Gynecologic oncology
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Gynecologic oncology · Dec 1994
Clinical Trial Controlled Clinical TrialMaturation of vaginal and endometrial epithelium in postmenopausal breast cancer patients receiving long-term tamoxifen.
To assess the estrogenic effects of tamoxifen on vaginal and endometrial epithelium and to investigate whether these changes are associated with any pathological findings in the endometrium, 53 postmenopausal breast cancer patients receiving long-term tamoxifen and 52 control breast cancer patients without any hormonal treatment were examined. Pathological findings in the endometrium were evaluated by hysteroscopy and curettage. The main outcome measures were the maturation index in Papanicolaou (Pap) smears, estrogen-like epithelial changes in the endometrium, serum concentrations of gonadotropins, sex hormone-binding globulin (SHBG), estradiol (E2), and testosterone (T). ⋯ Endometrial adenocarcinoma was found in 3 patients in the tamoxifen group and in 2 in the control group. Pap smears showed atrophy in 2 patients in the former and in one in the latter group. These findings confirmed estrogen-like effects of tamoxifen on the vaginal and endometrial epithelium in postmenopausal breast cancer patients, but these were not closely associated with benign or malignant endometrial lesions.
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Gynecologic oncology · Jul 1994
Experience with implanted subcutaneous ports for intraperitoneal chemotherapy in ovarian cancer.
Peritoneal access devices (port-catheters) were subcutaneously implanted in 125 patients for intraperitoneal chemotherapy of ovarian cancer. In 98% of patients Pharmacia's Port-A-Cath was used. Four hundred sixty-five intraperitoneal courses were given to these patients, with a median of 4 courses per patient (range 0-8). ⋯ Total patient access time was 141.9 years. In conclusion, the complication rate after implantation of intraperitoneal access devices is acceptable. The rate of infections associated with the system is lower than that associated with open catheter systems.
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Gynecologic oncology · Jun 1994
Clinical TrialIntraperitoneal therapy administered through a Groshong catheter.
This report describes a new device for delivery of intraperitoneal therapy. From October 1989 through March 1991, 27 externally accessed Groshong (Bard Access Systems, UT) catheters were placed transabdominally into 24 patients with presumed epithelial ovarian cancer at the conclusion of primary or second-look laparotomy. Total duration of catheter use was 81 months (range, 1-62 weeks). ⋯ The device-related infection rate of 4.2 per 100 patients is similar to that described using other implanted devices. Catheter maintenance is easy and patient acceptance is good. The Groshong catheter is a safe, reliable, and acceptable means of delivering intraperitoneal therapy.
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Gynecologic oncology · Apr 1994
Comparative Study Clinical TrialNeoadjuvant chemotherapy for advanced ovarian cancer.
The purpose of this study was to compare the survival of women with clinical, radiologic, and histologic findings compatible with advanced ovarian cancer who were treated with neoadjuvant chemotherapy to that of a group of women with FIGO stage IIIC (suboptimal debulking) and stage IV epithelial ovarian cancers treated with the same chemotherapy. Eleven women with physical, radiologic, and histologic findings compatible with advanced ovarian cancer (median age, 73 years) treated with neoadjuvant carboplatin and cyclophosphamide chemotherapy were compared to 18 women (median age, 60 years) who had stage III and suboptimal surgical cytoreduction (> 2 cm residual tumor, 13 patients) or stage IV (5 patients) ovarian cancer followed by the same chemotherapy. The progression-free survival for the 11 women receiving neoadjuvant chemotherapy was 9.1 months which was not statistically different from the 8.5 months progression-free survival for the 18 women with suboptimally debulked stage IIIC or stage IV disease (P = 0.98). ⋯ Neoadjuvant-treated patients tended to tolerate chemotherapy better as none required dose reduction for bone marrow suppression, while 6 of 18 conventionally treated patient required dose reductions. In conclusion, neoadjuvant chemotherapy appears to be an effective means of palliating women with clinical, radiological, and histologic findings compatible with advanced ovarian cancer. A prospective study is necessary in which women with findings compatible with advanced ovarian cancer that is not likely to be effectively cytoreduced surgically are randomized to either undergo cytoreductive surgery followed by chemotherapy or receive neoadjuvant chemotherapy.
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Gynecologic oncology · Apr 1994
Case ReportsVulvar fibroepithelial polyp with myxoid stroma: an unusual presentation.
A case of fibroepithelial polyp arising from the labium majus is described. The tumor measured 12 cm in its largest diameter and was connected to the left labium majus by a 12-cm pedicle. ⋯ One year following surgical excision, the patient did not manifest any signs of recurrence. This case is very unusual in that almost all reported vulvar fibroepithelial polyps are small and sessile.