A Clinical and Pathological Observation of Microinvasive Carcinoma of Uterine Cervix / 대한부인종양콜포스코피학회잡지

Microinvasive carcinoma of the uterine cervix(Stage Ia) is the earliest stage of squamous carcinoma. The transition from preinvasive to invasive disease is a crucial juncture in the development of cervical cancer. The clinical experience that microinvasive lesions carry a better prognosis justifies a separate diagnostic category. To investigate the clinical and pathological aspects of microinvasive cervical carcinoma, a retrospective study was made on 84 cases, histologically reconfirmed surgical specimens, which had been treated during the period from January, 1985 to December, 1996 at Department of Obstetrics and Gynecology, Kyung-pook National University Hospital. We defined microinvasive carcinoma as stromal invasion not exceeding a depth of Smm from the base of the epithelium presented by FIGO in 1985. The results obtained were as follows; 1. Mean age of 84 patients was 46.9 year old, all were parous women but not 1 patients. 60 cases(71.4%) belonged to stage Ial and 24 cases(28,6%) to stage Ia2. 2. Chief complaints were postcoital spotting and leukorrhea. 3, The corresponding rate of Pap. smear to histologic diagnosis was approximately 29.8%. However correponding rate within one histologic grade was about 33,3%. 4. According to the colposcopic examination, 26.4% of cases revealed suspected abnormal findings suggesting invasive lesion. 5. As to the reports of punch biopsy, 55.1% of cases showed microinvasive and/or invasive lesion. With additional diagnostic conization of cervix, the preoperative diagnosis were correct in 72%. 6. Operation performed were simple hysterectomy, extrafascial hysterectomy or modified radical hysterectomy with both pelvic LN dissection, Simple hysterectomy was most commonly performed. 7. Post-treatment complications were developed in 73.9% of patients who were done with modified radical hysterectomy with both pelvic LN dissection and bladder dysfunction was developed in 50% of the patients.

The Clinical Analysis of Endometrial Cancer by Surgical Staging / 대한부인종양콜포스코피학회잡지

In 1988, the International Federatioa of Gynecology and Obstetrics(FIGO) Cancer Committee changed the staging of endometrial carcinoma from a clinical one to a surgicopathologic one. The emphasis in the new FIGO system was changed to the pathologic findings in the uterus, cervix, adnexae, and pelvic and/or periaortic nodes, and peritoneal cytologic findings. The major changes in this staging system were the use of the depth of myometrial invasion and the identification of tumor cells in peritoneal cytologic examination and of invasion in the retroperitoneal lymph nodes, Preoperative endocervical curettage was no longer necessary. This is a reflection of the increase in the primary surgical approach to the treatment of this disease and has allowed the identification of a number of prognostic factors on which postoperative therapy can be based. This retrospective study was based on a clinical review of 45 patients with endometrial carcinoma from Jan, 1985 through Jan, 1996 who underwent primary surgical evaluation at the Department of Obstetrics and Gynecology, Kyungpook National University Medical College. The results obtained are as follows; l. Age distribution of endometrial cancer was concentrated on the age group of 50-59(55.6%) and mean age was 53.9 years. 2. The mean parity and mean BMI(Body Mass Index) of endometrial cancer were 3.8 and 25.0(cm/kg2). 3. The Menstrual status at the time of development of endometrial cancer showed that 24 cases (53.3%) were postmenopausal, 11 cases (24.4%) were premenopausal and 10 cases(22.2%) were menstruating. 4. According to the clinical stage adopted by FIGO classification, stage I was found in 71.1%, stage II in 17.8%, stage III in 2,2%, stage IV in 0.0%. 5. Surgical restaging according to new FIGO classification(1988), stage IA was found in 4.4%, stage IB in 37.8%, stage IC in 28.9%, stage IIA in 0.0%, stage IIB in 0.0%, stage IIIA in 6.7%, stage IIIB in 4.4%, stage IIIC in 8.9%, stage IVA in 2.2% and IVB in 6.7%. 6. According to WHO histopathological classification, the percentage of the adenocarcinoma was 86.7%, adenoacanthoma 4.4%, papillary serous adenocarcinoma 2.2%, and adenosquamous cell carcinoma 6.7%. 7, The relationship between histologic grade and depth of invasion was somewhat correlated but no staistical significance. 8. There was no correlation between BMI(Body Mass Index) and histologic grade, depth of invasion. 9. Surgery upstaged 15.6% of clinical stage I patients and 62,5% of clinical stage II, but 37.5% of clinical stage II patients was downstaged. 10. All cases were primarily treated by surgery. Regarding the types of operation, total abdominal hysterectomy with bilateral salpingoophorectomy was performed in 44.4%, radical hysterectomy with both pelvic lymphadnectomy in 42.2%, total abdominal hysterectomy with bilateral salpingoophorectomy with selective pelvic lymph node dissection in 8.9%, and laparoscopic assisted vaginal hysterectomy in 2.2%. 11. The mean follow up interval was 38.6 months. 28 cases were followed up and 10 cases of surgical stage I revealed over 5 year salvage. 5-year survivals for surgical stage IA, IB, IC, III, and IV were 100, 100, 92.3, 88.9, and 100%, respectively.

Clinicopathological Analysis of Malignant Germ Cell Tumors of Ovary / 대한부인종양콜포스코피학회잡지

Malignant germ cell tumors occur in children and young women in reproductive age, of all the germ cell malignancies, only pure dysgerminomas had a high cure rate prior to 1970. This was due to the exquisite radiosensitivity of these tumors. Multiple-agent chemotherapy has dramatically improved the pmgnosis of patients with malignant ovarian germ cell tumors. Clinicopathological analysis was performed on 21 cases of malignant germ cell tumors of the ovary, 9 cases at the department of Obstetrics & Gynecology, Kyung-pook National University Hospital, 4 cases, at the department of Obstetrics and Gynecology, Dong-guk University Kyungju Hospital and 8 cases, at the department of Obstetrics and Gynecology, Dae-gu Fatima Hospital during the period 10 years from July. 19S8 to June. 1997 The results were summarized as follows: 1. The mean age of the patients was 21.8 years old, ranging from 10 to 61 years old. 2. Main initial symptoms were abdominal distension(33.3%), abdominal mass palpation(33.3%), abdominal pain(28.6%), amenorrhea(4.8%) in order. 3. Histologically, the tumors were classified as immature teratoma(57.1%), dysgerminoma(19%), mixed germ cell tumor(9.5%), endodermal sinus tumor(9.5%), embryonal cell carcinoma(4.8%). 4, According to FIGO classification Stage I was the most prevalent(57.1%) at the time of diagnosis while Stage III was forward in 48.6%, Stage II in 9.5%, and no Stage IV, 5. The 5-year survival rate was 80.4% and three patients have died of malignancy and the other 18 patients live without disease from 11 to 102 months, with a median follow-up of 34.2 months. 6. Prognostic factors of malignant germ cell tumors in this study were the clinical stage, the presence of ascites and the residual tumor mass.