.

    Burbos, Nikolaos / Musonda, Patrick / Rufford, Barnaby

    Archives of gynecology and obstetrics

    2011  Volume 284, Issue 6, Page(s) 1495–1500

    Abstract: Purpose: The objective of this study was to investigate the outcome of the urgent referrals with suspected gynaecological malignancy.: Methods: Retrospective analysis of the data of the urgent referrals for suspected gynaecological cancers over a 12- ... ...

    Abstract Purpose: The objective of this study was to investigate the outcome of the urgent referrals with suspected gynaecological malignancy.
    Methods: Retrospective analysis of the data of the urgent referrals for suspected gynaecological cancers over a 12-month period at a gynaecological oncology cancer centre in the UK.
    Results: A total of 233 patients (70.61%) were referred with suspected endometrial pathology, 59 patients (17.88%) with suspected ovarian, 25 patients (7.58%) with suspected cervical and 13 patients (3.94%) with suspected vulval malignancy. The positive predictive value of referrals for diagnosing endometrial, ovarian, cervical and vulval malignancy was 11.6, 23.7, 12.0 and 15.4%, respectively. Amongst the indications for referral for suspected endometrial cancer, presence of postmenopausal vaginal bleeding had the higher odds for cancer (odds = 0.13; 95% CI 0.08-0.21). The odds for cancer for women referred with a pelvic mass was 0.17 (95% CI, 0.07-0.42) and for women referred with abdominal bloating was 0.66 (95% CI, 0.18-2.36). All the cases of malignancy were diagnosed in women referred with suspicious appearance of the cervix on clinical examination. The odds for cancer was 0.50 if the indication for referral was vulval itching. The majority of cases of gynaecological cancers during the study period were diagnosed following routine referrals.
    Conclusion: The overall predictive value of two-week wait referrals for suspected gynaecological malignancies is low. Refinement of the current referral guidelines is required with particular emphasis in the premenopausal women where the diagnostic performance of the urgent referrals is significantly poorer.
    MeSH term(s) Female ; Genital Neoplasms, Female/diagnosis ; Humans ; Middle Aged ; Odds Ratio ; Practice Guidelines as Topic ; Predictive Value of Tests ; Prognosis ; Referral and Consultation/statistics & numerical data ; Retrospective Studies ; Time Factors ; United Kingdom ; Waiting Lists
    Language English
    Publishing date 2011-12
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 896455-5
    ISSN 1432-0711 ; 0932-0067
    ISSN (online) 1432-0711
    ISSN 0932-0067
    DOI 10.1007/s00404-011-1854-5
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  5. Article ; Online: The use of laparostomy in patients with gynecologic cancer: first report from a UK cancer center.

    Kaushik, Sonali / Akhter, Khurram / Rufford, Barnaby / Ind, Thomas E J / Kolomainen, Desiree F / Butler, John / Barton, Desmond P J

    International journal of gynecological cancer : official journal of the International Gynecological Cancer Society

    2013  Volume 23, Issue 5, Page(s) 951–955

    Abstract: Objective: To report on the use of laparostomy after major gynecologic cancer surgery.: Methods: Operative records and surgical databases of patients who underwent major open abdominal surgery over a 6.5-year period at a tertiary referral center were ...

    Abstract Objective: To report on the use of laparostomy after major gynecologic cancer surgery.
    Methods: Operative records and surgical databases of patients who underwent major open abdominal surgery over a 6.5-year period at a tertiary referral center were searched. Patients who had diagnostic procedures, operative laparoscopy, and surgery for vulval cancer were excluded. All patients who had laparostomy were identified; and the diagnosis, indication for laparostomy, method of temporary cover, and complications were recorded.
    Results: A total of 1592 laparotomies, including 37 emergencies, were performed. Of these, 14 patients (0.88%) had a laparostomy. Seven patients had primary cancer and 7 had recurrent cancer. As more patients had surgery for primary disease, laparostomy was more common in patients who underwent surgery for recurrent cancer. Seven patients had ovarian/fallopian tube/primary peritoneal cancer, 4 patients had uterine cancer, 2 patients had cervical cancer, and one patient had vaginal cancer. Ten laparostomies (71.4%) were performed after an emergency procedure; thus, laparostomy was approximately 100 times more common after emergency than elective major surgery. Massive bowel distension and bowel wall edema were the major indications for laparostomy. The method of temporary closure was variable, and a sterile saline bag was the most commonly used. The laparostomy was closed in all but 2 patients, most often on postoperative day 2 or 3. Two patients (14.3%) died within 30 days of the laparostomy, and 2 others died at postoperative days 40 and 62. Three of these 4 patients had recurrent cancer, and 2 patients had emergency procedures.
    Conclusions: The overall incidence of laparostomy associated with laparotomy for gynecological cancer surgery was less than 1:100 cases, was more common after surgery for recurrent cancer, and in particular, was approximately 100 times more common after emergency procedures. The 30-day operative mortality rate was 14.3%.
    MeSH term(s) Adult ; Aged ; Female ; Follow-Up Studies ; Genital Neoplasms, Female/mortality ; Genital Neoplasms, Female/pathology ; Genital Neoplasms, Female/surgery ; Humans ; Laparotomy/mortality ; Middle Aged ; Neoplasm Recurrence, Local/mortality ; Neoplasm Recurrence, Local/pathology ; Neoplasm Recurrence, Local/surgery ; Neoplasm Staging ; Postoperative Complications ; Prognosis ; Survival Rate ; Tertiary Care Centers ; United Kingdom
    Language English
    Publishing date 2013-03-30
    Publishing country England
    Document type Journal Article
    ZDB-ID 1070385-8
    ISSN 1525-1438 ; 1048-891X
    ISSN (online) 1525-1438
    ISSN 1048-891X
    DOI 10.1097/IGC.0b013e31829169fc
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Malignant clear cell hidradenoma of the vulva: report of a unique case and review of the literature.

