The impact of combined radiation and chemotherapy on outcome in uterine papillary serous carcinoma compared to chemotherapy alone

Haider Mahdi,Benjamin Nutter,Fadi Abdul-Karim,Sudha Amarnath,Peter G. Rose 대한부인종양학회 2016 Journal of Gynecologic Oncology Vol.27 No.2

Objective: To investigate the impact of pelvic radiation on survival in patients with uterine serous carcinoma (USC) who received adjuvant chemotherapy. Methods: Patients with stage I-IV USC were identified from the Surveillance, Epidemiology, and End Results program 2000 to 2009. Patients were included if treated with surgery and chemotherapy. Patients were divided into two groups: those who received chemotherapy and pelvic radiation therapy (CT_RT) and those who received chemotherapy only (CT). KaplanMeier curves and Cox regression proportional hazard models were used. Results: Of the 1,838 included patients, 1,272 (69%) were CT and 566 (31%) were CT_ RT. Adjuvant radiation was associated with significant improvement in overall survival (OS; p<0.001) and disease-specific survival (DSS; p<0.001) for entire cohort. These findings were consistent for the impact of radiation on OS (p<0.001) and DSS (p<0.001) in advanced stage (III-IV) disease but not for early stage (I–II) disease (p=0.21 for OS and p=0.82 for DSS). In multivariable analysis adjusting for age, stage, race and extent of lymphadenectomy, adjuvant radiation was a significant predictor of OS and DSS for entire cohort (p=0.003 and p=0.05) and in subset of patients with stage III (p=0.02 and p=0.07) but not for patients with stage I (p=0.59 and p=0.49), II (p=0.83 and p=0.82), and IV USC (p=0.50 and p=0.96). Other predictors were stage, positive cytology, African American race and extent of lymphadenectomy. Conclusion: In USC patients who received adjuvant chemotherapy, adjuvant radiation was associated with significantly improved outcome in stage III disease but not for other stages. Positive cytology, extent of lymphadenectomy and African race were significant predictors of outcome.

Lymph node metastasis and pattern of recurrence in clinically early stage endometrial cancer with positive lymphovascular space invasion

Haider Mahdi,Amelia Jernigan,Benjamin Nutter,Chad Michener,Peter G. Rose 대한부인종양학회 2015 Journal of Gynecologic Oncology Vol.26 No.3

Objective: To investigate the rate, predictors of lymph node metastasis (LNM) and pattern of recurrence in clinically early stage endometrial cancer (EC) with positive lymphovascular space invasion (LVSI). Methods: Women with clinically early stage EC and positive LVSI 2005 to 2012 were identified. Kaplan-Meier curves and logistic regression models were used. Results: One hundred forty-eight women were identified. Of them, 25.7% had LNM (21.7% pelvic LNM, 18.5% para-aortic LNM). Among patients with LNM who had both pelvic and para-aortic lymphadenectomy, isolated pelvic, para-aortic and both LNM were noted in 51.4%, 17.1%, and 31.4% respectively. Age and depth of myometrial invasion were significant predictors of LNM in LVSI positive EC. Node positive patients had high recurrence rate (47% vs. 11.8%, p<0.05) especially distant (60.9% vs. 7.9%, p<0.001) and para-aortic (13.2% vs. 1.8%, p=0.017) recurrences compared to node negative EC. LNM was associated with lower progression-free survival (p=0.002) but not overall survival (p=0.73). Conclusion: EC with positive LVSI is associated with high risk of LNM. LNM is associated with high recurrence rate especially distant and para-aortic recurrences. Adjuvant treatments should target prevention of recurrences in these areas.

Prognostic impact of lymphadenectomy in uterine clear cell carcinoma

Haider Mahdi,David Lockhart,Mehdi Moselmi-Kebria 대한부인종양학회 2015 Journal of Gynecologic Oncology Vol.26 No.2

