There is currently controversy regarding the criteria for low and intermediate risk of cervical cancer (CC) after surgery. In the present study, the Gynecology Oncology Group (GOG) score was used to detect intermediate risk. Adjuvant radiotherapy was applied in the case of a GOG score >120. The present study aimed to evaluate the validity of the recurrence risk classification using the GOG score for stage IB-IIA node-negative CC. All cases of stage IB-IIA node-negative CC who underwent radical surgery between February 2007 and December 2015 were retrospectively reviewed. The GOG scores were determined from clinical and pathological findings and accordingly, subjects were divided into 4 groups: A, ≤40; B, >40 and ≤70; C, >70 and ≤120; and D, >120. Overall survival (OS) and recurrence-free survival (RFS) curves were generated using the Kaplan-Meier method. The log-rank test produced an estimated P-value by comparing the OS and RFS of group A (low-score group) with those of others. The present study included 61 patients (mean age, 47.82 years; age range, 22-76 years) and the median follow-up was 79 (39-149) months. Of these, 60 patients were observed for at least 60 months. During the follow-up period, the OS and RFS rates of group C were 94.7 and 84.2%, respectively, while those of group D were 100 and 91.7%, respectively; the OS and RFS of groups A and B were 100%. Log-rank tests for all OS and RFS indicated no significant differences compared to group A. It was indicated that a GOG score ≤70 does not require adjuvant therapy; however, a GOG score >70 requires consideration of adjuvant therapy based on the risk factors which constitute the score.
Giant cell tumor is a highly aggressive tumor characterized by a marked proliferation of pleomorphic, bizarre giant cells usually observed in the lungs. The importance of histopathological imaging and the clinical course of this tumor are unknown. The objective of our report was to investigate whether these components affect treatment outcomes and prognosis compared to conventional cancers. A 40-year-old woman with cervical cancer showed leukocytosis and elevated granulocyte colony simulating factor (G-CSF). The patient underwent a radical abdominal hysterectomy. Pathology revealed a poorly differentiated squamous cell carcinoma of the cervix, similar to giant cell carcinoma. The patient recovered from the disease and is alive 37 months after concurrent chemoradiotherapy (CCRT). Leukocytosis and G-CSF were normalized after treatment. This was our second case of giant cell carcinoma of the cervix. Cumulative data on giant cell carcinoma are limited, thus we considered the prognostic significance of the presence of giant cell carcinoma in uterine carcinoma.
Objective: This study aimed to report the experiences and problems associated with surgical training using a cadaver.Materials and Methods: A surgical technique training was held in our department using a cadaver, which was embalmed using Thiel's method once a year since 2014. In consideration of the widespread introduction of laparoscopic surgery, we set up the first laparoscopic booth in addition to laparotomy training in 2016. The Thiel's method was used to treat the corpse.Result: The Thiel's method, which preserves the texture of the corpse as close to the living body as possible compared with the conventional embalming method, leads to good operability. Manual operation with radical hysterectomy and exteriorization of the blood vessels/nerves in the deep pelvis could be performed with an almost similar protocol as in the actual operation. However, as bleeding did not occur, tension reduced and the procedure was not performed with as much care and precision. During laparoscopic training, in addition to the confirmation of the anatomy, performing the surgical procedure becomes easier. Thus, among the doctors who perform laparoscopic radical hysterectomy, the timing to change from manual operation to professional laparoscopy is difficult. Due to the limitation in the number of donations and time constraints, setting goals according to the experience of the laparoscopic surgeon with malignant tumor surgeries and to devise measures such as changing of operators for each technique should be considered.
Conclusion:Laparoscopic training using a cadaver treated with Thiel's method was thought to be useful for practical training and anatomical learning.
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