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1. McNally OM, Delaney E, Petty RD, Cruickshank ME, Hutcheon AW, Parkin DE: Is optimal first-line chemotherapy deliverable in all newly diagnosed ovarian cancers? A population-based study. Br J Cancer; 2003 Sep 15;89(6):966-7
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  • [Title] Is optimal first-line chemotherapy deliverable in all newly diagnosed ovarian cancers? A population-based study.
  • NICE guidance recommends the use of paclitaxel and a platinum therapy for all cases of ovarian cancer.
  • We report our experience of treating 133 patients with ovarian cancer over a 3-year period.
  • Where indicated, 91% received chemotherapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Ovarian Neoplasms / drug therapy. Paclitaxel / analogs & derivatives. Taxoids
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Carboplatin / administration & dosage. Combined Modality Therapy. Female. Humans. Middle Aged. Mixed Tumor, Mullerian / diagnosis. Mixed Tumor, Mullerian / drug therapy. Neoplasm Staging. Neoplasms, Glandular and Epithelial / diagnosis. Neoplasms, Glandular and Epithelial / drug therapy. Practice Guidelines as Topic / standards. Prospective Studies. Radiotherapy Dosage. Survival Rate

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  • [Cites] BMJ. 2002 Apr 6;324(7341):842-5 [11934781.001]
  • [Cites] J Clin Oncol. 2002 Jan 1;20(1):173-8 [11773167.001]
  • [Cites] Lancet. 2002 Aug 17;360(9332):505-15 [12241653.001]
  • [CommentOn] Br J Cancer. 2003 Sep 15;89(6):957-8 [12966407.001]
  • (PMID = 12966409.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Comment; Comparative Study; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Taxoids; 15H5577CQD / docetaxel; BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel
  • [Other-IDs] NLM/ PMC2376968
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2. Brown E, Stewart M, Rye T, Al-Nafussi A, Williams AR, Bradburn M, Smyth J, Gabra H: Carcinosarcoma of the ovary: 19 years of prospective data from a single center. Cancer; 2004 May 15;100(10):2148-53
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  • [Title] Carcinosarcoma of the ovary: 19 years of prospective data from a single center.
  • BACKGROUND: A review of clinicopathologic features and outcome in women with carcinosarcoma of the ovary (also known as malignant mixed mesodermal tumor [MMMT]) compared with a group of women with serous adenocarcinoma (SAC) of the ovary was conducted.
  • METHODS: Between 1984 and 2002, 1568 patients with epithelial ovarian carcinoma and 70 patients with ovarian carcinosarcoma underwent treatment at the Edinburgh Cancer Centre.
  • Baseline variables were recorded prospectively and response to chemotherapy and progression-free and cause-specific survival between the groups were compared.
  • The objective response rate to platinum-based chemotherapy was found to be significantly lower in patients with carcinosarcoma (25% vs. 60%; P = 0.02).
  • Achieving optimal debulking at the time of initial surgery was found to be a highly significant factor in patients with carcinosarcoma with regard to determining outcome (median survival of 14.8 months for patients with optimally debulked International Federation of Gynecology and Obstetrics Stage III disease vs. 3.1 months for patients with suboptimally/nondebulked Stage III disease; P < 0.001).
  • CONCLUSIONS: Ovarian carcinosarcoma is a distinct entity with a poor prognosis.
  • Patients with carcinosarcoma differ from those with SAC with regard to having an older mean age of onset, an inferior response to platinum-based chemotherapy, and worse progression-free and cause-specific survival.
  • The extent of benefit from chemotherapy is unclear.
  • [MeSH-major] Carcinosarcoma / pathology. Ovarian Neoplasms / pathology
  • [MeSH-minor] Aged. Antineoplastic Agents / therapeutic use. Cystadenoma, Serous / drug therapy. Cystadenoma, Serous / mortality. Cystadenoma, Serous / pathology. Female. Humans. Middle Aged. Neoplasm Recurrence, Local. Neoplasm Staging. Prospective Studies. Survival Rate

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  • [Copyright] Copyright 2004 American Cancer Society.
  • (PMID = 15139057.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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3. Zhang C, Li XP, Cui H, Shen DH, Wei LH: Advanced primary peritoneal carcinoma: clinicopathological and prognostic factor analyses. J Zhejiang Univ Sci B; 2008 Jun;9(6):435-40
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  • RESULTS: There were 15 cases of primary peritoneal serous papillary carcinoma (PPSPC), 6 cases of mixed epithelial carcinoma (MEC) and 3 cases of malignant mixed Mullerian tumor (MMMT).
  • Among those receiving first-line chemotherapy, 13 patients received the TP regimen (paclitaxel-cisplatin or carboplatin) and 7 patients received the PAC regimen (cisplatin-doxorubicin-cyclophosphamide).
  • The median overall survival of all patients was 42 months, while the breakdown for survival time for patients with PPSPC, MMT and MEC was 44, 13 and 19 months, respectively.
  • Another significant difference in the median progression-free survival (PFS) was identified between patients with positive p53 immunostaining and those with negative p53 immunostaining (15 months vs 47 months, P<0.05), whereas age, menopausal status, residual tumor size and the other molecular factors did not significantly impact survival.
  • CONCLUSION: Patients with PPC should be treated with a comprehensive management plan including appropriate cytoreductive surgery and responsive chemotherapy.
  • The pathologic subtype, chemotherapy regimen and p53 overexpression were significant prognostic factors.
  • [MeSH-minor] Adult. Aged. Antigens, Neoplasm / metabolism. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biomarkers, Tumor / metabolism. China / epidemiology. Combined Modality Therapy. Cystadenocarcinoma, Papillary / metabolism. Cystadenocarcinoma, Papillary / mortality. Cystadenocarcinoma, Papillary / pathology. Cystadenocarcinoma, Papillary / therapy. DNA Topoisomerases, Type II / metabolism. DNA-Binding Proteins / metabolism. Female. Humans. Immunohistochemistry. Ki-67 Antigen / metabolism. Middle Aged. Mixed Tumor, Mullerian / metabolism. Mixed Tumor, Mullerian / mortality. Mixed Tumor, Mullerian / pathology. Mixed Tumor, Mullerian / therapy. Ovarian Neoplasms / metabolism. Ovarian Neoplasms / mortality. Ovarian Neoplasms / pathology. Ovarian Neoplasms / therapy. Prognosis. Receptor, ErbB-2 / metabolism. Survival Rate. Tumor Suppressor Protein p53 / metabolism

