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Jing-he Lang

Publications and source records attributed to Jing-he Lang.

At least 19 recordsLinked to original sources

[The study on the prevalence and associated risk factors of female urinary incontinence in Beijing women].

OBJECTIVES: To evaluate the prevalence, the clinical characteristics and associated risk factors of urinary incontinence in Beijing women. METHODS: In the cross-sectional study, 5300 Beijing women aged over 20 years were interviewed through a questionnaire including International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms Module (ICIQ-FLUTS). Aged from 20 to 99 years old (mean 46 +/- 17). Divided into 8 groups every 10 years. 4812 cases are married. RESULTS: The overall prevalence of UI was 38.5% (2008/5221), among theses women, 22.9% (1197/5221), had stress incontinence, 2.8% (147/5221) urge incontinence and 12.4% (649/5221) mixed incontinence. In multiple logistic models, age, delivery mode, smoking, hypertension, constipation, body mass index, chronic pelvic pain (CPP) were relation factors for stress incontinence. CONCLUSIONS: The prevalence of urinary incontinence is high (38.5%). Urinary incontinence is major disease that affects female quality of life. 22.9% (1197/5221) of the incontinence women had stress urinary incontinence, 2.8% (147/5221) urge urinary incontinence and 12.4% (649/5221) mixed urinary incontinence. Old, vaginal delivery, smoking, hypertension, constipation, CPP and higher BMI are potential risk factors for stress urinary incontinence. Cesarean section are protective factors for stress urinary incontinence.

Adult↗

[Cervical carcinoma in situ: a clinical and pathological analysis of 118 cases].

OBJECTIVE: To analyze the clinical characteristics and treatment of cervical carcinoma in situ. METHODS: The clinical data of 118 patients with cervical carcinoma in situ (CIS), aged 38.8 (24-77), were retrospectively analyzed. RESULTS: Cervical cytology showed that most of the lesions were cervical intraepithelial neoplasm (CINIII), high-grade squamous intraepithelial lesion (HSIL), or CIS. Most of the patients underwent colposcopic examination. All the patients underwent conization. 54% of the patients were given cold knife conization, and 46% of the patients received electric knife conization. 71 of the patients undergoing conization (60%) were followed-up. Another 40% received total hysterectomy and/or bilateral salpingo-oophorectomy. 17 cases were found pregnant after the conization. There were no differences in pathologically thorough resection and operational complication between the two surgery methods: cold knife conization and electric knife conization. Follow up study showed that conization had no effect on the subsequent pregnancy. CONCLUSION: Conization is necessary for the final diagnosis of cervical carcinoma in situ. Both cervical cytology and colposcopic examination are very important for screening of CINIII or CIS. For the young patients conization suffices, however, for the postmenopausal women or those unable to receive follow-up examination total hysterectomy and bilateral salpingo-oophorectomy should be considered.

Adult↗

Role of laparoscopy in the diagnosis and treatment of adnexal masses.

