In the name of ALLAH The All Compassionate The All ...

In the name of ALLAHThe All Compassionate, The All merciful

&&'(#$!% " ! Gynecological OncologyForThe 1 st International congress on Gynecological oncologyThe 35 th Comprehensive Collection of books in RASANE TAKHASSOSIAll rights reserved and monopolized ofRASANE TAKHASSOSI

+ .- , + ()* ' ! "# $%%&# : International Congress on Gynecological Oncology ( 1st + , +yazd)$ (1 7 2 &802 90 01: 6 ! " #$%%& # 0# 50 + ! "# : 0122 3- 0 #4? >$==* 9 PB > 7 2&8>$O# 4$ (1+0D# QS R/ ,QRC + 2 SS 6 P Q, +$ 2 TP ,+$ %$ ;( & Gynecological Oncology Collector : Mohammad Reza Ashtyani Disigner : Farzaneh Vahdat Behroty !"#$Commercial affairs : Zahra Tadayon por%&'(Financial affairs : Mojtaba ekteshafiPrinting turn : first/ 1390Circulation :-*,,*,*+*)IBSN : 978-600-5805-74-1Price :4,/!#012(!")*#,/3)*#+#,#-#.This is book is freely available to congress participants and related companies.Address : No. 29 GF, Unit 2, Razi st,Novell Le Chateau, Bfore Vali-e- Asr Cross,RASANE TAKHASSOSI PUBLSHINGTel : 982166737133- 66737332-989123049109 %'#%& !"#$-&,%*-.&,-& (()*),** (()*)**%

Appreciation and thanksCompilation and publication of this book owes a lot of partners that belowwe introduce some of these excellent people.• Dr. Sayed Jalil Mirmohammadi• Dr. Mojgan Karimi Zarchi• Dr. Mohammad Hossein Mollanouri• Dr. Fatemeh Ezoddini• Dr. Esmat Barouti• Dr. Masoud Mirzaei• Dr. Amir Houshang Mehrparvar• Dr. Abbas Aflatonian• Dr. Mohammad Ali Karimzadeh• Dr. Razieh Dehghani Firouzabadi• Dr. Mohammad Reza Mirjalili• Dr. Ali Mohammad Abdoli• Dr. Mohammad Reza Aghaei• Dr. Azam Sadat Hashemi• Dr. Azam Sadat Mousavi• Dr. Hassan Ali Vahedian Ardekani• Dr. Ali Akbar Vaezi• Prof. Parviz Hanjani• Prof. Fatemeh Ghaemmaghami• Prof. Mitra Modares Gilani• Prof. Nadereh Behtash• Mr. Atef Atefi• Mr. Mehdi Jafari• Ms. Fatemeh Ghanizadeh• Mr. Mohammad Ali Dehghani• Mr. Mohammad Hossein Nazmieh• Mr. Ali Dehghani• Mr. Mohammad Hossein Nikookaran• Ms. Maryam Nikfard• Ms. Nazila Naghshin• Mr. Seyed Kazem Mirafzali• Mr. Hassan Tavakoli• Mr. Abolfazl Banapor• Ms. Maryam Mohammadi• Mr. Tohid Emami• Ms. Soraya Teimouri• Mr. Hamid Reza Soltani39

CONTENTS40

CONTENTSMessage from the Chair of the Scientific Committee................................ 13Introducing some famous And pioneers, related Companies & ScientificCommittee Specialists.......................................................................... 19Congress Scientific Committee Specialists..................................................................................30Student Research Committee..........................................................................................................33An interview with the chair of scientificMojgan Karimi...................................................................................................................................34ABSTRACTSThe 1 st International Congress on Gynecological OncologyORAL PRESENTATIONSSurgical Staging in Cervical CancerSetareh Akhavan................................................................................................................................39The Role of Radiotherapy in Uterine SarcomaAli Akhavan.........................................................................................................................................40Staging and Surgical Treatment of Uterine SarcomaTajossadat Allameh ..........................................................................................................................42Classification and Management of GTNAmini Moghadam..............................................................................................................................43Fertility Sparing Surgery in the Management of Cervical CancerHaleh Ayatollahi................................................................................................................................44Benign HPV Related Genital Infection in Women and Available VaccinationHeshmatollah , Azhar.......................................................................................................................45Premalignant Lesion and New Management on Abnormal Pap SmearFariba Behnamfar.............................................................................................................................46Pelvic Exenteration in Cervical CancerK.K. Chan............................................................................................................................................47The Role of Neoadjuvant Chemotherapy, Post-Radiation and Post-SurgicalChemotherapy in Cervical CancerK.K. Chan............................................................................................................................................48Vulvar and Vaginal Intraepitelial NeoplasiaFereshteh Fakor................................................................................................................................. 49Chemotherapy in the Endometrial CancerForat Yazdi ........................................................................................................................................5139

CONTENTSFalse Positive or Phantom hCG Result:A Serious Problem in GTN Follow-UpTahereh Ashrafganjooei ..................................................................................................................52Assessment of Gross Examination and Frozen Section of Uterine Specimen inEndometrial Cancer PatientsFatemeh Ghaemmaghami &… ......................................................................................................53Novel Cancer Therapy: Gene Therapy and Immunotherapy in Ovarian CancerGhasemi N...........................................................................................................................................54Role of Imaging in Cervical CarcinomaM. Gity, &… ......................................................................................................................................55Targeted Therapy in Ovarian CancerParviz Hanjani................................................................................................................................... 56New Approaches for Treatment of Recurrence Epithelial Ovarian CancerParviz Hanjani...................................................................................................................................57Planning Front Line Management of Epithelial Ovarian Cancer in 2011Parviz Hanjani...................................................................................................................................58Chemotherapy in Vulvar CancerRazieh Hashemi .................................................................................................................................59Polycystic Ovary Syndrome (PCOS) and Endometrial CarcinomaKarimzade MA & … ........................................................................................................................60Recurrence DVT and VTE in Gynecological Cancers and the Role of Celexan inPreventionMojgan Karimi Zarchi......................................................................................................................61Status of Gynecologic Cancers in Asia - Comparison with the WorldMalcolm A Moore..............................................................................................................................62Neoadjuvant Chemotherapyfor Advanced Ovarian CancerMitra Mohit......................................................................................................................................... 63Fertility Preservation and CancerAzamsadat Mousavi MD..................................................................................................................64Novel Nanomedicine-Based MRI Contrast Agents for Gynecological CancerReza Nafisi-Moghadam....................................................................................................................66Problems of Dealing with Trophobelastic Disease in IranRazi T...................................................................................................................................................67Endometrial Cancer, Novel Staging SystemSayyah-Melli Manizheh, MD ..........................................................................................................68Uterine SacrcomaVahidfar...............................................................................................................................................6940

CONTENTSRole of Primary Surgery in Treatment L of Patients with Ovarian CancerZohrhe Yousefi,.................................................................................................................................. 70Poster PresentationsThe Role of TLR in Endometrial CancerNarjes Abbasi rad..............................................................................................................................73Review of the Nutritional Risk Factors of Ovarian CancerAhadi Z &… .......................................................................................................................................74Alpha Fetoprotein Production by an Endometrioid Adenocarcinoma of UterusA.Akhavan ..........................................................................................................................................76Incidence and Risk Factors for Non-Alcoholic Steatohepatitis in Females TreatedMohsen Akhondimeybodi.................................................................................................................77Malignant Epithelial Tumor of the Vulva with Neuroendocrine FeaturesModerately Differentiated:Case Report and Review of the LiteratureSoheila Amini Moghaddam&… .....................................................................................................78Inflammatory Indices and its Relevant Factors in Pregnant Iranian WomenZatollah Asemi &… ........................................................................................................................79Effect of Gabapentin on Postoperative Pain and Complications: A Randomized PlaceboControlled TrialShokoufeh Behdad &… ..................................................................................................................81Primary Cervical Choriocarcinoma: Case Report and the Review of LiteraturesBehtash N &… .................................................................................................................................83The Prevalence of Cervical Cancers Related to Human Papillomavirus in Germany, Iranand TurkeyN. Navaliand M.H. Biglu..................................................................................................................84Broom Cytobrush or Ayre Spatula for Pap Smear, Which One is Better?Mahshid Bokaie &… ........................................................................................................................86Evaluation of Accuracy and Consistency of External Radiation Therapy andBrachytherapy of Cervical CancerChaparian A &… ............................................................................................................................87Association of CA125 and CA19.9 Serum Concentration in Ovarian Cancer PatientsDashti Fatemeh sadat &… .............................................................................................................88Challenges of Nursing Care in OncologyMohammad Ali Dehghan................................................................................................................. 9041

CONTENTSSentine Lymph Node Biopsy in Uterus CancerDehghan L &… .................................................................................................................................91Nursing Care Related to Specific Cancer TherapiesAli Mohammad Dehghani ...............................................................................................................92The Role of Nurse in Nursing Care of Patient after Gynecological Cancer SurgeryAli Mohammad Dehghani................................................................................................................93Evaluation of Diagnostic Value of CT Scan, Physical Examination and Ultrasound Basedon Pathological Findings in Patients with Pelvic Mass and Determination of CT ScanEfficacy in Surgical Procedure AdaptationRazieh Dehghani Firoozabadi &… ...............................................................................................94A Huge Abdominal Mass due to Short Clomiphene Citrate RegimenKarimi Zarchi M &… ......................................................................................................................96Benefit of Metformin Use in Cancer TreatmentTahereh Eftekhar...............................................................................................................................97Risk Factors of Gynecological Cancer in Middle Aged Women of YazdEnjezab B, Bokaie M ........................................................................................................................98Lifestyles and Gynecologic CancersEnjezab B &… ..................................................................................................................................99Frequency of Cervical Cancer, Diagnostic Methods, Pathologic Characteristics, andTreatment in Gilan From 1385Till 1389Fakor Fereshteh &… ......................................................................................................................101Exercise to Fight Cancer Related FatigueFarnia Farahnaz &… ......................................................................................................................103Communication Skill Enhancement: The Opportunity to Make Profound Difference inOncologic Patients’ ExperiencesFarnia, Farahnaz &…......................................................................................................................105Vulvar Melanoma 7 Years after Cervical Melanoma, Case Presentation and Review ofLiteratureAzamsadat Mousavi &… .................................................................................................................107Treatment Failure Assessment In Immature Teratoma: 5 Cases PresentationMitra Modares&… ...........................................................................................................................109Primary Malignant Nevoid (Amelanotic) Vulvar Melanoma in a 40-year -old WomanMitra Modares Gilani &…..............................................................................................................110Longterm Disease Free and Successful Pregnancy in a Gonadectomized Woman with46,XY Gonadal Dysgenesis and Dysgerminoma (Stageii)Azamsadat Mousavi &… ................................................................................................................11142

Message from the Chair of the Scientific Committee ofthe 1 st International Congress on Gynecological Oncology14Causes of increased cancer rate• Western life style and sedentary living• Increased consumption of meat, fat and smoking• Industrialized society and bioenvironmental pollutions• Occupational pollutions• Biologic pollutions (especially viruses)Other causes include: inadequate consideration of food standards, executiveproblems in occupational rules, inappropriate following of cancer treatmentguidelines by physicians, negative belief regarding cancer in society whichleads to delayed follow-up, wrong conception about cancer risk factors andfinally population unawareness about their rights of being confronted toenvironmental carcinogens.Cancer prevention methods• Nutritional improvement• Weight control• Individual genetic study• Using preventive agents• VaccinationCancer prevention Primary prevention1- Identify, control and omit the carcinogens2- Use preventive and protective methods Secondary preventionEarly diagnosis of cancer (more than 40% of cancers are preventable). Onethird of cancers are curable if diagnosed in early stages.Cervical cancer prevention• Cervical cancer is the third leading cancer in women.14

15Message from the Chair of the Scientific Committee ofthe 1 st International Congress on Gynecological Oncology• Cervical cancer is a sexual transmitted disease caused by a known virusin 90% of patients.• The virus is found in female external genitalia and anus.• The probability of cancer regarding this virus is more in multi-partnerwomen. So cultural conditions and unrestrained behavior increase itsprevalence in society.• Cervical cancer is more common in immunocompromised patients.• Number of parity, social poverty and passive or active smokingincrease cervical cancer prevalence.• The incidence of cervical cancer is more in women who get married inyounger ages (due to more susceptibility to virus).• To prevent cervical cancer, HPV vaccine is administered to 12- 26 yearold virgin women. We hope this vaccine become routine in our country.• Cervical cancer incubation period is about 10years ; it is curable ifdiagnosed in this period.• In fact the most curable cancer in women is cervical cancer.• Early diagnosis of cervical cancer is possible by Pop-smear test whichis suggested to be performed in women, three years after first sexualintercourse or from the age of 21, annually.• If there were three negative Pop-smear test results, the intervals will beincreased to 2-3 year.• There are more than 100 species of the venereal virus responsible forcervical cancer, some of which cause genital warts.Uterine cancer prevention• According to the global statistics, uterine cancer is the most pelviccancer in women.• Majority of uterine cancers have abnormal uterine bleeding. Thissymptom is valuable in early diagnosis.15

Message from the Chair of the Scientific Committee ofthe 1 st International Congress on Gynecological Oncology16• Uterine cancer is more common in fat, diabetic, hypertensive,nulliparous and women with delayed menopause.• Prevalence of uterine cancer is more in menopausal women and abovethe age of 50.• Post menopausal vaginal bleeding is an important symptom of uterinecancer.• All the post menopause uterine bleeding need to be evaluated byphysician.• 20% of uterine cancers are seen between the age of 20to 40; soconsidering abnormal bleeding in this period is crucial.• All women above 40years old with abnormal vaginal bleeding need tobe evaluated by uterine biopsy or diagnostic curettage.O varian cancer prevention• Ovarian cancer is the second leading cancer in female and the eighthone in both sexes.• One out of each 58women wi ll develop ovarian cancer in her life.• Ovarian cancer is related to obesity, inappropriate nutrition, high fatdiet, infertility, nulliparity and negative history of breast feeding (same as thebreast cancer). Also 10% of its incidence is related to genetic risk factors.• The prevalence age of ovarian cancer is above 40 especially from 55to60.• Ovarian cancer have delayed and nonspecific manifestations such asgastrointestinal symptoms, abdominal distension and pressure feeling inpelvic.• Ovarian cancer survival in early stages and late stages is 90% and 30%respectively, thus its early diagnosis is vital.• Vaginal examination, done every 6 months is beneficial for women todiagnose ovarian cancer in early stages.16

17Message from the Chair of the Scientific Committee ofthe 1 st International Congress on Gynecological Oncology• Ovarian cancer screening is suggested in women with family history ofovarian cancer in first-degree relatives or one ovarian cancer and one breastcancer in first-degree relatives.• Women with family history of ovarian cancer in first-degree relativesor one ovarian cancer and one breast cancer in first- degree relatives or oneovarian cancer and one intestinal cancer in first-degree relatives should havevaginal examination, vaginal ultrasound study and chemical markers testingevery 6 months.Dr. Mojgan KarimiAssistant Professor, Gynecological Oncology FellowshipChair, Scientific Committee17

Introducing some famousand pioneers, related companies & …2020

21Introducing some famousand pioneers, related companies & …Prof. PARVIZ HANJANIPersonalAddress: Director , Hanjani Institute for GynecologicOncology ,Abington Memorial Hospital 1200 OldYork RoadAbington, PA ,19001 Professor of GynecologyTemple University School of Medicine Philadelphia,PAA. Education:Degree Field of Study University Country YearM.D Medicine Tehran University Iran 1958-65Residency TrainingObstetrics and GynecologyHouse surgeonEngland-Chicago 1967-69fellowship Gynecologic oncology The University of Tennessee New York 1972-74B. Work:TitleProfessorOrganizationProfessor, Department of Obstetrics and Gynecology Temple UniversityHealth Science Center, Philadelphia, PennsylvaniaYearJuly 1984 - present21

Introducing some famousand pioneers, related companies & …22Prof. TAGHI RAZIPersonalBorn: 1939Place of Birth: Behbahan, IranEmail: TaghiRazi@gmail.comAddress: 2nd Floor, Obstetrics & Gynecologydepartment, Imam Khomaini Hospital, AzadeganSt., Ahvaz, IRANA. Education:DegreeField ofStudyUniversity Country YearState Board of registration Medicine Michigan USA 1973Fellowship Gynecologic oncology Wayne state University Michigan,USA 1972 to 1974B. Work:Title Organization YearChief Director of Obstetricsand Gynecology departmentJundishapur University of medical sciences/ Ahvaz, Iran1976 -1998Head of Medical School Jundi Shapur University of medical sciences/ Ahvaz, Iran. 1980 -1981Head of medical education Jundi Shapur University of Medical Sciences/Ahvaz,Iran. 1975 -197722

23Introducing some famousand pioneers, related companies & …Prof. FATEMEH GHAEMMAGHAMIPersonalBorn: 1331Place of Birth: TehranEmail: ftghaemmagh@yahoo.comA. Education:Degree Field of Study University Country YearM.D Medicine Tehran University IRAN 1970-1977Residency Training Obstetrics and Gynecology Tehran University IRAN 1977-1981Fellowship Gyn-Oncology Tehran University IRAN 1996-1998B. Work:Title Organization YearAssociate professor of Obs&Gyn, Gyn, Oncology Tehran University of Medical sciences 1981Professor of Obs&Gyn, Gyn, Oncology Tehran University of Medical sciences 2003-presentMembership of International Network in Central ofGynecological Cancer1999Active member of International Gynecology CancerSociety (IGCS)200023

Introducing some famousand pioneers, related companies & …24Prof. MITRA MODARES GILANIPersonalBorn: 1335Place of Birth: TehranAddress: Vali-e-Asr Hospital, Imam KhomainiHospital. Tehran University of medical sciences.Keshavarz Blvd.A. Education:Degree Field of Study University CountryM.D Medicine Tehran University IRANResidency Training Obstetrics and Gynecology Tehran University IRANFellowship Gyn-Oncology Tehran University IRANB. Work:TitleAssociate professor of Obs&Gyn, Gyn, Oncology.Professor of Obs&Gyn, Gyn, Oncology.Membership of International Network in Central of GynecologicalCancerActive member of International Gynecology Cancer Society(IGCS)OrganizationTehran University of Medical sciences, Tehran, Iran.Tehran University of Medical sciences, Tehran, Iran.24

25Introducing some famousand pioneers, related companies & …Prof. NADEREH BEHTASHPersonalPlace of Birth: TehranEmail: nadbehtash@ yahoo.comAddress: Vali-e-Asr Hospital, Imam KhomainiHospital. Tehran University of medical sciences.Keshavarz Blvd.A. Education:Degree Field of Study University CountryM.D Medicine Tehran University IRANResidency Training Obstetrics and Gynecology Tehran University IRANFellowship Gyn-Oncology Tehran University IRANB. Work:TitleAssociate professor of Obs&Gyn, Gyn, Oncology.Professor of Obs&Gyn, Gyn, Oncology.OrganizationTehran University of Medicalsciences, Tehran, Iran.Tehran University of Medicalsciences, Tehran, Iran.Membership of International Network in Central of Gynecological CancerActive member of International Gynecology Cancer Society (IGCS)25

Introducing some famousand pioneers, related companies & …26Dr. AZAM–SADAT MOUSAVIPersonalBorn1336Place of Birth: TehranEmail: azamsadat_mousavi@ yahoo .comAddress :Vali-e-Asr Hospital, Imam KhomainiHospital. Tehran University of medical sciences.Keshavarz Blvd.A. Education:Degree Field of Study University CountryM.D Medicine Tehran University IRANResidency Training Obstetrics and Gynecology Tehran University IRANFellowship Gyn-Oncology Tehran University IRANB. Work:TitleAssociate professor of Obs&Gyn, Gyn, Oncology.Membership of International Network in Central of Gynecological CancerActive member of International Gynecology Cancer Society (IGCS)OrganizationTehran University of Medical sciences26

27Introducing some famousand pioneers, related companies & …Prof. MANIZHEH SAYYAH MELLIPersonalBorn: 1956Place of Birth:TabrizA. Education:Degree Field of Study University Country YearM.D Medicine Tabriz University IRAN 1983Residency Training Obstetrics and Gynecology Tabriz University IRAN 1987Fellowship Gyn-Oncology Washington University USA 2004B. Work:TitleAssociate professor of Obs&Gyn, Gyn, Oncology.Professor of Obs&Gyn, Gyn, Oncology.OrganizationTabriz University of Medical sciences, Tabriz, Iran.Tabriz University of Medical sciences, Tabriz, Iran.27

Introducing some famousand pioneers, related companies & …28Dr. TAJOSSADAT ALLAMEHPersonalPlace of Birth: EsfahanEmail: t_allameh@med.mui.ac.irAddress: OB&GYN dept. Isfahan univercity ofmedical sciencesA. Education:Degree Field of Study University Country YearM.D Medicine Esfahan University IRAN 1685Residency Training Obstetrics and Gynecology Esfahan University IRAN 1991Fellowship Gyn-Oncology Mishigan USA 2000B. Work:TitleAssociate professor of Obs&Gyn, Gyn, Oncology.OrganizationEsfahan University of Medical sciences, Esfahan, Iran.28

29Introducing some famousand pioneers, related companies & …Dr. ZOHREH YOUSEFIPersonalEmail: yousefiz@mums.ac.irAddress: Mashhad –Ghaem HospitalA. Education:Degree Field of Study University CountryM.D Medicine Mashad University IRANResidency Training Obstetrics andMashad UniversityIRANGynecologyFellowship Gyn-Oncology Tehran University IRANB. Work:TitleAssociate professor of Obs&Gyn, Gyn, Oncology.OrganizationMashad University of Medical sciences, Mashad, Iran.29

Introducing some famousand pioneers, related companies & …30Congress Scientific CommitteeSpecialistsNO Last Name, Name Title UNIVERSITY1. Abbasi, Fatemeh Assistant Prof. Tehran University of Medical Sciences,2. Abbasi, Hamid Reza Assistant Prof. Shahid Sadoughi University of Medical Sciences, Yazd3. Abolghasemi, Hassan Full Professor Tehran University of Medical Sciences4. Abrovani, Masoud Assistant Prof. Tehran University of Medical Sciences5. Aflatonian, Abbas Full Professor Shahid Sadoughi University of Medical Sciences, Yazd6. Aghili, Kazem MD. Shahid Sadoughi University of Medical Sciences, Yazd7. Akhavan Tafti, Mahmoud Assistant Prof. Shahid Sadoughi University of Medical Sciences, Yazd8. Akhavan, Ali Assistant Prof. Shahid Sadoughi University of Medical Sciences, Yazd9. Akhavan, Setareh Assistant Prof. University of Medical Sciences, Kermanshah10. Ali Moghadam, Kamran Associate Prof. Tehran University of Medical Sciences11. Amini Moghadam, Soheila Assistant Prof. Iran University of Medical Sciences12. Anbiaei, Robabeh Assistant Prof. Shahid Beheshti University of Medical Sciences13. Ashraf-Gangoui, Tahere Assistant Prof. Shahid Beheshti University of Medical Sciences14. Ayatolahi, Haleh Associate Prof. University of Medical Sciences, Oroomieh15. Ayattolahi, Vida Assistant Prof. Shahid Sadoughi University of Medical Sciences, Yazd16. Azhar, Heshmattollah Associate Prof. Shahid Beheshti University of Medical Sciences17. Bahar, Babak Assistant Prof. Tehran University of Medical Sciences18. Barooti, Esmat Associate Prof. Shahid Beheshti University of Medical Sciences19. Behdad, Shekofeh Assistant Prof. Shahid Sadoughi University of Medical Sciences, Yazd20. Behnamfar, Fariba Assistant Prof. University of Medical Sciences, Esfahan21. Behtash, Nadereh Full Professor Tehran University of Medical Sciences22. Ben Razavi, Soheil Assistant Prof. Shahid Sadoughi University of Medical Sciences, Yazd23. Binesh, Fariba Assistant Prof. Shahid Sadoughi University of Medical Sciences, Yazd24. Chan, K.K. Full Professor England25. Davar, Robabeh Assistant Prof. Shahid Sadoughi University of Medical Sciences, Yazd26. Dehghan, Hamid Reza Assistant Prof. Shahid Beheshti University of Medical Sciences27. Eftehkar, Mitra Associate Prof. Tehran University of Medical Sciences28. Eftekhar, Maryam Assistant Prof. Shahid Sadoughi University of Medical Sciences, Yazd29. Fakour, Fereshteh Assistant Prof. University of Medical Sciences, Rasht30. Fallah, Mahmoud Assistant Prof. Shahid Sadoughi University of Medical Sciences, Yazd31. Farzaneh, Farah Assistant Prof. Shahid Beheshti University of Medical Sciences30

