Pub Date : 2018-07-03DOI: 10.1080/20742835.2018.1479213
P. Barnardt, S. Griffith-Richards
Bleomycin, an antibiotic agent with antitumour activity, is an important drug in the management of many oncological malignancies such as lymphoma and germ cell tumours. These tumours are potentially curable and mostly affect young people. The potential side effects and long-term toxicities should be considered. The major limitation of bleomycin therapy is pulmonary toxicity and may be life threatening in about 10% of cases. This article reports a case of an ovarian mixed germ cell tumour, which presented with bleomycin-associated pulmonary toxicity.
{"title":"Ovarian germ cell tumour and bleomycin-induced lung injury","authors":"P. Barnardt, S. Griffith-Richards","doi":"10.1080/20742835.2018.1479213","DOIUrl":"https://doi.org/10.1080/20742835.2018.1479213","url":null,"abstract":"Bleomycin, an antibiotic agent with antitumour activity, is an important drug in the management of many oncological malignancies such as lymphoma and germ cell tumours. These tumours are potentially curable and mostly affect young people. The potential side effects and long-term toxicities should be considered. The major limitation of bleomycin therapy is pulmonary toxicity and may be life threatening in about 10% of cases. This article reports a case of an ovarian mixed germ cell tumour, which presented with bleomycin-associated pulmonary toxicity.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"10 1","pages":"30 - 33"},"PeriodicalIF":0.3,"publicationDate":"2018-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2018.1479213","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42172368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-07-03DOI: 10.1080/20742835.2018.1491139
BT Guzha, N. Ngxola, T. Adams, L. Rogers, N. Mbatani, H-T Wu, N. Fakie, V. Muzenda, L. Denny
Incidence and mortality of cervical cancer in South Africa is still very high and 4-6% of women present with FIGO stage IVB disease. However, the management of oligometastatic cervical cancer is not well decribed in literature. Treatment of stage IVB cervical cancer is individualised, but it mainly involves palliative systemic chemotherapy with a median survival time of about ten months. There is a growing body of evidence showing that in women with low volume oligometastatic disease, curative doses of radiation therapy to the pelvis and metastatic sites with or without chemotherapy can prolong survival significantly. Since South Africa is one of the few countries in Africa with functional chemoradiation therapy facilities, there is a need to review this evidence and see if the standard of care has to be changed in women with oligometastatic cervical cancer.
{"title":"Synchronous oligometastases in cervical cancer: a case report","authors":"BT Guzha, N. Ngxola, T. Adams, L. Rogers, N. Mbatani, H-T Wu, N. Fakie, V. Muzenda, L. Denny","doi":"10.1080/20742835.2018.1491139","DOIUrl":"https://doi.org/10.1080/20742835.2018.1491139","url":null,"abstract":"Incidence and mortality of cervical cancer in South Africa is still very high and 4-6% of women present with FIGO stage IVB disease. However, the management of oligometastatic cervical cancer is not well decribed in literature. Treatment of stage IVB cervical cancer is individualised, but it mainly involves palliative systemic chemotherapy with a median survival time of about ten months. There is a growing body of evidence showing that in women with low volume oligometastatic disease, curative doses of radiation therapy to the pelvis and metastatic sites with or without chemotherapy can prolong survival significantly. Since South Africa is one of the few countries in Africa with functional chemoradiation therapy facilities, there is a need to review this evidence and see if the standard of care has to be changed in women with oligometastatic cervical cancer.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"10 1","pages":"34 - 37"},"PeriodicalIF":0.3,"publicationDate":"2018-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2018.1491139","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48926561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-07-03DOI: 10.1080/20742835.2018.1531469
I. Fourie, H. Simonds
Introduction: Locally advanced stages of invasive cervical cancer (ICC) are associated with poor outcomes; factors influencing survival include increased tumour volume. In resource-constrained settings access to diagnostic imaging with CT and MRI is limited. Alternative methods of establishing tumour volume can be defined with use of the planning target volume (PTV) delineated prior to radiotherapy. The aim of this study is to determine whether increased PTV size impacted on overall survival in a cohort of cervical cancer patients with Stage IIB/IIIB disease who completed radical radiotherapy. Materials and methods: A retrospective analysis was undertaken of patients with histologically confirmed Stage IIB/IIIB ICC treated with radical radiotherapy. Exclusion criteria included patients who did not complete prescribed radiotherapy and brachytherapy. Demographic and treatment details were collected. Planning target volumes were