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1.
Gynecol Oncol ; 154(3): 539-546, 2019 09.
Article in English | MEDLINE | ID: mdl-31230821

ABSTRACT

OBJECTIVE: Low-grade epithelial ovarian cancers (EOC), constitute the minority among all epithelial cancers. Our study objective was to focus on low-grade recurrent EOC and compare the survival with high-grade disease, as well as in regard to "platinum-sensitive" and "-resistant" recurrences according to platinum-free interval. METHODS: This is an exploratory analysis within the North-Eastern German Society of Gynecological Oncology (NOGGO) database including five randomized phase II/III trials comparing different chemotherapy regimens in recurrent EOC. We conducted survival analyses and cox-proportional regression models. RESULTS: Out of 1050 patients having the first recurrence, 42 (4%) patients had low-grade and 1008 (96%) patients had high-grade disease. In the subgroup of platinum-sensitive recurrences, progression-free survival (PFS) (8.7 m vs 9.7 m, p = 0.7) and overall survival (OS) (23.9 m vs 24.8 m, p = 0.9) did not differ between low-grade and high-grade diseases. In platinum-resistant recurrences, patients with low-grade ovarian cancer had significantly better PFS (7.6 m vs 3.6 m, p = 0.03) and OS (41.9 m vs 9.5 m p = 0.002) in comparison to those with high-grade cancer. At low-grade EOC, there were no significant PFS (p = 0.91) and OS (p = 0.25) differences between platinum-sensitive and -resistant recurrences. Patients with low-grade non-serous histology had lower PFS with compared to those with low-grade serous histology (p = 0.004). At cox regression analysis presence of ascites and residual disease after secondary cytoreductive surgery were independently associated with poor PFS within low-grade recurrent EOC. CONCLUSION: Our study indicates, platinum-free interval does not have any prognostic significance at recurrent low-grade EOC and non-serous histology is associated with poorer outcome in recurrence. Secondary surgical cytoreduction to no-gross residual disease and ascites are independently associated with disease progression.


Subject(s)
Carcinoma, Ovarian Epithelial/drug therapy , Ovarian Neoplasms/drug therapy , Adult , Aged , Aged, 80 and over , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Ovarian Epithelial/mortality , Carcinoma, Ovarian Epithelial/pathology , Clinical Trials, Phase II as Topic , Clinical Trials, Phase III as Topic , Drug Resistance, Neoplasm , Female , Humans , Middle Aged , Neoplasm Grading , Neoplasm Recurrence, Local/drug therapy , Neoplasm Recurrence, Local/mortality , Neoplasm Recurrence, Local/pathology , Organoplatinum Compounds/administration & dosage , Ovarian Neoplasms/mortality , Ovarian Neoplasms/pathology , Prognosis , Proportional Hazards Models , Randomized Controlled Trials as Topic , Survival Analysis , Topotecan/administration & dosage , Young Adult
2.
Eur J Gynaecol Oncol ; 37(4): 584-586, 2016 08.
Article in English | MEDLINE | ID: mdl-29894092

ABSTRACT

Pregnancies resulting in viable fetuses are extremely rare in accompanying a hydatiform mole, often due to the development of maternal complications, including preeclampsia and vaginal bleeding. The risk for gestational trophoblastic neoplasm is another concern because of the delayed evacuation of the molar tissue. In this paper, the authors present a case of complete mole hydatiform with a live co-twin fetus (CHMLF) resulting in the delivery of a healthy male infant with the partial regression of the molar tissue and the decline of serum beta human chorionic gonadotropin (P-hCG) during the pregnancy. In the management of CHMLF, each patient must be considered individually and eligible patients can be followed in the absence of serious maternal complications. Serial ultrasound examinations and close clinical and laboratory surveillance of the mother are certainly indicated.


Subject(s)
Hydatidiform Mole/pathology , Pregnancy Outcome , Pregnancy, Twin , Uterine Neoplasms/pathology , Adult , Delivery, Obstetric , Female , Humans , Hydatidiform Mole/diagnostic imaging , Hydatidiform Mole/surgery , Pregnancy , Uterine Neoplasms/diagnostic imaging , Uterine Neoplasms/surgery
3.
Eur J Gynaecol Oncol ; 36(4): 406-9, 2015.
Article in English | MEDLINE | ID: mdl-26390692

ABSTRACT

PURPOSE: The purpose of this study was to evaluate serum concentrations of human epididymis protein 4 (HE4) and cancer antigen 125 (CA 125) in healthy women and their pregnant counterparts to determine the influence of pregnancy on these biomarkers. MATERIALS AND METHODS: Serum concentrations of CA 125 and HE4 were measured in 27 healthy non-pregnant women and 26 healthy pregnant women in the first and second trimesters. RESULTS: Higher concentration of CA 125 was found in pregnants than in non-pregnant women (p = 0.002). There was no difference in CA 125 concentrations between first and second trimesters (p = 0.13). Serum HE4 concentration was not different in pregnant group compared to non-pregnant women (p = 0.510). Likewise, no difference was found in HE4 levels between the trimesters (p = 0.485). There was a positive correlation between increasing parity and CA 125 (p = 0.023), but not HE4 (p = 1.0). CONCLUSION: HE4 serum biomarker is unaffected by pregnancy status and may be useful for evaluation of doubtful pelvic masses in pregnancy. Contrarily, increased serum levels of CA 125 could yield increased number of false-positive results.


Subject(s)
Adnexal Diseases/diagnosis , Biomarkers, Tumor/blood , Pregnancy Complications, Neoplastic/diagnosis , Proteins/analysis , Adnexa Uteri , Adnexal Diseases/blood , Adolescent , Adult , CA-125 Antigen/blood , Diagnosis, Differential , Female , Humans , Pilot Projects , Pregnancy , Pregnancy Complications, Neoplastic/blood , WAP Four-Disulfide Core Domain Protein 2
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