The Role of Para-Aortic Lymphadenectomy in the Surgical Staging of Women with Intermediate and High-Risk Endometrial Adenocarcinomas

Objectives:. To characterize clinical outcomes in patients with intermediate or high-risk endometrial carcinoma who underwent surgical staging with or without para-aortic lymphadenectomy. Methods:. This is a retrospective cohort study of patients with intermediate or high-risk endometrial adenocarcinoma who underwent surgical staging with (PPALN group) or without (PLN) para-aortic lymphadenectomy. Data were collected, Kaplan-Meier curves were generated, and univariate and multivariate analyses performed to compare differences in adjuvant therapy, disease recurrence, disease-free survival (DFS), and overall survival (OS). Results. 118 patients were included in the PPALN group and 139 in the PLN group. Patients in the PPALN group were more likely to receive adjuvant vaginal brachytherapy (25.4% versus 11.5%, OR = 2.5, P = 0.03) and less likely to receive adjuvant multimodal combination therapy (17.81% versus 28.8%, OR = 0.28, P = 0.002). DFS was improved in the PLN group as compared to PPALN (80% versus 62%, P = 0.02). OS was equivalent (P = 0.93). Patients in the PPALN group who had less than 10 para-aortic nodes removed were twice as likely to recur than patients who had 10 or more para-aortic nodes or patients in the PLN group (HR 2.08, CI 1.20–3.60, P = 0.009). Conclusions:. Patients in the PLN group were more likely to receive multimodal adjuvant therapy and had better DFS than the PPALN group. Pelvic lymphadenectomy followed by adjuvant radiation and chemotherapy may represent an effective treatment option for patients with intermediate or high-risk disease. If systematic para-aortic lymphadenectomy is performed and less than 10 para-aortic lymph nodes are obtained, multimodality adjuvant therapy should be considered to improve DFS

Nitrasi Asam Sinamat dengan Asam Nitrat Pekat Berkatalis Asam Sulfat Pekat dan Uji Aktivitasnya sebagai Tabir Surya.

iABSTRAKShoni, S. M. 2008. Nitrasi Asam Sinamat dengan Asam Nitrat Pekat BerkatalisAsam Sulfat Pekat dan Uji Aktivitasnya sebagai Tabir Surya. Skripsi,Jurusan Kimia FMIPA Universitas Negeri Malang. Pembimbing: (I)Dr. Sutrisno, M.Si. (II) Dra. Dedek Sukarianingsih, M.Pd., M.Si.Kata kunci: nitrasi, asam nitrosinamat, tabir surya.Kulit merupakan bagian tubuh terluar yang berfungsi sebagai pelindungterhadap faktor-faktor luar seperti radiasi. Salah satu pengaruh yang cukup besaradalah radiasi sinar ultraviolet (UV). Sinar UV (sinar UV-A dan UV-B)memberikan pengaruh yang buruk terhadap kulit manusia, oleh karena itudiperlukan perlindungan tambahan, yaitu dengan memakai tabir surya. Senyawatabir surya merupakan senyawa yang dapat menyerap secara efektif radiasi sinarmatahari terutama pada daerah emisi radiasi UV. Senyawa-senyawa yangmempunyai karakter dapat menyerap radiasi sinar UV adalah senyawa yangmemiliki gugus aromatik yang berkonjugasi dengan ikatan rangkap lain dan ataupasangan elektron bebas, contohnya asam sinamat dan turunannya. Senyawaturunan asam sinamat yang dapat diperoleh dengan cara nitrasi asam sinamat.Penelitian ini bertujuan untuk memperoleh senyawa turunan asam sinamat melaluireaksi nitrasi asam sinamat dan uji aktivitasnya sebagai tabir surya.Penelitian ini merupakan penelitian eksperimental laboratorik yang terdiridari tiga tahap. Tahap pertama adalah mereaksikan asam sinamat dengan asamnitrat pekat berkatalis asam sulfat pekat. Tahap kedua adalah karakterisasi danidentifikasi senyawa hasil nitrasi, karakterisasi meliputi penentuan titik lebur danuji kelarutan. Identifikasi senyawa hasil nitrasi menggunakan spektrofotometerUV dan spektrofotometer inframerah (IR). Tahap ketiga adalah uji aktivitassenyawa hasil nitrasi sebagai bahan tabir surya menggunakan spektrofotometerUV.Hasil Penelitian ini menunjukkan bahwa reaksi nitrasi asam sinamatberkatalis asam sulfat pekat dapat berlangsung yang ditandai dengan berubahnyakarakter dari senyawa awal. Senyawa hasil nitrasi berwujud padat, berwarna putih,melebur pada suhu 241-250oC, larut dalam metanol, aseton, dan dietil eter, tidaklarut dalam air, kloroform, n-heksana, dan etil asetat. Hasil penelitian jugamenunjukkan bahwa senyawa hasil nitrasi dengan konsentrasi 0,5 g/L dalammetanol tidak berpotensi sebagai tabir surya. Berdasarkan hasil penelitian ini,disarankan agar dilakukan penelitian lebih lanjut dengan mengubah konsentrasisenyawa hasil yang digunakan untuk uji aktvitas sebagai tabir surya

Increased number of non-degranulated mast cells in pancreatic ductal adenocarcinoma but not in acute pancreatitis.

