- The study evaluated 39 patients in Saudi Arabia who underwent conservative surgery for ovarian cancer between 2000-2010 to preserve ovarian function and fertility.
- Most patients (80%) had stage I cancer, with germ cell tumors being the most common (52% of cases).
- After treatment, 98% of patients returned to regular menstruation, and 20% went on to have a normal pregnancy and delivery.
- The study found conservative surgery for ovarian cancer to be safe and allow for ovarian preservation and fertility in most selected cases.
A prospective study of breast lump andclinicopathologicalanalysis in relation...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Dr. Stephanie Blank and Dr. Melissa Frey update us on the latest developments in ovarian cancer research and treatment from the annual conference of the Society of Gynecologic Oncology. Dr. Blank is a gynecologic oncologist at Perlmutter Cancer Center at NYU Langone Medical Center and an associate professor at NYU School of Medicine. Dr. Frey is a Gynecological Oncology Fellow at NYU Langone Medical Center.
Impact of Multidisciplinary Discussion on Treatment Outcome For Gynecologic C...Emad Shash
Tumor conferences are multidisciplinary meetings at which the
management of cancer patients is discussed. They have been
an integral part of oncology services and are regarded
as an essential component of quality control and continuing
medical education. There are data to suggest that the tumor conference enhances patient care. Many studies of effectiveness have been conducted. Reported benefits include improved patient management and treatment. In this presentation, I'll try to assess the role of the multidisciplinary tumor conference in patient management in gynecologic oncology services.
Clinicopathologic Features and Survival Analysis of Non-metastatic Breast Can...Hugo Raul Castro Salguero
Background: Breast cancer (BC) is a leading cause of cancer related death
worldwide. Unfortunately, data concerning clinicopathologic features of this
malignancy in non-developed countries is scarce. This study aims to characterize a
cohort of Guatemalan female patients with non-metastatic BC and to determine
risk factors for overall survival (OS).
A prospective study of breast lump andclinicopathologicalanalysis in relation...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Dr. Stephanie Blank and Dr. Melissa Frey update us on the latest developments in ovarian cancer research and treatment from the annual conference of the Society of Gynecologic Oncology. Dr. Blank is a gynecologic oncologist at Perlmutter Cancer Center at NYU Langone Medical Center and an associate professor at NYU School of Medicine. Dr. Frey is a Gynecological Oncology Fellow at NYU Langone Medical Center.
Impact of Multidisciplinary Discussion on Treatment Outcome For Gynecologic C...Emad Shash
Tumor conferences are multidisciplinary meetings at which the
management of cancer patients is discussed. They have been
an integral part of oncology services and are regarded
as an essential component of quality control and continuing
medical education. There are data to suggest that the tumor conference enhances patient care. Many studies of effectiveness have been conducted. Reported benefits include improved patient management and treatment. In this presentation, I'll try to assess the role of the multidisciplinary tumor conference in patient management in gynecologic oncology services.
Clinicopathologic Features and Survival Analysis of Non-metastatic Breast Can...Hugo Raul Castro Salguero
Background: Breast cancer (BC) is a leading cause of cancer related death
worldwide. Unfortunately, data concerning clinicopathologic features of this
malignancy in non-developed countries is scarce. This study aims to characterize a
cohort of Guatemalan female patients with non-metastatic BC and to determine
risk factors for overall survival (OS).
Presented at the American Society for Clinical Oncology Gastroenterology in January 2017 in San Francisco by Eric Raymond
Background: Sunitinib was approved by the FDA in 2011 for treatment of progressive, well-differentiated, advanced pancreatic neuroendocrine tumors (pNETs) based on a pivotal phase III study (NCT00428597) that showed a significant increase in progression-free survival (PFS) over placebo following early study termination. Subsequently, the FDA requested a post-approval study to support these findings.
Methods: In this open-label, phase IV clinical trial (NCT01525550), patients with progressive, well-differentiated, unresectable advanced/metastatic pNETs received continuous sunitinib 37.5 mg once daily. Eligibility criteria were similar to the phase III study. Primary endpoint was investigator-assessed PFS per RECIST 1.0. This study is ongoing.
