“
“OBJECTIVE: To estimate the risk of metastatic disease in microinvasive adenocarcinoma of the cervix in a large cohort.
METHODS: Thirty-six cases were identified from the Mayo Clinic
health information database, and 30 cases were identified using the University of Southern California gynecologic oncology patient database. Histopathology was reviewed by a single pathologist at each institution to confirm histologic subtype and grade of tumor, depth of invasion, linear extent of the tumor, the presence or absence of lymphovascular space invasion, margin status, parametrial involvement, and the presence of nodal metastasis.
RESULTS: Fifty-two patients had stage IA1 cancers and 14 had stage IA2 cancers. Therapy ranged from cold knife conization to radical
hysterectomy Dibutyryl-cAMP with lymphadenectomy. No parametrial involvement was noted in any selleck chemical of the patients who underwent parametrial resection. One patient with stage IA1 cancer had micrometastasis to a pelvic lymph node. No recurrences were noted with an average follow-up of 80 months.
CONCLUSION: The management of microinvasive adenocarcinoma remains controversial, and radical therapy is applied more frequently to microinvasive adenocarcinoma than microinvasive squamous cell carcinoma of the cervix. The risk of extracervical disease is low and the risk of recurrence is not affected by the radicality find more of resection. Our data suggest that microinvasive adenocarcinoma is amenable to treatment with nonradical surgery. (Obstet Gynecol 2010;116:1150-7)”
“The role of surgery for gastric linitis plastica (GLP) is questioned. This study aimed to analyze our experience in the surgical treatment of GLP with specific reference to the resectability rate, prognosis, and mode of recurrence.
Results of surgery
were analyzed in 102 patients with GLP.
Of the 102 patients, 92 underwent surgical exploration, with resection performed in 60 cases. R2 resection was carried out in 20 patients and R1 in 12 patients, while the resection was considered potentially curative (R0) in 28 (27.5%). Overall, the median (95% confidence interval [CI]) survival time was 5.7 (3.7-7.5) months, with none of the patients alive at the end date of the study. For R0 patients the median (95% CI) survival time was 15.8 (11-20.7) months. The great majority of recurrences were intra-abdominal (peritoneal and/or locoregional), with a systemic component of the relapse that was rarely observed (5 cases).
After primary surgery, GLP showed a poor prognosis without regard to the extent or type of resection. The failure of surgical treatment related mainly to the peritoneal spread of the disease. Specifically designed multimodality treatment protocols should be tested in this setting.