BACKGROUND: Laparoscopy has been accepted for years as a management of benign ovarian tumors. The aim of this study was to estimate the feasibility and safety of laparoscopy in diagnosis and management of adnexal masses. METHODS: A total of 2083 patients with benign adnexal mass were treated by laparoscopy at Peking Union Medical College Hospital from January 2000 to December 2003. Their clinical data were reviewed retrospectively. All the adnexal masses suspicious of malignancy at the time of laparoscopy were sent for frozen section evaluation intraoperatively. The rates of unexpected intracystic vegetation and low malignant potential (LMP) tumor or malignancy were investigated. The sensitivity, specificity, positive predictive value, and negative predictive value of laparoscopic diagnosis for LMP or ovarian malignancies were calculated. The ratios were compared by Chi-square test and the continuous variables were tested using two-tailed t test. RESULTS: Of the 2083 patients, 16 had LMP or invasive tumors (0.77%), among which 14 were diagnosed histologically intraoperatively and 2 postoperatively. Fifty-five (2.6%) of the 2083 patients had unexpected intracystic vegetations. Their frozen sections showed benign tumors in 41 (74.5%), LMP tumors in 8 (14.5%), and focal invasive ovarian cancers (stage Ic) in 6 (10.9%). The final pathological diagnosis were benign tumors in 41 (74.5%), LMP tumors 7 (12.7%), and focal invasive ovarian cancers (stage Ic) in 7 (12.7%). Laparoscopy achieved a sensitivity of 87.5%, specificity of 98%, positive predictive value of 25.5%, and negative predictive value of 99.9% in the diagnosis of ovarian malignancies. 2067 cases with benign adnexal masses underwent laparoscopy successfully. No conversion to laparotomy, or intra- and postoperative complications in this series. Of the 16 patients with LMP or invasive ovarian cancer, seven underwent laparoscopic surgery including immediate staging laparoscopy in 3. The mean follow-up was 17.3 months for the 16 patients. Among them, 1 developed a recurrent LMP tumor in the contralateral ovary 36 months after laparoscopic salpingo-oophorectomy, and received subsequent laparoscopic cystectomy and pelvic lymph node sampling; the others had no evidence of recurrent tumor during the follow-up. CONCLUSION: Laparoscopy is feasible for diagnosis of adnexal masses, and the surgery is safe for patients with benign ovarian tumors.

Adolescent↗

Treatment options for patients with recurrent ovarian cancer: a review of 54 cases.

OBJECTIVE: To evaluate the efficacy of treatment options for patients with recurrent ovarian cancer. METHODS: From 1990 to 2000, 54 patients with recurrent ovarian cancer primarily treated in Peking Union Medical College Hospital were selected and reviewed. All the clinical data related to the recurrent tumor were collected. Two-side P values for differences in survival were calculated by the Cox regression model. RESULTS: The platinum-free interval > 6 months and the surgery followed by salvage chemotherapy prolonged survival time of the patients with recurrent ovarian cancer (95% CI = 0.153-0.987, P = 0.047; 95% CI = 1.611-10.914, P = 0.003, respectively). The increased number of chemotherapy cycles ( > 10 months) offered some benefit on the survival (95% CI = 0.110-1.090, P = 0.070). The initiation of treatment and chemotherapy regiments failed to demonstrate an improvement in survival. CONCLUSION: The treatment options for patients with recurrent ovarian cancer depend on the platinum-free-interval of the patients. A strategy of secondary surgical cytoreduction followed by salvage chemotherapy is suggested for the patients with platinum-sensitive disease.

Adult↗

Fallopian tube prolapse following hysterectomy.

OBJECTIVE: To investigate the clinical diagnosis, treatment, and prevention of fallopian tube prolapse (FTP) after hysterectomy. METHODS: A total of 7949 patients received hysterectomy from January 1983 to August 2005 in Peking Union Medical College Hospital, and 9 cases (including 1 case from other hospital) of FTP after hysterectomy were involved during this period. All of them were diagnosed according to pathological results and were followed up. The symptoms, diagnosis, and treatment of the FTP patients were analyzed retrospectively. RESULTS: The incidence of FTP after hysterectomy was 0.1% (8/7949), with the incidence of FTP after transabdominal hysterectomy being 0.06% (4/6229), after trans-vaginal hysterectomy being 0.5% (4/780), after laparoscopic assistant vaginal hysterectomy being 0 (0/940). There was no symptom in 3 cases. The pelvic examination revealed the typical prolapsed fimbrial end of a fallopian tube in 3 cases and the other 6 cases revealed red granulation tissue. All of them were excised vaginally and cauterized. The results were proved by pathological examination. No recurrence was reported during follow-up. CONCLUSIONS: FTP is a rare complication after hysterectomy. The prognosis is well after proper diagnosis and treatment Fixation of accessories onto the pelvic wall and complete peritonealization at the time of hysterectomy are the most important methods to prevent FTP after hysterectomy.

Adult↗

[Expressions of matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 mRNA in endometriosis].

