Surgical Treatment in Ovarian Cancer - Complete or Optimal Surgery?

Abstract Surgical integration in the overall ovarian cancer protocol is conditioned by the performance it has allowed in cytoreduction, the benefits obtained in the interest of the patients in terms of risk (postoperative mortality, severe sequelae, oncology survival criterion at 5 years). Surgical treatment remains the fundamental technical means in the treatment of ovarian cancer. It is performed either in the “first intention” (the strand: High-Probability Clinical Diagnosis, Extemporaneous Histopathological Examination Surgery, Continued Intervention, Postoperative Adjuvant Treatments: Chemotherapy, Radiotherapy, Immunotherapy, Hormone Therapy, Second-look 6 Months), or in “second intent” (precise histopathological / pelviscopic or classic diagnosis, followed by chemotherapy, radiotherapy, immunotherapy and radical surgery).

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Surgical management of bronchopulmonary carcinoids: A single center experience

South Asian Journal of Cancer ◽

10.4103/2278-330x.202568 ◽

2017 ◽

Vol 06 (01) ◽

pp. 006-010 ◽

Cited By ~ 1

Author(s):

Ashish Jakhetiya ◽

Pankaj Kumar Garg ◽

Rambha Pandey ◽

Palaniappan Ramanathan ◽

Sunil Kumar ◽

...

Keyword(s):

Surgical Treatment ◽

Histopathological Examination ◽

Postoperative Mortality ◽

North India ◽

Biological Behavior ◽

Long Term Results ◽

Surgical Approaches ◽

Delayed Presentation ◽

Duration Of Symptoms ◽

Tertiary Teaching

Abstract Introduction: Bronchopulmonary carcinoids are uncommon tumors with relatively indolent biological behavior but a distinct malignant potential. Surgery is the mainstay of treatment. Our aim was to study preoperative characteristics, surgical approaches, and outcome in patients with bronchopulmonary carcinoid tumors. Patients and Methods: This retrospective study was done in the Department of Surgical Oncology of a Tertiary Teaching Hospital of North India. The case records of all the patients who underwent surgical treatment for lung neoplasms and were diagnosed to have bronchopulmonary carcinoids were reviewed. Details concerning the clinical presentation, preoperative therapy, operative procedure, postoperative complications, and outcome were retrieved from the case records. Results: Sixteen patients who underwent surgical treatment were found to have bronchopulmonary carcinoids on histopathological examination. The median age of the patients was 34 years (range 18–62 years). There were 11 men and five women. All patients were symptomatic, and the median duration of symptoms was 12 months (range 6–72 months) before presentation. Six patients had received antitubercular treatment before presentation, and one patient had been treated with chemotherapy due to misdiagnosis. Surgical procedures included six pneumonectomies (one with carinoplasty), four bilobectomies, three lobectomies, and three bronchoplastic procedures (two with lobectomy and one with bilobectomy). There was no postoperative mortality; three patients had morbidity in the form of lobar collapse, prolonged pleural collection, and surgical site infection. With a median follow-up time of 11 months (range 2–85 months), all the 16 patients are alive and disease-free. Conclusions: Delayed presentation and misdiagnosis of bronchial carcinoid are major concerns in North India. Adequate surgical resection can be performed without undue morbidity and is associated with good long-term results.

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Second-look laparotomy in the management of patients after radical surgery for ovarian cancer

Annals of Oncology ◽

10.1093/oxfordjournals.annonc.a058424 ◽

1993 ◽

Vol 4 (2) ◽

pp. 169-171 ◽

Cited By ~ 4

Author(s):

M. Kolyszko Tuxen ◽

B. Lund ◽

O. Paaske Hansen ◽

M. Hansen

Keyword(s):

Ovarian Cancer ◽

Radical Surgery ◽

Second Look

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Case 1 – Stage IV low-grade serous ovarian carcinoma management in an elderly patient

Cancer Breaking News ◽

10.19156/cbn.2017.0047 ◽

2017 ◽

Vol 5 (2) ◽

pp. 39-45

Author(s):

Luisa Sánchez-Lorenzo ◽

Antonio González-Martín ◽

David M. Gershenson

Keyword(s):

