Cover -- Half-title -- Title -- Copyright -- Dedication -- Contents -- Contributors -- Preface -- Abbreviations -- Chapter 1 Epidemiology of gynaecological cancers -- Introduction -- What is epidemiology? -- Classification of gynaecological cancers -- Measuring the risk or burden of gynaecological cancers -- Incidence -- Age-standardized incidence (or mortality) rate (ASR) -- Cumulative incidence (or cumulative risk) -- Prevalence -- Survival -- Quality-adjusted life-years (lost)/disability-adjusted life-years (lost) -- Mortality -- Cancer screening -- Ovarian cancer -- Incidence and mortality -- Trends in incidence and mortality -- Aetiology -- Prevention -- Endometrial cancer -- Incidence and mortality -- Trends in incidence and mortality -- Aetiology -- Prevention -- Cervical cancer -- Incidence and mortality -- Trends in incidence and mortality -- Aetiology -- Prevention -- Vulvar and vaginal cancers -- Incidence and mortality -- Trends in incidence and mortality -- Aetiology -- Prevention -- Further reading -- Chapter 2 Screening and prevention of gynaecological cancers -- Introduction -- Ovarian and fallopian tube cancer -- Screening for ovarian and tubal cancer -- Improving CA125 sensitivity and specificity -- Screening trials -- Prevention -- Familial risk -- Risk-reducing salpingo-oophorectomy -- Endometrial cancer -- Familial endometrial cancer -- Screening -- High-risk population -- Low-risk population -- Other modalities -- Prevention -- Cervical cancer -- Screening for cervical cancer -- Pap smear and liquid-based cytology -- Other screening methods -- Screening protocols /guidelines -- Prevention of cervical cancer -- HPV vaccines -- Conclusions -- Further reading -- Chapter 3 Pathology of gynaecological cancers -- Introduction -- Ovarian tumours -- Epithelial serous tumours -- Mucinous tumours -- Pseudomyxoma peritonei.

Endometrioid tumours -- Clear cell tumours -- Other ovarian carcinomas -- Sex cord-stromal, germ cell and other ovarian tumours -- Endometrial tumours -- Endometrial carcinomas -- Endometrioid carcinoma -- Prognostic factors in endometrial carcinoma -- Serous papillary and clear cell carcinomas -- Other variants of endometrial carcinoma -- Malignant mesenchymal tumours of the uterus -- Leiomyosarcomas -- Endometrial stromal sarcomas -- Mixed Müllerian tumours of the uterus including carcinosarcoma/malignant mixed Müllerian tumour -- Cervical cancer -- Microinvasive squamous cell carcinoma -- Invasive squamous cell carcinoma (stage IB and above) -- Other prognostic factors and human papillomaviruses -- Variants of squamous cell carcinoma -- Adenocarcinoma -- Variants of adenocarcinoma -- Rare variants of cervical carcinoma -- Vaginal cancer -- Vaginal squamous carcinoma -- Vaginal clear cell carcinoma -- Vulval cancer -- Superficially invasive carcinoma of the vulva -- Squamous carcinoma -- Paget's disease of the vulva -- Other malignant tumours -- Further reading -- Chapter 4 Imaging in gynaecological oncology -- Principles of imaging -- Imaging modalities -- Ultrasound -- Technique and general issues -- Role of ultrasound in ovarian carcinoma -- Screening -- Characterization of ovarian masses -- Role of ultrasound in endometrial cancer -- Role of ultrasound in cervical cancer -- Role of ultrasound in vulval cancer -- Computed tomography -- Technique and general issues -- Role of CT in ovarian carcinoma -- Diagnosis -- Staging and assessment of resectability -- Role of CT in endometrial cancer -- Role of CT in cervical cancer -- Role of CT in vulval cancer -- Magnetic resonance imaging -- Technique and general issues -- Role of MRI in ovarian carcinoma -- Characterization of ovarian masses -- Staging and assessment of resectability.

Assessment of follow-up response and detection of recurrent disease -- Role of MRI in endometrial cancer -- Diagnosis -- The role of MRI in staging and treatment planning -- Role of MRI in cervical cancer -- Staging -- Treatment follow-up -- Disease recurrence -- Role of MRI in vulval cancer -- FDG-PET and FDG-PET/CT -- Role of FDG-PET and FDG-PET/CT in ovarian carcinoma -- Diagnosis -- Staging and prediction of tumour response -- Evaluation of treatment response -- Detection of recurrent disease -- Role of FDG-PET in endometrial cancer -- Role of FDG-PET/CT in cervical cancer -- Role of FDG-PET in vulval cancer -- Recommended imaging algorithms -- Ovarian carcinoma -- Endometrial cancer -- Cervical cancer -- Vulval cancer -- Other imaging modalities -- Skeletal scintigraphy -- Lymph node imaging with MR lymphography -- Conclusion -- Further reading -- Chapter 5 Surgery for gynaecological cancers -- Introduction -- Basic principles -- Choose your patient -- Know your aims -- Know your anatomy -- Apply good surgical techniques -- Treat complications early -- Be a good team member -- Know your limitations -- Preoperative assessment -- History -- Examination -- Special investigations -- Bowel preparation -- Drainage of pleural effusion -- Antibiotic prophylaxis -- Thromboprophylaxis -- Counselling -- Consent -- Skin preparation -- Abdominal incisions -- Intraoperative complications -- Bowel -- Urinary tract -- Haemorrhage -- Minimal access surgery -- Diagnostic laparoscopy -- Therapeutic laparoscopy -- Radical hysterectomy -- Radical trachelectomy -- Summary -- Further reading -- Chapter 6 Radiotherapy for gynaecological cancers -- Introduction -- Indications for radiotherapy -- Types of radiotherapy -- External-beam radiotherapy -- Brachytherapy -- Principles of radiotherapy -- Mechanism of action -- Dose and fractionation -- Normal tissue tolerance.