Results: Sixty one treatment-naïve and 45 previously treated patients with progressive pNETs were treated with sunitinib: mean age, 54.6 years; males, 59.4%; white, 63.2%; ECOG PS 0, 65.1% or PS 1, 34.0%; and prior somatostatin analog, 48.1% (treatment-naïve, 39.3%; previously treated, 60.0%). At the data cutoff date, 82 (77%) patients discontinued treatment, mainly due to disease progression (46%). Median duration of treatment was ~11.9 months. Investigator-assessed median PFS (mPFS) was 13.2 months (95% CI, 10.9–16.7) in the overall population, with comparable mPFS in treatment-naïve and previously treated patients (13.2 vs 13.0 months). mPFS per independent radiologic review was 11.1 months (95% CI, 7.4–16.6). Objective response rate (ORR) per RECIST was 24.5%: 21.3% in treatment-naïve and 28.9% in previously treated patients. Median overall survival, although not yet mature, was 37.8 months. Treatment-emergent, all-causality adverse events (AEs) reported by ≥20% of all patients included neutropenia, diarrhea, leukopenia, fatigue, hand–foot syndrome, hypertension, abdominal pain, dysgeusia, and nausea. Most common grade 3/4 AEs were neutropenia (22%) and diarrhea (9%).
Conclusions: The mPFS of 13.2 months and ORR of 24.5% observed in this study support the outcomes of the pivotal phase III study of sunitinib in pNETs and confirm its activity in this setting. AEs were consistent with known safety profile of sunitinib.
Join Dr. Kara Long Roche, Associate Director of the Gynecologic Oncology Fellowship Program at Memorial Sloan Kettering Cancer Center, as she breaks down new advancements in ovarian cancer research and treatment.
Dr. Maurie Markman, President of Science and Medicine at Cancer Treatment Centers of America, shares his expertise on the latest developments in immunotherapy for ovarian cancer.
Incidence and Management of Ovarian Cancer Cases in a Tertiary Hospital- A 10...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Toward Integrated Clinical and Gene Expression Profiles for Breast Cancer Pro...CSCJournals
Breast cancer patients with the same diagnostic and clinical prognostic profile can have markedly different clinical outcome. This difference is possibly caused by the limitation of current breast cancer prognostic indices, which group molecularly distinct patients into similar clinical classes based mainly on morphological of disease. Traditional clinical based prognosis models were discovered contain some restriction to address the heterogeneity of breast cancer. The invention of microarray technology and its ability to simultaneously interrogate thousands genes has changed the paradigm of molecular classification of human cancers as well as it shifted clinical prognosis model to broader prospect. Numerous studies have revealed the potential value of gene expression signatures in examining the risk of disease recurrence. However, currently most of these studies attempted to implement genetic marker based prognostic models to replace the traditional clinical markers, yet neglecting the rich information contain in clinical information. Therefore, this research took an effort to integrate both clinical and microarray data in order to obtain accurate breast cancer prognosis, by taking into account that these data complements each other. This article presents a review of the development of breast cancer prognosis models, concentrating precisely on clinical and gene expression profiles. The literature is reviewed in an explicit machine learning framework, which include the elements of feature selection and classification techniques.
Association between genomic recurrence risk and well-being among breast cance...Enrique Moreno Gonzalez
Gene expression profiling (GEP) is increasingly used in the rapidly evolving field of personalized medicine. We sought to evaluate the association between GEP-assessed of breast cancer recurrence risk and patients’ well-being.
Presented at the American Society for Clinical Oncology Gastroenterology in January 2017 in San Francisco by Eric Raymond
Background: Sunitinib was approved by the FDA in 2011 for treatment of progressive, well-differentiated, advanced pancreatic neuroendocrine tumors (pNETs) based on a pivotal phase III study (NCT00428597) that showed a significant increase in progression-free survival (PFS) over placebo following early study termination. Subsequently, the FDA requested a post-approval study to support these findings.
Methods: In this open-label, phase IV clinical trial (NCT01525550), patients with progressive, well-differentiated, unresectable advanced/metastatic pNETs received continuous sunitinib 37.5 mg once daily. Eligibility criteria were similar to the phase III study. Primary endpoint was investigator-assessed PFS per RECIST 1.0. This study is ongoing.
Results: Sixty one treatment-naïve and 45 previously treated patients with progressive pNETs were treated with sunitinib: mean age, 54.6 years; males, 59.4%; white, 63.2%; ECOG PS 0, 65.1% or PS 1, 34.0%; and prior somatostatin analog, 48.1% (treatment-naïve, 39.3%; previously treated, 60.0%). At the data cutoff date, 82 (77%) patients discontinued treatment, mainly due to disease progression (46%). Median duration of treatment was ~11.9 months. Investigator-assessed median PFS (mPFS) was 13.2 months (95% CI, 10.9–16.7) in the overall population, with comparable mPFS in treatment-naïve and previously treated patients (13.2 vs 13.0 months). mPFS per independent radiologic review was 11.1 months (95% CI, 7.4–16.6). Objective response rate (ORR) per RECIST was 24.5%: 21.3% in treatment-naïve and 28.9% in previously treated patients. Median overall survival, although not yet mature, was 37.8 months. Treatment-emergent, all-causality adverse events (AEs) reported by ≥20% of all patients included neutropenia, diarrhea, leukopenia, fatigue, hand–foot syndrome, hypertension, abdominal pain, dysgeusia, and nausea. Most common grade 3/4 AEs were neutropenia (22%) and diarrhea (9%).