retrieved. Kaplan–Meier analysis was used to calculate the overall survival rate. A multivariate Cox proportional hazard model was derived to assess associations with all-cause mortality. Results: A total of 71 patients met the inclusion/exclusion criteria. The median PTV was 653 cc. On univariate analysis factors significantly associated with a lower overall survival included HIV positivity and the presence of hydronephrosis. Increased PTV size paradoxically showed a trend to improved overall survival. On multivariant analysis HIV status, advanced stage, hydronephrosis and a smaller PTV were significantly related to higher all-cause mortality. Conclusion: It is concluded that, when using planning target volumes, the hypothesis that larger volumes impact on overall survival was disproved. A larger cohort and more accurate methods of determining tumour volume, including PET/CT, will be considered in future prospective studies.
{"title":"A retrospective analysis of the effect of planning tumour volume on survival in cervical carcinoma","authors":"I. Fourie, H. Simonds","doi":"10.1080/20742835.2018.1531469","DOIUrl":"https://doi.org/10.1080/20742835.2018.1531469","url":null,"abstract":"Introduction: Locally advanced stages of invasive cervical cancer (ICC) are associated with poor outcomes; factors influencing survival include increased tumour volume. In resource-constrained settings access to diagnostic imaging with CT and MRI is limited. Alternative methods of establishing tumour volume can be defined with use of the planning target volume (PTV) delineated prior to radiotherapy. The aim of this study is to determine whether increased PTV size impacted on overall survival in a cohort of cervical cancer patients with Stage IIB/IIIB disease who completed radical radiotherapy. Materials and methods: A retrospective analysis was undertaken of patients with histologically confirmed Stage IIB/IIIB ICC treated with radical radiotherapy. Exclusion criteria included patients who did not complete prescribed radiotherapy and brachytherapy. Demographic and treatment details were collected. Planning target volumes were retrieved. Kaplan–Meier analysis was used to calculate the overall survival rate. A multivariate Cox proportional hazard model was derived to assess associations with all-cause mortality. Results: A total of 71 patients met the inclusion/exclusion criteria. The median PTV was 653 cc. On univariate analysis factors significantly associated with a lower overall survival included HIV positivity and the presence of hydronephrosis. Increased PTV size paradoxically showed a trend to improved overall survival. On multivariant analysis HIV status, advanced stage, hydronephrosis and a smaller PTV were significantly related to higher all-cause mortality. Conclusion: It is concluded that, when using planning target volumes, the hypothesis that larger volumes impact on overall survival was disproved. A larger cohort and more accurate methods of determining tumour volume, including PET/CT, will be considered in future prospective studies.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"10 1","pages":"25 - 29"},"PeriodicalIF":0.3,"publicationDate":"2018-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2018.1531469","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43724834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-07-03DOI: 10.1080/20742835.2018.1509928
Sharon Attipoe-Dorcoo, Vedantha Singh, J. Moodley
Background: Cervical cancer is the leading cause of cancer-related deaths among females in South Africa. In 2014 South Africa launched a national human papillomavirus (HPV) vaccination programme for grade 4 girls attending public schools. Approximately 49% of South Africans have access to the Internet and the content and quality of vaccination information could play a role in vaccine awareness and decision-making. This study examined the content, accuracy and tone of online news articles reporting on the HPV vaccination programme in South Africa. Methods: South Africa national online news sites, online community/regional newspapers and two global aggregated online news search engines (Google News and Yahoo News) were searched for relevant articles using a comprehensive set of keywords. Articles published between January 1, 2014 and June 30, 2015 were assessed for commonly cited sources of information, tone of the headline and article, accuracy of information about vaccine characteristics, South Africa HPV vaccine programmatic details and information on HPV and cervical cancer. Results: A total of 56 articles were included in the analysis. The majority had a neutral headline tone (n = 45) and positive overall article tone (n = 38). Information on the dose of HPV vaccine administered during the South African vaccination campaign was accurately mentioned in 38 articles. Twenty articles accurately mentioned the vaccine was efficacious and 12 accurately mentioned herd immunity; however, details on side effects were mostly not mentioned in articles (n = 8). Conclusions: The online media coverage of the South Africa HPV vaccination programme was generally positive with accurate but sometimes incomplete information.
