Pathology
maryam deldar; Robab Anbiaee; Masoumeh Keshvari
Articles in Press, Accepted Manuscript, Available Online from 28 February 2024
Abstract
Background: Neoadjuvant chemotherapy (NACT) is used to treat advanced or irreversible breast cancer tumors and increases the possibility of Breast-conserving surgery. There is evidence that pathological complete response (pCR) after NACT reduces the risk of recurrence and increases survival.
Objectives: ...
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Background: Neoadjuvant chemotherapy (NACT) is used to treat advanced or irreversible breast cancer tumors and increases the possibility of Breast-conserving surgery. There is evidence that pathological complete response (pCR) after NACT reduces the risk of recurrence and increases survival.
Objectives: This study aimed to investigate the factors affecting the pathological complete response in breast cancer patients treated with NACT.
Methods: We identified non-metastatic breast cancer patients receiving NACT during 2010–2020. Patients’ and disease characteristics, rates of pCR based on these characteristics were recorded in different subgroups. Analyzes were performed by descriptive and analytical statistics using SPSS.ver26.
Results: 204 patients had mean age of 45.3 years, 32.4% had grade 3, and 89.7% had ductal histology. Overall pCR rate was 33.3% and differed according to disease subtype (p<0.001), receptor status (p<0.001), grade (p=0.015), ki-67 (p=0.004), but not according to age, BMI, menopausal status, tumor size, surgery type after NACT.
Conclusion: In our study, pCR rates are conformed with other studies. Many patients have residual disease following NACT that suggests lower survival or higher risk of recurrence, therefore determining the factors affecting the pathological complete response can help physicians in treatment decisions.
Gynecology Oncology
Kavitha Nagandla; Khine Khine Lwin; Phyu Synn Oo; Thin Thin Win; Afshan Sumera
Articles in Press, Accepted Manuscript, Available Online from 13 March 2024
Abstract
Background and Objective: The management of cervical cancer during pregnancy is significantly challenging. This systematic review summarises the current data on chemotherapy agents (platinum and taxanes) in the management of cervical cancer during pregnancy.
Methods: Two independent investigators searched ...
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Background and Objective: The management of cervical cancer during pregnancy is significantly challenging. This systematic review summarises the current data on chemotherapy agents (platinum and taxanes) in the management of cervical cancer during pregnancy.
Methods: Two independent investigators searched the literature and extracted data from all studies that examined the efficacy and safety of platinum and taxanes in managing cervical cancer during pregnancy. A quantitative synthesis of the published articles was performed and Kaplan–Meier survival curves were estimated to determine the overall and progression-free survival.
Results: Overall, 43 studies with 114 patients were included in this systematic review. All patients received neoadjuvant chemotherapy during pregnancy; the majority received platinum-based chemotherapy. Cisplatin was the main platinum-based chemotherapy agent in 49% (n = 56) of patients, followed by combined platinum and paclitaxel therapy in 36% (n = 41) of patients. A few and two patients were treated with single-agent vincristine and platinum with external beam radiation therapy, respectively. Bleomycin and 5-fluorouracil were administered to two patients. The most frequent complications were grade 2 thrombocytopenia and grade 3 hepatotoxicity in 32 (28%) and 18(20.5%) cases, respectively. The common fetal complications were low birth weight and growth restriction. Chemotherapy was well tolerated by most women in the case group. The progression-free survival was 35% (n = 22).
Conclusion: Platinum and taxane neoadjuvant chemotherapy has proven to be safe and effective in preventing cervical cancer disease progression until definitive surgical treatment.
Gynecology Oncology
Fariba Behnamfar; Safoura Rouholamin; Taj Sadat Allameh; Fahimeh Sabet; Leila Mousavi Seresht; Maryam Nazemi
Volume 7, Issue 1 , September and October 2021, , Pages 32-37
Abstract
Background & Objective: Comparative study between laparoscopic and laparotomy scoring in patients with advanced ovarian cancer.Materials & Methods: This prospective study included 27 patients with advanced ovarian cancer who underwent laparoscopy and laparotomy scoring at hospitals affiliated ...
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Background & Objective: Comparative study between laparoscopic and laparotomy scoring in patients with advanced ovarian cancer.Materials & Methods: This prospective study included 27 patients with advanced ovarian cancer who underwent laparoscopy and laparotomy scoring at hospitals affiliated with Isfahan University of Medical Sciences (IUMS) during 2020 and 2021. The laparoscopic predictive index value (PIV) score (range: 0-14) was calculated for all patients. In patients with PIV scores <8, primary cytoreductive surgery (PCS) was performed, and patients with scores ≥8 were candidates for neoadjuvant chemotherapy (NACT). In the PCS group, laparotomy scoring and surgical findings for each anatomical area were registered for all patients, and concordance between laparoscopy and laparotomy findings was compared. Residual disease following PCS was documented for all patients.Results: A total of 27 patients underwent laparoscopic scoring surgery; 25 patients (92/5%) had a PIV score <8, and two patients (7/5%) had a PIV score ≥8. There was 92% agreement between PIV scores at laparoscopy and laparotomy. Agreements in different anatomical regions in laparoscopy and laparotomy were as follows: involvement of the bowel 76%, mesenteric 92%, liver 96%, omental 92%, diaphragm 96%, stomach 100%, peritoneal carcinomatosis 96%. A laparoscopic PIV score of <8 had a PPV of 84% at predicting R0 at PCS.Conclusion: Laparoscopic scoring is a precise approach in the management of patients with advanced ovarian cancer. Laparoscopic scoring is a screening method of selecting patients for primary surgery or NACT and improved R0 resection at PCS. The present study was designed to assess patients who would gain the maximum benefits from primary surgery.
