scholarly journals Clinicopathological importance of survivin immunoexpression in reproductive age patients with serous borderline ovarian tumors

2021 ◽  
Vol 46 (4) ◽  
pp. 1401-1408
Author(s):  
Erdem ŞAHİN ◽  
Hulya AKGUN ◽  
Yusuf MADENDAĞ ◽  
Mehmet Mete KIRLANGIÇ ◽  
Erol KARAKAŞ ◽  
...  
2019 ◽  
Vol 15 (2) ◽  
pp. 57-61
Author(s):  
F. V. Novikov ◽  
V. P. Bondarev ◽  
E. S. Mishina ◽  
M. V. Mnikhovich

Background. Borderline ovarian tumors (BOT), due to their unclear biological potential, remain a problem for oncogynecologists. On the one hand, frequent recurrences of tumors, and on the other hand, a high survival rate in the diagnosis of patients requires careful weighing of all risk factors when choosing surgical intervention tactics in patients with BOT. A large number of recurrences of BOT in patients of fertile age lead to disability of patients, deterioration of their quality of life and loss of reproductive function.Objective: evaluation of the influence of clinical and morphological factors (the presence of non-invasive implants, bilateral lesion of the ovaries, the presence of psammous bodies and malignization tricks) and surgical factors (damage to the cyst capsule and carrying out fertility preserving operations) on the recurrence of BOT in various age groups.Materials and methods. The material for the study was the protocols of an in vivo pathoanatomical study of a biopsy (surgical) material obtained from patients with a diagnosis of BOT for the period from 2000 to 2017 inclusive, according to the Regional Forensic Medical Bureau of Kursk. A total of 110 protocols for the first occurrence of BOT and 14 protocols for the tumor recurrences were analyzed. The age of patients undergoing an in vivo pathologic examination ranged from 19 to 75 years.Results and conclusions. It has been revealed that psammous bodies, fertility preserving operations and reproductive age are associated with tumor recurrence. Groups of patients with foci of malignancy and bilateral lesions have a lower risk of BOT recurrence due to the radical surgical treatment tactics and possibly the use of chemotherapy in the first case. Non-invasive implants are not associated with the risk of BOT recurrence.


2021 ◽  
Vol 23 (1) ◽  
pp. 106-111
Author(s):  
Irina I. Davydova ◽  
Marina A. Chekalova ◽  
Apollon I. Karseladze ◽  
Viktor V. Kuznetsov ◽  
Liudmila A. Meshcheriakova ◽  
...  

Relevance. Borderline ovarian tumors (BOT) occur mainly in women of reproductive age and account for 20% of all neoplasms of the female genital organs. Currently, there is an increase in the incidence of ВОТ. One of the reasons for the increase in morbidity is the improvement of knowledge and experience in relation to the morphological diagnosis of tumors of low malignancy potential. Nevertheless, the results of a preliminary instrumental assessment of the nature of the disease and the final diagnosis formed by histological examination are not always satisfactory, since borderline tumors are a thin layer that occupies an intermediate position between benign and malignant tumors. And, in spite of the fact that ВОТ is an independent nosological form in the histological classification, nevertheless, they have signs of both benign and malignant neoplasms. In this regard, the complexity of both instrumental and morphological diagnostics of ВOT becomes understandable, and, therefore, difficulties arise in determining the tactics of treatment, choosing the optimal operation, and the need for drug therapy. All these issues are directly related to the patients quality of life, and, most importantly, to survival. Because an incorrectly established diagnosis entails incorrect treatment and unsatisfactory results. Thus, the study of the peculiarities of ВOT diagnostics is extremely important. The ultrasound computed tomography method is simple, relatively cheap and affordable. Considering that almost all patients with ovarian neoplasms undergo this type of examination, it is extremely important and interesting to assess the role of the ultrasound method in the diagnosis of ВОТ. Moreover, at present more and more gynecological oncologists are resorting to organ-preserving surgical interventions for ВOТ. Therefore, it is especially important to study the possibility of ultrasound diagnostics in monitoring the course of the disease after breast-conserving operations, identifying recurrences of the disease in the ovary, differentiating recurrence and cystic formations of the ovaries. Aim. To determine the effectiveness of computer-assisted ultrasound diagnostics in monitoring the course of BOT after breast-conserving operations. Materials and methods. At Blokhin National Medical Research Center of Oncology carried out a retrospective and prospective analysis of 405 patients with serous BOT for the period 19702013. The age of the patients varied in a wide range, the minimum was 15, the maximum was 78 years, the median corresponded to 38 years. Before the start of treatment, the patients underwent an ultrasound examination (ultrasound) of the abdominal organs, the pelvic organs and the retroperitoneal space. The studies were carried out on expert ultrasonic systems Siemens ACUSON S2000, Hitachi ARIETTA V70 and Philips EPIQ 5. Results. We studied the capabilities of the ultrasound method for diagnosing serous BOT based on the analysis of morpho-ultrasound comparisons in patients after conservative and ultra-conservative operations. Conclusion. It has been established that ultrasound diagnostics is of decisive importance both in the initial diagnosis and in the dynamic observation of patients with conservative and ultra-conservative surgery for serous BOT. Echography makes it possible to diagnose a tumor in the ovary in 83.3% of cases and to reject the diagnosis in 86.7% of cases.


