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O477 Relationship between CA-125 and osteoporosis in otherwise healthy postmenopausal women
Free communication (oral) presentations / International Journal of Gynecology & Obstetrics 107S2 (2009) S93–S396
carcinoma (AdSCCa), and adenocarcinoma (AdCa) of the uterine cervix. Materials and Methods: This retrospective analysis included 836 patients with FIGO stage IB-IIA SCCa (n = 660), AdSCCa (n = 33), and AdCa (n = 143) of the uterine cervix who underwent type 3 radical hysterectomy with pelvic and/or paraaortic lymphadenectomy at Asan Medical Center, Seoul, Korea between 1997 and 2008. Results: The mean age were 49, 49, and 45 years for patients with SCCa, AdSCCa, and AdCa, respectively (P = 0.004). The mean tumor size were 28, 24, and 25 mm for patients with SCCa, AdSCCa, and AdCa, respectively (P = 0.036). Lymphovascular space invasion was more common in patients with AdCa (P = 0.002). Grade 3 histology was more common in patients with AdSCCa (P < 0.001). Vaginal involvement was more common in SCCa (P = 0.039). Deep stromal invasion, parametrial involvement, lymph node metastasis, and resection margin involvement were not different among groups. Adjuvant therapy was given to 33%, 33%, and 33% of patients with SCCa, AdSCCa, and AdCa, respectively. The mean follow-up time was 52 months (range, 1–138 months). In univariate analysis, age, grade, size, deep stromal invasion, parametrial involvement, and lymph node metastasis were significantly associated with disease free survival (DFS) and overall survival (OS). After adjusting for these factors in multivariate analsysis, DFS and OS were not different by histologic types. The mean time to recurrence was 26, 20, and 16 months for patients with SCCa, AdSCCa, and AdCa, respectively. Recurrences on distant sites were more common in patients with AdSCCa and AdCA. Conclusions: The mean time to recurrence was shorter and recurrences on distant site were more common in patients with AdSCCa and AdCa. However, the prognosis was not different by histologic types. O477 Relationship between CA-125 and osteoporosis in otherwise healthy postmenopausal women Y. Kim, K. Ahn, J. Shin, S. Hong, T. Kim, J. Hur, K. Lee, S.H. Kim. Korea University Medical Center Objectives: This study was aimed to investigate whether the known tumor markers were associated with osteoporosis in otherwise healthy postmenopausal women. Materials and Methods: 2,874 healthy postmenopausal women were selected among the 8,840 patients who participated in the health screening program between 2006 and 2007. Each participant had undergone basic body measurements, cardiopulmonary exam, blood, urine and stool analyses, abdominal ultrasound, gastro- and colonoscopies, and gynecological exam. Serum carbohydrate antigen-125 (CA-125), CA-19–9, carcinoembryonic antigen (CEA), and alpha-fetoprotein levels were evaluated as tumor marker. The selected 2,874 women were divided into two groups with or without osteoporosis according to the lowest T-score in lumbar spine or femur. Parametric t-test and multivariate logistic regression analysis were performed to determine the main factors of osteoporosis. Results: CA-125 (P = 0.000) and CEA (P = 0.000) levels were different between patients with and without osteoporosis. On logistic regression analysis, only CA-125 level among tumor markers was significantly lower in postmenopausal women with osteoporosis compared to without osteoporosis (P = 0.019; OR = 0.969, 95% confidence interval: 0.944–0.995). Conclusions: Lower CA-125 levels were significantly associated with osteoporosis in otherwise healthy postmenopausal women. Therefore, CA-125 levels need to be evaluated as confounding factor when osteoporoses are detected in otherwise healthy postmenopausal women.
