Presurgical prognostic factors in carcinoma of the cervix, stages IB and IIA

Citations from the Literature etan (n = 32) and cefoxitin (n = 36). There were six tuboovarian abscesses in each group. C. trachomatis was recovered from 7 (10%) and N. gonorrhoeae from 48 (71%) of the patients. Anaerobic an aerobic bacteria were recovered from the upper genital tract in 53 (78%) of the patients. Cefotetan plus doxycycline and cefoxitin plus doxycycline demonstrated high rates of initial clinical response in the treatment of acute pelvic inflammatory disease. Clinical cure was noted in 30 (94Vo) of the cefotetan plus doxycycline group and 33 (92%) of the cefoxitin plus doxycycline group. Four failures were sonographically diagnosed tuboovarian abscesses that responded to clindamycin plus gentamicin therapy. The fifth failure was an uncomplicated case that did not respond to cefoxitin and doxycycline and required additional therapy. At 1 week and 3 weeks. respectively, the posttreatment cultures demonstrated eradication, in all instances, of N. gonorrhoeae and C. trachomatis. These regimens also were very effective in eradicating anaerobic and aerobic pathogens from the endometrial cavity. Both regimens were well tolerated by the patients, and few adverse drug affects were noted.

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GYNECOL. ONCOL.; 29/3 (290-304)/1988/ Although the clinical and pathological features of sarcoma botryoides of the vagina in infancy are well documented in the literature, only occasional cases of a histologically similar tumor of the uterine cervix have been described, mostly as individual case reports. We have reviewed 13 cases sarcoma botryoides of the cervix. The patients range in age from 12 to 26 years, with a mean of 18 years. All presented with vaginal bleeding, ‘something’ protruding from the introitus, or both. On gross examination the tumors were polypoid, smooth, glistening, and focally hemorrhagic. Microscopic examination revealed the presence of a cambium layer and cells showing the features of rhabdomyoblasts in all the cases. Sii of the 13 tumors (45%) contained foci of mature cartilage. All the patients were alive and well 1 to 8 years (average 3.5 years) postoperatively except for one who died of the tumor after 1 year. Although most of the patients had a radical operation, sometimes followed by chemotherapy, three had excellent results after polypectomy or cervicectomy. The findings indicate that, unlike its counterpart in the vagina, which has a poor prognosis, sarcoma botryoides of the cervix in young women has a favorable outlook.

ONCOLOGY Presorgieal prognostic factors in carcinoma of the cervix, stages IB and IIA

O’Brien DM; Carmichael JA Division of Gynaecologic Oncology, Department of Obstetrics and Gynaecology, Queen’s University, Kingston, Ont., Canada AM. J. OBSTET. GYNECOL.; 158/2 (250-254)/1988/ Possible prognostic factors in early stage cervical cancer include patient age, tumor size. cell type, differentiation, and channel invasion. In this study each of these factors was evahtated based only on the findings available before surgery, and the observations are compared with patient survival and incidence of node metastases. One hundred consecutive patients with stage IB or HA cervical cancer treated by primary radical surgery and followed by at least 2 years are reported. Diseasefree survival was 9OVoat 2 years and 85% at 5 years; 19% had node metastases. Of the factors studied, only age >50 years was associated with poor prognosis (p < 0.02 versus age < 50 years). Only large tumor size was associated with increased node metastases (p < 0.001 versus medium and small size). Tumor cell type, differentiation, and channel involvement had no bearing on survival or node metastases. Because older age and large tumors appear to be factors of poor prognosis for surgery, and yet it is not clear that these patients fare better with radiotherapy, we suggest a prospective trial of radiotherapy versus surgery for this group.

Sarcoma botryoides of the uterine cervix in young women: A clinkopnthological study of 13 cases

Daya DA; Scully RE Department of Pathology, Henderson Hamilton, On t. Lg V 1C3, Canada

General Hospital,

Continuous iafusion fluoropyrimidiues as salvage therapy for patients wltb advanced ovarian carcinoma

Goodman HM; Dottino PR; Kredenster D; et a.I Division of Gynecologic Oncology, The Department of Obstetrics, Gynecologv and Reproductive Science, The Mount Sinai School of Medicine, New York, NY 10029, USA GYNECOL. ONCOL.; 29/3 (348-355)/1988/ A major challenge facing those caring for patients with ovarian carcinoma is inducing remission following the failure of first-line treatment. Toward this end, we have examined the efficacy of continuous infusion fluoropyrimidines. During a 2year period, nine patients with recurrent ovarian carcinoma received treatment with continuous infusion S-fluorouracil (5FU) or 5-fluorouracil-deoxyribose as single agents or in combination with other drugs. Eight patients were evaluable, with responses obtained with each treatment regimen. Myelotoxicity was mild, with only 3 episodes of grade 4 toxicity out of 70 total cycles of chemotherapy. Mucositis was moderate to severe, tending to be the dose-limiting adverse effect. Continuous infusion 5-FU in these combinations appears to be active with every acceptable toxicity in heavily pretreated patients.

Predictive value of preoperative serum CA 125 levels in clinically localized and advanced endometrial carcinoma

Patsner B; Mann WJ; Cohen H; Loesch M Division of Gynecologic Oncologv, Department of Obstetrics and Gynecology, School of Medicine, State University of New York, Stony Brook, NY 11794-8091, USA AM. J. OBSTET. GYNECOL.; 158/2 (399-402)/1988/ Serum CA 125 levels were measured preoperatively by standard radioimmunometric techniques in 89 patients with primary endometrird carcinoma before definitive surgical stagInt / Gynecol Obstet 28