{"title":"A content analysis of online news media reporting on the human papillomavirus vaccination programme in South Africa","authors":"Sharon Attipoe-Dorcoo, Vedantha Singh, J. Moodley","doi":"10.1080/20742835.2018.1509928","DOIUrl":"https://doi.org/10.1080/20742835.2018.1509928","url":null,"abstract":"Background: Cervical cancer is the leading cause of cancer-related deaths among females in South Africa. In 2014 South Africa launched a national human papillomavirus (HPV) vaccination programme for grade 4 girls attending public schools. Approximately 49% of South Africans have access to the Internet and the content and quality of vaccination information could play a role in vaccine awareness and decision-making. This study examined the content, accuracy and tone of online news articles reporting on the HPV vaccination programme in South Africa. Methods: South Africa national online news sites, online community/regional newspapers and two global aggregated online news search engines (Google News and Yahoo News) were searched for relevant articles using a comprehensive set of keywords. Articles published between January 1, 2014 and June 30, 2015 were assessed for commonly cited sources of information, tone of the headline and article, accuracy of information about vaccine characteristics, South Africa HPV vaccine programmatic details and information on HPV and cervical cancer. Results: A total of 56 articles were included in the analysis. The majority had a neutral headline tone (n = 45) and positive overall article tone (n = 38). Information on the dose of HPV vaccine administered during the South African vaccination campaign was accurately mentioned in 38 articles. Twenty articles accurately mentioned the vaccine was efficacious and 12 accurately mentioned herd immunity; however, details on side effects were mostly not mentioned in articles (n = 8). Conclusions: The online media coverage of the South Africa HPV vaccination programme was generally positive with accurate but sometimes incomplete information.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"10 1","pages":"19 - 24"},"PeriodicalIF":0.3,"publicationDate":"2018-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2018.1509928","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48550790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-02DOI: 10.1080/20742835.2018.1467998
T. Ralefala, L. Van Wijk, R. Saidu
Objective: To compare two types of postoperative radiation therapy (PORT) in early-stage, node-negative cervical cancer treated at Groote Schuur Hospital, Cape Town, South Africa. Materials and methods: A retrospective observational study of patients with stage IB cervical cancer treated with radical surgery between 1984 and 2010. Node-negative patients regarded as at risk of pelvic recurrence received PORT, with or without concurrent cisplatin or additional vaginal brachytherapy. The PORT was given with either whole pelvis fields (WPF), or with central small pelvic fields (SPF). Data concerning indications for adjuvant therapy, treatment outcomes and grade 3–4 treatment-related toxicities, including leg lymphoedema, were extracted from clinical records. Results: Thirty-one patients received WPF, and 56 SPF. The overall 5-year survival rate was 85%. No significant differences in survival rates were found between the WPF and SPF groups (log rank p = 0.67). Relapse patterns and the crude grade 3–4 treatment morbidity rates did not differ, although two patients in the WPF group (6%) died of treatment-related complications. Conclusions: The expected benefit of PORT with SPF, which targets the cervical tumour bed and para-cervical tissues only, is a reduction in small bowel morbidity and lymphoedema. It is not possible to ascertain from this audit whether the SPF technique reduces complications, or that it increases out-of-field pelvic relapses. It seems unlikely that a randomised controlled trial will ever be performed, as a large sample size would be required. Comparisons of pooled SPF data with historical WPF controls seem the best option to establish the safety of this approach.
