A multi-institutional review of outcomes of endometrial stromal sarcoma
ABSTRACT To compare the clinical behavior and outcomes of low- and high-grade endometrial stromal sarcomas (LGESS and HGESS), respectively.
Patients with endometrial stromal sarcoma from five different institutions were identified and reviewed for clinicopathologic variables, surgical management and outcomes. Statistical calculations including Chi-square, t-test and survival using the Kaplan-Meier method with the log rank test were performed.
One hundred and five patients were identified with 72 having LGESS, 31 with HGESS and 2 having unclassified tumors. The mean age was 50 years for patients with LGESS and 64 years for those with HGESS (p<0.0001). In patients with LGESS, 68% (49 patients) had disease confined to the uterine corpus or cervix compared to 39% (12 patients) in HGESS (p=0.002). The median overall survival was 53 months for HGESS and had not yet been reached in LGESS with 87.8% alive at 80 months (p<0.0001). In HGESS patients with extrauterine disease, the presence of residual disease greater than 2 cm had a significant effect on median survival. Median survival was 52 months for those who underwent optimal cytoreduction versus 2 months for those with suboptimal residual disease (p=0.007). The impact of cytoreduction was not seen in LGESS patients with extrauterine disease with 82.1% alive at 78 months.
Low-grade and high-grade endometrial stromal sarcomas represent two distinct clinical entities and should be treated as such. Survival in patients with high-grade tumors appears to be related to amount of residual disease at the completion of initial surgery and would suggest the need for aggressive cytoreduction. The role of surgical staging and optimal adjuvant therapy remains unclear.
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ABSTRACT: Low-grade endometrial sarcoma is a rare gynecological tumor (0.2% of female genital tract tumors) mainly observed in women before their 50's. The authors present a series of 10 patients followed in two institutions and describe the treatment administered (cytoreductive surgery, i.e. bilateral annexectomy and total hysterectomy, and medical treatments) and the follow-up. Local recurrence occurred in 70% of cases, whereas metastasis was rare even after suboptimal surgical removal of the tumor. Adjuvant progestin therapy is currently the most effective treatment for curing and preventing local recurrence. The use of aromatase inhibitors is a promising research approach.Anticancer research 09/2008; 28(5B):2869-74. · 1.87 Impact Factor
Conference Paper: Efficient estimation of signal transition activity in MAC architectures.[Show abstract] [Hide abstract]
ABSTRACT: Because of the increasing demand of portable digital systems, it is of great interest to extend the existing high-level power estimation techniques to handle architectures with nonlinear components, as they appear in relevant practical applications. In this paper we focus on the estimation of the transition activity in MAC structures implementing FIR filters. Based on a divide and conquer approach, an accurate yet efficient estimation procedure is developed. The technique has been evaluated for different synthetic and real data sets. In all cases, our results depict only very slight discrepancies with respect to precise bit level simulations.Proceedings of the 2002 International Symposium on Low Power Electronics and Design, 2002, Monterey, California, USA, August 12-14, 2002; 01/2002
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ABSTRACT: A Digital Matched Filter (DMF) is an essential device for Direct- Sequence Spread-Spectrum (DS-SS) communication systems. Reducing the power consumption of a DMF is especially critical for battery-powered terminals. The reception registers and the correlation-calculating unit dissipate the majority of the power in a DMF. In this paper we discuss this problem and propose a lowpower architectural approach to a DMF. The total switching activity factor and the switched capacitance are reduced. As a result of power analysis at the gate level, the implementation of the proposed architecture in a standard 0.18-$ \mu $m CMOS technology achieved a reduction in the power consumption of more than 70 %.