1.Ovarian Tumors of Low Malignant Potential.
Korean Journal of Gynecologic Oncology and Colposcopy 1993;4(4):97-109
Ouarian tumors of low malignant potential(OTLMP) or borderline tumors account for approximately 10% of all ovarian neaplasms. Borderline tumors have some but not all of the histologic characteristics af ma lignancy : stratification of epitheliial cells, with some degree of nuclear atypia a,nd inereased mitotic actitity but. without stromal invasion. We reviwed 20 published Rnglish written articlea from 1978 to 1992 and Korean gynecologic cancer regestry of 1990. In this review, we tried to concentrate on several debating is sues in OTLMP: 1) What kind of surgery is needed for each stages?, 2) Is postoperative adjuvant t.herapy needed?, 3) Jf needed, which type? Following result were obtained from the besis of 1516 patients with OTLMP. Patients withh OTLMIP are younger than those with invasive ovarian cancers', mean age was in their forties. The majority of patients(74.5%) had stage I disease, and the incidence dropped ahruptly to 9.4% for stage ll, 15.7% for stage III and 0.4% for stage IV. The most cammon histologic subtype was serous(56.7%), followed by muci noua(38.1%), However, interestingly in Korea and Japan, the mucinous type was the most common one. The primary treatment for OTLMP was surgery, and the conservative surgery to preserve fertility in young women was sufficient for stage I disease with careful follow-up. The majority of patients(79.1%) with stage I disease were treated by surgery alone. Adjuvant such as chemotherapy (CT) and/or radiotherapy(RT) could prolong the recurrence of disease a little later, but failed to increase diaease-free survival significantly in stage I disease. In stageII disease, the surgery should be a total abdominal hysterectomy and bilateral salpingo-oophorectomy with multiple sampling of the peritoneal cavity. About a third of patients with stageII disease received no adjuvant therapy and the others received CT and/or RT, however, there was no difference in outcome of recurrence and survival. In advanced stage. 15% of patients received no adjuvant therapy after initial debulking surgery, and the rest of patients received CT and/or RT. No differences in recurrence and survival between each groups were noticed , too. The status of second-look laparotomy(SLL) did not depend on the stage of the disease. Positive rate of SLL for stage I diaease was not statistically different from that for the combined stages II-IV. Survival for stage I at 5 years was reported to range from 80 to 100%, and even stage III had survival ranging from 64 to 96%. Long-term survival at 15~20 years was also good. Although it is quite difficult to make conclusions because of the lack of prospective randomized studies from this review, it appears clear that surgical removal of the tumor and careful follow-up of patients are all that are necessary in stage I disease and further multi-center prospective study for the effect of adjuvant therapy in advanced disease is definitely needed.
Drug Therapy
;
Female
;
Fertility
;
Follow-Up Studies
;
Humans
;
Hysterectomy
;
Incidence
;
Japan
;
Korea
;
Mucins
;
Peritoneal Cavity
;
Prospective Studies
;
Recurrence
2.Flow cytometric analysis of DNA patterns in carcinoma of the uterine cervix.
Korean Journal of Obstetrics and Gynecology 1991;34(9):1254-1260
No abstract available.
Cervix Uteri*
;
DNA*
;
Female
3.Early Diagnosis of Ovarian Cancer.
Korean Journal of Gynecologic Oncology and Colposcopy 1991;2(1):1-10
No abstract available.
Early Diagnosis*
;
Ovarian Neoplasms*
4.Clinical analysis of the effect of maternal age on primary cesarean birth rate.
Ahm KIM ; In Sik LEE ; Jung Eun MOK
Korean Journal of Perinatology 1993;4(1):57-65
No abstract available.
Birth Rate*
;
Maternal Age*
;
Parturition*
5.The efficacy of NST and fetal umbilical artery doppler velocimetry in prenatal surveillance of high-risk pregnancy.
In Sik LEE ; Ahm KIM ; Jung Eun MOK
Korean Journal of Perinatology 1993;4(1):37-45
No abstract available.
Pregnancy, High-Risk*
;
Rheology*
;
Umbilical Arteries*
6.Comparison of blood velocity waveforms of the fetal umbilical artery and the fetal aorta between normal and hypertensive pregnancies.
In Sik LEE ; Young Tak KIM ; Jung Eun MOK
Korean Journal of Obstetrics and Gynecology 1991;34(8):1096-1105
No abstract available.
Aorta*
;
Pregnancy*
;
Umbilical Arteries*
7.Analysis of prognostic factors associated with the treatment failures in stage IB and IIA carcinoma of the uterine cervix.
Seon Kyung LEE ; Jae Hyun LEE ; Jung Eun MOK
Korean Journal of Gynecologic Oncology and Colposcopy 1993;4(1):76-88
One hundred fifty-seven patients wha underwent radical hysterectomy and pelvic lymphadenectomy for FIGO stage IB and IIA carcinoma of the cervix between February l975 and May 1987 were retros-pectively analysed to identify specific risk factors associsted with treatment failures. Prognostic factors inciuded clinical stage, histologic cell type, degree of differentiation, size of primary tumor, depth of stromal invasian, lymph-vaseular space invasion, and lymph node metastasis. Treatment results were evaluated according to the recurrence rate and 2-year absolute recurrence-free survival(NED) rate by the prognostie faetors and treatment modalities. Patients with lymph node me tases had a significantly higher incidence of bulky primary(-> 4cm), depth of stromal invasion(> 60% thickness), and lymph-vascular invasion(P<0.005). There was significant difference in the recurrence rate and 2-year, NED rate between cervical carcinoma stage IB and I1A(P <0.005). The pat,ients who had bulky primary tum~or(>4cm) and/or depth of stromal invasion (>60% thickness) had a higher recurrence and lower 2-year NKD rate(P<0.025, P<0.005), Unfortunately, it was not possible to demonstrate that these detrimentel effects could be overeorne by postoperetive radiation. When adjoined for these risk group, traditionally reported poor prognostic factors such as nodal metatasis, cell type and differentiation, lyrnphi-vascular mvasion assume less importance in our studies. In this study, prognosis is most inf1ueneed by clinical stage, depth of stromal invasion, and size of primary tumor,
Cervix Uteri*
;
Female
;
Humans
;
Hysterectomy
;
Incidence
;
Lymph Node Excision
;
Lymph Nodes
;
Neoplasm Metastasis
;
Prognosis
;
Recurrence
;
Risk Factors
;
Treatment Failure*
8.The efficacy of computed tomography in pretreatment evaluation of invasive cervical carcinoma.
In sik LEE ; Jae Hyun CHUNG ; Jung Eun MOK
Korean Journal of Obstetrics and Gynecology 1993;36(7):1808-1814
No abstract available.
9.Flow cytometric analysis of DNA patterns in benign and malignant ovarian tumors.
Young Tak KIM ; In Sik LEE ; Jung Eun MOK
Korean Journal of Obstetrics and Gynecology 1991;34(10):1443-1450
No abstract available.
DNA*
10.Two cases of squamous cell carcinoma arising from benign teratomaas of ovary.
Young Bae LEE ; In Sik LEE ; Young Tak KIM ; Dong Geun JUNG ; Ahm KIM ; Jung Eun MOK
Korean Journal of Obstetrics and Gynecology 1992;35(8):1253-1258
No abstract available.
Carcinoma, Squamous Cell*
;
Female
;
Ovary*