Pretreatment total lymphocyte count as a prognostic factor of survival in patients with recurrent cervical cancer after definitive radiation-based therapy: a retrospective study.

OBJECTIVE: This study evaluated the association between pretreatment total lymphocyte count (TLC) and overall survival (OS) in patients with recurrent cervical cancer. METHODS: We retrospectively reviewed 290 patients with recurrent cervical cancer with definite complete responses to either definitive radiotherapy or concurrent chemoradiotherapy between January 2009 and December 2022. The associations between pretreatment TLC and progression-free survival (PFS) and OS rates were evaluated. RESULTS: Ninety-three patients (32%) had a pretreatment TLC <1,000 cells/mm3. Patients with a pretreatment TLC <1,000 cells/mm3 had lower treatment response rates than their counterparts (P=0.045). The OS and PFS rates were significantly higher in patients with pretreatment TLC ≥1,000 cells/mm3 than in those with pretreatment TLC <1,000 cells/mm3 (10.74 vs. 3.89 months, P<0.0001; 8.32 vs. 4.97 months, P=0.042; respectively). Moreover, pretreatment TLC ≥1,000 cells/mm3 was identified as an independent prognostic factor for OS in both univariate analysis (hazard ratio [HR], 0.57; 95% conficence interval [CI], 0.44-0.74; P<0.001) and multivariate analysis (HR, 0.64; 95% CI, 0.47-0.86; P=0.003). However, TLC ≥1,000 cells/mm3 was identified as a prognostic factor for PFS only in univariate analysis (HR, 0.71; 95% CI, 0.51-0.99; P=0.043) but not in the multivariate analysis (HR, 0.81; 95% CI, 0.55-1.18; P=0.3). CONCLUSION: Pretreatment TLC was associated with treatment response and was identified as an independent prognostic factor associated with the survival outcomes of patients with recurrent cervical cancer.

Ovarian steroid cell tumor (not otherwise specified) with subsequent spontaneous pregnancy after tumor removal: a case report and literature review.

Steroid cell tumors not otherwise specified are rare sex cord-stromal tumors of the ovary that may produce various steroids and are associated with hirsutism and virilization. We report a rare case of ovarian steroid cell tumor with subsequent spontaneous pregnancy after tumor removal. A 31-year-old woman presented with secondary amenorrhea, hirsutism, and inability to conceive. Clinical and diagnostic evaluations revealed a left adnexal mass and elevated serum total testosterone and 17α-hydroxyprogesterone levels. She underwent a left salpingo-oophorectomy, and histopathological examination confirmed the diagnosis of a steroid cell tumor not otherwise specified. Her serum total testosterone and 17α-hydroxyprogesterone normalized one month after surgery. Her menses resumed spontaneously one month after the operation. She spontaneously conceived 12 months after the surgery. The patient had an uncomplicated pregnancy and delivered a healthy male infant. In addition, we reviewed the literature on steroid cell tumors not otherwise specified with subsequent spontaneous pregnancies after surgery and data regarding pregnancy outcomes.

Secondary Erythrocytosis Associated with Uterine Myoma Is Rare but Should Be of Concern.

Myomatous erythrocytosis syndrome (MES) is a rare gynecological condition, defined by the presence of the clinical triad of erythrocytosis, uterine fibroids, and normalization of red blood cell counts after the surgical removal of uterine fibroids. Herein, we report the case of a woman, in the postmenopausal stage, with the clinical triad of MES. She had a history of erythrocytosis of unknown etiology and underwent phlebotomy for a year prior to visiting our hospital. Pre-operative hemoglobin (Hb) level, hematocrit (Hct) level, and red blood cell (RBC) count were 18.1 g/dL, 56.1%, and 6.52 million cells/µL, respectively. She underwent exploratory laparotomy, transabdominal hysterectomy, and bilateral salpingo-oophorectomy. The operative findings revealed a large uterine myoma, and the pathology result was compatible with uterine leiomyoma. All hematologic parameters returned to the normal range on post-operative day 1. Her hematologic parameters returned to normal values 4 weeks after surgery with a Hb level of 13.5 g/dL, Hct level of 41.2%, and RBC count of 4.92 million cells/µL. The exact pathophysiology of this condition remains unknown. However, surgical removal of uterine myoma is the mainstay of treatment. Despite the rarity of this condition, its diagnosis should be considered in patients presenting with erythrocytosis and uterine masses.

Pretreatment lymphocyte count as independent prognostic factor in patients with locally advanced cervical cancer treated with concurrent chemoradiotherapy.

OBJECTIVE: To evaluate the association between pretreatment total lymphocyte counts (TLC) and survival outcome in locally advanced cervical cancer (LACC) patients treated with definite concurrent chemoradiotherapy (CCRT). METHODS: We retrospectively reviewed the data of 789 patients diagnosed with cervical cancer stage IIB to IVA treated with CCRT between January 2011 and December 2015. We assessed the association of pretreatment TLC with 5-year disease-free survival (DFS) and overall survival (OS) rates. RESULTS: Fifty-two patients had pretreatment TLC < 1000 cells/mm3 . The median pretreatment TLC in TLC groups <1000 cell/mm3 and ≥1000 cell/mm3 were 573.9 cells/mm3 (range, 350.9-827.7 cells/mm3 ) and 2211.3 cells/mm3 (range, 1751.3-2785.8 cells/mm3 ), respectively. Patients in pretreatment TLC < 1000 cell/mm3 group had a lower number of treatment responses. The 5-year DFS and OS rates were significantly higher in patients with pretreatment TLC ≥ 1000 cells/mm3 than their counterparts (67.7% vs. 35.4% [P < 0.0001] and 57.6% vs. 25.7% [P < 0.0001], respectively). In multivariate analysis, pretreatment TLC ≥ 1000 cells/mm3 was an independent predictor of DFS (HR, 0.39; 95% confidence interval [CI] 0.26-0.59, P < 0.001) and OS (HR, 0.59; 95% CI 0.42-0.84, P = 0.006). CONCLUSION: Pretreatment TLC was associated with treatment response and survival outcome in patients with LACC treated with definite CCRT.