Ovarian Cancer ◽

Hormone Therapy ◽

Histopathological Examination ◽

Tumor Biology ◽

Treatment Strategies ◽

Progesterone Receptors ◽

Stage Iv ◽

Initial Assessment ◽

Low Grade ◽

Serous Ovarian Cancer

Recurrent low-grade serous ovarian cancer (LGSOC) is considered relatively chemoresistant; until more effective chemotherapy approaches become available, surgical management remains the mainstay of treatment. However, some subtypes of LGSOC behave distinctly differently from high-grade SOC. The upregulation of estrogen and progesterone receptors in ovarian cancer suggests hormone therapy as a possible treatment modality. Our patient was a 75-year-old woman with advanced low-grade papillary serous ovarian cancer. In consultation, supported by appropriate histopathological examination and immunohistochemical study to guide the treatment decisions, our Gynaecological Oncology Multi-Disciplinary Team recommended primary debulking surgery. The patient underwent surgery followed by hormone therapy with letrozole, after declining bevacizumab-containing adjuvant chemotherapy. Eighteen months of ongoing monitoring has shown no signs of progressive disease and stable tumor markers. This case highlights the importance of initial assessment by a multidisciplinary team experienced in gynecological oncology, together with knowledge of the tumor biology, to determine effective treatment strategies for the management of advanced LGSOC.

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ROLE OF ULTRASOUND IN THE DETECTION OF RECURRENT OVARIAN CANCER

UZBEK MEDICAL JOURNAL ◽

10.26739/2181-0664-2020-6-4 ◽

2020 ◽

Vol 6 (1) ◽

pp. 23-31

Author(s):

M. Alisherova ◽

◽

M. Ismailova

Keyword(s):

Ovarian Cancer ◽

Surgical Treatment ◽

Reproductive System ◽

Malignant Tumors ◽

Recurrent Ovarian Cancer ◽

Primary Diagnosis ◽

Female Reproductive System

Currently, there are no standard approaches to monitoring patients with ovarian cancer (OC). While the role of ultrasound (US) has been identified in the primary diagnosis of OS, it is still controversial during the subsequent surgical treatment of OC. In world statistics, ovarian cancer is consistently among the four main localizations of malignant tumors of the female reproductive system, along with tumors of the breast, body and cervix.

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A prospective observational study on the effectiveness of risk of malignancy index score (RMI 3) in a tertiary care centre in Eastern India

Asian Journal of Medical Sciences ◽

10.3126/ajms.v11i5.29548 ◽

2020 ◽

Vol 11 (5) ◽

pp. 54-60

Author(s):

Apurba Mandal ◽

Shibram Chattopadhyay ◽

Sushanta Mondal ◽

Arunava Biswas

Keyword(s):

Ovarian Cancer ◽

Adnexal Mass ◽

Malignant Tumors ◽

Histopathological Examination ◽

Tertiary Care ◽

Ca 125 ◽

Tertiary Care Centre ◽

Gynecology And Obstetrics ◽

Risk Of Malignancy ◽

Malignant Lesions

Background: Adnexal mass is a common presentation in today’s gynecological practice. The incidence of ovarian cancer is increasing day by day and diagnosis is often difficult to be made pre operatively with inadequate surgical exploration is a regular occurrence. Aims and Objectives: To assess and validate the importance of RMI-3 score as pre-operative diagnostic tool of differentiating benign from malignant adnexal mass for starting first line therapy of ovarian cancer and to find out the incidences of ovarian malignancy among study population. Material and Methods: The study was conducted in the Department of Gynecology and Obstetrics on (n=115) patients attending GOPD and indoor with adnexal mass fulfilling the inclusion and exclusion criteria using purposive sampling technique. All the selected cases underwent ultrasonography and serum CA- 125 level estimation necessary for calculating RMI score. A score of >200 was taken as suggestive of malignancy and confirmatory diagnosis was performed by histopathological examination obtained from staging laparotomy of adnexal mass. The individual scores were then correlated with final outcomes with statistical analyses. Results: The study revealed benign ovarian tumors are more under 50 years (78.46%) and patients with normal BMI are diagnosed with maximum of malignancy (n = 28). History of tubal ligation carried less risk of malignancy (p<0.0001). Histologically malignant tumors found mostly in 71.4% postmenopausal group whereas 94.1% benign pathology were present in perimenopausal group and there is no association found between parity and histopathology (p=0.058). Bilateral (p=0.013), multilocular (p=0.000) tumors with solid areas (p<0.0001) and thick papillary projections (p<0.0001) had statistically significant association with malignant lesions. RMI score (>200) had more efficacy than serum CA-125 level (>46) in differentiating malignant lesions from benign one in terms of specificity (96% vs 83.87%) and positive predictive value (95% vs 79.17%). Conclusions: RMI-3 score is a simple, reliable and effective tool in differentiating benign from malignant adnexal masses thereby help in quick referral and management of cases with increase chances of survival of the patients.