OBJECTIVE: To investigate mRNA expression of matrix metalloproteinase (MMP-9) and tissue inhibitor of metalloproteinase (TIMP-1) in ectopic endometriosis tissue and uterine endometrium from women with and without endometriosis. METHODS: Thirty-eight women with endometriosis (Revised American Fertility Society classification, RAFSI-IV) were selected as study group. Thirty-eight specimens of ovarian endometrioma (ovarian chocolate cysts, OCC), 16 red peritoneal endometriotic lesions (RPL), and 35 matched eutopic endometrium (Eu) were collected from them simultaneously at the time of surgery. Twenty specimens of endometrium from reproductive women undergoing laparoscopic surgery without endometriosis were obtained as control group. The mRNA expressions of MMP-9 and TIMP-1 were detected by reverse transcription polymerase chain reaction (RT-PCR). RESULTS: Expression of TIMP-1 mRNA was detected in all samples. The level from endometriosis patients and control group was similar (2.31 +/- 1.21, 2.40 +/- 0.89). However, ectopic endometrium expressed significantly fewer TIMP-1 mRNA (OCC 1.67 +/- 0.79, RPL 1.45 +/- 0.68) compared with eutopic endometrium from both endometriosis and endometriosis-free patients (P < 0.05). The positive expression rate of MMP-9 mRNA was not distinctively different among all samples. The density of MMP-9 mRNA expression in endometrium (0.49 +/- 0.28) from endometriosis patients was similar to that in ectopic endometriosis (OCC 0.46 +/- 0.22, RPL 0.33 +/- 0.12), but was significantly higher compared with endometrium (0.29 +/- 0.12) without endometriosis (P < 0.05). CONCLUSIONS: An increase of MMP-9 mRNA expression of eutopic endometrium with endometriosis might enhance the endometrial implantation ability, thus facilitate the ectopic implantation of endometrium. Ectopic lesions express significantly less TIMP-1 mRNA, indicating they have increased invasive ability, which might facilitate the development of endometriosis.

Actins↗

[Primary study on fusions of ovarian carcinoma cells to dendritic cell transfected with interleukin-12 gene in vitro].

OBJECTIVE: To investigate the immune response of the fusions of ovarian carcinoma cells to dendritic cell (DC) transfected with interleukin (IL)-12 gene in vitro. METHODS: Recombinant human granulocyte macrophage colony stimulating factor and recombinant human tumor necrosis factor alpha were used to generate DC from cord blood in vitro. IL-12 fusion gene was cloned into a eukaryotic vector-pcDNA3.1 (+). DC were transfected with IL-12-pcDNA3.1 (+) using lipofectamine transfection method and electric transfection method respectively. Then polyethylene glycol mediated the fusion of transfected DC and ovarian carcinoma cells, and 3-(4, 5-dimethylthiazol-2-yl) 2, 5-diphenyl tetrazolium bromide (MTT) test was carried out to observe the immune response. RESULTS: DC were generated in vitro from cord blood and expressed high levels of costimulatory (50%) and MHC II molecules (99%). RT-PCR showed that IL-12-pcDNA3.1 (+) had been successfully transfected into DC. RT-PCR and immunofluorescence analysis showed that DC were fused with ovarian carcinoma cells successfully. Then the fusion cells of ovarian carcinoma cells to transfected DC, and the fusions of ovarian carcinoma cells to DC were cocultured with peripheral blood mononuclear cell respectively. MTT test showed that both fusions could induce cytolytic T cell activity and lysis of ovarian carcinoma cells, and the former effect was stronger. CONCLUSION: The cytolytic T cell activity induced by the fusions of ovarian carcinoma cells to transfected DC is enhanced.

Cell Fusion↗

[Visual and histologic analysis of laparoscopic diagnosis of endometriosis].

