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1.
Artigo em Inglês | MEDLINE | ID: mdl-31089287

RESUMO

Although allogeneic hematopoietic stem-cell transplantation (HSCT) provides high cure rates for children with high-risk acute lymphoblastic leukaemia (ALL), relapses remain the main cause of treatment failure. Whereas donor killer cell immunoglobulin-like receptor (KIR) genotype was shown to impact on relapse incidence in adult myeloid leukaemia similar studies in paediatric ALL are largely missing. Effect of donor KIR genotype on transplant outcome was evaluated in 317 children receiving a first myeloablative HSCT from an HLA-matched unrelated donor or sibling within the prospective ALL-SCT-BFM-2003 trial. Analysis of donor KIR gene polymorphism revealed that centromeric presence and telomeric absence of KIR B haplotypes was associated with reduced relapse risk. A centromeric/telomeric KIR score (ct-KIR score) integrating these observations correlated with relapse risk (hazard ratio (HR) 0.58; P = 0.002) while it had no impact on graft-versus-host disease or non-relapse mortality. In multivariable analyses ct-KIR score was associated with reduced relapse risk (HR 0.58; P = 0.003) and a trend towards improved event-free survival (HR 0.76; P = 0.059). This effect proved independent of MRD level prior to HSCT. Our data suggest that in children with ALL undergoing HSCT after myeloablative conditioning, donor selection based on KIR genotyping holds promise to improve clinical outcome by decreasing relapse risk and prolonged event-free survival.

2.
Bone Marrow Transplant ; 54(10): 1701-1709, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30953025

RESUMO

HLA matching is a critical factor for successful allogeneic hematopoietic stem cell transplantation. For unrelated donor searches, matching is usually based on high-resolution typing at five HLA loci, looking for a 10/10 match. Some studies have proposed that further matching at the haplotype level could be beneficial for clinical outcome. In this study, we determined the phased haplotypes of 291 patients using family members and segregation analysis. The sum of ranks of the haplotypes carried by patients was used as a surrogate predictor of a successful unrelated donor search. The putative impact of haplotypes was then analyzed in a cohort of 211 recipients transplanted with 10/10 matched unrelated donors. A logistic regression analysis showed a highly significant effect of the haplotypes in the outcome of a search, but we did not find any significant effect on overall survival, graft versus host disease or relapse/progression following HSCT. This study provides useful data for the optimization of unrelated bone marrow donor searches, but does not confirm previous reports that matching at the haplotype level has a clinical impact following HSCT. Due to the extreme polymorphism of HLA genes, further studies are warranted to better understand the many factors at play.

3.
Artigo em Inglês | MEDLINE | ID: mdl-30945525

RESUMO

Vulvar cancer is rarely seen. The complex inguinofemoral anatomy and the limited number of surgical procedures per year by per gynecologic oncologist decrease the competency level. This step by step cadaveric educational video was recorded to understand the anatomy and technique of inguinofemoral lymphadenectomy.

4.
Artigo em Inglês | MEDLINE | ID: mdl-30905139

RESUMO

Pevic lymph node dissection is one of the leading surgical procedures in gynecologic oncology practice. Learning the proper technique with anatomical landmarks will improve the surgical skills and confidence. This video demonstrates a right side systematic pelvic lymphadenectomy in a cadaveric model.

