STUDY OF RECURRENCE AND SITE OF RECURRENCE IN PATIENTS WITH ADVANCED EPITHELIAL OVARIAN CANCER - A SINGLE CENTER EXPERIENCE

2021 ◽  
pp. 80-81
Author(s):  
Bijan Kumar Saha ◽  
Shabber S. Zaveri
Keyword(s):  
Ovarian Cancer ◽  
Lymph Node ◽  
Physical Examination ◽  
Peritoneal Cavity ◽  
Biochemical Recurrence ◽  
Inguinal Lymph Node ◽  
Ca 125 ◽  
Common Site ◽  
Clinical Recurrence

OBJECTIVE– Study of recurrence and pattern of recurrence in Stage III epithelial ovarian cancer. METHODOLOGY – A prospective observational, study was conducted at a tertiary hospital in Bangalore, India from April 2017 to April 2019. Informed and written consent was taken before including the patient in the study. All patients diagnosed with stage III epithelial ovarian with no residual disease following cytoreductive surgery (primary, interval and secondary) with or without Hyperthermic Intraperitoneal Chemotherapy (HIPEC) were included in the study. Patients were followed every 3-6 months up to maximum period of 24 months from the date of surgery. Last date of follow up was on 30/04/19. During follow up patient symptoms, physical examination and serum CA-125 were recorded to detect recurrence. If patient symptoms, physical examination and rising serum CA-125 are suggestive of recurrence, imaging in form of CECTabdomen/ PETCT was done for detection of recurrence. Patients were monitored for two types of recurrence. Biochemical recurrence dened as rising CA125 in absence of clinical evidence of recurrence either by physical examination or by imaging. Clinical recurrence dened as recurrence in any part of body noted on physical examination or imaging and then proving it by biopsy with or without rise in serum CA-125.Site of rst recurrence was recorded. RESULTS- A total of 84 patients were included in the study. 45 patients underwent interval, 25 patients underwent primary and 14 patients underwent secondary cytoreductive surgery. Mean duration of follow up was 18.25 months. 4 patients lost follow up. 2 patients died following surgery. Recurrence was noted in 14 patients (16.66%). Clinical recurrence was noted in 13 patients (15.47%) and biochemical recurrence was noted in 1 patient (1.19%). 8 patients had recurrence in peritoneal cavity (57.14%). 1 patient each had recurrence right inguinal lymph node, paraaortic lymph node+ peritoneum, left iliac lymph node, left supraclavicular lymph node and left inguinal lymph node. CONCLUSION – In this study clinical recurrence was more common than biochemical recurrence. Peritoneal cavity was most common site for recurrence. This study shows importance of optimal cytoreductive reductive surgery in preventing recurrence in carcinoma ovary as peritoneal cavity is most common site of recurrence

Prognostic Relevance of Celiac Lymph Node Involvement in Ovarian Cancer

2014 ◽  
Vol 24 (1) ◽  
pp. 48-53 ◽  
Author(s):  
Alejandra Martínez ◽  
Cristophe Pomel ◽  
Thomas Filleron ◽  
Marjolein De Cuypere ◽  
Eliane Mery ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Lymph Node ◽  
Oncologic Outcome ◽  
Progression Free Survival ◽  
Disease Spread ◽  
Short Term ◽  
Free Survival ◽  
Increased Risk

ObjectiveThe aim of the study was to report on the oncologic outcome of the disease spread to celiac lymph nodes (CLNs) in advanced-stage ovarian cancer patients.MethodsAll patients who had CLN resection as part of their cytoreductive surgery for epithelial ovarian, fallopian, or primary peritoneal cancer were identified. Patient demographic data with particular emphasis on operative records to detail the extent and distribution of the disease spread, lymphadenectomy procedures, pathologic data, and follow-up data were included.ResultsThe median follow-up was 26.3 months. The median overall survival values in the group with positive CLNs and in the group with negative CLNs were 26.9 months and 40.04 months, respectively. The median progression-free survival values in the group with metastatic CLNs and in the group with negative CLNs were 8.8 months and 20.24 months, respectively (P = 0.053). Positive CLNs were associated with progression during or within 6 months after the completion of chemotherapy (P = 0.0044). Tumor burden and extensive disease distribution were significantly associated with poor progression-free survival, short-term progression, and overall survival. In multivariate analysis, only the CLN status was independently associated with short-term progression.ConclusionsDisease in the CLN is a marker of disease severity, which is associated to a high-risk group of patients with presumed adverse tumor biology, increased risk of lymph node progression, and worst oncologic outcome.

