quality of care for patients with advanced ovarian carcinoma

To assess the quality of care for patients with advanced ovarian carcinoma at Mansoura University Teaching Hospital. Case notes of 96 patients with advanced ovarian carcinoma [stages III-IV] were reviewed. Operative intervention was carried out by Gynecologists in 50 patients and optimal debulking was achieved in 19 [38%]. A combined team of Gynecologists and Surgeons achieved optimal debulking in 17/21 [81%], while general surgeons achieved optimal debulking in 5/25 [20%] of patients. 78% of patients completed 6 cycles of platinum based chemotherapy. The median progression-free and overall survival was 16 and 22.9 months respectively. Optimal cytoreduction was the single favorable prognostic factor. Patients were managed on individual basis with no specialization or multi-disciplinary team management. Multidisciplinary surgical management achieved the best survival for patients with advanced ovarian carcinoma. Centralization of care and surgical sub-specialization are still suboptimal in Mansoura

Patient profile and results of multimodality therapy in patients with colorectal carcinoma treated in tertiary referral hospital in Egypt

The objective of this work was to study the disease pattern in colorectal carcinoma patients, evaluate the results of the therapy adopted and to speculate the possible advances which can improve the results of treatment. A retrospective analysis of 97 patients with rectal adenocarcinoma treated at the Clinical Oncology Department and the Surgical Oncology Unit at Mansoura University Hospital in Egypt in the period from January 1998 to December 2003 was done. The patients' age, sex and presenting symptom were recorded. The tumor grade and clinical staging were collected, then the treatment plan and survival data were recorded. The mean age of the studied group was 42 [16-80] years, 54 were males and 43 were females. Seventy-two cases had curative surgery, abdominoperineal resection [APR] in 45 patients and low anterior rectal resection [LAR] in 25 patients. Eighty-seven patients received radiation therapy; of them, 66 cases received postoperative radiation therapy, 6 patients preoperative and 15 palliative irradiation. Eighty-three patients received chemotherapy, 5-Fu and leucovorin being the commonest regimen received. The local recurrence rate in this study was 8.4%. The 5-year disease free survival and overall survival were 54% and 56.5%, respectively

Influence of tumor grade and CD95 expression on progression-free survival following surgery and irradiation for localized intracranial ependymoma

This study was conducted to evaluate the impact of extent of tumor resection, histological grade and CD95 expression on the progression-free survival [PFS] after surgical excision and irradiation [RT] for patients with localized intracranial ependymomas. This study includes thirty four patients with localized intracranial ependymomas with median age of 23.5 [range 2-65] at the time of surgical excision. All patients underwent microsurgical resection followed by RT with or without chemotherapy during the period between January 2000 and June 2003. Ten patients were histologically identified as anaplastic ependymoma [AEP]. Immunohistochemical staining for CD95 was applied as a marker for apoptosis for all specimens of the studied group. The extent of surgical resection was estimated as gross total resection in 21 patients [61.8%], near total resection in 4 patients [11.8%] and subtotal resection in 9 patients [26.5%]. The median dose of RT to the primary site was 55Gy. Only 8 patients received pre RT chemotherapy [CTh]. At a median follow up period of 24.5 months [range 6-51 months], 25 patients were alive, while, at a median follow up of 22 months [range 8-49 months], progression occurred in 15 patients [12 local and 3 local and distant], with a median time to failure after RT of 18 months [range 5-37 months]. There was a significant influence of gross total resection [p=0.003] and tumor grade [p=0.009] on the PFS after RT. The two years PFS rate was 26% +/- 13% for patients with AEP compared with 82% +/- 7% for patients with EP. When correlating these findings with the extent of surgical resection, age less than 4 years, pre-RT CTh and CD95 expression, they remained significant. AEP was more frequent in the supratentorial ependymomas. Five of 9 patients with supratentorial tumors developed recurrence and all were anaplastic type [AEP] and CD95-stained tumors. Progression-free survival was found to be significantly influenced by the extent of surgical resection. Tumor grade and apoptosis have an impact upon the outcome of patients with ependymoma treated with surgery and RT. CTh before RT had a worse effect on the PFS and overall survival.