Clinical Ovarian and Other Gynecologic Cancer最新文献

{"title":"Explorative Study on the Predictive and Prognostic Value of Early Complete Metabolic Response By FDG-PET–CT During Neoadjuvant Chemotherapy in Patients With Advanced Ovarian Cancer","authors":"Andrea Angelo Martoni ,&nbsp;Marta Rosati ,&nbsp;Claudio Zamagni ,&nbsp;Pierandrea De Jaco ,&nbsp;Paolo Castellucci ,&nbsp;Sara Quercia ,&nbsp;Alessandra Bernardi ,&nbsp;Stefano Fanti","doi":"10.1016/j.cogc.2012.04.003","DOIUrl":"10.1016/j.cogc.2012.04.003","url":null,"abstract":"<div><h3>Background and Aim</h3><p>Early complete metabolic response (e-CMR) by fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) during neoadjuvant chemotherapy (NACT) in advanced ovarian cancer (AOC) could have predictive and prognostic value. The present explorative study prospectively investigated changes of dual-time FDG-PET, at baseline and after 3 cycles of NACT in patients who were not candidates for upfront debulking surgery by comparing with standard serum cancer antigen 125 (CA-125) monitoring.</p></div><div><h3>Patients and Methods</h3><p>Fifty consecutive patients with AOC were treated with 6 cycles of carboplatin/paclitaxel before surgery. FDG-PET and serum CA-125 were evaluated at baseline and after 3 cycles. e-CMR and early complete biochemical response (e-CBR) were defined as the normalization of the maximum standardized uptake values and serum CA-125 levels, respectively.</p></div><div><h3>Results</h3><p>e-CMR and e-CBR were observed in 34% and 38% of patients, respectively. At the end of NACT, an optimal pathologic response (pR) and optimal surgery with no residual tumor (R0) were achieved in 23 (46%) and 26 (52%) patients, respectively. E-CMR and e-CBR positive predictive value was 88% and 84% for pR and 88% and 89% for R0, respectively. After a median follow-up of 42 months, 41 (82%) patients had progressed and 32 (64%) died. Median progression-free survival and overall survival were 13.8 and 28.1 months, respectively. At multivariate analysis, e-CMR, but not e-CBR, showed an independent prognostic value with regard to both progression-free survival and overall survival.</p></div><div><h3>Conclusions</h3><p>e-CMR may predict pR and R0 surgery obtained at the end of NACT and identify patients a favorable long-term outcome.</p></div>","PeriodicalId":100274,"journal":{"name":"Clinical Ovarian and Other Gynecologic Cancer","volume":"5 1","pages":"Pages 2-9"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cogc.2012.04.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84413571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraperitoneal Catheter Placement: The “Hammock” Technique","authors":"Christina L. Kushnir ,&nbsp;Aimee C. Fleury ,&nbsp;David F. Silver ,&nbsp;Nick M. Spirtos","doi":"10.1016/j.cloc.2011.08.001","DOIUrl":"10.1016/j.cloc.2011.08.001","url":null,"abstract":"<div><h3>Background</h3><p>Ovarian cancer is the leading cause of death from gynecologic malignancies in the United States. The NCI released a clinical announcement supporting the use of intraperitoneal chemotherapy in addition to intravenous chemotherapy. However, multiple trials have shown that IP administration is severely limited by catheter complications.</p></div><div><h3>Purpose</h3><p>We present a new technique for inserting and securing IP catheters in order to prevent the previously reported complications, in particular obstruction of the catheter, bowel and vaginal cuff perforation.</p></div><div><h3>Methods</h3><p>From March 2006 through February 2010, 38 patients with stage III or IV ovarian cancer underwent optimal cytoreductive surgery and had an IP catheter placed via the “Hammock” technique.</p></div><div><h3>Results</h3><p>14 patients underwent modified posterior exenteration (37%); 6 underwent splenectomy (16%); thirteen small bowel resections (34%). All 38 patients underwent pelvic and aortic lymphadenectomy. Two patients had reservoir complications; one “flipped over”, and the other had an infection at the port site. Both patient’s elected to discontinue the IP portion of the chemotherapy regimen. 219 cycles of chemotherapy were completed (96%) out of a possible 228 cycles. The only complications were related to the reservoir. There were no catheter-related complications.</p></div><div><h3>Conclusion</h3><p>As an increasing number of IP catheters are placed at the time of cytoreductive surgery, we will continue to have catheter complications and IP chemotherapy administration difficulties. In using the “Hammock” Technique, we had no catheter complications, and a 96% chemotherapy completion rate. We recommend using the “Hammock” Technique for inserting and securing IP catheters at the time of cytoreductive surgery. .</p></div>","PeriodicalId":100274,"journal":{"name":"Clinical Ovarian and Other Gynecologic Cancer","volume":"5 1","pages":"Pages 24-26"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cloc.2011.08.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85597240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Recall of Health Care Events and Time to Diagnose a Suspected Ovarian Cancer","authors":"Lisa M. Hess ,&nbsp;Michael W. Method ,&nbsp;Frederick B. Stehman ,&nbsp;Tess D. Weathers ,&nbsp;Paridha Gupta ,&nbsp;Jeanne M. Schilder","doi":"10.1016/j.cogc.2012.04.001","DOIUrl":"10.1016/j.cogc.2012.04.