A gorgeously written, sharp debut novel about three middle-aged couples who find themselves unmoored in the prime of their lives Three couples in San Diego—best friends, empty nesters living the California dream—have reached a tipping point. With the blurry years of child rearing and corporate ladder-climbing over, each pair is finally free to enjoy the golden years together. Until two of the husbands suddenly announce they want a divorce. As marriages and friendships unravel and the prosperity of the last few decades spins toward financial meltdown, Adele, Maggie and Sylvia find their carefully established footholds and expectations crumbling. Denting the Bosch marks the debut of a talented new voice, and offers an alternatively hilarious and devastating assessment of modern life, marriage, middle age, friendship, money, sex and the American Dream.

Abstract: Background Malignant sex cord-stromal cell tumours (SCST) account for only 7% of ovarian malignancies. The Arbeitsgemeinschaft fuer Gynaekologische Onkologie (AGO) study group has established a clinicopathological database to provide an overview of the current treatment strategies and survival of SCST patients and to identify research needs. Methods Twenty centres provided mixed retro- and prospective data of patients with tumour specimens and second-opinion pathology review treated between 2000 and 2014. Descriptive analyses of treatment strategies, Kaplan-Meier curves and cox regression analyses were conducted. Results Two hundred and sixty-two SCST patients were included. One hundred and ninety-one Granulosa-cell tumour (GCT) and 17 Sertoli-Leydig cell tumour (SLCT) patients were stage I disease (>80%). Forty four GCT (18.7%) and two (8.3%) SLCT patients received adjuvant systemic treatment. After a median observation time of 78.2 months, 46% of all SCST patients experienced disease recurrence, treated predominantly with secondary debulking surgery (> 90%). Advanced FIGO stage, lymph node involvement and intra-operative capsule rupture were associated with disease recurrence on univariate analysis (all p 0.05). Median OS time was not reached.brDiscussionbr