Objective: The aim of this study was to estimate the survival impact of lymphadenectomy in patients diagnosed with uterineclear cell cancer (UCCC). Methods: Patients with a diagnosis of UCCC were identified from Surveillance, Epidemiology, and End Results (SEER) programfrom 1988 to 2007. Only surgically treated patients were included. Statistical analysis using Student t-test, Kaplan-Meier survivalmethods, and Cox proportional hazard regression were performed. Results: One thousand three hundred eighty-five patients met the inclusion criteria; 955 patients (68.9%) underwentlymphadenectomy. Older patients (≥65) were less likely to undergo lymphadenectomy compared with their younger cohorts(64.3% vs. 75.9%, p<0.001). The prevalence of nodal metastasis was 24.8%. Out of 724 women who had disease clinicallyconfined to the uterus and underwent lymphadenectomy, 123 (17%) were found to have nodal metastasis. Lymphadenectomywas associated with improved survival. Patients who underwent lymphadenectomy were 39% (hazard ratio [HR], 0.61; 95%confidence interval [CI], 0.52 to 0.72; p<0.001) less likely to die than patient who did not have the procedure. Moreover, moreextensive lymphadenectomy correlated positively with survival. Compared to patients with 0 nodes removed, patients withmore extensive lymphadenectomy (1 to 10 and >10 nodes removed) were 32% (HR, 0.68; 95% CI, 0.56 to 0.83; p<0.001) and 47%(HR, 0.53; 95% CI, 0.43 to 0.65; p<0.001) less likely to die, respectively. Conclusion: The extent of lymphadenectomy is associated with an improved survival of patients diagnosed with UCCC.

Universal tolerance of nab­paclitaxel for gynecologic malignancies in patients with prior taxane hypersensitivity reactions

Kathryn Maurer,Chad Michener,Haider Mahdi,Peter G. Rose 대한부인종양학회 2017 Journal of Gynecologic Oncology Vol.28 No.4

Objective: To report on the incidence of nab-paclitaxel hypersensitivity reactions (HSRs) inpatients with prior taxane HSR. Methods: From 2005 to 2015, all patients who received nab-paclitaxel for a gynecologicmalignancy were identified. Chart abstraction included pathology, prior therapy, indicationfor nab-paclitaxel, dosing, response, toxicities including any HSR, and reason fordiscontinuation of nab-paclitaxel therapy. Results: We identified 37 patients with gynecologic malignancies with a history of paclitaxelHSR who received nab-paclitaxel. Six patients (16.2%) had a prior HSR to both paclitaxel anddocetaxel while the other 31 patients had not received docetaxel. No patients experienced aHSR to nab-paclitaxel. Median number of cycles of nab-paclitaxel was 6 (range 2–20). Twelvepatients received weekly dosing at 60 to 100 mg/m2. The remainder of patients received 135mg/m2(n=13), 175 mg/m2(n=9), or 225 mg/m2(n=3). Thirty four patients (91.9%) receivedreceived nab-paclitaxel in combination with carboplatin (n=28, 75.7%), IP cisplatin (n=1,2.7%), carboplatin and bevacizumab (n=3, 8.1%), or carboplatin and gemcitabine (n=2,5.4%). Reasons for discontinuing nab-paclitaxel included completion of adjuvant therapy(n=16), progressive disease (n=18), toxicity (n=1), and death (n=1). There were no grade4 complications identified during nab-paclitaxel administration. Grade 3 complicationsincluded: neutropenia (n=9), thrombocytopenia (n=4), anemia (n=1), and neurotoxicity (n=1). Conclusion: Nab-paclitaxel is well-tolerated with no HSRs observed in this series of patientswith prior taxane HSR. Given the important role of taxane therapy in nearly all gynecologicmalignancies, administration of nab-paclitaxel should be considered prior to abandoningtaxane therapy

Corrosion Behavior Optimization by Nanocoating Layer for Low Carbon Steel in Acid and Salt Media

( Ahmed S. Abbas ),( Bahaa Sami Mahdi ),( Haider H. Abbas ),( F. F. Sayyid ),( A. M. Mustafa ),( Iman Adnan Annon ),( Yasir Muhi Abdulsahib ),( A. M. Resen ),( M. M. Hanoon ),( Nareen Hafidh Obaeed ) 한국부식방식학회 2023 Corrosion Science and Technology Vol.22 No.1

In this paper, a SiC nano electroless nickel plating layer with excellent corrosion resistance was fabricated using the Taguchi method. The electroless plated low carbon steel was subjected to tests to examine the influence of corrosive media, microhardness, and corrosion rate on the corrosion resistance of this alloy. Three different corrosive media (HCl, Na₂SO₄, and NaCl) at various temperatures (80, 90, and 100 ℃) were used, and at three different times (40, 80, and 120 min.) with a speed of stirring equal to 500 rpm. The results of microhardness were found from 134.276 HV to 278.578 HV at various conditions, while the corrosion rate results were obtained from 0.89643 mpy to 7.12571 mpy at different circumstances. Corrosion, and mechanical characteristics were explained using Taguchi design. Taguchi technique was used to account for all possible combinations of elements in order to conduct a complete study. Models that link the response and procedure parameters were developed using the results of these tests, and the analysis of variance was utilized to validate these models (ANOVA). For maximum efficiency, a function called “desirability” was applied to all responses at once.