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RISS 인기검색어
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- 저자 : Jessie Y. Li (검색결과 2 건)
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Stage III uterine serous carcinoma: modern trends in multimodality treatment
Jessie Y. Li,Melissa R. Young,Gloria Huang,Babak Litkouhi,Alessandro Santin,Peter E. Schwartz,Shari Damast 대한부인종양학회 2020 Journal of Gynecologic Oncology Vol.31 No.4
Objective: To examine outcomes in a modern treatment era for stage III uterine serouscarcinoma (USC). Methods: Fifty women were retrospectively identified as 2009 International Federation ofGynecology and Obstetrics stage III USC patients who received radiotherapy (RT) at ourinstitution between 1/2003–5/2018. The patients were divided into 2 cohorts: 20 in the earlyera (2003–2010) and 30 in the modern era (2011–2018). Patient characteristics were comparedusing χ2tests for categorical variables and t-tests for continuous variables. Recurrence freesurvival (RFS) and overall survival (OS) were analyzed with Kaplan-Meier estimates, the log rank test, and Cox proportional hazards. Results: The modern era differed from the early era in the increased use of volume-directedexternal beam RT (EBRT) as opposed to vaginal brachytherapy (VB) alone (33.3% vs 5.0%,p=0.048), minimally invasive surgery (56.7% vs. 25%, p=0.027), sentinel node sampling(26.7% vs. 0%, p=0.012), computed tomography imaging in the perioperative period (63.3%vs. 30%, p=0.044), and human epidermal growth factor receptor 2/neu testing (96.7% vs. 55%, p=0.001). Median follow-up for early and modern eras was 37.27 and 33.23 months,respectively. The early vs. modern 3-year RFS was 33% and 64% (p=0.039), respectively, whilethe 3-year OS was 55% and 90% (p=0.034). Regional nodal recurrence more common amongthe patients who received VB only (p=0.048). Conclusion: Modern era treatment was associated with improved RFS and OS in patientswith stage III USC. Regional nodal recurrences were significantly reduced in patients whoreceived EBRT
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Jessie Y. Li,Christopher K. Arkfeld,Joan Tymon-Rosario,Emily Webster,Peter Schwartz,Shari Damast,Gulden Menderes 대한부인종양학회 2022 Journal of Gynecologic Oncology Vol.33 No.2
Objective: To evaluate prognostic factors, outcomes, and management patterns of patients treated for squamous cell carcinoma of the vulva. Methods: One hundred sixty-four women were retrospectively identified with primary squamous cell carcinoma of the vulva treated at our institution between 1/1996–12/2018. Descriptive statistics were performed on patient, tumor, and treatment characteristics. The χ2 tests and t-tests were used to compare categorical variables and continuous variables, respectively. Recurrence free survival (RFS), overall survival (OS), and disease-specific survival (DSS) were analyzed with Kaplan-Meier estimates, the log-rank test, and Cox proportional hazards. Results: Median follow-up was 52.5 months. Five-year RFS was 67.9%, 60.0%, 42.1%, and 20.0% for stage I–IV, respectively. Five-year DSS was 86.2%, 81.6%, 65.0%, and 42.9% for stage I–IV, respectively. On multivariate analysis, positive margins predicted overall RFS (hazard ratio [HR]=3.55; 95% confidence interval [CI]=1.18–10.73; p=0.025), while presence of lichen sclerosus on pathology (HR=2.78; 95% CI=1.30–5.91; p=0.008) predicted local RFS. OS was predicted by nodal involvement (HR=2.51; 95% CI=1.02–6.13; p=0.043) and positive margins (HR=5.19; 95% CI=2.03–13.26; p=0.001). Adjuvant radiotherapy significantly improved RFS (p=0.016) and DSS (p=0.012) in node-positive patients. Median survival after treatment of local, groin, and pelvic/distant recurrence was 52, 8, and 5 months, respectively. Conclusion: For primary treatment, more conservative surgical approaches can be considered with escalation of treatment in patients with concurrent precursor lesions, positive margins, and/or nodal involvement. Further studies are warranted to improve risk stratification in order to optimize treatment paradigms for vulvar cancer patients.
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