OBJECTIVE: To determine the characteristics of anatomical distribution of pelvic endometriosis and the correlation between visual and histologic findings of endometriosis at laparoscopy. METHODS: A prospective study of 62 patients undergoing laparoscopy for the pelvic pain, infertility and/or pelvic masses was carried out. All lesions with the diagnosis of endometriosis laparoscopically were excised and examined pathologically. Normal-appearing peritoneal biopsies were obtained randomly. All lesions were identified by anatomical site and color of the foci. The positive predictive value (PPV), sensitivity, negative predictive value (NPV), and specificity were determined for visually identified endometriosis versus the histologic findings. RESULTS: Totally, 219 peritoneal endometriotic lesions, 54 normal peritoneal biopsies, and 71 ovarian endometriotic cysts were obtained. Peritoneal lesions tended to locate in posterior part of the pelvis (80.8%, 177/219) and in left (58.0%, 127/219) with most in black (39.2%). The PPV was 67.6%; sensitivity, 93.7%; NPV, 81.4%; and specificity, 38.3% for visual versus histologic diagnosis of peritoneal endometriosis. Lesions in black or from sacral ligaments were confirmed histologically in 94.2% and 84.7% respectively, and 80.3% (57/71) of ovarian endometriotic cysts diagnosed by laparoscopy were confirmed histologically with 43.6% in the left, 27.3% in the right; and 29.1% (16/55) in both sides of the ovary. In addition, 18.5% (10/54) of normal-appearing peritoneal biopsy were identified as endometriosis by pathological examination. Laparoscopy was confirmed to be in 100% diagnostic accordance with pathology for patients with endometriosis. CONCLUSIONS: Our study showed asymmetrical distribution of pelvic endometriosis. Peritoneal lesions in black or from sacral ligament are more likely to be histologically confirmed, and microscopic lesions are not a rare phenomenon of endometriosis.

Adult↗

[Analysis of 16 patients with early cervical cancer treated by laparoscopic vaginal radical trachelectomy].

OBJECTIVE: To evaluate the therapeutic efficacies of preserving fertility treatment in patients with early cervical cancer. METHODS: Sixteen patients with early cervical cancer treated by laparoscopic vaginal radical trachelectomy and pre- or postoperative chemotherapy were analyzed retrospectively, focusing on the treatment indication and management of high risk patients. RESULTS: The median age was 29 years (range 26 to 34 years). Eleven were nulligravida and 4 multipara. All patients had a desire to maintain fertility. For clinical stage, 2 were stage Ia2, 13 stage Ib1 and 1 stage Ib2. Fifteen patients had squamous cell carcinoma and 1 had adenosquamous cell carcinoma. Mean operative time was 3 hours and 12 minutes, and mean blood loss was 320 ml. There were no intra- or postoperative complications. With mean follow-up time of 13 months, one patient had recurrence (6%), and no one became pregnant. CONCLUSIONS: It is possible to preserve fertility in the treatment of patients with early cervical cancer, but treatment indication should be considered carefully. The management of high risk patients should be investigated extensively.

Adult↗

[Outcome analysis of conservative treatment of well-differentiated endometrial adenocarcinoma and severe atypical hyperplasia in young women].

OBJECTIVE: To evaluate the effect of hormonal therapy on well-differentiated endometrial adenocarcinoma and severe atypical hyperplasia in young women aged 35 years and younger. METHODS: We retrospectively studied the clinical characteristics of 25 patients under 35 years of age (average: 28.6) diagnosed with well-differentiated endometrial adenocarcinoma or severe atypical hyperplasia, who were treated with progestin in Peking Union Medical College Hospital from 1991 to 2005. According to pathologic results, 25 patients were divided into two groups: 8 cases of endometrial carcinoma and 17 cases of severe atypical hyperplasia. In the endometrial carcinoma group, pelvic ultrasound, MRI, chest X-ray and serum CA(125) were used in pretreatment evaluation. Progesterone receptors were examined with immunohistochemical method. All patients received dilation and curettage of endometrium every 1-6 months as an assessment of treatment results. For chemotherapy, most of them were treated with medroxyprogesterone acetate. RESULTS: Six cases (6/7) in endometrial carcinoma group, and 17 cases (100%) in severe atypical hyperplasia group responded to treatment respectively; among them, 5 cases (5/7) and 14 cases (82%) had complete response, which was defined as the absence of any carcinoma or hyperplasia on endometrial samplings; one case (1/5) and 3 cases (21%) recurred within 6 to 30 months after their complete response. Follow-up on 14 patients with complete response, and the desire for childbearing showed that none of the 4 cases of endometrial carcinoma had conceived a pregnancy and 4 (40%) patients had pregnancy for totally 7 times of 10 cases of severe atypical hyperplasia. Three patients delivered full-term fetuses with induced ovulation, one of whom had artificial abortion 3 times after her delivery. One patient was lost to follow up after her spontaneous pregnancy. CONCLUSIONS: Progestin therapy is a good choice for young women having fertility desires diagnosed with well-differentiated endometrial adenocarcinoma or severe atypical hyperplasia. Endometrial carcinoma patients should be selected carefully before therapy. Pregnant rate is not satisfactory after conservative treatment. Assistant reproductive technology is potentially helpful to improve pregnant rate of patients responded to progestin therapy.

