Epithelial ovarian tumors of borderline malignancy: a study of 50 cases

1992 ◽  
Vol 2 (4) ◽  
pp. 189-197 ◽  
Author(s):  
B. Piura ◽  
R. Dgani ◽  
I. Blickstein ◽  
I. Yanai-Inbar ◽  
B. Czernobilsky ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Ovarian Tumors ◽  
Adequate Treatment ◽  
Initial Surgery ◽  
Stage Ia ◽  
Borderline Malignancy

Of 50 patients with borderline epithelial ovarian tumors, 32 (64%) had serous, 17 (34%) had mucinous and one (2%) had endometrioid tumor. All patients with mucinous tumor had stage I disease, whereas 4 patients with serous tumor had stage II–III disease. Five patients (10%) were pregnant at the time of diagnosis. Seventeen patients (34%) had initial surgery with ovarian conservation and 7 of them were not subjected to further surgery. Five patients (10%) received adjuvant chemotherapy. Five-year survival and 5-year disease-free survival rates were 100% and 96.4%, respectively. It is concluded that for patients with stage IA disease unilateral salpingo-oophorectomy seems to be adequate treatment and for those with more than stage IA disease, surgery should include total abdominal hysterectomy and bilateral salpingo-oophorectomy. Although the effectiveness of chemotherapy in these tumors is uncertain, adjuvant chemotherapy is advocated for patients in whom spread of the tumor beyond the ovaries has occurred.

Retrospective analysis of 105 cases of uterine sarcoma

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 16079-16079
Author(s):  
A. Yoney ◽  
S. Eskici ◽  
B. Eren ◽  
A. Salman ◽  
M. Unsal
Keyword(s):  
Therapeutic Option ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Distant Metastases ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Uterine Sarcoma ◽  
Therapeutic Modality ◽  
Uterine Sarcomas ◽  
Pathologic Classification

16079 Background: Currently there is no randomized study based or widely accepted therapeutic modality in uterine sarcomas which are rare tumors forming a heterogeneous group in respect to their pathologic classification. Methods: In our trial, 105 pts. with uterine sarcoma who were referred to our clinic between years 1995–2003 have been retrospectively researched to evaluate the results in this tumor group. 43.8% had Leiomyosarcoma (LMS), 28.6% had Endometrial Stromal Sarcoma (ESS) and 27.6% had a Malign Mullarian Mixed Tumor (MMMT) while the distribution according to the histological subgroups were found to be 58.8% and 41.2% in low + middle grade tumors combined and in high grade tumors respectively. 76.2% had a Total Abdominal Hysterectomy + Bilateral Salphingooverectomy (TAH+BSO), 18.1% had a Total Abdominal Hysterectomy + Bilateral Salphingooverectomy + Lymphadenectomy (TAH+BSO+LND) and 5.7% had a suboptimal surgery as a surgical procedure. 38.1% of the pts. had Radiotherapy (RT), 18.1% had Chemotherapy (CT) and 12.4% had Chemo-radiotherapy (CT+RT) in addition to surgery. Results: The median age of the whole group is 51 (24–87). 55% of our pts. are under 50 years old and 68.5% had an “organ limited disease” ( stages I-II combined). The distant metastases rate is 30% and the local recurrence is 16.2%. All the local recurrences and 90% of the distant metastases have occurred within the first two years. The disease free survival rates at 3 and 5 years are 54.46% and 49.88% ; while the overall survival rates at 3 and 5 years are 54.63% and 51.09% all respectively. The stage is the most important factor effecting on the O.S and 5- year O.S rate is 68.43% in Stage I disease. Conclusions: The aggressive tumor progression pattern and the poor prognosis of uterine sarcomas require adjuvant therapies. The merit of current therapeutic options are still on debate since none of them has proved any specific effects. Planning further multi-center retrospective studies with high number of pts., a more clear description of the prognostic factors and thus the determination of the most appropriate therapeutic option is definitely needed. No significant financial relationships to disclose.