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  • (PMID = 18543395.001).
  • [ISSN] 1673-1581
  • [Journal-full-title] Journal of Zhejiang University. Science. B
  • [ISO-abbreviation] J Zhejiang Univ Sci B
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Antigens, Neoplasm; 0 / Biomarkers, Tumor; 0 / DNA-Binding Proteins; 0 / Ki-67 Antigen; 0 / TP53 protein, human; 0 / Tumor Suppressor Protein p53; EC 2.7.10.1 / ERBB2 protein, human; EC 2.7.10.1 / Receptor, ErbB-2; EC 5.99.1.3 / DNA Topoisomerases, Type II; EC 5.99.1.3 / DNA topoisomerase II alpha
  • [Other-IDs] NLM/ PMC2408695
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4. Sabbatini PJ, Ragupathi G, Hood C, Aghajanian CA, Juretzka M, Iasonos A, Hensley ML, Spassova MK, Ouerfelli O, Spriggs DR, Tew WP, Konner J, Clausen H, Abu Rustum N, Dansihefsky SJ, Livingston PO: Pilot study of a heptavalent vaccine-keyhole limpet hemocyanin conjugate plus QS21 in patients with epithelial ovarian, fallopian tube, or peritoneal cancer. Clin Cancer Res; 2007 Jul 15;13(14):4170-7
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  • [Title] Pilot study of a heptavalent vaccine-keyhole limpet hemocyanin conjugate plus QS21 in patients with epithelial ovarian, fallopian tube, or peritoneal cancer.
  • PURPOSE: To characterize the safety and immunogenicity of a heptavalent antigen-keyhole limpet hemocyanin (KLH) plus QS21 vaccine construct in patients with epithelial ovarian, fallopian tube, or peritoneal cancer in second or greater complete clinical remission.
  • EXPERIMENTAL DESIGN: Eleven patients in this pilot trial received a heptavalent vaccine s.c. containing GM2 (10 microg), Globo-H (10 microg), Lewis Y (10 microg), Tn(c) (3 microg), STn(c) (3 microg), TF(c) (3 microg), and Tn-MUC1 (3 microg) individually conjugated to KLH and mixed with adjuvant QS21(100 microg).
  • Eight of nine patients developed responses against at least three antigens.
  • [MeSH-major] Fallopian Tube Neoplasms / immunology. Hemocyanin / therapeutic use. Neoplasms, Glandular and Epithelial / immunology. Ovarian Neoplasms / immunology. Peritoneal Neoplasms / immunology. Saponins / therapeutic use. Vaccines, Conjugate / therapeutic use
  • [MeSH-minor] Adjuvants, Immunologic / therapeutic use. Adjuvants, Immunologic / toxicity. Adult. Drug Therapy, Combination. Female. Humans. Middle Aged. Models, Molecular. Neoplasm Staging. Safety


5. Marret H, Lhommé C, Lécuru F, Canis M, Léveque J, Golfier F, Morice P, French Working Group on Gynecological Cancers in Pregnancy, SFOG, SFCP, CNGOF: [French recommendations for ovarian cancer management during pregnancy]. Gynecol Obstet Fertil; 2009 Sep;37(9):752-63
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  • [Title] [French recommendations for ovarian cancer management during pregnancy].
  • [Transliterated title] Recommandations pour la prise en charge du cancer de l'ovaire pendant la grossesse.
  • Evaluation of the fetus using prenatal ultrasound has resulted in increased detection of asymptomatic adnexal masses during pregnancy.
  • It is a common assumption by both patients and physicians that if an ovarian cancer is diagnosed during pregnancy, treatment necessitates sacrificing the well-being of the fetus.
  • However, in most cases, it is possible to offer appropriate treatment to the mother without placing the fetus at serious risk.
  • We suggest surgery be performed after 15 SA for ovarian masses which (1) persist into the second trimester, (2) are greater than 5 to 10 cm in diameter, or (3) have solid or mixed solid and cystic ultrasound characteristics.
  • Women found to have advanced stage epithelial ovarian cancer should consider having completion of the debulking of the reproductive organs at the conclusion of the pregnancy.
  • If chemotherapy is indicated, we recommend delaying administration, if possible, after the delivery or at least after 20 SA in order to minimize the potential fetal toxicity.
  • [MeSH-major] Neoplasms, Glandular and Epithelial / surgery. Ovarian Neoplasms / surgery. Practice Guidelines as Topic. Pregnancy Complications, Neoplastic / surgery
  • [MeSH-minor] Antineoplastic Agents / adverse effects. Antineoplastic Agents / therapeutic use. Female. France. Gestational Age. Humans. Neoplasm Staging. Pregnancy. Risk Assessment. Ultrasonography, Prenatal

