ABSTRACT
BACKGROUND: With regard to incidence, ovarian cancer has the highest mortality of all gynecologic cancers. PATIENTS AND METHODS: The treatment of 139 consecutive patients with epithelial ovarian cancer who were treated in an oncology group practice in Koblenz, Germany between 1995 and 2003 was evaluated retrospectively. RESULTS: The median age of the patients was 61 years (18-84). FIGO stages were distributed as follows: stage I 15.8%, stage II 12.9%, stage III 53.2%, stage IV 16.5%. 49 patients (35.5%) received surgical treatment at a university hospital or a teaching hospital. 89 patients (64.5%) were operated on in a local or district hospital. A macroscopically complete resection was achieved in only 15 patients (10.8%). The residual tumor was <1 cm in 50 patients (36%), >1 cm in 24 patients (17.3%), and >2 cm in 49 patients (35.5%). 93.3% of the patients received postoperative, platinum-based chemotherapy. Median survival since first diagnosis was 42 months (1-346(+)). The 5-year survival rate of the whole cohort was only 28%. CONCLUSIONS: Overall survival in epithelial ovarian cancer was significantly inferior in this patient cohort compared to the results of the FIGO report from 2003. One possible cause may be the suboptimal surgical treatment, with 52.8% of the patients having a postoperative residual tumor larger than 1 cm.
Subject(s)
Drug Therapy/statistics & numerical data , Gynecologic Surgical Procedures/statistics & numerical data , Neoplasm Recurrence, Local/mortality , Neoplasm Recurrence, Local/prevention & control , Ovarian Neoplasms/mortality , Ovarian Neoplasms/therapy , Risk Assessment/methods , Adolescent , Adult , Aged , Aged, 80 and over , Female , Germany/epidemiology , Humans , Incidence , Middle Aged , Quality Assurance, Health Care/statistics & numerical data , Retrospective Studies , Risk Factors , Survival Analysis , Survival RateABSTRACT
Posaconazole is a new antifungal drug used in prophylaxis and therapy of fungal infections in patients with immunodeficiency. In the clinical development, posaconazole exhibits variable oral bioavailability. Hence drug monitoring is recommended. For this purpose, a rapid and a convenient high-performance liquid chromatography (HPLC) method has been developed. To 200 mul serum, 50 mul internal standard (itraconazole) was added. After precipitation of the proteins with acetonitrile, the clear supernatant was evaporated in a centrifugal evaporator, and the residue was dissolved in the HPLC elution. Separation was done on a chromatography performed by injecting a 50 mul aliquot of the resuspended sample onto a Multohyp C18 BDS column (250 x 4 mm). Column temperature was maintained at 50 degrees C. The flow rate was 1 ml min(-1). Retention time of posaconazole was about 9 min and those of itraconazole was 17 min. The limit of quantification was 50 mug l(-1) and the limit of detection about 10 mug l(-1). Until now the concentration of posaconazole was measured in 14 patients (64 samples). After a daily dosage of 600-800 mg posaconazole the serum concentrations varied between 100 and 3000 mug l(-1) (582 +/- 579 mug l(-1)). Oral bioavailability was especially low in patients with cytostatic therapy and/or bone marrow transplantation. Further studies are needed to establish the therapeutic range of the posaconazole concentrations.