ESGO Statement on the Role of CA‐125 Measurement in Follow-Up of Epithelial Ovarian Cancer

2012 ◽  
Vol 22 (1) ◽  
pp. 175-175 ◽  
Author(s):  
Nicoletta Colombo ◽  
Gerald Gitsch ◽  
Nicolas Reed ◽  
Frederic Amant ◽  
David Cibula ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Ca 125

scholarly journals Mammary Gland Malignant Myoepithelioma in a Domestic Rabbit (Oryctolagus cuniculus)

2019 ◽  
Vol 47 ◽  
Author(s):  
Halana Do Carmo Silva ◽  
Avisa Rodrigues De Oliveira ◽  
Rodrigo Dos Santos Horta ◽  
Betânia Souza Moereira ◽  
Tatiany Luiza Silveira ◽  
...  
Keyword(s):  
Mammary Gland ◽  
Lymph Node ◽  
Oryctolagus Cuniculus ◽  
Blood Count ◽  
Complete Blood Count ◽  
Inguinal Lymph Node ◽  
Serum Biochemistry ◽  
Domestic Rabbit ◽  
Mitotic Figures

Background: Malignant myoepithelioma is a rare neoplasm in humans and rats, poorly reported in dogs and not previously described in rabbits. This study aimed to report a case of malignant mammary myoepithelioma in a domestic rabbit (Oryctolagus cuniculus). Case: A domestic, hybrid, female, entire, nulliparous, seven-year-old rabbit was attended in the Veterinary Hospital Prof. Ricardo Alexandre Hippler at Universidade Vila Velha (UVV) with a history of apathy, lethargy and anorexia. In the clinical examination a 5 cm tumour was observed in the right abdominal mammary gland (M2), along with floating smaller lesions in M1 and M3. There were no palpable abnormalities in the axillary and inguinal lymph nodes. Complete blood count and serum biochemistry were within the normal range. Fine needle aspiration was performed for cytopathological evaluation of the tumour in M2 and it was suggestive of a malignant glandular neoplasm, with probable epithelial origin. Complete staging included chest and abdominal radiographs, but they were unremarkable. The patient was submitted to a right unilateral mastectomy, involving resection of the inguinal lymph node. The sample was sent to the Laboratory of Animal Pathology of UVV for routine histological evaluation. Histopathological evaluation in M2 was compatible with malignant myoepithelioma based on the literature, while nodules in M1 and M3 were classified as mammary cysts. The inguinal lymph node showed no significant abnormalities. An immunohistochemical panel was performed in the Comparative Pathology Laboratory of the Institute of Biological Sciences of the Universidade Federal de Minas Gerais (UFMG), using immunomarkers (pan-cytokeratin, p63 and vimentin) to characterize the tumour and confirm its diagnosis. Immunohistochemistry revealed expression of p63, and was negative for pan-cytokeratin and vimentin, which confirmed the myoepithelial origin, without involvement of the epithelial compartment. Clinical follow-up was recommended every 2-3 months, including abdominal ultrasonography, chest X-rays, complete blood count and serum biochemistry. Ultrasonography showed thinning of the uterine wall, dilation of 3.7 cm in diameter and presence of endometrial cysts of varied sizes, around 0.7 cm. Neutering was recommended but it was not elected by the pet´s responsible. These findings remained stable throughout the follow-up, which was greater than 405 days.Discussion: This is the first report of a malignant myoepithelioma in rabbit, with a detailed description of the clinical, surgical, pathological and immunophenotypic aspects of this neoplasm in this species. This is a tumour characterized by proliferation of epithelioid to spindle-like myoepithelial cells, as observed in this case, forming an extensive and well delimited solid area with marked central necrosis, compatible with what has already been described in the literature on bitches and women. As observed in this case, the neoplastic cells usually exhibit moderate cellular and nuclear pleomorphism, moderate anisocytosis and anisokaryosis, and several mitotic figures; different from what is observed in women, in which mitotic figures vary from small to moderate amount. Neoplasia and mammary cysts were removed by mastectomy, and the owner choose not to castrate the animal. On ultrasonography, after 12 months, the endometrium presented structures similar to cysts and was hyperplastic, which is commonly reported in association to mammary neoplasia. Nervertheless, the pet´s owner choose not to spay the rabbit and the lesions were stable on imaging follow-up

Fifth Alon Dembo Memorial Workshop: Case 3

2010 ◽  
Vol 20 (Suppl 2) ◽  
pp. S24-S26 ◽  
Author(s):  
Peter E. Schwartz
Keyword(s):  
Ovarian Cancer ◽  
Ovarian Cancer Patient ◽  
Recurrent Ovarian Cancer ◽  
Ca 125 ◽  
Advanced Stage ◽  
Recurrent Cancer ◽  
Treatment Regimens ◽  
Platinum Sensitive ◽  
Very High