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O478 Adjuvant concurrent chemoradiotherapy-induced neutropenia as a prognostic indicator of treatment in cervical cancer Y.H. Kim, H. Chung, J. Kim, N. Park, Y. Song, S. Kang. Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Republic of Korea Objective: To evaluate the association of adjuvant concurrent chemoradiotherapy-induced neutropenia with survival in patients with squamous cell carcinoma of the uterine cervix. Materials and Methods: One hundred seven patients with stage IB-IIB cervical cancer were analyzed. The median followup was 39.3 months (6.7–74.1 months). All patients had received radical surgery, including pelvic lymphadenectomy, followed by paclitaxel + carboplatin-based concurrent chemoradiotherapy. Relative neutropenia, defined as an absolute neutrophil count <1000/mm3 at the concurrent chemoradiotherapy cycle nadir, was correlated to the pathologic findings and survival outcomes. Results: Sixty-two percent of patients (n = 66) experienced neutropenia at least once during concurrent chemoradiotherapy, and demonstrated improvement in disease-free survival (P = 0.047), although not in overall survival. Disease-free survival gain was more significant, especially in the subgroups with parametrial invasion or lymph node metastasis (P = 0.033 and P = 0.028, respectively). Treatment-induced neutropenia was proved as the only significant independent factor to recur in cervical cancer (P = 0.037) among several variables, such as parametrial invasion, involvement of the resection margin, and lymph node metastasis. Conclusions: Concurrent chemoradiotherapy-induced neutropenia is a prognostic indicator of treatment efficacy in patients with cervical cancer, especially in patients with advanced disease. Individualized dose titration of concurrent chemoradiotherapy could be beneficial, although further systemic study is required. O479 Years from menopause to surgery is a major determinant of postoperative symptomatic improvement in postmenopausal pelvic organ prolapse Y.T. Kim, K. Ahn, H. Park, J. Song, T. Kim, J. Hur, K. Lee, S. Kim. Korea University Medical Center Objectives: This study was aimed to investigate what the main factors for symptomatic improvement were postoperatively in postmenopausal women with pelvic organ prolapse (POP). Materials and Methods: Ninety-four postmenopausal women were selected among the patients who had undergone surgery for symptomatic POP between 2003 and 2007. Age, body mass index (BMI), parity, menopausal age, years from menopause to surgery, years from symptom onset to surgery, operative time, and the follow-up interval were investigated. The symptomatic improvement of POP was evaluated by the Patient Global Impression of Improvement (PGI-I) scale. Ordered logistic regression analysis was performed to determine the main factor for symptomatic improvement after surgery for POP. Results: The mean age of the study participants was 63.7 years, the mean BMI and parity were 25.1 kg/m2 and 3.6, respectively. The mean menopausal age, years from menopause to surgery, and years from symptom onset to surgery were 49.8, 13.9, and 5.8 years, respectively. The mean follow-up interval was 2.3 years. The mean PGI-I scale of the patients was 1.5. The symptoms at the time of surgery included pelvic pressure, urinary incontinence, frequency, urgency, difficulty voiding and with defecation, and dyspareunia (in order of frequency). There was no recurrence of POP. The significant factors for PGI-I were age (b = −0.144, P = 0.022) and years from menopause to surgery (b = 0.133, P = 0.018). Conclusions: The older the age at the time of surgery, the more improved the symptoms of POP after surgery. The longer the interval from menopause to surgery, the less satisfied the patients
carcinoma (AdSCCa), and adenocarcinoma (AdCa) of the uterine cervix. Materials and Methods: This retrospective analysis included 836 patients with FIGO stage IB-IIA SCCa (n = 660), AdSCCa (n = 33), and AdCa (n = 143) of the uterine cervix who underwent type 3 radical hysterectomy with pelvic and/or paraaortic lymphadenectomy at Asan Medical Center, Seoul, Korea between 1997 and 2008. Results: The mean age were 49, 49, and 45 years for patients with SCCa, AdSCCa, and AdCa, respectively (P = 0.004). The mean tumor size were 28, 24, and 25 mm for patients with SCCa, AdSCCa, and AdCa, respectively (P = 0.036). Lymphovascular space invasion was more common in patients with AdCa (P = 0.002). Grade 3 histology was more common in patients with AdSCCa (P < 0.001). Vaginal involvement was more common in SCCa (P = 0.039). Deep stromal invasion, parametrial involvement, lymph node metastasis, and resection margin involvement were not different among groups. Adjuvant therapy was given to 33%, 33%, and 33% of patients with SCCa, AdSCCa, and AdCa, respectively. The mean follow-up time was 52 months (range, 1–138 months). In univariate analysis, age, grade, size, deep stromal invasion, parametrial involvement, and lymph node metastasis were significantly associated with disease free survival (DFS) and overall survival (OS). After adjusting for these factors in multivariate analsysis, DFS and OS were not different by histologic types. The mean time to recurrence was 26, 20, and 16 months for patients with SCCa, AdSCCa, and AdCa, respectively. Recurrences on distant sites were more common in patients with AdSCCa and AdCA. Conclusions: The mean time to recurrence was shorter and recurrences on distant site were more common in patients with AdSCCa and AdCa. However, the prognosis was not different by histologic types. O477 Relationship between CA-125 and osteoporosis in otherwise healthy postmenopausal women Y. Kim, K. Ahn, J. Shin, S. Hong, T. Kim, J. Hur, K. Lee, S.H. Kim. Korea University Medical Center Objectives: This study was aimed to investigate whether the known tumor markers were associated with osteoporosis in otherwise healthy postmenopausal women. Materials and Methods: 2,874 healthy postmenopausal women were selected among the 8,840 patients who participated in the health screening program between 2006 and 2007. Each participant had undergone basic body measurements, cardiopulmonary exam, blood, urine and stool analyses, abdominal ultrasound, gastro- and colonoscopies, and gynecological exam. Serum carbohydrate antigen-125 (CA-125), CA-19–9, carcinoembryonic antigen (CEA), and alpha-fetoprotein levels were evaluated as tumor marker. The selected 2,874 women were divided into two groups with or without osteoporosis according to the lowest T-score in lumbar spine or femur. Parametric t-test and multivariate logistic regression analysis were performed to determine the main factors of osteoporosis. Results: CA-125 (P = 0.000) and CEA (P = 0.000) levels were different between patients with and without osteoporosis. On logistic regression analysis, only CA-125 level among tumor markers was significantly lower in postmenopausal women with osteoporosis compared to without osteoporosis (P = 0.019; OR = 0.969, 95% confidence interval: 0.944–0.995). Conclusions: Lower CA-125 levels were significantly associated with osteoporosis in otherwise healthy postmenopausal women. Therefore, CA-125 levels need to be evaluated as confounding factor when osteoporoses are detected in otherwise healthy postmenopausal women.