Adult↗

[Study of sexual function in women after surgery for stress urinary incontinence].

OBJECTIVE: To investigate the change of the patients' sexual function after the surgeries for stress urinary incontinence (SUI). METHODS: Pelvic organ prolapse-urinary incontinence sexual function questionnaire (PISQ) was sent to 62 sexually active patients who underwent laparoscopic Burch colposuspension or had a tension free vaginal tape (TVT) inserted at least 6 months after the operation, to a maximum of 3 years. The patient was divided into two groups according to different operations, different follow-up intervals and whether there was concomitant coital incontinence before the operations respectively. The changes of PISQ scores before and after the operation were compared between two groups. For the groups not having significant difference in PISQ score, we compared the rate of PISQ score improvement and the rate of satisfaction postoperatively. Multivariate logistic regression analyses were performed to determine whether age, parity, body mass index, menstrual status, surgical history, medical illness, severity of SUI, concomitant hysterectomy and intraoperative or postoperative complications affected the change of sexual function. RESULTS: Fifty-six patients answered the questionnaire giving a follow-up rate of 90%. The average score of PISQ was 85.2 +/- 10.7 and 82.4 +/- 17.7 before and after the surgery, and there was no significant difference (P > 0.05); however behavioral emotional domain scores worsened (30.5 +/- 6.6 vs 26.8 +/- 10.7, P < 0.05). The PISQ scores of the patients who underwent the operation within a year declined significantly (86.0 +/- 10.7 vs 77.7 +/- 18.6, P < 0.05), especially in behavioral emotional domain (31.0 +/- 7.2 vs 23.7 +/- 11.3, P < 0.01); however after a year, there was no significant change (84.4 +/- 10.8 vs 86.5 +/- 16.1, P > 0.05) and even an improvement in the physical domain (34.5 +/- 5.6 vs 36.9 +/- 4.3, P < 0.05). Regarding the sexual function improvement ratio, the patients who had the TVT operations (54% vs 12%) or had concomitant coital incontinence before the operations (62% vs 23%) were better (P < 0.01). The change of PISQ scores was independent of clinical features. CONCLUSIONS: The operations of SUI have an adverse effect on the patients' sexual life within a year, which may recover after that period. TVT operation has a better effect on the patients sexual function compared with laparoscopic Burch colposuspension; the patients who have concomitant coital incontinence before the operations have a better sexual function improvement.

Adult↗

[Analysis of prognostic factors of malignant ovarian tumor after fertility-preserving treatment].

