Invasive recurrence of serous borderline ovarian tumor as multifocal lymphadenopathy 25years after initial diagnosis

► We present the case with the latest reported recurrence of low malignant potential ovarian tumor. ► Borderline ovarian tumors have the potential for delayed recurrence that is not always salvageable surgically. ► Optimization of surveillance strategies and lifelong follow up is required for these patients

Case report: Minimally invasive primary debulking surgery for advanced stage epithelial ovarian cancer

The surgical management of advanced ovarian cancer has historically emphasized an open technique, but advances in minimally invasive surgery (MIS) have led to its increasing use in ovarian cancer. Most research has focused on the utility of MIS in the interval debulking setting. Here, we present a case of a 38-year-old patient with incidentally diagnosed advanced stage ovarian cancer. We describe the robotic surgery techniques used to achieve complete primary cytoreduction, including resection of disease on the diaphragm. The patient has completed standard adjuvant chemotherapy and maintenance treatment and remains without evidence of disease for more than 2 years. This case details the techniques utilized to achieve complete cytoreduction including trocar placement, robotic instrument preference, and rotation of the robotic boom. This patient has had successful perioperative and oncologic outcomes, and her case highlights the role for minimally invasive primary debulking surgery for select patients with advanced ovarian cancer

Should tumor VEGF expression influence decisions on combining low-dose chemotherapy with antiangiogenic therapy? Preclinical modeling in ovarian cancer

Because of its low toxicity, low-dose (LD) chemotherapy is ideally suited for combination with antiangiogenic drugs. We investigated the impact of tumor vascular endothelial growth factor A (VEGF-A) expression on the efficacy of LD paclitaxel chemotherapy and its interactions with the tyrosine kinase inhibitor SU5416 in the ID8 and ID8-Vegf models of ovarian cancer. Functional linear models using weighted penalized least squares were utilized to identify interactions between Vegf, LD paclitaxel and antiangiogenic therapy. LD paclitaxel yielded additive effects with antiangiogenic therapy against tumors with low Vegf expression, while it exhibited antagonism to antiangiogenic therapy in tumors with high Vegf expression. This is the first preclinical study that models interactions of LD paclitaxel chemotherapy with antiangiogenic therapy and tumor VEGF expression and offers important lessons for the rational design of clinical trials

Increased immunogenicity of surviving tumor cells enables cooperation between liposomal doxorubicin and IL-18

<p>Abstract</p> <p>Background</p> <p>Liposomal doxorubicin (Doxil) is a cytotoxic chemotherapy drug with a favorable hematologic toxicity profile. Its active drug, doxorubicin, has interesting immunomodulatory properties. Here, the effects of Doxil on surviving tumor cell immunophenotype were investigated.</p> <p>Methods</p> <p>Using ID8 murine ovarian cancer cells, the immunomodulatory effects of Doxil were studied by measuring its impact on ovarian cancer cell expression of MHC class-I and Fas, and susceptibility to immune attack <it>in vitro</it>. To evaluate the ability of Doxil to cooperate with cancer immunotherapy, the interaction between Doxil and Interleukin 18 (IL-18), a pleiotropic immunostimulatory cytokine, was investigated <it>in vivo </it>in mice bearing ID8-Vegf tumors.</p> <p>Results</p> <p>While Doxil killed ID8 tumor cells in a dose-dependent manner, tumor cells escaping Doxil-induced apoptosis upregulated surface expression of MHC-I and Fas, and were sensitized to CTL killing and Fas-mediated death <it>in vitro</it>. We therefore tested the hypothesis that the combination of immunotherapy with Doxil provides positive interactions. Combination IL-18 and Doxil significantly suppressed tumor growth compared with either monotherapy <it>in vivo </it>and uniquely resulted in complete tumor regression and long term antitumor protection in a significant proportion of mice.</p> <p>Conclusion</p> <p>These data demonstrate that Doxil favorably changes the immunophenotype of a large fraction of the tumor that escapes direct killing thus creating an opportunity to expand tumor killing by immunotherapy, which can be capitalized through addition of IL-18 <it>in vivo</it>.</p

Authors, texts, themes: a contribution to the study of the post-hagiographical literature

