RESUMO
Clear cell carcinoma of the ovary accounts for 2 to 3% of all epithelial ovarian neoplasms. Patient profiles, pathological characteristics, and results of treatment are reviewed for 59 patients. The median age was 51. Disease extent at diagnosis was as follows: stage I, 18 patients (31%); stage II, 20 patients (34%); stage III, 15 patients (25%); stage IV, 3 patients (5%); and unknown stage, 3 patients (5%). Endometriosis was identified in 13 patients (22%). Hysterectomy and bilateral salpingo-oophorectomy were performed in 47 patients (80%), unilateral salpingo-oophorectomy in 8 patients (14%), and bilateral salpingo-oophorectomy in 4 patients (7%). Radiotherapy was given to 15 patients (25%), and chemotherapy was given to 42 patients (71%). The overall 2- and 5-year survival rates were 49 and 43%. The median survival was 26 months. Patients with tumors with fewer than 10 mitoses per 10 high-power fields and less than 50% solid areas had significantly longer disease-free intervals. Clear cell tumors are usually diagnosed at an earlier disease stage than the other epithelial ovarian cancers; stage for stage, however, the prognoses are similar.
Assuntos
Adenocarcinoma/terapia , Neoplasias Ovarianas/terapia , Adenocarcinoma/mortalidade , Adenocarcinoma/patologia , Antineoplásicos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Feminino , Seguimentos , Humanos , Histerectomia , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Neoplasias Ovarianas/mortalidade , Neoplasias Ovarianas/patologiaRESUMO
Fifty-one patients were admitted to a single practice at St. Joseph's Hospital between April 1, 1978, and April 1, 1986 with a diagnosis of squamous cell carcinoma of the vulva greater than 1 mm in depth. Five advanced lesions were treated with combinations of radiation and surgery. Four patients had recurrent squamous cell carcinoma. Of 42 patients treated surgically with intention of cure, 14 were treated with complete radical vulvectomy and bilateral inguinofemoral lymphadenectomies, and 28 patients were treated with complete radical vulvectomy and bilateral inguinofemoral lymphadenectomies, and 28 patients were treated in 26 instances with bilateral inguinofemoral lymphadenectomies in one of five different excision patterns individualized to the site of primary tumor. None of the 28 patients have had a recurrence. Five had positive nodes. Eight have died of unrelated causes. Lesions in 25 cases were stage I or II and in three cases they were stage III. Modified radical vulvectomy and bilateral groin dissection is a safe approach for most patients with stage I or II and occasionally even stage III lesions.