Ann Buhl

Pilot Phase 2 Trial of 4 Months of Maintenance Pegylated Liposomal Doxorubicin in Patients with Advanced Ovarian Cancer after Complete Response to Platinum and Paclitaxel-Based Chemotherapy

Background/Aims: Stages III and IV ovarian and peritoneal cancer patients are commonly treated with combination chemotherapy after surgical debulking. This phase II trial investigated the use of pegylated liposomal doxorubicin as consolidation chemotherapy for these patients. Methods: Women with stage III or IV ovarian or primary peritoneal carcinoma demonstrating no clinical evidence of disease after primary therapy were eligible for enrollment. Patients received 4 cycles of 40 mg/m2 IV of pegylated liposomal doxorubicin every 28 days. Results: Twelve patients were enrolled. There were 6 stage IIIC and 6 stage IV patients. Ten patients received 4 cycles. Two patients had dose limiting skin toxicity manifest as hand–foot syndrome and received only 3 cycles. Forty-six of a planned 48 cycles were administered. Median disease-free survival from registration is 10 months with a mean of 18 months. Median overall survival has not yet been reached. Four patients are disease-free, two have relapsed and six have died from disease progression. Conclusion: Pegylated liposomal doxorubicin is a well-tolerated choice for consolidation chemotherapy in patients with ovarian or primary peritoneal carcinoma.

Cone biopsy and pathologic findings at radical hysterectomy in stage I cervical carcinoma

OBJECTIVE To examine the association between cone biopsy and pathologic findings at radical hysterectomy in stage I cervical carcinoma. METHODS Fifty‐four patients diagnosed by cone biopsy with stage I cervical carcinoma and treated with radical hysterectomy comprised the study group. The association between the depth of invasion on conization, lymph‐vascular invasion, positive cone margins, positive endocervical curettage (ECC), and the depth of residual invasion in the radical hysterectomy specimen was examined using Pearson r and point biserial correlation. Independent predictors of the depth of residual invasion were determined by multiple regression. RESULTS The depth of residual invasion correlated significantly with the depth of invasion (r = .374) and presence of lymph‐vascular invasion (rpb = .372) in the conization specimen, post‐cone ECC status (rpb = .669), and age at diagnosis (r = .347). The same factors were jointly assessed using multiple regression (R2 = .636, P < .001). Depth of invasion on conization, lymph‐vascular invasion, and ECC status were identified as independent predictors of the depth of residual invasion. Patients with deep (5 mm or greater) stromal invasion and lymph‐vascular invasion on conization had significantly higher rates of positive parametrial margins (22% compared with zero, P = .001) and adjuvant radiation (66.7% compared with 20%, P = .004) compared with all other patients. CONCLUSION Depth of invasion, presence of lymph‐vascular invasion, and age at diagnosis were independent predictors of the depth of residual invasion in the subsequent hysterectomy specimen. These factors should be considered in treatment planning. Patients with a combination of these factors may have increased risk for deep residual invasion, positive hysterectomy margins, and adjuvant radiation.

Magnetic resonance imaging in the preoperative determination of tumor resectability in previously irradiated groin tumor

We present an unusual case in which magnetic resonance (MR) imaging was utilized in the preoperative determination of resectability of a large inguinal tumor. The patient had previously presented with a large fungating, surgically nonresectable mass, which impinged upon the anterior ramus of the pubic bone. Following chemotherapy and radiation, the mass appeared more mobile and surgically resectable. Due to fibrosis and induration, the relationship of the tumor and underlying femoral vascular bundle were unclear. MR imaging clearly depicted that the tumor was sufficiently distant from the vessels, to allow safe resection with an adequate surgical margin. Resection was performed with clear lateral and deep margins. Histopathology demonstrated squamous cell carcinoma of the inguinal skin replacing subcutaneous tissue.