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Patient recall is often used by clinicians to create a history of care leading to consultation with a gynecologic oncologist. Although patient recall may be an efficient method to explore the context of the patient's concerns, the accuracy of recall and its potential impact on care are unknown. This study sought to explore the consistency of patient recall compared with data found in health care records.</p></div><div><h3>Patients and Methods</h3><p>This study enrolled 105 eligible patients who were referred to a gynecologic oncologist for suspected ovarian cancer. Ninety-one of these patients were interviewed regarding symptoms, health care events, and the dates leading to diagnosis. The medical records of these patients from all previous providers were obtained and data were abstracted. The intraclass correlation coefficient (intraclass correlation coefficient, ICC[3,1]) was used to examine correspondence between recall and medical record data.</p></div><div><h3>Results</h3><p>There was low correspondence between patient recall and the medical record for time to diagnosis (ICC = 0.12; 95% confidence interval [CI] = −0.09 to 0.33; <em>P</em> = .12) and health care events (0.15; 95% CI, −0.05 to 0.348; <em>P</em> = .008).</p></div><div><h3>Conclusions</h3><p>There should be limited confidence in information obtained from patient recall given the inconsistency between recall and actual dates and events.</p></div>","PeriodicalId":100274,"journal":{"name":"Clinical Ovarian and Other Gynecologic Cancer","volume":"5 1","pages":"Pages 17-23"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cogc.2012.04.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91480856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serous Borderline Tumor of the Fallopian Tube Presenting as an Ectopic Pregnancy: Case Report and Review of the Literature","authors":"Judit Albareda ,&nbsp;M. Jose Garcia Rubio ,&nbsp;Manuel Albi ,&nbsp;Patricia Dhimes","doi":"10.1016/j.cogc.2012.05.001","DOIUrl":"10.1016/j.cogc.2012.05.001","url":null,"abstract":"","PeriodicalId":100274,"journal":{"name":"Clinical Ovarian and Other Gynecologic Cancer","volume":"5 1","pages":"Pages 40-43"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cogc.2012.05.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86138623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Symptoms of Pelvic Floor Disorders and Quality of Life Measures in Postoperative Patients With Endometrial Cancer","authors":"Patrick A. Nosti ,&nbsp;Colleen D. McDermott ,&nbsp;Jeanne M. Schilder ,&nbsp;Frederick B. Stehman ,&nbsp;Patrick J. Woodman","doi":"10.1016/j.cogc.2012.04.002","DOIUrl":"10.1016/j.cogc.2012.04.002","url":null,"abstract":"<div><h3>Background</h3><p>The primary goal of this study was to determine the prevalence of pelvic floor symptoms in postoperative patients with endometrial cancer. The secondary goal was to assess the impact of these issues on patient quality of life.</p></div><div><h3>Methods</h3><p>This cross-sectional study looked at women (N = 25) returning for postoperative care at least 6 months after total abdominal hysterectomy for endometrial cancer. Demographic and clinical data were collected. Severity of pelvic floor symptoms was assessed using the short-form version of the Pelvic Floor Distress Inventory (PFDI-20). The impact of these symptoms on quality of life was assessed using the short-form version of the Pelvic Floor Impact Questionnaire (PFIQ-7). Demographic data and PFDI-20 and PFIQ-7 scores were summarized using descriptive statistics.</p></div><div><h3>Results</h3><p>Pelvic symptoms were reported at a much higher rate than seen in the general public. Symptom prevalence was reported by 21/25 (84%) patients on the PFDI-20 questionnaire, with a mean score of 52.5 ± 64.8. Patients reported prevalence of symptoms in the following order: urinary symptoms (19/25 [76%]) &gt; colorectal-anal symptoms (17/25 [68%]) &gt; pelvic organ prolapse symptoms (11/25 [44%]). Slightly fewer than half (11/24) of the study participants reported quality of life issues associated with their pelvic symptoms, with a mean score in the mild range: 26.4 ± 64.5. The reported prevalence of the effect of pelvic symptoms on quality of life was urinary (10/25 [40%]) &gt; colorectal-anal (8/24 [33%]) &gt; pelvic organ prolapse (4/24 [17%]).</p></div><div><h3>Conclusion</h3><p>This study has shown that there was a high prevalence of symptoms of PFDs in our population after abdominal hysterectomy for endometrial cancer.</p></div>","PeriodicalId":100274,"journal":{"name":"Clinical Ovarian and Other Gynecologic Cancer","volume":"5 1","pages":"Pages 27-30"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cogc.2012.04.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73685006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malignant Uterine Perivascular Epithelioid Cell Tumor: A Case Report","authors":"Dina J. Chamsy ,&nbsp;Scott C. Purinton ,&nbsp;Kelley S. Carrick ,&nbsp;Debra L. Richardson","doi":"10.1016/j.cogc.2012.05.002","DOIUrl":"10.1016/j.cogc.2012.05.002","url":null,"abstract":"","PeriodicalId":100274,"journal":{"name":"Clinical Ovarian and Other Gynecologic Cancer","volume":"5 1","pages":"Pages 37-39"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cogc.2012.05.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87310893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}