Is there a justification for hysterectomy in patients with borderline ovarian tumors?

OBJECTIVE: To determine the frequency of uterine involvement in patients with borderline ovarian tumors (BOT) and to evaluate the recurrence risk and survival after hysterectomy. MATERIALS AND METHODS: In two French hospitals: A tertiary referral centre (University hospital centre of Tours, France) and the Alliance community hospital of Tours (France), we reviewed data of consecutive women undergoing surgery for presumed stage I BOT between January 1997 and December 2012. Patients were divided into two groups: patients treated with fertility sparing surgery (group 1) and those treated with radical surgery (group 2). RESULTS: A total of 135 patients were evaluated. 35 had fertility sparing surgery, 81 had radical surgery with hysterectomy and 19 had previous hysterectomy for other reasons. There were more recurrent borderline ovarian disease and more ovarian invasive disease developed in group 1 (p = 0.02, p = 0.04, respectively). Hysterectomy affected favorably borderline disease-free survival, OR = 0.09 95%CI (0.005-0.69), p = 0.04, but perceived benefits may be related to bilateral salpingo-oophorectomy and not hysterectomy directly.

Plasma fibronectin in mammary and uterine carcinomas.

Plasma fibronectin was determined in cancer patients and in age- and sex-matched controls and analyzed as a function of age, size of tumor, receptor content of the tumor, metastases and treatment. In the control population, plasma fibronectin increased with age exponentially. The age-dependent increase in plasma fibronectin was strongly attenuated in the cancer population. As normal and cancer curves intersect at about 40-46 years, below this age cancer plasmas have slightly higher values than normal, above this age the inverse is true. No correlation was found between estrogen or progesterone receptor levels and plasma fibronectin values, nor with plasma albumin. Tumor patients with distant metastases gave slightly but significantly higher values than those with local or no metastases. No significant difference was found between tumors when Bloom grading was taken as the second parameter instead of age. The size of the tumor or the type of treatment had no influence. Increased proteolytic activity, increased trapping of plasma fibronectin in tissues and especially in the stromal (desmoplastic) reaction and/or modifications in plasma fibronectin biosynthesis may well be responsible for these results.

[Clinically isolated discharges from the nipples. Apropos of 74 cases]. / Les écoulements mamelonnaires cliniquement isolés. A propos de 74 cas.

74 cases with discharge from the breasts were treated surgically by pyramidectomy and histology. The histology was studied. The causes were: 1) ectasia (55%), 2) papilloma (30%) and 3), much more rare, cancer (8%). A blood-stained discharge (31 cases, 42%) could be due to these three causes, but the 4 cancers and the 2 borderline lesions belonged to the group of blood-stained discharges. A serious discharge (17 cases, 23%) could be due to ectasia or a papilloma. A thick discharge (16 cases, 21.5%) is always due to ectasia. The lactiferous duct is treated clinically and using X-rays to outline it. X-ray diagnostic methods and cytology are used in making the diagnosis. Clusters of papillae show that there is intra-canular proliferation. The literature is reviewed and a scheme of treatment is outlined.