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  • (PMID = 19709917.001).
  • [ISSN] 1297-9589
  • [Journal-full-title] Gynécologie, obstétrique & fertilité
  • [ISO-abbreviation] Gynecol Obstet Fertil
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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6. Drisko JA, Chapman J, Hunter VJ: The use of antioxidants with first-line chemotherapy in two cases of ovarian cancer. J Am Coll Nutr; 2003 Apr;22(2):118-23
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  • [Title] The use of antioxidants with first-line chemotherapy in two cases of ovarian cancer.
  • OBJECTIVE: Because of poor overall survival in advanced ovarian malignancies, patients often turn to alternative therapies despite controversy surrounding their use.
  • Currently, the majority of cancer patients combine some form of complementary and alternative medicine with conventional therapies.
  • Of these therapies, antioxidants, added to chemotherapy, are a frequent choice.
  • METHODS: For this preliminary report, two patients with advanced epithelial ovarian cancer were studied.
  • One patient had Stage IIIC papillary serous adenocarcinoma, and the other had Stage IIIC mixed papillary serous and seromucinous adenocarcinoma.
  • Both patients were optimally cytoreduced prior to first-line carboplatinum/paclitaxel chemotherapy.
  • Patient 2 had a delay in initiation of chemotherapy secondary to co-morbid conditions and had evidence for progression of disease prior to institution of therapy.
  • Patient 1 began oral high-dose antioxidant therapy during her first month of therapy.
  • In addition to the oral antioxidant therapy, patient 1 added parenteral ascorbic acid at a total dose of 60 grams given twice weekly at the end of her chemotherapy and prior to consolidation paclitaxel chemotherapy.
  • Patient 2 added oral antioxidants just prior to beginning chemotherapy, including vitamin C, beta-carotene, vitamin E, coenzyme Q-10 and a multivitamin/mineral complex.
  • Patient 2 received six cycles of paclitaxel/carboplatinum chemotherapy and refused consolidation chemotherapy despite radiographic evidence of persistent disease.
  • RESULTS: Patient 1 had normalization of her CA-125 after the first cycle of chemotherapy and has remained normal, almost 3(1/2) years after diagnosis.
  • Patient 2 had normalization of her CA-125 after the first cycle of chemotherapy.
  • After her first round of chemotherapy, the patient was noted to have residual disease in the pelvis.
  • She declined further chemotherapy and added intravenous ascorbic acid.
  • There is no evidence for recurrent disease by physical examination, and her CA-125 has remained normal three years after diagnosis.
  • CONCLUSION: Antioxidants, when added adjunctively, to first-line chemotherapy, may improve the efficacy of chemotherapy and may prove to be safe.
  • Because of the positive results found in these two patients, a randomized controlled trial is now underway at the University of Kansas Medical Center evaluating safety and efficacy of antioxidants when added to chemotherapy in newly diagnosed ovarian cancer.
  • [MeSH-major] Adenocarcinoma, Papillary / drug therapy. Antineoplastic Agents / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Antioxidants / therapeutic use. Ovarian Neoplasms / drug therapy
  • [MeSH-minor] Carboplatin / therapeutic use. Complementary Therapies. Female. Humans. Middle Aged. Neoplasm Recurrence, Local. Paclitaxel / therapeutic use. Treatment Outcome. Vitamins / therapeutic use

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  • (PMID = 12672707.001).
  • [ISSN] 0731-5724
  • [Journal-full-title] Journal of the American College of Nutrition
  • [ISO-abbreviation] J Am Coll Nutr
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Antioxidants; 0 / Vitamins; BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel
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7. Athavale R, Thomakos N, Godfrey K, Kew F, Cross P, de Barros Lopes A, Hatem MH, Naik R: The effect of epithelial and stromal tumor components on FIGO stages III and IV ovarian carcinosarcomas treated with primary surgery and chemotherapy. Int J Gynecol Cancer; 2007 Sep-Oct;17(5):1025-30
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  • [Title] The effect of epithelial and stromal tumor components on FIGO stages III and IV ovarian carcinosarcomas treated with primary surgery and chemotherapy.
  • The aim of this study is to assess the effect of epithelial and stromal tumor components on survival outcomes in FIGO stage III or IV ovarian carcinosarcomas (OCS) treated with primary surgery and adjuvant chemotherapy at the Northern Gynaecological Oncology Centre (NGOC), Gateshead.
  • Age, FIGO stage, details of histology, treatment, and overall survival were recorded.
  • Of 34 cases (1994-2006, all FIGO stages), 17 were treated with primary surgery followed by adjuvant chemotherapy for FIGO stage III or IV.
  • Epithelial predominant (EP) or stromal predominant (SP) tumor (defined as >50% of either component in the primary tumor) was noted in 12 and 5 cases, respectively.
  • Epithelial types included serous (n= 9), endometrioid (n= 5), and mixed types (n= 3).
  • On univariate analysis, survival was not affected by optimal/suboptimal debulking, platinum/doxorubicin-containing chemotherapy, or homologous/heterologous stromal components.
  • Stromal components (>25%) adversely affected survival (P= 0.02), and there was a trend to worse survival with serous compared with nonserous epithelial components (P= 0.07).
  • Cox regression (multivariate analysis) showed that SP tumors (P= 0.04), suboptimal debulking (P= 0.01), age (P= 0.01), and tumors with serous epithelial component (P= 0.05) were adverse independent prognostic factors.
  • Type of chemotherapy and homologous/heterologous components (P= 0.24) did not affect overall survival.
  • Tumors with serous epithelial components adversely affected the survival compared with nonserous components.
  • Larger studies are required to confirm these effects and to identify the optimum chemotherapy regimen for OCS.
  • [MeSH-major] Carcinosarcoma / pathology. Ovarian Neoplasms / pathology
  • [MeSH-minor] Aged. Aged, 80 and over. Chemotherapy, Adjuvant. Epithelial Cells / pathology. Female. Humans. Middle Aged. Neoplasm Staging. Stromal Cells / pathology. Survival Analysis. Treatment Outcome

