OBJECTIVETo evaluate the clinical characteristics, results of treatment, and prognostic factors of patients diagnosed as having primary female genital system lymphoma (PFGSL).

METHODSTwenty-eight cases of PFGSL were retrospectively surveyed and the clinical data of the patients were analyzed by statistic software package of SPSS10.0 for relation between clinical stage, grade, pathologic feature, treatment and prognosis.

RESULTSThe median age was 44 in the cohort. It mainly involved cervix uterus, ovary and vulva. The disease had a broad range of pathologic type and 20 patients were diagnosed as suffering from B-cell by immunophenotyping, 4 patients were diagnosed as T-cell and 4 patients lesions were indefinite. According to International Working Formulation (IWF), 66.7% belonged to the intermediate-grade. The Ann Arbor stage included: Stage I(E)-12 pts (42.86%), Stage II(E)-3 pts (10.7%), Stage III(E)-1 pts (3.6%) and Stage IV-12 pts (42.86%). According to International Prognostic Index (IPI), 10 were low risk, 9 low-medium risk, 3 medium-high risk and 6 high risk, The median follow-up of the surviving patients was 2.0 years (range: 3 months-17 years), The 5-year overall survival rate was 39.3%. Most patients were given comprehensive treatment without any mode showing significant advantage over the others in survival (P = 0.2554), The involved organs, Ann Arbor stage, IWF and also IPI were significant prognostic factors for survival,

CONCLUSIONThe management of PFGSL should be based on comprehensive treatment including chemotherapy as the chief means. The significant prognostic factors of survival is Ann Arbor stage, IPI, IWF and the kind of involved organs.

Adolescent ; Adult ; Aged ; Child ; Female ; Genital Neoplasms, Female ; mortality ; pathology ; therapy ; Humans ; Lymphoma, Non-Hodgkin ; mortality ; pathology ; therapy ; Middle Aged ; Retrospective Studies ; Survival Rate

This study analyzes the clinical characteristics of the brain metastasis (BM) of gynecologic cancer based on the type of cancer. In addition, the study examines the factors influencing the survival. Total 61 BM patients of gynecologic cancer were analyzed retrospectively from January 2000 to December 2012 in terms of clinical and radiological characteristics by using medical and radiological records from three university hospitals. There were 19 (31.1%) uterine cancers, 32 (52.5%) ovarian cancers, and 10 (16.4%) cervical cancers. The mean interval to BM was 25.4 months (21.6 months in ovarian cancer, 27.8 months in uterine cancer, and 33.1 months in cervical cancer). The mean survival from BM was 16.7 months (14.1 months in ovarian cancer, 23.3 months in uterine cancer, and 8.8 months in cervical cancer). According to a multivariate analysis of factors influencing survival, type of primary cancer, Karnofsky performance score, status of primary cancer, recursive partitioning analysis class, and treatment modality, particularly combined therapies, were significantly related to the overall survival. These results suggest that, in addition to traditional prognostic factors in BM, multiple treatment methods such as neurosurgery and combined chemoradiotherapy may play an important role in prolonging the survival for BM patients of gynecologic cancer.
Adult ; Aged ; Brain/*pathology ; Brain Neoplasms/*mortality/*secondary/therapy ; Chemoradiotherapy ; Female ; Genital Neoplasms, Female/*mortality/pathology/therapy ; Humans ; Middle Aged ; Multivariate Analysis ; Ovarian Neoplasms/mortality/pathology/therapy ; Prognosis ; Retrospective Studies ; Uterine Cervical Neoplasms/mortality/pathology/therapy ; Uterine Neoplasms/mortality/pathology/therapy ; Young Adult

OBJECTIVE: To explore the appropriate treatment of malignant germ cell tumor (MGCT) in the female genital system, and to analyze the factors influencing both therapeutic response and survival outcome. METHODS: A cohort of 230-Chinese women diagnosed with MGCT of the genital system was retrospectively reviewed and prospectively followed. The demographic and pathological features, extent of disease and surgery, treatment efficiency, recurrence and survival were analyzed. RESULTS: MGCTs from different genital origins shared a similar therapeutic strategy and response, except that all eight vaginal cases were infantile yolk sac tumors. The patients' cure rate following the initial treatment, 5-year overall survival and disease-free survival (DFS) were 85.02%, 95.00%, and 86.00%, respectively. Although more extensive excision could enhance the remission rate; it did not improve the patients' survival. Instead, the level of the medical institution, extent of surgery and disease were independent prognostic factors for relapse (p<0.05). Approximately 20% of patients had recurrent or refractory disease, more than half of whom were in remission following secondary cytoreductive surgery with salvage chemotherapy. CONCLUSION: Fertility-sparing surgery with or without standardized PEB/PVB (cisplatin, etoposide/vincristine, and bleomycin) chemotherapy is applicable for female MGCTs of different origins. Comprehensive staging is not required; nor is excessive debulking suggested. Appropriate cytoreduction by surgery and antineoplastic medicine at an experienced medical institution can bring about an excellent prognosis for these patients.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Combined Modality Therapy ; Cytoreduction Surgical Procedures ; Female ; Genital Neoplasms, Female/diagnosis/mortality/pathology/*therapy ; Humans ; Infant ; Middle Aged ; Neoplasms, Germ Cell and Embryonal/diagnosis/mortality/pathology/*therapy ; Prognosis ; Recurrence ; Survival Analysis ; Young Adult