The study of hagiology is the proof of the living experience of the Church as the fruits of the holy spiritual presence in the world are narrated and described. The study focuses on highlighting the hagiological literature of the post-Byzantine era, i.e. from the landmark date of the fall of Constantinople in the year 1453 to the date marking the beginning of the Greek revolution in the year 1821. The promotion and recording of the hagiological works of this period with a parallel examination of the biographical notes of the hagiologists of those authors who created this literature is the main purpose of this work. Moreover, in the second part, an analytical examination of the collected data is attempted, resulting in its quantification by category. This quantification contributes to the research as it constitutes a methodological tool for managing and classifying the texts of the examined period, in such a way that the reader is informed about the hagiological trends of each century separately. As a result, the hagiology of the period focuses mainly on the fact of holiness and the effort to imitate the heroes of the faith either in the first golden millennium of Christianity, which is reproduced and largely fermented in the given era or in the present bloody years with the new martyrs. Although the centuries of the Turkish rule are considered to be largely dark, it is found through research that Christianity, despite the realistic difficulties of living conditions and the consequent difficulty of developing spirituality, flourishes and gives such sweet and pleasant fruits that encapsulate and highlight both the evangelical message as well as the whole theological tradition of the first millennium, with the emphasis being on that of the East, due to the great schism of the Church in the year 1054.Η μελέτη της αγιολογίας αποτελεί την απόδειξη της ζώσας εμπειρίας της Εκκλησίας καθότι ιστορούνται και περιγράφονται οι καρποί της αγιοπνευματικής παρουσίας στον κόσμο. Κέντρο της παρούσας μελέτης είναι η ανάδειξη της αγιολογικής γραμματείας της μεταβυζαντινής εποχής, ήτοι από την ημερομηνία ορόσημο της άλωσης της Κωνσταντινούπολης το έτος 1453 μέχρι την ημερομηνία της έναρξης της ελληνικής επανάστασης το έτος 1821. Η ανάδειξη και η καταγραφή των αγιολογικών έργων της περιόδου με την παράλληλη εξέταση των βιογραφικών σημειωμάτων των αγιολόγων εκείνων συγγραφέων που φιλοπόνησαν τούτη τη γραμματεία είναι ο μείζων σκοπός του πονήματος. Ωστόσο, στο δεύτερο μέρος επιχειρείται μια αναλυτική εξέταση των δεδομένων που συλλέχθηκαν με αποτέλεσμα την ποσοστοποίηση ανά κατηγορίες. Η ποσοστοποίηση αυτή συμβάλλει στην έρευνα ως ένα μεθοδολογικό εργαλείο διαχείρισης και ταξινόμησης των κειμένων της εξεταζόμενης περιόδου, με τέτοιο τρόπο ούτως ώστε ο αναγνώστης να πληροφορείται για τις αγιολογικές τάσεις κάθε αιώνα ξεχωριστά. Η αγιολογία της περιόδου εκ του αποτελέσματος επικεντρώνεται κυρίως στο γεγονός της αγιότητας και την προσπάθεια μίμησης των ηρώων της πίστης είτε της πρώτης χρυσής χιλιετίας του Χριστιανισμού, η οποία αναπαράγεται και εν πολλοίς ζυμώνεται στην εποχή είτε των παρόντων αιμάτινων χρόνων με τους νεομάρτυρες. Παρόλο που οι αιώνες της τουρκοκρατίας θεωρούνται εν πολλοίς σκοτεινοί διαπιστώνεται μέσω της έρευνας ότι ο Χριστιανισμός παρά τις ρεαλιστικές δυσκολίες των συνθηκών διαβίωσης και της συνακόλουθης δυσχέρειας ανάπτυξης πνευματικότητας, ανθίζει και δίνει γλυκείς και εύχυμους καρπούς τέτοιους που συμποσώνουν και αναδεικνύουν το ευαγγελικό μήνυμα και όλη σύσσωμη τη θεολογική παράδοση της πρώτης χιλιετίας, φυσικά με έμφαση εκείνης της Ανατολής, λόγω του μεγάλου σχίσματος της Εκκλησίας το έτος 1054

Video_1_Case report: Minimally invasive primary debulking surgery for advanced stage epithelial ovarian cancer.mp4

The surgical management of advanced ovarian cancer has historically emphasized an open technique, but advances in minimally invasive surgery (MIS) have led to its increasing use in ovarian cancer. Most research has focused on the utility of MIS in the interval debulking setting. Here, we present a case of a 38-year-old patient with incidentally diagnosed advanced stage ovarian cancer. We describe the robotic surgery techniques used to achieve complete primary cytoreduction, including resection of disease on the diaphragm. The patient has completed standard adjuvant chemotherapy and maintenance treatment and remains without evidence of disease for more than 2 years. This case details the techniques utilized to achieve complete cytoreduction including trocar placement, robotic instrument preference, and rotation of the robotic boom. This patient has had successful perioperative and oncologic outcomes, and her case highlights the role for minimally invasive primary debulking surgery for select patients with advanced ovarian cancer.</p

Video_2_Case report: Minimally invasive primary debulking surgery for advanced stage epithelial ovarian cancer.mp4

The surgical management of advanced ovarian cancer has historically emphasized an open technique, but advances in minimally invasive surgery (MIS) have led to its increasing use in ovarian cancer. Most research has focused on the utility of MIS in the interval debulking setting. Here, we present a case of a 38-year-old patient with incidentally diagnosed advanced stage ovarian cancer. We describe the robotic surgery techniques used to achieve complete primary cytoreduction, including resection of disease on the diaphragm. The patient has completed standard adjuvant chemotherapy and maintenance treatment and remains without evidence of disease for more than 2 years. This case details the techniques utilized to achieve complete cytoreduction including trocar placement, robotic instrument preference, and rotation of the robotic boom. This patient has had successful perioperative and oncologic outcomes, and her case highlights the role for minimally invasive primary debulking surgery for select patients with advanced ovarian cancer.</p