Background:OVO5/EORTC 55855, a study punitively refuting the value of CA-125 in the follow-up of ovarian cancer patients, has many deficiencies, including a heterogeneous ovarian cancer patient population, no control of initial treatment regimens, and no control of subsequent surgery or chemotherapeutic management for recurrence. Recent studies suggest a role for prompt surgery in selected cases of recurrent ovarian cancer with CA-125 elevations, a role for tamoxifen in managing rising CA-125 levels in patients without evidence of disease and the use of platinum doublets for treating recurrent platinum-sensitive disease, none of which were incorporated into OVo5/EORTC 55955.Case:A patient with advanced stage ovarian cancer presenting with a CA-125 level of 2000 U/mL, who is initially treated with surgery followed by chemotherapy and has a normal CT scan and normal CA-125 at completion of her initial chemotherapy.Conclusion:This patient remains at a very high risk for recurrence. I would continue to monitor this patient with serial CA-125 levels to identify recurrent cancer and consider initiating treatment before it is clinically obvious.

The relevance of rising CA-125 levels within the normal range in predicting recurrence in patients with advanced stage ovarian cancer: A validation study

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e16521-e16521
Author(s):  
F. AbuShain ◽  
P. Escobar ◽  
S. Shahabi ◽  
C. Michener ◽  
R. Drake ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Stage Iv ◽  
Complete Response ◽  
Disease Recurrence ◽  
Ca 125 ◽  
Normal Range ◽  
Number Of Patients ◽  
Response To Chemotherapy ◽  
Significant Difference

e16521 Background: Small published series suggested that three progressively rising CA-125 values, doubling of CA-125, and an absolute rise of 5 U/mL from the nadir, all while remaining in the normal range were highly associated with disease recurrence. This study aims to validate these proposed criteria in a larger population. Methods: We conducted a retrospective review of the records of patients with stages IIIC and IV epithelial ovarian cancer treated with primary surgery and adjuvant chemotherapy between 1994 and 2006. Only patients who had a complete response to chemotherapy verified by normal CT scan, CA-125 and physical examination were included. Nadir CA-125 level was defined as the first CA-125 measurement after completing chemotherapy. Available CA-125 values from diagnosis to recurrence or to last follow up were collected and evaluated for meeting any of the criteria above. Results: 91 patients with a median age of 59 (42 - 88) met the inclusion criteria. 82 patients had stage IIIC (90%) and 9 patients (10%) had stage IV. 86 patients (94.5%) had papillary serous histology and 88 patients had grade 3 (96.7%) disease. Median follow up was 43.7 months (12.6 - 156). Table 1 shows the number of patients who met any of the above CA-125 criteria in total and divided by the presence or absence of recurrence. There was no statistically significant difference in meeting any of the CA-125 criteria between the recurrence and no recurrence groups. Meeting at least one of the CA-125 criteria had 50% sensitivity, 65% specificity, and 86% positive predictive value for recurrence. The median time to recurrence in patients who met at least one CA-125 criteria was 3.8 months (0.2 - 12.4) and the median follow up time after meeting one of the CA 125 criteria in patients who did not recur was 88.5 months (10.4 - 188) Conclusions: Rising CA-125 levels within the normal range that meet any of the above criteria are highly predictive (86%) of recurrence within 12 months and closer observation is warranted. [Table: see text] No significant financial relationships to disclose.

Defining predictors of early, intermediate, and late biochemical recurrence in men with clinically localized prostate cancer treated with minimally invasive radical prostatectomy.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 113-113
Author(s):  
Silvia Garcia Barreras ◽  
Igor Nunes-Silva ◽  
Rafael Sanchez-Salas ◽  
Fernando P. Secin ◽  
Victor Srougi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Logistic Regression ◽  
Lymph Node ◽  
Laparoscopic Surgery ◽  
Radical Prostatectomy ◽  
Minimally Invasive ◽  
Biochemical Recurrence ◽  
Surgical Margins ◽  
Positive Surgical Margins