{"title":"A retrospective study of stage IB node-negative cervical cancer treated with adjuvant radiation with standard pelvic versus central small pelvic fields","authors":"T. Ralefala, L. Van Wijk, R. Saidu","doi":"10.1080/20742835.2018.1467998","DOIUrl":"https://doi.org/10.1080/20742835.2018.1467998","url":null,"abstract":"Objective: To compare two types of postoperative radiation therapy (PORT) in early-stage, node-negative cervical cancer treated at Groote Schuur Hospital, Cape Town, South Africa. Materials and methods: A retrospective observational study of patients with stage IB cervical cancer treated with radical surgery between 1984 and 2010. Node-negative patients regarded as at risk of pelvic recurrence received PORT, with or without concurrent cisplatin or additional vaginal brachytherapy. The PORT was given with either whole pelvis fields (WPF), or with central small pelvic fields (SPF). Data concerning indications for adjuvant therapy, treatment outcomes and grade 3–4 treatment-related toxicities, including leg lymphoedema, were extracted from clinical records. Results: Thirty-one patients received WPF, and 56 SPF. The overall 5-year survival rate was 85%. No significant differences in survival rates were found between the WPF and SPF groups (log rank p = 0.67). Relapse patterns and the crude grade 3–4 treatment morbidity rates did not differ, although two patients in the WPF group (6%) died of treatment-related complications. Conclusions: The expected benefit of PORT with SPF, which targets the cervical tumour bed and para-cervical tissues only, is a reduction in small bowel morbidity and lymphoedema. It is not possible to ascertain from this audit whether the SPF technique reduces complications, or that it increases out-of-field pelvic relapses. It seems unlikely that a randomised controlled trial will ever be performed, as a large sample size would be required. Comparisons of pooled SPF data with historical WPF controls seem the best option to establish the safety of this approach.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"10 1","pages":"11 - 15"},"PeriodicalIF":0.3,"publicationDate":"2018-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2018.1467998","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46278846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-02DOI: 10.1080/20742835.2018.1429521
M. Heunis, DC Lombe, M. McCaul
Introduction: Breast cancer is the most commonly diagnosed cancer worldwide. With the challenges of cancer treatment in developing countries there is a need for a systematic and methodical approach to treatment in resource-limited settings. Objective: To retrospectively evaluate the profile of breast cancer patients irradiated with curative intent and discuss the therapeutic outcomes, and to compare this cohort with the available developed-world data. Methods: A retrospective cohort of 689 breast cancer patients from 2010–2014 at Tygerberg Hospital, Western Cape Province was analysed. The best-case disease-free survival was calculated at five years and compared with the SEER database. Various prognostic factors were calculated by univariate and multivariate analysis. Results: The five-year best-case disease-free survival (DFS) for Stage I is 94.7% (95% CI 68–99) and for Stage IIIC, 71.3% (95% CI 39–88). Conclusion: Outcomes of treatment at this institution are comparable to data reported in first-world countries. As two-dimensional radiotherapy compares with most Cobalt specifications, the majority of breast cancer patients in sub-Saharan Africa can be treated efficiently with Cobalt-type technology.
