Kan Komai

Vascular endothelial growth factor C and vascular endothelial growth factor receptor 2 are related closely to the prognosis of patients with ovarian carcinoma

The vascular endothelial growth factor (VEGF) family and VEGF receptors (VEGFR) play an essential role in the angiogenesis of both pathologic and nonpathologic conditions. However, the prognostic significance of VEGF and VEGFR expression in ovarian carcinoma is unclear.

Anthropometric and Other Risk Factors for Ovarian Cancer in a Case‐Control Study

Because it has been suggested that an environmental factor may play a role in the etiology of ovarian cancer, a case‐control study was conducted to assess some environmental and other risk factors for ovarian cancer from 1994 to 1996 in northern Kyushu, Japan. We analyzed the data of 89 cases with epithelial ovarian cancer and 323 controls without any cancer or ovarian disorder. After controlling for the effect of potential confounders, the odds ratios of ovarian cancer across increasing quartiles of the heaviest body weight were 1.00, 1.15, 1.71, 2.29 (P=0.008, test for trend). Significantly increased risks were noted for a history of diabetes mellitus (P<0.05), and for a family history of ovarian cancer (P<0.05). Significantly decreased trends for risk were obtained for the number of pregnancies (P<0.01) and the number of live births (P<0.001). This study provides additional support for an association between obesity and the risk of ovarian cancer. This relationship may at least partly explain the recent increase in the incidence of ovarian cancer in Japan, although possible contributions of other factors can not be ruled out.

Comparison of CA 125 assays with abdominopelvic computed tomography and transvaginal ultrasound in monitoring of ovarian cancer.

Objective: To compare serum CA 125 assays with computed tomography (CT) and transvaginal ultrasound (TVUS) for early detection of disease recurrence in patients with ovarian cancer. Methods: Sixty‐two patients with nonmucinous epithelial ovarian cancer who had positive CA 125 levels (> 35 U/ml) were studied. We performed a retrospective review to determine the usefulness of serum CA 125 measurements. Setting the cut‐off limit at either 35 U/ml or 16 U/ml, the accuracy of CA 125 measurements was compared with that of CT scanning, TVUS and operative findings at second‐look laparotomy (SLL) in the early detection of recurrent tumors. Results: Compared with SLL, both the specificity and the positive predictive value of CA 125 measurements were 100% at 16 and 35 U/ml. The sensitivity and the negative predictive value were 30.8 and 71.9%, respectively, below 35 U/ml and 53.8 and 79.3%, respectively, below 16 U/ml. The false‐negative rate of CT was 36.1%. When the cut‐off limit was reduced from 35 to 16 U/ml, 57.1% of patients considered to be in remission were reclassified as having persistent disease. A complete response confirmed by CT did not represent remission: CA 125 levels were 7.5‐fold higher at the time of re‐evaluation by CT. TVUS also lagged behind CA 125 assays in detecting disease recurrence. The sensitivity of ultrasound appeared to be lower than that of CT because it failed to detect extrapelvic lesions. Conclusion: A screening threshold (cut‐off level) of 16 U/ml for CA 125 should be used to detect recurrent serous ovarian adenocarcinoma. Although ultrasound is a convenient method of detecting intrapelvic lesions, and has cost benefits, CT is necessary to detect extrapelvic recurrence. Neither CT nor ultrasound are more accurate than serial CA 125 assays in detecting disease recurrence.

Fertility-preserving treatment for patients with malignant germ cell tumors of the ovary

Aim:  The aim of this study was to investigate whether fertility preservation influences the clinical outcome in patients with malignant germ cell tumors of the ovary (MGCTO).

