@article {10812, title = {Management of endometrial, ovarian and cervical cancer in the elderly: current approach to a challenging condition.}, journal = {Arch Gynecol Obstet}, volume = {299}, year = {2019}, month = {2019 Feb}, pages = {299-315}, abstract = {

PURPOSE: Gynaecological cancer management in older people represents a current challenge. Therefore, in the present paper, we aimed to gather all the evidence reported in the literature concerning gynecological cancers in the elderly, illustrating the state of art and the future perspectives.

METHODS: We searched MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials, IBECS, BIOSIS, Web of Science, SCOPUS and Grey literature (Google Scholar; British Library) from January 1952 to May 2017, using the terms "ovarian cancer", "endometrial cancer", "cervical cancer", "gynecological cancers" combined with {\textquoteright}elderly{\textquoteright}, {\textquoteright}cancer{\textquoteright}, {\textquoteright}clinical trial{\textquoteright} and {\textquoteright}geriatric assessment{\textquoteright}.

RESULTS: The search identified 81 citations, of which 65 were potentially relevant after initial evaluation and met the criteria for inclusion and were analyzed. We divided all included studies into three different issue: "Endometrial cancer", "Ovarian cancer" and "Cervical cancer".

CONCLUSIONS: The present literature review shows that, in spite of the higher burden of comorbidities, elderly patients can also benefit from standard treatment to manage their gynecological cancers. It is important to overcome the common habit of undertreating the elderly patients because they are more fragile and with a lower life expectancy than their younger counterpart. Further trials with elderly women are warranted.

}, issn = {1432-0711}, doi = {10.1007/s00404-018-5006-z}, author = {Vitale, Salvatore Giovanni and Capriglione, Stella and Zito, Gabriella and Lopez, Salvatore and Gulino, Ferdinando Antonio and Di Guardo, Federica and Vitagliano, Amerigo and Noventa, Marco and La Rosa, Valentina Lucia and Sapia, Fabrizio and Valenti, Gaetano and Rapisarda, Agnese Maria Chiara and Peterlunger, Isabel and Rossetti, Diego and Lagan{\`a}, Antonio Simone} } @article {3628, title = {Medical treatments for endometriosis-associated pelvic pain.}, journal = {Biomed Res Int}, volume = {2014}, year = {2014}, month = {2014}, pages = {191967}, abstract = {

The main sequelae of endometriosis are represented by infertility and chronic pelvic pain. Chronic pelvic pain causes disability and distress with a very high economic impact. In the last decades, an impressive amount of pharmacological agents have been tested for the treatment of endometriosis-associated pelvic pain. However, only a few of these have been introduced into clinical practice. Following the results of the controlled studies available, to date, the first-line treatment for endometriosis associated pain is still represented by oral contraceptives used continuously. Progestins represent an acceptable alternative. In women with rectovaginal lesions or colorectal endometriosis, norethisterone acetate at low dosage should be preferred. GnRH analogues may be used as second-line treatment, but significant side effects should be taken into account. Nonsteroidal anti-inflammatory drugs are widely used, but there is inconclusive evidence for their efficacy in relieving endometriosis-associated pelvic pain. Other agents such as GnRH antagonist, aromatase inhibitors, immunomodulators, selective progesterone receptor modulators, and histone deacetylase inhibitors seem to be very promising, but there is not enough evidence to support their introduction into routine clinical practice. Some other agents, such as peroxisome proliferator activated receptors-γ ligands, antiangiogenic agents, and melatonin have been proven to be efficacious in animal studies, but they have not yet been tested in clinical studies.

}, keywords = {Endometriosis, Female, Gonadotropin-Releasing Hormone, Histone Deacetylase Inhibitors, Hormone Antagonists, Humans, Pain Management, Pelvic Pain, Progestins}, issn = {2314-6141}, doi = {10.1155/2014/191967}, author = {Zito, Gabriella and Luppi, Stefania and Giolo, Elena and Martinelli, Monica and Venturin, Irene and Di Lorenzo, Giovanni and Ricci, Giuseppe} } @article {1835, title = {Management of the adnexal mass.}, journal = {Obstet Gynecol}, volume = {118}, year = {2011}, month = {2011 Oct}, pages = {956; author reply 956-7}, keywords = {Female, Humans, Ovarian Neoplasms}, issn = {1873-233X}, doi = {10.1097/AOG.0b013e318230dde3}, author = {Ricci, Giuseppe and Zito, Gabriella and Fischer-Tamaro, Leo} }