Hallazgos genitourinarios en mujeres con tumores ováricos / Genito-urinary findings in women with ovarian tumors

Los tumores de ovario son los trastornos ginecológicos más comunes. Los tumores de ovario son el tercer tumor más común en las mujeres. Los tumores de ovario a veces son asintomáticos y tienen síntomas no específicos, lo que hace que la mayoría de los casos sean difíciles de detectar temprano. El objetivo de este estudio fue investigar las características genitourinarias del tumor ovárico en un estudio hospitalario. Se realizó un estudio observacional en Bagdad, Iraq, entre septiembre de 2018 y febrero de 2021. Las mujeres diagnosticadas con tumores ovarios a los 18 años de edad o más. Un total de cincuenta mujeres que se inscribieron en nuestro hospital. Datos clínicos y patológicos recopilados y analizados. Los datos sobre comorbilidades y resultados fueron aprobados y diagnosticados por un equipo completo de médicos ginecológicos y urológicos multidisciplinarios. La incidencia general de tumores ováricos fue 70% maligna y 30% benigna. El estudio mostró que la mayor parte del grupo de edad de tumores ováricos era superior a 55 años (62%). La mitad de los pacientes eran nuliparidades. El nivel educativo era principalmente de bajo nivel en analfabeto (20%), primario (24%), secundario (36%) en comparación con el alto nivel. Las mujeres usaron anticoncepción en 52%. La historia familiar informó en el 18% de las mujeres. El tipo histopatológico más común era el carcinoma seroso ovárico 15 (30%). Las etapas regionales eran comunes en el 50% de los pacientes. Tumores de bajo grado en 32%, intermedio en 36%y alto en 32%. Casi, el 80% de las mujeres se sometieron a TAH. Alrededor del 60% de los pacientes recibieron quimioterapia. Los resultados de salud genitourinaria adversos a largo plazo incluyeron nefritis (6%), insuficiencia renal aguda (16%), enfermedad renal crónica (18%), infección urinaria (38%), cálculo (16%), hidronefrosis (20%), Obstrucción de la vejiga (2%), estenosis ureteral (12%), retención de orina (8%), incontinencia de orina (12%), hematuria (22%), PID (14%), adhesión de órganos (8%), cervicitis (2 %), Endometriosis (2%), quiste (6%), trastornos menstruales (24%), infertilidad (2%) y dolor menopáusica (32%). En conclusión, el cáncer de ovario representa el tercer tipo de cáncer ginecológico más común. Era más común en mujeres mayores de cinco décadas. El tipo histopatológico más común es el carcinoma seroso ovárico. Observamos que los sobrevivientes de cáncer de ovario experimentaron mayores riesgos de varias enfermedades genitourinarias. Comprender los escenarios de la morbilidad múltiple para los tumores ováricos es de vital importancia para mejorar la atención clínica después del diagnóstico.

Ovarian tumors are the most common gynecological disorders. Ovarian tumors are the third most common tumor in women. Ovarian tumors are sometimes asymptomatic and have non-specific symptoms, making most cases difficult to detect early. The aim of this study was to investigate genitourinary features of ovarian tumor in a hospital-based study. An observational study was conducted in Baghdad, Iraq, between September 2018 and February 2021. Women diagnosed with ovarian tumors at 18 years of age or older. A total of Fifty women who enrolled in our hospital. Clinical and pathological data collected and analyzed. Data about comorbidities and outcomes were approved and diagnosed by full team of multidisciplinary gynecological and urological doctors were recorded. Overall incidence of ovarian tumors was 70% malignant and 30% benign. The study showed that the most age group of ovarian tumors was above 55 years (62%). Half of patients were nulliparities. Educational level was mostly of low level in illiterate (20%), primary (24%), secondary (36%) compared to high level. Women used contraception in 52%. The family history reported in 18% of women. The most common histopathological type was ovarian serous carcinoma 15(30%). Regional stages were common in 50% of patients. Low grade tumors in 32%, intermediate in 36% and high in 32%. Almost, 80% of women underwent TAH. About 60% of patients received chemotherapy. The long-term adverse genitourinary health outcomes correlated included Nephritis (6%), Acute renal failure (16%), Chronic kidney disease (18%), UTI (38%), Calculus (16%), Hydronephrosis (20%), Bladder obstruction (2%), Ureteric stenosis (12%), Urine retention (8%), Urine incontinence (12%), Hematuria (22%), PID (14%), Organ adhesion (8%), Cervicitis (2%), Endometriosis (2%), Cyst (6%), Menstrual disorders (24%), Infertility (2%), and Menopausal pain (32%). In conclusion, ovarian cancer represents the third most common gynecologic cancer type. It was more common in women aged above five decades. The most common histopathological type is ovarian serous carcinoma. We observed that ovarian cancer survivors experienced increased risks of various genitourinary diseases. Understanding the multi-morbidity scenarios for ovarian tumors is of vital importance to improve clinical care after diagnosis.