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  • (PMID = 17466043.001).
  • [ISSN] 1048-891X
  • [Journal-full-title] International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
  • [ISO-abbreviation] Int. J. Gynecol. Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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8. Duska LR, Garrett A, Eltabbakh GH, Oliva E, Penson R, Fuller AF: Paclitaxel and platinum chemotherapy for malignant mixed müllerian tumors of the ovary. Gynecol Oncol; 2002 Jun;85(3):459-63
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  • [Title] Paclitaxel and platinum chemotherapy for malignant mixed müllerian tumors of the ovary.
  • OBJECTIVE: Malignant mixed müllerian tumor (MMMT) of the ovary is a rare tumor with a dismal prognosis.
  • The most effective therapy is unknown.
  • The current study was undertaken to characterize a group of patients treated as if they had aggressive epithelial ovarian tumors, with cytoreductive surgery and combination paclitaxel/platinum chemotherapy.
  • METHODS: Retrospective analysis of data obtained from tumor registry and hospital records of cases of malignant mixed müllerian tumor between January 1, 1992 and January 1, 2000 treated at the Massachusetts General Hospital, Brigham and Women's Hospital, and University of Vermont was performed.
  • Only patients treated with combination paclitaxel and platinum therapy were included in the analysis.
  • Data were collected regarding cytoreduction, response to chemotherapy, disease-free interval, and survival.
  • Twenty-eight patients with a clearly ovarian primary had received treatment with combination paclitaxel and platinum.
  • Paclitaxel and carboplatin was given as second-line therapy in 2 patients who had chemoresponsive but incurable disease; the remaining patients were treated with paclitaxel and platinum therapy as first-line therapy.
  • Treatment was generally well tolerated.
  • Sixteen patients of 26 treated with paclitaxel and platinum as first-line therapy achieved a complete clinical response (55%) and 6 patients achieved partial response for a total response rate of 72%.
  • Optimal cytoreduction was associated with increased time to recurrence (P = 0.001) but not with survival.
  • CONCLUSION: Although treatment fails many patients, a minority of patients with MMMT in this highly selected population do unexpectedly well.
  • An aggressive approach with surgery and combination paclitaxel-platinum chemotherapy appears to offer very effective therapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Mixed Tumor, Mullerian / drug therapy. Ovarian Neoplasms / drug therapy
  • [MeSH-minor] Aged. Aged, 80 and over. Carboplatin / administration & dosage. Female. Humans. Middle Aged. Neoplasm Staging. Paclitaxel / administration & dosage. Retrospective Studies. Survival Rate

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  • (PMID = 12051874.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] United States
  • [Chemical-registry-number] BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel
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9. Camci C, Sevinc A, Aslan Y, Kalender ME, Buyukberber S: Complete remission of platinium refractory ovarian cancer with second line tegafur with uracil monotherapy: a case report. Cancer Chemother Pharmacol; 2009 Mar;63(4):745-8
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  • [Title] Complete remission of platinium refractory ovarian cancer with second line tegafur with uracil monotherapy: a case report.
  • BACKGROUND: Ovarian cancer remains one of the most lethal of all gynecologic malignancies, accounting for more deaths than cervical and uterine cancer combined.
  • Advanced ovarian cancer is a chemosensitive tumor and most patients initially respond to platinum-based combination chemotherapy with response rates of about 70%, including a high proportion of complete responses.
  • However, despite aggressive surgery and chemotherapy, more than 80% of patients will relapse and will then be treated with second line chemotherapy with objective responses in about 20% of patients and even lower percentages of complete responses.
  • CASE: We observed a 42-months of complete response with administration of 1-[2-tetrahydrofuryl]-5-fluorouracil mixed with uracil (UFT) in patient with platinium refractory ovarian cancer.
  • CONCLUSION: We report a complete remission of platinium refractory epithelial ovarian cancer with UFT monotherapy that was not reported previously.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Drug Resistance, Neoplasm. Ovarian Neoplasms / drug therapy
  • [MeSH-minor] Carcinoma, Papillary / drug therapy. Carcinoma, Papillary / secondary. Carcinoma, Papillary / surgery. Combined Modality Therapy. Cystadenocarcinoma, Serous / drug therapy. Cystadenocarcinoma, Serous / secondary. Cystadenocarcinoma, Serous / surgery. Dose-Response Relationship, Drug. Female. Humans. Middle Aged. Neoplasm Recurrence, Local. Neoplasm Staging. Prognosis. Remission Induction. Salvage Therapy. Tegafur / administration & dosage. Treatment Outcome. Uracil / administration & dosage

