A Case of Peritoneal Desmoplastic Small Round Cell Tumor which involved both ovaries / 대한산부인과학회지

Peritoneal desmoplastic small round cell tumor is a very rare malignant neoplasm and has specific clinical features; It is predominant in children and young males and has a well-demarcated large intra-abdominal tumor, which has not been associated with a primary visceral organ, with diffusely scattered multiple small tumors and rarely involves ovaries. It is a very aggressive and fast growing tumor along the peritoneal surfaces of the abdomen and pelvis. It has a typical histologic features and a specific immunohistochemical staining pattern. There is no definite treatment. It responses to surgery and chemotherapy at early period of therapy but relapses soon and rapidly progresses and then causes the death. We have experienced a peritoneal desmoplastic small round cell tumor which involved both ovaries, so we report this case with a brief review of literature.

Docetaxel and Carboplatin Combination Chemotherapy against Persistent or Recurrent Ovarian Cancer as 2nd or more line Chemotherapy / 대한산부인과학회잡지

OBJECTIVE: We evaluated the effects and toxicities of docetaxel-carboplatin combination chemotherapy against recurrent or persistent ovarian cancer who were previously heavily treated with one or more lines of chemotherapy. METHODS: Sixteen patients with a recurrent or persistent ovarian cancer, previously received first or more line chemotherapy, had been treated with docetaxel-carboplatin combination chemotherapy at Kosin Medical Center from December 2001 to May 2003. The docetaxel-carboplatin combination chemotherapy consists of docetaxel 75 mg/m2 and carboplatin 450 mg/m2 given i.v. every 3-4 weeks. The response of patients was evaluated with the tumor marker (serum CA-125) and imaging studies (ultrasonogram, CT, MRI). The toxicities were defined according to the WHO toxicity criteria. RESULTS: The overall response rate was 50% (8/16). Eight patients were evaluable for response by WHO criteria. The response rate by WHO criteria was 37.5% (3/8). In detail, complete response was 12.5%, partial response was 25%, stable disease was 37.5% and progressive disease was 25%. The serologic CA-125 response rate was 50% (8/16), in detail serologic partial response was 50%, and serologic stable disease was 31% and serologic progressive disease was 19%. The median response duration was 10 months (3 to 17 months), the median time to response was 1 month (1/2 to 2 months) and the median time to re-progression was 5 months (3 to 7 months). The most common toxicity was gastrointestinal toxicity and the bone marrow suppression was proved as a most serious side effect. CONCLUSION: The docetaxel-carboplatin chemotherapy as a 2nd or more lines regimen against heavily pre-treated recurrent or persistent ovarian cancer is considerable but was associated significant gastrointestinal and bone marrow side effects. Routine premedication is recommended.

The alteration of p16 protein in invasive cervical cancer / 대한산부인과학회잡지

OBJECTIVE: Recently p16 gene has been found as a new factor for cervical carcinogenesis. The purpose of this study is to investigate the p16 protein alteration in invasive cervical cancers, and to find the correlation with the p53 protein overexpression, HPV infection and the clinicopathologic prognostic parameters, as well as to predict the prognosis by examining the influences of the p16 gene, p53 gene, HPV to the survival rate. MATERIAL & METHODS: We examined 29 invasive cervical cancer patients who visited and operated in Obstetrics & Gynecology department of Kosin University Gospel Hospital from Jan. 1994 to Dec. 1995. We investigated clinicopathologic parameters and p16 protein alteration, p53 protein overexpression, HPV 16, 18 infection in these patients. p16 protein and p53 protein were examined by immunohistochemistry method and HPV was done by PCR method. The survival rate was examined by Kaplan-Meier method. RESULTS: The rate of p16 protein alteration, p53 protein overexpression, HPV infection were respectively 31% (9/29), 72.4% (21/29), 80.6% (26/29), and all of these factors had no statistical correlations with the clinicopathologic parameters (p>0.05).Among the 21 positive cases for p53 protein overexpression, p16 protein alteration was positive in 6 (28.6%), negative in 15 (71.4%) cases and among the 8 negative cases for p53 overexpression, p16 showed positive in 3 (37.5%), negative in 5 (62.5%). Finally among the 26 positive cases of HPV infection, p16 alteration was positive in 9 (34.6%) and negative in 17 (65.4%) and all of the 3 HPV infection negative cases showed no p16 alteration. The p16 alteration had no significant correlation with the p53 overexpression and HPV infection.The total 5 years survival rate in 29 cases of invasive cervical cancer patients was 86.2%. In the negative group of p16 protein alteration the survival rate was 80% and the positive group was all alive. In the positive groups of p53 protein overexpression and HPV infection the survival rate were 80.9% and 84.6% respectively and the negative groups were all alive. And these factors had no significant correlation with the survival rates. CONCLUSION: This results indicate that p16 protein alteration had no correlation with clinicopathologic prognostic parameters and survival rates in invasive cervical cancer. In addition p16 protein alteration had no correlation with p53 protein overexpression and HPV infection respectively.