5.
J Inherit Metab Dis ; 42(2): 286-294, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30815900

RESUMO

BACKGROUND: Farber disease (FD) is a rare, lysosomal storage disorder caused by deficient acid ceramidase activity. FD has long been considered a fatal disorder with death in the first three decades of life resulting either from respiratory insufficiency as a consequence of airway involvement or from progressive neurodegeneration because of nervous system involvement. Peripheral symptoms associated with FD, including inflammatory joint disease, have been described to improve relatively rapidly after hematopoietic cell transplantation (HCT). AIMS: To evaluate the disease-specific status and limitations in the long-term follow-up after HCT, investigate genotype/phenotype correlations and the benefit of allogeneic HCT in FD patients with nervous system involvement. PATIENTS AND METHODS: Transplant- and disease-related information of ten FD patients was obtained by using a questionnaire, physicians' letters and additional telephone surveys. ASAH1 gene mutations were identified to search for genotype/phenotype correlations. RESULTS: After mainly busulfan-based preparative regimens, all patients engrafted with one late graft loss. The inflammatory symptoms resolved completely in all patients. Abnormal neurologic findings were present pre-transplant in 4/10 patients, post-transplant in 6/10 patients. Mutational analyses revealed new mutations in the ASAH1 gene and a broad diversity of phenotypes without a genotype/phenotype correlation. With a median follow-up of 10.4 years, overall survival was 80% with two transplant-related deaths. CONCLUSION: Allogeneic HCT leads to complete and persistent resolution of the inflammatory aspects in FD patients. It appears to have no beneficial effect on progression of nervous system involvement. New mutations in the acid ceramidase gene were identified. A genotype/phenotype correlation could not be established.

6.
J Ovarian Res ; 12(1): 16, 2019 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-30744662

RESUMO

SUBJECTIVE: The aim of the present study was to investigate the prognostic significance of preoperative complete blood count inflammatory markers in women operated for invasive Epithelial Ovarian Cancer (EOC). METHOD: Two hundred forty four patients that underwent operation with the diagnosis of invasive EOC between 2006 and 2014 were included in the study. The date of operation, date of recurrence and final mortality evaluations were performed for survival analysis. The sensitivity, specificity, PPV and NPV were separately calculated with ROC analysis. Survival analysis was carried out with Kaplan Meier-Log Rank Method. RESULTS: Five-years overall survival rate was 56, 9% and 5-year disease-free survival (DFS) rate was 45,5%. Advanced disease stage, moderate-poor tumor differentiation, and the presence of recurrence were determined to have significant inverse relation at mean survival and 5-year survival rates. Neutrophil/lymphocyte ratio (NLR) and Platelet lymphocyte ratio (PLR) had prognostic effect on both DFS and overall survival based upon the cut-off values determined in the study (PLR = 231, s36, NLR = 3,83). Histopathological subtypes were not found to have any prognostic value. In correlation analysis, PLR and NLR had positive correlation with each other and negative correlation with overall survival. CONCLUSIONS: Inflammatory markers such as NLR and PLR have independent prognostic value for women who undergo surgery for invasive EOC.


Assuntos
Carcinoma Epitelial do Ovário/sangue , Carcinoma Epitelial do Ovário/cirurgia , Neoplasias Ovarianas/sangue , Neoplasias Ovarianas/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/sangue , Contagem de Células Sanguíneas , Plaquetas , Carcinoma Epitelial do Ovário/mortalidade , Feminino , Humanos , Linfócitos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/diagnóstico , Neutrófilos , Neoplasias Ovarianas/mortalidade , Período Pré-Operatório , Prognóstico , Curva ROC , Estudos Retrospectivos , Análise de Sobrevida
7.
Taiwan J Obstet Gynecol ; 58(1): 82-89, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30638487

