Padrão histopatológico e incidência de carcinomatose peritoneal ao diagnóstico em mulheres com câncer de ovário / Histopathological pattern and incidence of peritoneal carcinomatosis at diagnosis in women with ovarian cancer

Objetivo: Descrever o padrão histopatológico e identificar a incidência de carcinomatose peritoneal no momento do diagnóstico de mulheres diagnosticadas com neoplasia de ovário. Métodos: Trata-se de um estudo transversal e descritivo, baseado na análise secundária de dados correspondentes aos prontuários de mulheres adultas com diagnóstico de neoplasia de ovário de um serviço de referência em oncologia clínica. Foram analisados 40 prontuários entre janeiro de 2007 e janeiro de 2017. Resultados: Ao estadiamento segundo o sistema da International Federation of Gynecology and Obstetrics, três mulheres (7,5%) apresentavam estadiamento clínico (EC) II, três (77,5%) estágio ECIII com carcinomatose peritoneal/invasão da pelve e seis (15%) estágio ECIV com metástases à distância, especialmente para pulmão e fígado. Em relação ao padrão histopatológico, 20 mulheres apresentaram adenocarcinoma seroso papilífero de alto grau (50%), 4 (10%) adenocarcinoma seroso papilífero de baixo grau, 3 (7,5%) adenocarcinoma endometrioide, 3 (7,5%) tumor de teca/granulosa, 3 (7,5%) carcinoma de células claras, 3 (7,5%) tumores não classificados, 2 (5%) disgerminoma e 2 (5%) com cistoadenocarcinoma mucinosos. Conclusão: É nítida a necessidade de mais estudos envolvendo essa patologia, de modo a favorecer o diagnóstico e a intervenção em estágios mais precoces e reduzir desfechos desfavoráveis. (AU)

Objective: To describe the histopathological pattern, and to identify the incidence of peritoneal carcinomatosis at the time of the diagnosis of women diagnosed with ovarian neoplasm. Methods: This is a cross-sectional and descriptive study, based on the secondary analysis of data corresponding to the medical records of adult women diagnosed with ovarian neoplasm in a reference service of clinical oncology. A total of 40 medical records were analyzed between January 2007 and January 2017. Results: At the staging (FIGO system) of the International Federation of Gynecology and Obstetrics, three women (7.5%) had clinical staging (EC) II staging, 31 (77.5%) were in the ECIII stage, with peritoneal carcinomatosis/pelvic invasion, six (15%) were in the ECIV stage, with metastases at a distance, especially to lung and liver. Regarding the histopathological pattern, twenty women had high-grade papillary serous adenocarcinoma (50%), 4 (10%) with low-grade papillary serous adenocarcinoma, 3 (7.5%) with endometrioid adenocarcinoma, 3 (7.5%) with granulosa-theca tumor, 3 (7.5%) with clear cell carcinoma, 3 (7.5%) with unclassified tumors, 2 (5%) with dysgerminoma, two (5%) with mucinous cystadenocarcinoma. Conclusions: There is a clear need for further studies involving this pathology, in order to favor diagnosis and intervention at earlier stages and to reduce unfavorable outcomes. (AU)

Incidence of epithelial ovarian cancer according to histologic subtypes in Korea, 1999 to 2012 / 부인종양

OBJECTIVE: To investigate trends in the incidence of epithelial ovarian cancer (EOC), according to histologic subtypes, in Korean women between 1999 and 2012. METHODS: Data from the Korea Central Cancer Registry recorded between 1999 and 2012 were evaluated. The incidences of EOC histologic subtypes were counted. Age-standardized incidence rates (ASRs) and annual percentage changes (APCs) in incidence rates were calculated. Patient data were divided into three groups based on age (59 years), and age-specific incidence rates were compared. RESULTS: Overall, the incidence of EOC has increased. Annual EOC cases increased from 922 in 1999 to 1,775 in 2012. In 1999, the ASR was 3.52 per 100,000 and increased to 4.79 per 100,000 in 2012 (APC, 2.53%; p<0.001). The ASRs in 2012 and APCs between 1999 and 2012 for the four major histologic subtypes were as follows (in order of incidence): serous carcinoma (ASR, 2.32 per 100,000; APC, 4.34%; p<0.001), mucinous carcinoma (ASR, 0.73 per 100,000; APC, -1.05%; p=0.131), endometrioid carcinoma (ASR, 0.51 per 100,000; APC, 1.48%; p=0.032), and clear cell carcinoma (ASR, 0.50 per 100,000; APC, 8.13%; p<0.001). In the sub-analyses based on age, clear cell carcinoma was confirmed as the histologic subtype whose incidence had increased the most since 1999. CONCLUSION: The incidence of EOC is increasing in Korea. Among the histologic subtypes, the incidence of clear cell carcinoma has increased markedly across all age groups since 1999.

