Vaginal hysterectomy with or without bilateral salpingo-oophorectomy may be an alternative treatment for endometrial cancer patients with medical co-morbidities precluding standard surgical procedures: a systematic review

2019 ◽  
Vol 29 (2) ◽  
pp. 299-304 ◽  
Author(s):  
Arnold-Jan Kruse ◽  
Henk G ter Brugge ◽  
Harm H de Haan ◽  
Hugo W Van Eyndhoven ◽  
Hans W Nijman
Keyword(s):  
Ovarian Cancer ◽  
Endometrial Cancer ◽  
Vaginal Hysterectomy ◽  
Cancer Survival ◽  
Survival Rates ◽  
Survival Outcomes ◽  
Ovarian Malignancy ◽  
Post Menopausal ◽  
Ovarian Cancer Survival ◽  
Overall Survival Rates

ObjectiveVaginal hysterectomy with bilateral salpingo-oophorectomy may be an alternative strategy for patients with low-risk endometrial cancer and medical co-morbidities precluding laparoscopic or abdominal procedures. The current study evaluates the prevalence of co-existent ovarian malignancy in patients with endometrial cancer and the influence of bilateral salpingo-oophorectomy on survival outcomes in these patients.MethodsMedline and EMBASE were searched for studies published between January 1, 2000 and November 20, 2017 that investigated (1) the prevalence of co-existing ovarian malignancy (either metastases or primary synchronous ovarian cancer in women with endometrial cancer, and (2) the influence of bilateral salpingo-oophorectomy on recurrence and/or survival rates.ResultsOf the pre-menopausal and post-menopausal patients (n=6059), 373 were identified with metastases and 106 were identified with primary synchronous ovarian cancer. Of the post-menopausal patients (n=6016), 362 were identified with metastases and 44 were identified with primary synchronous ovarian cancer. Survival outcomes did not differ for pre-menopausal patients with endometrial cancer with and without bilateral salpingo-oophorectomy (5-year overall survival rates were 89–94.5% and 86–97.8%, respectively).ConclusionBilateral salpingo-oophorectomy during vaginal hysterectomy seems to have a limited impact on disease outcome in patients with endometrial cancer. These results support the view that vaginal hysterectomy alone or with bilateral salpingo-oophorectomy may be an option for patients with endometrial cancer who are not ideal surgical candidates.

scholarly journals Double-Emulsion Copolyester Microcapsules for Sustained Intraperitoneal Release of Carboplatin

2019 ◽  
Vol 10 (4) ◽  
pp. 55
Author(s):  
Aneta Cymbaluk-Płoska ◽  
Peter Sobolewski ◽  
Anita Chudecka-Głaz ◽  
Ewa Wiśniewska ◽  
Joanna Łapczuk ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cancer Survival ◽  
Survival Rates ◽  
Double Emulsion ◽  
Ovarian Adenocarcinoma ◽  
Local Inflammatory Response ◽  
Sustained Drug Delivery ◽  
Emulsion Process ◽  
Ovarian Cancer Survival

Despite on-going medical advances, ovarian cancer survival rates have stagnated. In order to improve IP delivery of platinum-based antineoplastics, we aimed to develop a sustained drug delivery system for carboplatin (CPt). Toward this aim, we pursued a double emulsion process for obtaining CPt-loaded microcapsules composed of poly(ethylene terephthalate-ethylene dilinoleate) (PET-DLA) copolymer. We were able to obtain PET-DLA microspheres in the targeted size range of 10–25 µm (median: 18.5 µm), to reduce intraperitoneal clearance by phagocytosis and lymphoid transit. Empty microspheres showed the lack of toxicity in vitro. The double emulsion process yielded 2.5% w/w CPt loading and obtained microcapsules exhibited sustained (>20 day) zero-order release. The encapsulated CPt was confirmed to be bioavailable, as the microcapsules demonstrated efficacy against human ovarian adenocarcinoma (SK-OV-3) cells in vitro. Following intraperitoneal injection in mice, we did not observe adhesions, only mild, clinically-insignificant, local inflammatory response. Tissue platinum levels, monitored over 14 days using atomic absorption spectroscopy, revealed low burst and reduced systemic uptake (plasma, kidney), as compared to neat carboplatin injection. Overall, the results demonstrate the potential of the developed microencapsulation system for long-term intraperitoneal sustained release of carboplatin for the treatment of ovarian cancer.

scholarly journals Double-Emulsion Copolyester Microcapsules for Sustained Intraperitoneal Release of Carboplatin

2019 ◽  
Author(s):  
Aneta Cymbaluk-Płoska ◽  
Peter Sobolewski ◽  
Anita Chudecka-Głaz ◽  
Ewa Wiśniewska ◽  
Joanna Łapczuk ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cancer Survival ◽  
Survival Rates ◽  
Double Emulsion ◽  
Ovarian Adenocarcinoma ◽  
Local Inflammatory Response ◽  
Sustained Drug Delivery ◽  
Emulsion Process ◽  
Ovarian Cancer Survival