{"title":"Retrospective analysis of radiotherapy outcomes in breast cancer radiotherapy at a single institution","authors":"M. Heunis, DC Lombe, M. McCaul","doi":"10.1080/20742835.2018.1429521","DOIUrl":"https://doi.org/10.1080/20742835.2018.1429521","url":null,"abstract":"Introduction: Breast cancer is the most commonly diagnosed cancer worldwide. With the challenges of cancer treatment in developing countries there is a need for a systematic and methodical approach to treatment in resource-limited settings. Objective: To retrospectively evaluate the profile of breast cancer patients irradiated with curative intent and discuss the therapeutic outcomes, and to compare this cohort with the available developed-world data. Methods: A retrospective cohort of 689 breast cancer patients from 2010–2014 at Tygerberg Hospital, Western Cape Province was analysed. The best-case disease-free survival was calculated at five years and compared with the SEER database. Various prognostic factors were calculated by univariate and multivariate analysis. Results: The five-year best-case disease-free survival (DFS) for Stage I is 94.7% (95% CI 68–99) and for Stage IIIC, 71.3% (95% CI 39–88). Conclusion: Outcomes of treatment at this institution are comparable to data reported in first-world countries. As two-dimensional radiotherapy compares with most Cobalt specifications, the majority of breast cancer patients in sub-Saharan Africa can be treated efficiently with Cobalt-type technology.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"10 1","pages":"1 - 4"},"PeriodicalIF":0.3,"publicationDate":"2018-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2018.1429521","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48632832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-02DOI: 10.1080/20742835.2018.1441694
M. Jemu, L. Van Wijk, M. Parker, Glennville Jones
Objective: This study examined the effects of treatment and tumour factors on the overall survival of patients completing chemo-radiation for stage IIB cervical cancer, to identify modifiable factors that might improve outcome. Materials and methods: A retrospective audit was undertaken of 228 patients with stage IIB cervical cancer treated between 1995 and 2010, who received chemo-radiation with at least 45 Gy external beam radiation, two to four brachytherapy sessions, and one to six weekly cycles of concurrent cisplatin (40 mg/m², capped at 60 mg/week). Results: Mean total dose to Point A from external beam radiation and brachytherapy was 83 Gy (range 61–96 – expressed as the linear quadratic equivalent dose to 2 Gy/fraction). Mean overall treatment time was 45 days. The average weekly haemoglobin (AWHB) during treatment was 11.6 g/dl (range 8.8–15.5). Overall, one-third of patients received blood transfusions before or during chemo-radiation, and two-thirds of patients completed five or six cycles of weekly cisplatin. Reasons for fewer than five cycles were scheduling failures, neutropenia, renal impairment and side effects. No outcome differences were observed for Monday vs. Thursday cisplatin administration. The five-year overall survival was 60%. Patients completing fewer than six cycles had a worse survival (55 vs. 76%, p = 0.02). By multiple regression for survival only six cycles of cisplatin, squamous histology and AWHB >10 g/dl were significant. Conclusions: Maintaining HB >10.0 and administering six cycles of weekly cisplatin are associated with better survival from chemo-radiation for stage IIB cervical cancer.
{"title":"Tumour and treatment factors influencing the outcome of chemo-radiation in stage IIB cervical cancer: a single institution experience","authors":"M. Jemu, L. Van Wijk, M. Parker, Glennville Jones","doi":"10.1080/20742835.2018.1441694","DOIUrl":"https://doi.org/10.1080/20742835.2018.1441694","url":null,"abstract":"Objective: This study examined the effects of treatment and tumour factors on the overall survival of patients completing chemo-radiation for stage IIB cervical cancer, to identify modifiable factors that might improve outcome. Materials and methods: A retrospective audit was undertaken of 228 patients with stage IIB cervical cancer treated between 1995 and 2010, who received chemo-radiation with at least 45 Gy external beam radiation, two to four brachytherapy sessions, and one to six weekly cycles of concurrent cisplatin (40 mg/m², capped at 60 mg/week). Results: Mean total dose to Point A from external beam radiation and brachytherapy was 83 Gy (range 61–96 – expressed as the linear quadratic equivalent dose to 2 Gy/fraction). Mean overall treatment time was 45 days. The average weekly haemoglobin (AWHB) during treatment was 11.6 g/dl (range 8.8–15.5). Overall, one-third of patients received blood transfusions before or during chemo-radiation, and two-thirds of patients completed five or six cycles of weekly cisplatin. Reasons for fewer than five cycles were scheduling failures, neutropenia, renal impairment and side effects. No outcome differences were observed for Monday vs. Thursday cisplatin administration. The five-year overall survival was 60%. Patients completing fewer than six cycles had a worse survival (55 vs. 76%, p = 0.02). By multiple regression for survival only six cycles of cisplatin, squamous histology and AWHB >10 g/dl were significant. Conclusions: Maintaining HB >10.0 and administering six cycles of weekly cisplatin are associated with better survival from chemo-radiation for stage IIB cervical cancer.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"10 1","pages":"10 - 5"},"PeriodicalIF":0.3,"publicationDate":"2018-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2018.1441694","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46098373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-02DOI: 10.1080/20742835.2018.1454144
