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M372 INCIDENCE OF AMENORRHEA IN PREMENOPAUSAL WOMEN WITH BREAST CANCER (BC) UNDERGOING CHEMOTHERAPY (CT) WITH ANTHRACYCLINE (A), CYCLOPHOSPHAMIDE (C) AND DOCETAXEL (T)
S650
Poster presentations / International Journal of Gynecology & Obstetrics 119S3 (2012) S531–S867
annual Pap test was promoted for years regardless of existence of uterine cervix. To assess if any difference, we tried to collect and analyze the Pap test data in women status-post hysterectomy for benign disease in Taiwan. Materials: Collect Pap test data in Chia-Yi Christian Hospital, Chia-Yi City, Taiwan from 2002 to 2011, 467796 Pap tests was gotten. They were reviewed based on relative pathological results. The number of Pap tests in women older then 30 and status-post hysterectomy for benign disease was 27037. Methods: Data was analyzed using statistical software SAS 9.2. The abnormal smear result consists of ASC-H, AGC-FN, LSIL, HSIL, AIS, and CANCER. The positive rates of that in women older then 30 and status-post hysterectomy for benign disease was calculated. And its relationship to age was further analyzed. Results: The total number of vaginal Pap test was 34699. That in women older then 30 and status-post hysterectomy for benign disease was 27037 (77.9%, 14132 persons). The positive (abnormal) rate was 0.68% (184 records). The positive rate of first vaginal Pap test post hysterectomy was 0.64%. The positive rate was increased as age growing. The highest was in the group aged then 80y/o (1.9%) (table 1). Conclusions: The positive rate of vaginal Pap test in women statuspost hysterectomy for benign disease was not higher than that in women with uterine cervix. (0.68% VS 0.94%). It could be discussed in Taiwan to continue vaginal Pap test in women status-post hysterectomy for benign disease or not. Table 1. The positive rate was increased as age growing Vaginal pap test age (years)
30–39
40–49
50–59
60–69
70–79
>80
Total
Positive Negative Positive rate Number of vaginal pap
4 775 0.51% 779
765 6227 0.11% 6234
65 10112 0.64% 10177
38 6961 0.93% 7026
5184 2520 1.49% 2558
258 1.90%
26853 0.68%
M371 WEEKLY CHEMOTHERAPY REGIMENS FEASIBILITY IN VERY ELDERLY PATIENTS WITH GYNECOLOGICAL MALIGNANCIES S. Mainenti1 , A. Pietragalla1 , M. Distefano1 , P. Malaguti1 , V. Masciullo1 , C. Conte1 , G. Scambia1 , V. Salutari1 . 1 Catholic University of Sacred Heart, Gynecologic Oncology Unit, Rome, Italy Objectives: In Europe 58% of all female cancers occur in women older than 65 years. The incidence of gynecological cancer rises steadily with advancing age during adulthood and peaks in the 7th8th decades of life. Age-specific analysis reveals that the incidence of mortality rate from gynecological cancer are continuously increasing in the elderly population. Although advanced stage at diagnosis seems to affect prognosis in the elderly population, treatments in this setting of patients is still controversial and a great number of patients are under-treated to avoid unacceptable sideeffects, thus limiting their possibility of survival. Several papers have been published concerning chemotherapy in patients with gynecological cancer >65 years, but few data have been reported about chemotherapy in patients older than 75 years old. Materials: Forty-five patients aged >75 yrs old were identified. Most patients (n = 32) were diagnosed as ovarian cancer while 13 as endometrial cancer. Methods: A retrospective chart review has been performed for women aged >75 yrs affected by gynecological malignancies treated with weekly chemotherapy regimen in our institution between 2003 and 2011. Results: Forty-five patients aged >75 yrs old were recruited. Mean age was 79.3 years (range, 75–88 yrs). ECOG performance status was 0–1 in 84% of cases. Seventeen patients received first line chemotherapy while 28 pts received chemotherapy for recurrent disease. Most patients (n = 34) received carboplatin 2AUC-paclitaxel 60 mg/mq d1–8-15, q28, 1 pt carboplatin 2 AUC d1–8-15, 2 pts paclitaxel 60 mg/mq 1–8-15, q28, 8 pts topotecan 3 mg/mq d1–8-15, q28. Mean number of cycles were 5.34; 6 cycles in first line setting
and 5.34 cycles in recurrent disease. No significant delay in recycling was recorded. Anemia G3 was reported in 4 patients, neutropenia G3–4 in 15 patients, thrombocytopenia G3 in 2 patients. About extra hematological toxicities, only 1 patient showed severe sensorial neuropathy in carboplatin-paclitaxel regimen. No patients required hospitalization for adverse events related to chemotherapy. Conclusions: Weekly chemotherapy regimens are valid options, with a favorable toxicity profile, in very elderly patients with gynecological malignancies, in which standard chemotherapy is not recommended. M372 INCIDENCE OF AMENORRHEA IN PREMENOPAUSAL WOMEN WITH BREAST CANCER (BC) UNDERGOING CHEMOTHERAPY (CT) WITH ANTHRACYCLINE (A), CYCLOPHOSPHAMIDE (C) AND DOCETAXEL (T) E. Basso1 , L. Rossi1 , F. Tomao2 , A. Papa1 , E. Zaccarelli1 , G.P. Spinelli1 , G. Lo Russo1 , F. Zoratto1 , M. Strudel1 , V. Stati1 , S. Tomao1 . 