Objective

Objective To critically analyze the diagnostic value of transvaginal sonography (TVS) for non-invasive, presurgical detection of bowel endometriosis.Methods MEDLINE (1966MEDLINE ( -2010 and EMBASE (1980EMBASE ( -2010

The combination of PV and TVS accurately predicts the presence of endometriosis affecting the ovaries, vagina, rectum, USL, RVS and POD in patients with suspected endometriosis. We suggest the routine combination of PV and TVS as an essential part of the standard primary assessment of pelvic pain patients with suspected endometriosis.

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We found a 100% concordance between the expression of nanobacteria and the presence of psammoma bodies in malignant ovarian tumours. Several lines of evidence suggest the involvement of these organisms in the process of biomineralization. We therefore conclude that nanobacterial infection of malignant ovarian tissue contributes to mechanisms leading to the formation of calcified deposits known as psammoma bodies.

Background: We have previously reported significantly improved disease-free survival (DFS) in premenopausal patients with endocrine-responsive early breast cancer receiving adjuvant zoledronic acid (ZOL) in ABCSG-12 (Gnant M, et al. NEJM. 2009;360:679–91). Other trials, such as ZO-FAST and the postmenopausal (>5 yr) subset analysis of AZURE, have demonstrated similar anticancer effects with ZOL. Now with >6 yr of follow-up in ABCSG-12, we report an overall survival (OS) benefit and preplanned subgroup analyses that more precisely define interactions between the ZOL benefit and patient/tumor characteristics. Methods: Premenopausal women with endocrine-receptor-positive early stage breast cancer (N = 1,803) were randomized to ovarian function suppression with goserelin (3.6 mg q28d) and tamoxifen (TAM; 20 mg/d) or anastrozole (ANA; 1 mg/d) ± ZOL (4 mg q6mo) for 3 yr. Endpoints included DFS and OS, both analyzed using logrank test and Cox models. Results: At median follow-up of 76 mo, patients receiving ZOL had a significant 27% reduction in the risk of DFS events (HR = 0.73; Cox P = .022) and a significant 41% reduction in the risk of death (HR = 0.59; Cox P = .027) vs no ZOL. Multivariate analyses showed a strong interaction between ZOL and patient age, but did not show any interactions between ZOL and ANA/TAM or any classic tumor parameter (eg, T, N, grade, ER). Among patients > 40 yr of age (n = 1,390) with presumed complete ovarian blockade, ZOL significantly reduced the risk of DFS events by 34% (HR = 0.66; Cox P = .014) and the risk of death by 49% (HR = 0.51; Cox P = .020); however, there were no significant DFS or OS benefits in patients <40 yr of age. Currently, all patients have completed 3 yr of ZOL and are in the follow-up phase with no reported cases of osteonecrosis of the jaw or renal failure. Additional analyses at a median follow-up of approximately 84 mo are planned for late 2011 and will be presented, providing additional insights into disease recurrence patterns with and without ZOL. Conclusions: Long-term follow-up of ABCSG-12 (76 months) confirms and extends previous results seen at 48 mo and 62 mo follow-up, and suggests that anticancer benefits of adjuvant ZOL result in highly significant DFS and OS benefits mainly in patients with a low-estrogen environment (ie, ovarian suppression and age >40 yr). These results are consistent with the significant DFS and OS improvements seen in the postmenopausal (>5 yr) cohort of the AZURE trial, and suggest that both estrogen deprivation and reduction of bone-turnover-derived growth factors in the bone marrow microenvironment are needed for sufficient suppression of dormant micrometastases. Taken together with the previously demonstrated bone-protective effects of ZOL, these DFS and OS benefits strongly suggest that adding ZOL to adjuvant endocrine therapy should be considered for premenopausal women with endocrine-receptor-positive early breast cancer. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr S1-2.

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Background:There exists evidence that body mass index (BMI) impacts on the efficacy of aromatase inhibitors in patients with breast cancer. The relationship between BMI and the efficacy of tamoxifen is conflicting. We investigated the impact of BMI on the efficacy of single tamoxifen and tamoxifen plus an aromatase inhibitor in the well-defined prospective study population of the ABCSG-06 trial.Methods:ABCSG-06 investigated the efficacy of tamoxifen vs tamoxifen plus aminoglutethimide in postmenopausal women with hormone receptor-positive breast cancer. Taking BMI at baseline, patients were classified as normal weight (BMI=18.5–24.9 kg m−2), overweight (BMI=25–29.9 kg m−2), and obese (30 kg m−2) according to WHO criteria.Results:Overweight+obese patients had an increased risk for distant recurrences (hazard ratio (HR): 1.51; Cox P=0·018) and a worse overall survival (OS; HR: 1·49; Cox P=0·052) compared with normal weight patients. Analysing patients treated with single tamoxifen only, no difference between overweight+obese patients and normal weight patients regarding distant recurrence-free survival (HR: 1.35; Cox P=0·24) and OS (HR: 0.99; Cox P=0·97) could be observed. In contrast, in the group of patients treated with the combination of tamoxifen plus aminoglutethimide, overweight+obese patients had an increased risk for distant recurrences (1.67; Cox P=0·03) and a worse OS (1.47; Cox P=0·11) compared with normal weight patients.Conclusion:BMI impacts on the efficacy of aromatase inhibitor-based treatment but not single tamoxifen.