    Biedrzycki, Olaf J / Rufford, Barnaby / Wilcox, Mark / Barton, Desmond P J / Jameson, Charles

    International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists

    2008  Volume 27, Issue 1, Page(s) 142–146

    Abstract: Clear cell hidradenoma (CCH) is a rare tumor derived from eccrine sweat glands with a predilection for the head, face, and upper extremities. Its biologic behavior is unpredictable, although frank malignant transformation is reportedly rare (prevalence ... ...

    Abstract Clear cell hidradenoma (CCH) is a rare tumor derived from eccrine sweat glands with a predilection for the head, face, and upper extremities. Its biologic behavior is unpredictable, although frank malignant transformation is reportedly rare (prevalence rate, 6.7% in a review). Malignant CCH (MCCH) exists only as case reports or very small series in the literature. We present a unique case of MCCH of the vulva with completely bland cytological features. A previously healthy 39-year-old woman underwent marsupialization of a presumed left-side vulval Bartholin gland cyst. Microscopy revealed a tumor with the features of CCH; no atypia, necrosis, or mitoses were observed. Ten months later, she developed enlarging left groin nodes, one of which contained a metastatic clear cell tumor. Radiological examination did not reveal any other primary source, and the diagnosis of MCCH was confirmed through an expert review. A reexcision of the vulval primary site, which contained residual tumor, was performed. The patient is currently free of any further recurrence 10 months after the excision of the lymph node metastasis. The case highlights the difficulty in predicting the behavior of CCH on the basis of histological examination alone. It also highlights the importance of considering MCCH in the differential diagnosis of a lymph node containing a metastatic clear cell tumor or an apparent metastatic clear cell lesion in the skin. We review the current literature on MCCH and discuss the problems in the differential diagnosis and treatment of this rare tumor.
    MeSH term(s) Adenoma, Sweat Gland/metabolism ; Adenoma, Sweat Gland/pathology ; Adult ; Bartholin's Glands/pathology ; Cysts/pathology ; Female ; Humans ; Immunohistochemistry ; Neoplasm Recurrence, Local/pathology ; Sweat Gland Neoplasms/metabolism ; Sweat Gland Neoplasms/pathology ; Vulvar Neoplasms/metabolism ; Vulvar Neoplasms/pathology
    Language English
    Publishing date 2008-01
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 604859-6
    ISSN 1538-7151 ; 0277-1691
    ISSN (online) 1538-7151
    ISSN 0277-1691
    DOI 10.1097/pgp.0b013e31804bdee1
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  7. Article ; Online: New paradigms for BRCA1/BRCA2 testing in women with ovarian cancer: results of the Genetic Testing in Epithelial Ovarian Cancer (GTEOC) study.

    Plaskocinska, Inga / Shipman, Hannah / Drummond, James / Thompson, Edward / Buchanan, Vanessa / Newcombe, Barbara / Hodgkin, Charlotte / Barter, Elisa / Ridley, Paul / Ng, Rita / Miller, Suzanne / Dann, Adela / Licence, Victoria / Webb, Hayley / Tan, Li Tee / Daly, Margaret / Ayers, Sarah / Rufford, Barnaby / Earl, Helena /
    Parkinson, Christine / Duncan, Timothy / Jimenez-Linan, Mercedes / Sagoo, Gurdeep S / Abbs, Stephen / Hulbert-Williams, Nicholas / Pharoah, Paul / Crawford, Robin / Brenton, James D / Tischkowitz, Marc

    Journal of medical genetics

    2016  Volume 53, Issue 10, Page(s) 655–661

    Abstract: Background: Over recent years genetic testing for germline mutations in BRCA1/BRCA2 has become more readily available because of technological advances and reducing costs.: Objective: To explore the feasibility and acceptability of offering genetic ... ...