Increasing evidence indicates that tumor microenvironment (TME) is crucial in tumor survival and metastases. Inflammatory cells accumulate around tumors and strangely appear to be permissive to their growth. One key stroma cell is the mast cell (MC), which can secrete numerous pro- and antitumor molecules. We investigated the presence and degranulation state of MC in pancreatic ductal adenocarcinoma (PDAC) as compared to acute ancreatitis (AP). Three different detection methods: (a) toluidine blue staining, as well as immunohistochemistry for (b) tryptase and (c) c-kit, were utilized to assess the number and extent of degranulation of MC in PDAC tissue (n=7), uninvolved pancreatic tissue derived from tumor-free margins (n=7) and tissue form AP (n=4). The number of MC detected with all three methods was significantly increased in PDAC, as compared to normal pancreatic tissue derived from tumor-free margins (p<0.05). The highest number of MC was identified by c-kit, 22.2&#x2213;7.5 per high power field (HPF) in PDAC vs 9.7&#x2213;5.1 per HPF in normal tissue. Contrary to MC in AP, where most of the detected MC were found degranulated, MC in PDAC appeared intact. In conclusion, MC are increased in number, but not degranulated in PDAC, suggesting that they may contribute to cancer growth by permitting selective release of pro-tumorogenic molecules

INCREASED NUMBER OF NON-DEGRANULATED MAST CELLS IN PANCREATIC DUCTAL ADENOCARCINOMA BUT NOT IN ACUTE PANCREATITIS

Increasing evidence indicates that tumor microenvironment (TME) is crucial in tumor survival and metastases. Inflammatory cells accumulate around tumors and strangely appear to be permissive to their growth. One key stroma cell is the mast cell (MC), which can secrete numerous pro- and antitumor molecules. We investigated the presence and degranulation state of MC in pancreatic ductal adenocarcinoma (PDAC) as compared to acute pancreatitis (AP). Three different detection methods: (a) toluidine blue staining, as well as immunohistochemistry for (b) tryptase and (c) c-kit, were utilized to assess the number and extent of degranulation of MC in PDAC tissue (n=7), uninvolved pancreatic tissue derived from tumor-free margins (n=7) and tissue form AP (n=4). The number of MC detected with all three methods was significantly increased in PDAC, as compared to normal pancreatic tissue derived from tumor-free margins (p&lt;0.05). The highest number of MC was identified by c-kit, 22.2 +/- 7.5 per high power field (HPF) in PDAC vs 9.7 +/- 5.1 per HPF in normal tissue. Contrary to MC in AP, where most of the detected MC were found degranulated, MC in PDAC appeared intact. In conclusion, MC are increased in number, but not degranulated in PDAC, suggesting that they may contribute to cancer growth by permitting selective release of pro-tumorogenic molecules

The Role of Para-Aortic Lymphadenectomy in the Surgical Staging of Women with Intermediate and High-Risk Endometrial Adenocarcinomas

Objectives. To characterize clinical outcomes in patients with intermediate or high-risk endometrial carcinoma who underwent surgical staging with or without para-aortic lymphadenectomy. Methods. This is a retrospective cohort study of patients with intermediate or high-risk endometrial adenocarcinoma who underwent surgical staging with (PPALN group) or without (PLN) para-aortic lymphadenectomy. Data were collected, Kaplan-Meier curves were generated, and univariate and multivariate analyses performed to compare differences in adjuvant therapy, disease recurrence, disease-free survival (DFS), and overall survival (OS). Results. 118 patients were included in the PPALN group and 139 in the PLN group. Patients in the PPALN group were more likely to receive adjuvant vaginal brachytherapy (25.4% versus 11.5%, OR = 2.5, = 0.03) and less likely to receive adjuvant multimodal combination therapy (17.81% versus 28.8%, OR = 0.28, = 0.002). DFS was improved in the PLN group as compared to PPALN (80% versus 62%, = 0.02). OS was equivalent ( = 0.93). Patients in the PPALN group who had less than 10 para-aortic nodes removed were twice as likely to recur than patients who had 10 or more para-aortic nodes or patients in the PLN group (HR 2.08, CI 1.20-3.60, = 0.009). Conclusions. Patients in the PLN group were more likely to receive multimodal adjuvant therapy and had better DFS than the PPALN group. Pelvic lymphadenectomy followed by adjuvant radiation and chemotherapy may represent an effective treatment option for patients with intermediate or high-risk disease. If systematic para-aortic lymphadenectomy is performed and less than 10 para-aortic lymph nodes are obtained, multimodality adjuvant therapy should be considered to improve DFS