RESUMEN
A 5-year survival of patients with Stage III colon cancer with prophylactic panhysterectomy in anamnesis was 83.3%, significantly higher than that of patients with Stage III colon cancer without panhysterectomy (69.3%) and than in colon cancer patients with metachronous ovarian metastases (42%). In families of patients with primary multiple malignant tumors (PMMT) of colon, endometrium and/or ovaries as well as in cases of accumulation in the same family of solitary tumors of the above locations it is necessary to carry out genetic testing to identify mutations in genes MSH2, MLH1, MSH6. Carriers of mutations in genes of mismatch repair MSH2, MLH1, MSH6 should be assumed to the high-risk group for the development of malignancies both PMMT of colon and organs of the female reproductive system and solitary tumors of the above locations. All women suffering from colon cancer, especially in the presence of mutations in genes of mismatch repair, in pre- and menopause should be undergone simultaneous prophylactic surgery: panhysterectomy. The question about the greater omentum should be decided situationally.
Asunto(s)
Colectomía/métodos , Neoplasias del Colon/cirugía , Heterocigoto , Histerectomía , Mutación , Prevención Primaria/métodos , Neoplasias Uterinas/prevención & control , Neoplasias Uterinas/cirugía , Proteínas Adaptadoras Transductoras de Señales/genética , Adulto , Anciano , Neoplasias del Colon/patología , Proteínas de Unión al ADN/genética , Femenino , Pruebas Genéticas , Humanos , Histerectomía/métodos , Masculino , Persona de Mediana Edad , Homólogo 1 de la Proteína MutL , Proteína 2 Homóloga a MutS/genética , Estadificación de Neoplasias , Proteínas Nucleares/genética , Linaje , Análisis de Supervivencia , Neoplasias Uterinas/genéticaRESUMEN
UNLABELLED: Adnexal masses are frequently found in both symptomatic and asymptomatic women. The frequency of them is 7,8% in reproductive aged women and 2,5-18% in postmenopausal patients. AIM: to investigate clinical significance of the Risk of Malignancy Index (RMI) and to compare it with histological findings in patients with adnexal masses. PATIENTS AND METHODS: 345 patients with adnexal masses were evaluated. Depending on the menopausal status, serum CA-125 level and ultrasonographic findings RMI scores were calculated for each of patients. RESULTS: according to RMI all the patients were divided in to two groups: first group - 283 (62%) of patients with RMI less then 200 and the second group -52 (38%) women with RMI more then 200. The patients of the second group were referred to the oncologist. Among the patients with RMI <200, 137(48,4%) endometriomas, 73(25,8%) serous cystadenoma, 45(15,9%) dermoid cysts, 22(7,8%) paraovarian cysts, 2 (0,7%) adenocarcinoma were detected after histological examination. In patients with RMI >200, 25% of benign ovarian tumors, 34,6% of borderline and 40, 4% of malignant tumors were verified. CONCLUSIONS: RMI when used in the presence of a pelvic mass is a useful triage tool to determine those women who should be referred to a gynaecological oncologist. During laparoscopy, in cases of intraoperative malignancy suspicion staging should be performed: videorecord of the surgery, biopsy of the adnexal mass and contralateral ovary, biopsy of the omentum and peritoneum, and aspiration of the peritoneal fluid for cytological examination.
Asunto(s)
Enfermedades de los Anexos/epidemiología , Menopausia , Medición de Riesgo/métodos , Enfermedades de los Anexos/diagnóstico , Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad , Morbilidad/tendencias , Estudios Retrospectivos , Factores de Riesgo , Federación de Rusia/epidemiología , Adulto JovenAsunto(s)
Cavidad Abdominal , Disección/métodos , Atrios Cardíacos , Leiomiomatosis , Ovario , Útero , Vena Cava Inferior , Cavidad Abdominal/patología , Cavidad Abdominal/cirugía , Adulto , Femenino , Atrios Cardíacos/patología , Atrios Cardíacos/cirugía , Humanos , Cuidados Intraoperatorios , Leiomiomatosis/patología , Leiomiomatosis/fisiopatología , Leiomiomatosis/cirugía , Monitoreo Intraoperatorio , Invasividad Neoplásica , Ovario/patología , Ovario/cirugía , Resultado del Tratamiento , Útero/patología , Útero/cirugía , Vena Cava Inferior/patología , Vena Cava Inferior/cirugíaRESUMEN
The analysis of 49 cases of synchronous and metachronous malignant mucinous tumors of the colon (rectum) and ovaries in the patients treated in 1990 to 2004 again has confirmed the data that metastatic ovarian cancer occurs from a primary focus in the colorectal region. Immunohistochemical studies (using cytokeratin 7 and cytokeratin 20) may be used in the differential diagnosis of ovarian mucinous ovarian carcinoma from metastatic colonic mucinous tumors.