OBJECTIVE: To explore the prognostic factors of malignant ovarian tumor after fertility-preserving treatment. METHODS: 189 patients with malignant ovarian tumor who had undergone fertility-preserving management in the past 20 years were retrospectively analyzed. The correlative factors for survival, recurrence and reproductive status were evaluated. Among the patients, 136 cases suffered from ovarian germ cell tumor (OGCT), 31 cases suffered from ovarian sex cord-stromal tumor (OSCST), and 22 cases suffered from epithelial ovarian cancer (EOC). The median follow-up time of different groups was 50 months for OGCT, 46 months for OSCST, 45 months for EOC respectively. RESULTS: The 5-year survival rates for OGCT, OSCST and EOC groups were 94.0% (131/134), 77.1% (26/30) and 64.7% (16/21) respectively. The recurrent rates were 29.9% (40/134), 20.0% (6/30) and 47.6% (10/21) respectively. 46 babies were delivered during the follow-up period. Standard chemotherapy was the most important prognostic factor for OGCT. FIGO stage and standard chemotherapy were favourable factors for prognosis in OSCST group. The important prognostic factors included FIGO stage and standard comprehensive surgical staging for EOC. CONCLUSION: Fertility-preserving treatment should be considered for OGCT without limitation of FIGO stage, whereas it should be performed individually for OSCST and EOC. The treatment outcome for OGCT is the best, for EOC the worst.

Adolescent↗

[A multicenter randomized clinical trial of weekly paclitaxel and carboplatin vs three weeks paclitaxel and carboplatin as first line chemotherapy in epithelial ovarian cancer].

OBJECTIVE: To compare the efficacy of combination regiments of taxol given weekly plus carboplatin and taxol given every three weeks plus carboplatin. To observe the toxicity of the two regiments. To observe the two-year survival rate in the two groups. METHODS: Total 125 eligible patients in 13 centers of CGOG were entered into the two arms of this randomized clinical trial, of whom 51 were entered into weekly taxol group and 74 entered into 3 weeks taxol group. RESULTS: 81.6% (102/125) of patients had satisfactory decreasing of CA125 level after optimal cytoreductive surgery and chemotherapy. 86.3% (44/51) of patients is in weekly group and 78.4% (58/74) of patients in three weeks group (P > 0.05). Relapse frequency is 29.7% in every three weeks group and 19.6% in weekly group (P > 0.05). Median interval to relapse is 15.7 months in every three weeks group and 13.6 months in weekly group (P > 0.05). One-year survival rate is 95.2% in every three weeks and 93.9% in weekly group (P > 0.05). Two-year survival rate is 78.7% in every three weeks and 85.3% in weekly group (P > 0.05). Grade III and IV myelosuooression is 45.9% in three weeks group and, 27.5% in weekly group (P < 0.05). CONCLUSION: (1) The two regiments had equal efficacy. (2) Myelosuppression was less frequency in the weekly group than in every three weeks group. (3) Weekly taxol therapy has mild toxicity and is more suitable for the old and feeble patients. Weekly taxol therapy can be conveniently administered in outpatients department.

Adult↗

[Expression of vascular endothelial growth factor receptors in the ectopic and eutopic endometrium of women with endometriosis].

OBJECTIVE: To study the localization and expression of the vascular endothelial growth factor receptors (VEGFR) Fms-like tyrosine kinase (Flt-1) and kinase insert domain-containing receptor (KDR) in human ectopic and eutopic endometrium of patients with endometriosis. METHODS: Specimens of endometriosis patients, aged (38 +/- 8) years, including 37 specimens of entopic endometrium, 34 specimens of ovarian chocolate cyst, 34 specimens of ovarian chocolate cyst, 15 specimens of red peritoneal endometriosis lesions, and 4 abdominal wall endometriosis lesions were collected. Specimens of endometrium of 33 patients with other gynecological diseases, aged (36 +/- 8) years, were collected during operation and used as controls. Immunohistochemistry was used to detect the location and expression of Flt-1 and KDR protein in different tissues. Western blotting was used to detect the protein expression of Flt-1 and KDR protein in different tissues. The mRNA expressions of Flt-1 and KDR were detected by RT-PCR. RESULTS: Flt-1 and KDR were expressed in the endometrial glandular epithelium and stromal cells besides the endometrial blood vessels. The positive expression rate of Flt-1 and KDR in the ectopic endometrium of endometriosis patients were 94.3% and 91.4% respectively, both significantly higher than those in the ovarian endometrial cyst (74.3% and 77.1% respectively, both P < 0.05), and similar to those in the eutopic endometrium of the endometriosis patients (93.8% and 90.6% respectively, both P > 0.05). In the eutopic endometrium of the endometriosis patients, the Flt-1 mRNA expression level was 2.4 +/- 1.2 and the Flt-1 protein expression level was 31 +/- 17, and the KDR mRNA expression level was 3.0 +/- 1.4 and the KDR protein expression level was 36 +/- 24, all significantly higher than those in the ovarian endometrial cyst (1.5 +/- 0.9 and 1.8 +/- 1.0 for the Flt-1 and KDR mRNA expressions, and 17 +/- 6 and 20 +/- 11 for the Flt-1 and KDR protein expressions, all P < 0.05), and similar to those in the eutopic endometrium of the non-endometriosis patients (1.9 +/- 0.8 and 2.3 +/- 1.3 for the Flt-1 and KDR mRNA expressions, and 24 +/- 18 and 25 +/- 16 for the Flt-1 and KDR protein expressions, all P > 0.05) CONCLUSION: VEGF may play certain biological role in the development of endometriosis through VEGFR (Flt-1 and KDR). The expression of Flt-1 and KDR in the endometriotic lesion appears to be associated with neovascualization.

