Prolonged response of relapsed high grade serous ovarian carcinoma to the oral angiokinase inhibitor nintedanib in a patient with a germline BRCA1 mutation.

► Nintedanib is an anti-angiogenic agent that has demonstrated activity in relapsed ovarian cancer. ► Our patient had prolonged response to nintedanib, allowing her to have potentially curative surgery 6 years after her diagnosis. ► The relationship between angiogenesis and BRCA mutation is worth exploring in ovarian cancer.

European consensus statement on "HPV Vaccination and Colposcopy".

We have developed a Europe-wide consensus statement on "HPV Vaccination and Colposcopy" under the aegis of the European Federation for Colposcopy. We look at the historical perspective, the currently available vaccines, cervical vaccination programs, future perspectives, and the impact all this will have on cervical cancer screening and colposcopy services.

Objective perspective in colposcopy.

Colposcopy is a widely used diagnostic procedure, primarily in the assessment of women with abnormal cervical cytology. It is used by appropriately trained individuals using techniques that allow a full assessment of the abnormality and plan for further investigation or treatment. Certain key features are specifically looked for, and a colposcopic impression formed. Using a systematic approach to the colposcopic assessment can improve the diagnostic accuracy. In this chapter, we review various factors and meta-analyses in relation to the diagnostic performance of colposcopy. Newer technologies are being developed that will assist the clinician in assessing the colposcopic changes. Quality assurance of the training and practise of colposcopy is important to maintain appropriate management for women with cytological abnormalities.

Histologic and colposcopic correlation of cervical cytology showing "? glandular neoplasia".

OBJECTIVE: To evaluate the role of cervical cytology and colposcopy in the management of patients with cervical smear reported "? glandular neoplasia". STUDY DESIGN: A retrospective study of 116 patients referred to the colposcopy clinic with cytology samples showing "? glandular neoplasia". RESULTS: Histological results were available for 114 patients; of those, 103 had cervical biopsy, 52 had endometrial biopsy and 41 patients had both. 17 (15.5%) had invasive disease, 12 cervical carcinoma (11 adenocarcinoma and one squamous cell carcinoma) and 5 endometrial adenocarcinoma. 12 (10.5%) had high-grade cervical glandular intra-epithelial neoplasia (HG CGIN). 23 (20.2%) had high-grade cervical intra-epithelial neoplasia (HG CIN). None of the patients in whom colposcopy was normal were found to have invasive cervical disease. All the patients with endometrial carcinoma were above the age of 50 years, and none of the patients with cervical carcinoma was above this age. CONCLUSIONS: Cytology samples with "? glandular neoplasia" are associated with significant pathology. Colposcopy is important in the assessment of this group of patients. Endometrial assessment should be offered to all patients above the age of 50 years or postmenopausal presenting with such cytology.

Radical hysterectomy.

The radical hysterectomy is the standard approach for the treatment of women with early cervical cancer. However, it has increasingly been recognized that a more individualized approach to treatment should be taken. In particular, careful pretreatment evaluation should reduce the number of women receiving adjuvant radiotherapy. Laparoscopic lymphadenectomy is an attractive technique that seems likely to reduce the use of dual modality therapy. The laparoscopic approach to the evaluation of lymph nodes in cervical cancer has also allowed the development of the fertility-preserving radical trachelectomy. Outcomes for women with early cervical cancer are generally good, and it therefore becomes increasingly relevant to develop methods of reducing long-term morbidity.