31Introducing some famousand pioneers, related companies & …NO Last Name, Name Title UNIVERSITY32. Fazel Associate Prof. Shahid Beheshti University of Medical Sciences33. Firouz Abadi, Raziye Associate Prof. Shahid Sadoughi University of Medical Sciences, Yazd34. Forat Yazdi, Mohammad Assistant Prof. Shahid Sadoughi University of Medical Sciences, Yazd35. Gahani, Mohammad Full Professor Tehran University of Medical Sciences36. Garahzadeh MD. Shahid Sadoughi University of Medical Sciences, Yazd37. Ghaem Maghami, Fatemeh Full Professor Tehran University of Medical Sciences38. Ghafari Assistant Prof. Tehran University of Medical Sciences39. Ghavamzadeh, Ardeshir Full Professor Tehran University of Medical Sciences40. Hanjani, Parviz Full Professor USA41. Hashemi Amouzegar, Farahnaz Associate Prof. Tehran University of Medical Sciences42. Hashemi, Azam Sadat Assistant Prof. Shahid Sadoughi University of Medical Sciences, Yazd43. Hashemi, Razieh Assistant Prof. Baghiyattallah University of Medical Sciences44. Hassanzadeh, Maliheh Associate Prof. University of Medical Sciences, Mashhad45. Hecker, Neviel Full Professor Australia46. Heirani, Fatemeh Assistant Prof. Tehran University of Medical Sciences,47. Hosseini, Habibollah Assistant Prof. Shahid Sadoughi University of Medical Sciences, Yazd48. Hosseini, Maryam Assistant Prof. Shahid Beheshti University of Medical Sciences49. Jalili, Mahdi Assistant Prof. Shahid Sadoughi University of Medical Sciences, Yazd50. Kargar, Saeid Assistant Prof. Shahid Sadoughi University of Medical Sciences, Yazd51. Karimi Zarchi, Mojgan Assistant. Prof. Shahid Sadoughi University of Medical Sciences, Yazd52. Karimzadeh, Mohammad Ali Full Professor Shahid Sadoughi University of Medical Sciences, Yazd53. Kimiaei, Parichehr Assistant. Prof. Shahid Beheshti University of Medical Sciences54. Kimiaei, Parichehr Associate Prof. Shahid Beheshti University of Medical Sciences55. Malcolm Moore Full Professor South Korea56. Mansourian, Hamid Reza Assistant Prof. Shahid Sadoughi University of Medical Sciences, Yazd57. Mirg h an iz ad eh , Mo h a m m ad R e z a Assistant Prof. Shahid Sadoughi University of Medical Sciences, Yazd58. Mir sh a m si, Moh a m m a d H os s e in Assistant Prof. Shahid Sadoughi University of Medical Sciences, Yazd59. Modares-Gilani, Mitra Full Professor Tehran University of Medical Sciences60. Moghimi, Mansour Assistant Prof. Shahid Sadoughi University of Medical Sciences, Yazd61. Mohit, Mitra Assistant Prof. University of Medical Sciences,azad Tehran62. Mojibian, Mahdieh Assistant Prof. Shahid Sadoughi University of Medical Sciences, Yazd63. Mollanori, Mohammad Hossein Assistant Prof. Shahid Sadoughi University of Medical Sciences, Yazd64. Mor ta z av iza de h, Mo ha m m ad R ez a Assistant Prof. Shahid Sadoughi University of Medical Sciences, Yazd31

Introducing some famousand pioneers, related companies & …32NO Last Name, Name Title UNIVERSITY65. Mousavi, Assadollah Assistant Prof. Tehran University of Medical Sciences66. Mousavi, Azam-Sadat Associate Prof. Tehran University of Medical Sciences67. Nafisi Moghadam, Reza Assistant Prof. Shahid Sadoughi University of Medical Sciences, Yazd68. Nazari, Zeinab Assistant Prof. University of Medical Sciences, Sari69. Nazhet, Far Full Professor USA70. Nili, Mehrdad Assistant Prof. Tehran University of Medical Sciences71. Ostad Ali, Mohammad Reza Assistant Prof. Tehran University of Medical Sciences72. Pourreza, Maryam Full Professor Tehran University of Medical Sciences73. Razi, Taghi Assistant Prof. Gondishapour University of Medical Sciences, Ahvaz74. Sadr Arhami, Abdoreza Assistant Prof. Shahid Sadoughi University of Medical Sciences, Yazd75. Samiee MD. Shahid Sadoughi University of Medical Sciences, Yazd76. Samiee, Farhad Associate Prof. Tehran University of Medical Sciences77. Sayyahmeli, Manijeh Associate Prof. Tabriz University of Medical Sciences78. Sekhavat, Leila Assistant Prof. Shahid Sadoughi University of Medical Sciences, Yazd79. Shabani Assistant Prof. Shahid Sadoughi University of Medical Sciences, Yazd80. Shahedi, Parichehr Assistant Prof. Shahid Beheshti University of Medical Sciences81. Shiryazdi, Mostafa Associate Prof. Shahid Sadoughi University of Medical Sciences, Yazd82. Sobhan, Mohammad MD. Shahid Sadoughi University of Medical Sciences, Yazd83. Tabatabaei Fard, Morteza Assistant Prof. Shahid Beheshti University of Medical Sciences84. Tabatabaei, Afsar Assistant Prof. Shahid Sadoughi University of Medical Sciences, Yazd85. Tabatabaei, Mahmoud MD. Shahid Sadoughi University of Medical Sciences, Yazd86. Taghipour, Shokooh Assistant Prof. Shahid Sadoughi University of Medical Sciences, Yazd87. Tehranian, Afsaneh Assistant Prof. Tehran University of Medical Sciences88. Vaghidi, Shiva Assistant Prof. Shahid Beheshti University of Medical Sciences89. Vahid Dastjerdi, Marzieh Full Professor Tehran University of Medical Sciences90. Vahidfar, Mohammad Reza Assistant Prof. Shahid Sadoughi University of Medical Sciences, Yazd91. Van der Zee, Ate Gerard Jan Full Professor The Netherlands92. Yao Full Professor China93. Yarandi, Fariba Associate Prof. Tehran University of Medical Sciences94. Yousefi, Zohreh Associate Prof. Mashhad University of Medical Sciences95. Zare, Fatemeh Assistant Prof. Shahid Sadoughi University of Medical Sciences, Yazd96. Zare, Mohammad Assistant Prof. Shahid Sadoughi University of Medical Sciences, Yazd32

33Introducing some famousand pioneers, related companies & …NO Last Name, Name Education University97 Bokaei, Mahshid MSc. in Midwifery Sha hid Sad ough i Un iv ers ity of Me d ic a l S c ien c e s98 Deh gh ani Ah ma dab ad i, A li BS. in Oncology Nursing Sha hid Sad ough i Un iv ers ity of Me d ic a l S c ien c e s99 Dehghani, Hamideh MSc. in Nursing Sha hid Sad ough i Un iv ers ity of Me d ic a l S c ien c e s100 Deh gh ani, Moh a m m ad A li MSc. in Nursing Sha hid Sad ough i Un iv ers ity of Me d ic a l S c ien c e s101 Enjezab, Behnaz Midwifery Ph.D. Student of102 Faraj Khoda, Tahmineh Midw if ery Ph.D. S tud en t of103 Farina, Farahnaz Nursing Ph.D. Student ofSha hid Sad ough i Un iv ers ity of Me d ic a l S c ien c e sSha hid Sad ough i Un iv ers ity of Me d ic a l S c ien c e sSha hid Sad ough i Un iv ers ity of Me d ic a l S c ien c e s104 Khoshbin, Azam MSc. in Midwifery Sha hid Sad ough i Un iv ers ity of Me d ic a l S c ien c e s105 Mojahed, Shahnaz MSc. in Midwifery Sha hid Sad ough i Un iv ers ity of Me d ic a l S c ien c e s106 Nasiriani, Khadijeh Nursing Ph.D. Student ofSha hid Sad ough i Un iv ers ity of Me d ic a l S c ien c e s107 Nazmieh, Hossein MSc. in Nursing Sha hid Sad ough i Un iv ers ity of Me d ic a l S c ien c e s108 Nikfard, Maryam MS c. Stu de nt of H e a lth c ar e Ma n ag e me nt Sha hid Sad ough i Un iv ers ity of Me d ic a l S c ien c e s109 Tavangar, Hossein Nursing Ph.D. Student of110 Vaezi, Ali Akbar Nursing Ph.D. Student ofSha hid Sad ough i Un iv ers ity of Me d ic a l S c ien c e sSha hid Sad ough i Un iv ers ity of Me d ic a l S c ien c e sStudent Research CommitteeNO Last Name, Name Education University1. Amini Rad, Omid Medical Student Shahid Sadoughi University of Medical Sciences2. Emami Meybodi, Tohid Medical Student Shahid Sadoughi University of Medical Sciences3. Rezaei, Mohammad Medical Student Shahid Sadoughi University of Medical Sciences4. Soltani, Hamid Reza Medical Student Islamic Azad University, Yazd Branch5. Teimoori, Soraya Medical Student Islamic Azad University, Yazd Branch33

Introducing some famousand pioneers, related companies & …34An interview with the chair of scientificDr. Mojgan Karimi• Dr. Karimi, Thank you for being with us, atfirst kindly tell us about the history of IranianSociety of Gynecological Oncology.o Gynecological oncology was considered as abranch of obstetrics and gynecology in 1970. TheInternational Gynecologic Cancer Society(IGCS) was then established in 1986. In Iran, thisfield was first submitted in Valiasr Hospital, Tehran University of MedicalSciences as a specific treatment for the patients in 1989, and the IranianSociety of Gynecological Oncology (IRSGO) was founded in 2003with theaim of decreasing the mortality rate of cancers through prevention, earlydiagnosis and effective treatment.• How is it possible for the candidates to apply for the membership in thissociety?o Candidates are supposed to fill out the membership form which will beprocessed according to the society regulations. Then they will be enrolled anda membership card signed by the society director will be issued for them. Bypaying membership fee, the society members will have some benefits such asattending scientific congresses, receiving educational publications, journalsand newsletters with special discounts.• What are the main objectives of the Society?o Scientific, research, technical and educational achievementso Cooperation with the Ministry of Health and the Universities34

35Introducing some famousand pioneers, related companies & …o Providing scientific, technical and educational serviceso Encouraging the researchers and scientists to have scientific andeducational activitieso Publishing scientific and educational journals and holding relatedcongresses and seminars• Have the society achievements been in accord with the objectives yet?o I would say Yes; for the society has accomplished to give educational andresearch services widely. Some of main scientific-social activities of theIRSGO include: conducting several educational classes regarding preventingcancer for the patients and their families, holding several seminars andmonthly scientific conferences, various national publications.The most important activities of the Society are as follows: Conducting regular seminars and international congresses Having interviews on the national media for informing the women aboutways of preventing cancer Publishing more than 150 scientific articles in internal and internationaljournals, half of which have been indexed in international journals and someaccepted in congresses Making the society website Publishing the society seasonal journal in English Affliction to the International Gynecologic Cancer Society• Please talk explain the 1 st International Congress on Gynecology andOncology in Yazd, regarding participation of internal and internationalprofessors, received articles and the congress different parts.o The congress planning was started from 2009. The IGCS and IRSGOhold this congress by the cooperation of Yazd Hematology Oncology andGenetics Research Center, Yazd Research & Clinical Center for Infertility,35

Introducing some famousand pioneers, related companies & …36Yazd Research Institute for Reproductive Medicine and European Society ofGynecological Oncology (ESGO).The congress chairman is the president of Shahid Sadoughi University ofMedical Sciences, Dr. Mirmohammadi, and the executive chairman is Dr.Mollanouri. Also we are delighted to have the help and cooperation of thepresident of Iranian Society of Gynecological Oncology, Dr. FatemehGhaem-maghami and national professors especially Dr. Azam SadatMousavi, Dr. Mitra Modarres Gilani and Dr. Fatemeh Behtash. Also I wouldlike to express my gratitude to the consultant of Minister of Health inWomen’s Affairs, Dr. Barouti, the professors of gynecologic oncology in Iranand abroad, ICGS and ESGO for all their help and support.In total 135 articles were sent to the congress secretariat, of which 32 wereaccepted as oral presentation and 60as poster presentation . Four workshopswill be held on the congress days. We are honored to host the professors fromIran and some other countries including England, Netherlands, the UnitedStates and South Korea.36

37ABSTRACTSThe 1 st International Congress on Gynecological OncologyABSTRACTSThe 1 st International Congresson Gynecological OncologyORAL PRESENTATIONS37

ABSTRACTSThe 1 st International Congress on Gynecological Oncology3838

39ABSTRACTSThe 1 st International Congress on Gynecological OncologySurgical Staging in Cervical CancerSetareh Akhavan M.DGynecologist Oncologist, Associated professor, Kurdistan University of MedicalSciencesWorldwide, cervical cancer is the second leading cause of cancer mortality inwomen. The staging system for cervical cancer is based solely on clinical parameters;staging assignment must be feasible in areas of the world where cervical cancer isendemic and resources are limited.The current FIGO staging system for locally advanced cervical cancer is inaccuratethat has several reasons, for example in clinical staging lymph node metastases areignored.For over 3 decades, pretreatment surgical staging has been touted as a gold standardfor establishing disease extent. Putative advantages to surgical staging include 1)identification of clinically occult extrapelvic disease sites; 2) excision of inflamedadnexae, which may complicate radiotherapy; and 3) down staging of patients toallow for more appropriate treatment.The question hovering over surgical staging today is not of feasibility but ofefficacy. Does surgical staging alter therapy and lead to overall improved outcome?In a Gynecologic Oncology Group (GOG) multivariate analysis of women whowere treated for cervical cancer with radiation therapy, the most important variablefor survival was the presence or absence of aortic lymph node metastases. Thoseinvestigators concluded that, for studies in patients with locally advanced cervicalcancer, the GOG still requires aortic lymph node evaluation. The required method ofaortic lymph node evaluation in GOG studies until recently has been surgical staging.Now surgical staging can be accomplished by laparascopy or laparatomy.39

ABSTRACTSThe 1 st International Congress on Gynecological Oncology40The Role of Radiotherapy in Uterine SarcomaDr. Ali AkhavanRadiotherapy-Oncology, Shahid Sadoughi University of Medical ScienceUterine sarcomas are rare neoplasms comprising 1% of all gynecologicmalignancies and 4–9% of all malignant uterine neoplasms. Pure uterine sarcomas ofthe homologous type arise from native elements, as is seen in endometrial stromalsarcoma, leiomyosarcoma, and sarcomas of nonspecific supporting tissues (fibroustissue, vessels, lymphatics). Heterologous sarcomas may contain elements withnonnative differentiation, such as skeletal muscle, bone, and cartilage. The malignantmixed Mullerian tumor is a combination of carcinoma and sarcoma and is also termedcarcinosarcoma. Although any combination is possible, serous carcinoma admixedwith endometrial stromal sarcoma is the most common histologic type. Despiteintensive treatment, local recurrence and distant metastasis are common. Overallsurvival is poor: 5-year survival rates of 50–70% for patients in stage I and 0–20% forthe remaining stages. The benefit of adjunctive chemotherapy and radiotherapy is inquestion. Some patients may respond to hormonal treatment.Carcinosarcomas (CSs)Carcinosarcomas represent a highly aggressive subtype of uterine malignancy .Offering adjuvant pelvic radiation applies only to patients that have not undergone acomplete surgical staging including lymph node staging.Leiomyosarcomas (LMSs)Smooth muscle cell tumours may be divided into three groups: benign(leiomyoma), malignant (leiomyosarcoma),and tumours of unknown malignantpotential Although radiation therapy has been shown to reduce the pelvic relapse rateby 50%, studies have not demonstrated a significant survival benefit with thisapproach A significant randomized trial demonstrated that patients with LMS did notshow the same benefit from radiation as patients with CSs.40

41ABSTRACTSThe 1 st International Congress on Gynecological OncologyEndometrial Stromal Sarcoma (ESSs)ESS is a rare entity of uterine malignancy, accounting for 0.2–1% of all uterinemalignancies and 6–20% of all uterine sarcomas. Adjuvant radiation therapy iseffective treatment for patients with ESS due to excellent local control in all stagesand good disease-specific survival in early stages. Adjuvant radiation therapy clearlyreduces the incidence of pelvic recurrence; however, in the majority of the studiesconducted it has no effect on overall survival.Undifferentiated Uterine Sarcomas (UUSs)Undifferentiated uterine sarcomas are high-grade epithelioid or spindle cellsarcomas that cannot be classified into one of the standard categories. Radiationtherapy is typically recommended for stage I and II UUSs .However, concernregarding distant recurrences has led to the consideration of combining irradiationwith chemotherapy.In general, RT should be recommended in those patients with substantial risk oflocoregional recurrence: higher grade tumors, positive nodes (more common inMMMT), positive margins, or evidence of gross residual disease41

ABSTRACTSThe 1 st International Congress on Gynecological Oncology42Staging and Surgical Treatment of Uterine SarcomaDr Tajossadat Allameh Associated Professor of Gyn.Fellowship of Gyn-OncologyIntroduction:Uterine sarcomas are rare malignancies accounting 3-6% of uterine cancers. Theyare aggressive and accounted for 26% of all deaths from uterine malignancies. Uterinesarcomas encompass a broad mesenchymal tumors and endometrial stromal tumors(leiomyosarcoma and endometrial stromal sarcma) to mixed epithelial /stromaltumors such as adenosarcoma and carcinosarcoma.Surgical treatment:Surgical treatment of malignant leiomyosarcoma is TAH.BSO. In young patientsOvaries could be preserved. Spread of leiomyosarcoma is hematogenous so surgicalstaging appears to be less importance for these tumors. Endometrial stromal tumorsinclude benign endometrial stromal nodules, endometrial stromal sarcoma andundifferentiated uterine sarcoma. TAH.BSO with radical cytoreduction of extrauterine disease is the standardTreatment of endometrial stromal sarcomas in premenopausal women with Stage 1ovaries could be preserved.Patients with undifferentiated uterine sarcoma should undergo TAH.BSO.Pelvic RAD decreases pelvic recurrence without improving survival.Carcinosarcomas should undergo complete surgical staging. Post operative RADAnd adjuant chemo based on the surgical findings.Key words: Uterine sarcoma, Endometrial stromal sarcoma, Endometrial stromalnodule42

43ABSTRACTSThe 1 st International Congress on Gynecological OncologyClassification and Management of GTNDr. Amini MoghadamAssistant Professor Tehran University of Medical Sciences - Firoozgar HospitalGynecology Department Tehran Iran”GTN is among the rare human malignancies that can be cured even in the presenceof wide spread metastases. GTN includes a spectrum of inter related tumors includinghydati form mole, invasive mole, pstt, choriocarcinoma .although persistent GTNmost commonly after a molar pregnancy, it may follow any gestational event,including therapeutic or spontanous abortion and ectopic or therm pregnancy.According to both anatomic staging and prognostic scoring system current stagingsystem is done and in low risk patient single agent chemotherapy (in recent evidenceActinomycin- D is better than MTX) and for high risk EMA-CO or EMA-CE used.in pstt the choice of treatment is hystrectomy follow up is advised and subsequentpregnancy after that is allowed hyper glycosylated HCG can be used43

ABSTRACTSThe 1 st International Congress on Gynecological Oncology44Fertility Sparing Surgeryin the Management of Cervical CancerDr. Haleh AyatollahiAssistant Professor of Gynecology Oncology, Oromiye UniversityAbstractCervical cancer is one of the major problems in developing countries. The lastdecade has seen a trend towards more conservative surgical approaches in thetreatment of early-stage disease in young patients. The trend of delaying childbearing,nowadays, increases preservation of fertility, and reproductive function is a majorconcern when counseling these young women with regard to the effects of treatmentfor cervical cancer. Radical trachelectomy, either with abdominal or vaginal surgicalapproach, showed promise as treatment option in young patients with early cervicalcancer. The basic principle of such a surgical approach is an operation aiming atpreserving the uterine body and removing the cervix, parametrium, with bilateralpelvic lymphadenectomy, and creating a utero-vaginal anastomosis, eitherlaparoscopically or by laparotomy.Keywords: Urmia Medical Science University, Obstetrics & gynecologydepartment, Gynecology oncology, Motahari Hospital44

45ABSTRACTSThe 1 st International Congress on Gynecological OncologyBenign HPV Related Genital Infectionin Women and Available VaccinationHeshmatollah , Azhar M.D.Prof. of Obstetrics and GynecologyWhat you should know about HPV, Cervical Cancer, and Genital warts.HPV is avirus than can affect both Women and men. For most women who have HPV, thevirus will go away on its own. But for some women who do not clear certain types ofthe virus cervical cancer can develop and there is no way to predict who will, or won`tclear the virus. There are just 4 important types of genital HPV. That is because theycause the most cases of HPV related disease in women Types 16,18 cause 70% ofcervical cancer cases and type 6,11 cause 90% of cases .genital warts Anyone whohas HPV infection can infect others too. Intercourse is not necessaryTransmission of HPV happens to many people during their first 2 to 3 years ofsexual intercourse. 80% of women at age 50 have had already HPV infection intheir lifetime. GARDASIL and CERVARIX are two at moment available vaccines.All girls between 9-26 years of age should get 3 shots of vaccination45

ABSTRACTSThe 1 st International Congress on Gynecological Oncology46Premalignant Lesion and New Managementon Abnormal Pap SmearFariba BehnamfarAssociate Professor, Isfahan University of Medical SciencesCancer of the cervix is a disease of sexually active women, and related to infectionwith specific high-risk strains of human papillomavirus (HPV).Cervical intraepithelial neoplasia (CIN) refers to pre-invasive dysplasia of cervicalepithelial cells , the precursor of malignant disease.CIN is categorized according tothe depth of involvement and the atypicality of the cells as CIN I,CIN II and CIN III .The papanicolaou smear screening test for cervical cancer which was introduced in1941, led to the first systematic effort to detect early cancer. Cytology results arebased on examination of cells but not tissue structure. The diagnosis of cervicalintraepithelial neoplasia or carcinoma requires a tissue sample obtained by biopsy tomake a histologic diagnosis.Pap smear results are now widely classified according to the Bethesda system, firstintroduced in 1988, and revised in 2001.The intent of Bethesda system is todistinguish between abnormalities which are unlikely to progress to cancer and thosewhich are more likely to indicate a precancerous or cancerous lesion.The Bethesda system also includes guidelines for determination of specimenaccuracy.46

47ABSTRACTSThe 1 st International Congress on Gynecological OncologyPelvic Exenteration in Cervical CancerK.K. Chan, charliekkchan@msn.comDespite the recent advances in the treatment of cervical cancer, recurrencescontinue to occur. For those patients in whom radiotherapy is not an option, salvagesurgery with some form of exenteration is the only potentially curative treatment. Thecriteria for this type of surgery and its results are reviewed. In particular the results ofthe series of exenteration carried out in Birmingham are presented and compared withother published series47

ABSTRACTSThe 1 st International Congress on Gynecological Oncology48The Role of Neoadjuvant Chemotherapy, Post-Radiationand Post-Surgical Chemotherapy in Cervical CancerK.K. Chan, charliekkchan@msn.comThe advances in cervical screening have significantly decreased the incidence ofcervical cancer in those countries with a national programme for cervical smears.Sadly there remains a number of women who present with cervical cancer beyondStage 1b1. For these patients and also those with neuroendocrine tumours,chemotherapy has an important role to play in their management. The role ofconcomitant chemotherapy and radiotherapy is now well established. This lectureaddresses the role of chemotherapy when used in a less conventional setting48

