Effect of Lymphadenectomy on Survival in Early-Stage Type II Endometrial Carcinoma and Carcinosarcoma.

PURPOSE: We aimed to investigate whether systematic pelvic and paraaortic lymph node dissection delivers any survival advantage in a subgroup of patients with type II endometrial carcinoma and carcinosarcoma. METHODS: We evaluated 135 patients with clinically early-stage (Stage I-II) type II endometrial carcinoma and carcinosarcoma who underwent systematic pelvic and paraaortic lymph node dissection or who did not undergo any lymph node dissection. RESULTS: Overall survival (OS) and recurrence-free survivals (RFS) were significantly longer in the systematic lymph node dissection group (hazard ratio 0.28, 95% CI 0.13-0.62 p=0.002 for OS and hazard ratio 0.31, 95% CI 0.14-0.69 p=0.004 for RFS). Multivariate analysis showed that lymph node dissection, age, lymph node metastasis, and adjuvant therapy were independent prognostic variables of OS and RFS. CONCLUSIONS: Systematic pelvic and paraaortic lymph node dissection independently and significantly prolongs the survival of patients with early-stage type II endometrial carcinoma and carcinosarcoma.

Extrapulmonary lymphangioleiomyomatosis mimicking lymphoma metastatic to uterus.

Lymphangioleiomyomatosis is a very rare disease that primarily affects the lungs. The atypical smooth muscle cells in these tumors stain both with smooth muscle markers and melanocytic markers characteristically like their counterparts in other members of the PEComa family. Extrapulmonary lymphangioleiomyomatosis, especially without pulmonary involvement, is extremely rare. The clinical importance of lymphangioleiomyomatosis lies in the fact that it may mimic other malignant diseases, such as lymphoma or sarcoma. Here, we report a case of extrapulmonary lymphangioleiomyomatosis without involvement of the lungs, in a patient pre-diagnosed as having lymphoma metastasized to the uterus or uterine sarcoma.

Malignant germ cell tumors of the ovary: a review of 41 cases and risk factors for recurrence.

OBJECTIVE: To review the outcome of treatment in patients with malignant ovarian germ cell tumors and to define the risk factors for recurrence. MATERIAL AND METHODS: Forty-one patients with malignant ovarian germ cell tumors were reviewed retrospectively. Survival time and survival rate were obtained. Risk factors such as stage, histological type, and type of operation were evaluated for reccurrence. RESULTS: Twenty-three (56%) had dysgerminomas, eight (19.5%) had mixed germ cell tumors, three (7.3%) had yolk sac tumors, three (7.3%) had immature teratomas, two (4.8%) had squamous cell carcinoma arising from a mature teratoma, one (2.4%) had embryonal carcinoma and one choriocarcinoma. Most of the cases (73%) were in Stage I. Twenty-nine patients (70.7%) underwent conservative surgery and 12 patients (29.3%) had at least bilateral salpingo-oophorectomy. Thirty patients were operated on optimally with surgical staging and 11 suboptimally. Seven patients (17%) had recurrence after remission. The overall survival time was 187 +/- 8.43 months for all cases, 195 +/- 8.49 for dysgerminoma and 161 +/- 10.96 for non-dysgerminoma cases with a median follow-up time of 98.52 (8-204) months. Non-dysgerminoma histologic type, being operated on suboptimally and radically, and advanced tumor stage have been found to be risk factors for recurrence. CONCLUSION: Regardless of histologic types and stages the prognosis of germ cell tumors are satisfactory with current therapeutic strategies.