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  • (PMID = 18504578.001).
  • [ISSN] 1432-0843
  • [Journal-full-title] Cancer chemotherapy and pharmacology
  • [ISO-abbreviation] Cancer Chemother. Pharmacol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 1548R74NSZ / Tegafur; 56HH86ZVCT / Uracil
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10. Veras E, Deavers MT, Silva EG, Malpica A: Ovarian nonsmall cell neuroendocrine carcinoma: a clinicopathologic and immunohistochemical study of 11 cases. Am J Surg Pathol; 2007 May;31(5):774-82
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  • [Title] Ovarian nonsmall cell neuroendocrine carcinoma: a clinicopathologic and immunohistochemical study of 11 cases.
  • Nonsmall cell neuroendocrine carcinoma (NSCNEC) of the ovary is a rare and aggressive tumor commonly associated with other surface epithelial and germ cell neoplasms.
  • In 8 cases, NSCNEC was associated with other epithelial neoplasms, including mucinous neoplasms of low malignant potential, mucinous carcinoma, endometrioid carcinoma, mixed endometrioid and mucinous carcinoma, and a high-grade carcinoma, not otherwise specified.
  • In 2 cases, the tumor was associated with a mature cystic teratoma; one of them also containing an invasive moderately differentiated adenocarcinoma.
  • A single case was associated with a benign ovarian cyst.
  • The latter case had a dermoid cyst in the contralateral ovary.
  • NSCNEC represented anywhere from 10% to 90% of the ovarian tumor.
  • Seven patients were treated with total abdominal hysterectomy and bilateral salpingo-oophorectomy followed by chemotherapy.
  • One patient had a bilateral salpingo-oophorectomy with omentectomy and appendectomy followed by chemotherapy; 1 patient had a total abdominal hysterectomy with right salpingo-oophorectomy followed by chemotherapy; one had a bilateral salpingo-oophorectomy followed by chemotherapy, and one had a right salpingo-oophorectomy with appendectomy followed by chemotherapy.
  • In summary, ovarian NSCNEC is an aggressive tumor with a tendency to present at advanced stage and cause death within a mean of 17 months after diagnosis; however, some patients, particularly those with stage I disease and/or those who have received platinum-based therapy, may have a more favorable prognosis.
  • [MeSH-major] Biomarkers, Tumor. Carcinoma, Neuroendocrine / pathology. Immunoenzyme Techniques. Ovarian Neoplasms / pathology
  • [MeSH-minor] Adult. Combined Modality Therapy. Fatal Outcome. Female. Humans. Middle Aged. Neoplasm Proteins / analysis. Neoplasm Staging. Neoplasms, Multiple Primary. Remission Induction. Treatment Outcome

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  • (PMID = 17460463.001).
  • [ISSN] 0147-5185
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Neoplasm Proteins
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11. Chura JC, Ryu HS, Simard M, Poirier D, Tremblay Y, Brooker DC, Blomquist CH, Argenta PA: Steroid-converting enzymes in human ovarian carcinomas. Mol Cell Endocrinol; 2009 Mar 25;301(1-2):51-8
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  • [Title] Steroid-converting enzymes in human ovarian carcinomas.
  • Anti-estrogen therapies for treating ovarian carcinoma have had mixed outcomes suggesting some tumors may be estrogen-dependent.
  • We assayed the activity levels of 17beta-hydroxysteroid dehydrogenase (17beta-HSD), 3beta-hydroxysteroid dehydrogenase (3beta-HSD), 3alpha-hydroxysteroid dehydrogenase (3alpha-HSD/3-KSR) and estrone sulfatase in a series of ovarian epithelial carcinomas.
  • A 17beta-HSD type 1 inhibition pattern was observed in 23% of the samples and a type 2 pattern in 25%.
  • 17beta-HSD type 1, type 2 and type 5 mRNA was detected in matched primary tumor and metastases.
  • Evaluation of 17beta-HSD and sulfatase activity levels, activity ratios and inhibition patterns may help predict tumor response to endocrine therapy.
  • [MeSH-major] 17-Hydroxysteroid Dehydrogenases / metabolism. 3-Hydroxysteroid Dehydrogenases / metabolism. Ovarian Neoplasms / enzymology. Sulfatases / metabolism
  • [MeSH-minor] Enzyme Inhibitors / pharmacology. Estradiol / metabolism. Estrogen Receptor alpha / metabolism. Female. Gene Expression Regulation, Enzymologic / drug effects. Humans. Neoplasm Metastasis. RNA, Messenger / genetics. RNA, Messenger / metabolism. Substrate Specificity / drug effects. Testosterone / metabolism

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  • (PMID = 18723074.001).
  • [ISSN] 0303-7207
  • [Journal-full-title] Molecular and cellular endocrinology
  • [ISO-abbreviation] Mol. Cell. Endocrinol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Ireland
  • [Chemical-registry-number] 0 / Enzyme Inhibitors; 0 / Estrogen Receptor alpha; 0 / RNA, Messenger; 0 / estrogen receptor alpha, human; 3XMK78S47O / Testosterone; 4TI98Z838E / Estradiol; EC 1.1.- / 17-Hydroxysteroid Dehydrogenases; EC 1.1.- / 3-Hydroxysteroid Dehydrogenases; EC 1.1.1.51 / 3 (or 17)-beta-hydroxysteroid dehydrogenase; EC 3.1.6.- / Sulfatases; EC 3.1.6.- / estrone sulfatase
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12. Matsuura Y, Kitajima M, Hachisuga T, Tanimoto A, Okura N, Kihara I: Malignant mixed müllerian tumor with malignant neuroectodermal components (teratoid carcinosarcoma) of the ovary: Report of a case with clinicopathologic findings. J Obstet Gynaecol Res; 2010 Aug;36(4):907-11
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  • [Title] Malignant mixed müllerian tumor with malignant neuroectodermal components (teratoid carcinosarcoma) of the ovary: Report of a case with clinicopathologic findings.
  • Malignant mixed müllerian tumor (MMMT) or carcinosarcoma of the female genital tract is a rare neoplasm.
  • Malignant ovarian tumor composed of müllerian epithelial tumor and malignant germ cell tumor is also rare, with most cases composed of endometrioid adenocarcinoma and yolk sac tumor.
  • Ovarian MMMT with malignant neuroectodermal components resembling immature teratoma is extremely rare.
  • We report a case of teratoid carcinosarcoma of the ovary occurring in a 40-year-old female.
  • The resected tumor measuring over 20 cm in diameter consisted of cystic and solid components and was very fragile.
  • Microscopic examination showed a heterogenous mixed tumor composed of malignant epithelial, malignant mesodermal and malignant neuroectodermal components.
  • There was no tumor immunoreactivity to alpha-fetoprotein, carcinoembryonic antigen, human chorionic gonadotropin, and inhibin.
  • In spite of aggressive combination chemotherapy and three times of laparotomy, the patient died of disease 3 years 10 months after the initial treatment.
  • This quite rare ovarian tumor closely resembled nasopharyngeal tumors described as 'teratoid carcinosarcoma' is biologically aggressive.
  • We report the fourth case of ovarian teratoid carcinosarcoma.
  • Further cases need to be accumulated to make diagnosis and to determine a successful treatment modality.
  • [MeSH-major] Carcinosarcoma / pathology. Mixed Tumor, Mullerian / pathology. Ovarian Neoplasms / pathology. Teratoma / pathology
  • [MeSH-minor] Adult. Fatal Outcome. Female. Humans. Ovary / pathology. Ovary / surgery