scholarly journals Recurrent Endometrial Stromal Sarcoma: Treatment with a Progestin and Gonadotropin Releasing Hormone Agonist

Sarcoma ◽  
2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Nefertiti Chianti duPont ◽  
Philip John DiSaia
Keyword(s):  
Combined Therapy ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Endometrial Stromal Sarcoma ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Good Prognosis ◽  
Low Grade ◽  
Stromal Sarcoma ◽  
Sarcoma Treatment

Endometrial stromal sarcoma (ESS) formerly classified as low-grade endometrial stromal sarcoma is a rare uterine malignancy with a good prognosis despite a tendency to recur. Primary surgical management for ESS includes total abdominal hysterectomy and bilateral salpingo-oophorectomy. Patients with ESS have long disease-free survival rates when treated with primary surgical therapy, but nearly fifty percent of these patients will recur. We present the case of a patient with recurrent ESS who had an excellent response to combined therapy with megestrol and leuprolide.

Docetaxel plus FOLFOX4 compared with FOLFOX4 as adjuvant chemotherapy for gastric cancer.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 181-181
Author(s):  
Chun-Xia Du ◽  
Xiao-Yan Liu ◽  
Hong-Gang Zhang ◽  
Ai-Ping Zhou
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Survival Rates ◽  
Subtotal Gastrectomy ◽  
Disease Free Survival ◽  
Adjuvant Radiation ◽  
Ptnm Stage ◽  
Gastric Cancer Patients

181 Background: To compare the efficacy of docetaxel plus FOLFOX4 to FOLFOX4 as adjuvant chemotherapy for gastric cancer patients. Methods: 320 patients with stage IB-IV (M0) gastric cancer were enrolled into the retrospective study. All patients received a total or subtotal gastrectomy with at least D1 lymph nodes dissection. 193 patients received FOLFOX4 as adjuvant chemotherapy. 127 patients received biweekly docetaxel plus FOLFOX4 (DOF regimen) as adjuvant chemotherapy. Docetaxel was administered at 40 mg/m2 on day 1, followed by FOLFOX4 regimen. Both of the regimens were repeated every 2 weeks for a maximum of 12 cycles. Results: In comparison with patients in FOLFOX4 group, patients in DOF group were relatively younger (p=.001), with more advanced disease in pN stage (p=.035) and pTNM stage (p=.031), received more cycles of adjuvant chemotherapy (p=.004), and had a higher percentage of adjuvant radiation (p =.002). After adjustment of unbalanced variables as mentioned above, no statistical difference was observed between DOF group and FOLFOX4 group in terms of 3-year disease-free survival (54% vs 69%, p = 0.100, HR 1.362, 95% CI (0.943-1.967)) and 3-year overall survival(70% vs 72%, p = 0.810, HR 1.049, 95% CI (0.711-1.548)). Stratified analysis according to clinicopathologic characters showed that there were almost no statistical differences of 3-year overall survival rates between two groups, except the primary site (middle 1/3) (p =.025) and pTNM stage (IIb stage) (p =.035) in favor of FOLFOX4 group. The incidences of grade 3/4 adverse events were obviously higher in DOF group than in FOLFOX4 group,including decreased appetite (18.1% V 10.4%, P = 0.046), diarrhea (4.7% V 0%, p=0.004 ), hypersensitivity reactions to oxaliplatin (3.1% V 0%, p=0.024) and neutropenia (47.3% V 31.6%, p=0.004). Conclusions: Compared to FOLFOX4 regimen, adjuvant docetaxel plus FOLFOX4 did not show significant survival advantages in gastric cancer patients. However, a more serious toxicity profile was observed in docetaxel plus FOLFOX4 arm. Further studies are needed to decide whether triplet regimen is appropriate as adjuvant chemotherapy of gastric cancer.

