ABSTRACT
OBJECTIVE: To evaluate the results of receiving no adjuvant treatment (NAT) or radiotherapy after radical hysterectomy in patients with International Federation of Gynecology and Obstetrics 2018 Stage IB1-IB3 cervical cancer with intermediate risk factors. METHODS: A retrospective cohort study was conducted at Baskent University School of Medicine's Department of Gynecology and Obstetrics in Ankara, Turkey between January 1, 2008, and December 31, 2016. In total, 134 women with at least two intermediate risk factors (positive LVSI, deep stromal invasion, and tumor size ≥4 cm) were included in the study. Patients were divided into two groups: NAT and radiotherapy. RESULTS: There were 66 patients in the NAT group and 68 in the radiotherapy group. The median follow-up time was 61.05 months. The 5-year overall survival (OS) rates were similar in both groups (84.1% vs 82.9%, respectively; P=0.57), while the 5-year disease-free survival (DFS) rates were 80.2% and 78.2% in the NAT and radiotherapy groups, respectively (P=0.25). Most importantly, both groups had similar local recurrence rates: 8 (12.1%) in the NAT group and 9 (13.2%) in the radiotherapy group (P=0.82). Multivariant analyses showed that the only independent risk factor for recurrence was tumor size ≥4 cm with a hazard ratio of 2.4 (95% confidence interval 1.12-5.24; P=0.02). CONCLUSION: Adjuvant treatment improved neither DFS nor local recurrence rates.
Subject(s)
Uterine Cervical Neoplasms/radiotherapy , Adult , Aged , Case-Control Studies , Female , Humans , Hysterectomy/methods , Middle Aged , Neoplasm Recurrence, Local/mortality , Neoplasm Recurrence, Local/pathology , Retrospective Studies , Risk Factors , Treatment Outcome , Turkey , Uterine Cervical Neoplasms/mortality , Uterine Cervical Neoplasms/pathologyABSTRACT
Synchronous ovarian tumours are rare. Management of these patients can differ from that of patients with uniform tumours. We present a case of synchronous epithelial ovarian cancer and malignant mixed Müllerian tumour in different ovaries, its follow-up and management until death. To our knowledge this is the second case in the English literature to date. A 61-year-old woman with bilateral adnexal masses underwent complete debulking surgery for ovarian cancer. The final pathology was reported as malignant mixed Müllerian tumour in the right ovary with intact borders and stage 2 grade 3 serous carcinoma in the left ovary. She had a 17-month disease-free interval after 6 cycles of paclitaxel and carboplatin. Recurrence of malignant mixed Müllerian tumour was reported in the pathology after secondary debulking including a partial ileal resection. After 6 cycles of gemcitabine and cisplatin she had a widespread recurrence in the thorax and abdomen. The patient died of disease recurrence at the 25th month after diagnosis. Coexistence of serous and malignant mixed Müllerian tumour in different ovaries is very rare. The main treatment is complete cytoreduction followed with chemotherapy. Platinum-taxane based chemotherapy resulted in an acceptable disease-free interval in our case, but it is not standard yet. A management protocol may be developed with the increasing number of similar cases in the literature.
