Prognostic and Predictive Factors in Gynecologic Cancers PDF

Preface

Experienced clinicians have long recognized limitations with regard to predicting the course of disease in individual patients.We rely heavily on the traditional prognostic and predictive factors such as tumor stage, histologic subtype and grade to provide broad guidelines for treatment recommendations.At the extremes of the prognostic spectrum, for example stage I and IV cervix cancer, traditional prognostic factors are fairly reliable. Nevertheless, we also know that occasionally patients with a favorable prognosis will suffer from recurrent cancer and conversely, patients with a terrible prognosis survive. In more ambiguous categories (for example stage II and III epithelial ovarian cancer), prognostication for individual patients can be particularly difficult. This high degree of uncertainty contributes to the patient's (and provider's) anxiety and leads to over-treatment of large numbers of patients.

There is a growing number of new prognostic and predictive factors that have been derived from molecular discoveries.These newly described molecular pathways and genetic markers are starting to become the basis of therapeutic intervention.We anticipate that in the coming years, treatment planning will be based on molecular profiling to a greater extent. Eventually, the traditional prognostic factors that we rely on so heavily now may be either complemented or superceded by molecular factors.

Our purpose in writing this book is to provide a single up-to-date resource of prognostic and predictive factors from both traditional and molecular categories for gynecologic malignancies. We hope that this book will be an easy to use resource for oncologists, translational and basic researchers, as well as fellows, residents and students who have an interest in gynecologic cancers. In order to provide a concise resource,we elected to focus on specific aspects of the major gynecologic cancers including ovarian, endometrial, and cervical cancer. Our hope is that this book will not only help clinicians at the bedside make informed treatment recommendations, but also stimulate scientists to continue to search for better prognostic and predictive markers for our patients.