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Histopathological specialized staining of oral lichen planus-induced fibrotic changes and surgical treatment of associated restricted mouth opening: a case report

Bulletin of the National Research Centre ◽

10.1186/s42269-021-00514-0 ◽

2021 ◽

Vol 45 (1) ◽

Author(s):

Atsushi Shudo

Keyword(s):

Surgical Treatment ◽

Lichen Planus ◽

Oral Lichen Planus ◽

Histopathological Examination ◽

Mouth Opening ◽

Ki 67 ◽

Collagen Formation ◽

Immune Mediated ◽

Cytokeratin 13 ◽

Oral Lichen

Abstract Background Oral lichen planus is a chronic inflammatory and immune-mediated disease that affects the oral mucosa. Recent findings have suggested that oral lichen planus is often associated with submucosal fibrotic changes. Fibrotic changes in the buccal submucosa may cause restricted mouth opening. This report discusses the histopathological examination (including specialized staining) and surgical treatment for oral lichen planus-induced fibrotic changes. Case presentation Here, we describe a 63-year-old woman who had oral lichen planus with fibrotic changes. Her maximum mouth opening distance was approximately 30 mm due to submucosal fibrotic changes, and she exhibited gradual fibrosis progression. Histological examinations were performed to assess the oral lichen planus-induced fibrotic changes. Then, double Z-plasty were performed as treatment for restricted mouth opening. The immunohistochemical staining results were negative for cytokeratin 13 and positive in some layers for cytokeratin 17 and Ki-67/MIB-1. Masson's trichrome staining showed enhanced collagen formation. Postoperative mouth opening training enabled the patient to achieve a mouth opening distance of > 50 mm. Conclusion Our findings suggest that histopathological examination with specialized staining can aid in the evaluation of oral lichen planus-induced fibrotic changes, and that Z-plasty is effective for the treatment of restricted mouth opening due to oral lichen planus.

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Clinical outcomes of patients with endometrioid epithelial ovarian cancer following surgical treatment

Journal of Surgical Oncology ◽

10.1002/jso.26597 ◽

2021 ◽

Author(s):

Paulina Cybulska ◽

Jill Tseng ◽

Qin C. Zhou ◽

Alexia Iasonos ◽

Deborah F. Delair ◽

...

Keyword(s):

Ovarian Cancer ◽

Surgical Treatment ◽

Epithelial Ovarian Cancer ◽

Clinical Outcomes

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Outcomes of Surgical and Nonsurgical Treatment for Colorectal Cancer in Nonagenarian Patients

The American Surgeon ◽

10.1177/0003134821995060 ◽

2021 ◽

pp. 000313482199506

Author(s):

Youngbae Jeon ◽

Kyoung-Won Han ◽

Won-Suk Lee ◽

Jeong-Heum Baek

Keyword(s):

Colorectal Cancer ◽

Overall Survival ◽

Surgical Treatment ◽

Postoperative Complications ◽

Postoperative Mortality ◽

Nonsurgical Treatment ◽

Perioperative Outcomes ◽

Rank Test ◽

Kaplan Meier ◽

Number Of Patients

Purpose This study is aimed to evaluate the clinical outcomes of surgical treatment for nonagenarian patients with colorectal cancer. Methods This retrospective single-center study included patients diagnosed with colorectal cancer at the age of ≥90 years between 2004 and 2018. Patient demographics were compared between the operation and nonoperation groups (NOG). Perioperative outcomes, histopathological outcomes, and postoperative complications were evaluated. Overall survival was analyzed using Kaplan-Meier methods and log-rank test. Results A total of 31 patients were included (16 men and 15 women), and the median age was 91 (range: 90‐96) years. The number of patients who underwent surgery and who received nonoperative management was 20 and 11, respectively. No statistical differences in baseline demographics were observed between both groups. None of these patients were treated with perioperative chemotherapy or radiotherapy. Surgery comprised 18 (90.0%) colectomies and 2 (10.0%) transanal excisions. Short-term (≤30 days) and long-term (31‐90 days) postoperative complications occurred in 7 (35.0%) and 4 (20.0%) patients, respectively. No complications needed reoperation, such as anastomosis leakage or bleeding. No postoperative mortality occurred within 30 days: 90-day postoperative mortality occurred in two patients (10.0%), respectively. The median overall survival of the operation group was 31.6 (95% confidence interval: 26.7‐36.5) and that of NOG was 12.5 months (95% CI: 2.4‐22.6) ( P = 0.012). Conclusion Surgical treatment can be considered in carefully selected nonagenarian patients with colorectal cancer in terms of acceptable postoperative morbidity, with better overall survival than the nonsurgical treatment.

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