Rohini V. Kulkarni, R. Bhat, Vibhawari Dhakharia, Jagannath Dixit, A. Gangoli, K. Sharma
Carcinosarcomas, also known as malignant mixed Müllerian tumours (MMMT), are aggressive neoplasms that are biphasic as they contain both carcinomatous and sarcomatous elements. Most commonly arising from the endometrium, extragenital carcinosarcomas are extremely rare and most cases develop from the peritoneum. The case is reported of a 70-year-old female who presented with abdominal pain and distention. On evaluation a large abdomino-pelvic mass with ascites was noted. She underwent complete cytoreductive surgery and the histopathology reported carcinosarcoma of primary peritoneal origin, of heterologous type arising de novo from the secondary Müllerian system with no synchronous or metachronous carcinomas or endometriosis. She declined adjuvant treatment and re-presented with disseminated abdominal disease and unfortunately succumbed to the disease within four months. Carcinosarcomas of the extragenital sites have been postulated to arise from pre-existing foci of endometriosis, Müllerian duct remnants, or the secondary Müllerian system, all of which are derivatives of the coelomic epithelium. They are extremely aggressive, and there is little knowledge concerning their natural history and scant data regarding their management.
{"title":"Primary peritoneal carcinosarcoma arising from the secondary Müllerian system: case report and literature review","authors":"Rohini V. Kulkarni, R. Bhat, Vibhawari Dhakharia, Jagannath Dixit, A. Gangoli, K. Sharma","doi":"10.1080/20742835.2018.1454144","DOIUrl":"https://doi.org/10.1080/20742835.2018.1454144","url":null,"abstract":"Carcinosarcomas, also known as malignant mixed Müllerian tumours (MMMT), are aggressive neoplasms that are biphasic as they contain both carcinomatous and sarcomatous elements. Most commonly arising from the endometrium, extragenital carcinosarcomas are extremely rare and most cases develop from the peritoneum. The case is reported of a 70-year-old female who presented with abdominal pain and distention. On evaluation a large abdomino-pelvic mass with ascites was noted. She underwent complete cytoreductive surgery and the histopathology reported carcinosarcoma of primary peritoneal origin, of heterologous type arising de novo from the secondary Müllerian system with no synchronous or metachronous carcinomas or endometriosis. She declined adjuvant treatment and re-presented with disseminated abdominal disease and unfortunately succumbed to the disease within four months. Carcinosarcomas of the extragenital sites have been postulated to arise from pre-existing foci of endometriosis, Müllerian duct remnants, or the secondary Müllerian system, all of which are derivatives of the coelomic epithelium. They are extremely aggressive, and there is little knowledge concerning their natural history and scant data regarding their management.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"10 1","pages":"16 - 18"},"PeriodicalIF":0.3,"publicationDate":"2018-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2018.1454144","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41497355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-11-24DOI: 10.1080/20742835.2017.1402434
J. Theuws, D. Allen
Abstract Background: Cervical adenocarcinoma in situ (AIS) is the known precursor condition of cervical adenocarcinoma. The aim of this study is to evaluate treatment choices for AIS in terms of residual disease, recurrence and progression to invasive cancer. Methods: This is a retrospective cohort study conducted at the Mercy Hospital for Women in Melbourne, Australia. Women diagnosed with AIS on histology between 2000 and 2013 were included. Patient records were reviewed for notes on symptoms, cytology, colposcopy and biopsy reports, initial treatment, any subsequent treatment, outcome and follow-up. Results: A total of 114 patients were included: 87 patients were treated with one or more fertility-sparing procedures; 25 patients received a subsequent hysterectomy, one a trachelectomy and one chemo- and radiotherapy. Residual disease was found in 31% (9/29) after a previous procedure with positive margins. In 13.3% (2/15) residual disease was diagnosed despite clear surgical margins. The mean follow-up time was 78.6 months (range 7.9–183). Two patients (2/87, 2.3%) who primarily received fertility-sparing treatment had recurrent AIS. None of the patients progressed to invasive cancer. Conclusion: Both positive and negative margins after initial treatment must be carefully considered in each case. With negative margins, fertility-sparing surgery should be a treatment choice available for all women, not only for those who want to preserve fertility. Fertility-sparing surgery requires regular follow-up.
