Berek & Hacker’s Gynecologic Oncology Sixth Edition Jonathan S. Berek, MD, MMS Laurie Kraus Lacob Professor Director, Stanford Women’s Cancer Center Stanford Cancer Institute Chair, Department of Obstetrics and Gynecology Stanford University School of Medicine Stanford, California Neville F. Hacker, AM, MD Professor of Gynaecologic Oncology Conjoint, University of New South Wales Director, Gynaecologic Cancer Centre Royal Hospital for Women Sydney, Australia Illustrations and design by Deborah Berek, ma Tim Hengst, cmi, fami LWBK1376-FM.indd 1 9/12/14 1:42 PM Acquisitions Editor: Jamie M. Elfrank Product Development Editor: Ashley Fischer Editorial Assistant: Brian Convery Production Project Manager: Bridgett Dougherty Design Coordinator: Stephen Druding Illustration Coordinator: Jennifer Clements Manufacturing Coordinator: Beth Welsh Marketing Manager: Stephanie Kindlick Prepress Vendor: Aptara, Inc. 6th edition Copyright © 2015 Wolters Kluwer Copyright © 2010 Wolters Kluwer Health/Lippincott Williams & Wilkins. Copyright © 2005 by Lippincott Williams & Wilkins. All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. To request permission, please contact Wolters Kluwer at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via email at [email protected], or via our website at lww.com (products and services). 9 8 7 6 5 4 3 2 1 Printed in China Library of Congress Cataloging-in-Publication Data Berek & Hacker’s gynecologic oncology / [edited by] Jonathan S. Berek, Neville F. Hacker ; illustrations and design by Tim Hengst, George Barile, Deborah Berek. – 6th edition. p. ; cm. Berek and Hacker’s gynecologic oncology Gynecologic oncology Includes bibliographical references and index. ISBN 978-1-4511-9007-6 (alk. paper) I. Berek, Jonathan S., editor. II. Hacker, Neville F., editor. III. Title: Berek and Hacker’s gynecologic oncology. IV. Title: Gynecologic oncology. [DNLM: 1. Genital Neoplasms, Female. 2. Genitalia, Female–physiopathology. WP 145] RC280.G5 616.99′465–dc23 2014032705 This work is provided “as is,” and the publisher disclaims any and all warranties, express or implied, includ- ing any warranties as to accuracy, comprehensiveness, or currency of the content of this work. This work is no substitute for individual patient assessment based upon healthcare professionals’ exami- nation of each patient and consideration of, among other things, age, weight, gender, current or prior medi- cal conditions, medication history, laboratory data and other factors unique to the patient. The publisher does not provide medical advice or guidance and this work is merely a reference tool. Healthcare profes- sionals, and not the publisher, are solely responsible for the use of this work including all medical judg- ments and for any resulting diagnosis and treatments. Given continuous, rapid advances in medical science and health information, independent professional verification of medical diagnoses, indications, appropriate pharmaceutical selections and dosages, and treat- ment options should be made and healthcare professionals should consult a variety of sources. When pre- scribing medication, healthcare professionals are advised to consult the product information sheet (the manufacturer’s package insert) accompanying each drug to verify, among other things, conditions of use, warnings and side effects and identify any changes in dosage schedule or contradictions, particularly if the medication to be administered is new, infrequently used or has a narrow therapeutic range. To the maximum extent permitted under applicable law, no responsibility is assumed by the publisher for any injury and/or damage to persons or property, as a matter of products liability, negligence law or otherwise, or from any reference to or use by any person of this work. LWW.com https://kat.cr/user/Blink99/ LWBK1376-FM.indd 2 9/12/14 1:42 PM To Deborah and Estelle, and to our patients, from whom we are always learning, and who continue to inspire us with their courage. LWBK1376-FM.indd 3 9/12/14 1:42 PM https://kat.cr/user/Blink99/ LWBK1376-FM.indd 4 9/12/14 1:42 PM Contributors Spencer R. Adams, MD Michael J. Campion, MD Assistant Clinical Professor Director of Preinvasive Disease Department of Internal Medicine Gynaecological Cancer Centre UCLA David Geffen School of Medicine Royal Hospital for Women Internal Medicine Hospitalist Sydney, Australia Director of Perioperative Medical Services Los Angeles, California Karen Canfell, DPhil Associate Professor Frédéric Amant, MD, PhD Lowry Cancer Research Centre Head, Scientific Section of Gynecological Oncology Prince of Wales Clinical School Catholic University of Leuven University of New South Wales Staff Member, Gynecological Oncology Sydney, Australia University Hospitals of Leuven Leuven, Belgium David Cibula, MD, PhD Professor Barbara L. Andersen, PhD First Faculty of Medicine Professor Charles University Department of Psychology Chair, Gynecologic