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postrecurrence Clinical Outcome of Patients with Stage I Epithelial Ovarian Cancer Who Underwent Fertility-Sparing Surgery Compared to Those with Radical Surgery

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Surgical Science 2013年第1期4卷 118-124页

作者： Hiroaki Kajiyama Kiyosumi Shibata Mika Mizuno Eiko Yamamoto Michiyasu Kawai Tetsuro Nagasaka Fumitaka Kikkawa Department of Medical Laboratory Sciences School of Health Science Nagoya University Graduate School of Medicine Nagoya Japan Department of Obstetrics and Gynecology Nagoya University Graduate School of Medicine Nagoya Japan Department of Obstetrics and Gynecology Toyohashi Municipal Hospital Toyohashi Japan

Background: To examine the difference in the survival of patients with recurrent ovarian cancer who received fertility-sparing surgery (FSS) and those receiving radical surgery. Methods: Clinicopathologic data on a total of 90 patients with stage I recurrent ovarian cancer collected under the central pathological review system were subjected to survival analyses. Patients were divided into 2 groups: 1) FSS (N = 11), 2) Radical (N = 79). Results: Five-year overall survival rates of patients in the two groups were as follows: 40.8% (FSS)/44.2% (Radical), respectively. There was no significant difference in overall survival among the groups (P = 0.887). Additionally, three-year postrecurrence survival rates of patients in the two groups were 24.8% (FSS) and 25.3% (Radical) (P = 0.730). Furthermore, we accumulated 137 patients {FSS (N = 58), Radical group (N = 79)} with stage I recurrent ovarian cancer from the current study and six representative reports in the literature. Patients who experienced recurrence in the remaining ovary alone (FSS) showed a more favorable prognosis than those who had extra-ovarian site recurrence (overall survival: P = 0.021, postrecurrence survival: P = 0.069). Conclusions: Although our retrospective analysis was very preliminary, we could propose the hypothesis that patients with stage I recurrent ovarian cancer who undergo FSS may not show poorer survival rates than patients who receive radical surgery.

关键词： Recurrent Ovarian Cancer Fertility-Sparing Surgery Overall Survival postrecurrence Survival

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Patterns of Recurrence and Their Significance in Patients with Endometrial Carcinoma<br>—For Improved Follow-Up after Initial Treatment<br>

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Surgical Science 2013年第2期4卷 154-159页

作者： Fumi Utsumi Hiroaki Kajiyama Kiyosumi Shibata Hiroko Mitsui Ryuichiro Sekiya Mika Mizuno Shiro Suzuki Tomokazu Umezu Eiko Yamamoto Fumitaka Kikkawa Department of Obstetrics and Gynecology Nagoya University Graduate School of Medicine Nagoya Japan

Objectives: The aim of this study was to identify the patterns of recurrence and their significance in patients with endometrial carcinoma (EMCA). Patients and Methods: After a search of the medical records from single institutions, a total of 49 patients with relapsed endometrial carcinoma were retrospectively evaluated. Various clinical information was examined, including the site of recurrence, detection procedure, and presence or absence of any symptom at the time of recurrence. Furthermore, the postrecurrence survival analysis was based on the Kaplan-Meier method. Results: The median follow-up period of all patients was 39.4 months (5.8 - 293.1). In all, twenty-five (51.0%) patients experienced recurrence within 12 months after the final treatment. At the time of recurrence, 15 (30.6%) and 34 (69.4%) patients were symptomatic and asymptomatic, respectively. Among the 34 asymptomatic patients, recurrence was detected by CT scan in 14 (28.6%), tumor markers alone in 14 (28.6%), and pelvic examination/ultrasound scan in 5 (10.2%). There was no relapsed case detected by vaginal vault cytology alone. The 5-year postrecurrence survival rates in symptomatic and asymptomatic patients were 57.5 and 36.6 months, respectively (P = 0.2973). After recurrence, 12 patients underwent debulking surgery, and 37 received salvage chemotherapy or radiotherapy. The postrecurrence survival of patients receiving surgery did not differ from that of those with chemotherapy/radiotherapy (P = 0.9198). Conclusion: Although imaging studies and tumor marker measurement contributed to the early detection of recurrence, they did not necessarily improve the prognosis postrecurrence.

关键词： Endometrial Carcinoma Recurrence Site postrecurrence Survival Symptomatic Vaginal Vault Cytology

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