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OBJECTIVE: To assess whether obesity is an independent predictor of mortality in women with cervical cancer. METHODS: This retrospective cohort study of patients with stages IB1-IVA cervical cancer treated with curative intent at MD Anderson Cancer Center from 1980 through 2007 categorized these women as underweight, normal weight, overweight, obese, or morbidly obese according to National Institutes of Health definitions. In addition to weight category, known prognostic factors for survival after a diagnosis of cervical cancer were included in a multivariate model. These known prognostic factors included age, smoking status, race or ethnicity (self-reported), socioeconomic status, comorbidities, tumor histologic subtype, tumor stage, tumor size, presence or absence of hydronephrosis, radiologic evidence of nodal metastasis, and the addition of concurrent chemotherapy with definitive radiation. RESULTS: A total of 3,086 patients met the inclusion criteria. The median survival for the entire cohort was 81 months (range 0-365 months). The presence of lymph node spread and advancing stage were the most significant predictors of survival. Compared with normal-weight women, morbidly obese women had a significantly higher hazard ratio for both all-cause death (hazard ratio 1.26, 95% confidence interval [CI] 1.10-1.45) and disease-specific death (hazard ratio 1.24, 95% CI 1.06-1.47). Underweight, overweight, and obese women did not have an increased risk for death compared with normal-weight women. CONCLUSION: After controlling for all previously known prognostic factors, morbid obesity remains an independent risk factor for death from cervical cancer. Overweight and obese women have the same prognosis as normal-weight women. [ABSTRACT FROM AUTHOR]

The article discusses the results of a study that examines the incidence of unverifiable publications among fellowship applicants in the field of gynecologic oncology. The study showed that out of 464 articles reported as published or in press, 83 percent were verified. It concludes with a suggestion that stringent review of fellowship applications before interview invitations is needed given the significant proportion of unverifiable publications.

This article discusses a study which described the clinical and pathologic features of vaginal melanoma and determined predictors of outcome in patients with the disease. The study included 37 women with clinical and radiographic stage I vaginal melanoma treated at one institution between 1980 and 2009. Researchers discovered that vaginal bleeding was the most common presenting symptom. They also learned that lesions were located in the distal third of the vagina in the majority of patients.

The article presents a study which examines the incidence of parametrial involvement in radical hysterectomy specimens from women with early-stage cervical cancer. It also evaluates the factors associated with parametrial spread. The authors of the study have identified a cohort of women with early-stage cervical cancer who were at low risk for parametrial involvement. They note that less radical surgery with pelvic lymphadenectomy maybe a therapeutic option for women with primary tumors.

The article presents a study on radical hysterectomy in obese and morbidly obese women with cervical cancer. A review of patients who underwent radical hysterectomy and pelvic lymphadenectomy for invasive cervical cancer between 1990 and 2006 was done. Results showed that radical hysterectomy and pelvic lymphadenectomy is feasible for obese and morbidly obese women with cervical cancer.

The article presents obstetrics and gynecology research that compares the pathologic, intraoperative, and postoperative outcomes of abdominal radical hysterectomy with pelvic lymphadenectomy and total laparoscopic radical hysterectomy for women patients with early state cervical cancer. Outcome paremeters included operative blood loss, postoperative hospitalization, and infectious morbidity.

In 1889, Thomas Eakins was commissioned to paint a portrait of Dr. David Hayes Agnew to commemorate his exemplary career as a physician and teacher at The University of Pennsylvania. What was originally proposed as a three-quarters portrait of the retiring professor quickly became an enormous painting depicting an operating theater with Dr. Agnew assuming his role as both surgeon and educator. When comparing this piece with an earlier Eakins’ painting, The Gross Clinic, one can trace the rapid evolution of surgical techniques that accompanied medicine’s advancement in the late 19th century. Eakins obviously embraced this progress, but was the public ready to do so too? [Copyright &y& Elsevier]

A response by Michael Frumovitz and Pedro Ramirez to a letter to the editor about their article "Comparison of total laparoscopic and abdominal radical hysterectomy for patients with early-stage cervical cancer," is presented.