Implications of a two-step procedure in surgical management of patients with early-stage endometrioid endometrial cancer / 부인종양

OBJECTIVE: Since European Society for Medical Oncology (ESMO) recommendations and French guidelines, pelvic lymphadenectomy should not be systematically performed for women with early-stage endometrioid endometrial cancer (EEC) preoperatively assessed at presumed low- or intermediate-risk. The aim of our study was to evaluate the change of our surgical practices after ESMO recommendations, and to evaluate the rate and morbidity of second surgical procedure in case of understaging after the first surgery. METHODS: This retrospective single-center study included women with EEC preoperatively assessed at presumed low- or intermediate-risk who had surgery between 2006 and 2013. Two periods were defined the times before and after ESMO recommendations. Demographics characteristics, surgical management, operative morbidity, and rate of understaging were compared. The rate of second surgical procedure required for lymph node resection during the second period and its morbidity were also studied. RESULTS: Sixty-one and sixty-two patients were operated for EEC preoperatively assessed at presumed low-or intermediate-risk before and after ESMO recommendations, respectively. Although immediate pelvic lymphadenectomy was performed more frequently during the first period than the second period (88.5% vs. 19.4%; p<0.001), the rate of postoperative risk-elevating or upstaging were comparable between the two periods (31.1% vs. 27.4%; p=0.71). Among the patients requiring second surgical procedure during the second period (21.0%), 30.8% did not undergo the second surgery due to their comorbidity or old age. For the patients who underwent second surgical procedure, mean operative time of the second procedure was 246.1+/-117.8 minutes. Third operation was required in 33.3% of them because of postoperative complications. CONCLUSION: Since ESMO recommendations, second surgical procedure for lymph node resection is often required for women with EEC presumed at low- or intermediate-risk. This reoperation is not always performed due to age/comorbidity of the patients, and presents a significant morbidity.

Clinical-pathological feature of primary endometrial cancer patients treated with hysterectomy at King Hussein medical center

To describe the clinical and histopathological features of patients with primary endometrial cancer operated at King Hussein Medical Center the last six years. This retrospective study included cases operated in at King Hussein Medical Center in the period between October 2001 and December 2007. Histopathological data were available for 78 females: however, only 52 patients with primary endometrial cancer were included in this study. Patients with endometrial cancer who were diagnosed after hysteroscopy and endometrial biopsy, and those who had secondary endometrial cancer were excluded from this study. Clinical and histopathological details were collected and analyzed. The sample consisted of 52 females. Age ranged from 14 - 78 years [mean 59.00 +/- 13.35]. The most common presenting symptom was postmenopausal bleeding which occurred in 37 patients [71.2%]. Endometrioid Adenocarcinoma was the predominant histological sub-type, being reported in 34 patients [65.4%], while other types including mixed Mullerian tumors, endometrial stromal sarcoma, clear cell carcinoma, adenosquamous carcinoma, adenocanthoma and papillary serous adenocarcinoma were found among 18 patients [34.6%]. The tumor was confined to the body of the uterus [Stage one] in 30 specimens [57.7%] at the time of surgery. Endometrioid adenocarcinoma of the endometrium is the most common primary endometrial carcinoma operated upon at King Hussein Medical Center. Postmenopausal bleeding was the predominant presenting symptom. Most of the patients were diagnosed early

Clinicopathological features and prognosis of Thai women with endometrioisis-associated ovarian carcinoma.

This study was undertaken to evaluate the clinical features and survival outcomes of ovarian cancer patients who had associated pelvic endometrioisis. The medical records of 1076 patients with ovarian cancer treated at Chiang Mai University Hospital between 1995 and 2005 were reviewed. Among of these patients, 37 (3.4%) had associated pelvic endometriosis. The mean age of the patients was 44 years (25-62 years). The most common presenting sign and symptom was an abdominal mass (12), followed by abdominal pain (10), abdominal distension (7), abnormal uterine bleeding (2). Twenty-one (56.8%) patients were nulliparous and 14 (37.8%) were single. The stage distribution was stage I (24), stage II (4), stage III (4), and stage IV (1). Four patients had 2 primary carcinomas. The most common histology of the 37 patients was clear cell carcinoma (17) followed by endometrioid carcinoma (11). The estimated 5-year disease - free survival was 55.4%. In conclusion, most patients associated with endometriosis- associated ovarian carcinoma present with abdominal masses and pain. Clear cell CA is the most common histology in ovarian cancer patients who have associated endometriosis. Three fourths of the patients are in stage I and have favorable prognosis.

Factores epidemiológicos en el adenocarcinoma del endometrio / Epidemiological factors in the endometrial adenocarcinoma

Se realiza un estudio descriptivo retrospectivo de los factores epidemiológicos de adenocárcinoma de endometrio en 72 pacientes ingresadas en el Hospital provincial Docente Materno Norte"Tamara Bunke" de Santiago de Cuba, desde 1993 a 1994, se investigaron las siguientes variables: edad, raza, paridad, enfermedades no trasmisibles como hipertensión arterial, diabetes mellitus, la obesidad, sintomatología, estudios histológicos y tratamiento, demostrándose que el predominio de el grupo etareo comprendido entre 51 y 65 años, la raza mestiza, la multiparidad, las enfermedades asociadas más frecuentes fueron: La hipertensión aretrial, la diabetes mellitus, la obesidad obtuvo el mayor por ciento,la metrorragia la de mayor aparición, el adenocarcinoma bien diferenciado con estudio histológico el de mayor por ciento siendo el tratamiento quirúrgico el más utilizado