RESUMO

OBJECTIVE: The purpose of this study was to determine the patterns of failure and prognostic factors for lymphovascular space invasion (LVSI)-positive endometrioid endometrial cancer (EC) patients in the setting of negative lymph nodes (LNs). MATERIALS AND METHODS: A multicenter, retrospective department database review was performed to identify LVSI-positive patients with disease surgically confined to the uterus at two gynecologic oncology centers in Turkey. Demographic, clinicopathological and survival data were collected. RESULTS: We identified 185 LVSI-positivewomen with negative LNs during the study period. Fifty-five (29.7%) were classified as Stage IA, 94 (50.8%) as Stage IB, and 36 (19.5%) as Stage II. The median age at diagnosis was 59 years and the median duration of follow-up was 44 months. The total number of the recurrences was 12 (6.5%). We observed 5 (2.9%) loco-regional recurrences, 3 (1.5%) retroperitoneal failures, and 4 (2.0%) distant relapses. The 5-year progression-free survival (PFS) was 86.1% while the 5-year overall survival (OS) rate was 87.7%. Grade 3 histology (Hazard Ratio [HR] 2.9, 95% Confidence Interval [CI] 1.02-8.50; p = 0.04), cervical stromal invasion (HR 4.5, 95% CI 1.61-12.79; p = 0.004) and age ≥ 60 years (HR 5.8, 95% CI 1.62-21.32; p = 0.007) were found to be independent prognostic factors for decreased OS. Adjuvant treatment did not appear as a prognostic factor for OS even in univariate analysis. CONCLUSION: The recurrence rate among LVSI-positive endometrioid EC patients is low in the setting of negative LNs. However, one out of three patients with a recurrence experiences distant relapses which usually portend worse outcomes.


Assuntos
Carcinoma Endometrioide/patologia , Neoplasias do Endométrio/patologia , Recidiva Local de Neoplasia/patologia , Idoso , Idoso de 80 Anos ou mais , Carcinoma Endometrioide/cirurgia , Neoplasias do Endométrio/cirurgia , Feminino , Humanos , Metástase Linfática , Pessoa de Meia-Idade , Invasividade Neoplásica/patologia , Estadiamento de Neoplasias , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Medição de Risco , Turquia , Neoplasias Uterinas , Útero/patologia
8.
Artigo em Inglês | MEDLINE | ID: mdl-30499283

RESUMO

Internal iliac artery is the main vascular supply of pelvic visceral structures. All the pelvic surgeons must know the anatomic landmarks and basic steps of internal iliac artery ligation to stop a massive pelvic hemorrhage. This cadaveric demonstration and clinical review of internal iliac artery shows the anatomic landmarks and basic steps of internal iliac artery ligation.

9.
Artigo em Inglês | MEDLINE | ID: mdl-30582318

RESUMO

Resection of all tumor implants with the aim of maximal cytoreduction is the main predictor of overall survival in ovarian carcinoma. However, there are high risk sites of tumor recurrence, and perihepatic region especially the point where ligamentum teres hepatis enters the liver parenchyma under the hepatic bridge (pont hepatique) is one of them. This video demonstrates the resection of ligamentum teres hepatis both in a cadaveric model and ovarian cancer patient.

10.
J Ovarian Res ; 11(1): 91, 2018 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-30376858

RESUMO

BACKGROUND: The purpose of this case-control study was to compare the prognoses of women with stage III mucinous ovarian carcinoma (MOC) who received maximal or optimal cytoreduction followed by paclitaxel plus carboplatin chemotherapy to those of women with stage III serous epithelial ovarian cancer (EOC) treated in the similar manner. METHODS: We performed a multicenter, retrospective review to identify patients with stage III MOC at seven gynecologic oncology departments in Turkey. Eighty-one women with MOC were included. Each case was matched to two women with stage III serous EOC in terms of age, tumor grade, substage of disease, and extent of residual disease. Survival estimates were measured using Kaplan-Meier plots. Variables predictive of outcome were analyzed using Cox regression models. RESULTS: With a median follow-up of 54 months, the median progression-free survival (PFS) for women with stage III MOC was 18.0 months (95% CI; 13.8-22.1, SE: 2.13) compared to 29.0 months (95% CI; 24.04-33.95, SE: 2.52) in the serous group (p = 0.19). The 5-year overall survival rate of the MOC group was significantly lower than that of the serous EOC group (44.9% vs. 66.3%, respectively; p < 0.001). For the entire cohort, presence of multiple peritoneal implants (Hazard ratio [HR] 2.39; 95% confidence interval [CI], 1.38-4.14, p = 0.002) and mucinous histology (HR 2.28; 95% CI, 1.53-3.40, p < 0.001) were identified as independent predictors of decreased OS. CONCLUSION: Patients with MOC seem to be 2.3 times more likely to die of their tumors when compared to women with serous EOC.