scholarly journals The Smallest Reported Malignant Struma Ovarii: A Case Report

2018 ◽  
Vol 11 (3) ◽  
pp. 693-698 ◽  
Author(s):  
Nobuko Yasutake ◽  
Hirotsugu Noguchi ◽  
Yuta Ibayashi ◽  
Hiroaki Nakamura ◽  
Kazuki Tateishi ◽  
...  
Keyword(s):  
Case Report ◽  
Treatment Decision ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Struma Ovarii ◽  
Malignant Struma Ovarii ◽  
Gynecology And Obstetrics ◽  
Good Clinical Condition ◽  
Stage Ia ◽  
Peripheral Areas

Introduction: Malignant struma ovarii is a rare neoplasm. It is usually asymptomatic and not commonly diagnosed preoperatively. In addition, there is currently no established diagnostic and therapeutic approach for malignant struma ovarii. Case Report: A 66-year-old asymptomatic female was referred to our hospital. Computed tomography showed the presence of a well-defined mass with enhancement in the internal and peripheral areas. The patient underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, and partial omentectomy. Histopathology revealed the presence of a papillary thyroid carcinoma arising from a 2.5-cm-diameter struma ovarii (malignant struma ovarii). According to the criteria of the International Federation of Gynecology and Obstetrics, the patient had stage IA disease. Subsequently, she underwent a thyroid scan with normal findings. At the 3-month follow-up, the patient was alive, in good clinical condition, and disease free. Conclusion: In this report, we present the smallest malignant struma ovarii reported so far in the literature. Because of the rarity of these tumors and the lack of firm prognostic factors, the treatment decision should be customized for each patient according to the pathological and clinical parameters.

Surveillance in stage I MOGCTs (malignant ovarian germ cell tumors): A MITO prospective study (multicenter Italian trials in ovarian cancer).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 5516-5516
Author(s):  
Alice Bergamini ◽  
Giorgio Giorda ◽  
Gabriella Ferrandina ◽  
Gennaro Cormio ◽  
Domenica Lorusso ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Mature Teratoma ◽  
Germ Cell Tumors ◽  
Disease Free Survival ◽  
Oncological Outcome ◽  
Stage I ◽  
Group A ◽  
Stage Ia ◽  
Surveillance Protocol ◽  
Group B

5516 Background: The standard of treatment of stage I MOGCTs is surgery followed by BEP (bleomycin + etoposide + cisplatin) chemotherapy, except for stage IA dysgerminoma (D) and IAG1 immature teratoma (IT). Surveillance has emerged as a possible option to avoid adjuvant chemotherapy in IB-C1 D, IA-C G2 – G3 IT, and in stage IA mixed and yolk sac tumors (YST), after comprehensive surgical staging (CSS) with negative postoperative markers. The aim of this study was to analyze oncological outcome of stage I MOGCT patients included in the MITO9 study. Methods: MITO9 was a prospective observational study analyzing data collected between 2013 and 2018. 41 patients with stage I conservatively treated MOGCTs were included. Three groups were identified: group A. IA D and IAG1 IT candidate to surveillance according to guidelines; group B. stages IB-C1 D, stage IA-C G2-G3 IT, stage IA mixed and YST were consulted about the option of close surveillance vs adjuvant chemotherapy in case of CSS; group C. all other patients receiving BEP. Results: Median age was 25.6 years (range 14-40). Median follow up was 36,4 months. Group A included 12 patients, 5 IA G1 IT and 7 IA D. Group B included 24 patients. Of these, 2 out of 5 patients (40%) were positive at restaging and were excluded from surveillance protocol. Seven of the 22 remaining patients (31.8%) received chemotherapy, while 15 (68.1%) were enrolled in the surveillance protocol. Out of these 15 patients, 4 were stage IC D (one IC1, one IC2 and two IC3), 2 were mixed stage IA with YST tumor, 9 were G3 IT (four IA, three IC2, one IC3 and one IB). The 7 patients receiving chemotherapy were: 1 dysgerminoma IC2, 2 YST IA, 3 IT G3 (one IA and one IC2) and 1 mixed IA tumour. Group C included 5 patients, three IC YST and two mixed IC2 with YST. Survival of these patients was 100%, while disease free survival was 97.5%. Only one patient in C Group, a stage IA G3 IT treated with adjuvant BEP, relapsed as mature teratoma. None of the patients in the surveillance protocol experienced relapse. Conclusions: These data suggest that close surveillance could be an alternative option to avoid adjuvant chemotherapy in properly staged IB-C1 D, stage IA G2 – G3 IT, stage IA mixed and YST. These findings deserve further confirmation in an international cooperative setting.