<p>Despite on-going medical advances, ovarian cancer survival rates have stagnated. In order to improve IP delivery of platinum-based antineoplastics, we aimed to develop a sustained drug delivery system for carboplatin (CPt). Toward this aim, we pursued a double emulsion process for obtaining CPt-loaded microcapsules composed of poly(ethylene terephthalate-ethylene dilinoleate) (PET‑DLA) copolymer. We were able to obtain PET-DLA microspheres in the targeted size range of 10–25 µm (median: 18.5 µm), to reduce intraperitoneal clearance by phagocytosis and lymphoid transit. Empty microspheres showed the lack of toxicity <i>in vitro</i>. The double emulsion process yielded 2.5% w/w CPt loading and obtained microcapsules exhibited sustained (>20 day) zero-order release. The encapsulated CPt was confirmed to be bioavailable, as the microcapsules demonstrated efficacy against human ovarian adenocarcinoma (SK-OV-3) cells <i>in vitro. </i>Following intraperitoneal injection in mice, we did not observe adhesions, only mild clinically-insignificant, local inflammatory response. Tissue platinum levels, monitored over 14 days using atomic absorption spectroscopy, revealed low burst and reduced systemic uptake (plasma, kidney), as compared to neat carboplatin injection. Overall, the results demonstrate the potential of the developed microencapsulation system for long-term intraperitoneal sustained release of carboplatin for</p><div><div><div><p>the treatment of ovarian cancer.</p></div></div></div>

Synchronous Ovarian and Endometrial Cancer—an International Multicenter Case-Control Study

2014 ◽  
Vol 24 (1) ◽  
pp. 54-60 ◽  
Author(s):  
Florian Heitz ◽  
Frederic Amant ◽  
Christina Fotopoulou ◽  
Marco J. Battista ◽  
Pauline Wimberger ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Endometrial Cancer ◽  
Case Control Study ◽  
Group Performance ◽  
Survival Rates ◽  
Figo Stage ◽  
Case Control ◽  
Control Study ◽  
Overall Survival Rates

ObjectivesThis study aimed to compare the prognosis of patients with synchronous endometrial and ovarian cancer (SEOC) to matched controls with either endometrial cancer (EC) or ovarian cancer (OC).MethodsA retrospective case-control study including all patients with SEOC who had been treated at 5 European tertiary gynecologic oncology centers between 1996 and 2011 and patients with either EC or OC matched for age, International Federation of Gynecology and Obstetrics (FIGO) stage, histology, year of diagnosis, and Eastern Cooperative Oncology Group performance score.ResultsThe study cohort comprised 77, 132, and 126 patients with SEOC, EC, and OC, respectively. The patient characteristics confirmed an equal distribution of matching factors, and the median follow-up did not differ (P = 0.44). 48.1% of the patients with SEOC showed early FIGO stage I for both EC and OC. The 5-year PFS rates differed between SEOC and EC (76.3% vs 86.3%; P = 0.047) but not the 5-year overall survival rates (71.6% vs 79.8%; P = 0.12) and did not differ between SEOC and OC (76.3% vs 63.8%; P = 0.19 and 71.6% vs 69.3%; P = 0.61, respectively). After the adjustment for the FIGO stage of the 2 components of SEOC, neither PFS nor overall survival rates were different.ConclusionsPrognosis of patients with SEOC tended to be the same in comparison with matched controls with either one EC or OC. Therefore, it could be considered that patients with SEOC may be eligible for clinical trials of the advanced tumor component if no additional therapy is indicated for the other component.

scholarly journals Double-Emulsion Copolyester Microcapsules for Sustained Intraperitoneal Release of Carboplatin

2019 ◽  
Author(s):  
Aneta Cymbaluk-Płoska ◽  
Peter Sobolewski ◽  
Anita Chudecka-Głaz ◽  
Ewa Wiśniewska ◽  
Joanna Łapczuk ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cancer Survival ◽  
Survival Rates ◽  
Double Emulsion ◽  
Ovarian Adenocarcinoma ◽  
Local Inflammatory Response ◽  
Sustained Drug Delivery ◽  
Emulsion Process ◽  
Ovarian Cancer Survival

<div><div><div><p>Despite on-going medical advances, ovarian cancer survival rates have stagnated. In order to improve IP delivery of platinum-based antineoplastics, we aimed to develop a sustained drug delivery system for carboplatin (CPt). Toward this aim, we pursued a double emulsion process for obtaining CPt-loaded microcapsules composed of poly(ethylene terephthalate-ethylene dilinoleate) (PET‑DLA) copolymer. We were able to obtain PET-DLA microspheres in the targeted size range of 10–25 µm (median: 18.5 µm), to reduce intraperitoneal clearance by phagocytosis and lymphoid transit. Empty microspheres showed the lack of toxicity <i>in vitro</i>. The double emulsion process yielded 2.5% w/w CPt loading and obtained microcapsules exhibited sustained (>20 day) zero-order release. The encapsulated CPt was confirmed to be bioavailable, as the microcapsules demonstrated efficacy against human ovarian adenocarcinoma (SK-OV-3) cells <i>in vitro. </i>Following intraperitoneal injection in mice, we did not observe adhesions, only mild clinically-insignificant, local inflammatory response. Tissue platinum levels, monitored over 14 days using atomic absorption spectroscopy, revealed low burst and reduced systemic uptake (plasma, kidney), as compared to neat carboplatin injection. We conclude that the developed microencapsulation system could be used for long-term intraperitoneal sustained release of carboplatin for the treatment of ovarian cancer. </p></div></div></div>

scholarly journals Double-Emulsion Copolyester Microcapsules for Sustained Intraperitoneal Release of Carboplatin