11.
J Exp Ther Oncol ; 12(4): 281-286, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30476382

RESUMO

Objective: Uterine sarcomas are very rare malignancies, and when a hysterectomy is performed for benign causes, a risk of about 1/500 is mentioned for possible uterine sarcomas. Endometrial stromal neoplasms are a rare subgroup of uterine sarcomas that account for less than 10% of all uterine sarcomas. Mixed endometrial stromal and smooth muscle tumors, also known as stromomyomas, are defined as having at least 30% each of endometrial stromal and smooth muscle components. As a result, stromomyoma is an extremely rare malignant mixed mesenchymal tumor of the uterus. Both clinically and histologically, the differential diagnosis is challenging. Stromomyoma should be kept in mind in the differential diagnosis of large uterine masses, even if these masses are seen in an asymptomatic woman of reproductive age. In this study, we aimed to present this bizarre tumor of the uterus detected in a premenopausal woman.

12.
Oncol Res Treat ; 41(12): 750-754, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30419557

RESUMO

INTRODUCTION: We aimed to assess risk factors for lymph node (LN) metastasis among lymphovascular space invasion(LVSI)-positive women with pure endometrioid endometrial cancer (EC) clinically confined to the uterus. METHODS: Medical records of women who underwent primary surgery for EC between 2007 and 2016 at either of 2 gynecological oncology centers were retrospectively reviewed. Patient data were analyzed with respect to LN involvement, and predictive factors for LN metastasis were investigated. RESULTS: 280 patients with surgically staged endometrioid-type EC with LVSI were identified. LN involvement was detected in 88 patients (31.4%) with a systematic LN dissection. In multivariate analysis, elevated baseline serum CA 125 levels, deep myometrial invasion (MMI), adnexal involvement and positive peritoneal cytology were found to be independent risk factors for LN metastasis. In women without deep MMI and elevated baseline serum CA 125 levels, the rate of LN metastasis was 19%. The presence of solely deep MMI increased this probability up to 29.1%. The rate of LN metastasis was found to be 46.8% for women with both deep MMI and elevated baseline serum CA 125 levels. CONCLUSION: These findings may be useful in the decision-making process for LVSI-positive women who are unstaged.

13.
Blood ; 132(19): 2088-2096, 2018 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-30104219

RESUMO

Asymptomatic carriers (ACs) of pathogenic biallelic mutations in causative genes for primary hemophagocytic lymphohistiocytosis (HLH) are at high risk of developing life-threatening HLH, which requires allogeneic hematopoietic stem cell transplantation (HSCT) to be cured. There are no guidelines on the management of these asymptomatic patients. We analyzed the outcomes of pairs of index cases (ICs) and subsequently diagnosed asymptomatic family members carrying the same genetic defect. We collected data from 22 HSCT centers worldwide. Sixty-four children were evaluable. ICs presented with HLH at a median age of 16 months. Seven of 32 ICs died during first-line therapy, and 2 are alive after chemotherapy only. In all, 23/32 underwent HSCT, and 16 of them are alive. At a median follow-up of 36 months from diagnosis, 18/32 ICs are alive. Median age of ACs at diagnosis was 5 months. Ten of 32 ACs activated HLH while being observed, and all underwent HSCT: 6/10 are alive and in complete remission (CR). 22/32 ACs remained asymptomatic, and 6/22 have received no treatment and are in CR at a median follow-up of 39 months. Sixteen of 22 underwent preemptive HSCT: 15/16 are alive and in CR. Eight-year probability of overall survival (pOS) in ACs who did not have activated HLH was significantly higher than that in ICs (95% vs 45%; P = .02), and pOS in ACs receiving HSCT before disease activation was significantly higher than in ACs receiving HSCT after HLH activation (93% vs 64%; P = .03). Preemptive HSCT in ACs proved to be safe and should be considered.

