Objective To evaluate the effectiveness of second cytoreductive surgery in the treatment of epithelial ovarian cancer.Methods From January 1989 to June 1994, second cytoreductive surgery was carried out on 33 patients with epithelial ovarian cancer who either underwent unsatisfactory primary debulking operation or had recurrence. According to FIGO staging (1987), there were 5 patients in stage Ⅰ, 2 in stage Ⅱ, 25 in stage Ⅲ, and 1 in stage IV. Pathological grading was G1 in 2 cases, G2 in 9, G3 in 19 and uncertain in 3. The 33 patients can be divided into 3 categories: Ⅰ, nine patients who had unsatisfactory primary debulking operation with macroscopic residual >2 cm, and 1-2 courses of postoperative chemotherapy; Ⅱ, 15 patients who had 6-8 courses of cisplatin-based postoperative chemotherapy and in whom recurrence was diagnosed after complete response for at least 3 months; and Ⅲ, 9 patients who had the same treatment as category Ⅱ and survived without cancer clinically for more than 6 months, and in whom recurrence was diagnosed during second-look laparotomy. All patients had been followed up for at least two years (27-168 months) dated from the primary debulking operation.Results Fifteen cases had no macroscopic residuals (group A), 5 had residuals <2 cm (group B), and 13 had residuals >2 cm (group C). The medium survival time and two-year survival rate in groups A, B and C were 59.09, 20.6 and 8.29 months, and 93.3%, 20% and 7.69% respectively (P<0.001, A vs C; P<0.05, A vs B and B vs C).Conclusions The results suggest that second cytoreductive surgery is of value, and the key to success is to eliminate any macroscopic residual focus, or at most, to leave only minimal residuals <2 cm. It is suggested that well-targeted multiple-route chemothe-rapy with sufficient courses before second cytoreductive surgery is important to achieving better results.

Objective To investigate the short-term effects of chemotherapy-surgery-chemotherapy regimen on clinically inoperable advanced ovarian cancer. Methods Retrospective analysis was made on 16 cases of stage Ⅲ and 2 cases of stage Ⅳ epithelial ovarian cancer with fixed pelvic mass. Neoadjuvant chemotherapy with CP (cisplatin+cyclophosphamide) or CAP (CP+adriamycin) regimen was given by intraarterial, intraperitoneal, or systemic routes accordingly for an average of 2.8 courses. Sixteen of the 18 cases were assessed to be operable after preoperative chemotherapy. The uterus, adnexa, omentum, pelvic lymphnodes (14/18), and implants were included in the cytoreductive surgery. Pelvic masses were found to have almost disappeared in 9, and macroscopic residuals were found in 11 (residuals <2 cm in 2, and >2 cm in 5) of the 18 cases. Postoperative chemotherapy (CP, CAP, or CEP, E=VP16) was given for an average of 5.9 courses. Results Five out of 7 patients followed up for over 3 years have been surviving for 46, 44, 40, 38 and 36 months, respectively. Conclusion Chemotherapy-surgery-chemotherapy regimen has beneficial effects on clinically inoperable advanced ovarian carcinoma.

Objective To compare the safety and efficacy of direct and remedial rotational atherectomy in the treatment of heavily calcified coronary artery lesions.Methods We retrospectively reviewed 58 patients admitted in the Shanghai Chest Hospital and Liaocheng People Hospital from May 2012 to July 2015 who had received stent implantation and rotational atherectomy.The 58 patients were divided into two groups which were the direct atherectomy group (n =27) and the remedial atherectomy group (n =31).General clinical date,lesion and procedural characteristics,intraoperative complications,in-hospital and follow-up MACCE were compared between the two groups.Results There were no differences between the two groups in general clinical date intraoperative complications,amount of contrast agent used,proceduraltime,rates of in-hospital and follow-up MACCE.Nevertheless,compared with the direct artherectomy group,the remedial group had more number of balloon dilations during procedure [3 (1,5) vs.2 (1,2),P ＜ 0.001] and higher peak cardiac troponin levels [1.1 (0.3,3.0) μg/L vs.0.5 (0.1,2.3) μg/L,P =0.032].Conclusions Remedial rotational atherectomy with drug-eluting stent had the same safety and efficacy as direct atheretomy with drug-eluting stent in treating patients with heavily calcified coronary lesions.It is reasonable and safe to transform routine PCI to remedial rotational atherectomy when the 2.0 mm semi compliant balloon or/and 2.5 mm non-compliant balloon cannot pass through or dilate the lesions.