49ABSTRACTSThe 1 st International Congress on Gynecological OncologyVulvar and Vaginal Intraepitelial NeoplasiaFereshteh FakorAssistant Professor, Reproductive Health Research center, Gynecology andOncology Department of Azzahra Hospital, Gilan University of Medical Sciences,Rasht, Iranh_fertility@gums.ac.irFereshtehfakor@yahoo.comPreviously, VIN was categorized as VIN 1, 2 and 3, according to the degree ofabnormalityINCIDENCE — The incidence of VIN is increasing worldwide, primarily due tothe increasing occurrence of this disease in young women, In a study based on datafrom a United States national cancer database, in 2000 the incidence of VIN 3 was2.86 per 100,000 women. The incidence of vulvar cancer is also increasing, but at aslower rate.VIN, usual type typically occurs in younger, premenopausal women. Riskfactors are similar to those for vulvar cancer of the warty or basaloid type, and includehuman papillomavirus (HPV) infection, cigarette smoking, and immunodeficiency orimmunosuppression.Pathogenesis — The anogenital epithelium is derived from the embryonic cloacaand includes the cervix, vagina, vulva, anus, and lower three centimeters of rectalmucosa up to the dentate line. Since the entire region shares the same embryologicalorigin and is susceptible to similar exogenous agents (eg, HPV infection), squamousintraepithelial lesions in this area are often both multifocal (i.e. multiple foci ofdisease within the same organ) and multicentric (ie, foci of disease involving morethan one organ).VIN, usual type is often multifocal and multicentric. The interlabialgrooves, posterior fourchette, and perineum are most frequently affected bymultifocal lesions; more extensive disease is often confluent, involving the labiamajora, minora, and perianal skin. Confluent or multifocal lesions exist in up to twothirdsof women with VIN .49

ABSTRACTSThe 1 st International Congress on Gynecological Oncology50CLINICAL MANIFESTATIONS — Pruritus is the most common complaintamong symptomatic women. Other presentations include a visible lesion , a palpableabnormality, perineal pain or burning, or dysuria. Approximately 50 percent ofwomen are asymptomatic and are diagnosed either when a lesion is observed during aroutine gynecological examination or at colposcopy for abnormal cervical cytology.TREATMENT —• Wide local excision• Skinning vulvectomy• Laser ablation• Topical treatmentVaginal intraepithelial neoplasia is defined by the presence of squamous cell atypiawithout invasion. The disease is classified according to the depth of epithelialinvolvement: VAIN 1 and 2 involve the lower one-third and two-thirds of theepithelium, respectively, and VAIN 3 involves more than two-thirds of the epitheliumIntraepithelial dysplasia of glandular origin, or atypical vaginal adenosis, is aseparate entity. This lesion has a well-established association with in uterodiethylstilbestrol (DES) exposure. In addition, it may be a precursor to DESassociatedclear-cell adenocarcinoma.Risk factors — Although multiple risk factors have been implicated in the genesisof lower genital tract neoplasias, infection with human papillomavirus (HPV) is acommon association. As an example, in a case-control study of 19 patients, low levelof education, low family income, and history of vaginal condyloma were all riskfactors for developing VAIN, but are also dependent variables predicting exposure toHPV. Genetic and acquired immunosuppression, including human immunodeficiencyvirus (HIV) infection, are risk factors for developing both VAIN and HPV infection,as with CIN.TREATMENT — A broad range of treatment options are available for therapy ofVAIN: excision, ablation, topical chemotherapy, and radiation of lesions.50

51ABSTRACTSThe 1 st International Congress on Gynecological OncologyChemotherapy in the Endometrial CancerDr. Forat YazdiAssistant Professor, Department of Gynecology, Shahid Sadoughi University ofMedical Sciences, Yazd, IranEndometrial cancer is a type of uterine cancer that involves the lining of the uterus(Endometrium).Treatment for endometrial cancer usually includes surgical removal of the uterus,cervix, ovaries, and fallopian tube. After surgery, radiation therapy or chemotherapyis recommended for some women.Patients with Low-risk endometrial cancer are usually treated with surgery andadditional treatment with chemotherapy or radiation therapy is not needed aftersurgery.For some women with Intermediate-risk cancer, Radiation therapy is recommended.Women who have High-risk endometrial cancer have spread of the cancer into thecervix, vagina, ovaries fallopian tubes, bladder, bowel.In addition, women who have types of endometrial cancer other than theendometroid variety (papillary serous or Clear-cell endometrial cancer) are alsoconsidered to be High-risk, regardless of the disease extend, and they all require someform of adjuvant therapy include radiation therapy, chemotherapy or both.The choice of radiation, chemotherapy or both depends on where cancer is located.If the tumor is High-risk and has spread outside of uterus, chemotherapy isrecommended after surgery and radiation started after chemotherapy.Combination chemotherapy with two or three drug is recommended.51

ABSTRACTSThe 1 st International Congress on Gynecological Oncology52False Positive or Phantom hCG Result:A Serious Problem in GTN Follow-UpDr. Tahereh AshrafganjooeiAssociate Professor, fellow of Gynecologic Oncology Department of Gynecology,Shahid Beheshti Medical UniversityGynecology oncology Department, Emam Hosein hospital, Shahid Madani Street,Tehran, IranPhone number: 0098-21-77558081dr _ ganjooei@hotmail.comBackground: Gestational trophoblastic neoplasia (GTN) refers to a subset of GTDwith a persistently elevated serum hCG in the absence of a normal pregnancy andwith a history of normal or abnormal pregnancy. A delay in the diagnosis mayincrease the patient's risk, and therefore the prompt identification of GTN isimportant.HCG test is essential for detection of GTN. False-positive hCG (phantomhCG) can occur in the absence of GTN. Low-level real hCG may occasionally persistin the absence of clinical evidence of pregnancy or GTD. Alternatively, low-level realhCG may be due to pituitary hCG.CONCLUSION: hCG has high diagnostic sensitivity, approaching 100%sensitivity, for managing the treatment of GTN and for detecting recurrences ofdisease. It is recommended to use hCG test that recognizes all forms of the hCGmolecule. In cases where low-level hCG persists, it must be differentiated whether itis real or false. Real-hCG may be due to quiescent gestational trophoblastic disease orpituitary hCG.Keywords: Human chorionic gonadotrophin (hCG), Gestational trophoblasticneoplasia (GTN), phantom hCG.52

53ABSTRACTSThe 1 st International Congress on Gynecological OncologyAssessment of Gross Examination and Frozen Sectionof Uterine Specimen in Endometrial Cancer PatientsFatemeh Ghaemmaghami, Soheila Aminimoghaddam, Mitra Modares-Gilani,Azamosadat Mousavi, Zahra Khazaeipour, Forozandeh FereidoniGynecology Oncology Department, Vali-e-Asr Hospital Comlex, Tehran Universityof Medical SciencesAbstract:Objective: The accuracy of Intra-operative gross visual examination of myometrialinvasion of uterine specimen has been evaluated in several studies with controversialresults. The intra-operative frozen section (IFS) analysis is used to identify patients athigh risk for pelvic and para-aortic nodal metastasis in order to avoidlymphadenectomy in low -risk patients. However, there is still some controversyconcerning the efficiency of IFS. The aim of this study was to evaluate the accuracyand validity of frozen section diagnosis and gross examination of uterine specimencompared to the final histological results in patients with endometrial cancer.Methods: The study group comprised 31 patients with a pre-operativehistopathological diagnosis of endometrial carcinoma. Comprehensive surgicalstaging was performed in all patients. Intra-operative gross examination of the uterinecavity and wall with frozen section analysis was performed. Lymphadencetomy wasperformed in all patients. After frozen section analysis, the uterus together withremoved lymph nodes was stored and subjected to final pathologic diagnosis.Results: Gross examination accurately identified microscopic invasion ofmyometrium in 86.6% of the patients with 88.9% sensitivity, 85.7% specificity andnegative and positive predicative values of 72.7 and 94.7%, respectively. The kappawas 0.70(p

ABSTRACTSThe 1 st International Congress on Gynecological Oncology54Novel Cancer Therapy:Gene Therapy and Immunotherapy in Ovarian CancerGhasemi NYazd Reproductive Medicine Institute, Medical Genetics Department, Yazd, IranOvarian cancer is the leading cause of death among gynecological cancers. It is nowrecognized that the cancer initiation is generally associated with the inactivation ofdifferenttumor suppressor gene products such p53 and p16. In addition to geneticalterations, epigenetic mechanisms, such as DNA methylation, histone modificationsand nucleosome remodeling, play an important role in the development andprogression of ovarian cancer. Gene therapyand immunotherapy remain promisingtherapeutic modalities for ovarian cancer.Numerous ovariangene therapieswere used based on replacement or knock out ofderegulated gene, suicide gene strategies, strengthening of the immune responseagainst a tumor, inhibition of tumor angiogenesis and growth factors.The field of genetherapy presents exciting new opportunities for advances in the management ofovarian cancer. Gene therapy research presents unique occasionsfor offeringthespectrum of ovarian cancer treatment possibilities, either alone or in combination withconventional chemotherapy regimens.In immunotherapy, monoclonal antibodies are being progressivelyused in cancertherapy dueto their ability to recognize specifically cancer cells and to activatecomplement- and cell-mediated cytotoxicity and/or to induce growth arrest orapoptosis.54

55ABSTRACTSThe 1 st International Congress on Gynecological OncologyRole of Imaging in Cervical CarcinomaM. Gity, M. Malek, N. AhmadynejadDepartment of Obstetrics and gynecology, Tehran University of Medical SciencesAbstractThe role of MRI in gynecologic oncology has evolved during the past two decades.There is now a substantial body of evidence that MRI is useful in evaluatingmalignant conditions of the pelvis. MRI has been shown to be superior to CT instaging of cervical carcinoma.Cervical carcinoma is the third most common gynecologic malignancy and istypically seen in younger women, often with serious consequences. The InternationalFederation of Gynecology and Obstetrics (FIGO) staging system provides worldwideepidemiologic and treatment response statistics. However, there are significantinaccuracies in the FIGO staging system, and magnetic resonance (MR) imaging,although not included in that system, is now widely accepted as optimal forevaluation of important prognostic factors such as lesion volume and metastaticlymph node involvement that will help determine the treatment strategy. MR imagingexamination obviates the use of invasive procedures such as cystoscopy andproctoscopy, especially when there is no evidence of local extension. Brachytherapyand external beam therapy are optimized with MR imaging evaluation of the shapeand direction of lesion growth. In general, T2-weighted MR imaging more clearlydelineates cervical carcinoma and is preferred for evaluation of the lymph nodes.Dynamic gadolinium-enhanced T1-weighted imaging may help identify smallertumors, detect or confirm invasion of adjacent organs, and identify fistulous tracts.MR imaging staging, when available, is invaluable for identifying importantprognostic factors and optimizing treatment strategies.55

ABSTRACTSThe 1 st International Congress on Gynecological Oncology56Targeted Therapy in O varian CancerProf. Parviz HanjaniDirector, Hanjani Institute for Gynecologic Oncology, Abington MemorialHospital, Professor of Gynecology, Temple University School of Medical SciencesAlthough in recent years ovarian cancer survival rate and patients quality of lifehave improved still most death from gynecological cancer are due to ovarianmalignancies and yearly death rate is over 141000 worldwide when the number ofnewly diagnosed ovarian cancer is around 230000. Reasons for this high mortalityrates can be attributed to some known factors such as advanced stage of disease atdiagnosis and development of tumor chemo-resistance. Until new modalities are notfound to prevent disease or to diagnose the disease in early stage the search for bettertreatment is needed to continue. .Presently standard treatment after cytoreductivesurgery is combination chemotherapy with platins and Taxanes IV or IP. But mostpatients will have recurrence and finally succumb to their disease. As technique ofmolecular and cell biology is developing, drugs which directly are targeting cancercell , its signaling pathways or vasculature of tumor with in part sparing normaltissues are most desirable. Angiogenesis playing a significant role in ovarian andother cancer and most promising agents at the present time are anti angiogenesiscompounds which have been tried as a single agent or mostly in combination withcytotoxic drugs and to continue as maintenance. PARP inhibitors, targetedchemotherapy and mTOR inhibitors are other targeted agents that have shown activityof reasonable significance to be further investigated. Recent positive reports ofresearch on such a compounds as single therapy or addition of targeted agents tochemotherapy have given hope for this kind of treatment to supply us with moreammunition to fight ovarian cancer. In addition work on molecular pathway torecognize high risk group for recurrences and to treat them with adjuvant therapy isattractive concept that will be helpful to clinicians treating ovarian cancer. Butheterogeneous nature of ovarian cancer will require identifying biomarkers that willhelp us to choose patients for treatment on the basis of this tests result and usespecific drugs for targeting tumor more precisely on the basis of molecular structureof each tumor and get closer to personalized medicine. This lecture will give anoverview of biologic therapy of ovarian cancer56

57ABSTRACTSThe 1 st International Congress on Gynecological OncologyNew Approaches for Treatmentof Recurrence Epithelial O varian CancerProf. Parviz HanjaniDirector, Hanjani Institute for gynecologic oncology, Abington Memorial HospitalProfessor of Gynecology, Temple University School of Medical SciencesManagement of recurrent ovarian cancer is still a challenge for oncologists as it isnot possible to predict rate of response to therapy and lack of uniform management inthis group of patients, which comprise of majority of women with diagnosis ofovarian cancer. It is a known fact that a large number of patients with this diagnosisare not treated according to best standard treatment plan available in addition todevelopment of drug resistance. It is outmost important that these patients withrecurrence be offered research protocol trials+ for better management and hope forfinding more option for therapy. This talk will discuss available therapy and attemptin finding other approaches with consideration of cellular and molecular biology57

ABSTRACTSThe 1 st International Congress on Gynecological Oncology58Planning Front Line Managementof Epithelial Ovarian Cancer in 2011Professor Parviz HanjaniDirector, Hanjani Institute for Gynecologic Oncology, Abington Memorial HospitalProfessor of Gynecology, Temple University School of Medical SciencesOvarian cancer is one of the world most treatable malignancies as it is very chemosensitivein spite of most patients having advanced stage. But although primarilytumor is responsive to therapy in most patients it will reoccur with a chronic courseending in death. Recent advances in therapy especially addition of biologic agents hasgiven us more hope to combat this tumor with addition of combination chemotherapyand cellular function inhibitors as front line and maintenance. It is of this knowledgeand some promising study that help us to continue developing new research protocolsfor the hope of finding better therapy to not only prolong the life but to cure thedisease in higher rate. This talk will discuss new clinical research protocols withpotential successes.58

59ABSTRACTSThe 1 st International Congress on Gynecological OncologyChemotherapy in Vulvar CancerRazieh Hashemi *Assistant Professor, Department of Gynecology, Baghiatallah University ofMedical Sciences, TehranVulvar carcinoma accounted approximately 4% of genital tract malignancies.During recent decades it appears that incidence of vulvar cancer has been increasingin young women. There are various treatment modalities in vulvar cancer treatment.In this review role of chemotherapy in treatment of squamous vulvar cancer isevaluated. Standard treatment for most patients with vulvar cancer is primary surgery.In advanced disease, extensive surgery such as anal sphincter resection and pelvicexenteration should be done for obtaining negative margins. These surgicalprocedures have many complications accompanying with physical and psychologicaldifficulties for patients. There is a trend to more conservative approaches in order topreserve structures such as urethra and anal sphincter. These are reasons for usingchemotherapy with or without radiation asneoadjuvant treatment in vulvar cancer.There are other applications for chemotherapeutic agents in studies. These drugshavebeen used as adjuvant treatment or in association with radiation asradiosensitizingdrugs. There is only littleinformation aboutpalliative role of chemotherapeutic agentsbut these agents have been offered for patients with distant metastasis.In conclusionmany studies have indicated chemo-sensitivity in squamous vulvar carcinoma. Largestudy designing is difficult because of almost rarity of this cancer. These can be leadto multicentre research to evaluate new possibilities in this field.59

ABSTRACTSThe 1 st International Congress on Gynecological Oncology60Polycystic Ovary Syndrome (PCOS)and Endometrial CarcinomaKarimzade MA 1 , Karimi Zarchi M 2 ,Teimoori S 3 ,Soltani HR 41. Professor, Department of Gynecology, Shahid Sadoughi University of MedicalSciences, Yazd, Iran.2. Assistant Professor, Department of Gynecology, Shahid Sadoughi University ofMedical Sciences, Yazd, Iran.3,4. Membership of Medical Students Scientific Association, Islamic AzadUniversity Branch Yazd.The objective of this study was to perform a review of the literature about anassociation between polycystic ovary syndrome (PCOS) and endometrial carcinoma.PCOS is an extremely common disorder that occurs in 4% to 7% of women ofreproductive age. Metabolic derangements associated with this condition maypredispose to a range of diseases with attendant morbidity and mortality risks. Anassociation between polycystic ovary syndrome (PCOS) and endometrial carcinoma iscomplete clear one of a major risk factor is continuous estrogen stimulation of theendometrium unopposed by progesterone in endometrial carcinoma in patient withPCOS. Obesity Hypersecretion of luteinizing hormone [LH], chronichyperinsulinemia and increased serum insulin-like growth factor [IGF]-I levels,hyperinsulinemia, and hyperandrogenism, which are also features of PCOS, are riskfactors for endometrial carcinoma, but it does not necessarily follow that theincidence or mortality from endometrial cancer is increased in women with thesyndrome. The results of previous research showed that women with PCOS are morelikely to develop cancer of the endometrium (OR 2.70, 95% CI 1.00-7.29). PCOStherapies include ovulation induction agents, oral contraceptives, intermittentprogesterone, and insulin sensitizers, in modifying such risks. In the meantime, closefollow-up of women with PCOS and encouragement of change lifestyle likely toreduce disease risks, such as regular exercise and weight control, should be standardpractice to reduce risk of endometrialcancer.Keywords: Polycystic ovary syndrome, Endometrial carcinoma, Risk60

61ABSTRACTSThe 1 st International Congress on Gynecological OncologyRecurrence DVT and VTE in Gynecological Cancersand the Role of Celexan in PreventionDr. Mojgan Karimi Zarchi,Assistant Prof., Obstetrics & Gynecology, Gynecological Oncology Fellowship,Shahid Sadoughi University of Medical Science , Yazd, Irandrkarimi2001@yahoo.comAbstract:Thrombosis affects 4% to20% of patients with cancer, and VTE is a leading causeof their deaths .The risk of VTE increases several–fold for people with cancer and isalso associated with several forms of active cancer treatment.The reported frequency of VTE in hospitalized patients with cancer has variedwidely with reported incidences ranging from 0.6% to 18%, while the most recentstudies report higher rates per hospitalization. Celexan should begin for initiateprophylaxis within 24 hours of surgery. Prophylaxis should be continued for at least 7to 10 days. Prolonged prophylaxis for up to 4 weeks may be considered in patients athigh risk of VTE. Celexan should be continued even after discharge for those patientsundergoing major abdominal or pelvic surgeries for cancer with residual malignantdisease after operation. Patients with obesity and those with a previous history ofVTE are the higher risk patients.UFH and LMWH are equally effective in reducing DVT. The potential advantagesof LMWHs over UFH in cancer surgery prophylaxes include once-daily versus twicedaily injections and a lower risk of heparin – induced thrombocytopenia.Fondaparinux, a factor Xa inhibitor was found to be at least as effective as one of theLMWHs. Recent randomized studies suggest that prolonging the duration ofprophylaxis up to four weeks is even more effective in reducing postoperative VTEand does not increase bleeding complications.61

ABSTRACTSThe 1 st International Congress on Gynecological Oncology62Status of Gynecologic Cancers inAsia - Comparison with the WorldMalcolm A Moore,UICC Asian Regional Office, APJCP Chief EditorCancers of the female reproductive organs, essentially of the uterine cervix, theendometrium and the ovary, demonstrate marked variation in both incidence andmortality across Asia. Highest rates for cervical cancer are found in the Indiansubcontinent, with the exception of Pakistan which like the other Muslim countries ingeneral has low incidences, followed by Southeast Asia. Low rates in Japan andKorea are at least partly due to population- based screening programs but these haveyet to be introduced elsewhere. Endometrial malignancies in the corpus uterus arefound most commonly in Turkey and the Central Asian Republics in Asia, whileovarian cancers are particularly frequent in Southeast Asian countries but rare inNortheast Asia. Consideration of the relative distributions of the various cancers ofthe reproductive organs with the prevalence of known risk factors is the majorconcern.62

63ABSTRACTSThe 1 st International Congress on Gynecological OncologyNeoadjuvant Chemotherapyfor Advanced Ovarian CancerMitra Mohit.Gyn-Oncologist. Islamic Azad University. Tehran Medical BranchIt is clear that primary debulking remains the standard of care within the treatmentof advanced ovarian cancer (FIGO stage III and IV). This debulking surgery shouldbe performed by a gynecological oncologist without any residual tumor load, or socalled"optimal debulking." Based on the GOG 152 data, interval debulking surgerydoes not seem to be indicated in patients who underwent primarily a maximal surgicaleffort by a gynecological oncologist.Over the last decades, interest in the use of neoadjuvant chemotherapy togetherwith an interval debulking has increased. Neoadjuvant chemotherapy for advancedovarian cancer was initially administered as an alternative treatment for patients notsuitable for primary debulking surgery because of unresectable tumor or poorpatient’s performance status. Neoadjuvant therapy can be used for patients who areprimarily suboptimally debulked due to an extensive tumor load. In this situation,based on the randomized European Organization for Research and Treatment ofCancer-Gynaecological Cancer Group (EORTC-GCG) trial, interval debulking by anexperienced surgeon improves survival in some patients who did not undergo optimalprimary debulking surgery.Neoadjuvant chemotherapy can also be used as an alternative to primary debulking.In retrospective analyses, neoadjuvant chemotherapy followed by interval debulkingsurgery does not seem to worsen prognosis compared to primary debulking surgeryfollowed by chemotherapy. Among the four Phase III studies to date, the earlieststudy from the European Organization for R esearch and Treatment of Cancer(EORTC) has revealed non inferior survival with less-serious morbidity in theneoadjuvant chemotherapy arm. These data suggest that neoadjuvant chemotherapyfollowed by surgical cytoreduction is an acceptable management strategy for patientswith advanced ovarian cancer.Open laparoscopy is probably the most valuable toolfor evaluating the operability primarily or at the time of interval debulking surgery. Inthis presentation we review the outcomes and discuss some unanswered questions inthis area.63

ABSTRACTSThe 1 st International Congress on Gynecological Oncology64Fertility Preservation and CancerAzamsadat Mousavi MD.Associate Professor, Tehran University of Medical SciencesThere is strong evidence that infertility is a dramatic and frequent side effect in menand women of childbearing age who are undergoing chemotherapy, surgery orradiotherapy for their cancer treatment.This, severe and often underestimated complication heavily deteriorates the qualityof life of affected patients and risks to reduce the therapeutic efforts and thecompliance towards the suggested treatments. Unfortunately medical oncologists,surgeons and gynaecologists have little consideration, for this complication and oftenpossess a limited knowledge about the clinical aspects of cancer, related infertility andthe possibilities of prevention and treatment of cancer related gonadic failure.Since more young people are offered adjuvant treatments at earlier stages of cancer,the problem of, chemotherapy related gonadic toxicity has considerably increased inthe last years. It is also important to consider the new opportunity derived from theassisted reproductive techniques, and also many conservative surgical techniques forsaving reproductive function.From this point of view the treating physicians need to be able to make accurateassessments of risks and benefits of antineoplastic treatments and deferent kinds ofsurgical approach in order to schedule the best approach to and to preserve thepossibility of reproduction in their young patients. in the other hand during the past 2decades have seen a significant increase in cancer survival rates, particularly formalignancies that commonly affect children and young adults. The 5-year cancersurvival rate among children improved from 58% for patients diagnosed between1975 and 1977 to 81% for those diagnosed between 1999 and 2005. Survivors ofchildhood and adolescent cancers now comprise 1 in every 570 individuals betweenthe ages of 20 and 34 years.An increasing proportion of these reproductive-aged survivors are interested inchildbearing.Both the American Society of Clinical Oncology and the American Society forReproductive Medicine, recommend that cancer patients be informed about options64

65ABSTRACTSThe 1 st International Congress on Gynecological Oncologyfor fertility preservation at the time of diagnosis. Studies show, however, that only50% of childhood cancer survivors had discussed fertility with their physicians, andhalf of the surveyed oncologists rarely or never raised the issue of fertilitypreservation with their patients.This paper reviews the current options for fertility preservation includedconservative surgery, less gonadic toxic drugs and emberyo,oocyte or tissuecryopreservation.65

