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Shinichi Tate,Kyoko Nishikimi,Kazuyoshi Kato,Ayumu Matsuoka,Michiyo Kambe,Takako Kiyokawa,Makio Shozu 대한부인종양학회 2020 Journal of Gynecologic Oncology Vol.31 No.3
Objective: This study aimed to evaluate the presence of pathological residual tumor (pRT) in each initial disseminated site after neoadjuvant chemotherapy (NACT) to assess the appropriate surgical margins during interval debulking surgery (IDS) for a favorable prognosis. Methods: This prospective descriptive study included patients with stage IIIC–IV epithelial ovarian, fallopian tubal, and peritoneal cancer. One hundred eleven patients underwent diagnostic exploratory laparotomy, and their initial intra-abdominal dissemination statuses were recorded. Any tumor >1 cm in diameter found during the exploratory laparotomy was resected during IDS even if it was macroscopically invisible after NACT. The pRT rate after NACT and negative predictive value (NPV; probability that sites with macroscopically invisible tumors have no pRT) during IDS were assessed in each disseminated site. Results: A median of 5 NACT cycles were performed. Sites with a high incidence of pRT and low NPV included the rectosigmoid colon (71.4%, 38.6%), transverse mesentery (70.3%, 50.0%), greater omentum (68.3%, 51.7%), right diaphragm (61.9%, 48.1%), paracolic gutters (61.1%, 50.0%), and vesicouterine pouch (56.6%, 50.0%). Organs/tissues with a high incidence of pRT featured a low NPV. The median progression-free survival and overall survival in this cohort were 27.7 and 71.9 months, respectively. Conclusion: Even if a disseminated site >1 cm in diameter before NACT is invisible during IDS, microscopic disease remains present within it. The appropriate surgical margins for IDS with a favorable prognosis could be secured by resecting a lesion of >1 cm before NACT even if it is invisible during IDS.
Ji Yon Agnes Jang,Nozomu Yanaihara,Eric Pujade-Lauraine,Yoshiki Mikami,Katsutoshi Oda,Michael Bookman,Jonathan Ledermann,Muneaki Shimada,Takako Kiyokawa,김병기,Noriomi Matsumura,Tsunehisa Kaku,Takafumi K 대한부인종양학회 2017 Journal of Gynecologic Oncology Vol.28 No.4
There has been significant progress in the understanding of the pathology and molecular biologyof rare ovarian cancers, which has helped both diagnosis and treatment. This paper provides anupdate on recent advances in the knowledge and treatment of rare ovarian cancers and identifiesgaps that need to be addressed by further clinical research. The topics covered include: low-gradeserous, mucinous, and clear cell carcinomas of the ovary. Given the molecular heterogeneity andthe histopathological rarity of these ovarian cancers, the importance of designing adequatelypowered trials or finding statistically innovative ways to approach the treatment of these raretumors has been emphasized. This paper is based on the Rare Ovarian Tumors Conferencefor Young Investigators which was presented in Tokyo 2015 prior to the 5th Ovarian CancerConsensus Conference of the Gynecologic Cancer InterGroup (GCIG).