8-year analysis of the prevalence of lymph nodes metastasis, oncologic and pregnancy outcomes in apparent early-stage malignant ovarian germ cell tumors.

PURPOSE: To determine the rate of lymph node metastasis, oncologic and pregnancy outcomes in apparent early-stage malignant ovarian germ cell tumor (MOGCT). MATERIALS AND METHODS: Medical records of apparent early-stage MOGCT patients undergoing primary surgical treatment at Siriraj Hospital, Bangkok, Thailand, between January 2006 and December 2013, were retrospectively reviewed. RESULTS: Thirty-eight patients had apparent stage I-II MOGCT. The mean age was 22.1±7.7 years (median, 20.8 years; range, 7.7-35.6 years). The mean tumor size was 17.8±6.5 cm with a median of 20 (range 4-30) cm. Three most common histopathologies were dysgerminoma (12 patients, 31.6%), immature teratoma (12 patients, 31.6%), and endodermal sinus tumor (6 patients, 15.8%). Twenty-seven of 38 patients underwent lymphadenectomy; 13 patients (48.2%) were stage IA and 8 patients (29.6%) were stage IC. The rate of retroperitoneal nodes metastasis was 7.4% (2/27 patients). At 26.1 months of median follow-up time (range 1.9-88.5 months), 9 patients retained fertility functions, with uneventful pregnancies in 3 of these. Only one patient (2.6%) had progression of disease at 4.9 months after surgery. The 5-year survival rate was 97.4%. CONCLUSION: As the rate of pelvic or para-aortic node metastasis in MOGCT is considerable, lymphadenectomy should be incorporated in surgical staging procedures.

Residual disease following conization of women with stage IA-IB1 cervical carcinoma in a high incidence region.

BACKGROUND: To determine rates of residual disease along with influencing factors in women with stage IA to IB1 cervical carcinoma after conization. MATERIALS AND METHODS: A retrospective study was conducted of medical records of 198 stage IA to IB1 cervical carcinoma patients who had undergoing cervical conization followed by primary surgical treatment during 2006-2013. Independent factors correlating with residual carcinoma in subsequent surgical specimens were analyzed by stepwise regression analysis. RESULTS: Mean age was 48.9 years. Cone specimens demonstrated free margins in 36 women (18.8%). In case of having disease at margin, high-grade cervical intraepithelial neoplasia (CIN) and carcinoma were evidenced in 58 and 97 women, respectively. Pathology of subsequent specimens revealed residual carcinoma in 78 women (39.4%), high-grade CIN or adenocarcinoma in situ (AIS) in 45 (22.7%), and no residual pathology in 75 (37.9%). Age more than 35 years, postmenopausal status, having symptoms, diseases or invasive lesions at conization margins or disease on endocervical aspect, and higher stage were significantly correlated with residual cancer in surgical treatment specimens. On regression analysis, postmenopause and stage were independent factors associated with residual carcinoma. CONCLUSIONS: Patient and tumor characteristics are predictive factors for residual cancer in the studied group of women.

Factors predicting pathologic significance among women with atypical glandular cells on liquid-based cytology.

OBJECTIVE: To determine incidence, originating organ, and factors predicting significant histopathology (premalignant and malignant lesions) among women with atypical glandular cells (AGCs) on liquid-based cytology (LBC). METHODS: In a retrospective study at Siriraj Hospital, Bangkok, Thailand, clinical and histologic data were reviewed for women with AGCs who underwent appropriate examinations from January 2007 to December 2010. RESULTS: There were 284 women with AGC cytology (mean age, 51.2 years). The incidence of significant pathology and invasive cancer was 43.3% and 34.5%, respectively. The most common malignant organ was the uterus (64/123, 52%). Predictors of serious pathology were AGC favor neoplasia (AGC-FN) endocervical (odds ratio [OR], 5.64; 95% confidence interval [CI], 1.62-19.57), AGC-FN endometrial (OR, 4.11; 95% CI, 1.27-13.32), AGC-FN glandular (OR, 8.23; 95% CI, 2.02-33.49) subtypes, and bleeding (OR, 2.88; 95% CI, 1.47-5.65). Combining patient age and AGC subtype, there were no serious cervical lesions among women aged 50 years or younger with AGC-FN glandular subtype, or serious non-cervical neoplasia among women aged 50 years or younger with AGC not otherwise specified (AGC-NOS) or AGC-FN endocervical subtypes. CONCLUSION: AGC subcategories defined from LBC, alone or combined with patient age, might be predictors of significant histopathology, cancer incidence, and originating organ.