ABSTRACTSThe 1 st International Congress on Gynecological Oncology66Novel Nanomedicine-BasedMRI Contrast Agents for Gynecological CancerReza Nafisi-MoghadamAssistant professor, Department of Radiology, Shahid Sadoughi University ofMedical Sciences, Yazd, IranAbstractGynecological cancers result in significant morbidity and mortality in womendespite advances in treatment and diagnosis. This is due to detection of the disease inthe late stages following metastatic spread in which treatment options become limitedand may not result in positive outcomes. In addition, traditional contrast agents arenot very effective in detecting primary metastatic tumors and cells due to a lack ofspecificity and sensitivity of the diagnostic tools, which limits their effectiveness.Recently, the field of nanomedicine-based contrast agents offers a great opportunityto develop highly sophisticated devices that can overcome many traditional hurdles ofcontrast agents including solubility, cell-specific targeting, toxicities, andimmunological responses. These nanomedicine-based contrast agents includingliposomes, micelles, dendrimers, multifunctional magnetic polymeric nanohybrids,fullerenes, and nanotubes represent improvements over their traditional counterparts,which can significantly advance the field of molecular imaging.66

67ABSTRACTSThe 1 st International Congress on Gynecological OncologyProblems of Dealing with Trophobelastic Disease in IranDr. Razi TDepartment Obstetrics and Gynecology, Imam Khomeini Hospital, Azadegan St.,Ahvaz, IRANGestationaltrophoblastic disease is a spectrum of disorders ranging frompremalignant hydatidiform moles through to malignant invasive moles,choriocarcinoma and rare placental site trophoblastic tumor. Thorough evaluation andstaging allow selection of appropriate therapy that maximizes chances for cure whileminimizing toxicity. Nonmetastatic (stage I) and low-risk metastatic (stages II and III,World Health Organization score < 7) GTN can be treated with single-agentchemotherapy, resulting in a survival rate approaching 100%. Although most womencan expect to be cured of their disease, many interesting questions arise in themanagement of gestationaltrophoblastic disease. Current issues pertain to diagnosis ofGTN, predicting progression from hydatidiform moles to GTN and the emergence ofdrug resistance in GTN. Our understanding of the genetics of GTN has helped usanswer some of these questions but many remain unresolved. Serum hCG level and arising World Health Organization score at the time of initiating pulse dactinomycinare important prognostic factors in patients with methotrexate-failed low-risk GTNreceiving pulse actinomycin as second-line chemotherapyProblems of dealing with trophobelastic disease in Iran include:1-lack of standard lab for detection of different kind of HCG and their ingredient2-poor patient follow-up by referring physician3-patient compliance4-Lack of facilities of different marks for correct diagnosis of different kind ofGTN5-Drug access difficulties67

ABSTRACTSThe 1 st International Congress on Gynecological Oncology68Endometrial Cancer, Novel Staging SystemSayyah-Melli Manizheh, MDWomen's Health Reproductive Center, Department of Oncology,Tabriz University of Medical Sciences, Tabriz, IranHow Is Endometrial Cancer Staged? This is a question should be answered.Endometrial cancer is staged based on examination of tissue removed during anoperation. The last revision of the International Federation of Obstetricians andGynecologists (FIGO) staging of uterine corpus tumors was in 1988, and itrepresented the transition from a clinical to a surgico-pathologic system with theintent of introducing a more accurate evaluation of the extent of metastaticdisease.This staging system had problems in the standardization of surgical staging inuterine cancer.This method has failed indefining the anatomical extent of thelymphadenectomy,the number of lymph nodes harvested to be considered adequatefor the assessment of pelvic and para-aortic node basins. After 20 years, the FIGOCommittee has introduced changes in the staging criteria. Surgical staging isnecessary to evaluate theextent of disease, determine biology of tumor,and determineprognostic factors. It is also helpful in guiding postoperative treatment, carrying apotential therapeutic benefit bypredicting survival and adequate outcome.In newstaging system changes have been made in the staging criteria for uterine cancer. TheFIGO Committee elected to merge substages IA and IB, merge the former Stage IIAwith Stage I disease, to eliminate peritoneal cytology from the new staging system,and subdivided Stage IIIC patients into 2 different risk categories based on thepresence (IIIC2) or absence (IIIC1) of metastatic disease in the para-aortic area. Thesedecisions to declassify some properties of staging are presumably based on prognosticconsiderations. In new endometrial staging system in addition tonew surgical staging,nuclear imaging technology, and new molecular markers have been used which willallow more precise predictability for the neoplastic potential and co-existance ofcancer before hysterectomy and to identify patients at risk for recurrences. Inaddition, early stage endometrial cancer treatment will be discussed.68

69ABSTRACTSThe 1 st International Congress on Gynecological OncologyUterine SacromaDr. VahidfarAssistant professor of oncology Shahid Sadooghi University of Medical Sciences,Yazd, IranUterine sarcomas are a rare form of uterine malignancy that arise from uterinemesenchymal elements (i.e., smooth muscle and connective tissue). Uterine sarcomasgenerally behave more aggressively and are associateed with a poorer prognosis thanendometrial carcinoma.A complete pelvic and general physical examination should be performed, withparticular attention to the size and mobility of the uterus and the presence ofextrauterine masses or lymphadenopathy. A medical evaluation should also beperformed prior to surgery, chemotherapy, or radiation.Distant spread may occur by intraabdominal, lymphatic, and hematogenous routes.Hematogenous dissemination can occur early and most frequently involves the lungs;therefore, all patients with a known or suspected diagnosis of uterine sarcoma shouldundergo preoperative thoracic imaging (computed tomography [CT] or radiograph).In addition, a preoperative CT of the abdomen and pelvis may be performed toidentify extrauterine disease.Benefit from adjuvant therapy (Adjuvant chemotherapy/radiation therapy)following surgery in patients with uterine sarcoma has never been proven inrandomized trials,. Most of the data suggesting benefit come from retrospectivereviews that compare outcomes of patients who have received adjuvant therapy versusthose who have not. Although many of these reviews suggest benefit in terms ofreducing relapse rates, few have suggested a survival advantage.69

ABSTRACTSThe 1 st International Congress on Gynecological Oncology70Role of Primary Surgery inTreatment of Patients with Ovarian CancerZohrhe YousefiProfesor of Mashhad University, Gynecologist Oncologistyousefiz@mums.ac.irAbstract:Malignant neoplasms of the ovary are one of the fatal malignancies in women .Incontrast to other genital cancers, the best strategy for therapeutic approach thesepatients is undoubtedly surgery .The principle treatment of early stage is competenceof surgical staging surgery and surgical management of all patients with advanceEOC is approach in a similar manner with cytoreduction surgery.The impact experience of surgeons as prognostic factor in many of studies Thisimperative to considered cytoredactive surgery should be performed by sciencesjudgments, experience and aggressiveness of surgeons as a gynecologistoncologist.In agreement with this issue improvement in achieving optimalcytoreduction surgery and availability multidisciplinary team along with carefulintegration between surgeon chemotherapists In conclusion, maximal effort forappropriate surgery appears to be a corner stone of potential effect on survival rate.Keywords: Ovarian cancer - Appropriate surgery - Surgical staging - Cytoreductivesurgery70

71ABSTRACTSThe 1 st International Congress on Gynecological OncologyPoster Presentations71

ABSTRACTSThe 1 st International Congress on Gynecological Oncology7272

73ABSTRACTSThe 1 st International Congress on Gynecological OncologyThe Role of TLR in Endometrial CancerNarjes Abbasi radImmunology Dep., Shahid Sadoughi University of Medical Science, YazdEndometrial cancers are the most common gynecological malignancies indeveloped countries. Multiple factors are involved in development and progression ofendometrial cancer such as: endocrine disorder; epidermal growth factor ; Astrocyteelevated gene over expression ;body Mass index ; obesity ; hypertension; diabetes;nulliparity and genetics factors. Many studies have shown an association betweeninflammation and cancer therefore alterations in immune response may predispose anindividual to disease. Recent Researches has been shifted to determine the role ofTLRs(toll-like receptor) in inflammatory disorders and oncogenesis.TLRs are partial of receptors innate immune system that able to recognitionpathogens. They are expressed on various immune cells but are also present onmucosal surfaces of the respiratory ; gastrointestinal and urinary tract.Applyingdifferent adaptor proteins such as toll-like receptor Adaptor molecule1(TRIF,TICAM1); myeloid differentiation primary response gene 88 (MyD88); translocationassociated membrane protein (TRAM); nuclear factor kappa-B (NFêB), signaltransducers and activators of transcription (STATs) or the activator protein 1 (AP1).These signals cascades result in enhanced secretion of various pro- and antiinflammatorycytokines such as interferons, tumor necrosis factor α (TNFα) and interleukins IL4,IL8, and IL12.These sytokines can play a role in extensive and development tumors.New insights into the role of polymorphisms genes TLRs in disease have thepotential to provide newavenues for treatment and to also identify individuals to risk.In this study, we will review the role of polymorphism TLRsin endometrial cancer.73

ABSTRACTSThe 1 st International Congress on Gynecological Oncology74Review of the Nutritional Risk Factors of Ovarian CancerAhadi Z 1 , Nabizadeh L 1 , Mozaffari- Khosravi H. 21. MSc student of Public Health in Nutrition, Department of Nutrition, School ofPublic Health, Shahid Sadughi University of Medical Sciences2. PhD of nutrition science, Department of Nutrition, School of Public Health,Shahid SadughiUniversity of Medical SciencesIntroduction: Ovarian cancer is among the five leading sites for cancer incidenceand mortality in women from developed countries. Our knowledge on risk factors ofovarian cancer is mainly related to hormonal and reproductive factors, and includesnulliparity, late age at menopause, family history of ovarian and breast cancer, andinfrequent oral contraceptive (OC) use. Nutrition has been suggested to have apotential influence on ovarian carcinogenesis, although dietary associations have notyet been established and well quantified and only scattered data from epidemiologicalstudies are available. The aim of this work was to review the related documents in thevalid international databases.Methods: the articles were searched in pubmed, Google scholar.Results: the results of previous studies on the association of dietary factors with therisk of ovarian cancer at the individual level were mixed. Several case-control studiesand a meta- analysis observed a positive association between dietary fat and ovariancancer, whereas two cohort studies and other case-control studies did not show similarresults. Some studies also found that consumption of dairy products was related to ahigher occurrence of ovarian cancer however, others failed to replicate thisassociation. Furthermore, some investigators reported that ovarian cancer risk wasassociated with other dietary factors, such as vegetable consumption (inverselyassociated) and dietary cholesterol and egg consumption (positively associated),although these relations were not shown in other studies. Studies on the association ofovarian cancer with vitamins or minerals from foods or supplements also showedinconsistent results, for example, both protective effects for vitamin E, β-carotene,vitamin A and vitamin C and no effects for vitamin E, β-carotene, vitamin A andvitamin C.74

75ABSTRACTSThe 1 st International Congress on Gynecological OncologyConclusion: These inconsistent results indicated a need for more studies toexamine the effect of these dietary factors on the risk of ovarian cancerKey words: ovarian cancer, diet, dietary pattern, fruit, vegetable75

ABSTRACTSThe 1 st International Congress on Gynecological Oncology76Alpha Fetoprotein Productionby an Endometrioid Adenocarcinoma of UterusDr.A.Akhavan 1 , Dr.M.Karimi Zarchi 2 , Dr.M.Akhavan Tafti 31- .Radiation Oncologist Shahid Ramazanzadeh Radiation Oncology Center Yazd2. Assistant Professor Gynecologist Oncologist Shahid Sadoughi Hospital. Yazd3- Assistant Professor Pathologist. Shahid Sadoughi Hospital. YazdWe present a 57 year old woman with endometrial adenocarcinoma producingalpha fetoprotein(AFP) She presented by abnormal vaginal bleeding In past medicalhistory she revealed metachoronous bilateral invasive breast carcinoma that wereoccurred in 9 and 7 years ago respectively. Because the tumors were hormonereceptor positive she had been received tamoxifen more than five years, butunfortunately without performing regular pelvic examination and pap smear test.Preoperative evaluations show normal CXR, normal liver CT scan, normal CA125level but sermoic level of alpha fetoprotein was increased (460 ng/ml) .Totalabdominal hysterectomy and bilateral salpingo-oophorectomy was performed inshahid Sadoughi hospital and AFP decreased until 188 ng/ml Surgical stagingrevealed stage IIb of endometrioid adenocarcinoma of uterus without any evidence ofgerm cell tumor, therefore she referred to Shahid Ramazanzadeh radiation oncologydepartment for adjuvant treatment. In the fifth week of radiation therapy shecomplained from dyspnea and CXR was repeated Surprisingly that showed multiplelung metastases. The treatment was interrupted and she was referred forchemotherapy .At this time AFP increased till 6464 ng/ml. At the time of writing thisarticle ,she received three courses of taxane based chemotherapy but AFP levelincreased despites of decreasing respiratory symptoms. Reports from AFP producingendometrial carcinoma are very few. In most of them lung metastases were occurredand prognosis was poor despites of aggressive combination chemotherapy .Our p atien th as a s p ecial situ atio n an d th at is his to ry o f p rev iou s b reas t can cer AFP p ro du cin gen d o m etrial carcin o m a is a v ery rare s itu atio n with po o r p rog n o sis o u tco m e.Key words : Adenocarcinoma , Uterus, Alpha Fetoprotein, Lung Metastases76

77ABSTRACTSThe 1 st International Congress on Gynecological OncologyIncidence and Risk Factors for Non-AlcoholicSteatohepatitis in Females TreatedMohsen AkhondimeybodiShahid Sadoughi University of Medical Science, Yazd, IranBackground: Tamoxifen used in the treatment of breast cancer is reported to causehepatic steatosis. This study aimed to assess the incidence and risk factors of thedevelopment of fatty liver disease,resulting from tamoxifen use, in females with breast cancer.Patients and methods: Seventy females aged between 28 and 80 years with breastcancer were recruited from ShahidSadoughi Clinic, Yazd, Iran in 2006–2008. Thepatients underwent chemotherapy followedby 20 mg tamoxifen daily as postoperative endocrine treatment. Only in patientswith normal baseline liver function, negative test for hepatitis C virus (HCV) andhepatitis B surface antigen (HbsAg) and normal liver ultrasonography were included.The development of fatty changes over a 6-months period of treatment was the mainoutcome measurement assessed by ultrasonography.Results: Thirty-five of 70 patients developed fatty change during follow-up, inwhich nine were in grade one, 20 in grade two and six patients in grade three. Riskfactors associated with the development of fatty change were elevation oftriglycerides (2.4, 1.2–4.8), elevation of fasting blood sugar (FBS) and lowhighdensity lipoprotein (HDL) (3.4, 1.4–7.8). No relation was found between thedevelopment of fatty change and age (1.3, 0.87–2.00), menopause (1.13, 0.69–1.9),previous history of diabetes (2.4, 0.7–8.4), previous chemotherapy regimen andreceptors type (c-erbB2, P53, progesterone receptor (PR), oestrogen receptor (ER))and stage of breast cancer. Further, there was no relation between the development offatty change and hypercholesterolemia, low-density lipoprotein (LDL), arterialhypertension and body mass index (BMI).Conclusion: Tamoxifen was associated with a high risk of development of nonalcoholicsteatohepatitis in patients with higher triglycerides and FBS and lowerHDL. However, no relationship was found with the level of BMI, LDL, hypertension,overweight and obesity77

ABSTRACTSThe 1 st International Congress on Gynecological Oncology78Malignant Epithelial Tumorof the Vulva with Neuroendocrine FeaturesModerately Differentiated:Case Report and Review of the LiteratureDr. Soheila Amini Moghaddam, Gynecologist Oncologist, Assistant Professor,Tehran University of Medical Sciences, Firoozgar Hospital, Tehran, IranDr. Samaneh Shafiee, Shahed University of Medical Sciences, MD,Fatemeh Mahmoudzadeh, Medical Student, Mazandaran University of medicalSciences, Sari, IranAli Zare Mehrjerdi, Associate professor, pathologist, Tehran university of medicalsciences, Firoozgar HospitalDepartment of Obstetrics and Gynecology, Firoozgar hospital, Tehran, IranAbstractPrimary neuroendocrine carcinoma of the vulva is a remarkably rare tumor. Thereare few cases reported in the literature of primary neuroendocrine carcinoma of thevulva considered as Merkel cell carcinoma and one case with paraganglioma-likefeatures. This presented case was diagnosed as a malignant epithelial tumor withmoderately differentiated neuroendocrine features. She underwent lefthemivulvectomy with bilateral inguinal lymphadenectomy. Permanent pathologyrevealed 5×5 cm mass with no lymphovascular invasion, tumor free margins andlymph nodes. Different regional and distant metastastatic evaluation excluded anymetastasis therefore, after extensive counseling with oncologist and radiotherapistthere was no need for chemotherapy and radiotherapy. Close follow-up wasrecommended to the patient. And now after 12 months she doesn`t seem to have anyproblem.Keywords:EpithelialTumor; Neuroendocrine Tumor; Vulvar; Radical Vulvectomy.78

79ABSTRACTSThe 1 st International Congress on Gynecological OncologyInflammatory Indicesand its Relevant Factors in Pregnant Iranian WomenZatollah Asemi 1 , Ph.D., Shima Jazayeri 2 , MD, Ph.D., Fatemeh Nazarinia 1 , BS,Ali Mohammad Faraji 1 , BS, fatemeh Zare 3 , BS, Leila Tagharrobi 3 , BS, MaryamYazdanparast 3 , BS, Zahra Jafari 3 , BS1 Kashan University of Medical Sciences, Department of Biochemistry and Nutrition2 School of Hygiene and Nutrition, Tehran University of Medical Sciences3 Kashan University of Medical SciencesAddress correspondence to: Dr. Shima Jazayeri, School of Hygiene and Nutrition,Tehran University of Medical Sciences, Iran. Tel. +98 (21) 88779118. Fax. +98 (21)88779118. E-mail: Sh_jazayeri@tums.ac.irAbstractObjective: The increase in pro-inflammatory indices during pregnancy has beenassociated with several complications. The aim of this study was to determine seruminflammatory indices and its relevant factors in pregnant Iranian women in maternityclinics in Kashan, Iran from October 2010 to March 2011.Methods: In a cross-sectional study, serum hs-CRP and TNF-α concentration andits relevant factors including maternal age, weight and BMI in pre-pregnancy, 13weeks of gestation and the seventh month of pregnancy were determined in eightynine primigravid pregnant women. Correlations coefficient of serum hs-CRP andTNF-α levels with independent variables were also reported.Results: Serum hs-CRP and TNF-α levels in the seventh month of pregnancy was(11.53± 9.47 µg/ml and 88.19± 52.12 pg/ml respectively). Weight in pre-pregnancy,13 weeks of gestation, the seventh month pregnancy, BMI in pre-pregnancy, 13weeks of gestation and the seventh month pregnancy were directly and significantlycorrelated with serum hs-CRP level (r=0.45, P

ABSTRACTSThe 1 st International Congress on Gynecological Oncology80correlated with serum TNF-α level (r=0.2, P=0.05; r=0.24, P=0.02; r=0.26, P=0.01;r=0.2, P= 0.05; r=0.24, P= 0.01 and r=0.27, P= 0.01).Conclusions: Findings showed that weight and BMI in pre-pregnancy, 13 weeks ofgestation and the seventh month of pregnancy were directly correlated with serum hs-CRP and TNF-α levels.Key words: Inflammatory factors, pregnant, women, hs-CRP, TNF-α80

81ABSTRACTSThe 1 st International Congress on Gynecological OncologyEffect of Gabapentin on Postoperative Pain and Complications:A Randomized Placebo Controlled TrialShokoufeh Behdad 1 , MD, Vida Ayatollahi 2 , MD, Afsarsadat Tabatabai bafghi 3 ,MD, Mohammad Dehghan tezerjani 4 ,MD, Mahshad Abrishamkar 51,2-Assistant professor, department of Anesthesiology, Shahid Sadoughi Universityof Medical Sciences3- Assistant professor, department of Gynecology, Shahid Sadoughi University ofMedical Sciences4- Resident in anesthesiology, department of Anesthesiology, Shahid SadoughiUniversity of Medical Sciences5-medical student, department of Anesthesiology, Shahid Sadoughi University ofMedical SciencesObjective: prevention and treatment of post operative pain and operationcomplications such as nausea and vomiting are most important concerns in postoperative care. There are several mechanism involved in postoperative pain.Gabapentin is a gamma amino butyric acid analogue that is known as an anticonvulsant drug. This drug is tolerated well and has known effects on pain andanxiety too. This study has compared effect of Gabapentin on postoperative pain,operation complications and hemodynamic situation.Methods: After confirmation of university institutional ethics committee study thisrandomized double blinded placebo controlled clinical trial has done on 61 patientswere candidates of total abdominal hysterectomy. Study were registered in Iranianregistry of clinical trials (http://irct.ir); IRCT138810122963N1. The patients weredivided in 2 groups randomly (30 as cases and 31 as controls).In first groups patientsgot 100 mg Gabapentin at the night and 300 mg Gabapentin (one capsule) 2 hoursbefore surgery orally. Second group got one capsule of multivitamin orally. Then allpatients were gone under same anesthesia protocol and total abdominal hysterectomy.During 24 hours after operation patient were assessed according to pain, nausea,vomiting, dizziness, Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP),Pulse rate (PR) and morphine use at 1, 6, 12 and 24 hours.81

ABSTRACTSThe 1 st International Congress on Gynecological Oncology82Results: Mean age and weight of patients were 45.86±4.06, 48.16±4.48,64.56±13.29 and 68.8±12.88 in study population and control groups respectively. Incomparison of pain scores, there were significant differences between two groups atall evaluated times (p

83ABSTRACTSThe 1 st International Congress on Gynecological OncologyPrimary Cervical Choriocarcinoma:Case Report and the Review of LiteraturesBehtash N* 1 , Karimi Zarchi M 2 , Shamshirsaz A A 3 , Mehrdad N 4 ,Teimoori S 5*1:,Professor,Obstetrics and Gynecology,Gynecological Oncologist ,TehranUniversity of Medical Science2: Assistant professor, Gynecology Oncology fellowship, Gynecology OncologyDepartment, Shahid Sadoughi University of Medical Science3 :medical doctors, Tehran University of Medical Science4.department of obstrics and gynecology ,Tehran University of Medical Science5. Membership of medical students scientific association, Islamic Azad universitybranch YazdAbstractBackground: Primary choriocarcinoma of the cervix is a very rare entity.Case: A 35-year-old patient had admitted to our hospital with vaginal bleeding for7 months. A cervical mass measured 4 x 4 cm was palpated on the anterior surface ofthe cervix. Biopsy of the lesion demonstrated extensive necrosis and was in favor ofsquamous cell carcinoma. Patient was accepted as FIGO stage I b1-2 and underwenttype II hysterectomy with bilateral salpingoopherectomy and bilateral pelvic lymphnode dissection was carried out. Post operative pathologic evaluation of the surgicalspecimen evinced that the case was primary cervical choriocarcinoma.Conclusion: Primary choriocarcinoma of the cervix should be considered in patientsin their reproductive years with cervical lesion and negative cervical cytology. BetahCGassay and transvaginal color Doppler sonography are useful for early diagnosis.Key Words: Choriocarcinoma, Cervix, Primary Evaluation of Diagnostic Value83

ABSTRACTSThe 1 st International Congress on Gynecological Oncology84The Prevalence of Cervical Cancers Related to HumanPapillomavirus in Germany, Iran and TurkeyN. Navali 1 and M.H. Biglu *2, 31 Dr. Nazli Navali PhD (Assistant Professor at Medicine Faculty of TabrizUniversity of Medical Science, Tabriz, Iran)*2 Dr. Mohammad Hossein Biglu PhD (Assistant Professor at Research Center forPharmaceutical Nanotechnology of Tabriz University of Medical Sciences)3 Dr. Mohammad Hossein Biglu PhD (Assistant Professor at Paramedical Facultyof Tabriz University of Medical Sciences, Tabriz, Iran)Mh_biglu@yahoo.comAbstract:Introduction: Human papillomavirus (HPV) is an affiliate of papillomavirusfamily that is capable of infecting humans. More than 30 types of HPV are typicallytransmitted through sexual contact and infect the anogenital region. The objective ofcurrent study is to measure the scientific production of leading countries in the fieldof HPV for a period of five years in MEDLINE.Methodology: On December 12th 2010 we extracted all documents indexed as amajor main heading of human papillomavirus from PubMed. We restricted theextraction of data to MEDLINE by selecting MEDLINE from the sub setting list. TheWHO/ICO Information Centre on HPV and C ervical Cancer was used to extract dataabout human papillomavirus and cervical cancers.Results and Conclusion:Analysis of data showed that the number of scientific output per population at riskof developing cervical cancer in Germany is 42 per 10.000 people whereas thisnumber in Turkey and Iran is 7 and 5 per 10.000 people respectively. It means thenumber of scientific activities in Germany is 6 times greater than in Turkey and 8.4times greater than in Iran. Although the number of population at risk of developingcervical cancer among women older than 15 in Turkey is approximately likewise inIran, but the number of scientific activity by Turkish scientists in the field is greater84

