[show abstract][hide abstract] ABSTRACT: The aim of this study was to assess the clinical characteristics and outcome of patients with either primary peritoneal carcinoma (PPC) or ovarian serous carcinoma (OSC) treated with paclitaxel plus carboplatin chemotherapy. We retrospectively identified 22 PPC patients and 55 stage III-IV OSC patients treated between 2002 and 2007. After exploratory laparotomy, all patients received paclitaxel and carboplatin every 3 weeks, with the goal of optimal cytoreduction. There were no statistically significant differences between the PPC and OSC groups with regard to tumor stage, residual tumor after debulking surgery (initial or interval), serum cancer antigen (CA) 125 levels at diagnosis, and completion of first-line chemotherapy. The progression-free survival (PFS) durations were 12.7 months (95% CI, 6.3-18.5) in the patients with PPC and 15.9 months (95% CI, 13.3-18.5) in those with OSC (p = 0.016). However, the median survival durations were 26.5 months (95% CI, 14.6-38.3) in the patients with PPC and 38 months (95% CI, 23.8-53.8) in those with OSC (p = 0.188). Survival was longer for all patients whose CA125 levels normalized to 26 U/ml during and after treatment. Overall survival (OS) of the patients with PPC was similar to that of the patients with OSC, suggesting that management for advanced-stage OSC would be similar to that for PPC. The combination of optimal debulking with paclitaxel plus carboplatin chemotherapy may offer patients the most effective treatment. The CA125 nadir after cytoreductive surgery can be considered a prognostic factor for OS and PFS in patients with PPC.
[show abstract][hide abstract] ABSTRACT: Although metastasis to the bone is common in solid tumors, it seldom occurs in endometrial cancer. A rare case of endometrial carcinoma that presented wth symptoms of bone metastasis in the right ischium and treated successfully by zoledronic acid is described. A 57-year-old woman presented with pain of the right ischium. Computed tomography and magnetic resonance imaging revealed bone metastasis and enlargement of the uterus. Endometrial biopsy confirmed endometrial adenocarcinoma. The patient underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy and biopsy of the ischium. Postoperatively, the patient received six courses of chemotherapy using paclitaxel and carboplatin. However, pain of the right-ischium reappeared 9 months after surgery. The patient was treated with 4 mg of zoledronic acid every 4 weeks. After 4 cycles of treatment, the visual analogue scale regressed from 70 to 10. Zoledronic acid can palliate bone pain caused by a variety of endometrial cancers.
Gan to kagaku ryoho. Cancer & chemotherapy 06/2011; 38(6):1035-8.
[show abstract][hide abstract] ABSTRACT: We report two cases of uterine carcinosarcoma associated with alpha-fetoprotein (AFP)-producing hepatoid adenocarcinoma. Samples were obtained from two women aged 63 and 82 years. Serum AFP levels of the two samples were 10,131 and 401 ng/ml, respectively. Histologically, in both cases the tumor cells were composed of hepatoid adenocarcinoma component and sarcoma component including rhabdomyosarcoma. Immunohistochemical analyses revealed that AFP was expressed in the cytoplasm of the carcinomatous component. After surgery, the patients received six courses of carboplatin/paclitaxel chemotherapy, and the serum levels of AFP decreased to normal range. The first patient is alive and well at the 2-year follow-up, while the second patient died of disease 1 year after initial operative treatment. This is, to our knowledge, the second report of carcinosarcoma of the uterine corpus with AFP-producing hepatoid adenocarcinoma, as proven by immunohistochemical analyses.
[show abstract][hide abstract] ABSTRACT: BACKGROUND: Massive ovarian edema is a benign enlargement of the ovary caused by accumulation of fluid occurring mainly in young women. Most cases are thought to result from venous and lymphatic obstruction. CASE REPORT: We treated a 40-year-old multiparous pregnant woman with massive ovarian edema who had been received clomiphene citrate. She was admitted at 13th week of pregnancy for acute pelvic pain. Left oophorectomy was performed, and pathologic examination disclosed massive ovarian edema. Our report is the first case of massive ovarian edema with pregnancy after ovulation induction using clomiphene citrate.
Archives of Gynecology and Obstetrics 05/2008; 277(4):375-8. · 1.33 Impact Factor
[show abstract][hide abstract] ABSTRACT: Little is known about the natural history of ovarian cancer with respect to the change of serum CA125 level.
The Shizuoka Cohort Study on Ovarian Cancer Screening (SCSOCS) Trial contains approximately 100,000 data on serum tumor marker CA125 prospectively obtained from more than 70,000 women. We reviewed the clinical charts and collected serum samples 2 months to 9.4 years prior to the surgery were available.
In 396 (95%) of the 419 patients with ovarian cancer, one serum sample was present before the diagnosis (mean, 4.1 years). The change of CA125 level before the diagnosis of ovarian cancer could be clearly separated into two groups according to the length of the following intervals: 47% (107/228) of patients with non-serous-type ovarian cancers develop secondarily from slightly elevated CA125 level (35 <CA125 <65 U/ml), with a mean interval of 3.8 years. On the other hand, 75% (126/168) of patients with serous-type ovarian cancer seem to develop suddenly from a normal CA125 level (CA125 <35 U/ml), with a mean interval of 1.4 years (p=0.011).
The slightly elevated CA125 level is typically present many years before the diagnosis especially in patients with non-serous-type ovarian cancer. However, serous-type ovarian cancer may exhibit a rapid progression possibly through de novo carcinogenesis.
International Journal of Gynecology & Obstetrics 12/2007; 99(2):95-9. · 1.84 Impact Factor