[Primary adenocarcinoma of the rectovaginal septum without associated endometriosis]. / A rectovaginalis sövény elsodleges adenocarcinomája az endometriosis egyideju jelenléte nélkül.

Primary adenocarcinoma of the rectovaginal septum is a rare clinical entity that arises in most of the cases from endometriosis. The authors report a successfully treated case of primary adenocarcinoma of the rectovaginal septum without associated endometriosis in a 68-year-old woman. Diagnostic and treatment modalities were reviewed by the authors emphasizing that the early diagnosis is difficult and the only curative method is primary surgical therapy.

[Procedures for fertility preservation in female cancer patients]. / A termékenység megorzésének lehetoségei rosszindulatú daganatos nobetegek kezelése kapcsán.

Improving survival rates and quality of life following modern combined cancer treatments have resulted a growing number of patients requesting maintenance of reproductive functions. Several methods are currently available to maintain fertility during oncotherapy. Even though most of them are still experimental and their efficacy and safety have not been determined, the future for fertility preservation in women with cancer is promising. In vitro fertilization with embryo cryopreservation offers an established method, but time to delay cancer treatment could be risky regarding the progression of several cancer types. Moreover, exposure to a high oestrogen milieu during ovarian stimulation is undesirable when patients have estrogen-sensitive malignant tumours. Cryopreservation of mature oocytes following in vitro fertilization and intracytoplasmatic sperm injection offers advantages, but it is still limited due to its low success rate. Emerging techniques of ovarian tissue cryopreservation followed by autotransplantation have been clinically explored. Novel technologies of tissue freezing and thawing promise improving results. However, only one live birth following autotransplanted frozen-thawed ovarian tissue has been established. This procedure can be offered in the future for prepubertal girls before cancer treatment to maintain future fertility. Gonadal tissue cryopreservation and transplantation should be considered experimental in humans for the present time until greater evidence regarding efficacy and safety is accrued.

[Treatment of epithelial ovarian cancer]. / A háimeredetu malignus petefészek-daganatok kezelése.

Epithelial ovarian cancer is the most lethal gynecological cancer among women. The median age at diagnosis is 63 years. The vast majority of patients present with advanced disease and require a combination of cytoreductive surgery and adjuvant chemotherapy. Important features that determine the outcome of treatment include the stage of disease, hystological type, grade and the size of the residual tumour after initial surgery. Current guidelines recommend that standard first-line chemotherapy should include a platinum-based regimen with paclitaxel. Despite the combined therapy, over 50% of all the patients has relapse. Relapsed ovarian cancer is incurable, however chemotherapy can improve quality of life and survival. Currently, there is no worldwide accepted standard treatment for patients with platinum-refractory ovarian cancer. Docetaxel, topotecan, gemcitabine, pegylated liposomal doxorubicin, etoposide and tamoxifen can be used in this group. However response duration rarely exceeds 12 months. Intraperitoneal chemotherapy, gene therapy, immunotherapy, signal transduction inhibitors (trastuzumab) and angiogenesis inhibitors (bevacizumab) are all potential future therapies, and are being investigated in ongoing clinical research. In this publication authors review the literature of current treatment options in epithelial ovarian carcinoma.

[Phosphor/sulphur ratio: indicator of malignant uterine changes]. / Foszfor/kén arány: a malignus uteruselváltozás indikátora.

The purpose of the present study was to find a correlation between gynaecological diseases--myoma (26), adenocarcinoma uteri (21) - and P/S (phosphor/sulphur) ratios of different regions of uterus. Routine histological specimens were re-examined with the intention to select representative regions of the uteruses for element analysis. Conventional haematoxylineosin stained sections were used to identify histological alterations by light microscopy. Energy-dispersive spectroscopic (EDS) investigations were carried out to analyse the morphology and the related element composition of the samples. The results of the non-parametric statistical test (Wilcoxon two-sample test) indicate that the P/S ratios were significantly higher in adenocarcinoma (0.8891 +/- 0.0757) than in myoma (0.4713 +/- 0.0306). P/S ratio of different pathologic regions of uteruses seems worth examining in a larger study population.

[The results of ovarian cancer therapy in the Hungarian Centers in 2002-2003]. / Petefészekrákos betegek kezelési eredményei a hazai centrumokban 2002-2003-ban.

UNLABELLED: Authors presented data of treatment results and course of disease in 487 ovarian cancer patients treated by primary surgery and paclitaxel-carboplatin combination chemotherapy between July 1, 2002 and December 31, 2003. PATIENTS: Most of our patients (87.8%) belonged to the age-group between 40-70 years. Distribution of their histological diagnosis was as 69.6% serous, 10.7% mucinous, 5.1% endometrial and 4.7% undifferentiated carcinoma. The grade distribution was found as 8.4% grade 1, 40.9% grade 2 and 35.9% grade 3. RESULTS: The primary surgery was evaluated as optimal in 41.7%, suboptimal in 37.3% and exploration was performed in 21.1%. Most patients started chemotherapy 20 days after surgery and 74.2% of them got six courses. During the evaluation period 61 intervallum laparotomies were performed, and resulted on 55.7% optimal debulking. Complete remission was found in 58.9%, and partial remission in 14.7% of patients. This treatment resulted on a complete remission in 40.9% at the follow-up of 12 months.