Oncology Centre James Cancer Hospital General University Hospital in Prague Solove Research Institute Prague, Czech Republic The Ohio State University Columbus, Ohio Daniel W. Cramer, MD Professor Walter F. Baile, MD Department of Obstetrics, Gynecology and Professor Reproductive Biology Department of Behavioral Science and Psychiatry Harvard Medical School Psychiatrist and Director Brigham and Women’s Hospital Program for Interpersonal Communication and Boston, Massachusetts Relationship Enhancement MD Anderson Cancer Center Catherine M. Dang, MD University of Texas Associate Director Houston, Texas Wasserman Breast Cancer Risk Reduction Program Department of Surgery Andrew Berchuck, MD Cedars-Sinai Medical Center Professor and Director Los Angeles, California Department of Obstetrics and Gynecology Division of Gynecologic Oncology Oliver Dorigo, MD, PhD Duke University School of Medicine Associate Professor and Director Durham, North Carolina Division of Gynecologic Oncology Director, Mary Lake Polan Ross S. Berkowitz, MD Gynecologic Oncology Research Laboratory William H. Baker Professor of Gynecology Department of Obstetrics and Gynecology Department of Obstetrics, Gynecology and Stanford University School of Medicine Reproductive Biology Director, Gynecologic Cancer Care Program Harvard Medical School Stanford Women’s Cancer Center Director of Gynecologic Oncology Stanford Cancer Institute Co-Director, New England Trophoblastic Disease Center Stanford, California Brigham and Women’s Hospital Dana Farber Cancer Institute Boston, Massachusetts v LWBK1376-FM.indd 5 9/12/14 1:42 PM Contributors Patricia J. Eifel, MD Walter H. Gotlieb, MD, PhD Professor Professor Department of Radiation Oncology Department of Oncology MD Anderson Cancer Center Department of Obstetrics and Gynecology University of Texas McGill University Houston, Texas Director of Gynecology Segal Cancer Center Patricia Eshaghian, MD Jewish General Hospital Assistant Clinical Professor of Medicine Montreal, Canada Division of Pulmonary and Critical Care Medicine UCLA David Geffen School of Medicine Kenneth D. Hatch, MD Santa Monica, California Professor Department of Obstetrics and Gynecology Michael L. Friedlander, MBChB, PhD University of Arizona School of Medicine Conjoint Professor of Medicine University Medical Center University of New South Wales Tucson, Arizona Director of Medical Oncology The Prince of Wales Hospital Michael R. Hendrickson, MD Consultant Medical Oncologist Professor Emeritus Royal Hospital for Women Department of Pathology Sydney, Australia Stanford University School of Medicine Director of Surgical Pathology Stéphanie Gaillard, MD, PhD Stanford Health Care Assistant Professor Stanford, California Division of Medical Oncology Duke Cancer Institute Ian Jacobs, MBBS, MD Durham, North Carolina Vice Chancellor University of New South Wales Alexandra Gentry-Mararaj, PhD Sydney, Australia Senior Research Associate Department of Women’s Cancer Amer Karam, MD EGA Institute for Women’s Health Associate Clinical Professor University College London Associate Director and Director of Outreach England, United Kingdom Division of Gynecologic Oncology Department of Obstetrics and Gynecology Arnando E. Giuliano, MD Stanford University School of Medicine Clinical Professor of Surgery Stanford Women’s Cancer Center UCLA David Geffen School of Medicine Stanford, California Executive Vice Chair Department of Surgery Reza Khorsan, MD Cedars-Sinai Medical Center Assistant Professor of Medicine Los Angeles, California Department of Medicine UCLA David Geffen School of Medicine Donald P. Goldstein, MD Los Angeles, California Professor Nephrologist, Department of Medicine Department of Obstetrics, Gynecology and Santa Monica-UCLA Medical Center Reproductive Biology Santa Monica, California Harvard Medical School Co-Director, New England Trophoblastic Disease Center Brigham and Women’s Cancer Center Boston, Massachusetts vi https://kat.cr/user/Blink99/ LWBK1376-FM.indd 6 9/12/14 1:42 PM Contributors Christina S. Kong, MD Usha Menon, MD Associate Professor Head, Department of Gynaecological Oncology Department of Pathology Gynaecological Cancer Research Centre Stanford University School of Medicine Institute for Women’s Health Director of Cytopathology Consultant Gynaecologist Stanford Health Care University College London Stanford, California England, United Kingdom Roger M. Lee, MD Roseanne Moses, MMed, MBBS Assistant Clinical Professor Senior Staff Specialist Department of Internal Medicine Palliative Medicine UCLA David Geffen School of Medicine Gynaecological Cancer Centre Los Angeles, California Royal Hospital For Women Santa Monica-UCLA Medical Center New South Wales, Australia Santa Monica, California Jennifer A. M. Philip, PhD, MMed, MBBS J. Norelle Lickiss, MD Associate Professor Clinical Professor Center for Palliative Care University of Sydney University of Melbourne Consultant Emeritus Deputy