Prognostic significance of tumor laterality in advanced ovarian cancer

Objective@#This study aimed to investigate the effect of incorporating tumor laterality into the International Federation of Gynecology and Obstetrics (FIGO) staging system for advanced ovarian cancer. @*Methods@#The clinical data of 131 patients with advanced ovarian cancer treated between 2008 and 2018 were retrospectively reviewed. To investigate the prognostic significance of tumor laterality, we divided the patients into unilateral and bilateral groups. The prognostic significance of tumor laterality (bilateral vs. unilateral) was evaluated using univariate and multivariate analyses. The effect of incorporating tumor laterality into the FIGO staging system to predict survival outcomes was evaluated using the Kaplan-Meier method. @*Results@#Both overall survival (OS) and progression-free survival (PFS) were longer in the unilateral group than in the bilateral group. Multivariate analysis demonstrated that tumor laterality was an independent predictor of OS (hazard ratio, 1.75; confidence interval, 1.05-2.92; P=0.032). In patients with stage III disease, the bilateral group had a shorter OS than the unilateral group, but it was comparable to the OS in stage IV patients (P=0.354). The incorporation of tumor laterality into the FIGO staging system improved the stratification of survival probabilities. @*Conclusion@#Tumor laterality can be an independent prognostic factor in patients with advanced ovarian cancer. The incorporation of tumor laterality may improve the predictive performance of the FIGO staging system in patients with advanced ovarian cancer.

Clinicopathologic features, treatment, prognosis and prognostic factors of neuroendocrine carcinoma of the endometrium: a retrospective analysis of 42 cases from the Kansai Clinical Oncology Group/Intergroup study in Japan / 부인종양

OBJECTIVE: We conducted a retrospective, multi-institutional, collaborative study to accumulate cases of neuroendocrine carcinoma of the endometrium, to clarify its clinicopathologic features, treatment, prognosis and prognostic factors to collate findings to establish future individualized treatment regimens. To our knowledge, this is the largest case study and the first study to statistically analyze the prognosis of this disease. METHODS: At medical institutions participating in the Kansai Clinical Oncology Group/Intergroup, cases diagnosed at a central pathologic review as neuroendocrine carcinoma of the endometrium between 1995 and 2014 were enrolled. We retrospectively analyzed the clinicopathologic features, treatment, prognosis and prognostic factors of this disease. RESULTS: A total of 65 cases were registered from 18 medical institutions in Japan. Of these, 42 (64.6%) cases were diagnosed as neuroendocrine carcinoma of the endometrium based on the central pathological review and thus included in the study. Advanced International Federation of Gynecology and Obstetrics stages (stage III and IV) and pure type small cell neuroendocrine carcinoma cases had a significantly worse prognosis. Upon multivariate analysis, only histologic subtypes and surgery were significant prognostic factors. Pure type cases had a significantly worse prognosis compared to mixed type cases and complete surgery cases had a significantly better prognosis compared to cases with no or incomplete surgery. CONCLUSION: Our findings suggest that complete surgery improves the prognosis of neuroendocrine carcinoma of the endometrium. Even among cases with advanced disease stages, if complete surgery is expected to be achieved, clinicians should consider curative surgery to improve the prognosis of neuroendocrine carcinoma of the endometrium.

Huge Solitary Fibrous Tumor of the Left Ventricular Epicardium / 日本心臓血管外科学会雑誌

<p>An 89-year-old woman had undergone a medical examination and treatment due to exertional dyspnea symptom and cardiac enlargement, but her symptoms had not improved. According to images from a computed tomography scan, a huge intrapercardial mass excluding the heart was detected, and the patient was referred to our department for surgical treatment. Because of cardiac failure due to the mass excluding the heart, we planned to excise the tumor for cure and also for diagnosis. We did not distinguish the tumor before operation as is often the case with cardiac tumor. The tumor arose from the epicardium of the left ventricular (LV) anterior wall, and was attached to the LV wall with a broad stalk (approximately 3×10 cm) along the left anterior descending coronary artery (LAD). We had to operate under cardiopulmonary bypass and cardiac arrest, since the tumor involved the LAD, so we underwent resection of a part of the LAD. The patient was discharged uneventfully on postoperative day 37. On histopathology, the tumor was diagnosed as a solitary fibrous tumor (SFT) of the epicardium. Cardiac SFTs are rare. Above all, SFTs arising from LV epicardium are very rare. We report this case with some literature review.</p>

