OVARIAN CANCER

A scholar from the Netherlands led multinational collaborative research suggest that the early epithelial ovarian cancer surgical staging, can predict whether the patients have residual ovarian cancer and the need for postoperative adjuvant chemotherapy.

Tags: age, cancer, carcinoma, cases, cell, chemotherapy, cisplatin, clinical, early, examination, group, ovarian, patients, poor, prognosis, rate, residual, staging, surgery, surgical, survival, therapy, time, tumor

Most of the malignant ovarian tumors, radiation therapy for various effects are poor. Therefore, in the treatment of malignant ovarian tumor was not first consider radiotherapy. After laparotomy confirmed to be malignant ovarian tumor resection not all, in vitro viable X-ray irradiation. But many of ascites are not OK radiotherapy; The abdominal tumor metastasis to the effect of not limited to those within the pelvic cavity. X-ray irradiation is also used in vitro malignant ovarian tumor before and after surgery. Preoperative radiotherapy for patients with radiation therapy after the word four to six weeks should surgery again night, while radiation caused by adhesions, surgery often caused difficulties. Surgery will be in regular radiation treatment after two weeks before and after the start, such as whole body ill patients should first correct.
(1), abdominal irradiation radiation field including full pots of abdominal viscera, or by Ono divided into two to four vertical irradiation of Ono, tumor dose of 25 Gy ~ / 6 to 8 weeks. General liver, kidney tolerance were 30 Gy and 18 Gy, such as the super-dose, should shielding protection. Whole abdominal irradiation after Ono, the largest general tolerance of 30 Gy / 6 to 7 weeks. This dose is not LD50 of ovarian cancer, while Ono irradiation reaction, difficult patient tolerance. Delcios in 1963, a fully mobile strip abdominal irradiation in the treatment of ovarian cancer. Each abdominal irradiation of 10 cm, radiation field from the upward movement in the entire basin to include abdominal, each irradiation in 12 days. Tumor radiation dose of 26 to 28 Gy. The biological effects of radiation and improve the patient's response to radiotherapy.
(2), pelvic tumor irradiation dose of 40 to 60 Gy, 6 to 8 weeks to complete.
(3), plus whole abdominal pelvic irradiation Ono whole abdominal irradiation may be, or transfer surgery strip irradiation dose with the former. Pelvic organ tolerance, to improve efficacy, and pelvic irradiation dose of 20 to 30 Gy, ovarian cancer is the commonly used method.
(4), abdominal radionuclide therapy for patients early preventive treatment, and only a small residual tumor after treatment. Surgery not cut net of malignant ovarian tumor metastases can be injected with the radioactive colloid 98 or 32 P, or diluted with saline injected into the abdominal cavity to prevent cancer formation of ascites, malignant ovarian cancer has been with ascites, the catheter may produce ascites part, to be injected colloidal gold 98 or 32 P . It should be noted 98 of the radioactive colloid and 32 P for intraperitoneal injection, also caused radioactive hepatitis possible, it should be repeated in application check liver function for timely processing.

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Denmark Gronloud such report, as paclitaxel plus platinum chemotherapy after complete remission in patients with ovarian cancer, if recurrence of a solitary lesion again cytoreductive surgery may improve survival. (Eur J Surg Oncol 2005,31:67)

In the retrospective study selected criteria: 1 Guide to the residual initial stage operation and confirmed by histological examination of epithelial ovarian cancer; (2) complete remission after first-line treatment; 3. Imaging confirmed pots peritoneal metastasis; (4) Surgical resection of lesions for the purpose.

Tags: age, cancer, cases, cell, chemotherapy, eat, examination, metastasis, ovarian, paclitaxel, patients, rate, resection, residual, study, surgery, surgical, survival, therapy, time, treatment, tumor, tumors

A large number of pre-clinical data and the right abdominal anatomy, physiology and biology of ovarian cancer have suggested that understanding, abdominal local cytotoxic drug treatment for ovarian cancer is very reasonable. Intraperitoneal chemotherapy Phase I clinical trial confirmed the chemotherapy drugs and intraperitoneal chemotherapy safety of the technology itself, confirmed the intraperitoneal chemotherapy in the pharmacokinetic advantages.

In some multi-center Phase II clinical trials, surgical results confirmed that about 20% to 40% of second-tier category to cisplatin-based chemotherapy in patients with celiac complete remission, the part of the residual cancer patients <0.5 cm before  acceptable to platinum-based chemotherapy effective systemic System .

