• Journal of Gynecologic Oncology
• /
• v.29 no.6
• /
• pp.82.1-82.13
• /
• 2018

Objective: The impact of beta blockers (BBs) on survival outcomes in ovarian cancer was investigated. Methods: By using Korean National Health Insurance Service Data, Cox proportional hazards regression was performed to analyze hazard ratios (HRs) with 95% confidence intervals (CIs) adjusting for confounding factors. Results: Among 866 eligible patients, 206 (23.8%) were BB users and 660 (76.2%) were non-users. Among the 206 BB users, 151 (73.3%) were non-selective beta blocker (NSBB) users and 105 (51.0%) were selective beta blocker (SBB) users. BB use in patients aged ${\geq}60$ years, longer duration use (${\geq}1$ year), in patients with Charlson Comorbidity Index (CCI) ${\geq}3$, and in cardiovascular disease including hypertension was associated with better survival outcome. These findings were observed in both NSBB and SBB. When duration of medication was analyzed based on number of days, NSBB (${\geq}180$ days) was associated with improved overall survival (OS) with a relatively shorter period of use compared to SBB (${\geq}720$ days). In multivariate Cox proportional hazards model, longer duration of BB medication (${\geq}1$ year) was an independent favorable prognostic factor for both OS and disease-specific survival in ovarian cancer patients. Conclusion: In our nationwide population-based cohort study, BB use was associated with better survival outcomes in ovarian cancer in cases of long term duration of use, in older patients, and in cardiovascular and/or other underlying disease (CCI ${\geq}3$).

• Journal of Digestive Cancer Research
• /
• v.10 no.2
• /
• pp.112-116
• /
• 2022

Idiopathic inflammatory myopathy (IIM) is known for its association with malignant diseases. Moreover, various solid organ malignancies, such as ovarian, breast, lung, esophageal, stomach, and colorectal cancers, have been reported to occur with IIM. Furthermore, its relationship with hematologic malignancies, including non-Hodgkin lymphoma, myeloma, and leukemia, has been reported. However, to date, IIM related to pancreatic cancer has scarcely been reported, particularly in patients with polymyositis (PM). Therefore, here we report a case of PM developed immediately after the diagnosis of pancreatic ductal adenocarcinoma.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.16
• /
• pp.7237-7242
• /
• 2015

Background: Epithelial ovarian cancer (EOC) is the commonest malignancy involving the ovaries. Maximum surgical cytoreduction (MCR) followed by adjuvant taxane-platinum chemotherapy are the standard of care treatments. Aims: To study treatment outcomes of EOC patients that were maximally cyto-reduced and received adjuvant paclitaxel-carboplatin (PC) chemotherapy. Materials and Methods: This retrospective cohort study included 174 patients with EOC treated at the Egyptian National Cancer Institute between 2006 and 2010. For inclusion, they should have had undergone MCR with no-gross residual followed by adjuvant PC chemotherapy. MCR was total abdominal hysterectomy/bilateral salpingo-oophorectomy [TAH/BSO] or unilateral salpingo-oophorectomy [USO] plus comprehensive staging. Results: The median age was 50 years. Most patients were married (97.1%), had offspring (92.5%), were postmenopausal (53.4%), presented with abdominal/pelvic pain and swelling (93.7%), had tumors involving both ovaries (45.4%) without extra-ovarian extension i.e. stage I (55.2%) of serous histology (79.9%) and grade II (87.4%). TAH/BSO was performed in 97.7% of cases. A total of 1,014 PC chemotherapy cycles were administered and were generally tolerable with 93.7% completing 6 cycles. Alopecia and numbness were the commonest adverse events. The median follow up period was 42 months. The 2-year rates for disease free survival (DFS) and overall survival (OS) were 70.7% and 94.8%, respectively. The respective 5-year rates were 52.6% and 81.3%. Advanced stage and high-grade were significantly associated with poor DFS and OS (p<0.001). Age >65 years was associated with poor OS (p =0.008). Using Cox-regression, stage was independent predictor of poor DFS and OS. Age was an independent predictor of poor OS.

• Journal of Yeungnam Medical Science
• /
• v.10 no.2
• /
• pp.417-422
• /
• 1993

Diagnosis of malignant germ cell tumors of the ovary is usually difficult because many ovarian neoplasms have similar clinical and radiologic manifestations. We reviewed retrospectively 12 cases of ovarian malignant germ cell tumor and evaluated with respect to size, mass characteristics on computed tomography for differential diagnosis. Endodermal sinus tumors were mainly cystic mass with some solid component and septations. Immature teratomas showed typical manifestations, such as fatty tissue, calcifications, cysts, and irregular shaped soft tissue densities. Dysgerminoma was mainly solid mass without cystic component, and mixed germ cell tumor showed nonspecific manifestations. All cases were relatively large in size, and young in age. In conclusion, CT findings of malignant germ cell tumors are helpful in differential disgnosis.

