Obstetrics and Gynecology
Shahrzad Sheikhhasani; Maryam Noorzadeh; Mahsa Naemi
Volume 9, Issue 2 , March and April 2024, , Pages 114-124
Abstract
Ovarian cancer is the second most common malignancy in women worldwide, causing many deaths each year. Chemotherapy is one of the most important therapeutic strategies that can increase the survival of these patients; however, one of the problems in chemotherapy is resistance against platinum treatment. ...
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Ovarian cancer is the second most common malignancy in women worldwide, causing many deaths each year. Chemotherapy is one of the most important therapeutic strategies that can increase the survival of these patients; however, one of the problems in chemotherapy is resistance against platinum treatment. Evaluating the effect of platinum- and non-platinum-based chemotherapy in patients with recurrent platinum-resistant ovarian cancer can enhance our view on this issue. The present review article sought to identify the treating efficacy of platinum and non-platinum-based chemotherapy in patients with recurrent platinum-resistant ovarian cancer by searching scientific databases and examining the aspects of platinum resistance in various articles. Oncological results have shown that ovarian cancer is a deadly disease, and most cases are diagnosed when the cancer spreads outside the ovary and often throughout the entire abdomen. On the other hand, in many cases, disease recurrence is associated with drug resistance. The use of a platinum-free interval has played an important role in its treatment efficacy. Understanding the cause of platinum resistance and discovering strategies to reduce drug resistance, especially to new ones, is very important. The present article suggested oncology teams agree on treatment methods and the best treatment approach against platinum resistance in malignant ovarian cancers and offer a better treatment solution by considering innovative strategies.
General Gynecology and Pelvic Floor
Zinat Ghanbari; Leila Pourali; Tahereh Eftekhar; Maryam Deldar Pesikhani; Soudabeh Darvish; Elnaz Ayati; Zahra Lotfi
Volume 8, Issue 5 , September and October 2023, , Pages 431-437
Abstract
Background & Objective: Pelvic organ prolapse (POP) is the herniation of the pelvic organs to or beyond the vaginal wall. Patients with POP may present with specific symptoms like vaginal bulge or pressure or associated symptoms including urinary, defecatory or sexual dysfunction, which could ...
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Background & Objective: Pelvic organ prolapse (POP) is the herniation of the pelvic organs to or beyond the vaginal wall. Patients with POP may present with specific symptoms like vaginal bulge or pressure or associated symptoms including urinary, defecatory or sexual dysfunction, which could negatively affect the quality of life in these patients. This study aimed to assess the surgical outcomes of native-tissue apical suspension by sacrospinous ligament fixation (SSLF) versus uterosacral ligament suspension (ULS).Materials & Methods: This prospective cohort study was conducted to evaluate the outcomes of native-tissue apical suspension for pelvic organ prolapse within one year after the surgery from March 2017 to July 2019 at Imam Khomeini hospital, an academic hospital of Tehran University of Medical Sciences, Tehran, Iran. Inclusion criteria were patients with uterine prolapse at Stage 2 or 3 according to the Pelvic Organ Prolapse Quantification System (POP–Q) who planned for total vaginal hysterectomy and apical suspension using uterosacral ligament suspension (ULS) or sacrospinous ligament fixation (SSLF) with no history of pelvic organ prolapse surgery. The main outcome was surgical consequences within 1 year after surgery.Results: There was no significant difference between the two groups in terms of relapse of anterior, posterior, or apical compartment prolapse. According to the clinical recurrence, although vaginal bulging and pressure were more common in sacrospinous ligament fixation (SSLF) group, the difference was not significant. The number of patients with severe buttock and pelvic pain was significantly higher in the sacrospinous ligament fixation (SSLF) group.Conclusion: sacrospinous ligament fixation (SSLF) and uterosacral ligament suspension (ULS) are both optimal procedures with the same complications and similar surgical outcomes; however, uterosacral ligament suspension (ULS) had lower post-operative pelvic pain, and also the number of retreatment was lower in this group.