1 Department of Medico-Surgical Sciences and Biotechnologies, Oncology Unit, ’Santa Maria Goretti’ Hospital – University of Rome ’Sapienza’, Latina, Lazio, Italy; 2 Department of Gynecology and Obstetrics, ’Policlinico Umberto I’ University of Rome ’Sapienza’, Roma, Lazio, Italy Objectives: Disruption of menstrual function and loss of reproductive potential in BC survivors is a frequent side effect of BC treatment. Adjuvant CT, although clearly beneficial to survival, may result in short or long-term CT-related amenorrhea (CRA), early menopause, and loss of reproductive potential, leading to profound physical and emotional alterations. These side-effects may not only impair or obstacle fertility, but also cause sexual dysfunction, bone loss and menopausal symptoms, with a strikingly negative effect on quality of life in many women. We analyzed the incidence of CRA in premenopausal patients (pts) affected by BC. Materials: 24 premenopausal BC pts, with a median of 43 years, treated with adjuvant CT (A+ C, without or with concomitant or sequential T). Methods: In this retrospective experience we evaluated the incidence of CRA. All the patients had regular menstrual cycles; moreover nobody received hormone therapy at the same time. Results: 10 pts (42%) were treated with only A + C, 6 pts (25%) received A + C + T, 8 pts (33%) received A + C and after T. In 22 pts (92%) amenorrhea appeared during CT; in particular, 9/10 pts (90%) treated with A + C, 5/6 pts (83%) with A + C + T and 8/8 pts (100%) with A + C and after T. In all patients amenorrhea appeared during first three cycles of CT in 18 pts (82%) and particularly 7 pts (32%) after 1 cycle, 7 pts (32%) after 2 cycles, 4 pts (18%) after 3 cycles and 4 pts (18%) in subsequent doses. CRA occurred within the first two doses of treatment in 14/22 pts (64%); in 6/9 pts (66.7%) treated with A + C, in 4/5 pts (80%) with A + C + T and in 4/8 (50%) with A + C and after T. Menstrual cycle reappeared at the end of CT in 7 pts (32%) with a median age 40 years. Conclusions: In our study incidence of CRA was extremely high and there were no differences among subgroups undergoing to CT with A + C alone or combined with T. In group of pts in which T were given concomitant with A and C, amenorrhea occurred earlier than in the other two groups. In younger pts (7 with median age of 40 years) menstrual cycle reappeared at the end of CT.
Poster presentations / International Journal of Gynecology & Obstetrics 119S3 (2012) S531–S867
annual Pap test was promoted for years regardless of existence of uterine cervix. To assess if any difference, we tried to collect and analyze the Pap test data in women status-post hysterectomy for benign disease in Taiwan. Materials: Collect Pap test data in Chia-Yi Christian Hospital, Chia-Yi City, Taiwan from 2002 to 2011, 467796 Pap tests was gotten. They were reviewed based on relative pathological results. The number of Pap tests in women older then 30 and status-post hysterectomy for benign disease was 27037. Methods: Data was analyzed using statistical software SAS 9.2. The abnormal smear result consists of ASC-H, AGC-FN, LSIL, HSIL, AIS, and CANCER. The positive rates of that in women older then 30 and status-post hysterectomy for benign disease was calculated. And its relationship to age was further analyzed. Results: The total number of vaginal Pap test was 34699. That in women older then 30 and status-post hysterectomy for benign disease was 27037 (77.9%, 14132 persons). The positive (abnormal) rate was 0.68% (184 records). The positive rate of first vaginal Pap test post hysterectomy was 0.64%. The positive rate was increased as age growing. The highest was in the group aged then 80y/o (1.9%) (table 1). Conclusions: The positive rate of vaginal Pap test in women statuspost hysterectomy for benign disease was not higher than that in women with uterine cervix. (0.68% VS 0.94%). It could be discussed in Taiwan to continue vaginal Pap test in women status-post hysterectomy for benign disease or not. Table 1. The positive rate was increased as age growing Vaginal pap test age (years)
30–39
40–49
50–59
60–69
70–79
>80
Total
Positive Negative Positive rate Number of vaginal pap
4 775 0.51% 779
765 6227 0.11% 6234
65 10112 0.64% 10177
38 6961 0.93% 7026
5184 2520 1.49% 2558
258 1.90%
26853 0.68%