85ABSTRACTSThe 1 st International Congress on Gynecological Oncologythan Iranian scientists.The number of population at risk of developing cervical cancerin Germany estimated to be 36.36 million (women ages 15 years and older who are atrisk of developing cervical cancer). This rate is ~ 1.5 times greater than those in Iranas well as in Turkey. On the other hand the current estimation indicates that 45% ofGerman women, those diagnosed with cervical cancer die from the disease, but thisrate for Iranian and Turkish women is 52% and 39% per annual respectively.Keywords: Cervical cancers, Papilomavirus, Scientometrics85

ABSTRACTSThe 1 st International Congress on Gynecological Oncology86Broom Cytobrush or Ayre Spatulafor Pap Smear, Which One is Better?Mahshid Bokaie¹ , Zohreh Fotoohi² , Fatemeh Khodaei², Zeynab Ghafori²1-Fa cu lty me mb er of Sh a h id Sa d o u gh i Un iver s ity o f Med ica l S cien ce & Hea lth S er vices2-BS Students Nursing Midwifery of Shahid Sadoughi UniversityIntroduction: The Papanicolaou smear screening test has been associated with asustained reduction in cervical cancer incidence and mortality. The conventional Papsmear consists of cells, sampled from the cervix and vagina using a brush or spatula,which are placed directly on a slide and fixed with a chemical fixative in the office orclinic. Result defined by the Bethesda 2001 classification. In the US, cases of invasivecervical cancer are more likely to represent failure to perform appropriate screeningthan inaccuracies of screening when performed. More than half of women whodevelop cervical cancer either have never had cervical cytology, have been screenedsporadically, or have not been screened within the previous five years. The purpose ofthis study was to compare the adequacy of cervical smears taken with the Ayrespatula as opposed to the broom cytobrush.Methods: This was a retrospective analytical study. One sampler, an experiencedgeneral practitioner, took the smears in the period 2010 to 2011. Initially, the Ayrespatula was used to consecutively sample the cervix and thereafter, a cytobrush alonewas used. Two groups were thus formed for comparison. The presence ofendocervical cells was accepted as an indicator of an adequate smear.Results: A total of 1034 smears were taken. In 712 smears taken with a broomcytobrush compared with 322 smears taken with an Ayre spatula. The difference wassignificant with an Odds Ratio of 4.56, 95% Confidence Interval 3.42-6.42. resultshow normal pap 95 (%13) , inflammation 448 (%63 ), metaplasia 160 (%23), ASC –US 5 (%0.7 ) ,ASC-H 1 (%0.1)and LSIL3 (%0.4) in broom cytobrush and 28 (%9 )normal pap , inflammation 272 (%84 ), metaplasia 18 (%16), ASC –US 4 (%1 ),ASC-H 0(%0.0)and LSIL0 (%0.0) in Ayre spatula .Conclusions: The cytobrush is significantly more efficacious than the Ayre spatulain obtaining adequate cervical smears and detect cell abnormality. Use of thecytobrush will ensure less repeat smears.86

87ABSTRACTSThe 1 st International Congress on Gynecological OncologyEvaluation of Accuracy and Consistency of External RadiationTherapy and Brachytherapy of Cervical CancerChaparian A 1 and Shokrani P 21- Shahid Sadoughi University of Medical Sciences, Department of MedicalPhysics, PhD, Yazd, Iran2- Esfahan University of Medical sciences. Department of Medical Physics, PhD,Esfahan, IranAbstractIntroduction: The implementation of radiation therapy of the carcinoma of the uterine cervix involvesseveral stages: simulation, treatment planning, dose calculations and treatment delivery. In each stage,many different factors can affect the accurate delivery of dose to the clinical target. Therefore it isnecessary to provide an advanced technique to assure quality in treatment delivery. For this reason aphantom was designed to address the quality and consistency of external radiation therapy andbrachytherapy of cervical cancer.Methods and Materials: An acrylic pelvis phantom (Antropomorphic) for imaging, treatment planningand dosimetry applications was designed and fabricated. The phantom configuration was based upon CTslices obtained from a patient study. Individual slices were machined with corresponding contours of thebladder, rectum, uterine, vagina, bones of pelvis and the right and left femurs. Most of the phantom is madeof acrylic, while the bones are made of bone equivalent material, using CT numbers from patient images.For each treatment protocol, the stages of simulation and treatment planning were done using the phantomand plato treatment planning software. External radiation therapy was done using 9MV photon of a Nepton10 pc linac and Brachytherapy was done using thirteen Cs-137 sources of an LDR selectron unit.Dosimetry was done using a PTW 23323 ionization chamber and NE 2570/1 electrometer. The formalismproposed by the IAEA TRS-398 dosimetry protocol was used for conversion of the ionization chamberreading to dose value.Results: The dose calculation performed with the treatment planning system was in good agreement withthe experimental results. The comparison between measurements and calculations showed a maximumvariation of ±2.8 % for external radiation therapy and ±3.6 % for brachytherapy.Conclusions: Results of this study showed that phantom study is a suitable method for the evaluation ofthe accuracy and consistency of radiotherapy of cervical cancer. The phantom can be used as acomprehensive tool for quality assurance at institutions participating in national collaborative clinical trailsinvolving radiotherapy of cervical cancer.Keywords: Carcinoma of the uterine cervix- External radiation therapy- Brachy therapy- Phantom- Theevaluation of the accuracy and consistency87

ABSTRACTSThe 1 st International Congress on Gynecological Oncology88Association of CA125 and CA19.9 Serum Concentrationin Ovarian Cancer PatientsDashti Fatemeh sadat,Valizadeh HamidehMsc of Immunology, Shahid Sadoughi University of Medical Sciences, Yazd, IranObjective: Despite recent advances in understanding the pathogenesis of ovariancancer, it remains the most important cause of mortality from gynecologicalmalignancies. Some of tumor markers have been considered as effective methods fordiagnosing ovarian cancer. CA125 is the most widely used marker for determining ofpatients with ovarian cancer. In this study we investigated whether a relationshipexists between serum CA125 and CA19.9.Method: A retrospective study was conducted on 190 patients referred to Bou-ali,Yazd, laboratory from 2007 to 2011. CA125 and CA19.9 serum levels weremeasured by ELISA method and also serum LDH concentration was determined .Data recorded and analyzed statistically.Result: The mean age of the patients was 41.22±14.58 years (range 15-77 ). Fortythree(22.63%) individuals had high serum CA125 levels (>35u/ml) and consideredpositive according to instruction of kit . In this group mean age was 40.05±15.92years (range 16-68). the mean CA125 concentration was 186±221.7 u/ml (range 35.2-998 ) and concentration of other variables were: CA19.9(35.07±70.69 u/ml),LDH(341.64±107.23 Iu/L). thirty-three(17.89%) patients had high serum CA19.9levels(>19u/ml). In this group mean age was 40.53± 12.13 u/ml (range 17-66).Themean CA19.9 concentration was 44.02±53.42 u/ml (range 19.20-313) andconcentration of other variables were: CA125 (46.86±62.1 u/ml),LDH (333.91±98.73Iu/L). There was positive but not significant correlation between CA125 and CA19.9concentration in positive samples (P=0.092,R=0.298). There was negative and notsignificant correlation between LDH concentration and serum CA125 and CA19.9levels in patients which considered positive. There was no correlation between LDHconcentration and CA125 and CA19.9 serum levels in all samples. Also there was nosignificant correlation between age and levels of CA125 and CA19.9.88

89ABSTRACTSThe 1 st International Congress on Gynecological OncologyConclusion: In this study mean age of patients with high serum CA125 level was40.05 years whereas in most of the other studies the mean age is 63 years and itshows that the mean age of patient with ovarian cancer is decreased in Yazd. BetweenCA125 and CA19.9 concentration there was positive but not significant correlation(P=0.092,R=0.298) and the reason of it could be the small sample size of this study .Ifmore samples were taken part in this study, the correlation between this two tumormarkers may be significant.Key words:CA125,CA19.9,ovarian cancer89

ABSTRACTSThe 1 st International Congress on Gynecological Oncology90Challenges of Nursing Care in OncologyMohammad Ali DehghanShahid Sadoughi University of Medical Sciences, Yazd, IranCancer, regardless of its etiology, is acknowledged as a chronic disease affectingmillions of people in the world, independently of social class, culture or religion.Receiving a cancer diagnosis is generally terrifying because, in spite of therapeuticadvancements, which have improved survival rates and quality of life, there is still astigma of it being a painful disease that impairs, mutilates and kills. Hence, there is anevident and urgent need for nursing interventions to help people cope with the diseaseand its consequences, with a view to rehabilitation and improvements in quality oflife.Over the last decades, nursing in oncology has evolved to become a specialty. Infact, this shows a substantial progress in professional practice, especially regardingcare for patients with a complex disease. There has been an extraordinary andgrowing understanding about cancer, seeing it not only as a biological, but also as asocial, economic, and psychological issue. Initially, nurses worked following the socalled“ bed-side” care and limited their actions to comforting measures forhospitalized patients and palliative treatment for terminal patients. However, nurses’work in oncology has grown with the advent of therapeutic protocols conducted withnew antineoplastic agents.90

91ABSTRACTSThe 1 st International Congress on Gynecological OncologySentine Lymph Node Biopsy in Uterus CancerDehghan L 1 , Teimoori S 2 , Soltani HR 31-Department of Pathology , Islamic Azad University Branch Yazd.2- Student of Medicine, Medical Students Scientific Association, Islamic AzadUniversity Branch Yazd.3-General Medicine, Medical Students Scientific Association, Islamic AzadUniversity Branch Yazd.The purpose of this study is review of the English literature on SN procedure indetect uterus cancer Sentinel Nodes (SN) procedure in uterus cancers andhistological techniques including hematoxylin and eosin (H&E) staining, serialsectioning, immunohistochemistry (IHC) and molecular techniques to detect . Inuterine cancers, H&E staining, serial sectioning and IHC appears the best histologicalcombined technique to detect micrometastases. the previous research showed thatsentine lymph node biopsy has taken the place of a complete lymphadenectomy.Whether SLN biopsy only is acceptable in the staging and surgical management ofearly cervicalcancerremains unknown. In vulvar and cervical carcinomas, sentinelnode identification may significantly reduce the number of patients undergoingunnecessary, extensive lymphadenectomy in the absence of disease. The addition ofnovel techniques, such as histopathologicultrastaging immunohistochemistry staining,and reverse transcriptase polymerase chain reaction assays, will help increase theaccuracy and rate of detection of disease.Although examination of PAM withultrastaging and IHC is expensive and time-consuming, and difficult to be routinelyapplied to all negative lymph node retrieved in a para-aortic lymphadenectomy butprevious researched showed , current evidence that removal of aortic nodemay benefita subgroup of advanced cervical capatients with PAM and negative aortic lymph nodeat imaging techniques including PET-scan. Large and multi-institutional trials arerequired in order to define the implementation of sentinelnode biopsy in clinicalpractice with the objective of achieving safer and more conservative surgery.91

ABSTRACTSThe 1 st International Congress on Gynecological Oncology92Nursing Care Related to Specific Cancer TherapiesAli Mohammad DehghaniShahid Sadooghi University of Medical Sciences, Yazd, IranNursing care of patients receiving surgery, radiotherapy, chemotherapy, or biologictherapy, alone and in combination, begins with physical and psychologicalpreparation. The oncology nurse reviews the treatment plan with the oncologist, isaware of expected outcomes and possible complications, and independently assessesthe patient’s general physical and emotional status. Assessment of the patient’sunderstanding of the disease and proposed treatment is fundamental in allayinganxiety and formulating a care plan. Obtaining this information will help avoidmisunderstanding and confused expectations. Possible side effects of treatment aswell as recommendations to prevent or minimize these effects should be explained.Thorough patient preparation improves compliance with treatment programs and mayimpact treatment outcomes as well. A nursing care plan is developed in response tothe particular needs identified from the assessment. At a minimum, this plan willpromote (1) the patient’s understanding of therapy goals, treatment schedules, andpossible side effects of therapy; (2) physical and psychological preparation fortherapy; (3) physical and psychological comfort; and (4) compliance. Patient andfamily education starts before therapy and continues during and after therapy.Reinforcement helps ensure success. Appropriate written and visual teaching aidsmay be utilized as well as referrals to other professionals or community programs,such as cancer support groups.92

93ABSTRACTSThe 1 st International Congress on Gynecological OncologyThe Role of Nurse in Nursing Careof Patient after Gynecological Cancer SurgeryAli Mohammad DehghaniShahid Sadooghi University of Medical Sciences, Yazd, IranSurgery is the most frequently used treatment for cancer. A definitive diagnosis ofcancer requires tissue confirmation and most patients undergo some type of surgicalprocedure early in the course of their treatment. Beyond diagnosis, surgery is thedefinitive means of cure for most solid tumors and has many other applications incancer management. Surgical procedures are performed for cancer prevention,primary tumor removal, disease staging, tumor debulking, hormonal ablations, diseasepalliation, reconstruction, and placement of vascular devices. The patient and familymay experience a wide range of emotions and reactions to the diagnosis of cancer andthe need for surgery. The diagnosis often has been made only a few days before amajor procedure is scheduled. The nurse has a key role in assessing the patient’sunderstanding of possible surgical outcomes, such as change or loss of body function,limitations of mobility, and change in physical appearance. Careful preoperativeassessment may identify significant factors that could increase surgical morbidity andmortality.2 Nursing care of the patient undergoing surgery for cancer includesfostering the patient’s understanding of the specific procedure and expected outcome,preparing the patient physically and psychologically for the surgery, reducing anxiety,supporting the patient’s postoperative physiologic stability, relieving pain, preventingcomplications, and promoting compliance with postoperative instructions93

ABSTRACTSThe 1 st International Congress on Gynecological Oncology94Evaluation of Diagnostic Value of CT Scan, Physical Examinationand Ultrasound Based on Pathological Findings in Patients withPelvic Mass and Determination of CT Scan Efficacy in SurgicalProcedure AdaptationDr. Razieh Dehghani Firoozabadi 1 , Dr. Mojgan Karimi Zarchi 2c , Dr. Hamid RezaMansurian 3 , Dr Bita Rafiei Moghadam 4 ,Soraya Teimoori 5 , Dr Ali NaseriBafrouei 61:Associate professor, Obstetrics & Gynecology, Shahid Sadoughi University ofMedical Science, Yazd, Iran2: Assistant professor, Gynecology Oncology fellowship, Gynecology OncologyDepartment, Shahid Sadoughi University of Medical Science, Yazd, Iran.3: Associate professor, Radiologist, Shahid Sadoughi University of MedicalScience, Yazd, Iran4: Obstetrics & Gynecology, Shahid Sadoughi University of Medical Science, Yazd,Iran5: Student of medicine, Medical student scientific association, Islamic AzadUniversity branch Yazd.6:Medical Doctor, Tehran University of Medical Science, IranAbstractHistory and Objective: Because benign and malignant cervical and ovarian massesoccur with different percentages in different age groups, the importance of primarydiagnosis and selection of a suitable surgical procedure is underlined. Diagnosis ofpelvic masses is carried out using ultrasound, physical examination ,CT scan andMRI. The objective of this study is to evaluate the diagnostic value of CT scan inpelvic masses in comparison with physical examination-ultrasound based onpathology of the lesion in patients undergoing laparotomic surgery and determinationof CT scan efficacy in surgical procedure adaptation.Methods: This study is an analytic-descriptive study with diagnostic study method.Variables consisting age,sonographic findings, physical examinations, CT scan andpathological findings in 139 patients with pelvic mass were gathered in questionnairesand statistically analyzed using SPSS software programme .94

95ABSTRACTSThe 1 st International Congress on Gynecological OncologyResults: Of 139 patients with pelvic mass and the mean age of 41.16 +/-15.21(patients aged from 17 to 75 years old)62(44%) cases were diagnosed as benignand 77(55.4%) cases as malignant tumors; among them malignant tratoma serocystadenocarsinoma with 33(23.7%) cases and benign myoma with 21(15.2%) casescomprised the most frequent cases.s The sensitivity and specificity of sonographyphysicalexamination were 51.9% and 87.9% respectively and the sensitivity andspecificity of CT scan images were 79.2% and 91.6% respectively.It was shown thatCT scan images were more consistant with pathological findings in predictingappropriate surgical procedures than do sonography-physical examinations.Discussion & Conclusion: The sensitivity of CT scan is far higher than that ofsonography-physical examination in the diagnosis of pelvic mass malignancy.Sonopraghy has less sensitivity in diagnosing malignant pelvic lesions with uterineorigin (liemyosarcoma) than in malignant pelvic lesions with ovarian origin. In thisstudy CT scan has a very high sensitivity(in the order of 90 per cent) in diagnosingmalignant pelvic masses with ovarian origin. Regarding the sensitivity of sonographyphysicalexamination, it was demonstrated that this diagnostic method was verypractical in ruling out some benign lesions from surgical operation list.Key words: CT scan, Physical Examination-Sonography, Pathology, SurgicalProcedures, Pelvic Masses95

ABSTRACTSThe 1 st International Congress on Gynecological Oncology96A Huge Abdominal Mass due to Short ClomipheneCitrate RegimenKarimi Zarchi M 1 , Dehghani Z 2 , Teimoori S 3 , Soltani HR 41: Assistant Professor, Gynecology Oncology Fellowship, Gynecology OncologyDepartment, Shahid Sadoughi University of Medical Science2: Obstetrics & Gynecology Assistant, Shahid Sadoughi University of MedicalScience, Yazd, Iran3.4. Membership of Medical Students Scientific Association, Islamic AzadUniversity, Yazd BranchClomiphene citrate is a selective estrogen receptor modulator (SERM) thatincreases production of gonadotropins by inhibiting negative feedback on thehypothalamus. It is used mainly in female infertility and also can increase risk ofcancer of the uterine and ovarian. Women who receive ovarian-stimulation drugs suchas clomiphene citratein long-term because of infertility treatment are very high risk.This report presents a 39-year-old women with clinical manifestation of ovarian hyperstimulation syndrome (OHSS) and a huge abdominal mass. She received short-termclomiphene citrate regime for infertility. Because of her poor response to OHSStherapy and possible malignant lesion patients was undergone hysterectomy.Pathology reported mucinous tumor after 2 weeks patient return with previous similarsymptoms and another hysterectomy was done for her that in second pathology repotborderline mucinous tumor was pointed after first hysterectomy patient had 11 kgweight loss. Also in the second surgery lymphadenectomy, salpingoophoorectomyand appendectomy were done.Discussion: In cases with borderline mucinous tumors, hysterectomy is not enoughalone and appendectomy and omentectomy must be done because it is possible thatthe source of tumor be another origin except ovary and this procedure reduce therecurrence chance meaningfully also short term of clomiphene citrate can be aneffective factor for malignant ovarian lesions.Keywords: Clomiphene citrate, Ovarian tumors, Mucinous tumors.96

97ABSTRACTSThe 1 st International Congress on Gynecological OncologyBenefit of Metformin Use in Cancer TreatmentTahereh EftekharFellowship of Gynecology Oncology, Tehran University of medical sciencesBiguanides have been developed for the treatment of hyperglycemia and type 2diabetes. Recently, metformin, the most widely prescribed biguanide, has emergedas a potential anticancer agent.Epidemiological, preclinical and clinical evidence supports the use of metforminas a cancer therapeutic. The ability of metformin to lower circulating insulin maybe particularly important for the treatment of cancers known to be associated withhyperinsulinemia, such as those of the breast and colon.Moreover, metformin may exhibit direct inhibitory effects on cancer cells byinhibiting mammalian target of rapamycin (mTOR) signaling and proteinsynthesis. The evidence supporting a role for metformin in cancer therapy and itspotential molecular mechanisms of action are discussedHowever, a number of issues need further consideration in the development ofmetformin as a cancer therapy. In particular, the retrospective epidemiologicalstudies that first identified the potential anticancer effects of metformin aredifficult to confirm and contain only diabetic patient populations97

ABSTRACTSThe 1 st International Congress on Gynecological Oncology98Risk Factors of Gynecological Cancerin Middle Aged Women of YazdEnjezab B *1 , Bokaie M 21-Ph.D Candidate in Reproductive Health, Midwifery Department, Shahid SadougiUniversity of Medical Science. Yazd. Iran2-Lecturer in Midwifery department, Shahid Sadougi University of MedicalScience. Yazd. IranIntroduction: The practice of health-promoting behaviors by middle aged womenhas been acknowledged as an important strategy for maintaining and enhancing theirhealth status and decreasing the mortality and morbidity due to cancer. Obesity,physical inactivity, hypertension, diabetes and smoking are risk factors for cancer.This study carried out with the aim of describing some of gynecological risk factorsamong middle-age women in Iran (Yazd).Method: In a cross-sectional study, 483 middle- age women were selected usingcluster random sampling from Yazd city in the central Iran. Data was collected byquestionnaire via face to face interview. The SPSS software version 16 was used foranalysis.Results: results showed that mean age was 48.51± 6.04 years. Mean weight was71.41± 10.55; mean BMI was 28.32± 4.40; %29.2 of participants were overweight,%24.2 obese and %7 excessive obese (BMI≥ 35). %37.9 of respondents wasmenopause and mean age of menopause was 48.18 ± 4.05 years. %23 of participantssuffering from hypertension and %14.7 diabetes, %74.1had sedentary lifestyle,although only %1.2 were smoker, but% 26.6 were passive smokers and % 64.2 ofthem never do Pap smear test.Conclusions: High prevalence of cancer risk factors in women's middle-agedwomen in Yazd, prone them to gynecological cancer. So training of healthy behaviorsis necessary for them.Key words: gynecological cancer, risk factor, healthy behavior98

99ABSTRACTSThe 1 st International Congress on Gynecological OncologyLifestyles and Gynecologic CancersEnjezab B *1, Bokaie M 2, Farnia F 31-Ph.D candidate in reproductive health, Midwifery department, Shahid SadougiUniversity of medical science. Yazd. Iran2-Lecturer in Midwifery department, Shahid Sadougi University of medical science.Yazd. Iran3-Ph.D candidate in Nursing Education, Nursing department, Shahid SadougiUniversity of medical science. Yazd. IranIntroduction: Cancer constituted 29% of NCD deaths globally in 2001.changes inlifestyles will lead to changes, often increases, in the rates of certain cancers. morethan half of the cancers are diagnosed in 50- to 75-year-olds, thus cases occurring in2030 are people aged 30–55 years today, those in 2050 will arise among today’s 10-to 35-year-olds. the current lifestyles of today’s young- and middle-aged adults, ifunchanged, will impact on their future cancer rates.Study design: Study was identified by searching PubMed and up to date databasesand screening the references of retrieved articles.Results: Scientific evidence is accumulating on physical activity as a means for theprimary prevention of cancer. The evidence is more consistent that physical activity,appeared to lower levels of biologically available sex hormones, which could lead todecreased risk of hormone-related cancers, including cancers of the breast,endometrium, ovaries, prostate and testes and decreased energy intake and bodyweight. Generally recommend at least 30 min of moderate-to-vigorous intensityphysical activity on > or =5 d/wk.Supporting evidence for the protective effect of folate and vit C was provided byinverse associations between CIN and folate in both serum and diet, both of which arefound in good quantity in fruits and vegetables, legumes and whole grains. Someprospective cohort studies did demonstrate increased risk of ovarian cancer with highintake of dairy foods. An increase in green tea intake of 2 cups/day was associated99

ABSTRACTSThe 1 st International Congress on Gynecological Oncology100with a 25% decreased risk of endometrial cancer. Furthermore, the protective effect ofgreen tea on endometrial cancer seemed more evident than that of black tea.Obese women are at higher risk for multiple cancers, including endometrial cancer,cervical cancer, breast cancer, and perhaps ovarian cancer. Endometrial carcinoma isstrongly related to obesity. Obese women with cancer may have decreased survivalbecause of later screening, co morbid illnesses, or poorer response to treatment. Obesewomen have increased surgical and possibly radiation complications. In addition,there is no current consensus regarding appropriate chemotherapy dosing for theobese patient. The increased levels of endogenous estrogen contribute to higher riskof several types of cancer.Smoking is an important risk factor in many cancers such as cervical cancer, But itis associated with a decreased risk of developing endometrial cancer inpostmenopausal women; obviously, the major health risks associated with tobacco usefar outweigh this benefit.Conclusion: modified in lifestyles will lead to changes in the rates ofgynecological cancers.Key words: lifestyle, endometrial, cervical, ovarian cancer100