    Abstract Background: Over recent years genetic testing for germline mutations in BRCA1/BRCA2 has become more readily available because of technological advances and reducing costs.
    Objective: To explore the feasibility and acceptability of offering genetic testing to all women recently diagnosed with epithelial ovarian cancer (EOC).
    Methods: Between 1 July 2013 and 30 June 2015 women newly diagnosed with EOC were recruited through six sites in East Anglia, UK into the Genetic Testing in Epithelial Ovarian Cancer (GTEOC) study. Eligibility was irrespective of patient age and family history of cancer. The psychosocial arm of the study used self-report, psychometrically validated questionnaires (Depression Anxiety and Stress Scale (DASS-21); Impact of Event Scale (IES)) and cost analysis was performed.
    Results: 232 women were recruited and 18 mutations were detected (12 in BRCA1, 6 in BRCA2), giving a mutation yield of 8%, which increased to 12% in unselected women aged <70 years (17/146) but was only 1% in unselected women aged ≥70 years (1/86). IES and DASS-21 scores in response to genetic testing were significantly lower than equivalent scores in response to cancer diagnosis (p<0.001). Correlation tests indicated that although older age is a protective factor against any traumatic impacts of genetic testing, no significant correlation exists between age and distress outcomes.
    Conclusions: The mutation yield in unselected women diagnosed with EOC from a heterogeneous population with no founder mutations was 8% in all ages and 12% in women under 70. Unselected genetic testing in women with EOC was acceptable to patients and is potentially less resource-intensive than current standard practice.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; BRCA1 Protein/genetics ; BRCA2 Protein/genetics ; Carcinoma, Ovarian Epithelial ; Female ; Genetic Predisposition to Disease ; Genetic Testing/economics ; Germ-Line Mutation ; Humans ; Middle Aged ; Neoplasms, Glandular and Epithelial/diagnosis ; Neoplasms, Glandular and Epithelial/genetics ; Ovarian Neoplasms/diagnosis ; Ovarian Neoplasms/genetics
    Chemical Substances BRCA1 Protein ; BRCA1 protein, human ; BRCA2 Protein ; BRCA2 protein, human
    Language English
    Publishing date 2016-05-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 220881-7
    ISSN 1468-6244 ; 0022-2593
    ISSN (online) 1468-6244
    ISSN 0022-2593
    DOI 10.1136/jmedgenet-2016-103902
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  8. Article: Prospective study using the risk of ovarian cancer algorithm to screen for ovarian cancer.

    Menon, Usha / Skates, Steven J / Lewis, Sara / Rosenthal, Adam N / Rufford, Barnaby / Sibley, Karen / Macdonald, Nicola / Dawnay, Anne / Jeyarajah, Arjun / Bast, Robert C / Oram, David / Jacobs, Ian J

    Journal of clinical oncology : official journal of the American Society of Clinical Oncology

    2005  Volume 23, Issue 31, Page(s) 7919–7926

    Abstract: Purpose: To evaluate prevalence screening in the first prospective trial of a new ovarian cancer screening (OCS) strategy (risk of ovarian cancer or ROC algorithm) on the basis of age and CA125 profile.: Patients and methods: Postmenopausal women, > ... ...

    Abstract Purpose: To evaluate prevalence screening in the first prospective trial of a new ovarian cancer screening (OCS) strategy (risk of ovarian cancer or ROC algorithm) on the basis of age and CA125 profile.
    Patients and methods: Postmenopausal women, > or = 50 years were randomly assigned to a control group or screen group. Screening involved serum CA125, interpreted using the ROC algorithm. Participants with normal results returned to annual screening; those with intermediate results had repeat CA125 testing; and those with elevated values underwent transvaginal ultrasound (TVS). Women with abnormal or persistently equivocal TVS were referred for a gynecologic opinion.
    Results: Thirteen thousand five hundred eighty-two women were recruited. Of 6,682 women randomly assigned to screening, 6,532 women underwent the first screen. After the initial CA125, 5,213 women were classified as normal risk, 91 women elevated, and 1,228 women intermediate. On repeat CA125 testing of the latter, a further 53 women were classified as elevated risk. All 144 women with elevated risk had TVS. Sixteen women underwent surgery. Eleven women had benign pathology; one woman had ovarian recurrence of breast cancer; one woman had borderline; and three women had primary invasive epithelial ovarian cancer (EOC). The specificity and positive predictive value (PPV) for primary invasive EOC were 99.8% (95% CI, 99.7 to 99.9) and 19% (95% CI, 4.1 to 45.6), respectively.
    Conclusion: An OCS strategy using the ROC algorithm is feasible and can achieve high specificity and PPV in postmenopausal women. It is being used in the United Kingdom Collaborative Trial of Ovarian Cancer Screening and in the United States in both the Cancer Genetics Network and the Gynecology Oncology Group trials of high-risk women.
    MeSH term(s) Algorithms ; CA-125 Antigen/metabolism ; Feasibility Studies ; Female ; Humans ; Mass Screening ; Middle Aged ; Ovarian Neoplasms/diagnosis ; Ovarian Neoplasms/epidemiology ; Ovarian Neoplasms/metabolism ; Postmenopause ; Prognosis ; Prospective Studies ; Risk Factors ; United Kingdom/epidemiology ; United States/epidemiology
    Chemical Substances CA-125 Antigen
    Language English
    Publishing date 2005-11-01
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 604914-x
    ISSN 1527-7755 ; 0732-183X
    ISSN (online) 1527-7755
    ISSN 0732-183X
    DOI 10.1200/JCO.2005.01.6642
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