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Background: To assess the validity and accuracy of GI-RADS classification in the prediction of malignancy and in triaging the management protocol in ovarian lesions.Results: One hundred fifty-six ovarian lesions were detected in the examined 116 women. The prevalence of malignant tumors was 44%. Overall GI-RADS classification rates were as follows: 41 cases (26.3%) were classified as GI-RADS 1, 26 cases (16 .7%) as GI-RADS 2, 34 cases (21.8%) as GI-RADS 3, 14 cases (8.9%) as GI-RADS 4, and 41 cases (26.3%) as GI-RADS 5. No follow-up was done in GI-RADS 1 patients. A final diagnosis of all GI-RADS 2 ovarian masses such as functional cyst (n = 10), hemorrhagic cysts (n = 8), corpus luteal cysts (n = 6), and some GI-RADS 3 as simple cysts (n = 10) was made by spontaneous resolution of these masses at follow-up after 6 weeks. Fifteen cases of GI-RADS 3 as mature teratoma, serous and mucinous cystadenoma, endometrioma, and ovarian torsion and all GI-RADS 4 and 5 underwent laparoscopic or surgical removal of the ovarian mass with histopathological examination. The diagnostic performance of the GI-RADS in predicting the risk of malignancy in ovarian masses was as follows: 98.11% sensitivity, 95.15% specificity, 91.2% positive predictive value (PPV), 99.2% negative predictive value (NPV), and 20.2 positive likelihood ratio, and the overall accuracy was 96.2% (area under receiver operating curve (AUC) = 0.96, P < 0.001).Conclusion: GI-RADS classification performs well as a reporting system of the ovarian masses with high diagnostic performance in the prediction of malignancy, and it seems to be a helpful tool in triaging management in patients with ovarian masses.

Aim: The aims of this study were to assess survival outcome of pediatric patients with localized osteosarcoma of the extremities in Upper Egypt, identify factors of prognostic significance for survival, and to determine factors predictive of surgical methods used in these patients, as well as developing a clinical model for risk prediction. Patients and Methods: A retrospective analysis of data assembled from medical records of 30 pediatric patients with a histologically verified nonmetastatic osteosarcoma of the extremities treated at South Egypt Cancer Institute with a unified chemotherapy protocol between January 2001 and December 2015 was carried out. Prognostic factors were determined using univariable and multivariable methods. A model for surgical outcomes in these patients based on the baseline clinical factors, and the parameters predictive of their tumor response to chemotherapy, was developed. Results: With a median follow-up of 63 months for the study population, the estimates for event-free survival and overall survival (OS) at 3 and 5 years were 69.5% and 79% and 65.2% and 65.3%, respectively. Age 16 years or above was independently associated with both worse metastasis-free survival (hazard ratio [HR]=6.05, 95% confidence interval [CI]: 1.43-25.6, P=0.015) and OS (HR=7.9, 95% CI: 1.71-36.2, P=0.008). In the multivariable analysis, a proximal location within the limb gained a statistical significance to be independently associated with worse OS (HR=2.4, 95% CI: 1.13-22.1, P=0.003). Poor response to chemotherapy was marginally associated with worse metastasis-free survival (HR=4.9, 95% CI: 1.02-23.8, P=0.047) only in the univariable analysis. The patients found to be more likely to undergo an amputation surgery (odds ratio=14.1, 95% CI: 1.34-149.4, P=0.028) were those in whom a tumor was poorly responding to chemotherapy. Conclusion: In Upper Egypt, despite the reasonable survival outcomes in nonmetastatic osteosarcoma, a relatively high limb amputation rate has been encountered. The development of a clinical prediction model for future planning of possible outcome improvement in these patients, however, is still feasible.

Background and objectives: Surgery is the primary therapy for localized gastric cancer, but even with the best results only 40% 5-year survival can be achieved with the use of postoperative adjuvant chemoradiotherapy. Preoperative therapy might help increase the R0 resection rate, which is an independent predictor of 5-year OS. Our study hypothesized that the concurrent combination of carboplatin-paclitaxel with radiation therapy would result in a pathological CR rate, which will be in turn associated with OAS and DFS benefits. Patients and methods: prospective phase II study included 32 patients with locally advanced gastric adenocarcinoma including gastroesophageal junction who received a combination of neoadjuvant conformal radiotherapy concurrently with carboplatin-paclitaxel followed by surgery. Results: Pathological CR and R0 resection rates were 18.8% and 75% respectively. With a median follow up of 24 months, 2 years disease-free survival was 28.1% and overall survival was 51.3%. The regimen was tolerated with neither grade 4 toxicities nor deaths. Conclusion: Neoadjuvant radiotherapy concomitant with carboplatin-paclitaxel chemotherapy is a well-tolerated approach for patients with locally advanced gastric adenocarcinoma resulting in significant pathological CR and R0 resection margins as reflected by the good DFS and OS.

Aim: To assess the outcome and determine predictors of survival in pediatric patients with osteosarcoma of the extremities treated with a unified chemotherapy protocol at a single institution over a 15-year period. Materials and Methods: We performed a retrospective analysis of medical records of 48 pediatric patients with histologically verified osteosarcoma of the extremities diagnosed at South Egypt Cancer Institute and received treatment between January 2001 and December 2015. Results: With a median follow-up of 61 months for the entire cohort, estimates of overall survival (OS) for 3- and 5-year were 50.9% and 42.1%, respectively. While the estimates of OS for 3- and 5-year in the nonmetastatic group were 79% and 65.2%, respectively. In the multivariable analysis, both metastatic disease at diagnosis and poor response to chemotherapy retained their statistical significance as independent predictors for event-free survival. Whereas for OS, a metastatic disease at diagnosis remained as the lone predictor of a dismal outcome, while a poor response to chemotherapy became marginally associated with an inferior outcome. Conclusions: In Upper Egypt, whereas slightly less than two thirds of children with localized osteosarcoma of extremities survives their disease, metastasis at presentation remains the key predictor of dismal survival outcomes.