2020 ◽  
Vol 14 (3) ◽  
pp. 269-282
Author(s):  
A. Yu. Vlasina ◽  
A. G. Solopova ◽  
A. E. Ivanov ◽  
I. M. Zhalyalova

Aim: to make a comparative evaluation of women with borderline ovarian tumors (BOTs) and surgical menopause (early symptoms) and explore their level of anxiety and depression depending on the age and volume of surgery.Materials and methods. The prospective comparative study included 117 patients, aged 44.3 ± 6.5 years, after surgical treatment of BOTs: 62 women at reproductive age with surgical menopause after radical treatment (group IА), 24 women at reproductive age after organ-preserving surgery (group IВ), 31 women at perimenopausal age after radical treatment (group II). The severity of menopausal syndrome (modified menopausal Kupperman–Uvarova index), anxiety and depression (Hospital Anxiety and Depression Scale, HADS) were determined 29–59 (36.4 ± 5.6) days after surgery.Results. Early symptoms of surgical menopause are found in 98.3 % of patients with BOTs. Reproductive age patients after radical surgery (group IA) had moderate neurovegetative (21.7 ± 4.0 points), mild metabolic (5.8 ± 1.8 points), and moderate psychoemotional disorders (8.9 ± 1.4 points). Young women who underwent organ-saving operations with preservation of at least one ovary (group IB), had normal range the indicators of neurovegetative disorders (8.2 ± 3.1 points), metabolic and psychoemotional disorders were regarded as moderate (2.6 ± 1.6 and 5.9 ± 2.3 points, respectively). Disorders due to surgical menopause (early symptoms) at perimenopausal age females (group II) corresponded to a mild degree: neurovegetative – 15.3 ± 2.7 points; metabolic – 6.0 ± 2.2 points; psychoemotional – 5.7 ± 1.5 points. Our data indicate that patients of group IA had moderate surgical menopause (early symptoms) – 36.4 ± 5.4 points, while in groups IB and II the total values were 16.8 ± 5.4 and 27.0 ± 4.3 points, which corresponds to mild severity. Patients with BOTs (one month after antitumor therapy) had early symptoms of surgical menopause (postovariectomy syndrome). The most typical clinical picture was observed among young women after removal of both ovaries.Conclusion. Surgical menopause affects by somatic and psychological health negatively. This leads to a significant decrease in the quality of life and an increase in the level of disability among patients with gynecological cancer. Therefore, even at the planning treatment, it is necessary to include pre-rehabilitation measures to minimize the negative consequences of cancer therapy.


2020 ◽  
pp. 21-25
Author(s):  
N. A. Chugunova ◽  
L. V. Pokul

Borderline ovarian tumors are often diagnosed in women under the age of 40 years (31.8 %), which determines the need to optimize the management of this cohort of patients, taking into account the possibility of maintaining their reproductive function. Purpose of the study. Assessment of the ovarian reserve based on a comprehensive sonographic diagnosis of the ovarian reserve in patients of reproductive age with borderline ovarian tumors. Materials and methods. Group I (n = 103) included patients with borderline serous epithelial ovarian tumors. Group II (n = 95) was formed from women with mucinous epithelial ovarian tumors. Comparison group III (n = 189) included patients with benign ovarian cystadenomas. Ultrasound scanning of the pelvic organs and color Doppler mapping (DLC) were performed using Aloka 3500, Semiens G‑60 ultrasound scanners operating in real time and equipped with a pulsed doppler using a 3.5 MHz convex sensor and a 7.5 MHz transvaginal sensor. Results. The number of antral follicles does not depend on the volume of the ovary. The healthy remaining ovarian tissue of the ovary is most pronounced in groups I and III, significantly less represented in group II (p ≤ 0.0001). Three months after adnexectomy, ovulatory function in the intact (healthy) ovary was preserved in 71% (n = 49) of women from group I; in 89% (n = 73) of patients of group II and in 93% (n = 25) of respondents of group III, with a predominance in group II (φ* = 2.7; p ≤ 0.0010 and φ* = 1.6; p ≤ 0.0500). After a conservative operation, the function of the operated (resected) ovary detected ovulation in 62% (n = 21) of group I participants; 68% (n = 9) of women of group II and 86% (n = 139) of patients of group III. After 6 months, an increase in the number of antral ovaries and the number of ovulations with a predominance of ovarian reserve in group III (p ≤ 0.0010 and p ≤ 0.0001) was generally observed. Conclusions. Integrated ultrasound is a reliable and objective method that evaluates the features of the ovulatory reserve in patients with borderline and benign ovarian tumors, which makes it possible to formulate a prognosis of a woman’s reproductive health after various types of surgical treatment.