Four pregnancies and two deliveries after unilateral orchidectomy and chemotherapy for testicular embryonal carcinoma.

This case report describes a 33-year-old patient diagnosed with left-sided testicular embryonic carcinoma with vascular invasion. Unilateral orchiectomy was performed and the patient subsequently underwent chemotherapy. He retained fertility and later fathered healthy children.

Phosphor/sulphur ratio: an indicator of malignant uterus change.

The purpose of the present study was to establish a correlation between gynaecological diseases (myoma, adenocarcinoma) and phosphor/sulphur (P/S) ratios of different regions of the uterus. Routine histological specimens were reexamined with the intention to select representative regions of the uteruses for element analysis. Conventional hematoxylin-eosin-stained sections were used to identify histological alterations by light microscopy. Scanning electron microscopic (SEM) and energy-dispersive spectroscopic (EDS) investigations were carried out to analyze the morphology and the related element composition of the samples. The results of the nonparametric statistical test (Wilcoxon rank-sum test) indicate that the P/S ratios were significantly higher in adenocarcinoma (0.8891 +/- 0.0757) than in myoma (0.4713 +/- 0.0306). P/S ratios of different pathologic regions of uteruses seem worth examining in a larger study population. Combination of routine histological examinations with element analysis of specimens may have useful applications in patients who have undergone radiation therapy and may identify a pattern for local recurrence at certain sites.

[Role of Caelyx in second line treatment of ovarian cancer]. / A Caelyx helye a petefészekrák másodvonalbeli kezelésében.

The authors published their own experiences and results of Caelyx treatment based on 40 ovarian cancer patients treated in 9 different institutions. Patients had been treated with platinum based or platinum-taxol combination chemoterapy. Their average age was 57.2 years (35-80). The average time to progression was 3.8 months (1-8). The effects of the therapy were assessed on 36 patients and the results were 3 CR, 8 PR, 7 SD and 18 PD. Summarised the Caelyx therapy caused improvement in 30.55% of the patients and stabilisation in 19.44%. Supportive therapy was needed in 8 cases.

[Status report on the chemotherapy of ovarian cancer at special cancer centers in Hungary (2002-2003)]. / A petefészekrák gyógykezelésének helyzete a különkeretes Centrumokban 2002-2003-ban Magyarországon.

Data on the first-line treatment of ovarian cancer in special centers of Hungary 2002 and 2003 are presented, involving 283 and 416 patients, respectively. Patients' age, clinical stage and histological type of the tumor were highly similar to literature data, while grades were different. Surgical effectiveness in case of IIIc staged tumors with >1 cm residual mass was 37%. The ratio of interval laparotomy was about 15%. Overall response rates of the first-line treatment of ovarian cancer was 82%, while the rate of complete remissions was 60%. The authors provide detailed analysis of factors that can improve the chemotherapy of ovarian cancer in Hungary.

Influence of leptin and the TNF system on insulin resistance in pregnancy and their effect on anthropometric parameters of newborns.

BACKGROUND: We studied the contribution of the tumor necrosis factor system and leptin to insulin resistance during the course of normal pregnancy. METHODS: Forty-five healthy pregnant women (15 in the 1st, 15 in the 2nd2 and 15 in the 3rd3 trimester) and 25 age-matched healthy nonpregnant women as controls. Twenty-three newborns delivered by women followed in the 2nd and 3rd trimesters were also investigated. Fasting serum immunoreactive tumor necrosis factor-alpha, soluble tumor necrosis factor receptor-1, soluble tumor necrosis factor receptor-2, leptin (by enzyme-linked immunoassay) and C-peptide (by radioimmunoassay) concentrations in the patients and controls were measured. Body weight, length and head circumference of the newborns were analyzed in connection with the measured maternal parameters. RESULTS: Significantly elevated tumor necrosis factor-alpha, tumor necrosis factor receptor-1 and -2, leptin, and C-peptide levels were found in the 3rd3 trimester as compared with the 1st1 and 2nd2 trimesters and with the nonpregnant controls. Tumor necrosis factor-alpha, tumor necrosis factor receptor-2, C-peptide, leptin concentrations and body mass index were found to be in a significant positive linear correlation with each other. Significant negative linear correlations were calculated among maternal serum C-peptide, tumor necrosis factor-alpha and leptin concentrations and the head circumference of the newborns. CONCLUSIONS: In conclusion, increased tumor necrosis factor-alpha and leptin levels may contribute to insulin resistance in late pregnancy. Tumor necrosis factor-alpha and leptin may be regulators of intrauterine bone development of newborns.