101ABSTRACTSThe 1 st International Congress on Gynecological OncologyFrequency of Cervical Cancer, Diagnostic Methods, PathologicCharacteristics, and Treatment in Gilan From 1385 Till 1389* Fakor Fereshteh, **Saidi Saedi H, ***Adeleh Isanazar* Assistant Professor, Gynecology and Oncology Department of Azzahra HospitalGuilan University of Medical Sciences, Rasht, Iran.** Assistant Professor, Radiotheraphy Department of Razi Hospital GuilanUniversity of Medical Sciences, Rasht, Iran.*** General Practitioner, Gilan University of Medical Sciencesh_fertility@gums.ac.irFereshtehfakor@yahoo.comIntroduction: Cervical Cancer is the sixth most common malignant neoplasm &second cause of cancer death in females. Early stage diagnosis of cervical cancerincreases the cure rate of disease. The relative importance of cervical cancer is evengreater for women in developing countries, where more than 80% of cases occur, andwhere it comprises about 15% of cancers in women, with a lifetime risk of about 2%., the mortality rates from cervical cancer were quite high and comparable to thoseseen in developing countries today. It is accepted that organized screening withcervical cytology (the Pap smear) was responsible for the improvements. In additionto cytology, other screening methods designed specifically for low-resource settingsare available, including visual inspection with acetic acid (VIA) and treatment withcryotherapy. The aim of this study is the assessment of frequency of cervical cancer,diagnostic methods, pathologic characteristics, and treatment in Gilan from 1385 till1389.Methods: In this descriptive study, we evaluated 52 cases of cervical cancer whichreferred to Razi & Al- Zahra hospitals and private radiation oncology center of Guilanfrom 1385 to 1389.In this groups we detected pathologic finding including Squamouscell carcinoma, adeno carcinoma and edeno squamous cell carcinoma , staging , typeof diagnosis (pap smear, cervical biopsy, conization, post surgery includinghysterectomy), types of treatment (surgery including radical hysterectomy,101

ABSTRACTSThe 1 st International Congress on Gynecological Oncology102chemoradiation, both surgery and chemoradiation) and demographic data includingage, parity, age of married .Result: The age of the study group ranged from 38 to 84 years (mean= 52.98±11).Squamous cell carcinoma comprised 86.5% of the cases , 7.7% adeno carcinoma and%5/8 edeno squamous cell carcinoma. Most patients (68%) had advanced- stagedisease and %32 were in early stage (Ia, Ib, IIa). %55.8 were diagnosed by biopsy and%44.2 were diagnosed after simple hysterectomy. Most of the patients (50%) weretreated with chemo radiation therapy, %46.1 with surgery and chemo radiation and%3/8 with surgery (radical hysterectomy).Conclusion: Our study revealed that a large number of the patients diagnosed aftersimple hysterectomy. We conclude that by close adherence to cervical cancerscreening guidelines and appropriate evaluation of presenting symptoms, we mayavoid inappropriate management of cervical carcinoma with simple hysterectomy.Keywords: Cervix Neoplasms, Diagnostic Tests, Routine, Hysterectomy,Radiotherapy102

103ABSTRACTSThe 1 st International Congress on Gynecological OncologyExercise to Fight Cancer Related FatigueFarnia Farahnaz*, Enjezab Behnaz 1 , Dehghani Mohammad Ali 2* Faculty Member of Shahid Sadoughi University of Medical Sciences, Nursing &Midwifery College,Ph.D. Nursing Student in Kerman Medical Sciences University1. Faculty Member of Shahid Sadoughi University of Medical Sciences, Nursing &Midwifery College, Reproductive Health Student in Isfahan Medical SciencesUniversity, Tel: 09133577034, Yazd, Iran. Email:behnaz_enjezab@yahoo.com2. Shahid Sadoughi Hospital; Nursing Educational Supervisor, Tel: 09133555782,Email:dehghani1347@yahoo.com,Yazd, IranIntroduction: Nowadays while living longer after diagnosis; nearly all cancersurvivors report one or more symptoms affecting their sense of well-being thatnegatively affects physical and social quality of life. Fatigue is a common side effectof cancer therapies and is reported to occur in 70–100% of patients. Oncologyclinicians often describe cancer-related fatigue as the sixth vital sign. It is one of themost recurrent complaints of people with cancer, having a profound effect on thewhole person and directly influencing the desire to continue with treatment.Therefore, research about the etiology and management of this symptom should beregarded as a priority. The aim of this study was “ to explore the interventions forrelieving fatigue in a cancer population”.Methods: A literature review was performed for searching this topic. Sourceselection was limited to those sources available online through INLM without timelimitation.Results: Result showed there is a variety of established interventions to aid inmodulating symptom severity. To avoid cancer-related fatigue, patients are frequentlyadvised to seek periods of rest and to reduce their amount of physical activity. Inorder to, most counseling was directed at energy conservation. But of theseinterventions during active cancer treatment, activity enhancement has been shown to103

ABSTRACTSThe 1 st International Congress on Gynecological Oncology104result in a reduction in fatigue levels of 40–50%. However, in the past two decades,literature has accumulated that indicates exercise after cancer diagnosis reduces theincidence and severity of a variety physiologic and psychosocial symptoms’frequently reported by cancer survivors. Physical activity clearly is important for allolder adults and for cancer survivors in particular. -Decreased physical activity, whichmay be the result of illness or of treatment, can lead to tiredness and lack of energy.Scientists have found that even healthy athletes forced to spend extended periods inbed or sitting in chairs develop feelings of anxiety, depression, weakness, fatigue, andnausea. Regular, moderate exercise can decrease these feelings. Even during cancertherapy, it is often possible to continue exercising.Discussion: Despite the growing body of evidence on the impact of fatigue oncancer patients’ health-related quality of life (HRQL), it remains under-reported,under-diagnosed and under-treated. Counseling approaches to the treatment ofCancer-related fatigue include education, counseling and behavioral interventions onactivity enhancement, nutrition and sleep. Exercise should not be used in isolationbut should definitely be included as one of the components in the package ofinterventions used during and after treatment. Therefore, this paper discussedindications , benefits and suitable exercise type for this patients.Key words: Fatigue, cancer related fatigue, Intervention, Exercise104

105ABSTRACTSThe 1 st International Congress on Gynecological OncologyCommunication Skill Enhancement: The Opportunity to MakeProfound Difference in Oncologic Patients’ ExperiencesFarnia*, Farahnaz; Dr. Abbaszadeh, Abbas 1 ; Nazmie, Hossein 2* Faculty Member of Shahid Sadoughi Nursing & Midwifery College & Ph.D.Nursing student in Kerman Medical Sciences University Shahid Sadoughi1. Kerman Medical Sciences University Faculty Member; Daneshyar;Tel:09131444119 ;Kerman, Iran ; Email: aabaszadeh@hotmail.com2. Shahid Sadoughi Hospital;Nursing manager;Tel:09138588501; Email:hossin.nazmiah@gmail.com,Yazd, IranBackground: Long-term illness usually requires profound care and resources tomaintain a normal lifestyle. In the oncology setting, patients interact with a variety ofhealthcare providers, including physicians and nurses. Nurses have a vital role insupporting this patients. The power of effective nursing care is strengthened andenriched by good communication .Because of the unique position of nurses in thehealth care system, they spend extended time periods talking with patients andhearing their concerns ,feelings ,and needs. Therefore effective communication is afundamental element of nursing care that is integral to the provision of quality patientcare.But communication in the patient-provider relationship can be complicated bypatient and family perceptions and expectations, emotional state, and disease course.Cancer diagnoses and treatment often produce anxiety in patients and families whoneed time to discuss their psychosocial concerns. Therefore, healthcare providersmust possess excellent communication skills. Since contemporary developments innursing and health-care emphasis evidence-based and outcome-oriented practice, wewere performed this study.Aim and Methods: The objective of this review is “ to establish the best availableevidence regarding strategies to enhance effective communication between nurses andoncology adult patients”. A literature review was performed for searching this topic.Source selection was limited to those sources available online databases throughINLM without time limitation in1389(2010-2011).The search terms used were105

ABSTRACTSThe 1 st International Congress on Gynecological Oncology106Cancer ; Nurse-patient relationship; oncology ; communication skill; interaction;enhancement.Results: Evidence suggests that the nature and context of relationships plays asignificant role in influencing the enhancement of nurse- patient relationship.Communication involves more than the transmission of information; it also involvestransmitting feelings, recognizing these feelings and letting the patient know that theirfeelings have been recognized. Quality care means that the nurse does not makeassumptions but assesses the needs and preferences of the patient and providescorresponding care to meet these needs .Therefore, it is important for nurses to createan environment of trust, in which the patient feels respected, involved and accepted.Nurses must possess good communication skills in order to provide humane,complete and comprehensive care. Such abilities imply: listening well, honesty,avoiding a conspiracy of silence, fake cheerfulness, never dismissing hope andproviding relief of pain.Discussion: Effective communication is increasingly recognised as a core clinicalskill. Many health and social care professionals, however, do not feel adequatelytrained in communicating and in handling interpersonal issues that arise in the care ofpatients with cancer. The knowledge ,skills and expertise of the nurse are importantattributes of the nurse in meeting the patient's health goals because patients depend onnurses for assistance in meeting health care needs. In this paper, we attempt toprovide information about available recognized results on the subject ofrelationship skills in practice.Keywords : Cancer ; Nurse-patient relationship; oncology ; communication skill;enhancement106

107ABSTRACTSThe 1 st International Congress on Gynecological OncologyVulvar Melanoma 7 Years after Cervical Melanoma,Case Presentation and Review of LiteratureAzamsadat Mousavi 1 , Mitramodares Gilani 1 , Shirin Goodarzi 1 *, Reza Shahsiah 2 ,Parvin Ghaffari 1 , Farnaz Amouzegar 3 .*Corresponding author: ShirinGoodarzi, shirin.goodarzi90@gmail.com1:Department of Gynecology Oncology, Imam khomeini Hospital, Blvd. keshavarz,Tehran, Iran.2:Department of Pathology, Imam Khomeini Hospital, Blvd.keshavaz, Tehran, Iran.3: Department of Radiotherapy, Imam Khomeini Hospital, Blvd .keshavarz,Tehran,Iran.Abstract:Objective: Vulvar melanoma is a very rare condition accounting for less than 1% ofall gynecological malignancies. Primary melanoma of the uterine cervix is extremelyrare, accounting for only 3% to 9% of gynecological melanomas, and it is 5 times lesscommon than primary melanoma of vegina and vulva. The prognosis for thesepatients is generally poor. Early diagnosis and appropriate treatment provideacceptable survival.Design: case report and review of literature.Setting: Gynecology Oncology Center, Valiasr hospital.Patient: A 45-year-old woman was diagnosed by vulvar melanoma. 7 years ago(2003) she underwent radical hysterectomy and pelvic lymphadenectomy along withradiotherapy due to primary malignant melanoma of cervix. She was disease free till2010.Radical vulvectomy and inguinal lymphadenectomy was performed, becausepositive margins after wide local excision. Inguinal and suburethral recurrence wasoccurred after 6 months of vulvectomy.Intervention: radical vulvectomy, inguinal lymphadenectomy, radiotherapy.Main outcome and measure: long-term disease-free and survival of cervicalmelanoma, vulvar melanoma.Conclusion: In patients with uterine cervix and vulvar melanoma, prognosis is poorand there is no standard treatment. Depth of invasion and lymph node involvementare the most important prognostic factors. Immunohistochemical methods are helpful107

ABSTRACTSThe 1 st International Congress on Gynecological Oncology108in uncertain cases. This is the first case of vulvar melanoma occurred 7 years afteruterine cervical melanoma diagnosis.Keywords: Vulvar melanoma, Cervical melanoma, Immunohystochemitry, Radicalsurgery108

109ABSTRACTSThe 1 st International Congress on Gynecological OncologyTreatment Failure Assessment In Immature Teratoma:5 Cases PresentationMitra Modares Gilani 1 , Azam-Sadat Mousavi 1 , Shirin Goodarzi 1 *, ParvinGhaffari 1 , seyed Amirhasan Matini 2 , Azadeh Zamiri 1DepartmentofGynecologyOncology, ImamkhomeiniHospital,Blvd.keshavarz,Tehran, Iran.Abstract:Introduction: Teratoma is the most frequent germ cell tumor but immatureteratoma represents only 1% of ovarian tumors. Differentiation between mature,immature, grading and also approach to them, are sometimes troubling. The aim ofthis article is evaluating of mismanagement and minimize them.Design: case series.Patients: We present 5 cases ( 13, 16, 17, 25 and 27 –year-old) of immatureteratoma with treatment failure . Three cases had primary report of mature teratomaand did not take any treatment , so recurrence and disease progression occurred afterfew months. Two cases, despite of immature teratoma report, did not undergo anytreatment because the surgeons’ interpretation was mature teratoma (mistake inreading pathology report). 1 of 5 cases expired due to disease tile writing this paper.Conclusion: Because of different behavior and management mature andimmature teratoma, so second analysis of initial histology is reasonable and maysignificantly affect patient care. Not only, proper surgery approach, tumor spillageprevention and begin appropriate chemotherapy after surgery (if indicated) affectsurvival, but also writing benign and malignant teratoma ( grading in detail), insteadof mature teratoma and immature teratoma, respectively, will minimize mistake inreading and choose the best way to decrease delayed treatment ,mortality andmorbidity.Key words: Ovarian Teratoma , Grading, Tumor Spillage, Mortality109

ABSTRACTSThe 1 st International Congress on Gynecological Oncology110Primary Malignant Nevoid (Amelanotic)Vulvar Melanoma in a 40-year-old WomanMitra Modares Gilani 1 , Azamsadat Mousavi 1 , Shirin Goodarzi 1* , Reza Shahsiah 2 ,Parvin Ghaffari 1 .Departmentof Gynecology Oncology, Imam khomeini Hospital,Blvd.keshavarz,Tehran, Iran.Abstract:Background: Vulvar melanoma is the second most common vulvar malignancybut represents less than 1% of all melanomas. Amelanotic melanoma is a subtype ofmelanoma with little or no pigment upon visual inspection. The lack of pigmentationis the reason for late diagnosis and poor outcome.Patient: A 40-year-old woman referred to our department with a non-pigmentednodular lesion in her right labium minus. She had no symptoms and it wasaccidentally detected by her partner. Histopathologic and immunohistochemicalstudies revealed amelanotic melanoma of the vulva with surface ulceration. Sheunderwent wide local excision and bilateral inguinal lymphadenectomy. One of thelymph nodes was positive. She was treated with alfa-Interferon and referred toradiotherapy.Conclusion: Amelelanotic vulval melanoma is a very rare condition. Whereas theoverall prognosis is poor it represents a significant issue in women’s health. Indoubtful cases immunocytochemistry with HMB-45 and S- 100 protein is essential forrevealing the correct diagnosis ofnevoid malignant melanoma.Keywords: Amelanotic melanoma, Immunocytochemical study, Wide localexcision, alfa-Interferon.110

111ABSTRACTSThe 1 st International Congress on Gynecological OncologyLongterm Disease Free and Successful Pregnancy in aGonadectomized Woman with 46,XY Gonadal Dysgenesis andDysgerminoma (Stageii)Azamsadat Mousavi, Mitra Modares Gilani, Shirin Goodarzi*, Parvin Ghaffari,Ensieh Sh Tehraninejad, Azadeh Zamiri.Department of Gynecology Oncology, Imam Khomeini Hospital, Blvd. Keshavarz,Tehran, Iran.Objective: To present a case of longterm disease free and successful pregnancyafter fertility sparing staging surgery with adjuvant chemotherapy in a 46,Xy gonadaldysgenetic with malignant garm cell tumor.Design: case report.Setting: Gynecology Oncology center, Valiasr Hospital.A 19-year-old female with 46,XY karyotype (Swyer syndrome), with primaryamenorrhea and pelvic mass, underwent bilateral gonadectomy and staging withuterus preservation. 6 course adjuvant chemotherapy with VBP (Vinblastin,Bleomycin, Cisplatin) was given.Intervention: fertility- preserving staging surgery and chemotherapy. oocytedonation and IVF.Main outcome measure(s):Disease free, successful pregnancy.Result(s): After treatment the patient is free of the disease after 11 year’s followup.She underwent in vitro fertilization treatment with oocyte donation and gave birthto a healthy child.Conclusion: Improved multimodality treatment, allow for consideration of fertilityoptions for some women with gynecologic cancers. Since major concern in womenwith XY gonadal dysgenesis is ovarian malignancy, however, even with stage IIdysgerminoma do not require hysterectomy in some cases because the opportunity forchildbearing with the use of embryo transfer.Keywords: Gonadal Dysgenesis, Dysgerminoma, Adjuvant Chemotherapy,Successful111

ABSTRACTSThe 1 st International Congress on Gynecological Oncology112Genetic polymorphisms of the SULF1 geneand the riskof epithelial ovarian carcinomaNasrin Ghasemi, Mojgan Karimi Zarchi, Mahnaz Zahraei , Samira Ghobadzadeh1. Medical Genetics Department, Yazd Reproductive scinces institute, Yazd, Iran2. Obstetrics and Gynecology Department, ShahidSadoughi Hospital, YazdShahidSadoughi Medical Sciences University, Yazd, Iran3. Medical Genetics Department, Medical School of Yazd ShahidSadoughi MedicalSciences University, Yazd, Iran4. Immunology Department, Medical School of Yazd ShahidSadoughi MedicalSciences University, Yazd, IranAbstractSULF1 is a newly identified human sulfatase with aryl-sulfatase activities.Thisendosulfatase selectively removes 6-o –sulphate group and alters the binding sites ofsignaling molecules.SULF1 expression is decreased in multiple malignant lineages. Inovarian cancer, decreased expression of SULF1 was also reported. Polymorphisms inthe SULF1 gene might influence epithelial ovarian cancer risk.The aim of this studywas to analyze frequency of the rs 2623047 andrs 6990375 polymorphisms of SULF1gene in patients with ovarian cancer and normal controls. DNA was extracted andRFLP_PCR analyzed these two common SNPs in 100 cases and controls. The Ggenotype of rs2623047 and the genotype A of rs6990375 were associated with theearly age of onset among carrires of these genotypes. Finding of the association ofthese polymorphisms with early age of onset is important for better treatment andprognosis.112

113ABSTRACTSThe 1 st International Congress on Gynecological OncologyAbdominal Wall Metastasis and Multiple Intra-Abdominal HugeMasses in a 14-Year-Old Girl after Ovarian CystectomyMitra Modares Gilani 1 , Shirin Goodarzi 1 *, Mahrooz Malek 2 ,Fatemeh Zamani 2 ,Amirhasan Matini 3 .*Corresponding author: Shirin Goodarzi, shirin.goodarzi90@gmail.com1:Department of Gynecology Oncology, Vali-Asr Hospital, Blvd.keshavarz,Tehran,Iran.2:Department of Radiology, Imam Khomeini Hospital, Blvd .keshavaz, Tehran, Iran.3: Department of Pathology, Imam Khomeini Hospital, Blvd.keshavaz, Tehran,Iran.Objective:Malignant ovarian germ cell tumors are account for only about 5 percent of allmalignant ovarian neoplasms. Ovarian germ cell tumors arise primarily in youngwomen between 10 and 30 years of age and represent 70 percent of ovarian tumors inthis age. Appropriate diagnostic approach provide early treatment and disease freesurvival.Design: case report.Setting: Gynecology Oncology Center, Vali-asr Hospital.Patient: A 14-year-old girl, referred to our gynecological oncology department withmultiple and huge intra abdominal, pelvic and abdominal wall massses, 2 monthsafter an right ovarian cystectomy, with rupture and spillage during that surgery. Theinitial histology of the cyst was an ovarian mature teratoma. After tumor markeranalysis and imaging, she underwent debulking surgery and chemotherapy with BEP,12 days after second surgery with the final histology of malignant mixed germ celltumor (95%immature teratoma,gIII+5%yolk sac tumor).Intervention: diagnostic process, debulking surgery, chemotherapy.Conclusion: Ovarian tumors in young girl should be always considered as beingpotentially malignant offer hope for curative treatment. It is advocated preoperativedetermination of alpha-fetoprotein in all women with ovarian tumors under 40 yearsof age. Appropriate first surgical approach and tumor spillage prevention arefundamental. Reanalysis mature teratoma report is reasonable.Keywords: immature teratoma grading, alpha-fetoprotein, chemotherapy113

ABSTRACTSThe 1 st International Congress on Gynecological Oncology114Role of Pap smear in Precancerous Lesions of CervixSattar Gorgani, Sattar Gorgani Firozjaee, Reza MeshkaniPh.D. Student Tehran University of Medical Sciences Medicine Faculty Departmentof BiochemistryObjective: To detected cervical carcinoma in early stage and to establish thediagnosis of Atypical cells in cervix.Materials and methods: three hundred cases were taken for cytological study aged20-40 years 298 patients were asyplomatic and without sign except for 2 patients wascontact bleeding. Bethesda system for categorization of cytopathology of uterinecervix has been employed.Result: one hundred Thirty eight patients had normal smear 48 smears showedinfection, 100 patients showed inflammation 2 patients showed ASCUS 4 patientsshowed low grade SIL 6 patients showed high grade SIL and 2 case was diagnosed assqumoscell carcinoma .Out of 4 patients SIL and 2 Ascus were subjected colposcopy and biopsy none ofthem showed malignancy and out of 6 patients high grade SIL and 2 cases squmoscellcarcinoma were positive on biopsy .Conclusion : Routine pap smear is a reliable diagnostic for early detection andprevention of carcinoma cervix .114

115ABSTRACTSThe 1 st International Congress on Gynecological OncologyCombined Decongestive Therapy Post MastectomyNarges hosieni*, Robab zaki zade, fatemeh kazemianShahid Sadoughi hospital in yazdBackground: method of combined decongestive therapy or CDT is the mostsuccessful treatment for chronic extremity lymph edema. CDT is a combination ofMLD or manual lymph drainage, bandaging of the affected areas, exercises and skinand nail care.Method: the essential aim of CDT consist of circulation of lymph fluid, control oflymphedema. CDT or combined decongestive therapy is consist of two stage .firststage is 3-5 weeks . lymph drainage is 30-40 minutes daily and then patient isbandaged, by activity, pressure on vessel of lymph is excessive,and pumping oflymph is improved. When combined decongestive therapy is finished the especiallysleeve for patient is prepared.Pump TherapyPneumatic compression pumps have been use the treatment lymph edema.Pneumatic compression pumps consist of an electric pneumatic pump that is used topush compressed room air into an inflatable garment or sleeve either continuously orintermittently depending on inflation and deflation times.MLD massage is applied in gentle strokes towards the heart. This technique willlightly stretch the walls of the lymph vessels and encourage lymph drainage.Massage therapy improved the range of motion in the shoulder of the affected arm.Patients that were subjected to circular massage and mobilization of their armexperienced a 15% improvement in shoulder extension and an 18% improvement inabducting their affected shoulder.ResultMassage therapy non-pharmacological alternative to reduce pain and encouragelymph drainage.Key words: Combined Decongestive Therapy, mastectomy, lymph edema.115

ABSTRACTSThe 1 st International Congress on Gynecological Oncology116Manual Lymph Drainage after MastectomyNarges Hosieni*, Maryam Mohammadi, Mozhgan MousaviShahid Sadoughi Hospital in YazdBackgroundManual Lymph Drainage (MLD) is a very gentle type of massage therapy used todrain excess fluid from the body and improve the overall functioning of the lymphaticsystem.. MLD is most commonly used to treat Lymphedema, which is characterizedby the blockage of lymph nodes in the arms.MethodMLD massage is performed by a certified MLD massage therapist, who applies alight form of circular massage to their clients skin. MLD massages must be applied tobare skin, and no massage oils can be used in order for the treatment to be effective.MLD massage is applied in gentle strokes towards the heart. This technique willlightly stretch the walls of the lymph vessels and encourage lymph drainage.During your MLD treatment your massage therapist may use one of four veryeffective MLD techniques to encourage lymph drainage.1) Stationary Circles these strokes are applied in continuous spirals with themassage therapists fingertips typically over the neck, face and lymphatic nodes.2) The Pump Technique the massage therapist will place their palms down on theskin, and make oval strokes with their fingers and thumbs to encourage lymph flow.3)The Rotary T echnique the therapist massages the skin in circular motions withtheir palms facing down. The wrists are used to apply and lessen the stroke pressure.4) Scoop StrokesMassage therapy non pharmacological alternative to reduce pain.ResultMassage therapy improved the range of motion in the shoulder of the affected arm.Patients that were subjected to circular massage and mobilization of their armexperienced a 15% improvement in shoulder extension and an 18% improvement inabducting their affected shoulder.Key Words: Lymph Drainage therapy, Mastectomy, Lymphedema116