Clinical features and management of women with borderline ovarian tumors in a single center in Brazil / Características clínicas e manejo de mulheres com tumores borderline de ovário em um hospital no Brasil

Abstract Objective The aim of the present study was to describe and analyze data of 57 women with borderline ovarian tumors (BOTs) regarding histological characteristics, clinical features and treatment management at the Department of Obstetrics and Gynecology of the Universidade Estadual de Campinas (Unicamp, in the Portuguese acronym). Methods The present retrospective study analyzed data obtained from clinical and histopathological reports of women with BOTs treated in a single cancer center between 2010 and 2018. Results A total of 57 women were included, with a mean age of 48.42 years old (15.43- 80.77), of which 30 (52.63%) were postmenopausal, and 18 (31.58%) were < 40 years old. All of the women underwent surgery. A total of 37 women (64.91%) were submitted to complete surgical staging for BOT, and none (0/57) were submitted to pelvic or paraortic lymphadenectomy. Chemotherapy was administered for two patients who recurred. The final histological diagnoses were: serous in 20 (35.09%) cases, mucinous in 26 (45.61%), seromucinous in 10 (17.54%), and endometrioid in 1 (1.75%) case. Intraoperative analyses of frozen sections were obtained in 42 (73.68%) women, of which 28 (66.67%) matched with the final diagnosis. The mean follow-up was of 42.79 months (range: 2.03-104.87 months). Regard ingthe current status of the women, 45(78.95%) are alive without disease, 2(3.51%) arealive with disease, 9 (15.79%) had their last follow-up visit > 1 year beforethe performanceof the present study but arealive, and 1 patient(1.75%) died of another cause. Conclusion Women in the present study were treated according to the current guidelines and only two patients recurred.

Resumo Objetivo O objetivo do presente estudo foi descrever uma série de 57 mulheres com tumores borderline de ovário (TBO) em relação às características histológicas, clínicas, e ao manejo do tratamento realizado no Departamento de Obstetrícia e Ginecologia da Universidade Estadual de Campinas (Unicamp). Métodos O presente estudo retrospectivo analisou dados obtidos dos registros clínicos e histopatológicos de mulheres com TBO tratadas em um único centro oncológico de 2010 a 2018. Resultados Um total de 57 mulheres foram incluídas, com uma média de idade de 48,42 anos (15,43-80,77), das quais 30 (52,63%) eram menopausadas, e 18 (31,58%) tinham < 40 anos. Todas as mulheres foram operadas. Um total de 37 mulheres (64,91%) foram submetidas a cirurgia de estadiamento completo para TBO, e nenhuma foi submetida a linfadenectomia pélvica ou paraórtica. O tratamento com quimioterapia foi administrado em duas pacientes que recidivaram. Os diagnósticos histológicos finais foram: seroso em 20 mulheres (35,09%), mucinoso em 26 (45,61%), seromucinoso em 10 (17,54%) e endometrióide em 1 (1,75%). A avaliação histológica intraoperatória foi realizada em 42 (73,68%) das mulheres, das quais 28 (66,67%) foram compatíveis com os diagnósticos finais. O tempo médio de seguimento foi de 42,79 meses (variando de 2,03 a 104,87 meses). Em relação ao status atual das mulheres, 45 (78.95%) estão vivas sem doença, 2 (3,51%) estão vivas com doença, 9 (15.79%) tiveram a última consulta de seguimento há > 1 ano antes da realização do presente estudo, mas estão vivas, e 1 paciente faleceu por outra causa. Conclusão As mulheres do presente estudo foram tratadas de acordo com as recomendações atuais e apenas duas mulheres apresentaram recorrência.

