Stage IV ovarian cancer: prognostic factors and survival beyond 5 years.

BACKGROUND: Ovarian cancer continues to be the leading cause of death due to gynecologic malignancies and most patients still present with advanced disease. In the present study we evaluated long-term survival and prognostic factors in patients with stage IV ovarian cancer. PATIENTS AND METHODS: The charts of 62 consecutive women with FIGO stage IV epithelial ovarian cancer were reviewed. RESULTS: Chemotherapy was the only factor associated with longer survival. Three patients (5%) survived for longer than 5 years. One died of disease at 6.3 years and two are alive without evidence of disease at 12.4 and 14.9 years, respectively. CONCLUSION: Survival seemed to correlate with the possibility of administering chemotherapy. Patients with verified stage IV ovarian cancer, in whom due to the initial tumor load, operative extent and concomitant illness, the possibility of postoperative chemotherapy administration seems questionable, might be considered for primary chemotherapy followed by surgery.

Long-term survival of a patient with fallopian tube cancer presenting with a supraclavicular mass.

BACKGROUND: Five-year survival of patients with stage IV cancer of the fallopian tube is poor. Furthermore, patients with gynecological cancers presenting with a supraclavicular mass generally have an unfavorable prognosis. CASE REPORT: We describe a 70-year-old patient who presented with a left supraclavicular mass. The mass was removed and histology showed metastatic papillary adenocarcinoma strongly suggestive of papillary serous carcinoma. Abdominal hysterectomy and salpingo-oophorectomy showed a primary carcinoma of the fallopian tube. Postoperatively the patient received six cycles of carboplatin-based chemotherapy and is alive and well with no evidence of disease 5 years and 10 months after the primary diagnosis. CONCLUSION: Surgery and adjuvant carboplatin-based chemotherapy seem justified even in older patients with fallopian tube cancer and distant metastasis at the time of diagnosis.

Spontaneous vaginal delivery in the birth-chair versus in the conventional dorsal position: a matched controlled comparison.

AIM: The aim of the study was to assess the effect of a birth-chair on obstetric outcome. PATIENTS AND METHODS: We reviewed the hospital records of 220 consecutive pregnant women who gave birth on a birth-chair at our institution. The control group consisted of 440 pregnant women who preceded and followed the index cases and who had spontaneous vaginal deliveries in the conventional dorsal supine position. The controls were matched for parity and for the attending mid-wife. RESULTS: Patients who delivered in the birth-chair had significantly lower rates of episiotomy and manual separation of the placenta. The umbilical blood cord pH was significantly higher in neonates of the birth-chair group. The duration of labour, rate of perineal and vaginal injury, Apgar scores and rate of admission to a neonatal intermediate care unit were not influenced by the mode of delivery. CONCLUSION: Our data support previous studies that a birth-chair delivery may be a safe alternative to conventional delivery in the supine position.