117ABSTRACTSThe 1 st International Congress on Gynecological OncologyPeritoneal Tuberculosis Mimicking Ovarian Cancerin Three PatientsKarimi Zarchi, Taghipour SH, Teimoori S, Nemati A, Naghshin NasilaAuthors: karimi zarchi M 1 , Taghipor SH 2 ,Teimoori S 3 ,Nemati A 4, Naghshin M1. Assistant Professor, Department of Gynecology, Shahid Sadooghi University ofMedical Sciences, Yazd, Iran.2. Assistant Professor, Department of Pathology, Shahid Sadooghi University ofMedical Sciences, Yazd, Iran3. 4. Student of Medicine, Medical Students Scientific Association, Islamic AzadUniversity Yazd Branch5. Shahid Sadoughi University of Medical Sciences, Yazd, IranAbstractIntroduction: Peritoneal tuberculosis is a rare disease that mimicking ovarianmalignancy that consist of 3/3% of cases of exterapolmonary tuberculosis (TB).Clinical manifestation of peritoneal TB is resemble to ovarian cancer and may thatgynecologist mistake and performance unnecessary extend surgeryMethods: We described three patients with complete physical examination, andmedical and family historical, routine biochemical test and level of CA-125 chest X-ray and abdominal ultrasonography record of women with symptom of abdominalpain, ascites, weight loss who referred to Shahid Sadoughi Hospital.Results: Three patients with peritoneal tuberculosis mimicking ovarian cancer wereencountered. All the patient had abdominal pain, elevated serum CA125 and one ofthem had fiver and severity ascites. Laparoscopy in on patient and laparotomy in twopatients revealed peritoneal TB and no malignancy. All of the patients treated withquadruple anti –TB drugs and we follow up our patient for 6 monthConclusion: it is very important that a gynecologist attend to this symptom anddon’t mistake and don’t lead to the performance of an unnecessary extended surgery,The diagnosis TB and ovarian carcinoma is very difficult and most do examination ofascites fluid by paracentesis and histopathology examination of biopsy from pelvicmass taken and give correct diagnosis in this study we done 2 unnecessary surgery.Keywords: Peritoneal tuberculosis, Ovarian, Cancer, Mimicking117

ABSTRACTSThe 1 st International Congress on Gynecological Oncology118Ovarian Function Preservation by GnRH Agonists DuringChemotherapy with Cyclophosphamide In Breast CancerPatients – A Double Blind Randomized Control Trial ClinicalDr. Mojgan Karimi Zarchi 1 *, Dr. Maryam Nakhaie Moghadam 2 , Dr MohammadForat Yazdi 3 , Soraya Teimoori 4 , Hamid Reza Soltani 51: Assistant professor, Gynecology Oncology fellowship, Gynecology OncologyDepartment, Shahid Sadoughi University of Medical Science.2: Obstetrics &Gynecology Assistant, Shahid Sadoughi University of MedicalScience, Yazd,Iran3: Assistant Professor,Oncology&Hematologist, Shahid Sadoughi University ofMedical Science,Yazd,Iran4,5: Student of medicine, Medical student scientific association, Islamic azadUniversity branch yazd,Abstract:Introduction: Chemotherapy has a remarkable effect on increasing survival ofcancerous patients but its side effect is avoidable, ovarian failure can lead toinfertility. This study is designed to evaluate ovarian preservation by GnRH agonistsin young women with breast cancer during cyclophosphamide chemotherapy regime.Material and Methods: This is a double blind randomized controlled trial that wasdone on 42 patients with breast cancer who referred for chemotherapy to ShahidSadooghi Hospital. Patients were asked as menstrual conditions and examined withvaginal sonography and also LH and FSH blood level at the end of 3 and 6 months.Finally data were analyzed by SPSS ver. 16.Results: Age average of samples was 36.5 year (from 30 to 45 year). After 3months, 84% of cases maintained ovarian function while this rate increased up to90.5% at the end of 6 months. In control group 19.5% maintained ovarian functionafter 3 months while this rate elevated to 33.3% after 6 months. This means that33.3% had menopause symptoms like flashes, night sweats, fatigue and vaginal118

119ABSTRACTSThe 1 st International Congress on Gynecological Oncologydryness. Finding showed that GnRH analogue can significantly preserve ovarianfunction (P value= 0.01)Conclusion: GnRH administration before and during chemotherapy in patients withbreast cancer seems to preserve post treatment ovarian function in young women inthe fertility ages. Therefore, more detailed study with larger samples in long timeperiod is suggested for more reliable results.Keywords: Cyclophosphamide, Chemotherapy, GnRH agonist, Breast cancer119

ABSTRACTSThe 1 st International Congress on Gynecological Oncology120Serum concentration of CA125and HE4 in ovarian cancer patientsMojgan Karimi Zarchi,Nasrin Ghasemi, Samira Ghobadzadeh , Mahnaz Zahraei1. Obstetrics and Gynecology Department, ShahidSadoughiHospital, YazdShahidSadoughi Medical Sciences University, Yazd, Iran2. Medical Genetics Department, Yazd Reproductive scinces institute, Yazd, Iran3. Immunology Department, Medical School of Yazd ShahidSadoughiMedicalSciences University, Yazd, Iran4. Medical Genetics Department, Medical School of Yazd ShahidSadoughi MedicalSciences University, Yazd, IranAbstractTumor markers with increased sensitivity and specificity for ovarian cancer areneeded to early detection and to help monitor response to therapy. Currently, thetumor maker CA125 is utilized in this role with limited value. The objective of thisstudy wereto evaluate the utility of novel serum tumor marker, HE4 either alone or incombination with CA125 in diagnosis early stage of patient with ovarian carcinoma.Sera were obtained preoperatively from 68 women underwent surgery for a pelvicmass and 68 age –matched healthy women . All samples were analyzed for levels ofCA125 by ELISA and HE4by chemiliuminescence method.The studied tumor markers were significantly increased in malignant compared tobenign cases and healthy subjects, and in benign cases compared tohealthy subject.Inthis study HE4 had the highest sensitivity as a marker in detecting ovarian malignancyand early stage malignancy ,followed by CA125.The combination of HE4 and CA125 gave the highest sensitivity in detectingovarian carcinoma and early stage disease.As a distinct marker, HE4 had the highestsensitivity for detecting ovariancancer particularlyearly stage disease.AssociatedCA125 and HE4was a more precise predictor of ovarian malignancythan either alone.120

121ABSTRACTSThe 1 st International Congress on Gynecological OncologyVaginal Ultrasonographic Finding vs. Diasgnostic Dilation andCurettage (D&C) in Premonoposal Women Suffering fromAbnormal Uterine Bleeding in IranKarimi Zarchi M 1 , Javaheri A 2 , Dehghan A 3 ,Teimoori S 41: Assistant professor, Gynecology Oncology fellowship, Gynecology OncologyDepartment, Shahid Sadoughi University of Medical Science2:Obstetrics &Gynecology Assistant, Shahid Sadoughi University of MedicalScience, Yazd, Iran3, Medical Doctor, Shahid Sadoughi University of Medical Science, Yazd, Iran4. Student of Medicine, Medical Student Scientific Association, Islamic AzadUniversity, Yazd Branch,Introduction:Abnormal uterine Bleeding (AUB) is a common gynecologic problem resultingfrom menstrual bleeding (with or without ovulation) or other pathologic condition.Diagnostic procedures include transvaginal sonography (TVS) and endometrialbiopsy. The purpose of this study was to use TVS to measure endometrial thicknessand dilatation and curttage (D&G) as standard diagnostic technique.Material &Method:114 AUB cases referring to Shahid Sadoughi hospital, were enrolled this cross_sectional cohort study scheduled for D&C. before the curettage was performed; thethickness of endometrium was TVS. Sensitivity and specificity of this procedure wasmeasured too.Result:114 women with mean age of 42.3 years (22-56) were enrolled. Most commonfinding by biopsy were secretary endometrium (24.8%) and prolifrative endometrium(22.9%) Thickness of endometrium was found as a predictor of biopsy findings.Depth of uterus measured by hysterometer was 6-13 cm. found on biopsy weresecretary endometrium (24.85), proliferative endometrium (22.9), simple hyperplasia121

ABSTRACTSThe 1 st International Congress on Gynecological Oncology122(10.1%), shedding endometrium (7.3%), atrophic endometrium (6.45%), simple cystichyperplasia (5.55%), and inconsiderable (5.5%).In 63.2% of cases uterus size was normal and in 36.8% was larger than normal,sensitivity and specificity , positive predictive value and negative predictive value ofTVS was 88%, 35%, 88% and 70%respectively in comparison with pathology.Conclusion:D&G is the diagnostic method of choice. Also sensitivity and specificity of TVS88% and 35% respectively .the finding of this study presented TVS so useful forendometrial evaluation and pelvic organ before Hormone Replacement Therapy.Key words: Vaginal ultrasonographic, Dilation and curettage, Abnormal UterineBleeding122

123ABSTRACTSThe 1 st International Congress on Gynecological OncologyBenign Metastasizing Leiomyma Involving Pulmonaryand CutaneosMortazavizade MR 1 , Hekmati H 2 , Teimoori S 3 , Dargahi M 41. Assistant Professor of Oncology. Islamic Azad University Yazd Branch2. Assistant Professor, Department of Pathology, Shahid Sadoughi University ofMedical Sciences, Yazd, Iran3. Student of Medicine, Medical Students Scientific Association, Islamic AzadUniversity Branch Yazd.4. Patologist,Department of Pathology Shohadayekargar HospitalAbstract:Benign metastases leiomyoma (BML) is a rare disease that in the first described bySteiner in 1939 that this disease is presence of benign smooth muscle tumors in anorgan distant from the uterus and often occurring in women who have undergonehysterectomy for uterine leiomyoma that subsequently present pulmonary metastasesduring the pre-menopusal period in our knowledge in English published literature it isfirst one case benign metastases leiomyoma with involving pulmonary and cutaneousleosion. A 47 years –old was admitted because of severity cough and dyspnea inphysical activity for 6 month ,on physical examination ,the breathing sound weredecreased on the both sides of the chest ,computed tomography (CT)of the chestshowed bilateral multiple variable –size nodules in both of the lung pulmonarynodule was performed pathology examination that was positive for desmin andsmooth muscle actin for patient start treatment with megestrol and imaging showedthat decreasing size pulmonary nodules.Keywords: Benign Metastases leiomyoma, Pulmonary, Cutaneous123

ABSTRACTSThe 1 st International Congress on Gynecological Oncology124Efficacy of Colposcopy in Diagnosis and Treatmentof Cervical Lesions and a Scientific Experiencein Iran- A Systematic Review StudyDr Mojgan Karimi Zarchi 1 , Prof. Abbas Aflatoonian 2 , Prof Mohammad AliKarim Zadeh 3 , Soraya Teimoori 4 , Hamid Reza Soltani 51.Associate Professor, Obstetrics & Gynecology, Shahid Sadoughi University ofMedical Science, Yazd, Iran2.3.Department of Obstrics and Gynecology, Research and Clinical Center forInfertility, Shahid Sadoughi University of Medical Scinces, Yazd ,Iran4.5. : Membership of Medical Students Scientific Association, Islamic AzadUniversity Branch Yazd.Abstract:This article in the latest findings about the performance of colposcopy and otherdiagnostic techniques such as DNA testing or cytology of the HPV virus examineddata. Recent studies of colposcopy as a second line method in the diagnosis ofepithelial lesions of the cervix (CIN) has supported. Because the treatment of cervicallesions intraepithelial(CIN)] or destructive treatments excisionalneed to have generalanesthesia, recent studies those destructive and Destructive therapies that can be donewith local anesthesia is toexcisional methods (excisional) considered preferable,especially in certain cases has recommended that there are low-grade lesions (LSIL)and the desire to preserve fertility increased morbidity due to pregnancy. In a studywhich was done in Yazd in Iran from 2007 to 2009 for determining efficacy ofcolposcopy, The sensitivity and specificity of a repeat Pap smear for ASCUS were 15and 93%, respectively, while the respective values for diagnosing cervical cancer withcolposcopy were 80 and 80%. They also concluded that due to the low accuracy ofthe Pap smear and the need for an early diagnosis of cervical cancer, a cervical biopsyand colposcopy are recommended for the vulnerable patients also colposcopy andendocervical curettage alone are better diagnostic tools than a repeat Pap smear forunsatisfactory Pap smears.Key Words: Colposcopy, Cervical Cancer, Diagnosis, Screening124

125ABSTRACTSThe 1 st International Congress on Gynecological OncologyLife Experience with Hysterectomy Operationin Under-50-Year Women (Qualitative Study)Marjan KhodabandehShahid Sadoughi University of Medical Sciences, Yazd, IranIntroduction: after caesarean surgery, hysterectomy is the most prevalent operationamong women. Statistics show 45 percent of women above 65 years old havehysterectomy surgery .Hysterectomy has a significant importance not only as anoperation for removing an organ but also for removing fertility organ in womenspecially before menopause age which is thought to be accompanied by extensivepsychological effects in addition to physical changes.About the therapeutic effects ofthis operation on endometrial malignancies some researches have been done, but theaim of this study is to understand and interpret under-50-year women’s life afterhysterectomy with a naturalistic approach.Method: present research has been done in a quality manner usingphenomenological method. The research participants in a targeted sampling include 7under-50-year women who have been under hysterectomy operation in one of theYazd hospitals in November and December 2010. Data collecting method is b y semistructuredinterviews which have been recorded word by word, two interviews weredone in participants’ houses and other 5 interviews were done via phone as a result ofnon-availability of participants. Data was analyzed using colaizzi method and checkedby research team members.Results: Analyzing data showed 2 main themes and 9 subthemes in effects ofhysterectomy in under-50-year women’s life. Mains themes are: 1. Worries abouttheir marital relations and sustainability of their married life 2.Effects of operation ontheir mental health.Discussion and conclusion: By the current study, most important concerns ofwomen with hysterectomy surgery and its effects on their life have been determinedin the research. In addition to this research, various Qualitative and Quantitativeresearches are necessary to formulate a standard form for evaluating effects ofHysterectomy on these patients life and performing supportive programs in order todecrease the operation effects on their life.Key word: Hysterectomy, Women, Life experience, Qualitative research125

ABSTRACTSThe 1 st International Congress on Gynecological Oncology126Effect of Contraception on Cervical CancerMaryam Mohammady Mahdiabadzade*’ Narges Hoseiny’ Masomeh Naghshi’Nazila Naghshin’ Mohammad Bagher Khani’ Gyti PakdelShahid Sadoughi HospitalIntroduction: cervical cancer symptom is non-specific and is abnormal uterinebleeding, vaginal discharge and post coital bleeding.. Some time it is asymptomaticuntil end stage.Method: This study was done experimentally on 1140 women’s who visited inShahid Sadoughi gynecology clinic for any reason. We evaluated their pap smear.There is 95/3% normal Pap smear.The patients divided in two groups. The first were the women who used condom forcontraception and in the other group women used other contraception .In fact we studied the differences between these two groups according to theirPap smear .Result: The results showed that 1.9%of the patients had cervical cancer, accordingto their findings in Pap smear. In women who used condom for contraception thesewere not any abnormal finding that suggestive for cervical cancer.1.1% of the women who did not use any contraception had cervical cancer.ConclusionIn the women who used condom for contraception, cervical cancer is less than theothers are.Key words: Condom, Cervical Cancer, Pap smear126

127ABSTRACTSThe 1 st International Congress on Gynecological OncologyPap Smear Result in Departmentof Pathology Hospital Shahid Sadoughi in 2010Mojgan Karim Zarchi’ Maryam Mohammado Mahdyabadzade’ Mojgan Mossavi’Raziye Akhondy’ Akbarrezae’ Mohammad Bagher KhaniShahid Sadoughi Hospital In YazdIntroduction: cervical cytology (annually beginning no later than age 21 years;every 2-3 years after three consecutive negative test result if age 30 years or olderwith no history of cervical intraepithelial neoplasia 2 or 3, immunosuppression,human immunodeficiency visors (HIV) infection, or diethylstilbestrol exposure inutero.Method: This descriptive cross sectional study was done on 1143 women’s Papsmear (18-87 years old) in Shahid Sadoughi hospital pathology ward.These data analysed by SPSS softwareResult: This study signification relation that between age and genital cancer withp = 0/002 and also Genital cancer and metaplasia with P = 0/005 and There is 22cervical cancer ’11 endometrial cancer and 10 ovarian cancer in this study.Also signification relation between age and metaplasia with P = 0/00.Almostmetaplasia had in woman’s above 42 years old and finally there isn’t associationbetween cancer and metaplasia .Conclusion: The goal of Pap smear is early diagnosis of dysplastic lesion andinvasive cervical cancer .therefor Pap smear is needed for all of the women.Key word: Cervical cancer,Pap smear, Metaplasia127

ABSTRACTSThe 1 st International Congress on Gynecological Oncology128Advanced Cervical Cancer in Pregnancy:Case Report and the Review of LiteraturesFaridmoghtahedi M 1 ,karimizarchi M 2 ,Bhtash N 3 , ,Ghaemmaghami F 3 ,ModaresGilani N 3 ,Mosavi A 3 ,Teimoori S 31. Obstetrics & Gynecology Assistant ,Shahid Sadoughi University of MedicalScience, Yazd, Iran2. Assistant professor, Department of Gynecology, Shahid Sadooghi University ofMedical Sciences, Yazd, Iran.3. Professor, Obstetrics and Gynecology, Gynecological Oncologist ,TehranUniversity of Medical Science4. Membership of Medical Students Scientific Association, Islamic Azad University,Yazd Branch.Introduction: Cervical cancer during the pregnancy is a rare and nonspecificpregnancy complication and it is consist of 1 per 1200 to 10000 pregnancies .there arereported of delaying treatment to allow fetal maturity in cases early pregnancy butdata researched showed maternal risk of this approach the patient are lacking but insecond or third trimester in early stage cervical cancer ,suggest that treatment can beafter delayed .in the literature data on treatment of patient beyond stage IB aremainly in the form of case reports. In this article we presented 3 patients withadvanced cervical cancer in pregnancy that referred to genecology clinic ShahidSaduoghi hospital of Yazd.Case1. A 34-year-old woman, gravida 1 para 0, at 16 weeks' gestation, wasdiagnosed with FIGO stage IB2 squamous cervical cancer. After refusing to terminatepregnancy, she was treated with neoadjuvant chemotherapy (cisplatin). A cesareansection with radical surgery was performed at 32 weeks and a healthy baby delivered.Four weeks later the patient started chemo radiation therapy. After 3 years patient isquality healthy.Case2. A 23 -year-old woman, gravida 1 para0,at24 weeks' gestationwas diagnosedwith FIGO stage IIB squamous cervical cancer. fetus was abortedin36 week and128

129ABSTRACTSThe 1 st International Congress on Gynecological Oncologystarted chemotropy but before completing treatment ,she had severe coughand ChestX-ray shoed lung involvement and she with respiratory distress dietCase3. A 32 -year-old woman, gravida 1 para0, at 18 weeks' gestationwasdiagnosed was stage IB squamous cervical cancershe was treated with neoadjuvantchemotherapy (cisplatin) and a healthy baby delivered but 6 months later she hadrecurrent sing .the patient anther go radical hysterectomy.Conclusion: Colposcopy directed biopsy is a safe and reliable method forevaluating pregnant patient with abnormal cervical cytology and abnormal vaginalbleeding and, it mainly correlating with pathological finding and fetal gestation andstage of disease must be first consideration in pregnant patient with cervical cancer.Key words: Cervical cancer, Pregnancy, Treatment129

ABSTRACTSThe 1 st International Congress on Gynecological Oncology130Empowering Oncology Patients by Internet: A Novel Tool forSelf Care EducationHossein NazmiyeNursing and Midwifery in Gynecological Oncology, shahrenaze@yahoo.comBackground: With the increasing number of cancer patients and growing numberof survivors over the last decade and shifting of treatment from inpatient settings tooutpatient or home-based settings has raised high demands on patient’s self-carecapabilities. Because patients and families have taken increasing responsibility for thephysical and emotional care at home. These need to informing and involving in theirown care. Recently, information and education provided through Internet has beenactively used to provide emotional and informational support for the patients and theirfamilies. Through education via Internet, patients gain significant medical knowledge,self-care and bio-clinical goals can change positively, and the quality of lifeimproved. In the United States indicated that 42% of breast cancer patients use theInternet as a source of information. Furthermore, according to data & communicationorganization, the number of internet users in Iran are about 33,200,000, accountingfor 43% of the population and 13 priority in the world ranking. Thus some patientsmay be give information about cancer and care via internet.Aim and Methods: The aims of this descriptive study was to evaluating andcritiquing of information give out via internet for self education in oncology patientsespecially gynecological oncology. Source selection was limited to those availableonline through Google database in Persian that is popular and understandable for themost Iranian people. Data collected in 3 times, separately to reliability.Results & Discussion: The result showed that most (above 90%) data was directedat primary prevention. Above half data in web were on the subject of cancer causes,signs &symptoms, diagnostic tests and treatment. A minority of websites hadcounseling regard treatment method or complications, and their contents plannedwithout considering self care education. Two sites consisted “the researches,education and cancer prevention” and “ the Cancer general education” were sites that130

131ABSTRACTSThe 1 st International Congress on Gynecological Oncologyhad educational issues about gynecological oncology. The content in one Persianjournal in title “ cancer knowable” was understandable for the public oncologicpatients. Whereas in English websites were many information for oncology patientswith multiple problems.In conclusion, we strongly believe that web-based educational program would bevery effective and efficient in supporting these oncologic patients for providing highquality of life by promoting comfort and independence in care, if that wereconsidered Perceived informational needs of gynecological oncology patientsreceiving one of the therapeutic methods, language and theirs’ culture .Furthermore,at minimum ,these findings suggest a direction for further study and more attentionfor virtual education importance in oncology patients.Keywords: Cancer, care ,self care, Gynecological oncology ,knowable131

ABSTRACTSThe 1 st International Congress on Gynecological Oncology132Dose Tamoxifen Have Effectson the Genital Tract in Patients with Breast CancerSadeghi N , Emami T, Karimizarchi M, Soltani HR,INTRODACTION: Tamoxifen is a selective estrogen receptor modulator (SERM)that is widely used in the treatment of patients with breast cancer. Invasive breastcancer is the most common malignancy in women. Due to the declining mortality ratethat is partly attributable to the use of screening mammography and effective adjuvanttherapy, more women survive their breast cancers. Whereas the effect of thiscompound on the female genital tract is mostly related to its agonistic properties. Inother parts of the genital tract, tamoxifen increases the risk of some benign conditionsand may cause difficulties in the interpretation of cervical smears.The aim of thisstudy was to evaluate the effects of tamoxifen on the genital tract with particularattention to the uterus and cervix.METHODS: We investigated the relationship between tamoxifen and cervical oruterine cancer in Iran, reviewing all the studies performed in Iran. In addition, theavailable data on Medline from 1980 until 2009 were reviewed.RESULTS: A total of 182 articles showed associations with gynecologicmalignancies. Although as many as 121 referred to links between the drug andendometrial abnormalities (polyps or cancers), 55 articles studied the relationshipwith changes of pap smears, four of which indicated isolated cervical metastasisfollowed tamoxifen use in patients with breast cancer.CONCLUSION: An association between the administration of tamoxifen inpatients with breast cancer and the development of endometrial cancer has beensuggested in a number of clinical studies. Despite numerous studies no effectivemethods of tamoxifen-user surveillance have been developed and currently no activescreening for endometrial cancer, apart from yearly gynaecological examination, isrecommended in these patients. it is necessary, therefore, to have an annual pelvicexam, pap smear and early endometrial with endocervical curettage for tamoxifen132

133ABSTRACTSThe 1 st International Congress on Gynecological Oncologyusers following a breast cancer in those with abnormal uterine bleeding or persistentvaginal discharge. Patients treated with tamoxifen exhibited a partial estrogenic effectin their smears regardless of whether they developed endometrial cancer. However,the presence of endometrial cells in the smears indicated a higher risk of endometrialadenocarcinoma.Key words: Tamoxifen, Genital Tract, Breast Cancer,133

