1,720,981 research outputs found
An unusual presentation of struma ovarii mimicking a malignant process
No full textBACKGROUND: Struma ovarii is a rare form of ovarian neoplasm, composed entirely or predominantly of thyroid tissue. This tumor is generally benign, although malignant transformation has been reported. CASE: We report an unusual presentation of a postmenopausal woman with benign struma ovarii associated with a large amount of ascites, a markedly elevated CA 125 serum level, and a large complex pelvic mass thereby mimicking an ovarian cancer. CONCLUSION: This case serves to remind clinicians that clinical features highly suspicious for ovarian cancer do not necessarily confirm a malignancy. (C) 2002 by The American College of Obstetricians and Gynecologists
Oral altretamine used as salvage therapy in recurrent ovarian cancer
No full textBackground. Altretamine has reported efficacy in the treatment of recurrent ovarian cancer following platinum-based therapy. This report presents the cases of two long-term survivors with recurrent ovarian cancer given oral altretamine. Cases. Two patients diagnosed with stage IIIC ovarian cancer underwent optimal cytoreductive surgery. Both women were subsequently treated with platinum-based chemotherapy. One had persistent cancer documented 2 months post therapy, while the other was disease-free for 22 months before recurring. Both received altretamine in a salvage setting. Each of these women achieved a prolonged response to third-line altretamine therapy, and one of whom was disease-free for 4 years and the other remains disease-free over 7 years following initiation of salvage therapy. Conclusion. Outpatient-administered oral altretamine can provide a prolonged disease-free interval with minimal toxicity. (C) 2003 Elsevier Inc. All rights reserved
The significance of molecular markers in the survival of younger women with advanced ovarian cancer
No full textBorderline ovarian tumors in reproductive-age women - Fertility-sparing surgery and outcome
No full textOBJECTIVE: To evaluate the fertility and survival outcomes in young women with borderline ovarian tumors treated with fertility-sparing surgery. STUDY DESIGN: From 1985 to 2002, 25 women with borderline ovarian cancers surgically managed with preservation of the uterus and at least a portion of 1 ovary were identified from tumor registry databases at 2 southern California hospitals. Data for analysis were collected from hospital charts, office records and tumor registry files. RESULTS: Twenty-five patients (median age, 29 years) with borderline ovarian tumors, including 10 with stage IA, 3 with stage IC, 1 with stage IIIA and 11 with unstaged disease, underwent fertility-sparing surgery, consisting of unilateral adnexectomy in 19, unilateral adnexectomy with contralateral cystectomy in 5 and unilateral cystectomy in 1. No disease recurred, providing an overall survival of 100%. Fertility status was available on 15 patients 4-157 months after surgery; 6 of them attempted to become pregnant. Five women had successful pregnancies, with a total of 5 live births. One woman underwent assisted reproductive techniques, became pregnant but aborted. The median follow-up was 80 months (range, 4-157). CONCLUSION: Conservative surgery for borderline ovarian tumors should be considered for women in the reproductive age group who desire preservation of fertility
Differences in prognostic molecular markers between women over and under 45 years of age with advanced ovarian cancer
No full textPurpose: The purpose of this study was to determine whether differences in molecular markers might explain the better prognosis of women less than or equal to45 years of age versus women >45 years of age diagnosed with ovarian cancers. Experimental Design: Tissue sections from women with stage III-IV ovarian cancers were examined for expression of CD34, p53, and HER2. The Kaplan-Meier method and Cox Proportional Hazard analyses were used to identify predictors for outcome. Results: Fifty-two women less than or equal to45 years of age were matched with 52 women who were >45 years old. Of the 44 available tissue sections, 24 were from the younger age group (mean age, 41 years), and 22 were from the older age group (mean age, 61 years). Based on CD34 expression, tumors from women >45 years of age had lower microvessel density (MVD) compared with tumors of younger women (10.3 versus 16.1 microvessels per x 400 field; P = 0.03). Lower MVD (less than or equal to11 microvessels per x 400 field) predicted for a worse prognosis than higher MVD (>11 microvessels per x 400 field) in the overall study group (P = 0.001) and within the older subgroup (P = 0.03). The expressions of p53 (P = 0.13) and HER2 (P = 0.49) did not vary between the two age groups. The median survivals of those with tumors that overexpressed p53 and HER2 were 28.6 and 23.9 months compared with 51.7 and 38.6 months in those with cancers that underexpressed these markers, respectively (P = 0.09 for p53, P = 0.15 for HER2). Conclusions: Ovarian cancers in women >45 years of age had lower MVD compared with those in women less than or equal to45 years of age. Lower MVD was an independent prognostic factor for decreased survival. Lower frequency of neovascularization in these cancers may contribute to the decreased survival observed in women >45 years of age
Survival outcomes in patients with recurrent ovarian cancer who were treated with chemoresistance assay-guided chemotherapy
No full textOBJECTIVE: The purpose of this study was to determine the outcome of patients with recurrent ovarian carcinoma after extreme drug resistance assay-directed therapy. STUDY DESIGN: Fifty women who were treated with chemotherapy based on extreme drug resistance assay guidance were compared with 50 well-balanced control subjects who were treated empirically. RESULTS: In the platinum-sensitive group, patients with extreme drug resistance-directed therapy had an overall response rate of 65% compared with 35% in the patients who were treated empirically (P = .02). The overall and progression-free median survival were 38 and 15 months in the extreme drug resistance assay group compared with 21 and 7 months in the control group, respectively (P = .005, overall; P = .0002, progression free). In the platinum-resistant group, there was no improved outcome in the patients who underwent assay-guided therapy. In multivariate analysis, platinum-sensitive disease, extreme drug resistance-guided therapy and early stage of disease were independent predictors for improved survival. CONCLUSION : In this retrospective analysis, our results indicate an improved outcome in patients with recurrent ovarian carcinoma who have platinum sensitive disease and who underwent extreme drug resistance-directed chemotherapy. Randomized, prospective, controlled trials are needed
Significance of comprehensive surgical staging in noninvasive papillary serous carcinoma of the endometrium
No full textObjective. To evaluate the biological behavior of noninvasive papillary serous carcinoma of the endometrium. Methods. From 1990 to 2001, all women with noninvasive uterine papillary serous carcinoma (UPSC) at three Southern California hospitals were identified from tumor registry databases. Data for analysis were collected from hospital charts, office records, and tumor registry files. Results. Of the 100 patients diagnosed with UPSC, 16 had noninvasive lesions. Twelve underwent a comprehensive surgical staging procedure with omental resection. Six of these 12 women were found to have disease beyond the uterine corpus, including 4 with adnexal involvement, 3 with omental disease, 2 with cervical extension, I with pelvic lymph node involvement, and 3 with positive washings. Three women were found to have positive cytology and metastases in more than one location. Of the 12 patients, 1 of the 6 with stage IA disease had distant recurrence and 4 of the 6 with stage II-IV disease recurred. Of the remaining 4 patients who underwent a staging procedure without pathologic omental assessment, I was found to have cervical extension. In these 4 women, I with stage IA disease recurred. Conclusion. The typical patterns of spread and prognostic factors for endometrioid carcinoma of the uterus do not apply to UPSC. In our series, omental assessment was necessary to detect the 25% of patients with stage IVB disease due to omental involvement. Thus, women with noninvasive UPSC should undergo a comprehensive staging procedure including omental sampling to determine the extent of disease. (C) 2003 Elsevier Science (USA). All rights reserved
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