14.
Int J Gynaecol Obstet ; 143(3): 300-305, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30129141

RESUMO

OBJECTIVE: To compare colposcopic biopsy results among women with normal cervical cytology who had positive test results for either HPV-16 only or HPV-18 only. METHODS: A cross-sectional study was conducted at Zekai Tahir Burak Women's Health Research and Training Hospital, Ankara, Turkey, between July 1, 2015, and October 31, 2017. Colposcopic biopsy results were compared among women in the HPV-16 only (n=185) and HPV-18 only (n=43) groups. RESULTS: Women who had HPV-16 only were more likely to be smokers than women with HPV-18 only (P=0.003). By contrast, women with HPV-18 only were more likely to be aged at least 45 years than women who had HPV-16 only (P=0.038). High-grade squamous intraepithelial lesions were detected more frequently in the HPV-16 only group (51 [27.6%]) than in the HPV-18 only group (4 [9.3%]; P=0.010). By contrast, no between-group difference was found for the rate of invasive cervical cancer, which was detected in 1 (0.5%) woman in the HPV-16 only group and 1 (2.3%) woman in HPV-18 only group (P=0.342). CONCLUSION: Although the risk of high-grade squamous intraepithelial lesions was increased among women with HPV-16 only, this finding did not influence the rate of invasive cervical cancer when compared with women in the HPV-18 only group.

15.
Br J Haematol ; 183(1): 104-109, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30028016

RESUMO

Osteonecrosis (ON) was prospectively assessed in 557 children and adolescents in the Berlin-Frankfurt-Münster Stem Cell Transplantation in children with acute lymphoblastic leukaemia 2003 trial. Median age at haematopoietic stem cell transplantation (HSCT) was 10·3 years (range 0·5-26). Cumulative incidence of symptomatic ON (sON) was 9% at 5 years (standard deviation 1%), median time from HSCT to diagnosis of sON was 12·4 months (range 1-126). Multivariate analysis identified age at HSCT [10-15 years vs. <10 years: hazard ratio (HR) 3·73, P = 0·009; >15 years vs. <10 years: HR 5·46, P = 0·001], diagnosis of sON prior to HSCT and chronic graft-versus-host disease (yes versus no: HR 2·696, P = 0·015) as significant independent risk factors for the development of sON.

16.
J Obstet Gynaecol Res ; 44(7): 1284-1293, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29727055

RESUMO

OBJECTIVE: To identify factors predictive of poor prognosis in women with stage III nonserous epithelial ovarian cancer (EOC) who had undergone maximal or optimal primary cytoreductive surgery (CRS) followed by six cycles of intravenous carboplatin/paclitaxel chemotherapy. METHODS: A multicenter, retrospective department database review was performed to identify patients with stage III nonserous EOC who had undergone maximal or optimal primary CRS followed by six cycles of carboplatin/paclitaxel chemotherapy at seven gynecological oncology centers in Turkey. Demographic, clinicopathological and survival data were collected. RESULTS: A total of 218 women met the inclusion criteria. Of these, 64 (29.4%) patients had endometrioid, 61 (28%) had mucinous, 54 (24.8%) had clear-cell and 39 (17.9%) had mixed epithelial tumors. Fifty-five (25.2%) patients underwent maximal CRS, whereas 163 (74.8%) had optimal debulking. With a median follow-up of 31.5 months, the 5-year progression-free survival (PFS) and overall survival (OS) rates were 34.8% and 44.2%, respectively. Bilaterality (hazard ratio [HR] 1.44, 95% CI 1.01-2.056; P = 0.04), age (HR 2.25, 95% CI 1.176-4.323; P = 0.014) and maximal cytoreduction (HR 0.34, 95% CI 0.202-0.58; P < 0.001) were found to be independent prognostic factors for PFS. However, age (HR 2.6, 95% CI 1.215-5.591; P = 0.014) and maximal cytoreduction (HR 0.31, 95% CI 0.166-0.615; P < 0.001) were defined as independent prognostic factors for OS. CONCLUSION: The extent of CRS seems to be the only modifiable prognostic factor associated with stage III nonserous EOC. Complete cytoreduction to no gross residual disease should be the main goal of management in these women.