ABSTRACTSThe 1 st International Congress on Gynecological Oncology134Women's Knowledge about the Etiologyof Cervix Cancer in BoroujerdSedigheh Sameti 1 , Mitra Goudarzi 2 , Fariba Falsafi 3Faculty Member of Islamic Azad University Borujerd Branch, Nursing DepartmentIntroduction: Cervix cancer is the second popular cancer in women between 45-50years old. Its prevalence is 500,000 each year and it caused 30,000 death every year,most of them are in developing country. The etiology of cervix cancer and premalignantlesions in cervix is human papilloma virus that transmit via sexualrelationship. It seems that Diet is a factor in cervix cancer, especially taking vitaminA,C and folic acid can prevent the risk of cervix cancer. Low socio-economic leveland low attention to health is important, too. With smoking and obesity increase theincidence of cervix cancer. Cervix cancer prognosis is often worse and most ofpatients are diagnosed with metastatic cases.Goal: This study aimed to assess knowledge about the etiology of cervix cancer inwomen.Materials and Methods: In this cross - sectional study, 404 women referred tohealth centers of Boroujerd were selected with simple random sampling method andwere examined. Data were analyzed with statistical SPSS software.Results: Women were in 16-40 years old. Respectively 91.2% and 6.8% knewcervix cancer from low attention to health and infection with human papilloma virus.49.9% of them being uncertain on a diet without fresh fruits and vegetables and theirrole in cervix cancer, and 40.9% completely opposed. Knowledge estimated showedthat 5.2% of women had poor knowledge, 51% moderate and 43.8% had goodknowledge about the etiology of gastric cancer. A mean score of awareness amongwomen had not significant differences with residence, educational level and agegroups.Conclusion: According to research findings and this matter that there is not anycure for cancers such as cervix cancer, is required to achieve the high level ofknowledge and appropriate training programs about the etiology of cervix cancer inwomen.Keywords: Awareness, Women, Etiology, Cervix Cancer134

135ABSTRACTSThe 1 st International Congress on Gynecological OncologyPrevalence of Cervical Cytological Abnormalities in YazdLeila SekhavatDepartment of Obstetrics and Gynecology, Shahid Sadoughi University of MedicalScience, Yazd, IranObjective: Screening for cancer of the cervix is a most important problems inwomen health care in the world. To provide baseline data for future efforts to improvescreening, we conducted a retrospective analysis of cervical smears to evaluate theprevalence of cervical cytological abnormalities in patient records obtained fromhealthcare centers of Yazd in Iran.Methods: We collected data on cervical smear cytology of cervical smears takenfrom 2008to 2010. Demographic characteristics and data on cervical cytologicalabnormalities of 824 adolescents who had participated this study were evaluated .We assessed risk factors for dysplasia, including age, age at first marriage, andnumber of pregnancies.Results: overall, the prevalence of cervical cytological abnormalities was 1.1%; theprevalence of ASCUS, ASC-H was 79.1%, 11.4%, respectively. of remained cervicalsmears 404 (49.1%) showed non-specific inflammation, 300(48.6%) were reported asnormal, and 11 (1.3%) samples were inadequate.Conclusion: The results of this study may serve as a baseline for futurecomparisons. A larger community-based study may establish the exact prevalence ofmalignant and premalignant lesions so as to plan for future screening.135

ABSTRACTSThe 1 st International Congress on Gynecological Oncology136Elevated Serum Homocysteine Levelsand Increased Risk of Cervical Cancer in WomenRobab SheikhpourDepartment of Biology, Science and Research Branch, Islamic Azad University,Tehran, IranIntroduction: Homocysteine is a sulfur amino acid, an intermediate metabolite ofmethionine metabolism and is metabolized in methionine or cysteine.Hyperhomocysteinemia, a condition that recent epidemiological studies have shownto be associated with increased risk of vascular disease, arises from disruptedhomocysteine metabolism. Severe hyperhomocysteinemia is due to rare geneticdefects resulting in deficiencies in cystathionine beta synthase,methylenetetrahydrofolate reductase. Elevated homocysteine plasma levels have beenassociated with chromosome damage even in the absence of folate or vitamin B12deficiencies, and this finding cannot be explained by a deficient methylation of uracilto thymine. Homocysteine can damage DNA by via the generation of reactive oxygenspecies and contribute in cancer. Folate is also fundamental in normal DNA synthesisand repair. In fact, folate deficiency is often associated with hyperhomocysteinemiaand folate intake can reduce the homocysteine level.Conclusion: High levels of homocysteine and low levels of folate were seen incervical Cancer in women.Keyword: Cervical cancer, Hyper homocysteine, DNA136

137ABSTRACTSThe 1 st International Congress on Gynecological OncologyScreening of Gynecological Cancer in Menopausal WomenSiyamak Sabours.sabour@sbmu.ac.irIntroduction:Worldwide the rise of life expectancy has created many challenges in health statusof menopausal women. The longer life can increase chance of malignant diseases andcancer especially gynecologic cancers in menopausal women. Control – prevention,early detection and diagnosis are essential components of cancer control plansbecause many of gynecologic cancers can be prevented by appropriate screening tests.This study was conducted to determine screening tests of gynecological cancer inmenopausal women of Yazd.Materials and Methods:In this descriptive cross-sectional study two hundreds menopausal women aged58.21+_7.73 referring to health centers of Shahid Sadoughi university of Yazd wereselected by conventional sampling. Inclusion criteria were at least three years lengthof menopause, without any history of cancer and cancer treatment. None of thewomen were nonsmoking. Data were collected using a self-administratedquestionnaire on healthy behaviors in menopause stage.Results:The mean of women age was 58.21+_7.73 and with a mean of 10.09+_8.40duration of menopause. The familial history of cancer was addressed by 28% ofwomen. Six percents of women used HRT. 62% of women mentioned they checktheir blood pressure regularly (most of them declared they have hypertension).Determining of Body Mass Index (BMI) was addressed by 35.5% of menopausalwomen. Only 15.5% of women pertained to perform regular routinely clinical breastexamination. Regular and routinely mammography was addressed by only 10.5% ofwomen. Performing of Pap Smear test was mentioned by 12% of them. The studyresults showed 24.5% of women had endometrial biopsy. Regular pelvic examinationwas mentioned by only 11% of women. Hysterectomy was reported in 18.5% ofwomen. Head and neck, heart and lung and abdominal exam were addressedrespectively in 8%, 20.5% and 8.5% of them.137

ABSTRACTSThe 1 st International Congress on Gynecological Oncology138Conclusion:The study results showed referring for screening tests was very low in menopausalwomen. Since gender plays a significant role in exposure to risks of gynecologiccancers and menopausal women had a greater risk because their health status.Monitoring trends in cancer risk factors in this population is important. Gynecologiccancers prevention should be planned and implemented in the context of other chronicdisease prevention programmes, and overall cancer control planning by applying earlydetection and diagnosis via appropriate screening tests.Keywords: Screening tests, menopause women, gynecologic cancers prevention138

139ABSTRACTSThe 1 st International Congress on Gynecological OncologyA Report about an Extremely Rare Case of Struma SalpingiAssociated with Struma Ovarii and StremosisMoghimi M (MD) 1 , Soltani HR (MD) 21. Department of Pathology, Shahid Sadoughi University of Medical Sciences ofYazd2. Student of Medicine, Scientific Society of Medicine of Islamic Azad University ofYazdIntroduction: Struma ovarii is rare, with only 150 reported cases in the medicalliterature defined by the presence of an ovarian tumor containing thyroid tissue as thepredominant cell type. Occurrence of struma salpingi have been taken place with alower prevalence than struma ovarii as just two similar tumor have been reported upto now.Case report: A 63 year old woman has referred since 5 years ago with abdominalswelling in pre-umbilical and supra pubic region associated with losing weight andfrequent constipation. After the hospitalization the patient underwent the laparatomy.In pathology report the masses was struma ovarii and mature cystic teratomaassociated with struma salpingi and peritoneal steremosis.Conclusion: Special demonstration accompanied struma salpingi in this case arestruma ovarii and multiple vesicular vegetasion in choledosac , Peritoneum andbladder that distinguished it from two previous similar cases so current case is thethird case of struma salpingi, second case of struma salpingi associated with strumaovarii and the first case of struma salpingi accompanied with struma ovarii andsteremosis that no similar exactly case have been reported up to now.Keywords: Struma salpingi, Struma ovarii, Steremosis.139

ABSTRACTSThe 1 st International Congress on Gynecological Oncology140Evaluation of Common Risk Factorsin Patients with Endometrial HyperplasiaMoghimi M (MD) 1 , Soltani H.R (MD) 2 , Partoei N (MD) 3 , Soltani E (MD) 41. Department of Pathology, Shahid Sadoughi University of Medical Sciences andHealth Services, Yazd.2. Student of Medicine, Membership of Medical Students Scientific Association,Islamic Azad University of Yazd.3. General Physician, Shahid Sadoughi University of Medical Sciences and HealthServices, Yazd4. General Physician, Shahid Sadoughi University of Medical Sciences and HealthServices, YazdAbstractIntroduction: One of the most common abnormalities in female genital system,especially in premenopausal period, is abnormal uterine bleeding caused byendometrial hyperplasia. Prevalence of endometrial hyperplasia is 5-20% with different riskfactors such as hypertension, diabetes mellitus (DM), multiparity, nulliparity, advancedage, and using estrogen consumption. This study tries to determine risk factors inendometrial hyperplasia.Material and methods: This case - control study has been done on 200 patients withendometrial hyperplasia who refer to Shahid Sadoughi and Mother Hospital withsimple sampling and compared to 200 controls with similar conditions. Questionnaireswere filled according to pathological records of 200 patients, which include age,parity, history of hypertension and DM. Finally data were analyzed by SPSS ver. 14 andANOVA and Chi-square statistical test.Results: The average age of cases was 47.88. Frequency distribution ofhypertension, DM nulliparity was significantly higher in cases more than controls.Cases had more pregnancy than control.Conclusion: Determining the endometrial hyperplasia risk factors that can be themajor etiological factor of endometrial carcinoma has especial importance and in other140

141ABSTRACTSThe 1 st International Congress on Gynecological Oncologyhand helps the medical groups for having superb diagnosing and presenting bettermedical services to high risk groups and significantly reduce side effects andunnecessary medical costs.Key words: Hyperplasia, Endometrial, Nulliparity141

ABSTRACTSThe 1 st International Congress on Gynecological Oncology142Giant Fibroadenoma of the Breastin a Pregnant Woman – A Case ReportMansour Moghimi 1 , Hamid Reza Soltani.G 2 , Abbas Modir 3 , Seyed MohammadSadegh Ahmadi Rashti 4 , Mehran Modir 51. Assistant professor of pathology, Shahid sadoughi university of medical sciences,Yazd, Iran2. General physician, scientific society of medicine, Islamic Azad university branchYazd3. Asistant professor of general surgery, Shahid sadoughi university of medicalsciences, Yazd, Iran4. Student of medicine , scientific society of medicine, Islamic Azad universitybranch Yazd5. Resident of anesthesiology, scientific society of medicine, Islamic Azad universitybranch YazdAbstractFibroadenoma (FA) is the most common benign mass in the females who are aged20-50 years. A -15-year old woman who was at 12 weeks of pregnancy was referred.She was suffering from a mass in right breast from one year ago. physicalexamination and imaging confirmed a large breast mass. Fine needle aspirationbiopsy (FNAB) showed a Fibroadenoma, during surgery mass enucleating and breastreconstruction was performed. pathologic examination showed a giant Fibroadenoma(GF). Patient had no complications after 1 month follow up. According to ourexperience and accessible literature, exact physical examination with imagingconfirmation is suggested in young patients referring with unilateral huge breastmasses for maintaining more reliable clinical outputs.142

143ABSTRACTSThe 1 st International Congress on Gynecological OncologyRelation between Cervical Abnormalityand Contraception Methods in Pap Smear1- A Tabatabaei M.D Gynecologist Assistant Professor of Shahid SadoughiUniversity of Medical Sciences2- A Hosseinzadeh Firozabadi M.DIntroduction:Cervical cancer is one of common cancers among women that probably has manyeffective factors in appearance of that. However, early diagnosis and appropriatemanagement especially in early stage of disease plays an important role in prognosisand life span of patient so the main aim of this study was to study of the relationbetween contraceptive method and cervical abnormality methods and materials.Method: In this study 500 cases of Pap smear selected by easy sampling method inmy office and Shahid Sadughi Hospital.Results: About 495 of cases had normal smears and inflammation, 3% had cervicaldysplasia, 1% of cases had CIN3 and 1 case had invasive carcinoma. Contraceptivemethods were OCP 21%, IUD15%, condom 19%, tubal ligation 35%, and 10% usedDMPA. The most frequency of dysplasia (2) used OCP in barrier method no dysplasiawere seen. Invasive carcinoma and CIN III were in tubal ligation women.Conclusion: Barrier method had the protective effect on cervical dysplasia wasshown in ocp user.Keyword: Cervix – Dysplasia - Contraceptive – Pap smear143

ABSTRACTSThe 1 st International Congress on Gynecological Oncology144Inguinal Lymph Node Metastasis of Endometrial Carcinoma asFirst Presentation (Rare Case Report)Shokouh Taghipour-Zahir* Saeed Kargar** Kiyanoosh Sedaghat****Associate Professor of Surgical and Clinical Pathology, Shahid SadoughiUniversity of Medical Sciences, Yazd, Iran**Assistant Professor of Surgery, Fellowship of Laparoscopy, Shahid SadoughiUniversity of Medical Sciences, Yazd, Iran*** Medical StudentIntroductionEndometrial carcinoma mostly occurs in postmenopausal women with abnormaluterine bleeding and vaginal discharge.It is unusual in young adult especially in lowerthan 40 years old. The risk factors are obesity, diabetes mellitus, hypertension ,andunopposed estrogen.Lymph node metastasis as the first presenting sign is rare inendometrial carcinoma.Case reportWe present 31 year- old woman with past history of nulliparity ,and two abortions.she came to our surgical ward with enlarged inguinal lymph node without history ofvaginal bleeding and discharge, diabetics mellitus , hypertension or familialcarcinoma. So metastatic adenocarcinoma with unknown origin was reported andrecommended that the patient follow up for especially genital tract malignancies, butgenital workup didn't find any abnormality.. Patient didn't come for otherinvestigation work up and after six months again had an enlarged another inguinallymph node without any clinical signs and symptoms in any other organs. Ovaries andcervix were free of tumor and tumor only confined to uterine. The patient with uterineadenocarcinoma stage IVb given chemotherapy and radiotherapy and in this time thatwe report the case, she is in good general condition .ConclusionEndometrial adenocarcinoma mostly seen in pre and postmenopausal women and inthe low stage pattern.Distant metastasis especially inguinal lymph node involvement144

145ABSTRACTSThe 1 st International Congress on Gynecological Oncologyis the uncommon first presentation of endometrial carcinoma and because one of thepredisposing factors for endometrial carcinoma is un opposed exposure to estrogensor infertility so in the young women with these histories and metastatic carcinoma inthe inguinal lymph nodes with unknown origin we must consider the endometrialcarcinoma in the first line differential diagnosis if she had no any gynecological signsand symptoms and diagnostic curettage must be done without any delay.145

ABSTRACTSThe 1 st International Congress on Gynecological Oncology146Long-Term Study of Bilateral Tubal Ligation Effect on Ovaryand Uterus i n Rat (Histological Study)Majid Tavafi 1 , Ahmad Tamjidipour 21-Associated professor of Histology, Department of Anatomy, Lorestan Universityof Medical Sciences, Faculty of Medicine, Khoram Abad, Iran. E-mailmtavafi@yahoo.com2- Instructure of Anatomy. Department of Anatomy, Department of Anatomy,Lorestan University of Medical Sciences, Faculty of Medicine, Khoram Abad, Iran.I n tr o d u c ti o n : B ecau s e o f b lo o d and h o rm o n al relatio n s b etwe en o v ary an d uteru s inrats th e effect o f b ilateral tu b al lig atio n (T L ) were s tud ied o n intern al g en ital o rg an s.Materials and methods: 60 female rats (Sprague-Dawley) two month ages weredivided in to control and TL groups (30 per group).The uterine tubes in animals of TLgroup were ligated bilaterally. Sampling was done after 3, 6 and 9 months after TL.Each 3 months, 10 control and 10 TL animals were selected randomly and afteranesthesia, internal genital organs sampled and fixed in formal saline solution.Paraffin sections were prepared from uterus and ovaries and stained by H&E andtrichrom gomori methods. Endometrial changes were studied qualitatively. Thenumbers of follicle types and corpus luteum were counted morphologically and datawere analyzed by Mann –withney test with SPSS 13 software at p

147ABSTRACTSThe 1 st International Congress on Gynecological OncologyManagement of Borderline Ovarian TumorShiva VahidiFellowship of Gynecology Oncology, Tehran UniversityBackground: Borderline ovarian tumors (BOTs) account for 10 to 20% of ovarianepithelial tumors and are characterized by earlier stage and younger age at diagnosis,more indolent behavior, longer survival, and later recurrence than seen in cases ofinvasive ovarian cancer.Result: Surgical removal of BOT is the cornerstone in the management of BOTs,but a lot of debate exists on the extent of the staging procedure and the surgicalapproach. Guidelines for surgical treatment of BOT are similar to ovarian cancer inwomen who do not wish any other pregnancy. Conservative management should beconsidered for young patients who wish to preserve fertility. Recently the applicationof fertility-sparing surgery has expanded to include patients with advanced-stagedisease by non-invasive implants. In the studies comparing fertility-sparing andradical surgery the recurrence rate was somewhat higher in the latter group.Nevertheless, this high rate has no impact on survival. The pattern of recurrence,however, differed between these two groups. Fertility-sparing surgery was associatedwith lower rates of abdominal and pelvic recurrences. Most recurrent lesions areborderline tumors and located in the remaining ovary, hence most patients withrecurrent disease can147

ABSTRACTSThe 1 st International Congress on Gynecological Oncology148Relation of Postmenopausal Ovarian Cystswith Transvaginal Sonography and their PathologyDr. Fatemeh Zare MDDepartment of Ob & Gyn, Shahid Sadughi Medical University, Yazd, IranE mail: zaretez@gmail.com09131512386AbstractObjective: relation of Postmenopausal Ovarian Cysts pathology with TransvaginalSonographyMaterials and Methods: We studied on 57 post menopausal women with ovariancyst .Transvaginal sonography (TVS) and serum CA-125 measurement wereperformed in all patients. Each ovarian cyst was classified based on two-dimensionalsonographic criteria such as maximum cyst diameter, echogenicity, uni- ormultilocular appearence, structure of the cyst wall and solid areas. All of the tissuesremoved were pathologically examined, and sonographic findings were comparedwith the histopathologic diagnosis.Results: In histopathological examination of 57 cysts; 45 (78.1%) non neoplasticcysts were found among which simple cysts being the most common (53.5%). Benignneoplastic cysts were found in 18.4% (11/57) among which serous cytadenomas beingthe most common (8.8%). 2 (3.5%) patients were found to have ovarian cancer. Whilethe frequency of malignancy in patients with complex ovarian cysts (n=13)(unilocular echogenicity) was 11.3%, anyone of the patients with simple cysts (n=30)(anechogenic, smooth and unilocular) were not found to have malignant lesion.Conclusion: TVS is useful diagnostic tools for predicting the nature ofpostmenopausal ovarian cysts. The risk of malignancy in simple unilocular cysts withnormal serum CA-125 levels is extremely low. Conservative management of thesecysts is alternative to surgical removal.Keywords: Postmenopause, Ovarian Cysts, Ultrasonography148

149ABSTRACTSThe 1 st International Congress on Gynecological OncologyGynecologic Cancer Prevention byHealthy Behaviors in Menopausal WomenAlieh shaikhalishahy,Tahmineh Farajkhoda, Fatemeh Zarezadeh, FaribaFrotan, Farideh Poorabedini, Mahshid Bokaei, Behnaz Enjezab, Mahnaz Emami,Nazila Naghshin, Susan MahabadiMidwifery student of Shahid Sadoughi university of YazdIntroduction:Health status of menopausal women is a global concern. Menopausal women needintensive care and more attention. Higher incidence and prevalence rate ofgynecologic cancer is one of the most important factors in their health status. The roleof healthy behaviors and life style has been well documented in cancer prevention butmost of menopausal women have not appropriate health behaviors. This study wasconducted to determine healthy behaviors in gynecologic cancer prevention inmenopausal women of Yazd.Materials and Methods:In this descriptive cross-sectional study two hundreds menopausal women aged58.21+_7.73 referring to health centers of Shahid Sadoughi university of Yazd wereselected by conventional sampling. Inclusion criteria were at least three years lengthof menopause, without any history of cancer and cancer treatment. Data was collectedusing a self-administration questionnaire on healthy behaviors in menopause stage.Results:The mean of women age was 58.21+_7.73 and with a mean of 10.09+_8.40duration of menopause. The familial history of cancer was addressed by 28% ofwomen. Six percents of women used HRT. Only eight percents of women pertainedusing fetoestrogen in order to decreasing menopausal symptoms. The study resultsshowed only 42% of women had an adequate, healthy diet and healthy eatingbehaviors. Regular physical exercises were mentioned by 46% of women. Regularexposure to sunlight was addressed by 28% of women. Supplementary therapy was149

ABSTRACTSThe 1 st International Congress on Gynecological Oncology150declared by 48% of women. Vaccination was mentioned by 21% of women. None ofthe women were smoking.Conclusion:The study results confirmed healthy behaviors in menopause women were low andnot desirable. Less than of 50% of menopause women had healthy behaviors. Healthybehaviors in menopause women not only improve their quality-of-life and promotetheir health status but also prevent incidence of cancers especially gynecologiccancers. These behaviors can decrease burden of chronic diseases, costs of diagnosistests and treatment and disability of menopausal women. Awareness and Appropriatetraining to menopausal women are two essential elements in cancer prevention.K e y w o rd s : H ealth y B eh av io rs, M en o p au s e W o m en , Gy n e co lo g ic C an c er Prev en tio n .150

151ABSTRACTSThe 1 st International Congress on Gynecological OncologyLaboratory Screening Testsof Gynecological Cancer in Menopausal WomenFatemeh Zarezadeh, Tahmineh Farajkhoda, Alie sheikhalishahy, Fariba Frotan,Farideh Poorabedini, Mahshid Bokaei, Behnaz Enjezab, Mahnaz Emami, NazilaNaghshin, Susan Mahabadi.Midwifery student of Shahid Sadoughi university of YazdIntroduction:Women are one of the most important parts of the family and society, andcommunity health is dependent on provision of the needs of this group. One third ofwomen life spends in menopausal stage. Incidence of Cancers, especiallygynecologic cancers are greater in this stage of women life. Menopausal women needspecial health caring. Diagnostic laboratory tests are one of the most important factorsfor gynecologic cancers prevention and early detection of them. This study wasdesigned to determine laboratory screening tests of gynecological cancer inmenopausal women of Yazd.Materials and Methods:In this descriptive cross-sectional study two hundreds menopausal women aged58.21+_7.73 referring to health centers of Shahid Sadoughi university of Yazd wereselected by conventional sampling. Inclusion criteria were at least three years lengthof menopause, without any history of cancer and cancer treatment. None of thewomen were smoking. Data were collected using a self-administrated questionnaireon healthy behaviors in menopause stage.Results:The mean of women age was 58.21+_7.73 and with a mean of 10.09+_8.40duration of menopause. The familial history of cancer was addressed by 28% ofwomen. Six percents of women used HT. 54% of women mentioned they check theirCBC regularly. Determining FBS was addressed by 63.5% of menopausal women. 64% of women pertained they check their serum lipoprotein. Performing of ThyroidFunctional Test and Liver Functional Test were addressed by 41% of women. Urine151

ABSTRACTSThe 1 st International Congress on Gynecological Oncology152Analysis was mentioned by 55.5% of them. The study results showed 3.5% of womenhad performed Guaiac test. Bone density assessment was mentioned by only 8% ofwomen.Conclusion:The study results confirmed performing laboratory screening tests was low inmenopausal women. Laboratory screening tests, in this critical stage of women’s life,are valuable for diagnostic, early detection and follow up of gynecologic cancers.Keywords: laboratory screening tests, menopause women, gynecologic cancerprevention.152