Gynecology Oncology
Ghodratolah Maddah; Mohammad Ali Mohammadzadeh Rezae; Zohreh Yousefi; Helena Azimi; Leila Mousavi Seresht
Volume 8, Issue 4 , July and August 2023, , Pages 411-416
Abstract
Background & Objective: Pelvic exenteration and other types of super-radical procedures are the standard of care in the management of patients with recurrent or persistent cervical cancer. But, since the extent of surgery and possible morbidities are considered as an important challenge in low-resource ...
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Background & Objective: Pelvic exenteration and other types of super-radical procedures are the standard of care in the management of patients with recurrent or persistent cervical cancer. But, since the extent of surgery and possible morbidities are considered as an important challenge in low-resource countries, there is need to investigate the outcomes of similar patient.Materials & Methods: The present study tries to report the successful outcome of radical surgery in detailed in 7 cases in a low-economic setting.Results: Total Pelvic exenteration was performed in three but free margin could be achieved by less radical approach in others. All were alive up to 5yaers of follow-up.Conclusion: What we had noticed was the excellent survival prognosis even in curative intent. It is highly recommended, considering the psychological effect of such an extensive surgery and quality of life in these patients with advanced disease and loss of hope.
Pathology
Amal Abd El hafez
Volume 7, Issue 1 , September and October 2021, , Pages 38-44
Abstract
Background & Objective: Adult granulosa cell tumors (AGCTs) are potentially malignant ovarian neoplasms with a well-known tendency for local spread and recurrence, years after prolonged follow-up. This study investigated the immunohistochemical (IHC) expression of SMAD3 (mothers against decapentaplegic ...
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Background & Objective: Adult granulosa cell tumors (AGCTs) are potentially malignant ovarian neoplasms with a well-known tendency for local spread and recurrence, years after prolonged follow-up. This study investigated the immunohistochemical (IHC) expression of SMAD3 (mothers against decapentaplegic homolog 3) in AGCTs to evaluate its association with a number of confirmed AGCT prognostic variables. Prognostic predictors of recurrence in AGCT were further defined.Methods: Upon database search, the clinicopathological data, slides, and paraffin blocks of 35 AGCTs were retrospectively retrieved from archives, then examined histopathologically, staged, and stained immunohistochemically using anti-SMAD3. After H scoring of SMAD3, the clinicopathological associations were investigated in positive- and negative-SMAD3 expression groups using appropriate statistical methods. Regression analysis was performed to define independent predictors of recurrence in AGCT.Results: SMAD3 was actively expressed in the nuclei of 51.4% of AGCTs. It was significantly associated with tumor recurrence, capsular rupture, and size (P < /em>=0.011, 0.018, and 0.028, respectively), but not with age, presentation, laterality, stage, tumor morphological pattern, or mitotic index. Capsular rupture and tumor size were defined as highly significant (P < /em>≤0.001), as well as SMAD3+ve expression and FIGO stage as significant independent predictors of recurrence (P < /em>=0.05 and 0.049, respectively) in AGCT.Conclusion: SMAD3 is actively expressed in the tumor cell nuclei of around one half of AGCTs and this expression associates with high propensity for tumor recurrence, capsular rupture, and increasing tumor size. Along with the other observed independent predictors of recurrence, SMAD3 may provide an outline for direct discovery of new risk-stratification criteria as well as therapeutic targets for AGCTs.
Mojgan Karimi Zarchi; Abolfazl Mehdizadeh Kashi; Leila Allahqoli; Razieh Sadat Tabatabai; Farimah Shamsi; Nafiseh Hashemian Asl
Volume 4, Issue 2 , May and June 2019, , Pages 57-61
Abstract
Background & Objective: This study investigated the recurrence and survival rates of patients with borderline ovarian tumors in Yazd in the last 10 years.
Materials & Methods: This census survival study was performed on 24 patients with borderline ovarian tumors who referred to hospitals ...
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Background & Objective: This study investigated the recurrence and survival rates of patients with borderline ovarian tumors in Yazd in the last 10 years.
Materials & Methods: This census survival study was performed on 24 patients with borderline ovarian tumors who referred to hospitals affiliated to Yazd University of Medical Sciences from 2006 to 2016. A data collection checklist was used as a measurement tool and was completed by the researcher by reviewing the subjects’ medical records. The questionnaire included age, infertility, the number of delivery, contraceptive use, body mass index, time of diagnosis, time to start the treatment, whether alive or not, stage of the disease, the type of pathology, the type of surgery, and postoperative treatment. Data was analyzed by SPSS 16 using descriptive statistics.
