Biweekly administration of docetaxel and carboplatin for advanced or recurrent endometrial and ovarian carcinomas.

OBJECTIVE: To examine efficacy and safety of biweekly administration of docetaxel and carboplatin for advanced or recurrent en- dometrial and ovarian carcinomas. MATERIAL AND METHODS: The recommended doses were determined in the phase I study. In the phase II feasibility study, the primary end-point was safety, and the secondary end-point was response rate and progression-free survival (PFS). RESULTS: The recommended doses of docetaxel and carboplatin were determined to be 45 mg/n(2) and AUC 3.0, respectively, in phase I study. In phase II feasibility study, no treatment-related death was observed. Most non-hematotoxicity cases were mild or moderate. Grade 4 neutropenia was confirmed in 13 patients (31.0%), whereas all cases showed tolerability with 2.6 days delay of anticancer drugs administration in both groups. Response rate was 55.0% in the ovarian carcinoma group, and average PFS was 8.7 months. In the endometrial carcinoma group, response rate was 50.0% and average PFS was 32.0 months. CONCLUSION: The present results showed that biweekly administration of docetaxel and carboplatin for advanced and recurrent endometrial and ovarian carcinomas results in acceptable side effects, response rate, and PFS.

Quality-of-life outcomes from a randomized phase III trial of dose-dense weekly paclitaxel and carboplatin compared with conventional paclitaxel and carboplatin as a first-line treatment for stage II-IV ovarian cancer: Japanese Gynecologic Oncology Group Trial (JGOG3016).

BACKGROUND: Dose-dense weekly paclitaxel (Taxol) and carboplatin (dd-TC) improved survival compared with conventional tri-weekly paclitaxel and carboplatin (c-TC) as a first-line chemotherapy for newly diagnosed stage II-IV ovarian cancer in the Japanese Gynecologic Oncology Group 3016 trial. We report the quality-of-life (QoL) results from this trial. PATIENTS AND METHODS: A total of 637 patients were randomly assigned to receive c-TC or dd-TC (c-TC, n = 319; dd-TC, n = 312) and were asked to complete a QoL assessment at baseline, just after the third and sixth chemotherapy cycles, and at 12 months after randomization. QoL was assessed using Functional Assessment of Cancer Therapy (FACT)-general (FACT-G), FACT-taxane subscale (FACT-T), and FACT-ovary subscale (FACT-Ov). The overall QoL and that according to each subscale were analyzed using mixed-effects models adjusted for treatment and time. RESULTS: Baseline QoL assessment was completed by 204 out of 319 (63.9%) and 200 out of 312 (64.1%) patients in the c-TC and dd-TC groups, respectively. In these groups, the compliance rates with regard to QoL assessment were 74.5% and 73.0%, respectively, after three chemotherapy cycles; 86.8% and 86.9%, respectively, after six chemotherapy cycles; and 74.2% and 71.6%, respectively, at 12 months after randomization. The overall QoL did not differ significantly between the two treatment groups up to 12 months after randomization (P = 0.46). However, QoL according to the FACT-T subscale was significantly lower in the dd-TC group than in the c-TC group (P = 0.02). CONCLUSION: dd-TC does not decrease overall QoL compared with c-TC.

A case of squamous cell carcinoma arising from endometriosis of the ovary.

Ovarian endometriosis sometimes develops into ovarian cancer, especially clear cell adenocarcinoma and endometrioid adenocarcinoma. However, endometriosis rarely develops into squamous cell carcinoma. We present a case of squamous cell carcinoma arising from endometriosis. A 47-year-old Japanese woman was given a diagnosis of ovarian squamous cell carcinoma arising from endometriosis. She was treated with combination chemotherapy consisting of paclitaxel and carboplatin once every three weeks. Four months after the initial chemotherapy, multiple liver tumors appeared, and her treatment was changed to palliative therapy. Based on this case, in which ovarian squamous cell carcinoma arose from endometriosis, endometriosis should be followed-up strictly.

[Study on expression of proliferating cell nuclear antigen (PCNA) in ovarian cancer].

Specimens of ovarian cancers, which were obtained through laparotomy from 17 patients who received no preoperative chemotherapy and were examined histopathologically, were immunohistologically stained with anti-PCNA antibody to examine the ability to proliferate. The percent age of stained tumor cells per 1,000 cells was used as a PCNA-labeled rate. This rate was analyzed in relation to the clinical stage/histological type and the presence or absence of lymph node metastasis. 1. Tissue specimens were stained with anti-PCNA antibody in all cases, and the PCNA-labeled rate was 49.5 +/- 13.3%. 2. There were no significant differences in PCNA-labeled rates between different histological types or between clinical stages. 3. The PCNA-labeled rates was significantly higher in cases with metastasis than in those without metastasis (p < 0.01). 4. No metastasis was detected in the cases showing a PCNA-labeled rate of 50% or below. It was indicated that this PCNA-labeled rate, which can be determined with formalin-fixed specimens, is useful for evaluating the degree of biological malignancy of ovarian cancer.

[Clinical study on total omentumectomy for ovarian cancer].

Omentumectomy as a basic surgical method at the site of metastasis of ovarian cancer was examined, and the importance of total omentumectomy was evaluated. Nineteen patients who underwent initial laparotomy and did not receive preoperative chemotherapy were examined histopathologically. 1. Omental metastasis was found in 9 of 19 patients (47%). 2. No significant correlation was seen between the maximum tumor diameter and omental metastasis. 3. No significant correlation was seen between the amount of ascites and omental metastasis. 4. Cytodiagnosis of the ascites and intraperitoneal lavage fluid showed significantly more omental metastasis in patients who tested positive. 5. Omentum in the upward direction from the teniae of the transverese colon showed a high incidence of metastasis. 6. Postoperative disturbances associated with total omentumectomy were mild. These results indicated that the omentum is the principle site of metastasis of ovarian cancer, and omentumectomy should be performed as total resection whenever possible since metastasis occurs in the upward direction because partial resection is not significant and postoperative disturbance is mild but there is the need for requiring further examination in the case of Ia stage.