W. Patrick Soutter

Meta-analysis of surgery in advanced ovarian carcinoma: Ismaximum cytoreductive surgery an independent determinant of prognosis?

OBJECTIVE If maximum cytoreductive surgery benefits the survival of women with advanced ovarian cancer, the median survival time of groups of such women will improve as the proportion of women undergoing maximum cytoreductive surgery is increased. STUDY DESIGN Fifty-eight suitable studies that encompass 6962 patients with advanced ovarian cancer were identified. Multiple linear regression was used to analyze the effects on median survival time of the following variables: the proportion of each cohort undergoing maximum cytoreductive surgery, the use of platinum-containing chemotherapy, the dose intensity of chemotherapy, the proportion of each cohort with stage IV disease, and the year of publication of the study. RESULTS Maximum cytoreductive surgery was associated with only a small improvement in median survival time, but platinum-containing chemotherapy improved median survival time substantially. Increased dose intensity also conferred a useful survival benefit. CONCLUSION Cytoreductive surgery probably has only a small effect on the survival of women with advanced ovarian cancer. The type of chemotherapy used is more important.

Pretreatment tumour volume measurement on high‐resolution magnetic resonance imaging as a predictor of survival in cervical cancer

Objective  To evaluate pretreatment tumour volume as a predictor of survival in patients with cervical cancer using both endovaginal and external coil magnetic resonance imaging in order to achieve high spatial resolution and delineate small volume disease.

Needle versus loop diathermy excision of the transformation zone for the treatment of cervical intraepithelial neoplasia: a randomised controlled trial

Objective  To determine whether lowwwer rates or incomplete resection of cervical intraepithelial neoplasia (CIN) may be achieved by needle excision of the transformation zone (NETZ) than with loop excision (LLETZ).

Human seminal plasma inhibits the lymphocyte response to infection with Epstein-Barr virus

Epidemiological studies have shown that infection by the Epstein-Barr virus (EBV) is most common in the age group in which sexual activity commences. This observation and the recent evidence that EBV replication can occur in the epithelium of the uterine cervix have led to the suggestion that EBV may be sexually transmitted. Activation of cytotoxic T lymphocytes is important in the control of EBV replication. Using an established lymphocyte regression assay, this study showed that dialyzed human seminal plasma in low concentrations inhibits the normal lymphocyte response to infection with EBV. These results suggest that seminal plasma may facilitate EBV replication in the uterine cervix by inhibition of lymphocyte function. This effect may also be important in the host response to other sexually transmitted viruses and may have some bearing on the etiology of cervical cancer.