Comparison of advanced stage mucinous epithelial ovarian cancer and serous epithelial ovarian cancer with regard to chemosensitivity and survival outcome: a matched case-control study / 부인종양

OBJECTIVE: The aim of this study was to compare clinicopathologic characteristics, surgery outcomes and survival outcomes of patients with stage III and IV mucinous epithelial ovarian cancer (mEOC) and serous epithelial ovarian carcinoma (sEOC). METHODS: Patients who had surgery for advanced stage (III or IV) mEOC were evaluated retrospectively and defined as the study group. Women with sEOC who were matched for age and stage of disease were randomly chosen from the database and defined as the control group. The baseline disease characteristics of patients and platinum-based chemotherapy efficacy (response rate, progression-free survival and overall survival [OS]) were compared. RESULTS: A total of 138 women were included in the study: 50 women in the mEOC group and 88 in the sEOC group. Patients in the mEOC group had significantly less grade 3 tumors and CA-125 levels and higher rate of para-aortic and pelvic lymph node metastasis. Patients in the mEOC group had significantly less platinum sensitive disease (57.9% vs. 70.8%; p=0.03) and had significantly poorer OS outcome when compared to the sEOC group (p=0.001). The risk of death for mEOC patients was significantly higher than for sEOC patients (hazard ratio, 2.14; 95% confidence interval, 1.34 to 3.42). CONCLUSION: Advanced stage mEOC patients have more platinum resistance disease and poorer survival outcome when compared to advanced stage sEOC. Therefore, novel chemotherapy strategies are warranted to improve survival outcome in patients with mEOC.

Primary and bilateral tubal carcinoma is associated with long-standing granulomatous inflammation and primary infertility: a case report.

We report a case of bilateral and primary tubal carcinoma associated with granulomatous inflammation and long-standing primary infertility. A 38-year-old woman with a 17-year history of primary infertility presented with lower abdominal pain and granulomatous inflammation in the endometrial biopsy. Bilateral adnexal masses measuring 4 and 6 cm in size were detected and the serum cancer antigen 125 level was 141 IU/ml. Laparoscopic surgical exploration and frozen section on the resected tubes revealed bilateral fallopian tube adenocarcinoma and then a staging laparotomy was performed. Histopathological examination showed a primary bilateral Grade 2 tubal serous adenocarcinoma of Stage 1b associated with granulomatous salpingitis. Primary fallopian tube carcinomas in young women are extremely rare gynecological tumors that are infrequently diagnosed prior to surgical exploration and their cause is unknown. A definitive diagnosis could be made on the histopathological examination in our case with the evidence of chronic pelvic inflammation. Our findings suggest that chronic pelvic inflammation may play a role in carcinogenesis in the tubes of infertile women.