113 Background: Follow up after radical prostatectomy should be tailored to clinical and pathologic characteristics. To determine predictive factors for early, intermediate and late biochemical recurrence (BCR) after minimally invasive radical prostatectomy (MIRP: lap and robot) in patients with localized prostate cancer (PCa). Methods: Prospective clinical, pathologic, and outcome data were collected for 6195 patients with cT1-3N0M0 PCa treated with MIRP at our institution from 2000 to 2016. None of them received neoadjuvant therapy. BCR was defined as PSA level greater than 0.2 ng/ml. Time to BCR was divided in terciles to identify variables associated with early ( < 12 months), intermediate (12-36 months) and late BCR ( > 36 months). Comparisons among groups were performed using ANOVA or Chi square test. Logistic regression models were built to determine risk factors associated with BCR at each time interval. Results: We identified 1148 (19%) patients with BCR. Median time to BCR was 24 months. Statistically significant differences were found between the groups concerning PSA preoperative, D’Amico risk, type of surgery, pT stage, pathological Gleason, positive margins and extracapsular extension. Multivariable logistic regression analysis showed preoperative PSA, positive nodes, positive surgical margins and laparoscopic surgery were associated with early BCR. Laparoscopic surgery was the only risk factor associated with intermediate term BCR. Significant predictors of late BCR included Gleason ≥ 7, ≥ pT3, positive surgical margins, lymph node dissection performance and laparoscopic surgery. Conclusions: Patients with high risk features like Gleason ≥ 7, ≥ pT3 and or positive surgical margins may develop late recurrence and deserve long term follow up. Identify patients with higher PSA and lymph node invasion has an important predictive role due to the risk of BCR within the first year. The association between laparoscopic technique and late BCR deserves further evaluation.

scholarly journals Hospital Follow Up in Ovarian Cancer: Physical Examination Does Not Improve Relapse Detection or Survival

2012 ◽  
Vol 23 ◽  
pp. ix324
Author(s):  
S. Chow ◽  
S. Ayers ◽  
A. Clamp ◽  
G.C. Jayson ◽  
J. Hasan
Keyword(s):  
Ovarian Cancer ◽  
Physical Examination

scholarly journals The Pedicled Flap of Adductor Longus, a New Technique for Inguinal Reconstruction

2021 ◽  
Vol 8 ◽  
Author(s):  
Hong Zhang ◽  
Zhenfeng Li ◽  
Jianmin Li ◽  
Lei Zhu ◽  
Yakubu Ibrahim
Keyword(s):  
Lymph Node ◽  
Lymph Node Dissection ◽  
Inguinal Lymph Node ◽  
Pedicled Flap ◽  
Local Resection ◽  
Inguinal Region ◽  
Node Dissection ◽  
Inguinal Lymph Node Dissection ◽  
Adductor Longus

Introduction: Reconstruction surgeries of the inguinal area pose a challenge for oncological and orthopedic surgeons, especially after radical local resection (RLR), radical inguinal lymph node dissection (RILND), or both. Although numerous surgical procedures have been reported, there is no report about a pedicle adductor longus flap method. The aim of this work is to show our experience about inguinal reconstruction with pedicled adductor longus flap and associated outcomes.Patients and Methods: A retrospective study of 16 patients with localized inguinal region interventions and reconstructed by adductor longus flap from March 2016 to July 2020. Patients' average age was 60.0 years (range = 38–79 years) and had postoperative follow-up of 10 months (ranging 2–19 months). All patients had unilateral inguinal region involvement—seven cases on the left and nine cases on the right. The patients' clinical course, operative course, and postoperative follow-up data were evaluated.Results: All 16 patients recovered well post-operatively and did not require any re-intervention. Four patients experienced negligible discomfort around the groin area. Five patients experienced a minor strength deficit in thigh adduction compared with that of preoperative strength in the same or contralateral leg. The aforementioned complications resolved during the postoperative course and had no functional impact on their activity of daily living. All adductor longus flaps survived, completely filled the inguinal dead space, and wounds healed uneventfully within 3 weeks except for three patients who suffered delayed wound healing for more than 4 weeks. Other common complications such as infection, seroma, or wound dehiscence were not encountered in this series.Conclusion: The adductor longus flap is a reliable alternative method for inguinal region reconstruction following radical local resection (RLR), radical inguinal lymph node dissection (RILND), or both.

What Surveillance Plan Should Be Advised for Patients in Remission After Completion of First-Line Therapy for Advanced Ovarian Cancer?

2010 ◽  
Vol 20 (Suppl 2) ◽  
pp. S27-S28 ◽  
Author(s):  
Gordon J. S. Rustin
Keyword(s):  
Ovarian Cancer ◽  
Medical Research Council ◽  
Advanced Ovarian Cancer ◽  
Clinical Indication ◽  
Ca 125 ◽  
First Line ◽  
The Third ◽  
First Line Therapy ◽  
Line Therapy

Based on the results of the Medical Research Council OVO5/European Organisation for Research and Treatment of Cancer 55955 trial, the follow-up plan I recommend for patients in remission after completion of first-line therapy for advanced ovarian cancer is appointments: every 3 months for 2 years, every 4 months on the third year, then every 6 months thereafter, and discharge if no relapse by 10 years. History and examination (not internal) should be performed at each appointment. CA-125 should only be measured if there is a suspicion of relapse or at patient's request. No scans should be performed unless clinical indication or rising CA-125.

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