QASICC has proved to be efficient, and to detect known issues regarding daily activities and body image. As our population was mostly composed of women with breast cancer, our results reflect specific aspects of this population. The TIVAD remains generally well-accepted and our questionnaire should help health-care workers to better address the specific needs of their patients based on the answers provided.
Background: Prognostic factors for pure mucinous carcinomas of the breast are controversial; data on DNA ploidy and S-phase fraction (SPF) are lacking. We examined the relation of these parameters with histological features and patient survival.Methods: DNA flow cytometry was performed on 69 fresh or frozen pure mucinous carcinomas samples. Results were interpreted according to patient survival.Results: Tumor size exceeded 2 cm in 40.5% of cases. Lymph nodes were involved in 11.5% of cases and never when tumor size was less than 2 cm. Aneuploidy was only observed in one-quarter of the tumors. Very few tumors had a high-SPF or a high histological grade (7.2% of all cases). These two parameters were of prognostic value respectively for disease-free (P = 0.035) and overall survival (0.050). Patients with tumors >2 cm had shorter overall survival than patients with tumors ≤2 cm (P 5 0.028). Disease-free and overall survivals were not influenced by nodal status and hormone receptors (HRs) status. Patients with aneuploid tumors had shorter disease-free survival than patients with diploid tumors (P 5 0.031). The combination of tumor size and DNA ploidy was strongly predictive of survival (P < 10 23 ): six patients with large aneuploid tumors had a poor outcome (1-year overall survival 16.7%).Conclusion: We identified a subset of patients with a poor prognosis, namely those with large aneuploid tumors. This study confirms the good prognosis of pure mucinous carcinomas, particularly when tumor is less than 2 cm (corresponding to cases without lymph nodes involvement), thus challenging the need for axillary nodal examination. q
ObjectiveThe aim of this study was to explore the feasibility and safety of the laparoscopic approach after neoadjuvant chemotherapy among selected chemosensitive patients with advanced ovarian cancer.MethodsThe CILOVE study was a phase II prospective non-randomized multicenter study. It aimed to enroll 47 women with unresectable disease at the time of initial diagnosis (International Federation of Gynecology and Obstetrics (FIGO) stage IV and/or diffuse extensive carcinomatosis for advanced FIGO stage IIIC or patients unfit to withstand radical primary surgery), in response to chemotherapy and fit to undergo laparoscopy.ResultsAmong the 48 patients enrolled in the trial, 44 (92%) patients underwent exploratory staging laparoscopy and, as a result, 41 patients were eligible for cytoreductive surgery. Among them, 32 were intended to be managed by laparoscopy and nine patients were managed by laparotomy. The conversion rate to laparotomy was 9.4% (3/32) and the reasons were multiple surgical adhesions (n=1), miliary carcinomatosis and adhesion to the intraperitoneal mesh (n=1), and poor laparoscopic evaluation of transverse colon involvement (n=1). All except one patient had optimal cytoreduction (97% complete cytoreduction, 3% incomplete cytoreduction (residual tumor <2.5 mm)). The median operative time was 267 min (range 146–415) and the median estimated blood loss was 150 mL (range 0–500). Two patients had intra-operative complications: one diaphragm rupture that was repaired during laparoscopy and one bradycardia. Six patients experienced early post-operative complications (<1 month), but there were no grade 3 and 4 complications (3 infections, 1 lymphoedema, 2 hemorrhage). After cytoreductive laparoscopy, the percentage of patients without progression at 12 months was 87.5%.ConclusionsInterval ovarian cytoreduction by a laparoscopic approach is safe and feasible for patients with a favorable response to chemotherapy. With the widespread use of neoadjuvant chemotherapy in the management of advanced ovarian cancer, a minimally invasive approach may be a potential option.
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