Adult↗

[Clinical analysis of prognostic factors for stage III ovarian epithelial carcinoma].

OBJECTIVE: To evaluate the prognostic factors for stage III ovarian epithelial carcinoma so as to provide scientific basis for further reasonable therapy. METHODS: The clinical records of 369 patients with stage III ovarian epithelial carcinoma, aged 53 +/- 9 (22-77), were reviewed retrospectively. SPSS 10.0 was utilized to analyze the possible prognostic factors statistically. RESULTS: All patients received cytoreductive surgery, 289 cases (71.8%) of which achieved optimal cytoreduction. During the operation, 150 cases (41.8%) and 265 cases (71.8%) were found with intestinal and diaphragmatic involvement respectively. Pathologic results showed that serous type was the most common histological type (48.9%) and mucinous type was the least one (2.2%). The grades G1, G2, and G3 accounted for 1.7%, 42.7%, and 55.6% respectively. 290 cases with effective response to surgery underwent chemotherapy for 3-22 (10 +/- 4) courses. Recurrence was recorded in 190 cases (51.5%) and death was recorded in 152 cases (41.2%). Multivariate analysis revealed that intestinal involvement, diaphragmatic invasion, tumor residuals, and course number of chemotherapy were significantly correlated with prognosis (P < 0.01, < 0.05, < 0.01, and < 0.01 respectively). CONCLUSION: Cytoreduction for the tumor in peritoneal cavity and positive chemotherapy should be emphasized sufficiently and may be helpful for the prognosis of stage III ovarian epithelial carcinoma.

Adult↗

[Clinical features and prognostic of double primary carcinoma of uterine corpus and the ovary].

OBJECTIVE: To investigate the clinical features, treatment and prognosis of patients with double primary carcinoma of uterine corpus and ovary. METHODS: The clinical features, operation findings, treatment and prognosis of 36 patients with double primary carcinoma of uterine corpus diagnosed and treated in the last 20 years, 25 with typical endometrial adenocarcinoma and endometrioid carcinoma of the ovary (group A) 11 with non-endometrioid carcinoma in uterine corpus and/or ovary (group B) were respectively analyzed. RESULTS: There was no significant difference in survival rate between the group A and group B. The 1, 3, and 5-year survival rates of these 36 patients were 89%, 83%, and 75% respectively, all equal to those of the patients with stage I ovarian cancer. The pelvic and abdominal involvement, histologic grade, positive abdominal washing and myometrial invasion were proven to be statistically significant indicators of the poor prognosis (all P < 0.05). Radiotherapy seemed to be useful for improving the survival. CONCLUSION: The prognosis of double primary carcinoma of uterine corpus and ovary is rather good. It is necessary to distinguish double primary carcinoma of uterine corpus and ovary from stage II ovarian cancer and stage III endometrial carcinoma.

Adult↗