M371 WEEKLY CHEMOTHERAPY REGIMENS FEASIBILITY IN VERY ELDERLY PATIENTS WITH GYNECOLOGICAL MALIGNANCIES S. Mainenti1 , A. Pietragalla1 , M. Distefano1 , P. Malaguti1 , V. Masciullo1 , C. Conte1 , G. Scambia1 , V. Salutari1 . 1 Catholic University of Sacred Heart, Gynecologic Oncology Unit, Rome, Italy Objectives: In Europe 58% of all female cancers occur in women older than 65 years. The incidence of gynecological cancer rises steadily with advancing age during adulthood and peaks in the 7th8th decades of life. Age-specific analysis reveals that the incidence of mortality rate from gynecological cancer are continuously increasing in the elderly population. Although advanced stage at diagnosis seems to affect prognosis in the elderly population, treatments in this setting of patients is still controversial and a great number of patients are under-treated to avoid unacceptable sideeffects, thus limiting their possibility of survival. Several papers have been published concerning chemotherapy in patients with gynecological cancer >65 years, but few data have been reported about chemotherapy in patients older than 75 years old. Materials: Forty-five patients aged >75 yrs old were identified. Most patients (n = 32) were diagnosed as ovarian cancer while 13 as endometrial cancer. Methods: A retrospective chart review has been performed for women aged >75 yrs affected by gynecological malignancies treated with weekly chemotherapy regimen in our institution between 2003 and 2011. Results: Forty-five patients aged >75 yrs old were recruited. Mean age was 79.3 years (range, 75–88 yrs). ECOG performance status was 0–1 in 84% of cases. Seventeen patients received first line chemotherapy while 28 pts received chemotherapy for recurrent disease. Most patients (n = 34) received carboplatin 2AUC-paclitaxel 60 mg/mq d1–8-15, q28, 1 pt carboplatin 2 AUC d1–8-15, 2 pts paclitaxel 60 mg/mq 1–8-15, q28, 8 pts topotecan 3 mg/mq d1–8-15, q28. Mean number of cycles were 5.34; 6 cycles in first line setting
and 5.34 cycles in recurrent disease. No significant delay in recycling was recorded. Anemia G3 was reported in 4 patients, neutropenia G3–4 in 15 patients, thrombocytopenia G3 in 2 patients. About extra hematological toxicities, only 1 patient showed severe sensorial neuropathy in carboplatin-paclitaxel regimen. No patients required hospitalization for adverse events related to chemotherapy. Conclusions: Weekly chemotherapy regimens are valid options, with a favorable toxicity profile, in very elderly patients with gynecological malignancies, in which standard chemotherapy is not recommended. M372 INCIDENCE OF AMENORRHEA IN PREMENOPAUSAL WOMEN WITH BREAST CANCER (BC) UNDERGOING CHEMOTHERAPY (CT) WITH ANTHRACYCLINE (A), CYCLOPHOSPHAMIDE (C) AND DOCETAXEL (T) E. Basso1 , L. Rossi1 , F. Tomao2 , A. Papa1 , E. Zaccarelli1 , G.P. Spinelli1 , G. Lo Russo1 , F. Zoratto1 , M. Strudel1 , V. Stati1 , S. Tomao1 . 1 Department of Medico-Surgical Sciences and Biotechnologies, Oncology Unit, ’Santa Maria Goretti’ Hospital – University of Rome ’Sapienza’, Latina, Lazio, Italy; 2 Department of Gynecology and Obstetrics, ’Policlinico Umberto I’ University of Rome ’Sapienza’, Roma, Lazio, Italy Objectives: Disruption of menstrual function and loss of reproductive potential in BC survivors is a frequent side effect of BC treatment. Adjuvant CT, although clearly beneficial to survival, may result in short or long-term CT-related amenorrhea (CRA), early menopause, and loss of reproductive potential, leading to profound physical and emotional alterations. These side-effects may not only impair or obstacle fertility, but also cause sexual dysfunction, bone loss and menopausal symptoms, with a strikingly negative effect on quality of life in many women. We analyzed the incidence of CRA in premenopausal patients (pts) affected by BC. Materials: 24 premenopausal BC pts, with a median of 43 years, treated with adjuvant CT (A+ C, without or with concomitant or sequential T). Methods: In this retrospective experience we evaluated the incidence of CRA. All the patients had regular menstrual cycles; moreover nobody received hormone therapy at the same time. Results: 10 pts (42%) were treated with only A + C, 6 pts (25%) received A + C + T, 8 pts (33%) received A + C and after T. In 22 pts (92%) amenorrhea appeared during CT; in particular, 9/10 pts (90%) treated with A + C, 5/6 pts (83%) with A + C + T and 8/8 pts (100%) with A + C and after T. In all patients amenorrhea appeared during first three cycles of CT in 18 pts (82%) and particularly 7 pts (32%) after 1 cycle, 7 pts (32%) after 2 cycles, 4 pts (18%) after 3 cycles and 4 pts (18%) in subsequent doses. CRA occurred within the first two doses of treatment in 14/22 pts (64%); in 6/9 pts (66.7%) treated with A + C, in 4/5 pts (80%) with A + C + T and in 4/8 (50%) with A + C and after T. Menstrual cycle reappeared at the end of CT in 7 pts (32%) with a median age 40 years. Conclusions: In our study incidence of CRA was extremely high and there were no differences among subgroups undergoing to CT with A + C alone or combined with T. In group of pts in which T were given concomitant with A and C, amenorrhea occurred earlier than in the other two groups. In younger pts (7 with median age of 40 years) menstrual cycle reappeared at the end of CT.