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  • (PMID = 20666968.001).
  • [ISSN] 1447-0756
  • [Journal-full-title] The journal of obstetrics and gynaecology research
  • [ISO-abbreviation] J. Obstet. Gynaecol. Res.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Australia
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13. Le T, Adolph A, Krepart GV, Lotocki R, Heywood MS: The benefits of comprehensive surgical staging in the management of early-stage epithelial ovarian carcinoma. Gynecol Oncol; 2002 May;85(2):351-5
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  • [Title] The benefits of comprehensive surgical staging in the management of early-stage epithelial ovarian carcinoma.
  • OBJECTIVE: The management of understaged patients with apparent clinically early ovarian cancer is difficult.
  • Options include offering chemotherapy based on histopathologic factors or reoperation to obtain the necessary information needed to assign an accurate surgical stage.
  • Patients not having surgical staging procedures were offered platinum-based chemotherapy based on high tumor grades, dense adhesions, and presence of surface excrescences or large necrotic areas.
  • Patients with surgically proven stage I disease were treated with no further therapy regardless of histopathologic factors.
  • RESULTS: One hundred and thirty-eight patients presented with tumor macroscopically confined to the ovary at the time of laparotomy.
  • The histology distribution was serous tumor in 28.3%, mucinous in 26.1%, endometrioid in 23.2%, clear cell in 14.5%, anaplastic in 2.2%, and mixed types in 5.8%.
  • Sixty-eight percent of the patients had a comprehensive surgical staging procedure initially.
  • Thirty-six percent of these patients were found to have extraovarian metastases and were subsequently treated with adjuvant chemotherapy.
  • Forty-three percent of those not having staging laparotomy were offered chemotherapy based on high risk factors only.
  • In terms of progression-free interval, only age (OR 1.027, P = 0.048) and tumor grade (OR 3.62, P = 0.05) are significant predictors.
  • CONCLUSION: Absence of surgical pathologic high-risk factors is inferior to comprehensive staging laparotomy findings in guiding recommendations for subsequent adjuvant therapy.
  • Patients who have not been properly staged stand a significant risk of recurrent disease despite more frequent use of chemotherapy.
  • All clinically early-stage ovarian cancer patients should be considered for comprehensive staging surgery prior to further treatment recommendations.
  • [MeSH-major] Ovarian Neoplasms / pathology. Ovarian Neoplasms / surgery
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carboplatin / administration & dosage. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Cyclophosphamide / administration & dosage. Female. Humans. Laparotomy. Middle Aged. Neoplasm Staging. Retrospective Studies. Risk Factors. Survival Rate

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  • [Copyright] (c) 2002 Elsevier Science (USA).
  • (PMID = 11972399.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] United States
  • [Chemical-registry-number] 8N3DW7272P / Cyclophosphamide; BG3F62OND5 / Carboplatin; Q20Q21Q62J / Cisplatin
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14. Wolf JK, Bodurka DC, Gano JB, Deavers M, Ramondetta L, Ramirez PT, Levenback C, Gershenson DM: A phase I study of Adp53 (INGN 201; ADVEXIN) for patients with platinum- and paclitaxel-resistant epithelial ovarian cancer. Gynecol Oncol; 2004 Aug;94(2):442-8
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  • [Title] A phase I study of Adp53 (INGN 201; ADVEXIN) for patients with platinum- and paclitaxel-resistant epithelial ovarian cancer.
  • This phase I study was designed as a toxicity study of multiple dosing of Adp53 administered by intraperitoneal (IP) delivery to patients with ovarian cancer.
  • EXPERIMENTAL DESIGN: Eligibility criteria included patients with platinum- and paclitaxel-resistant metastatic epithelial ovarian cancer; a Zubrod performance status of 0, 1, or 2; and adequate bone marrow, liver, and renal function.
  • All but one patient received two or more chemotherapy regimens before study entry.
  • Two of 17 patients (12%) had a mixed response.
  • With a negative randomized trial of ovarian cancer in front-line treatment that included an adenovirus p53 plus chemotherapy, we feel that further refinement of gene therapy is required before additional trials are undertaken.
  • OVERVIEW SUMMARY: Ovarian cancer is the most lethal of the gynecologic malignancies.
  • Because of this, regional intraperitoneal therapy for ovarian cancer is attractive.
  • Mutation and/or deletion of the p53 gene are common in advanced ovarian cancer.
  • In this study, we have tested the safety and practicality of using an adenovirus-mediated delivery of the p53 gene to patients with chemo-refractory ovarian cancer via an intraperitoneal catheter.
  • The best mechanism of delivery of gene therapy for patients is unclear, however, no severe toxicities were found using an adenovirus-mediated p53 gene in this group heavily pretreated patients with recurrent ovarian cancer.
  • [MeSH-major] Genes, p53 / genetics. Genetic Therapy / methods. Ovarian Neoplasms / therapy
  • [MeSH-minor] Adenoviruses, Human / genetics. Adult. Aged. Drug Resistance, Neoplasm. Feasibility Studies. Female. Humans. Injections, Intraperitoneal. Middle Aged. Organoplatinum Compounds / pharmacology. Paclitaxel / pharmacology