Phase III Trial Comparing Doxorubicin Plus Cyclophosphamide With Docetaxel Plus Cyclophosphamide As Adjuvant Therapy for Operable Breast Cancer

2006 ◽  
Vol 24 (34) ◽  
pp. 5381-5387 ◽  
Author(s):  
Stephen E. Jones ◽  
Michael A. Savin ◽  
Frankie Ann Holmes ◽  
Joyce A. O'Shaughnessy ◽  
Joanne L. Blum ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Standard Dose ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Metastatic Breast ◽  
Surgical Excision ◽  
Phase Iii ◽  
Hormone Receptor Positive ◽  
Complete Surgical Excision

Purpose The combination of doxorubicin and cyclophosphamide (AC) is a standard adjuvant chemotherapy regimen. Studies of docetaxel and cyclophosphamide (TC) in metastatic breast cancer (MBC) showed promise in MBC. In 1997, we initiated a randomized adjuvant trial of TC compared with standard-dose AC with a primary end point of disease-free survival (DFS). Patients and Methods Patients were eligible if they had stage I to III operable invasive breast cancer with complete surgical excision of the primary tumor. Between June 1997 and December 1999, 1,016 patients were randomly assigned to four cycles of either standard-dose AC (60 and 600 mg/m2, respectively; n = 510) or TC (75 and 600 mg/m2, respectively; n = 506), administered intravenously every 3 weeks as adjuvant chemotherapy. Radiation therapy (as indicated) and tamoxifen, for patients with hormone receptor–positive disease, were administered after completion of chemotherapy. Results Both treatment groups (TC and AC) were well balanced with respect to major prognostic factors. Patients were observed through 2005 for a median of 5.5 years. At 5 years, DFS rate was significantly superior for TC compared with AC (86% v 80%, respectively; hazard ratio [HR] = 0.67; 95% CI, 0.50 to 0.94; P = .015). Overall survival rates for TC and AC were 90% and 87%, respectively (HR = 0.76; 95% CI, 0.52 to 1.1; P = .13). More myalgia, arthralgia, edema, and febrile neutropenia occurred on the TC arm; more nausea and vomiting occurred on the AC arm as well as one incident of congestive heart failure. Conclusion At 5 years, TC was associated with a superior DFS and a different toxicity profile compared with AC.

scholarly journals Epithelial Borderline Ovarian Tumor: Clinicopathological Features, Outcome and Prognostic Factors

2018 ◽  
Vol 3 (4) ◽  
pp. 75
Author(s):  
Amornrat Temtanakitpaisan ◽  
Pilaiwan Kleebkaow ◽  
Apiwat Aue-aungkul
Keyword(s):  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Residual Disease ◽  
Early Stage ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Borderline Ovarian Tumor ◽  
Free Survival ◽  
Pathologic Features ◽  
Disease Free