Conclusions: The mPFS of 13.2 months and ORR of 24.5% observed in this study support the outcomes of the pivotal phase III study of sunitinib in pNETs and confirm its activity in this setting. AEs were consistent with known safety profile of sunitinib.
Join Dr. Kara Long Roche, Associate Director of the Gynecologic Oncology Fellowship Program at Memorial Sloan Kettering Cancer Center, as she breaks down new advancements in ovarian cancer research and treatment.
Dr. Maurie Markman, President of Science and Medicine at Cancer Treatment Centers of America, shares his expertise on the latest developments in immunotherapy for ovarian cancer.
Incidence and Management of Ovarian Cancer Cases in a Tertiary Hospital- A 10...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Toward Integrated Clinical and Gene Expression Profiles for Breast Cancer Pro...CSCJournals
Breast cancer patients with the same diagnostic and clinical prognostic profile can have markedly different clinical outcome. This difference is possibly caused by the limitation of current breast cancer prognostic indices, which group molecularly distinct patients into similar clinical classes based mainly on morphological of disease. Traditional clinical based prognosis models were discovered contain some restriction to address the heterogeneity of breast cancer. The invention of microarray technology and its ability to simultaneously interrogate thousands genes has changed the paradigm of molecular classification of human cancers as well as it shifted clinical prognosis model to broader prospect. Numerous studies have revealed the potential value of gene expression signatures in examining the risk of disease recurrence. However, currently most of these studies attempted to implement genetic marker based prognostic models to replace the traditional clinical markers, yet neglecting the rich information contain in clinical information. Therefore, this research took an effort to integrate both clinical and microarray data in order to obtain accurate breast cancer prognosis, by taking into account that these data complements each other. This article presents a review of the development of breast cancer prognosis models, concentrating precisely on clinical and gene expression profiles. The literature is reviewed in an explicit machine learning framework, which include the elements of feature selection and classification techniques.
Association between genomic recurrence risk and well-being among breast cance...Enrique Moreno Gonzalez
Gene expression profiling (GEP) is increasingly used in the rapidly evolving field of personalized medicine. We sought to evaluate the association between GEP-assessed of breast cancer recurrence risk and patients’ well-being.
Radiation-Induced Angiosarcoma of the Breast: Retrospective Analysis at a Reg...semualkaira
Radiation-induced angiosarcoma (RIA) of the breast is an uncommon but morbid complication after radiotherapy for breast cancer. This retrospective study analysed the treatment and outcome of breast RIA patients at Cambridge University Hospital (CUH), a regional treatment centre in the East of England.
Radiation-Induced Angiosarcoma of the Breast: Retrospective Analysis at a Reg...semualkaira
Radiation-induced angiosarcoma (RIA) of the breast is an uncommon but morbid complication after radiotherapy for breast cancer. This retrospective study analysed the treatment and outcome of breast RIA patients at Cambridge University Hospital (CUH), a regional treatment centre in the East of England.
A retrospective study on ovarian cancer with a median follow-up of 36 months ...AI Publications
Ovarian cancer is relatively common but serious and has a poor prognosis. The aim of this study is to highlight the epidemiological, diagnostic, therapeutic and evolutionary aspects of this malignant pathology managed at the Bejaia university hospital center. This is a retrospective and descriptive study over a period of 3 years (2019 - 2022) carried out on 20 patients who developed ovarian cancer. The average age of the patients was 50 years old, 53.23% of whom were over 45 years old. The CA-125 blood test was positive in 18 out of 20 patients. The tumors were discovered on ultrasound in 87.10% of cases and at laparotomy in 12.90%. Total hysterectomy with bilateral adnexectomy was the most performed procedure (64.52%). The early postoperative course was simple. 15 patients underwent second look surgery (16.13%) for locoregional recurrences. Epithelial tumors were the most frequent histological type (93.55%), including 79% in the advanced stage ( IIIc -IV) and 21% in the early stage (Ia- Ib ). Adjuvant chemotherapy was administered in 80% of patients. With a median follow-up of 36 months, 2 patients were lost to follow-up. The evolution was favorable in 27.42% and in 25.81% deaths occurred late postoperatively. Ovarian cancer is not common but serious given the advanced stages and the high rate of late postoperative deaths which were largely observed in patients deprived of adequate neoadjuvant or adjuvant chemotherapy.