Side effects of radiotherapy -- Acute side effects -- Late side effects -- The therapeutic ratio -- Exploiting radiobiological differences -- Minimizing volume of normal tissue -- Chapter 7 Systemic therapies for gynaecological cancers -- Introduction -- Types of chemotherapy and modes of action -- Platinum compounds -- Taxanes -- Topo-isomerase inhibitors -- Oral etoposide -- Anthracyclines -- Anti-metabolites -- 5-Fluorouracil/capecitabine -- Gemcitabine -- Neoadjuvant/adjuvant treatment in epithelial ovarian cancer -- Epithelial ovarian cancer and first-line chemotherapy -- Role of paclitaxel first line with carboplatin -- Duration of treatment -- Dose intensification -- Philosophy of treatment of relapsed epithelial ovarian cancer/palliative chemotherapy of gynaecological cancers -- Significance of platinum-free interval -- Treatment beyond second line -- Oral chemotherapy -- Quality-of-life assessments and patients' expectations -- Endometrial cancer -- Hormonal treatment in gynaecological malignancy -- Endometrial cancer and hormonal manipulation -- Epithelial ovarian cancer and endocrine manipulation -- Further reading -- Chapter 8 Palliative care in gynaecological oncology -- Symptom control -- Pain management -- Difficult pains -- Incident pain -- Neuropathic pain -- Bone pain -- Total pain -- Nausea and vomiting -- Anti-emetics (Box 8.1) -- Constipation -- Prevention -- Diagnosis -- Treatment -- Oral treatment -- Hypercalcaemia -- Diagnosis -- Treatment -- Cautions -- Complex, fungating and malodorous wounds -- Breathlessness -- Entering the palliative phase -- Anxiety and depression -- Practical issues -- Key points -- Further reading -- Chapter 9 Ovarian cancer -- Introduction -- Pathology -- Risk factors -- Familial ovarian cancer -- Screening programmes -- Diagnosis and clinical presentation -- Markers -- Treatment -- Staging -- Surgery.

Early-stage disease -- Advanced-stage disease -- Fertility-sparing procedures -- Chemotherapy -- Early-stage disease -- Advanced-stage disease -- Intraperitoneal chemotherapy -- Consolidation and maintenance therapy -- Chemotherapy for recurrent disease -- Palliative care -- New therapeutic strategies -- Conclusion -- Chapter 10 Endometrial cancer -- Aetiology and risk factors -- Pathology of endometrial cancers -- Clinical presentation -- Assessment of the woman with postmenopausal bleeding (Fig. 10.3) -- Ultrasound scan -- Outpatient endometrial assessment -- Role of imaging in treatment planning -- X-ray -- Magnetic resonance imaging -- Computed tomography -- Positron-emission tomography (PET) -- Surgery for endometrial cancer -- Total abdominal hysterectomy and bilateral salpingo-oophorectomy -- Role of extended surgical staging -- Minimal access surgery -- Vaginal hysterectomy -- Complications of surgery -- Radiotherapy in the treatment of endometrial cancer -- Adjuvant radiotherapy -- Radical primary radiotherapy -- Palliative radiotherapy -- Complications of radiotherapy -- Chemotherapy -- Hormonal treatment -- Adjuvant progestogens -- Hormones in the treatment of recurrent and metastatic disease -- Recurrent endometrial cancer -- Further reading -- Chapter 11 Cervical and vaginal cancer -- Cervical Cancer -- Epidemiology -- Diagnosis -- Staging -- Clinical examination and routine investigations -- Radiological examination -- Pathology -- Squamous cell carcinoma -- Adenocarcinoma -- Neuroendocrine tumours -- Prognostic variables -- Overall survival by FIGO stage (Table 11.1) -- Lymph node metastasis and histopathological variables -- Radiological characteristics -- Management -- Early-stage disease -- Stage IA -- Stages IB and IIA -- Advanced stages (IIB-IVA) -- Follow-up and recurrent disease -- Special clinical situations.

Cervical cancer in pregnancy.