Director, Palliative Medicine Royal Prince Alfred Hospital, Camperdam & St. Vincent’s Hospital Royal Hospital for Women Melbourne, Australia New South Wales, Australia Joshua Z. Press, MD, MSc Teri A. Longacre, MD Gynecologic Oncologist Professor Pacific Gynecology Specialists Department of Pathology Division of Oncology and Pelvic Surgery Stanford University School of Medicine Seattle, Washington Associate Director of Surgical Pathology Stanford Health Care Norman W. Rizk, MD Stanford, California Berthod and Bell N. Guggenhime Professor in Medicine Senior Associate Dean for Clinical Affairs Paul M. Maggio, MD Stanford University School of Medicine Assistant Professor Chief Medical Officer Department of Surgery Stanford Health Care Stanford University School of Medicine Stanford University School of Medicine Co-director, Critical Care Medicine Stanford, California Stanford Health Care Stanford, California Samuel A. Skootsky, MD Chief Medical Officer Maurie Markman, MD UCLA Faculty Practice Group and Medical Group Clinical Professor of Medicine Professor of Medicine Drexel University College of Medicine UCLA David Geffen School of Medicine President of Medicine and Science Los Angeles, California Cancer Treatment Centers of America Philadelphia, Pennsylvania M. Iain Smith, MD Assistant Clinical Professor G. Larry Maxwell, MD Department of Medicine Professor of Obstetrics and Gynecology UCLA David Geffen School of Medicine Virginia Commonwealth University School of Medicine Los Angeles, California Chair, Department of Obstetrics and Gynecology Inova Fairfax Hospital Anil K. Sood, MD Falls Church, Virginia Professor Department of Gynecologic Oncology MD Anderson Cancer Center Houston, Texas vii LWBK1376-FM.indd 7 9/12/14 1:43 PM Contributors Kathryn L. Terry, ScD Jan B. Vermorken, MD, PhD Assistant Professor Emeritus Professor of Medical Sciences Obstetrics, Gynecology, and Reproductive Biology Antwerp University Harvard Medical School Antwerp, Belgium Associate Epidemiologist Consultant in Medical Oncology Brigham and Women’s Hospital Antwerp University Hospital Boston, Massachusetts Edegem, Belgium Laszlo Ungar, MD Kristen C. Williams, MA Professor Department of Psychology Department of Obstetrics and Gynecology James Cancer Hospital Albert Szentgyorgyi Medical University Solove Research Institute Head, Metropolitan Gynecological Service The Ohio State University St. Stephen and Jahn Ferenc Hospitals Columbus, Ohio Budapest, Hungary viii https://kat.cr/user/Blink99/ LWBK1376-FM.indd 8 9/12/14 1:43 PM Foreword to the First Edition Close to the beginning of this century, William Osler observed, “The practice of medicine is an art, based on science.” That brief characterization of our profession rings true, even as we approach the next century in the midst of brilliant, accelerating scientific discovery. Some aspects of the art—including compassion and the basic skills of history taking and physical examination—are, or should be, common to all physicians and remain largely unchanged by a century of research. In other ways, the “art,” which can also be translated as “craft” from the original Greek work “techne,” has been greatly enlarged and diversified by science and technology. Thus, the special skills required by a gynecologic oncologist derive not only from experience and practice, but also from the proliferation of knowledge in many branches of science. Indeed, it is mainly the developments of science in obstetrics and gynecology—and in some other disciplines— that have evolved the clinical subspecialty of gynecologic oncology. The art and the science are connected not only by ancestry, however. Their relationship continues to be an interdependent one. One of the ever-expanding glories of medicine is that what is learned in the laboratory can enhance learning at the bedside and what is learned from experience with patients helps to shape and direct scientific inquiry. Doctors who remain lifelong students are exhilarated by these interconnections and make the best teachers of clinical medicine. It is in the scholarly tradition that Jonathan S. Berek and Neville F. Hacker, with contributions from distinguished colleagues in their own discipline and in fields that bear upon it, have brought together the salient information required to develop the acumen and skills that enable clinicians to understand and to care for women suffering from tumors. Practical Gynecologic Oncology reflects the indivisibility of art and science in medicine. The two editors—one in Los Angeles and one in Sydney—worked and studied together for 7 years in the same hospital and laboratories and remain mutually helpful intellectual allies on opposite shores of the Pacific Ocean. Sherman M. Mellinkoff, MD Dean Emeritus Professor of Medicine UCLA David Geffen School of Medicine Los Angeles, California ix LWBK1376-FM.indd 9 9/12/14 1:43 PM https://kat.cr/user/Blink99/ LWBK1376-FM.indd 10 9/12/14 1:43 PM