Citorreducción óptima en cáncer de ovario avanzado tratado con paclitaxel a dosis densa y carboplatino seguido de cirugía de intervalo en el Instituto Nacional de Enfermedades Neoplásicas del Perú / Optimal cytoreduction in advanced ovarian cancer treated with dose-dense paclitaxel and carboplatin followed by interval surgery at the Peruvian National Institute of Neoplastic Diseases

RESUMEN Objetivos. Determinar la tasa de citorreducción óptima en pacientes con cáncer de ovario avanzado que recibieron quimioterapia neoadyuvante con carboplatino y paclitaxel dosis densa seguido de cirugía de citorreducción de intervalo (CCI). Materiales y métodos. Estudio de una serie de casos retrospectiva de mujeres peruanas tratadas con quimioterapia neoadyuvante con carboplatino (AUC 6 mg/ml/min) y paclitaxel (80 mg/m2 semanal) seguido de CCI, en el Instituto Nacional de Enfermedades Neoplásicas durante el período 2010-2014. Resultados . Los 41 pacientes que alcanzaron cirugía de intervalo, tuvieron una mediana de edad de 59 años (rango: 47-73 años). En 37 (90,2%) pacientes se reportó histología de adenocarcinoma seroso de alto grado. Treinta y cuatro (82,9%) lograron citorreducción óptima y cinco (14,7%) respuesta patológica completa. La sobrevida libre de progresión al año y 2 años fueron 74,7% y 51,8%, respectivamente. La sobrevida global al año y 2 años fue 85,2% y 71,4%, respectivamente. El riesgo de progresión y muerte fue mayor en pacientes sin citorreducción óptima y pacientes con niveles de dosaje del antígeno carcinoembrionario 125 postoperatorio > 30 U/ml. Conclusiones . La neoadyuvancia con carboplatino y paclitaxel dosis densa logró una frecuencia elevada de citorreducción óptima. Los niveles de antígeno carcinoembrionario 125 postoperatorios y citorreducción óptima resultaron factores independientes de sobrevida libre de progresión y sobrevida global.

ABSTRACT Objectives. To determine the rate of optimal cytoreduction in patients with advanced ovarian cancer who received neoadjuvant chemotherapy with dose-dense carboplatin and paclitaxel followed by interval debulking surgery (IDS). Materials and Methods. A retrospective study of a series of cases of Peruvian women treated with neoadjuvant chemotherapy with carboplatin (6 AUC mg/mL/min) and paclitaxel (80 mg/m2 weekly) followed by IDS, at the National Institute of Neoplastic Diseases during the 2010-2014 period. Results. The 41 patients who made it to the interval surgery had a median age of 59 years (range: 47-73 years). In 37 (90.2%) patients, high-grade serous adenocarcinoma histology was reported. Thirty-four (82.9%) achieved optimal cytoreduction and five (14.7%), a complete pathological response. Progression-free survival at one year and two years was 74.7% and 51.8%, respectively. Overall survival at one year and two years was 85.2% and 71.4%, respectively. The risk of progression and death was greater in patients without optimal cytoreduction and in patients with postsurgery levels of carcinoembryonic antigen 125 > 30 U/mL. Conclusions. Neoadjuvant therapy with dose-dense carboplatin and paclitaxel achieved an elevated frequency of optimal cytoreduction. The post-surgery levels of carcinoembryonic antigen 125 and optimal cytoreduction were independent factors of progression-free survival and overall survival.

