1.Negative peritoneal washing cytology during interval debulking surgery predicts overall survival after neoadjuvant chemotherapy for ovarian cancer.
Ayaka IURA ; Morihito TAKITA ; Aiko KAWANO ; Kazuaki IMAI ; Katsuyuki KONNAI ; Ryo ONOSE ; Hisamori KATO
Journal of Gynecologic Oncology 2018;29(5):e70-
OBJECTIVE: Optimal debulking in interval debulking surgery (IDS) after neoadjuvant chemotherapy (NAC) has been reported as a prognostic factor for patients with ovarian cancer. However, the identification of microscopic residual disease (MRD) using visualization and palpation is subjective. Peritoneal washing cytology (PWC) during IDS is an easy-to-implement, objective approach for assessing disease status, although its clinical relevance and association with MRD is not known. The aim of this study was to evaluate the efficacy of PWC during IDS. METHODS: In total, 164 patients diagnosed with ovarian cancer at our institution were retrospectively evaluated, including 64 who had received NAC. Seventeen patients had undergone an exploratory laparotomy followed by NAC, while the remaining patients were diagnosed based on imaging, peritoneal cytology, and tumor markers. The PWC was performed before intraperitoneal observation at laparotomy during IDS. RESULTS: NAC-treated patients had stage III–IV disease. IDS was performed in 78.1% of NAC-treated patients. Seventeen patients (26.6%) were PWC-negative and 33 patients (51.6%) were PWC-positive. Fourteen patients (21.9%) had progressive disease and were ineligible for IDS. The median overall survival of the PWC-negative, PWC-positive, and non-IDS groups was 47, 18, and 5 months, respectively. The differences were significant (p < 0.01). PWC was an independent prognostic factor in the multivariate Cox regression analysis (p < 0.001). CONCLUSION: PWC during IDS may be a prognostic factor for NAC-treated patients with ovarian cancer. PWC may be more useful than visualization and palpation in IDS for determining the presence of MRD.
Biomarkers, Tumor
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Drug Therapy*
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Humans
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Laparotomy
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Neoadjuvant Therapy
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Ovarian Neoplasms*
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Palpation
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Prognosis
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Retrospective Studies
2.Successful Pre-Operative Local Control of Skin Invasion of Breast Cancer Using a Combination of Systemic Chemotherapy and Mohs Paste
Masahiro TAKEUCHI ; Takefumi KATSUKI ; Kumiko YOSHIDA ; Masahiko ONODA ; Michinori IWAMURA ; Toshihiro INOKUCHI ; Akira FURUTANI ; Tomoe KATOH ; Kazuaki KAWANO ; Keiji HIRATA
Journal of Breast Cancer 2021;24(5):481-490
Locally advanced breast cancer (tumor > 5 cm, widespread infiltration of the skin and muscle, or metastases to lymph nodes) is difficult to resect by surgery, and even when it is resectable, there is a high probability of local recurrence and distant metastasis. Therefore, systemic therapy should be administered first. However, as cutaneous infiltration progresses, the patient's quality of life is impaired by pain, bleeding, presence of exudates, and a foulsmelling odor. Treatment with Mohs paste with systemic therapy can control symptoms associated with skin infiltration and can also be expected to decrease tumor volume.Herein, we report a case in which a tumor was resected following Mohs paste and systemic chemotherapy administration, and the skin defect was reconstructed with a latissimus dorsi myocutaneous flap. We also review the literature for previously reported cases of breast cancer involving Mohs paste.