Clinical characteristics of struma ovarii / 부인종양

OBJECTIVE: To evaluate the clinical characteristics of struma ovarii. METHODS: Twenty-five cases of struma ovarii were reviewed retrospectively from June 1994 to April 2007. The presenting clinical, radiologic, and pathologic features of the patients were reviewed. RESULTS: The mean age of the patients in this study was 45.3 years. The majority was of premenopausal status. Sixteen patients had clinical symptoms such as low abdominal pain, palpable abdominal mass and vaginal bleeding. Although one patient had an abnormal thyroid function test, the laboratory findings normalized after operative treatment. CA-125 levels were elevated in 6 cases. Diagnosis by preoperative imaging studies were 8 dermoid cysts, while only 3 cases were diagnosed as struma ovarii. There were 4 cases of malignant struma ovarii, and no patients with recurrent disease. CONCLUSION: Struma ovarii is a rare tumor. The presented clinical, laboratory and radiological findings of patients are very diverse. The diagnosis was confirmed by pathologic findings. The treatment of benign struma ovarii is surgical resection only. The cases of malignant struma ovarii may need adjuvant treatment, but recurrence is uncommon.

Significance of postoperative CA-125 decline after cytoreductive surgery in stage IIIC/IV ovarian cancer / 부인종양

OBJECTIVE: The purpose of this study was to evaluate whether the decline in serum CA-125 levels following primary cytoreductive surgery prior to starting adjuvant chemotherapy has a prognostic value in patients with stage IIIC/IV ovarian carcinoma. METHODS: A retrospective review was conducted of all patients with stage IIIC/IV ovarian carcinoma who underwent primary cytoreductive surgery followed by platinum-based chemotherapy from 1994 to 2007. Demographic, pathologic, treatment, and survival data were collected. Patients were included if serum CA-125 levels were drawn preoperatively and within one week prior to their first chemotherapy cycle, and whose postoperative CA-125 level declined. Percentage decline was calculated, and was compared with standard statistical tests in groups by 25% declination intervals. RESULTS: Of the 112 stage IIIC/IV patients, 81 (72.3%) met the above inclusion criteria. The median time from surgery to postoperative CA-125 sampling was 16 days (range: 7-42). A > or =75% decline was associated with a median progression-free survival (PFS) of 25 months (95% CI=0-63). This was significantly longer when compared with each of the other 25% interval groups. After multivariate analysis, independent prognostic factors included a > or =75% decline in CA-125 levels after surgery and the presence of residual tumor. Age, grade, histology, and preoperative CA-125 levels were not statistically significant factors. CONCLUSION: A > or =75% decline in serum CA-125 serum levels from primary cytoreductive surgery to the start of adjuvant chemotherapy has independent prognostic value for PFS in patients with stage IIIC/IV ovarian carcinoma.

Prognostic factors in recurrent cervical cancer patients with pulmonary metastasis / 대한산부인과학회지

OBJECTIVE: To characterize prognostic factors in patients with pulmonary metastasis in recurrent cervical cancer. METHODS: The records of 2,042 patients treated for cervical cancer from 1994 to 2004 at two institutions were retrospectively reviewed. Twenty-five (1.04%) patients had pulmonary lesions consistent with metastatic cervical cancer. The data were analyzed retrospectively and reviewed for patient characteristics. RESULTS: Patients were treated with chemotherapy, radiotherapy only, chemoradiotherapy, surgery, and conservative treatment. There were no significant differences in survival rates between each treatment method (p=0.3410). Mean survival after treatment of pulmonary metestasis was 23 months. Histologic type, lymph node metastasis, other organ metastasis, and pretreatment SCC level were not significant prognostic factors, but FIGO stage (p=0.039) and disease-free interval (p=0.033) were significant factors. CONCLUSION: This study revealed that FIGO stage and disease-free interval were independent prognostic factors of pulmonary metestasis in recurrent cervical cancer.

Simplified prognostic factor scoring system in patients with lymph node-negative stage IB-IIA cervical cancer / 대한산부인과학회지

OBJECTIVE: The aim of this study is to apply a prognostic factor scoring system in patients with lymph node-negative stage IB - IIA cervical cancer. METHODS: One hundred and ninety-one stage IB - IIA cervical cancer patients were enrolled in this retrospective study from 1994 to 2005 in our gynecologic department. All patients were treated by radical abdominal hysterectomy with lymph node dissection, and there were no patients with involvement of lymph nodes or parametrial invasion. Statistical analysis comprised of clinical characteristics, pathology result, post-operative adjuvant therapy, and recurrence rate. RESULTS: Among the 191 patients, recurrence occurred in 9 patients (4.7%), while no recurrence was observed in the remaining 182 patients (95.3%). No significant difference was found between the two study groups in terms of average age, weight, parity, FIGO stage, and postoperative adjuvant therapy. After univariate analysis, tumor size and deep stromal invasion were factors found to be statistically significant for risk of recurrence. Cell type, close surgical margin, lymphovascular permeation were not significant factors. Multivariate analysis demonstrated deep stromal invasion was the only significant prognostic factor (RR=11.7, p=0.028). The scoring system was applied to tumor size, close surgical margin, and deep stromal invasion, 1, 1, and 2 points given for each factor, respectively. Using the ROC curve, based on 2 points as the cut-off level, the recurrence rate was significantly higher (p<0.0025). CONCLUSION: Deep stromal invasion was the most important prognostic factor in patients with early stage cervical cancer in the absence of lymph node metastasis. Herein, the scoring system may be applied to predict disease outcome.