OBJECTIVES: This study was conducted to evaluate the relationship between HPV infection status and clinicopathologic parameters and to define the predictive parameters including treatment modality affecting survival in patients with vulva cancer. MATERIALS AND METHODS: Data were collected from 30 patients who were diagnosed for vulva carcinoma from Jan 1991 to June 2005. The cancer-related variables including age, stage, cell type, lesion size, multifocality, lymph node involvement, treatment modality and HPV infection were evaluated by reviewing medical records. Statistical analysis was performed by chi-square, log rank test and Cox proportional hazards analysis using SPSS program. RESULTS: Among all 30 patients of vulva carcinoma, HPV infection status was tested in 17 patients. And of these patients, 11 (64.7%) had positive HPV infection. Although there was no survival difference according to HPV infection status, patients with positive HPV infection had significantly more positive lymph nodes (p=0.04). Among all the cancer-related variables, radiation therapy was significantly more associated with poor overall survival than surgery (p=0.007). And squamous cell type was related with decreased overall survival although not statistically significant (p=0.06). However, on the basis of multivariate analysis, there was no significant independent prognostic factor affecting overall survival for vulva carcinoma. CONCLUSIONS: Although this study didn't show any direct relationship between HPV infection and prognosis, HPV infected patients were significantly associated with lymph node metastasis. And the surgery might be an important treatment modality affecting overall survival in patients with vulva carcinoma.
Humans ; Humans* ; Lymph Nodes ; Medical Records ; Multivariate Analysis ; Neoplasm Metastasis ; Papillomavirus Infections* ; Prognosis ; Vulva* ; Vulvar Neoplasms

OBJECTIVE: To determine whether characteristics of sperm motility obtained by computer-assisted sperm analysis (CASA) could predict pregnancy after intrauterine insemination (IUI) in couples with unexplained infertility. METHODS: Three hundred eighty-three cycles of intrauterine insemination with superovulation were retrospectively analyzed. Semen analysis was performed with CASA before and after swim-up and the parameters were compared between pregnant and non-pregnant women. RESULTS: The pregnancy rate per cycle was 14.1%. Pregnant and non-pregnant women were comparable in terms of age, infertility duration, the number of dominant follicles. While sperm concentration, motility, and parameters such as average path velocity (VAP) and percentage rapid (RAPID) before semen preparation were significantly different between the pregnancy and non-pregnancy groups, there were no differences in sperm parameters when comparing the two groups after preparation. Using a receiver operating characteristic curve to measure sensitivity and specificity, the optimal threshold value for the predictors of pregnancy was revealed to be a concentration of > or =111x10(6)/mL, a motility of > or =51.4%, and RAPID > or =30.1% before preparation for IUI. CONCLUSION: Sperm parameters including concentration, motility, and RAPID before sperm preparation could have predictive value for pregnancy outcome after intrauterine insemination with superovulation in couples with unexplained infertility, and would be helpful when counseling patients before they make the decision to proceed with IVF/ICSI-ET.
Counseling ; Family Characteristics ; Female ; Humans ; Image Processing, Computer-Assisted ; Infertility ; Insemination ; Insemination, Artificial ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Retrospective Studies ; ROC Curve ; Semen ; Semen Analysis ; Sensitivity and Specificity ; Sperm Motility ; Spermatozoa ; Superovulation

OBJECTIVE: To determine whether characteristics of sperm motility obtained by computer-assisted sperm analysis (CASA) could predict pregnancy after intrauterine insemination (IUI) in couples with unexplained infertility. METHODS: Three hundred eighty-three cycles of intrauterine insemination with superovulation were retrospectively analyzed. Semen analysis was performed with CASA before and after swim-up and the parameters were compared between pregnant and non-pregnant women. RESULTS: The pregnancy rate per cycle was 14.1%. Pregnant and non-pregnant women were comparable in terms of age, infertility duration, the number of dominant follicles. While sperm concentration, motility, and parameters such as average path velocity (VAP) and percentage rapid (RAPID) before semen preparation were significantly different between the pregnancy and non-pregnancy groups, there were no differences in sperm parameters when comparing the two groups after preparation. Using a receiver operating characteristic curve to measure sensitivity and specificity, the optimal threshold value for the predictors of pregnancy was revealed to be a concentration of > or =111x10(6)/mL, a motility of > or =51.4%, and RAPID > or =30.1% before preparation for IUI. CONCLUSION: Sperm parameters including concentration, motility, and RAPID before sperm preparation could have predictive value for pregnancy outcome after intrauterine insemination with superovulation in couples with unexplained infertility, and would be helpful when counseling patients before they make the decision to proceed with IVF/ICSI-ET.
Counseling ; Family Characteristics ; Female ; Humans ; Image Processing, Computer-Assisted ; Infertility ; Insemination ; Insemination, Artificial ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Retrospective Studies ; ROC Curve ; Semen ; Semen Analysis ; Sensitivity and Specificity ; Sperm Motility ; Spermatozoa ; Superovulation

Neoplastic plexopathy is usually associated with advanced systemic cancer, regional progression of the primary tumor and complication of cancer treatment including radiotherapy. Lumbosacral plexopathy is most commonly found in colorectal cancer and its symptom begins with leg pain, and thereafter numbness and weakness develops. Radiotherapy is generally considered as the 1st line therapy for metastatic plexopathy and it is also a way to relieve pain. We experienced one case of recurrent cervix cancer with lumbosacral nerve root metastasis after radical abdominal hysterectomy without additional radiation therapy and then we report it together with a brief review of literatures.
Cervix Uteri* ; Colorectal Neoplasms ; Female ; Hypesthesia ; Hysterectomy ; Leg ; Neoplasm Metastasis* ; Radiotherapy ; Uterine Cervical Neoplasms*

OBJECTIVE: Clinical evaluation of tumor size in cervical cancer is often difficult. Digital imaging technique using computer has shown an eye opening progress. Quantitative analysis of tumor size or tumor volume using magnetic resonance imaging (MRI) has been reported as useful in the prediction of prognosis in patients with cervical cancer. The purpose of this study was to evaluate whether quantitative analysis can further improve the efficacy of using MR imaging to predict the prognosis of cervical cancer. METHODS: MRI on 0.5- or 1.5-T scanners was performed in 93 consecutive women with invasive carcinoma of the uterine cervix. Initial tumor diameter and volume were determined on T2-weighted images; volume was calculated by the standard technique of multiplying the sum of the areas by the slice thickness. Patients were treated by radical surgery, radiotherapy, or a concurrent chemoradiotherapy based on clinical International Federation of Gynecology and Obstetrics (FIGO) stage and individual patient criteria. Clinical data (patient age and FIGO stage), MRI-derived tumor dimensions (diameter and volume), and histological findings (tumor invasion depth and histological type) were associated and linked to patient outcome. RESULTS: Tumor volume on MRI was significantly associated with recurrence of cervical cancer (P=0.018). Univariate analysis demonstrated graphically that MRI-derived tumor volume and clinical stage were associated with progression-free survival. CONCLUSION: Our preliminary results suggest that tumor volume, determined by pretreatment MRI, predict progression-free survival for patients with invasive cervical carcinoma. This study reveals the value of MRI as an adjunctive tool to clinical evaluation of invasive cervical cancer.
Cervix Uteri ; Chemoradiotherapy ; Disease-Free Survival ; Female ; Gynecology ; Humans ; Magnetic Resonance Imaging* ; Obstetrics ; Prognosis* ; Radiotherapy ; Recurrence ; Tumor Burden* ; Uterine Cervical Neoplasms