2019 ◽  
Author(s):  
Aneta Cymbaluk-Płoska ◽  
Peter Sobolewski ◽  
Anita Chudecka-Głaz ◽  
Ewa Wiśniewska ◽  
Joanna Łapczuk ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cancer Survival ◽  
Survival Rates ◽  
Double Emulsion ◽  
Ovarian Adenocarcinoma ◽  
Local Inflammatory Response ◽  
Sustained Drug Delivery ◽  
Emulsion Process ◽  
Ovarian Cancer Survival

<p>Despite on-going medical advances, ovarian cancer survival rates have stagnated. In order to improve IP delivery of platinum-based antineoplastics, we aimed to develop a sustained drug delivery system for carboplatin (CPt). Toward this aim, we pursued a double emulsion process for obtaining CPt-loaded microcapsules composed of poly(ethylene terephthalate-ethylene dilinoleate) (PET‑DLA) copolymer. We were able to obtain PET-DLA microspheres in the targeted size range of 10–25 µm (median: 18.5 µm), to reduce intraperitoneal clearance by phagocytosis and lymphoid transit. Empty microspheres showed the lack of toxicity <i>in vitro</i>. The double emulsion process yielded 2.5% w/w CPt loading and obtained microcapsules exhibited sustained (>20 day) zero-order release. The encapsulated CPt was confirmed to be bioavailable, as the microcapsules demonstrated efficacy against human ovarian adenocarcinoma (SK-OV-3) cells <i>in vitro. </i>Following intraperitoneal injection in mice, we did not observe adhesions, only mild clinically-insignificant, local inflammatory response. Tissue platinum levels, monitored over 14 days using atomic absorption spectroscopy, revealed low burst and reduced systemic uptake (plasma, kidney), as compared to neat carboplatin injection. Overall, the results demonstrate the potential of the developed microencapsulation system for long-term intraperitoneal sustained release of carboplatin for</p><div><div><div><p>the treatment of ovarian cancer.</p></div></div></div>

scholarly journals 647Use of menopausal hormone therapy before and after ovarian cancer diagnosis and ovarian cancer survival

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Nina Renhua Na ◽  
Susan J Jordan ◽  
Andreas Obermair ◽  
Penelope M Webb ◽  
Keyword(s):  
Ovarian Cancer ◽  
Propensity Score ◽  
Hormone Therapy ◽  
Cancer Survival ◽  
Menopausal Hormone Therapy ◽  
Cancer Prognosis ◽  
Confounding By Indication ◽  
Menopausal Women ◽  
Post Menopausal ◽  
Ovarian Cancer Survival

Abstract Background Menopausal hormone therapy (MHT) use before ovarian cancer (OvCa) diagnosis has been suggested to improve survival but data on type, duration and use after treatment for OvCa are scarce. Methods We investigated MHT use and OvCa survival among participants with newly diagnosed OvCA in the Ovarian cancer Prognosis And Lifestyle (OPAL) Study. Analysis of pre-diagnosis use was restricted to 661 post-menopausal women and analysis of post-diagnosis use included 254 women aged ≤55-years. We used multivariable Cox proportional hazards regression to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between MHT and OvCa-specific survival. We used propensity score-based approaches to account for potential bias due to confounding by indication. Results Approximately 14% of post-menopausal women were current/recent users of oestrogen-only (7%) or oestrogen-progestin/unknown MHT (E-P=7%) at the time of diagnosis. In the pre-diagnosis analysis, E-P use was associated with better survival (HR = 0.60, 95%CI=0.37-0.98; HR = 0.93, 95%CI=0.79-1.09 per 5-years/use). The association between oestrogen-only MHT and survival was weaker and non-significant (HR = 0.74, 95%CI=0.47-1.16). Among women ≤55-years at diagnosis, the HR was 0.91 (95%CI=0.50-1.67) for new use after diagnosis regardless of type; and 0.89 (95%CI 0.51-1.54) for any use post-diagnosis compared to never users. Propensity-score-based methods showed similar estimates. Conclusions Pre-diagnosis MHT use is associated with better ovarian cancer survival. Post-diagnosis MHT use might also improve survival for women younger than 55-years, even after accounting for bias due to confounding by indication. Key messages Menopausal hormone therapy may be considered to manage menopausal symptoms in women with ovarian cancer.

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