15. Nagai Y, Kishimoto T, Nikaido T, Nishihara K, Matsumoto T, Suzuki C, Ogishima T, Kuwahara Y, Hurukata Y, Mizunuma M, Nakata Y, Ishikura H: Squamous predominance in mixed-epithelial papillary cystadenomas of borderline malignancy of mullerian type arising in endometriotic cysts: a study of four cases. Am J Surg Pathol; 2003 Feb;27(2):242-7
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  • [Title] Squamous predominance in mixed-epithelial papillary cystadenomas of borderline malignancy of mullerian type arising in endometriotic cysts: a study of four cases.
  • Mixed-epithelial papillary cystadenoma of borderline malignancy of mullerian type (MEBMM) is composed of a mixture of mullerian epithelial types, such as mucinous, serous, endometrioid, and squamous.
  • The clinical stages were Ia (two cases), Ic (one case), and IV based on the presence of tumor cells in pleural fluid (one case).
  • In one of those three cases, there was no recurrence after undergoing surgery only; in the other two of those three cases, there was no recurrence after undergoing surgery and receiving postoperative chemotherapy.
  • The tumors were mainly composed of a proliferation of squamous-type epithelium, with minor foci containing a mixture of other mullerian-type epithelia, especially mucinous.
  • The differential diagnosis of MEBMMSO includes proliferating Brenner tumors.
  • [MeSH-major] Cystadenoma, Papillary / pathology. Ovarian Neoplasms / pathology
  • [MeSH-minor] Biomarkers, Tumor / blood. Chemotherapy, Adjuvant. Female. Humans. Middle Aged. Neoplasm Recurrence, Local. Neoplasm Staging

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  • (PMID = 12548172.001).
  • [ISSN] 0147-5185
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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16. Schilder JM, Thompson AM, DePriest PD, Ueland FR, Cibull ML, Kryscio RJ, Modesitt SC, Lu KH, Geisler JP, Higgins RV, Magtibay PM, Cohn DE, Powell MA, Chu C, Stehman FB, van Nagell J: Outcome of reproductive age women with stage IA or IC invasive epithelial ovarian cancer treated with fertility-sparing therapy. Gynecol Oncol; 2002 Oct;87(1):1-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Outcome of reproductive age women with stage IA or IC invasive epithelial ovarian cancer treated with fertility-sparing therapy.
  • OBJECTIVES: The purpose of this study was to determine the recurrence rate, survival, and pregnancy outcome in patients with Stage IA and Stage IC invasive epithelial ovarian cancer treated with unilateral adnexectomy.
  • METHODS: A multi-institutional retrospective investigation was undertaken to identify patients with Stage IA and IC epithelial ovarian cancer who were treated with fertility-sparing surgery.
  • All patients with ovarian tumors of borderline malignancy were excluded.
  • Long-term follow-up was obtained through tumor registries and telephone interviews.
  • The time and sites of tumor recurrence, patient survival, and pregnancy outcomes were recorded for every patient.
  • RESULTS: Fifty two patients with Stage I epithelial ovarian cancer treated from 1965 to 2000 at 8 participating institutions were identified.
  • Cell type was distributed as follows: mucinous, 25; serous, 10; endometrioid, 10; clear cell, 5; and mixed, 2.
  • Twenty patients received adjuvant chemotherapy (mean 6 courses, range 3-12 courses).
  • Five patients developed tumor recurrence 8-78 months after initial surgery.
  • Sites of recurrence were as follows: contralateral ovary, 3; peritoneum, 1; and lung, 1.
  • At present, 50 patients are alive without evidence of disease and 2 have died of disease 13 and 97 months after initial treatment.
  • CONCLUSION: The long-term survival of patients with Stage IA and IC epithelial ovarian cancer treated with unilateral adnexectomy is excellent.
  • Fertility-sparing surgery should be considered as a treatment option in women with Stage I epithelial ovarian cancer who desire further childbearing.
  • [MeSH-major] Fertility. Ovarian Neoplasms / surgery
  • [MeSH-minor] Adolescent. Adult. Child. Combined Modality Therapy. Epithelial Cells / pathology. Female. Humans. Neoplasm Recurrence, Local / pathology. Neoplasm Staging. Ovariectomy / methods. Pregnancy. Pregnancy Complications, Neoplastic. Pregnancy Outcome. Retrospective Studies. Survival Rate. Treatment Outcome


