Francesca Martra

Adjuvant treatment and survival in obese women with endometrial cancer: An international collaborative study

OBJECTIVE The purpose of this study was to determine the impact of patient weight on the frequency of surgical staging lymphadenectomy and pelvic radiation. Adverse effects, disease relapse, and survival outcomes were investigated. STUDY DESIGN Records of 766 women who underwent surgery for presumed corpus-confined endometrial cancer were reviewed. Body mass index (BMI) was calculated to categorize women as obese (BMI, > or = 30 kg/m2) or nonobese (BMI, < 30 kg/m2). Radiation-related toxicity was scored retrospectively. Median duration of follow-up period was 38 months. Chi2, logistic regression, correlation, Kaplan-Meier, and Cox multivariate proportional hazards were used for analysis. RESULTS Lymphadenectomy was completed as often in nonobese as obese women (P = .24). Adjuvant pelvic radiation treatment was administered more often in nonobese women (P = .01). Among 681 women with endometrioid histopathologic findings, 4-year cancer-related survival in obese women was 10% higher than all cause deaths, compared with 6% in nonobese women. CONCLUSION Obesity was not a barrier to lymphadenectomy, but did influence adjuvant pelvic radiation use.

A Search for Predictive Factors for Hypersensitivity Reactions to Paclitaxel and Platinum Salts in Chemotherapy for Gynecologic Pelvic Neoplasms

Aims: To investigate the frequency of and predictive factors for hypersensitivity reactions (HR) to taxanes and platinum salts in a cohort of patients treated for pelvic gynecologic malignancies. Methods: The medical records of all patients with gynecologic pelvic neoplasms treated with chemotherapy at the Department of Gynecologic Oncology, AO Mauriziano Umberto I of Turin, from September 2007 through August 2008, were retrospectively reviewed. Two multivariate models, regarding carboplatin and taxane chemotherapy, respectively, were performed to evaluate the potential predictive value of various clinical features. Results: The incidence of HR was 14% (22/157). Multivariate models showed that menopausal women had a significantly lower probability of HR (OR 0.12, CI 0.02–1.13, p = 0.06 for the carboplatin model and OR 0.05, CI 0.01–0.63, p = 0.02 for the taxane model) while a history of systemic hypersensitivity was associated with a higher but non-significant risk of HR (OR 2.64, CI 0.78–8.95, p = 0.11, for the carboplatin model and OR 3.42, CI 0.94–12.45, p = 0.06, for the taxane model). Conclusion: We confirmed a history of hypersensitivity as a risk factor for HR. Other larger cohorts should be analyzed: we need to find new predictive factors in order to select women who should be submitted to experimental prophylactic strategies.

Chemotherapy plus radiation in advanced-stage endometrial cancer

Hypothesis We hypothesize that adjuvant radiation and chemotherapy improve the clinical benefit from treatment of advanced-stage endometrial adenocarcinoma. Methods We conducted a retrospective review of 125 patient with stage III or IVA endometrial adenocarcinoma who received adjuvant chemotherapy (n = 60) or chemoradiation (n = 65). Primary end points were rate of clinical benefit (ie, the percentage of patients who were alive and disease-free for at least 6 months after the last day of adjuvant treatment) and progression-free and overall survival. Results The addition of radiation to chemotherapy improved the rate of clinical benefit from 55% to 77%. Differences in clinical benefit were attributed to a reduction in the number of pelvic relapses after chemoradiation. There were no substantial differences in the rate of extrapelvic relapse events seen between the chemotherapy alone and chemoradiation groups. Patients receiving radiation had prolonged median progression-free survival (36 vs 17 months in chemotherapy alone) and median overall survival (70 vs 64 months in chemotherapy alone). Conclusions The addition of radiation to chemotherapy improved the clinical benefit of patients with stage III or IVA endometrial adenocarcinoma. A clinical trial powered to evaluate clinical benefit and survival outcomes of chemotherapy and radiation is under way.

Syringoid eccrine carcinoma: Case report of a rare tumor occasionally detected in the vulva

► Syringoid eccrine carcinoma (SEC) is a rare tumor. ► There are no published reports describing diagnosis of this tumor on the vulva. ► We report a case of a 58-year-old female with a SEC of left labia majora.