2020 ◽  
pp. 10-14
Author(s):  
N. V. Spiridonova ◽  
A. A. Demura ◽  
V. Yu. Schukin

According to modern literature, the frequency of preoperative diagnostic errors for tumour-like formations is 30.9–45.6%, for malignant ovarian tumors is 25.0–51.0%. The complexity of this situation is asymptomatic tumor in the ovaries and failure to identify a neoplastic process, which is especially important for young women, as well as ease the transition of tumors from one category to another (evolution of the tumor) and the source of the aggressive behavior of the tumor. The purpose of our study was to evaluate the history of concomitant gynecological pathology in a group of patients of reproductive age with ovarian tumors and tumoroid formations, as a predisposing factor for the development of neoplastic process in the ovaries. In our work, we collected and processed complaints and data of obstetric and gynecological anamnesis of 168 patients of reproductive age (18–40 years), operated on the basis of the Department of oncogynecology for tumors and ovarian tumours in the Samara Regional Clinical Oncology Dispensary from 2012 to 2015. We can conclude that since the prognosis of neoplastic process in the ovaries is generally good with timely detection and this disease occurs mainly in women of reproductive age, doctors need to know that when assessing the parity and the presence of gynecological pathology at the moment or in anamnesis, it is not possible to identify alarming risk factors for the development of cancer in the ovaries.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Peng Wang ◽  
Lei Fang

Abstract Background To compare the postoperative recurrence and fertility in patients with borderline ovarian tumors (BOTs) who underwent different surgical procedures: salpingo-oophorectomy versus cystectomy. Methods Potentially relevant literature from inception to Nov. 06, 2020, were retrieved in databases including Cochrane Library, EMBASE (Ovid), and MEDLINE (Pubmed). We applied the keywords “fertility-sparing surgery,” or “conservative surgery,” or “cystectomy,” or “salpingo-oophorectomy,” or “oophorectomy,” or “adnexectomy,” or “borderline ovarian tumor” for literate searching. Systemic reviews and meta-analyses were performed on the postoperative recurrence rates and pregnancy rates between patients receiving the two different surgical methods. Begger’s methods, Egger’s methods, and funnel plot were used to evaluate the publication bias. Result Among the sixteen eligible studies, the risk of recurrence was evaluated in all studies, and eight studies assessed the postoperative pregnancy rates in the BOT patients. A total of 1839 cases with borderline ovarian tumors were included, in which 697 patients (37.9%) received unilateral salpingo-oophorectomy and 1142 patients (62.1%) underwent unilateral/bilateral cystectomy. Meta-analyses showed that BOT patients with unilateral/bilateral cystectomy had significantly higher recurrence risk (OR=2.02, 95% CI: 1.59-2.57) compared with those receiving unilateral salpingo-oophorectomy. Pooled analysis of four studies further confirmed the higher risk of recurrence in patients with cystectomy (HR=2.00, 95% CI: 1.11-3.58). In addition, no significant difference in postoperative pregnancy rate was found between patients with the two different surgical procedures (OR=0.92, 95% CI: 0.60-1.42). Conclusion Compared with the unilateral/bilateral cystectomy, the unilateral salpingo-oophorectomy significantly reduces the risk of postoperative recurrence in patients with BOT, and it does not reduce the pregnancy of patients after surgery. Trial registration PROSPERO CRD42021238177


2007 ◽  
Vol 23 (7) ◽  
pp. 373-376 ◽  
Author(s):  
Maite Cusidó ◽  
Rafael Fábregas ◽  
Pere Barris S ◽  
Cecilia Escayola ◽  
Pere Nolsac Barri

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