• Journal of Gynecologic Oncology
• /
• v.29 no.6
• /
• pp.98.1-98.13
• /
• 2018

Objective: We describe a systematic review and meta-analysis of the performance of ${18}F$-fluorodeoxyglucose ($^{18}F-FDG$) positron emission tomography/computed tomography (PET/CT) for detecting metastasis in ovarian cancer. Methods: MEDLINE and Embase were searched for diagnostic accuracy studies that used $^{18}F-FDG$ PET or PET/CT for pre-treatment staging, using surgical findings as the reference standard. Sensitivities and specificities were pooled and plotted in a hierarchic summary receiver operating characteristic plot. Potential causes of heterogeneity were explored through sensitivity analyses. Results: Eight studies with 594 patients were included. The overall pooled sensitivity and specificity for metastasis were 0.72 (95% confidence interval [CI]=0.61-0.81) and 0.93 (95% CI=0.85-0.97), respectively. There was considerable heterogeneity in sensitivity ($I^2=97.57%$) and specificity ($I^2=96.74%$). In sensitivity analyses, studies that used laparotomy as the reference standard showed significantly higher sensitivity and specificity (0.77; 95% CI=0.67-0.87 and 0.96; 95% CI=0.92-0.99, respectively) than those including diagnostic laparoscopy (0.62; 95% CI=0.46-0.77 and 0.84; 95% CI=0.69-0.99, respectively). Higher specificity was shown in studies that confirmed surgical findings by pathologic evaluation (0.95; 95% CI=0.90-0.99) than in a study without pathologic confirmation (0.69; 95% CI=0.24-1.00). Studies with a lower prevalence of the FDG-avid subtype showed higher specificity (0.97; 95% CI=0.94-1.00) than those with a greater prevalence (0.89; 95% CI=0.80-0.97). Conclusion: Pre-treatment $^{18}F-FDG$ PET/CT shows moderate sensitivity and high specificity for detecting metastasis in ovarian cancer. With its low false-positive rate, it can help select surgical approaches or alternative treatment options.

• Tuberculosis and Respiratory Diseases
• /
• v.51 no.4
• /
• pp.386-389
• /
• 2001

An endobronchial metastasis is defined as a subsegmental or a more proximal central bronchial metastasis of a nonpulmonary neoplasm in the bronchoscopically visible range. However, the frequencies of endobronchial metastasis range from 2 to 50% of pulmonary metastases from extrathoracic neoplasms by a different definition of an endobronchial metastasis. Primary neoplasms of an endobronchial metastasis including breast cancer, colon cancer, renal cell carcinoma, and ovarian cancer are relatively common. However, an endobronchial metastasis arising from thyroid cancer, parotid gland tumor, bone tumor, bladder cancer, and stomach cancer has only rarely been reported in the literature. Here we report a case of an endobrochial metastases from a hepatocellular carcinoma.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.12
• /
• pp.4909-4913
• /
• 2014

Malignant ovarian germ cell tumors (MOGCT) are rare neoplasms that most frequently occur in women at a young reproductive age. There have been limited data regarding this disease from Southeast Asian countries. We therefore conducted a retrospective study to analyze the clinical characteristics and the treatment outcomes of MOGCT treated at our institute between January, 2003 and December, 2012. Seventy-six patients were recruited from this period with the mean age of 21.6 years and 11.8% were pre-puberty. The two most common symptoms were pelvic mass and pelvic pain. Two-thirds of the studied patients presented at an early stage. The most common histology was immature teratoma (34.2%) followed by endodermal sinus tumor (28.9%), dysgerminoma (25%), mixed type (10.5%) and choriocarcinoma (1.3%). Over 80% of these patients received fertility sparing surgery and about 70% received adjuvant chemotherapy with the complete response rate at 73.3% and partial response at 11.1%. The most frequent chemotherapy was BEP regimen (bleomycin, etoposide, cisplatin). With the mean follow up time at 56.0 months, 12 patients (15.8%) developed recurrence and only an advanced stage was the independent prognostic factor. The ten year progression free survival (PFS) and overall survival rate of our study were 81.9% and 86.2%, respectively. In conclusion, MOGCT often occurs at a young age. Treatment with fertility sparing operations and adjuvant chemotherapy with a BEP regimen showed a good outcome. An advanced stage is a significant prognostic factor for recurrence.

