Publications (3)0 Total impact
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ABSTRACT: Vulvar epithelioid sarcoma is a rare, undifferentiated soft-tissue sarcoma, with a high rate of local relapse, regional nodal spread and distant metastases. The aim of this study was to investigate the clinical features, diagnosis, treatment and prognosis of this malignancy. We studied the clinicopathologic features of 20 cases of vulvar epithelioid sarcoma, of which 4 cases were admitted to our hospital from 1999 to 2009. All of the patients received radical local excision with inguinofemoral lymphadenectomy. Seven patients were treated without adjuvant therapy. Seven patients received postoperative radiotherapy only and three underwent chemotherapy. Chemotherapy plus radiotherapy were given postoperatively in three. The patients ranged in age from 23 to 80 years (median: 36 y). The tumors ranged from 1 to 10 cm in their greatest diameter (median: 5.1 cm). All cases showed immunoreactivity for both vimentin and cytokeratin. Follow-up information on all 20 patients was available, and covered periods ranging from 3 to 104 months.11 patients were alive with no evidence of disease. 2 patients developed lymph node metastases but alive. 7 patients had died of the disease. Survival of the early stage (I-II) patients was significantly longer than those in the advanced stage (III-IV) (median, 21 vs. 6 months, P < 0.01). There was no significant difference between survival of patients with or without inguinofemoral lymphadenectomy (median, 11.5 vs. 6 months, P = 0.086). Because of the relatively frequent misdiagnosis, a differential diagnosis combined with immunohistochemistry is needed to determine an early and accurate diagnosis. The tumor markers exhibiting immunoreactivity includ vimentin, epithelial membrane antigen (EMA) and cytokeratin (CK). Radical local excision with adequate margin (at least 2 cm) and bilateral inguinofemoral lymphadenectomy is effective for the treatment of vulvar epithelioid sarcoma. The role of adjuvant therapy, chemotherapy and radiation remains unclear but merits consideration.Zhonghua zhong liu za zhi [Chinese journal of oncology] 12/2010; 32(12):935-8.
Article: [Preliminary study of nerve sparing radical hysterectomy in patients with cervical cancer].[show abstract] [hide abstract]
ABSTRACT: To assess the feasibility of nerve sparing radical hysterectomy (NSRH) technique and the impact on the improvement of postoperative bladder function in patients with cervical cancer. Forty-two patients with FIGO stage Ib1 approximately Ib2 cervical cancer were selected to receive NSRH (study group, 21 cases) or routine hysterectomy (RH) (control group, 21 cases). Duration of surgery, blood loss and mean length of postoperative stay were compared between the two groups. Immunohistochemical analysis of surgical margins using a general nerve marker (S-100) was performed to compare the nerve damages. The operation time of NSRH group and RH group was (248 +/- 24) min and (227 +/- 27) min, respectively, with a significant difference between the two groups (P < 0.01). No significant difference in blood loss was found between the NSRH and RH group [(459 +/- 143) ml vs. (454 +/- 121) ml, P > 0.05]. However, the median urinary catheterization time was 7 days in NSRH group versus 16 days in the RH group, with a statistically significant difference between the two groups (P < 0.01). The rate of patients who had postoperative residual urine volume in bladder (PVR) < or =100 ml was 66.7% in the NSRH group versus 19.0% in the RH group, with a significant difference between the two groups (P < 0.01). No severe perioperative complications occurred in both groups. After a follow-up of 11 to 16 months (median: 14 months), no recurrence was detected in the two groups. Immunohistochemistry with S-100 staining revealed only small nerve fibers in the surgical margins of the NSRH group, but full with large nerve bundles in that of the RH group. There was a significant difference between two group (P < 0.01). The results of our preliminary study indicate that nerve sparing radical hysterectomy (NSRH) for the patients with FIGO stage Ib1 approximately Ib2 cervical cancer is safe and feasible, and can well preserve the pelvic autonomic nerves and improve the recovery of bladder voiding function.Zhonghua zhong liu za zhi [Chinese journal of oncology] 08/2009; 31(8):607-11.
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ABSTRACT: The preoperative diagnosis and management of stage IA(1) squamous carcinoma of the cervix remains a controversial subject. The aim of this study was to discuss diagnosis and appropriate management options of this disease. Clinical data and pathological materials of 30 patients with stage IA(1) squamous carcinoma of the cervix, who were treated in Cancer Hospital, Chinese Academy of Medical Science, Peking Union Medical College between 1992 to 2001, were reviewed. Seven of 30 patients (23.3%) had neither specific symptoms nor signs. Twenty-three patients had cytological examination with the positive rate of 86.9% (20/23). Colposcopy was performed in 23 of the women; the accuracy of colposcopical impression was 78.2%(18/23). Of 10 endocervical curettage (ECC) specimens, 4 cases had abnormal pathology. Among 30 patients, 22 (73.3%) were treated with radical hysterectomy, 6 with simple hysterectomy, and 2 with cold conization only. There was no parametrical involvement and no positive vaginal margin in any of 28 patients who had hysterectomy. Lymphadenectomy was performed in 8 cases; the mean number of lymph nodes removed was 22, and no metastasis was found. The two conization specimens had free surgical margin. The preoperative diagnosis agreed with final diagnosis in only 56.7% (17/30); there was statistically significant difference between them (P< 0.01). During median 34 months follow-up (range, 17-111 months), no developed recurrences and no died from cancer. The diagnostic accuracy of colposcopically directed biopsy is quite poor for stage IA(1) cervical carcinoma. Cervical cold conization may increase the diagnostic accuracy and may be recommended for patients who desire conservation of fertility.Ai zheng = Aizheng = Chinese journal of cancer 03/2004; 23(2):204-6.