Estudo epidemológico de pacientes com tumor de ovário no município de Jundiaí no período de junho de 2001 a junho de 2006 / Epidemiological study of ovary tumor patients in the city of Jundiaí from June, 2001 to June, 2006

O estudo teve como objetivo avaliar o perfil sociodemográfico e reprodutivo de mulheres com diagnóstico de câncer de ovário na cidade de Jundiaí, São Paulo, no período de junho de 2001 a junho de 2006. Foi realizado um estudo descritivo, retrospectivo, através de inquérito, de todos os casos de tumores malignos do Laboratório de Anatomia Patológica do Sistema Único de Saúde (SUS) de Jundiaí e do Ambulatório de Saúde da Mulher da Secretaria de Saúde do Município de Jundiaí, a fim de identificar o perfil dos casos de tumor de ovário maligno. As características sociodemográficas das pacientes portadoras de tumor de ovário evidenciaram que: a média de idade no momento do diagnóstico foi de 55 (mais ou menos 13,5 anos); a média de nível educacional no momento do diagnóstico foi de 5,8 (mais ou menos 3 anos); e a maior prevalência foi de mulheres casadas e de raça branca. As características reprodutivas das pacientes portadoras de tumor de ovário evidenciaram que: a média de idade da menarca foi de 13 (mais ou menos 1,6 ano); a maior prevalência foi de multiparidade; houve aumento de peso desde a idade do diagnóstico até a idade atual; a média de tempo de amamentação foi de 8,6 meses (mais ou menos 6,5 meses); e houve maior prevalência de mulheres que fizeram uso de anticoncepcional hormonal oral.

Linfadenectomía lumboaórtica sistemática: Unidad de Ginecología Oncológica, Hospital Carlos Van Buren de Valparaíso / Systematic lumboaortic lymphadenectomy: Oncological Gynecology Unit of Hospital Carlos Van Buren, Valparaiso

Objetivo: Dar a conocer la técnica de linfadenectomía lumboaórtica sistemática (LLS) en el cáncer de endometrio y ovario, así como los resultados quirúrgicos obtenidos con ella en éste grupo de pacientes. Método:Se presenta una cohorte prospectiva de pacientes portadoras de cáncer de endometrio y ovario que requieren LLS entre agosto de 2005 y marzo de 2008. Se describe la técnica empleada y los resultados obtenidos. Resultados: 76 pacientes portadoras de cáncer de endometrio y ovario son sometidas a LLS. La edad promedio es de 57 años; 40 pacientes (52,6%) presentan cáncer de endometrio y 35 (46%) cáncer de ovario. El tiempo operatorio promedio fue de 55 minutos y el sangrado estimado de 120 ml. Se obtiene un recuento ganglionar promedio de 25,4 ganglios. Fallecen 2 pacientes y otra debe ser intervenida en el postoperatorio por hemoperitoneo. Conclusión: La técnica descrita es fácilmente realizable, con mínimas complicaciones y con una adecuada exposición del retroperitoneo, lo que permite obtener un número de ganglios necesarios para la etapificación del cáncer de endometrio y ovario.

Objective: To reports and describes the results of the paraaortic lymphadenectomy technique in the management of endometrial and ovarian cancer. Methods: We report a prospective cohort of patients with diagnosis of endometrial and ovarian cancer that required a systematic paraaortic lymphadenectomy, between August 2005 and March 2008, describing the surgical technique and the main results. Results: During this period seventy-six patients carrying endometrial or ovarian cancer are submitted to a systematic paraaortic lymphadenectomy. The average age was 57 years; 40 patients (52.6%) diagnosed with an endometrial cancer and 35 (46%) with an ovarian one. The average surgical time was 55 minutes, with an estimated bleeding of 120 ml. We obtained an average of 25.4 lymph nodes. Two patients deceased in this cohort and one was reintervened for a hemoperitoneum. Conclusion: The described surgical technique is feasible, with minimal complications and allows an appropriate exposure of the retroperitoneum to obtain an adequate number of lymph nodes for endometrial and ovarian cancer staging.