• Radiation Oncology Journal
• /
• v.35 no.2
• /
• pp.144-152
• /
• 2017

Purpose: The role of radiotherapy (RT) was largely deserted after the introduction of platinum-based chemotherapy, but still survival rates are disappointingly low. This study focuses on assessing the clinical efficacy of RT in relation to chemotherapy resistance. Materials and Methods: From October 2002 to January 2015, 44 patients were diagnosed with epithelial ovarian cancer (EOC) and treated with palliative RT for persistent or recurrent EOC. All patients received initial treatment with optimal debulking surgery and adjuvant platinum-based chemotherapy. The biologically effective dose (BED) was calculated with ${\alpha}/{\beta}$ set at 10. Ninety-four sites were treated with RT with a median BED of 50.7 Gy (range 28.0 to 79.2 Gy). The primary end-point was the in-field local control (LC) interval, defined as the time interval from the date RT was completed to the date any progressive or newly recurring disease within the RT field was detected on radiographic imaging. Results: The median follow-up duration was 52.3 months (range 7.7 to 179.0 months). The 1-year and 2-year in-field LC rates were 66.0% and 55.0%, respectively. Comparisons of percent change of in-field tumor response showed similar distribution of responses among chemoresistant and chemosensitive tumors. On multivariate analysis of predictive factors for in-field LC analyzed by sites treated, $BED{\geq}50Gy$ (hazard ratio, 0.4; confidence interval, 0.2-0.9; p = 0.025) showed better outcomes. Conclusion: Regardless of resistance to platinum-based chemotherapy, RT can be a feasible treatment modality for patients with persistent of recurrent EOC. The specific role of RT using updated approaches needs to be reassessed.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.20
• /
• pp.9009-9013
• /
• 2014

Background: The aim of this study was to explore the efficacy and adverse reactions of CT-guided radioactive 125I-seed implantation treatment combined with chemotherapy for platinum-resistant recurrent ovarian carcinoma. Materials and Methods: From September 2010 to December 2012, 23 patients with platinum-resistant recurrent ovarian carcinoma were enrolled. All the patients refused, could not bear, or were not suitable for surgery. They all had no more than 3 lesions, which were detected and could also be measured by CT. All were clarified as single-lesion or multiple-lesion groups. A total of 41 lesions underwent implantation of from 8 to 106 125I seeds (median=43). Multi-plane implanting was adopted and 125I-seeds of (0.4-0.7)mCi were placed at intervals of (0.5-1.0) cm. After implantation treatment, all patients underwent 4 cycles of chemotherapy with gemcitabine $800mg/m^2$ (days 1, 8 and 15). Results: The outcome was evaluated with CT 3 weeks and every 3 months after implantation treatment. After 6 months, the volume of 32 out of 41 lesions (78.0%) was reduced at least 30%, within which 9 lesions completely disappeared(22.0%). Complete response was observed in 7 cases (30.4%), with a partial response in 4 cases (17.4%), 4 cases stable(17.4%)and 8 cases showing progression (34.8%). The total clinical remission rate was 47.8% (11/23). The clinical remission rate was 77.8% (7/9) in the single-lesion group and 28.6% (4/14) in the multiple-lesion group with a significant difference between the two(P=0.036). The common side effects observed were mild gastrointestinal reactions. Conclusions: 125I-seed implantation combined with chemotherapy applies an effective way in the treatment of platinum-resistant recurrent ovarian epithelial carcinoma with the advantages of high local control rates, good short-term effects, little trauma and less side effects.

• Journal of Gastric Cancer
• /
• v.11 no.3
• /
• pp.180-184
• /
• 2011

Letrozole is a drug used in the treatment of postmenopausal women with breast and ovarian tumours. There is no evidence in the literature indicating its use in treating gastric cancer. We present a 68 year old lady admitted from the emergency department with weight loss, malaise and anaemia. Investigations confirmed the presence of two different primary tumours in the left breast and the stomach. Following that this patient with oestrogen receptor positive breast cancer and oestrogen receptor negative gastric cancer was treated with letrozole for her breast cancer followed by a gastric resection. Independent histology by two pathologists pre-operatively diagnosed gastric adenocarcinoma. Post-operatively, independent analysis of the resected stomach, omentum and lymph nodes revealed no evidence of gastric cancer. Therefore we conclude that there is a possibility of letrozole having an effect on gastric cancer. Further studies are needed.