ABSTRACT
To evaluate the outcomes of patients treated with cyclic administration of dienogest after ovarian endometriotic cystectomy, following the completion of treatment. We retrospectively evaluated 26 patients treated with dienogest (2 mg/day) after cystectomy (revised American Society for Reproductive Medicine [r-ASRM] stage III-IV) in a pilot study. Dienogest was administered cyclically, for a total of six cycles, each comprising three weeks on and one week off. Outcomes of interest included severity of menstrual pain and recurrence of cysts at baseline, during the immediate post-treatment period and at the final outpatient follow-up. The mean outpatient follow-up period was 45.0 months. The visual analog scale score for menstrual pain following 6 cycles of dienogest treatment was significantly lower than that at baseline; it remained low at the final follow-up. The recurrence rates of cysts were 4% and 21% at 24 and 48 months after the completion of dienogest treatment, respectively. Six patients with recurrent disease were all classified as having r-ASRM stage IV. Our results suggest that cyclic dienogest for six months after cystectomy could relieve menstrual pain and reduce the recurrence of cysts, for approximately four years. The necessary treatment period for patients with r-ASRM stage IV disease requires further study.
Subject(s)
Antineoplastic Agents, Hormonal/therapeutic use , Nandrolone/analogs & derivatives , Ovarian Cysts/surgery , Pelvic Pain/prevention & control , Adult , Antineoplastic Agents, Hormonal/administration & dosage , Drug Administration Schedule , Female , Humans , Laparoscopy , Nandrolone/administration & dosage , Nandrolone/therapeutic use , Retrospective Studies , Treatment Outcome , Young AdultABSTRACT
A 60-year-old woman underwent emergency operation for ileus due to rectosigmoid cancer. Intraoperative cytology and peritoneal dissemination were positive. After performing sigmoid colostomy, she underwent neoadjuvant radiation therapy (40 Gy)and eight courses of a XELOX and bevacizumab regimen. FDG-PET did not indicate FDG accumulation after chemoradiotherapy, thus, we performed low anterior resection. Peritoneal dissemination and washing cytology were negative in the second operation. Neoadjuvant chemoradiotherapy with XELOX and bevacizumab were useful for down staging in patients with advanced colorectal cancer.