Results: The mean age of these 24 patients was 33.58±10.61 and the mean recurrence time was 14±2 months. Sixteen (66.7%) patients had serous tumors and 8 (33.3%) patients had mucinous tumors. Among them, 18 (75%) patients underwent a hysterectomy, 2 (8.3%) patients underwent an oophorectomy and 4 (16.7%) patients underwent both total abdominal hysterectomy (TAH) and oophorectomy. Of the 24 studied patients, 4 patients (16.7%) received medicinal treatment (clomiphene citrate, HCG, HMG) after surgery. Three patients experienced recurrences, all in the contralateral ovary.
Conclusion: The recurrence time of epithelial borderline ovarian tumor was 14±2 months. There was no significant relationship between postoperative medicinal treatment and the recurrence rate.
Nafiseh Faghih; Maliheh Arab
Volume 3, Issue 4 , November and December 2018, , Pages 169-171
Abstract
Background & Objective: Endometrial cancer is one of the most common gynecologic malignancies in developed countries. Survival rate in metastatic endometrial adenocarcinoma recurrence is reduced, and treatment in these patients is mostly palliative. One of the therapeutic options in the endometrial ...
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Background & Objective: Endometrial cancer is one of the most common gynecologic malignancies in developed countries. Survival rate in metastatic endometrial adenocarcinoma recurrence is reduced, and treatment in these patients is mostly palliative. One of the therapeutic options in the endometrial adenocarcinoma recurrence is hormone therapy. The expected response to the hormonal treatment is about 10-20%.
Case Report: This is a case report from 57-year-old woman suffering from stage IA - Grade 1 endometrial cancer, who had vaginal carcinoma recurrence with liver and pulmonary metastasis 5.5 years after the initial treatment. Due to positive hormone receptor and the pathological profile of the tumor, hormone therapy with tamoxifen and megestrol was started. The treatment evaluation revealed complete response within five months with clearance of lung and liver metastatic lesions. There is no evidence of disease and metastases in the patient's examination and imaging after 3 years of starting hormone therapy.
Conclusion: In the case of well-differentiated recurrent and metastatic endometrial cancer, good response to the hormone therapy by the least complications might be achieved.
Azamsadat Mousavi; Mahshid Shooshtari; Setare Nassiri; Abas Ali Aipour; Setare Akhavan; Narges Zamani
Volume 2, Issue 4 , November and December 2017, , Pages 1-5
Abstract
Background: Currently, the prevalence of borderline ovarian tumors (BOT) is increasing, and given the higher diagnosis in the third and fourth decades of life, fertility sparing procedures are widely used. There are important consequences in females with borderline ovarian tumors and number of effective ...
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Background: Currently, the prevalence of borderline ovarian tumors (BOT) is increasing, and given the higher diagnosis in the third and fourth decades of life, fertility sparing procedures are widely used. There are important consequences in females with borderline ovarian tumors and number of effective factors on recurrence and fertility rate.
Methods: In this cohort study, the required information was collected from a file of 43 patients with final pathologic diagnosis of borderline ovarian tumor, who had undertaken fertility sparing surgery at Imam Khomeini Hospital, Tehran University of Medical Sciences, and recurrence rate, fertility rate, and the effect of different variables were studied.
Results: There were significant correlations between oral contraceptive pill (OCP) consumption, serous pathology, micro invasion in pathology, advanced stages, and recurrence rate of BOT, while this relationship was not found between parity, surgical methods (laparotomy and laparoscopy), surgical techniques (cystectomy and USO), papillary projection, and recurrence rate.
Conclusions: Although the recurrence rate was higher in the current research when compared to other previous studies, yet only in one patient, the pattern of recurrence was invasive epithelial carcinoma, thus in the current study the overall survival did not seem to change. The results of this study on fertility rate are comparable to other studies on this issue. Therefore, these methods are recommended for young patients and emphasis should be place on follow-up.