Assuntos
Antineoplásicos/farmacologia , Carboplatina/farmacologia , Procedimentos Cirúrgicos de Citorredução/métodos , Neoplasias Epiteliais e Glandulares , Avaliação de Resultados (Cuidados de Saúde) , Neoplasias Ovarianas , Paclitaxel/farmacologia , Adolescente , Adulto , Idoso , Antineoplásicos/administração & dosagem , Carboplatina/administração & dosagem , Carcinoma Epitelial do Ovário , Feminino , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Epiteliais e Glandulares/diagnóstico , Neoplasias Epiteliais e Glandulares/tratamento farmacológico , Neoplasias Epiteliais e Glandulares/mortalidade , Neoplasias Epiteliais e Glandulares/cirurgia , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias Ovarianas/mortalidade , Neoplasias Ovarianas/cirurgia , Paclitaxel/administração & dosagem , Prognóstico , Estudos Retrospectivos , Adulto Jovem
17.
J Gynecol Oncol ; 29(4): e48, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29770619

RESUMO

OBJECTIVE: The purpose of this study was to investigate the prognostic value of lymph node ratio (LNR) in women with stage IIIC endometrioid endometrial cancer (EC). METHODS: A multicenter, retrospective department database review was performed to identify patients with stage IIIC pure endometrioid EC at 6 gynecologic oncology centers in Turkey. A total of 207 women were included. LNR, defined as the percentage of positive lymph nodes (LNs) to total nodes recovered, was stratified into 2 groups: LNR1 (≤0.15), and LNR2 (>0.15). Kaplan-Meier method was used to generate survival data. Factors predictive of outcome were analyzed using Cox proportional hazards models. RESULTS: One hundred and one (48.8%) were classified as stage IIIC1 and 106 (51.2%) as stage IIIC2. The median age at diagnosis was 58 (range, 30-82) and the median duration of follow-up was 40 months (range, 1-228 months). There were 167 (80.7%) women with LNR ≤0.15, and 40 (19.3%) women with LNR >0.15. The 5-year progression-free survival (PFS) rates for LNR ≤0.15 and LNR >0.15 were 76.1%, and 58.5%, respectively (p=0.045). An increased LNR was associated with a decrease in 5-year overall survival (OS) from 87.0% for LNR ≤0.15 to 62.3% for LNR >0.15 (p=0.005). LNR >0.15 was found to be an independent prognostic factor for both PFS (hazard ratio [HR]=2.05; 95% confidence interval [CI]=1.07-3.93; p=0.03) and OS (HR=3.35; 95% CI=1.57-7.19; p=0.002). CONCLUSION: LNR seems to be an independent prognostic factor for decreased PFS and OS in stage IIIC pure endometrioid EC.

