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( Pabashi Poddar ),( Shilpa Patel ),( Ruchi Arora ),( Chetana Parekh ),( Pariseema Dave ),( Sangeetha Amin ) 대한산부인과학회 2020 Obstetrics & Gynecology Science Vol.63 No.2
Objective This study aimed to study the patterns of recurrence in surgically treated cases of vulvar cancer (VC) and determine the factors associated with recurrence, with a special emphasis on lymph node ratio (LNR). Methods This retrospective study examined VC patients primarily treated with surgery at our institute from January 2005 to December 2015. Demographic data, clinical characteristics, surgicohistopathological data, adjuvant treatment, follow up, and recurrence site and treatment were studied. Results Among the 111 cases treated, a recurrence rate of 18.9% was noted. Recurrence was most commonly local (61.9%). On univariate and multivariable analyses of clinicopathological parameters, an LNR >20 had the highest hazard ratio for recurrence. Conclusion LNR may provide useful prognostic information in VC patients with positive inguinal lymph node status.
Abhilash Vasanth,Shilpa M Patel,Ruchi Arora,Chetana D Parekh,Pariseema Dave,Bijal M Patel,Priyanka Vemanamandhi 대한부인종양학회 2024 Journal of Gynecologic Oncology Vol.35 No.2
Objective: To study clinical characters and outcomes in patients of malignant ovarian germcell tumor (MOGCT) undergoing surger y following neoadjuvant chemotherapy (NACT). Methods: Retrospective study of patients undergoing surger y following NACT for MOGCT atour institute. Platinum based chemotherapy was given in all patients in NACT. Results: Between March 2013 and Februar y 2023, 30 patients had surger y after NACT. Patient’s median age was 22 years (range, 12 to 35 years) and median follow up 42months(range, 6 to 132 months). Majority had endodermal sinus tumor (n=12), dysgerminoma (n=9)and mixed GCT (n=7). All had either International Federation of Gynecology and Obstetrics(FIGO) stage 3 (n=19) or FIGO stage 4 disease (n=11). Complete response to NACT seen in5 patients and 23 patients had partial response. Fertility sparing surger y in 18 patients andcomplete surger y in 12 patients. Suboptimal surger y was seen in 4 patients. Currently, 20of 30 patients are alive and disease free, 3 lost for follow up and 7 patients had progressionafter adjuvant therapy. Five patients had mortality—4 with progression and 1 with bleomycintoxicity. Fifteen of 17 eligible patients have resumed menstruation and one had successfulpregnancy. Prognostic factors noted in study are stage, optimal surger y and viable tumor inhistopathology. Dysgerminoma had better outcome than other histology. Conclusion: NACT may be a reasonable option in patients with extensive unresectable diseaseor in whom fertility sparing is not possible or in the poor general condition. Fertility sparingsurger y can be attempted post neoadjuvant chemotherapy without adversely affecting prognosis.
Nishith Govil,Kumar Parag,Pankaj Arora,Hariom Khandelwal,Ashutosh Singh,Ruchi 대한통증학회 2020 The Korean Journal of Pain Vol.33 No.1
Background: Duloxetine is an antidepressant that is also useful in chronic neuropathic and central origin pain. In this study, the role of duloxetine in decreasing acute postoperative pain after lumbar canal stenosis surgery is explored. Methods: In this single center, triple blinded, and placebo-controlled trial, 96 patients were randomized for statistical analysis. The intervention group received oral duloxetine 30 mg once a day (OD) for 2 days before surgery, 60 mg OD from the day of surgery to the postoperative second day and 30 mg OD for the next 2 days (a total duration of 7 days). A placebo capsule was given in the other group for a similar time and schedule. The same standard perioperative analgesia protocols were followed in both groups. Results: Total morphine consumption up to 24 hours was significantly decreased in the duloxetine group (P < 0.01). The time to the first analgesia requirement was similar in both groups but the time to the second and third dose of rescue analgesia increased significantly in the duloxetine group. The time to ambulation was decreased significantly (P < 0.01) in the duloxetine group as compared to the placebo group. Pain scores remained similar during most of the time interval. No significant difference was observed in the complication rate and patient satisfaction score recorded. Conclusions: Duloxetine reduces postoperative pain after lumbar canal stenosis surgery with no increase in adverse effects.