Survival Impact of Secondary Cytoreductive Surgery for Recurrent Ovarian Cancer in an Asian Population

Objective: The aim of this study was to evaluate the role of secondary cytoreductive surgery in Asian patients with recurrent ovarian cancer and to assess prognostic variables on overall post-recurrence survival time. Methods: We conducted a retrospective review of patients with recurrent ovarian cancer who underwent secondary cytoreduction at the Gynaecological Cancer Center at the KK Women’s and Children’s Hospital, Singapore, between 1999 and 2009. Eligible patients included those who had been firstly treated by primary cytoreductive surgery and followed by adjuvant chemotherapy and had a period of clinical remission of at least six months and subsequently underwent secondary cytoreductive surgery for recurrence. Univariate analysis was performed to evaluate various variables influencing the overall survival. Results: Twenty-five patients met our eligibility criteria. The median age was 52 years (range=31–78 years). The median time from completion of primary treatment to recurrence was 25.1 months (range=6.4–83.4). Secondary cytoreduction was optimal in 20 of 25 patients (80%). The median follow-up duration was 38.9 months (range=17.8–72.4) and median overall survival time was 33.1 months (95% confidence interval, 15.3–undefined.). Ten (40.0%) patients required bowel resection, but no end colostomy was performed. One (4.0%) patient had wedge resection of the liver, one (4.0%) had a distal pancreatectomy, one (4.0%) had a unilateral nephrectomy, and one (4.0%) had adrenalectomy. There were no operative deaths. The overall survival of patients who responded to secondary cytoreductive surgery and adjuvant chemotherapy was significantly longer than those patients who did not respond to the treatment. Of those patients who responded to the surgical management, patients with clear cell carcinoma fared well compared to those with the endometrioid, mucinous adenocarcinoma, and papillary serous type (p<0.001). Complete secondary cytoreductive surgery appeared to have some relationship to overall survival but was not statistically significant. Conclusion: In carefully selected patients with recurrent ovarian cancer, optimal cytoreductive surgery is possible and in a subgroup of patients who respond to surgery and chemotherapy survival is significantly longer

Global Impact of the COVID-19 Pandemic on Orthopedics and the Implications of Telemedicine: A Systematic Review of the Literature

This study aimed to systematically review the literature on the impact of the coronavirus disease (COVID-19) pandemic on the orthopedics field by focusing on multiple aspects, including orthopedic training and application, performance, work loading, change of practice, research work, and other psychological factors. Published articles were searched using the PubMed database. Articles were selected in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Of 58 studies published between 1 January 2020 and 1 October 2021, 57 peer-reviewed original articles were included. Nearly 90% of students experienced an impact of the pandemic on application. The impact on training stemmed from redeployment rates of 20.9–23.1%. The rate of emergency or outpatient visits decreased from 18% to 58.6%. The rates of all surgeries or emergency surgeries decreased by 15.6–49.4%, while the rates of elective surgeries decreased by 43.5–100%. The rate of work loading ranged from 33% to 66%. Approximately 50–100% of surgeons had a change of practice. A total of 40.5% of orthopedic surgeons experienced mild psychological pressure. Approximately 64% had stopped research participant recruitment. Most of the included studies were conducted in Europe, followed by Asia and North America. It is suggested orthopedic surgeons prepare more sufficient, flexible, and reservable staffing measures, proper preventive strategies and surgical scheduling algorithms, and set up dedicated venues and equipment for routine telemedicine with staff training for virtual teaching or consultations in case of future impacts on orthopedics

Uterine leiomyosarcoma in asian patients: Validation of the revised federation of gynecology and obstetrics staging system and identification of prognostic classifiers

10.1634/theoncologist.2012-0124Oncologist17101286-1293OCOL

Clinicopathologic features by HER2 status.

<p>Abbreviation: OGD, oesophagogastroduodenoscopy.</p

Progression-free survival analysis.

<p>Abbreviation: HR, hazard ratio; CI, confidence interval; NE, not estimable.</p>a<p>P values for age at diagnosis, CA125 and HER2 amplification ratio were based on Wald test, and P values for all other variables were based on the log-rank test.</p>b<p>Based on Wald test.</p>c<p>To interpret with caution as there were <10 deaths in the fitted multivariable model.</p

HER2 amplification, age, and frequency of cancers reported in family history of mEOC.

<p>(A) Previous genome-wide copy number alteration study on a small cohort of mEOC (n = 17) showed significant amplification of HER2. x-axis shows chromosomes 1-X, with alternating gray blocks. y-axis is the −log(q) where q is the false discovery rate. Positive values indicate amplification and negative values are deletion. (B) Age distribution was of normal distribution overall and for both HER2+ and HER2− cases. The median age was 48.3 (range: 15 to 89 years). (C) Frequency of reported cancers in family history. Majority of cancers were of breast and gastrointestinal (colon/stomach) origin. Note: some patients reported more than 1 case of cancer in family history.</p

Survival outcomes by HER2 status.

<p>No statistical significance was observed for HER2+ compared to HER2− cases in (A) overall survival (log-rank p = 0.249), and (B) progression free survival (log-rank p = 0.120).</p

Asian society of gynecologic oncology workshop 2010

This workshop was held on July 31-August 1, 2010 and was organized to promote the academic environment and to enhance the communication among Asian countries prior to the 2nd biennial meeting of Australian Society of Gynaecologic Oncologists (ASGO), which will be held on November 3-5, 2011. We summarized the whole contents presented at the workshop. Regarding cervical cancer screening in Asia, particularly in low resource settings, and an update on human papillomavirus (HPV) vaccination was described for prevention and radical surgery overview, fertility sparing and less radical surgery, nerve sparing radical surgery and primary chemoradiotherapy in locally advanced cervical cancer, were discussed for management. As to surgical techniques, nerve sparing radical hysterectomy, optimal staging in early ovarian cancer, laparoscopic radical hysterectomy, one-port surgery and robotic surgery were introduced. After three topics of endometrial cancer, laparoscopic surgery versus open surgery, role of lymphadenectomy and fertility sparing treatment, there was a special additional time for clinical trials in Asia. Finally, chemotherapy including neo-adjuvant chemotherapy, optimal surgical management, and the basis of targeted therapy in ovarian cancer were presented