{"title":"Effect of treatment choices for cervical adenocarcinoma in situ on rates of residual disease, recurrence and progression","authors":"J. Theuws, D. Allen","doi":"10.1080/20742835.2017.1402434","DOIUrl":"https://doi.org/10.1080/20742835.2017.1402434","url":null,"abstract":"Abstract Background: Cervical adenocarcinoma in situ (AIS) is the known precursor condition of cervical adenocarcinoma. The aim of this study is to evaluate treatment choices for AIS in terms of residual disease, recurrence and progression to invasive cancer. Methods: This is a retrospective cohort study conducted at the Mercy Hospital for Women in Melbourne, Australia. Women diagnosed with AIS on histology between 2000 and 2013 were included. Patient records were reviewed for notes on symptoms, cytology, colposcopy and biopsy reports, initial treatment, any subsequent treatment, outcome and follow-up. Results: A total of 114 patients were included: 87 patients were treated with one or more fertility-sparing procedures; 25 patients received a subsequent hysterectomy, one a trachelectomy and one chemo- and radiotherapy. Residual disease was found in 31% (9/29) after a previous procedure with positive margins. In 13.3% (2/15) residual disease was diagnosed despite clear surgical margins. The mean follow-up time was 78.6 months (range 7.9–183). Two patients (2/87, 2.3%) who primarily received fertility-sparing treatment had recurrent AIS. None of the patients progressed to invasive cancer. Conclusion: Both positive and negative margins after initial treatment must be carefully considered in each case. With negative margins, fertility-sparing surgery should be a treatment choice available for all women, not only for those who want to preserve fertility. Fertility-sparing surgery requires regular follow-up.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"9 1","pages":"30 - 34"},"PeriodicalIF":0.3,"publicationDate":"2017-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2017.1402434","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43618209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-11-05DOI: 10.1080/20742835.2017.1394628
BT Guzha, T. Adams, L. Rogers, N. Mbatani, H-T Wu, N. Fakie, J. Opie, L. Denny
Abstract A case is presented of a 67-year-old woman referred to the authors’ institution with endometrioid endometrial cancer with a leucoerythroblastic blood film and marked thrombocytopenia. On further evaluation, it was confirmed that she had grade 3 endometrial cancer with bone marrow involvement (FIGO stage IVB). This is a rare complication of endometrial cancer and her marked thrombocytopenia severely limited her treatment options.
{"title":"Endometrial cancer with bone marrow metastases: a management dilemma","authors":"BT Guzha, T. Adams, L. Rogers, N. Mbatani, H-T Wu, N. Fakie, J. Opie, L. Denny","doi":"10.1080/20742835.2017.1394628","DOIUrl":"https://doi.org/10.1080/20742835.2017.1394628","url":null,"abstract":"Abstract A case is presented of a 67-year-old woman referred to the authors’ institution with endometrioid endometrial cancer with a leucoerythroblastic blood film and marked thrombocytopenia. On further evaluation, it was confirmed that she had grade 3 endometrial cancer with bone marrow involvement (FIGO stage IVB). This is a rare complication of endometrial cancer and her marked thrombocytopenia severely limited her treatment options.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"9 1","pages":"22 - 24"},"PeriodicalIF":0.3,"publicationDate":"2017-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2017.1394628","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47594849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：