Objective: To evaluate clinic-pathological characteristics, treatment outcomes, factors affecting survival in patients with borderline ovarian tumors (BOTs).Methods and Objective: Medical records of patients with BOTs who had been treated at Srinagarind Hospital from 2001 to 2016 were reviewed. Abstracted data included baseline characteristics, clinic-pathologic features, disease-free survival (DFS), and overall survival (OS). Results: Fifty-two patients with BOTs were included in the study.The mean age+ SD was 41.15+ 15.34 years. Most patients were premenopausal and the most common presenting symptom was adnexal mass. Most patients were in the early stage (90.4%). Thirty-two patients underwent radical surgery (61.5%). Twenty-one patients (40.3%) underwent lymphadenectomy. An appendectomy was performed in 19 (36.5 %) cases. The median follow-up period was 67.5 months (range, 7 to 180 months). The 5-year and 10-year overall survival rates for all stages were 90% and 85%, respectively. The 5-year and 10-year disease-free survival rates for all stages was 87% and 87%, respectively. Seven (13.5 %) patients had the recurrence. Absent residual disease (HR = 0.33; 95 %CI 0.11 – 0.96) and receiving postoperative adjuvant chemotherapy (HR = 0.22; 95 %CI 0.08 – 0.65) were associated factors for DFS. Conclusion: The majority of patients with BOTs presented at the young age and early stage. Residual lesion and adjuvant chemotherapy are significant factors predicting DFS.

scholarly journals Evaluation of Incompletely Staged Ovarian Malignancy: A Study in Western India

2017 ◽  
Vol 5 (2) ◽  
pp. 133-137
Author(s):  
Anusha Kamath ◽  
Pariseema Dave ◽  
Meeta Mankad
Keyword(s):  
Ovarian Tumor ◽  
Histopathological Examination ◽  
Granulosa Cell Tumor ◽  
Ovarian Tumors ◽  
Benign Tumors ◽  
Western India ◽  
Ovarian Malignancy ◽  
Tumor Patients ◽  
Initial Surgery ◽  
Borderline Malignancy

ABSTRACT Introduction Incomplete initial surgery complicates subsequent management of ovarian tumors. This study aimed to study demographic and clinical factors associated with incompletely staged ovarian tumor patients. Materials and methods Twenty five patients who had undergone incomplete staging surgery for ovarian tumors outside Gujarat Cancer & Research Institute, Ahmedabad, Gujarat, India, were included in this study. Their demographic and clinical features were studied in detail. Patients were either subjected to restaging or were referred for chemotherapy initially. Results Mean age of patients was 42 years (23—60 years); 64% of patients had abdominal pain as initial complaint; 64% patients were operated initially using a transverse incision. Only four patients were managed laparoscopically initially, others by laparotomy. Single/part of one ovary was removed in 60% of patients as part of initial surgery. Infundibulopelvic ligament was tied distally in 40% of patients. Omentectomy (Om) and lymphadenectomy were not done in most of the patients. Nineteen patients were found to have malignancy on final histopathological examination; 3 borderline malignancy; 1 granulosa cell tumor; and 2 benign tumors; 52% (n = 13) patients were subjected to chemotherapy; 4% (n = 1) were observed, and rest underwent restaging procedures. Conclusion Incompletely staged ovarian tumor patients, especially those with malignant histopathology, should be managed by gynecologic oncologists. The management needs to be individualized and cannot be a blanket therapy. How to cite this article Kamath A, Dave P, Mankad M. Evaluation of Incompletely Staged Ovarian Malignancy: A Study in Western India. J South Asian Feder Menopause Soc 2017;5(2):133-137.

Outcomes of patients with endometrial cancer and aggressive histology.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e16536-e16536
Author(s):  
Samed Rahatli ◽  
Nadire Kucukoztas ◽  
Omer Dizdar ◽  
Polat Dursun ◽  
Selim Yalcin ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Adjuvant Chemotherapy ◽  
Early Stage ◽  
Total Abdominal Hysterectomy ◽  
Figo Stage ◽  
Abdominal Hysterectomy ◽  
Aggressive Histology ◽  
Patient Series ◽  
Post Menopausal