17. Khalique L, Ayhan A, Weale ME, Jacobs IJ, Ramus SJ, Gayther SA: Genetic intra-tumour heterogeneity in epithelial ovarian cancer and its implications for molecular diagnosis of tumours. J Pathol; 2007 Feb;211(3):286-95
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  • [Title] Genetic intra-tumour heterogeneity in epithelial ovarian cancer and its implications for molecular diagnosis of tumours.
  • Genetic analysis of solid tumours using DNA or cDNA expression microarrays may enable individualized treatment based on the profiles of genetic changes that are identified from each patient.
  • This could result in better response to adjuvant chemotherapy and, consequently, improved clinical outcome.
  • So far, most research studies that have tested the efficacy of such an approach have sampled only single areas of neoplastic tissue from tumours; this assumes that the genetic profile within solid tumours is homogeneous throughout.
  • The aim of this study was to evaluate the extent of genetic intra-tumour heterogeneity (ITH) within a series of epithelial ovarian cancers.
  • Several different regions (five to eight regions) of tumour tissue from 16 grade 3, serous epithelial ovarian cancers were analysed for genetic alterations using a combination of microsatellite analysis and single nucleotide polymorphism (SNP) analysis, in order to establish the extent of ITH.
  • Maximum parsimony tree analysis was applied to the genetic data from each tumour to evaluate the clonal relationship between different regions within tumours.
  • Extensive ITH was identified within all ovarian cancers using both microsatellite and SNP analysis.
  • Evolutionary analysis of microsatellite data suggested that the origin of all tumours was monoclonal, but that subsequent clonal divergence created mixed populations of genetically distinct cells within the tumour.
  • SNP analysis suggested that ITH was not restricted to random genetic changes, but affected genes that have an important functional role in ovarian cancer development.
  • The frequent occurrence of ITH within epithelial ovarian cancers may have implications for the interpretation of genetic data generated from emerging technologies such as DNA and mRNA expression microarrays, and their use in the clinical management of patients with ovarian cancer.
  • The basis of genetic ITH and the possible implications for molecular approaches to clinical diagnosis of ovarian cancers may apply to other tumour types.
  • [MeSH-major] Adenocarcinoma, Papillary / genetics. Gene Expression Regulation, Neoplastic. Genetic Heterogeneity. Ovarian Neoplasms / genetics. Polymorphism, Single Nucleotide
  • [MeSH-minor] Alleles. Disease Progression. Female. Genotype. Humans. Microsatellite Instability. Microsatellite Repeats. Neoplasm Staging

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  • [Copyright] Copyright 2006 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
  • (PMID = 17154249.001).
  • [ISSN] 0022-3417
  • [Journal-full-title] The Journal of pathology
  • [ISO-abbreviation] J. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
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18. Merideth MA, Cliby WA, Keeney GL, Lesnick TG, Nagorney DM, Podratz KC: Hepatic resection for metachronous metastases from ovarian carcinoma. Gynecol Oncol; 2003 Apr;89(1):16-21
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  • [Title] Hepatic resection for metachronous metastases from ovarian carcinoma.
  • OBJECTIVE: Hepatic resection for recurrent ovarian carcinoma is controversial because of the paucity of relevant published data.
  • The principles of cytoreduction before chemotherapy suggest that resection of measurable liver lesions in properly selected patients would be beneficial.
  • To determine the effect of resection of metachronous liver metastases on morbidity and survival, we reviewed our experience with this treatment.
  • METHODS: Medical records were reviewed retrospectively for all patients who had anatomic hepatic resection for metachronous parenchymal liver metastases from ovarian carcinoma (epithelial or malignant mixed Müllerian tumors) at Mayo Clinic from 1976 to 1999.
  • RESULTS: We identified 26 patients (median age at hepatic resection, 62 years; range, 39-75 years) who had hepatic resection requiring complete segmentectomies or more extensive hepatic surgery for recurrent ovarian carcinoma.
  • Factors significantly associated with improved disease-related survival were consistent with known prognostic factors associated with cytoreductive surgery, including more than 12 months since original diagnosis (27.3 vs 5.7 months, P = 0.004) and less than or equal to 1 cm of residual disease after hepatic resection (27.3 vs 8.6 months, P = 0.031).
  • [MeSH-major] Liver Neoplasms / secondary. Liver Neoplasms / surgery. Neoplasm Recurrence, Local / pathology. Neoplasms, Second Primary / secondary. Neoplasms, Second Primary / surgery. Ovarian Neoplasms / pathology
  • [MeSH-minor] Adult. Aged. Female. Humans. Middle Aged. Neoplasm Staging. Retrospective Studies. Treatment Outcome

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  • (PMID = 12694649.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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19. Kommoss F, Kommoss S, Eichhorn J, Schmidt D: [Transitional cell carcinoma of the ovary. Morphological and clinical features]. Pathologe; 2007 May;28(3):209-14
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  • [Title] [Transitional cell carcinoma of the ovary. Morphological and clinical features].
  • Transitional cell carcinoma of the ovary (TCC-O) is a less common type of malignant surface epithelial-stromal tumor of the ovary, still with uncertain incidence.
  • Histologically, TCC-O resembles urothelial carcinoma of the urinary system, and by definition does not contain a Brenner tumor component.
  • TCC-O may not be a bona fide urothelial neoplasm, however, but rather a lesion of the Müllerian type derived from the ovarian surface epithelium.
  • This notion is supported by the existence of mixed tumors consisting of TCC-O and other histological types of ovarian carcinoma, as well as the observation that TCC-O has a Müllerian type but not a urothelial-like immunohistochemical profile.
  • Besides metastatic urothelial carcinoma of the urinary tract, the other types of ovarian carcinoma, as well as sex cord-stromal tumors such as adult granulosa cell tumors, have to be considered in the differential diagnosis of TCC-O.
  • A recent analysis of a large series of advanced ovarian carcinomas treated by radical surgery and postoperative chemotherapy confirms studies that had suggested that TCC-O has a better prognosis (with current treatment) than that of the other histological types of ovarian carcinoma.
  • [MeSH-major] Carcinoma, Transitional Cell / pathology. Ovarian Neoplasms / pathology
  • [MeSH-minor] Biomarkers, Tumor / analysis. Combined Modality Therapy. Diagnosis, Differential. Female. Humans. Immunohistochemistry

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  • (PMID = 17447068.001).
  • [ISSN] 0172-8113
  • [Journal-full-title] Der Pathologe
  • [ISO-abbreviation] Pathologe
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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