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Patients with malignant ovarian tumor when treatment is late (> Phase II), ovarian cancer is the surgical treatment called tumor or cytoreductive surgery or large resection.
Surgery is to do everything possible to the original tumor resection and can see the pots, peritoneal metastasis, so that each region of residual lesion diameter of less than 2.0 cm to 1.5 cm. Intraoperative from ascites fluid or cells for blood screening. Because ovarian and uterine cancer often, the annex or visco-invasion, peritoneal and keep pots, it is more of "carpet-volume" or "dumplings", from extraperitoneal space elements from the peritoneal wall, bladder and pelvic floor serous peritoneal, along with the uterus and pelvic peritoneum block tumor resection. The pots have peritoneal metastasis tissues or organs should be possible to complete resection or partial resection, resection of the omentum, some intestinal resection, resection of the bladder or ureter shifting values. The removal of the tumor as possible aim is to enhance postoperative radiotherapy and chemotherapy effect. The merger of ovarian cancer ascites, regardless of whether all resection are advised to intraperitoneal indwelling catheter for intraperitoneal injection of anti-cancer drugs. Anti-cancer drugs or radioisotopes for preparation also can be injected directly unresectable tumors.
Surgery can not decide in its benign and malignant ovarian tumor resection specimens should be admitted or contralateral ovarian tissue frozen tablets sent for histopathologic examination. There is no such conditions, generally after the contralateral normal ovarian As can be temporarily retained, pathological specimens were sent checks to clear in nature, and close observation. The previous suspected metastatic ovarian tumor and failed to find its source, should be in operation in detail in the original exploration of abdominal lesions, after further treatment for reference.

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Basic symptoms: early ovarian cancer usually no obvious symptoms, if there is non-specific symptoms, such as menstrual disorder, mild gastrointestinal discomfort. With the growth of tumors may arise under bloating, discomfort, or sometimes because of oppression involved in the bladder or rectum and frequency, diarrhea, constipation,. More advanced symptoms from ascites, omental or metastatic gastrointestinal such as abdominal distension, shortness of breath, abdominal discomfort, and incomplete intestinal obstruction or even obstructive symptoms. Part of mesenchymal tumors or tumor invasion of genistein and uterus can cause irregular vaginal bleeding. If a tumor metastasis may have different performance of the corresponding organ involvement.

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I. Overview

With the aging of the global trend of development, improve the economic status of women, more and more women start hormone replacement therapy (Hormone Replacement Therapy, HRT), to improve access to after menopause due to the decrease in the level of sex hormones related to various diseases. Clear evidence that: postmenopausal women with age, the incidence of coronary heart disease increased by about four times the fracture due to osteoporosis by 20%, died of complications due to pelvic fracture rate of 30%, after the 65-year-old Alzheimer's incidence rate increase every year <BR> and Application HRT can peer groups coronary heart disease risk 50% Alzheimer's risk reduced three times, especially worth mentioning is significantly reduced the incidence of rectal cancer. Long-term use of HRT cancer risk reduced year by year. HRT can also greatly improve the menopause, postmenopausal women with disease or ovarian surgery, radiotherapy in patients with a series of artificial menopause syndrome.

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Cytoreductive surgery in the treatment of ovarian cancer Comprehensive Application and prospects

Foreign Medical Obstetrics and Gynecology volumes in 1999 Vol 26 No. 2

Tianjin Medical University General Hospital of Obstetrics and Gynecology (300,052) of the new QU (Summary) if Mi (revision)

Abstract <BR> since the 1980s, complete cytoreductive surgery to cisplatin-based combination chemotherapy for ovarian cancer as a conventional model, cytoreductive surgery is the complete impact of the prognosis of patients with one of the important factors for recurrent ovarian cancer once again cytoreductive surgery still some value , but to improve the survival rate of patients is more important to be effective after chemotherapy treatment as a necessary complement. Early ovarian cancer retroperitoneal lymph node dissection is reasonable and significance of the still controversial.

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[Summary]

Ovarian cancer is a common cancer of female genital mutilation one of the incidence of cervical cancer and after cancer of the uterus, which ranked third. But ovarian cancer death, accounts of the first gynecologic tumors, right pose a serious threat to women's lives. Because ovarian embryonic development, organization anatomy and endocrine function more complicated, it may be suffering from benign tumors or malignant. Because of early ovarian cancer in asymptomatic, and the identification of its type benign and malignant very difficult, ovarian carcinoma laparotomy in ovarian tumor confined to only 30%, most have spread to the uterus, bilateral annex, the omentum and pelvic organs, both in the diagnosis of ovarian cancer and governance the treatment is a major problem indeed. Over the years experts on the pathological form of ovarian cancer, the development of clinical and treatment programs for many of accumulated a lot of experience, so far, statistics on domestic and foreign clinical data, the five-year survival rate of only 25% to 30%.

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Common and prognosis factors:

• clinical stage and is closely related to survival;

• histological type and grade pathology and prognosis is directly related;

• differentiation and biological characteristics and the prognosis also directly related to a direct impact on the survival rate and survival time.

• In addition, the age factor and the prognosis of more closely. Another treatment option with a reasonable and thorough, but also directly affect the prognosis of ovarian cancer.

Tags: age, body, cancer, chemotherapy, clinical, eat, exploration, life, method, ovarian, patients, prognosis, rate, residual, surgery, survival, therapy, time, treatment, tumor