S229
O478 Adjuvant concurrent chemoradiotherapy-induced neutropenia as a prognostic indicator of treatment in cervical cancer Y.H. Kim, H. Chung, J. Kim, N. Park, Y. Song, S. Kang. Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Republic of Korea Objective: To evaluate the association of adjuvant concurrent chemoradiotherapy-induced neutropenia with survival in patients with squamous cell carcinoma of the uterine cervix. Materials and Methods: One hundred seven patients with stage IB-IIB cervical cancer were analyzed. The median followup was 39.3 months (6.7–74.1 months). All patients had received radical surgery, including pelvic lymphadenectomy, followed by paclitaxel + carboplatin-based concurrent chemoradiotherapy. Relative neutropenia, defined as an absolute neutrophil count <1000/mm3 at the concurrent chemoradiotherapy cycle nadir, was correlated to the pathologic findings and survival outcomes. Results: Sixty-two percent of patients (n = 66) experienced neutropenia at least once during concurrent chemoradiotherapy, and demonstrated improvement in disease-free survival (P = 0.047), although not in overall survival. Disease-free survival gain was more significant, especially in the subgroups with parametrial invasion or lymph node metastasis (P = 0.033 and P = 0.028, respectively). Treatment-induced neutropenia was proved as the only significant independent factor to recur in cervical cancer (P = 0.037) among several variables, such as parametrial invasion, involvement of the resection margin, and lymph node metastasis. Conclusions: Concurrent chemoradiotherapy-induced neutropenia is a prognostic indicator of treatment efficacy in patients with cervical cancer, especially in patients with advanced disease. Individualized dose titration of concurrent chemoradiotherapy could be beneficial, although further systemic study is required. O479 Years from menopause to surgery is a major determinant of postoperative symptomatic improvement in postmenopausal pelvic organ prolapse Y.T. Kim, K. Ahn, H. Park, J. Song, T. Kim, J. Hur, K. Lee, S. Kim. Korea University Medical Center Objectives: This study was aimed to investigate what the main factors for symptomatic improvement were postoperatively in postmenopausal women with pelvic organ prolapse (POP). Materials and Methods: Ninety-four postmenopausal women were selected among the patients who had undergone surgery for symptomatic POP between 2003 and 2007. Age, body mass index (BMI), parity, menopausal age, years from menopause to surgery, years from symptom onset to surgery, operative time, and the follow-up interval were investigated. The symptomatic improvement of POP was evaluated by the Patient Global Impression of Improvement (PGI-I) scale. Ordered logistic regression analysis was performed to determine the main factor for symptomatic improvement after surgery for POP. Results: The mean age of the study participants was 63.7 years, the mean BMI and parity were 25.1 kg/m2 and 3.6, respectively. The mean menopausal age, years from menopause to surgery, and years from symptom onset to surgery were 49.8, 13.9, and 5.8 years, respectively. The mean follow-up interval was 2.3 years. The mean PGI-I scale of the patients was 1.5. The symptoms at the time of surgery included pelvic pressure, urinary incontinence, frequency, urgency, difficulty voiding and with defecation, and dyspareunia (in order of frequency). There was no recurrence of POP. The significant factors for PGI-I were age (b = −0.144, P = 0.022) and years from menopause to surgery (b = 0.133, P = 0.018). Conclusions: The older the age at the time of surgery, the more improved the symptoms of POP after surgery. The longer the interval from menopause to surgery, the less satisfied the patients