A Clinicopathologic Study of Immature Teratoma of the Ovary / 대한산부인과학회잡지

OBJECTIVE: In this retrospective study, we analyzed the clinical and pathological characteristics of immature teratoma of the ovary. METHODS: Between 1990 and 2003, 26 patients with immature teratoma of the ovary treated in the Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea were identified, and reviewed retrospectively for patient profiles, International Federation of Gynecologists and Obstetricians (FIGO) disease stage, mode of therapy, and length of survival. RESULTS: The mean and median age at diagnosis was 27.0 and 25.5 years (range 11-58 years), respectively. Tumors were 73.1% (19/26) stage I, 3.8% (1/26) stage II, 19.2% (5/26) stage III, and 3.8% (1/26) stage IV. Eighteen patients (69.2%) had pathologic grade 2 or 3. Twenty of 26 patients underwent the conservative surgery including unilateral salpingo-oophorectomy, unilateral oophorectomy or cystectomy, and other patients were performed the total abdominal hysterectomy with bilateral salpingo-oophorectomy. All except five patients received adjuvant combination chemotherapy. Second look operation following combination chemotherapy was done in nine cases. Two patients who had grade III tumors died. Follow-up was available for all the patients, with a mean duration of 43.9 months. No recurrence was observed during this period. CONCLUSION: Immature teratoma of the ovary is a potentially curable disease in today's practice. Low stage and low grade tumors have an excellent prognosis and conservative surgery and preservation of fertility is warranted in those cases.

A Clinical Study of Granulosa Cell Tumor of Ovary / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study is to evaluate the clinical and pathological characteristics of granulosa cell tumor of the ovary. METHODS: Between 1990 and 2000, 27 patients with granulosa cell tumor of the ovary treated in the Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea were identified and reviewed retrospectively for patient profiles, International Federation of Gynecologists and Obstetricians (FIGO) disease stage, mode of therapy, and length of survival. RESULTS: The median age at diagnosis was 43.9 years (range 9-75 years). Tumors were 70.3% (19/27) stage I, 7.5% (2/27) stage II, 11.1% (3/27) stage III, and 11.1% (3/27) stage IV. There was a 15% association between granulosa cell tumor and endometrial hyperplasia. All patients underwent cytoreductive surgery, and 14 patients followed by postoperative chemotherapy. One patient received adjuvant pelvic radiotherapy and 3 patients were treated with adjuvant pelvic radiotherapy and chemotherapy. The survival rate in stage I was 100.0% after 5 years, and in stage II-IV was 62.5% after 5 years. Overall survival was 88.8% at 5 years. Mitotic index influenced the survival rate; with less 10/10 HPF the survival was 100% in 5 years, and with more or equal 10/10 HPF the longest survival was 44 months. CONCLUSION: Although most granulosa cell tumors of the ovary are slow growing, wide variation is possible, with high mitosis counts leading to a worse prognosis. However, it is difficult to predict early or late recurrences using pathologic parameters. It is therefore important that patients with theses tumors are followed up indefinitely.

A Case of Complete Hydatidiform Mole with Coexisting Surviving Fetus / 대한산부인과학회잡지

No abstract available.

Collagen-induced Activation of MMPs ( Membrane -type Matrix Metalloproteinase and Matrix Metalloproteinase-2) in ovarian cancer cell lines in Vitro / 대한산부인과학회잡지

OBJECTIVE: Metastatic dissemination of epithelial ovarian carcinoma is thought to be mediated via tumor cell exfoliation into the peritoneal cavity, followed adhesion to and invasion through the mesothelium which overlies the contents of the peritoneal cavity. MMP-2 is secreted as a zymogen, the activation of which has been associated with metastatic progression in human ovarian cancer cell lines. METHODS: We have utilized short-term cultures to analyze the effect of specific extracellular matrix proteins, type I collagen. RESULTS: Culturing Caov-4 ovarian cell line on type I collagen led to a significant increase in conversion of the MMP-2,72kD to the MMP-2,66kD, and MT-MMP expression. MT-MMP expression correlates with expression and activation of MMP-2 during malignant progression. Altered MT-MMP expression in ovarian cell lines might contribute to MMP-2 activation, which facilitates invasion of these tumors. CONCLUSION: In summary, we found increased expression of MT-MMP that correlated with increased level of activated MMP-2 and cellular counts in chemoinvasion assay in Caov-3 cell line. But no significant increases in Skov-4 cell line on type I collagen. Conclusion: These data suggest that type I collagen induces MMP-2 activation in part by up-regulation of MT-MMP expression but has a more complicated mode of action involving additional processes.

Neoadjuvant Quick Cisplatin-VP16 in High Risk Cervical Cancer / 대한산부인과학회잡지

The potential role and determinants of response to a cisplatin-based regimen of neoadju-vant chemotherapy in women with a histologically confirmed first diagnosis of stage IB-III cervical cancer were analyzed. From 1993 to 1996, 92 patients with bulky(designated as more than 3X3 cm2 size) mass were treated with cisplatin 60 mg/m2 and etoposide 100 mg/m2, admi-nistered intravenously at 7 day intervals. Seventy cases of radical hysterectomy with pelvic lymph node dissection and 22 cases of radiation therapy were performed 2 to 3 weeks after chemotherapy. At the end of the cycles, the overall clinical response rate of portio was 83.7 %(34.8 % with a complete response and 48.9 % with a partial response). The older ages, lower stages, and squamous cell types correlated favorably with the clinical response of the portio, but neither with the parametrium nor with the vagina. After the operation, we found the diff-erences in histologic responses, with the following parameters : lymphovascular space invasion, 3 mm below stromal invasion and lymph node metastasis. Theses parameters correlated with the clinical responses, and the down-staging of cases were 70 %. In comparison with radiolog-ical findings of pretreatment and postoperative tissue pathology, we could find a decrease in pelvic LN metastasis. The tumor-free survival rate calculated by the Kaplan-Meier product limit method was 75 % but it was 86.1 % for cases without the occurrence of persistent disease after the completion of the treatments. All patients suffered from nausea and vomiting, but grade 4 toxicity was not detected after the routine use of antiemetics. There were no events that delayed the next step in the treatment or caused difficulty during the operation. The results of this study suggest that the neoadjuvant chemotherapy should be accepted as a routine tool in treating high risk cervical cancer in order to improve the likelihood of favorable outcomes.