Peptide YY producing strumal carcinoid of the ovary as the cause of severe constipation with contralateral epithelial ovarian cancer

Primary ovarian carcinoid tumors are rare. It has been reported that constipation was a presenting symptom in some patients with ovarian carcinoid. A case of strumal carcinoid of the ovary with contralateral clear cell adenocarcinoma of the ovary discovered with a complaint of constipation is described. Constipation was dramatically improved by resectioning the tumor. The tumor cells were positive for peptide YY (PYY) in the carcinoid component, but not in any other components. The present case could provide evidence of the correlation between constipation and PYY that has been reported elsewhere. Interestingly, the constipation caused by PYY also helped in discovering epithelial ovarian cancer.

Solitary splenic recurrence of ovarian cancer: case report and review of the literature

Abstract We report a rare case of solitary recurrence of ovarian cancer in the spleen which developed 4 years after initial treatment. Only six cases have been reported in the literature and all were serous carcinoma. Our patient had a splenectomy without any complications but developed a liver metastasis 10 months after splenectomy.

Desmoplastic small round cell tumor in the ovary: Report of two cases and literature review.

Desmoplastic small round cell tumor (DSRCT) is a rare intra‐abdominal tumor of uncertain histogenesis that occurs predominantly in young males. We report two cases of DSRCT in young women that presented clinically as ovarian tumor with extensive pelvic and abdominal dissemination. Both patients underwent debulking surgery and combined chemotherapy. After primary therapy, the tumors recurred and both women died of the disease. The clinical presentation and differential diagnosis, as well as the treatment, including surgical debulking and combined chemotherapy are discussed.

Injury to the endometrium prior to the frozen–thawed embryo transfer cycle improves pregnancy rates in patients with repeated implantation failure

This retrospective cohort study evaluated the effectiveness of injury to the endometrium prior to the frozen–thawed embryo transfer (FET) cycle in patients with repeated implantation failure (RIF) in our clinic.

Successful treatment of two patients with recurrent endometrial cancer by weekly paclitaxel

OBJECTIVE The aim of this study was to evaluate the toxicity and efficacy of weekly paclitaxel in patients with recurrent endometrial cancer. METHODS Paclitaxel (70 mg/m(2) by 1-h infusion weekly) was administered to two patients with recurrent endometrial cancer of the lung. RESULTS After 5 cycles, both patients with platinum-resistant disease achieved clinical partial responses confirmed by computed tomography (CT) scan. The serum CA125 levels of case 1 decreased to cut-off level. The response duration of both patients was 4 months. The toxicity was acceptable and probably less pronounced than that characterize of the standard tri-weekly schedules. CONCLUSION Although conclusions regarding survival are premature, weekly paclitaxel might offer better quality of life during treatment.

Transitional cell carcinoma of the ovary: Report of three cases

BackgroundWe investigated retrospectively the records and tissue samples of patients with primary ovarian transitional cell carcinoma to determine clinical and pathologic features.MethodsThe records of 3 patients with ovarian transitional cell carcinoma were reviewed using data from several imaging techniques: transvaginal ultrasound, computed tomography, and magnetic resonance imaging. We also determined levels of several tumor marker molecules; and the level of carbohydrate antigen 125 (CA 125), was examined by means of immunohistochemistry.ResultsThe tumors of 2 patients were classified as pure trnasitional cell carcinoma; in the remaining patient, as predominantly transitional cell carcinoma. All tumors were bilateral, and 2 of the 3 tumors formed solid masses. Areas of irregular high intensity signals were seen in magnetic resonance images of the solid parts of the tumors. All 3 tumors tested positive for CA 125; histochemical expression was confined to the tumor cell membrane and/or the cytoplasm in all cases. The tumors of all 3 patients tested negative for carcinoembryonic antigen (CEA), and second-look laparotomies did not reveal any residual neoplasms in any of the patients. The patients have been in a disease-free state for 34, 42, and 14 months, respectively.ConclusionOur results suggest that transitional cell carcinomas tend to arise bilaterally and to form solid tumors. Magnetic resonance imaging was a useful diagnostic modality in these cases. Transitional cell carcinoma was characterized by the presence of CA 125 and the absence of CEA.