A Case of Acute Aortic Regurgitation due to Leaflet Dehiscence of the Carpentier-Edwards Pericardial Bioprosthesis 18 Years after Implantation / 日本心臓血管外科学会雑誌

A 65-year-old man, who had undergone the aortic valve replacement with a Carpentier-Edwards pericardial bioprosthesis (CEP 25 mm) 18 years previously (at age 48), was admitted to our hospital with a diagnosis of acute heart failure due to acute aortic regurgitation. Redo surgery was performed. The ascending aorta was cross clamped, and cardiac arrest was induced, and aortotomy was done. One of the leaflets of the CEP was entirely collapsed and dislocated to the LV side, which caused acute aortic regurgitation. Although there was no evidence of endocarditis, the other two leaflets of CEP were severely calcified. Aortic valve replacement was performed with a CEP 23 mm. He was discharged in good condition on the 16th post-operative day.

A Case of Redo Aortic Valve Replacement by Right Minithoracotomy Approach with Port Access for Aortic Valve Stenosis after Coronary Artery Bypass Grafting / 日本心臓血管外科学会雑誌

We report a case of redo aortic valve replacement by right minithoracotomy approach for aortic stenosis after coronary artery bypass grafting (CABG). An 81-year-old man was followed-up once a year for 9 years after CABG. He complained of increasing respiratory distress, showed narrowing of the aortic valve area, elevation of the aortic valve pressure gradient, and tricuspid valve regurgitation by echocardiography. He was admitted for surgery. We considered minimally invasive operation would be better for him and performed aortic valve replacement (Carpentier-Edwards Perimaunt valve 19 mm) by a right minithoracotomy approach because graft injury could occur by median sternotomy after CABG, and he had the risks of advanced age, low activities of daily living, and mild dementia. His postoperative course was uneventful. On echocardiography performed at postoperative days 9, the ejection fraction recovered to 75% from 53% before surgery and the mean aortic valve pressure gradient was 8 mmHg. He was discharged on postoperative day 12. Right minithoracotomy approach with port access is a good option for redo operation for aortic valve stenosis after CABG.

Nutritional Evaluation in Blood Chemical Test. Effects on Free Thyroxine Index of Iodine Through. Wakame Seaweed / 日本農村医学会雑誌

In this study, the effects of excessive iodine intake on free thyroixine index (FTI) were studied, and the results are presented in the following.<BR>FTI tended to decrease during the basal diet period without wakame seaweed and the decrease tended to continue further during the periods of TEST 1 (wakame seweed 10g/day) and TEST 2 (wakame seaweed 20g/day). The trend changed in the period of TEST 3 (wakame seaweed 40g/day), and FTI rose slightly. When the basal diet was resumed after completion of experimental diets, the level returned to the base line levels measured before the beginning of the experiment.

Studies on the variation of human serum lipids by intaking lentinus edodes for the preservation of health in rural areas / 日本農村医学会雑誌

For the preservation of health in rural areas, this paper reports on the variation of human serum lipids by intaking lentinus edodes.<BR>Serum lipids levels showed no significant change by intaking lentinus edodes that amounts of 20, 40 and 60g per day each for 5 days. From data of correlationship between serum lipid levels and nutrition intake of experimental diet, it was recognized that high-density-lipoprotein cholesterol level was directly proportional to carbohydrate-fat ratio significantly (p< 0.02), and was inversely proportional to fat intake, fat-protein ratio and carbohydrate-protein ratio significantly (p< 0.05), respectively. Triglycerides level was inversely proportional to protein intake significantly (p< 0.05).<BR>These results concluded that the decrease of serum cholesterol level by intaking of lentinus edodes in healthy young men whose serum cholesterol levels were in normal range was not recognized.