The perinatal outcome of vaginal delivery in twin pregnancy / 대한산부인과학회지

OBJECTIVE: To evaluate the perinatal outcome of vaginal delivery in twin pregnancy according to the presentation of the fetus. METHODS: A total of 274 cases suitable to this objective were selected from the 301 cases of twin pregnancy delivered between March 2000 and February 2005. They were categorized into 3 groups according to the presentation of the fetus; vertex/vertex as the group A (133 cases), vertex/nonvertex as the group B (80 cases), nonvertex in the first twin as the group C (61 cases). And then each group also was divided into 2 subgroups according to the mode of delivery; vaginal delivery and cesarean delivery. The difference between the subgroups in each group as to perinatal outcome was retrospectively compared and analyzed for statistical significance. RESULTS: The incidence of vaginal delivery in group A (46/133, 34.6%) was significantly higher than in group B (5/80, 6.3%) and C (5/61, 8.2%). A total of 218 (79.6%) cases were underwent the cesarean delivery and the most common indication of cesarean delivery was elective twin cesarean delivery in all 3 groups (65.4%, 93.8%, 91.8% respectively). The incidence of neonatal admission to the neonatal intensive care unit was, however, higher in vaginal delivery (40.2%) than in cesarean delivery (32.8%) in group A. The most common cause for neonatal intensive care unit admission was low birth weight for simple observation, and average admission dates of vaginal delivery was 17.0 days and cesarean delivery was 16.8 days. CONCLUSION: Vaginal delivery of twins depends on the presentation of the fetus, but no significant difference in perinatal outcome of group A were observed between the mode of delivery. Therefore attempt to decrease the incidence of elective twin cesarean delivery in group A is demanded.

The analysis of prognostic factors in patients with epithelial ovarian cancer / 대한산부인과학회지

OBJECTIVE: To determine pathologic variables associated with overall survival and disease free survival of patients with epithelial ovarian cancer. METHODS: Diesease free survival and overall survival of 80 ovarian cancer patients treated with primary surgery between January 1997 and December 2003 at our center were compared about various histopathologic variables. Survival analyses were performed by the Kaplan-Meier curves and the log-rank test. Independent prognostic factors were determined by Cox's proportional hazards model. RESULTS: With regard to disease free survival, univariate analysis revealed no significant differences in subgroups according to age category, histologic type and grade. However, significant differences in disease free survival were found in stage category and residual tumor volume. Among these significant subgroups, the Cox-proportional hazards model showed that residual tumor volume was the only independent prognostic factor. There were significant differences in the overall survival of patients in subgroups according to stage categoty and residual tumor volume. Multivariate analysis revealed that residual tumor volume was the only independent significant adverse prognostic factor. CONCLUSION: Our results showed that only residual tumor volume was the independent prognostic factor of disease free survival and overall survival in epithelial ovarian cancer patients.

The analysis of prognostic factors in endometrial cancer managed with surgical staging / 부인종양

OBJECTIVE: To determine pathologic variables associated with overall survival and disease free survival of patients with endometrial cancer. METHODS: Survival of 81 endometrial cancer patients treated with primary surgery between January 1997 and December 2003 at our center was compared about various histopathologic variables. All patients underwent complete surgical staging including pelvic +/- paraaortic lymph node dissection. Survival analyses were performed by the Kaplan-Meier curves and the log-rank test. Independent prognostic factors were determined by Cox's proportional hazards model using likelihood-ratio statistics based on the conditional parameter estimate (Conditional). RESULTS: With regard to disease free survival, univariate analysis revealed no significant differences in subgroups according to age category, grade and adjuvant radiotherapy. However, significant differences in disease free survival were found between stage I+II and stage III, and between endometrioid type and the others type. Among these significant subgroups, the Cox-proportional hazards model showed that stage was the only independent prognostic factor. There were no significant differences in the overall survival of patients in subgroups according to age category and adjuvant radiotherapy. But, significant differences in overall survival were found in subgroups according to stage, histology and grade. Multivariate analysis revealed that stage was the only independent significant adverse prognostic effect. CONCLUSION: Our results showed that only stage was an independent prognostic factor of disease free survival and overall survival in endometrial cancer patients.