e16536 Background: To present patterns of practice and outcomes of patients with early stage poor histology endometrial cancer. Methods: Records of the patients with FIGO stage I-II serous papillary, clear cell, mixed or undifferentiated endometrial cancer were retrospectively evaluated. All patients were initially treated surgically by the same surgeon with comprehensive staging lymphadenectomy, i.e. total abdominal hysterectomy, bilateral salphingooopherectomy, bilateral pelvic and paraaortic lymph node dissection and omentectomy. Adjuvant chemotherapy was offered to all patients and given unless the patient refused. Results: 38 patients with early stage poor histology were identified Median age was 61 and 86.8 % of the patients were post menopausal. Median BMI was 31.2 kg/m2. 28 patients (73.7%) received chemotherapy (90% with paclitaxel and carboplatin for 6 cycles). 5 patients (13.2 %) received external radiotherapy 3 patients (7.9%) received brachytherapy. Median follow up was 19 mos. Totally 3 patients (7.9%) had relapse on follow up; Among those who received adjuvant chemotherapy, only one patient had recurrence on vaginal cuff and was treated with radiotherapy and currently disease free for 4 years. Among those who did not receive adjuvant chemotherapy, 2 patients had widespread abdominal and distal recurrence and died on follow up. 2 patients died without recurrence. Conclusions: Complete surgical staging and adjuvant chemotherapy results in excellent prognosis in our patient series. [Table: see text]

ALINA: A phase III study of alectinib versus chemotherapy as adjuvant therapy in patients with stage IB–IIIA anaplastic lymphoma kinase-positive (ALK+) non-small cell lung cancer (NSCLC).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. TPS8569-TPS8569 ◽  
Author(s):  
Benjamin J. Solomon ◽  
Jin Seok Ahn ◽  
Fabrice Barlesi ◽  
Rafal Dziadziuszko ◽  
Makoto Nishio ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Survival Rates ◽  
Stage Ii ◽  
Phase Iii ◽  
Disease Stage ◽  
Efficacy And Safety ◽  
Anaplastic Lymphoma ◽  
Stage Ib ◽  
Phase Iii Study ◽  
Stage Ia

TPS8569 Background: Patients with early-stage NSCLC (stage IA–IIIA) account for ~40% of cases at diagnosis; despite surgery, 5-year survival rates are low. Platinum-based adjuvant chemotherapy is the standard of care (SoC) for stage II–IIIA disease. Although patients with stage IA NSCLC do not benefit from adjuvant chemotherapy, patients with stage IB disease and large tumors (≥4cm) do. Adjuvant chemotherapy produces a 4–5% increase in 5-year survival rates, leaving significant unmet need for improved treatments. Approximately 5% of patients with NSCLC harbor an oncogenic fusion of the ALK gene. Treatment of advanced ALK+ NSCLC with ALK inhibitors improves efficacy and safety compared with chemotherapy. Alectinib, a potent ALK inhibitor, is the SoC first-line treatment for advanced ALK+ NSCLC. The ongoing ALINA trial will compare alectinib versus chemotherapy as adjuvant treatment for patients with stage IB–IIIA ALK+ NSCLC. Methods: ALINA is a randomized, multicenter, open-label phase III study investigating the efficacy and safety of adjuvant alectinib versus chemotherapy in ALK+ NSCLC (confirmed by an FDA-approved and CE-marked test). Adult patients (≥18 years) with completely resected stage IB (tumors ≥4cm) to IIIA disease and ECOG PS 0–1 are eligible for inclusion. Patients (N=255) from ~170 centers across ~30 countries will be randomized 1:1 to receive twice-daily alectinib 600mg for 24 months or four 21-day cycles of platinum-based chemotherapy (cisplatin 75mg/m2 [day 1] plus vinorelbine 25mg/m2 [days 1 and 8] or gemcitabine 1250mg/m2 [days 1 and 8] or pemetrexed 500mg/m2 [day 1]) according to local prescribing information. Stratification factors are disease stage (stage IB [≥4cm] vs stage II vs stage IIIA) and race (Asian vs non-Asian). Treatment will continue until planned completion, disease recurrence, unacceptable toxicity, withdrawal of consent, or death, whichever occurs first. The primary endpoint is disease-free survival per investigator; secondary endpoints are overall survival, safety, and pharmacokinetics. Clinical trial information: NCT03456076.

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