Epithelial ovarian cancer and type of peritoneal insult: a case-control study.

OBJECTIVE: To evaluate the association between different types of peritoneal insults and the development of sporadic epithelial ovarian cancer (EOC) subtypes in the general population. STUDY DESIGN: Hospital based case control study comparing sporadic cases of EOC with age matched control group between 2003 and 2008. Medical, surgical, and gynecological histories were compared between 208 women with histological diagnosis of EOC and 224 women in the control group matched for age at presentation for well woman examination. RESULTS: 18% patients in the study population and 5% patients in the control group had history of diverticulosis (OR 7.3, 95% CI 2.8-19.1). 10% patients in the study populations and 39% patients in the control group had history of diabetes mellitus (OR 0.41, 95% CI 0.23-0.75). Sub classification of EOC into type 1 and type 2 further revealed 12% patients (OR 0.44, 95% CI 0.22-0.87) in type 1 group, 35% patients (OR 0.43, 95% CI 0.27-0.69) in type 2 group, and 71% patients in the control group had no prior surgical history. Furthermore, 3% patients (OR 0.27; 95% CI 0.08-0.9) in the type 1 group, 48% patients (OR 2.0, CI 95% 1.24-3.24) in the type 2 group, and 41% patients in the control group had history of bilateral tubal ligation (BTL). CONCLUSION: A significant association was found between diverticulosis, hysterectomy and endometriosis increasing the likelihood of type 1 EOC; while diverticulosis, exploratory laparotomy and hysterectomy increased the likelihood of type 2 EOC. BTL was significantly associated with decreasing the likelihood of type 1 EOC, but increasing the likelihood of type 2 EOC. Diabetes mellitus and no prior surgical history were found to significantly decrease the likelihood of all EOC.

Nonsurgical Management of Neuroendocrine Cancer of the Cervix: Brief Report.

OBJECTIVES: The aim of this study was to evaluate disease progression and overall survival in patients diagnosed with neuroendocrine carcinoma of the cervix treated with chemotherapy and radiation without surgical intervention; we hypothesize similar overall survival to the surgical intervened cases. METHODS: This study used a retrospective analysis of patients with neuroendocrine carcinoma of the cervix who were not surgically managed. Review was performed from 1990 to 2014. The data collected included demographics, stage of disease, and outcomes after each treatment. Specific chemotherapy regimen given and radiation dosage were reviewed. Overall survival and recurrence rates were calculated. RESULTS: A total of 16 patients met inclusion criteria. Six patients were diagnosed with stage I; these patients had 83.3% 2-year overall survival, 83.3% 5-year overall survival, and a recurrence rate of 16.6%. Three patients were diagnosed with stage II; these patients had 66.6% 2-year overall survival, 0% 5-year overall survival, and a recurrence rate of 100%. Seven patients were diagnosed with stage IV; these patients had 14.3% 2-year overall survival and 0% 5-year overall survival and never underwent remission. CONCLUSIONS: Our findings noted a comparable overall survival with lower rates of recurrence in patients with early-stage disease using chemotherapy and radiation therapy alone as primary means of treatment. Nonsurgical management of neuroendocrine carcinoma of the cervix may be of benefit in early-stage disease.