Abstract:
OBJECTIVE:To evaluate the influence of surgical debulking performed on patients with Stage IV ovarian cancer and to determine prognostic factors which identify pts who may benefit from aggressive initial surgical debulking. METHODS:A retrospective chart review was conducted (1/1/87-12/31/93). Eligible patients included all women with FIGO Stage IV ovarian cancer. Clinical information abstracted included age at diagnosis, histology type, tumor grade, criteria for Stage IV classification, surgical procedure performed, and tumor residuum. Optimal surgical status was defined as < or = 2 cm residual disease. Chemotherapy treatment was recorded, as was follow-up. Survival estimates were computed by Kaplan-Meier method with differences in survival calculated by the log-rank test. The Cox proportional hazards regression model was used to identify independent variables which were associated with an improved survival rate. RESULTS:One hundred five women were found in our database with Stage IV ovarian cancer and 97 had complete information available. Median age of the patients was 57 years (range 24-81 years). Papillary-serous histology was found in 55/97 patients (57%) and 50 patients (52%) had grade 3 tumors. Forty-one of 97 patients (42%) had malignant pleural effusion and 20/97 (21%) had liver metastases. Ninety-two patients underwent a primary attempt at surgical debulking and 40/92 were optimally debulked. Twenty-one of 41 patients (51%) with pleural effusion were optimally debulked compared to 20/51 (39%) with other criteria for Stage IV disease (P = NS). Overall median survival was 21 months; optimally debulked patients' median survival was 40 months compared to 18 months for patients with bulky residual disease (P = 0.01). The survival advantage for optimally debulked patients was statistically significant for the two subgroups of patients with and without malignant pleural effusion. In the multivariate analysis only age less than 65 years and optimal debulking were independent predictors of outcome. CONCLUSIONS:Surgical debulking appears to be an important determinant of prognosis in women with Stage IV ovarian cancer, including patients with malignant pleural effusion.
journal_name
Gynecol Oncoljournal_title
Gynecologic oncologyauthors
Curtin JP,Malik R,Venkatraman ES,Barakat RR,Hoskins WJdoi
10.1006/gyno.1996.4550subject
Has Abstractpub_date
1997-01-01 00:00:00pages
9-12issue
1eissn
0090-8258issn
1095-6859pii
S0090825896945503journal_volume
64pub_type
杂志文章abstract::Management of Stage I adenocarcinoma of the uterus includes hysterectomy, bilateral salpingo-oophorectomy, and selective paraaortic and pelvic lymphadenectomy. Postoperative radiation therapy (RT) is selectively employed in patients with histologically defined poor prognostic indicators. We attempted to identify these...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(89)90162-5
更新日期:1989-09-01 00:00:00
abstract::Two cases are presented which demonstrate histologically an endometrial response to endogenous hormones after pelvic teletherapy and brachytherapy in patients who have undergone lateral ovarian transposition. Reasons for such a response are briefly discussed. ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(90)90118-5
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:It has been suggested that mutation of the TP53 tumor suppressor gene is involved in endometrial carcinogenesis. However, the status of p53 function in endometrial cancers has not yet been investigated in detail. METHODS:We surveyed inactivating p53 mutations in endometrial carcinomas using the yeast p53 fu...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.2001.6429
更新日期:2001-12-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to determine the efficacy and hematologic toxicity of salvage chemotherapy in patients with recurrent ovarian cancer following high-dose chemotherapy and peripheral blood stem cell transplantation (PBSCT). METHODS:A retrospective analysis of 19 Massachusetts General Hospital c...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1999.5710
更新日期:2000-04-01 00:00:00
abstract::The incidence of endometrial cancer (EC) in the U.S. has been rising, from an estimated annual incidence of 49,560 in 2013 to 61,380 in 2017. Meanwhile, the SEER-based relative survival of women with EC in the U.S. has remained flat [82.3% from 1987 to 1989, 82.8% from 2007 to 2013] and our recent increased understand...
journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1016/j.ygyno.2018.02.005
更新日期:2018-02-22 00:00:00
abstract::The purpose of this study was to evaluate the biological significance of Ki67 antigen expression in serous ovarian tumors, through the analysis of MIB 1 monoclonal antibody reactivity in cystoadenomas, borderline tumors, and invasive cystoadenocarcinomas; the correlation between this index of cell proliferation and cl...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1995.1026
更新日期:1995-02-01 00:00:00
abstract:INTRODUCTION:The rationale for lymphadenectomy in primary peritoneal cancer (PPC) is unclear. We sought to define the pattern of lymphatic metastasis in PPC and propose evidence-based rationale for lymphadenectomy in relevant cases. METHODS:Patients with PPC undergoing primary surgery at Mayo Clinic were identified. D...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2009.03.020
更新日期:2009-07-01 00:00:00
abstract:OBJECTIVE:To design and implement a standardized postoperative voiding management protocol that accurately identifies patients with urinary retention and reduces unnecessary re-catheterization. METHODS:A postoperative voiding management protocol was designed and implemented in patients undergoing major, inpatient, non...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2020.01.036
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVE:To prospectively evaluate tumor control, survival, and toxic effects in patients with International Federation of Gynecology and Obstetrics (1988) stage I-IIIA papillary serous carcinoma of the endometrium treated with concurrent chemoradiation and adjuvant chemotherapy. METHODS:Thirty-two patients were enro...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2013.01.025
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:According to current treatment guidelines, comprehensive surgical staging procedures in endometrial cancer confined to the uterus depend on uterine risk factors: a systematic lymph node dissection (LND) is recommended in high risk patients and should be omitted in low risk patients. Its role in intermediate ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2019.04.002
更新日期:2019-07-01 00:00:00
abstract::A 46-year-old woman with the complaint of hypermenorrhea underwent hysterectomy for a presumed uterine myoma. The solid tumor in the myometrium was gray in color, was 4 cm in diameter, and showed hemorrhage and necrosis. Histologically, the tumor consisted of round or polygonal cells arranged in cords and nests, and i...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1996.0319
更新日期:1996-11-01 00:00:00
abstract:BACKGROUND:Recurrence of endometrial cancer in the brain is a rare event generally accompanied by limited life expectancy. We present an unusual case of long-term survival following surgical resection of an intracranial endometrial cancer metastasis. CASE:The present case is a patient with FIGO stage IIB, grade III en...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2004.07.030
更新日期:2004-10-01 00:00:00
abstract::The Patient Protection and Affordable Care Act (ACA) was signed into law by President Barack Obama in 2010. While initial implementation of the law began shortly thereafter, the full implementation will take place over the next few years. With respect to cancer care, the act was intended to make care more accessible, ...
journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1016/j.ygyno.2013.02.036
更新日期:2013-06-01 00:00:00
abstract::Flow cytometric cell cycle analysis was performed on paraffin-embedded blocks from 49 patients with stage I endometrial carcinoma. Care was taken to separate tumor tissue from normal tissue in each specimen; normal tissue was used as a control for each individual specimen. DNA index, proliferative activity, and cell D...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1994.1084
更新日期:1994-04-01 00:00:00
abstract:OBJECTIVE:Retinoids are important modulators of cell growth, differentiation, and proliferation. 9cUAB30, 9cUAB124, and 9cUAB130 are three novel retinoid compounds that show cytotoxic effects in other malignancies. We evaluated these novel retinoids in combination with chemotherapy against ovarian cancer stem cells (CS...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2011.12.425
更新日期:2012-04-01 00:00:00
abstract:INTRODUCTION:Cervical cancer spreads directly and through lymphatic and vascular channels. Perineural invasion is an alternative method of spread. Several risk factors portend poor prognosis and inform management decisions regarding adjuvant therapy. OBJECTIVE:To evaluate the incidence and significance of PNI in early...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2011.08.028
更新日期:2011-12-01 00:00:00
abstract:OBJECTIVES:Ovarian cancer remains a leading cause of death in women and development of new therapies is essential. Second mitochondria derived activator of caspase (Smac) has been described to sensitize for apoptosis. We have explored the proapoptotic activity of a small molecule mimic of Smac/DIABLO on ovarian cancer ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2007.01.011
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVE:Brachytherapy plays a major role in the treatment of patients with carcinoma of the cervix. However, routine intracavitary brachytherapy may not be feasible or adequate to treat locally advanced disease. The purpose of this prospective study was to assess treatment outcome for patients with locally advanced g...
journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章
doi:10.1016/j.ygyno.2005.06.001
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVE:To prospectively evaluate the feasibility of detecting human papillomavirus (HPV) type 16, 18 and 52 DNA in the peripheral blood of patients with cervical cancer using real-time polymerase chain reaction (PCR) and to determine its prognostic importance. METHODS:Blood and cervical swab specimens from 135 cons...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2005.07.004
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:Microglandular adenocarcinoma is a rare type of endometrium carcinoma and had some potential diagnostic problems with difficulties in discriminating from some malign and benign lesions of cervix. CASE REPORT:A 70-year-old woman misdiagnosed as cervical adenocarcinoma was referred to our clinic, and the lesi...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2005.08.009
更新日期:2005-12-01 00:00:00
abstract::Clear cell carcinoma of the ovary accounts for 2 to 3% of all epithelial ovarian neoplasms. Patient profiles, pathological characteristics, and results of treatment are reviewed for 59 patients. The median age was 51. Disease extent at diagnosis was as follows: stage I, 18 patients (31%); stage II, 20 patients (34%); ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(89)90043-7
更新日期:1989-11-01 00:00:00
abstract:BACKGROUND:The prognosis of cancer patients with distant metastases is extremely poor. CASE:A 51-year-old Japanese woman with Stage IIIc serous cystoadenocarcinoma of the ovary achieved complete remission. At 30 and 39 months after the initiation of therapy, solitary brain and then spleen metastases without intraperit...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/s0090-8258(03)00265-8
更新日期:2003-08-01 00:00:00
abstract::Progress has been made in identifying the molecular changes that occur in ovarian carcinoma; still our understanding of these changes and their interactions remains incomplete. In the present study the authors examined the expression of retinoblastoma protein, a tumor suppressor protein, in a spectrum of ovarian epith...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1998.5015
更新日期:1998-06-01 00:00:00
abstract::Endocrine and clinicopathologic findings in a 77-year-old woman with ovarian mucinous adenofibroma of borderline malignancy are reported. The preoperative levels of testosterone, androstenedione, estrone, and estradiol in her peripheral blood were 91 ng/ml, 3.78 ng/ml, 82 pg/ml, and 35 pg/ml, respectively, abnormally ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1994.1197
更新日期:1994-08-01 00:00:00
abstract:OBJECTIVE:Carcinosarcoma (CS) of the uterus or ovary is a rare, biphasic tumor comprising epithelial and mesenchymal elements, and exhibits more aggressive clinical features than its carcinoma counterpart. Four molecular subtypes of CS were recently established based on genomic aberration profiles (POLE, MSI, CNH, and ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2020.11.030
更新日期:2021-02-01 00:00:00
abstract:INTRODUCTION:We describe a case of conservatively treated endometrial endometrioid (EE) adenocarcinoma which showed an aggressive clinical outcome after pregnancy. CASE:A 30-year-old woman with a well differentiated EE adenocarcinoma decided to attempt a conservative approach and underwent progestin treatment with sub...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2005.05.025
更新日期:2005-10-01 00:00:00
abstract::As gynecologic surgeons garnered a better understanding of various clinical-pathological prognostic factors, there evolved a number of modifications in the surgical approach allowing for more individualized therapy with less morbidity, while still retaining the curative potential of the radical vulvectomy operation. T...
journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1016/j.ygyno.2009.01.004
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVE:Ras gene mutations have been identified in squamous cell carcinomas of the cervix and are associated with advanced-stage tumors. The current study was designed to determine the prevalence of c-Ki-ras mutations in invasive endocervical adenocarcinomas and associations between mutations, HPV status, and known p...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1993.1064
更新日期:1993-03-01 00:00:00
abstract:BACKGROUND:Central nervous system (CNS) metastases from an ovarian malignancy are uncommon. The long-term prognosis for these patients is poor, with studies reporting a mean survival of less than 12 months. CASES:We present three ovarian cancer patients who developed metastatic disease to the brain. All patients were ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2005.02.019
更新日期:2005-06-01 00:00:00
abstract::Dermatofibrosarcoma protuberans (DFSP) of the vulva is a rare, low- to intermediate-grade sarcoma of dermal origin. This case report represents the 13th reported patient with vulvar DFSP and the first reported patient with metastatic vulvar DFSP. Although metastasis is rare, the possibility remains that the frequent r...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1998.5173
更新日期:1998-11-01 00:00:00