19.
J Obstet Gynaecol Res ; 44(6): 1140-1149, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29516573

RESUMO

AIM: The purpose of this study was to determine the prognostic factors and patterns of failure in lymphovascular space invasion (LVSI)-positive women with stage IIIC endometrioid endometrial cancer (EC). METHODS: A multicenter, retrospective, department database review was performed to identify LVSI-positive patients with stage IIIC endometrioid EC at five gynecological oncology centers in Turkey. Demographic, clinicopathological and survival data were collected. RESULTS: We identified 172 LVSI-positive women with stage IIIC endometrioid EC during the study period; 75 (43.6%) were classified as Stage IIIC1 and 97 (56.4%) as Stage IIIC2 . The median age at diagnosis was 59 years, and the median duration of follow up was 34.5 months. The total number of recurrences was 46 (26.7%). We observed 14 (8.1%) locoregional recurrences, 12 (7.0%) retroperitoneal failures and 20 (11.6%) distant relapses. For the entire study cohort, 5-year progression-free survival (PFS) was 67.4%, while the 5-year overall survival (OS) rate was 75.1%. Grade 3 histology (hazard ratio [HR] 2.62, 95% confidence interval [CI] 1.34-5.12; P = 0.005), cervical stromal invasion (HR 2.33, 95% CI 1.09-4.99; P = 0.028) and myometrial invasion (MMI) ≥50% (HR 4.0, 95% CI 1.16-13.69; P = 0.028) were found to be independent prognostic factors for decreased OS. CONCLUSION: Uterine factors such as grade 3 disease, cervical stromal invasion and deep MMI seem to be independently associated with decreased OS in LVSI-positive women with stage IIIC endometrioid EC. The high distant recurrence rate in this subgroup of patients warrants further studies in order to identify the most effective treatment strategy for those patients.


Assuntos
Carcinoma Endometrioide , Neoplasias do Endométrio , Vasos Linfáticos/patologia , Recidiva Local de Neoplasia , Carcinoma Endometrioide/diagnóstico , Carcinoma Endometrioide/epidemiologia , Carcinoma Endometrioide/patologia , Intervalo Livre de Doença , Neoplasias do Endométrio/induzido quimicamente , Neoplasias do Endométrio/diagnóstico , Neoplasias do Endométrio/epidemiologia , Neoplasias do Endométrio/patologia , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Turquia/epidemiologia
20.
J Ovarian Res ; 11(1): 21, 2018 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-29506569

RESUMO

BACKGROUND: The purpose of this retrospective study was to determine the prognosis of non-serous epithelial ovarian cancer (EOC) patients with exclusively retroperitoneal lymph node (LN) metastases, and to compare the prognosis of these women to that of patients who had abdominal peritoneal involvement. METHODS: A multicenter, retrospective department database review was performed to identify patients with stage III non-serous EOC at 7 gynecologic oncology centers in Turkey. Demographic, clinicopathological and survival data were collected. The patients were divided into three groups based on the initial sites of disease: 1) the retroperitoneal (RP) group included patients who had positive pelvic and /or para-aortic LNs only. 2) The intraperitoneal (IP) group included patients with > 2 cm IP dissemination outside of the pelvis. These patients all had a negative LN status, 3) The IP / RP group included patients with > 2 cm IP dissemination outside of the pelvis as well as positive LN status. Survival data were compared with regard to the groups. RESULTS: We identified 179 women with stage III non-serous EOC who were treated at 7 participating centers during the study period. The median age of the patients was 53 years, and the median duration of follow-up was 39 months. There were 35 (19.6%) patients in the RP group, 72 (40.2%) in the IP group and 72 (40.2%) in the IP/RP group. The 5-year disease-free survival (DFS) rates for the RP, the IP, and IP/RP groups were 66.4%, 37.6%, and 25.5%, respectively (p = 0.002). The 5-year overall survival (OS) rate for the RP group was significantly longer when compared to those of the IP, and the IP/RP groups (74.4% vs. 54%, and 36%, respectively; p = 0.011). However, we were not able to define "RP only disease" as an independent prognostic factor for increased DFS or OS. CONCLUSIONS: Primary non-serous EOC patients with node-positive-only disease seem to have better survival when compared to those with extra-pelvic peritoneal involvement.


Assuntos
Neoplasias Epiteliais e Glandulares/mortalidade , Neoplasias Epiteliais e Glandulares/patologia , Neoplasias Ovarianas/mortalidade , Neoplasias Ovarianas/patologia , Adolescente , Adulto , Idoso , Carcinoma Epitelial do Ovário , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Gradação de Tumores , Invasividade Neoplásica , Metástase Neoplásica , Estadiamento de Neoplasias , Neoplasias Epiteliais e Glandulares/terapia , Neoplasias Ovarianas/terapia , Prognóstico , Fatores de Risco , Análise de Sobrevida , Adulto Jovem
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