Study on Histopathological Correlation with ER, PR, and HER 2 Neu Receptor Status in Breast Carcinoma and its Prognostic Importance
Mahendra Singh, Jagdish Kumar*, Anita Omhare, Vandana Mishra, Chayanika Kala
http://dx.doi.org/10.21276/SSR-IIJLS.2019.5.1.3
Evaluation of Breast Cancer in Reference to Skin ChangesQUESTJOURNAL
Introduction:- Breast cancer is the most commonly occurring female cancer in the world which is more than double that of the second ranked cancer i.e. cervical cancer. Breast cancer accounts for 23% of all cancer deaths. It is the most frequent cancer death in developing countries of the world. Mammary skin changed in breast carcinoma is categorized as advance stage in breast cancer classification. In the present study we evaluated the correlation of macroscopic, microscopic and no skin changes with axillary lymph node using histologic factor dermal lymphatic involvement. Materials and methods: prospective study was conducted on 42 breast cancer admitted patients of different age groups. Based on degree of skin involvement patients were placed into four groups, i.e. clinical stageT1 toT4. All groups were compared on the basis of percentage of patients involvement according to T1, T2, T3 and T4 stage, tumor size, histopathological dermis and epidermis involvement, dermal lymphatic invasion, tumor size and tumor subtype. Results: Majority of the patients with skin (dermis and epidermis) infiltration by the tumor (94.4%) were of T4 stage (along with dermal lymphatic invasion). Majority of the patients with only dermal lymphatic involvement (87.5%) without dermis and epidermis infiltration were of T2 stage. Conclusion: In our study, most of the patients of stage T2 and T3 with dermal lymphatic invasion had involved node when studied by routine histologic technique even though they were not clinically palpable. The identification of characteristics of the primary tumor like dermal lymphatic invasion that are associated with nodal metastases should encourage the surgeon to perform a more extensive axillary lymph node dissection and the pathologist to use methods of examining the nodes that increase the likelihood of finding metastatic disease. From this we can conclude that patients in early stage breast cancer may also have metastatic axillary lymph nodes. Dermal lymphatic invasion may be regarded as the precursor of nodal involvement, and all patients with nodal involvement can be assumed to have lymphatic invasion in the primary tumors. However the converse may not be true, not all patients with lymphatic invasion have nodal involvement.
Correlation between vascular endothelial growth factor-A expression and tumor...UniversitasGadjahMada
Vascular endothelial growth factor-A (VEGF-A) has been observed as the predominant angiogenic factor in colorectal cancer (CRC) and the assessment of microvessel density (MVD) has been used to quantify tumor neoangiogenesis. This study aimed to determine clinicopathological and prognostic significance of both angiogenic markers in the local CRC patients. We analyzed tissue samples obtained from 81 cases with CRC. VEGF-A expression and MVD counts were immunohistochemically detected using anti VEGF-A and CD31. The assessments of both markers were classified as low and high. Correlation between VEGF-A expression and MVD value and clinicopathological characteristics were examined using Chi-square test. The overall survival (OS) was plotted using the Kaplan-Meier method. The results indicated a high VEGF-A expression was found more frequently in the rectal location (P=0.042) and T4 tumors (P=0.041) compared to their counterparts. Older patients tended to show a higher MVD value compared to younger cases (P=0.062). In addition, survival analysis showed that males had a worse OS compared to females (P=0.029), and VEGF-A expression and MVD count did not correlate with patients’ survival. In conclusion, there were significant differences of VEGF-A expression according to tumor location and T invasion. Sex, but not angiogenic markers, had an influence on the survival of CRC patients.
An Audit of the Management and Associated Contextual Correlates of Clinical P...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Similar to Conservative treatment of ovarian cancer (16)
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
1. Conservative treatment of ovarian cancer
Safety, ovarian function preservation, reproductive ability, and emotional
attitude of the patients in Saudi Arabia
Khalid H. Sait, MBchB, FRCS(C).
913
ABSTRACT
2000
2010
3
22 39
80% 31
52% 20
39% 15
8% 3
98% 38
20% 8
10
44%
52% 12
39% 9
Objectives: To evaluate the safety, ovarian function
preservation, reproductive ability, and the emotional
attitude after a conservative surgery for ovarian cancer.
Methods: This is a retrospective study of women
conservatively treated for primary ovarian cancer
between January 2000 and December 2010 at
King Abdulaziz University Hospital, Jeddah, Kingdom
of Saudi Arabia. Patient’s charts were reviewed for
pathology, stage, requirement of adjuvant chemotherapy,
and recurrent, as well as menstrual history, and pregnancy
after treatment. During follow up the patients were asked
3 questions about their emotional attitude toward their
disease.
Results: There were 39 patients identified (mean age 22
years). Thirty-one (80%) patients were presented with
stage I and 20 (52%) were Germ cell tumor. Fifteen
(39%) patients received initial chemotherapy after
primary surgery. Three (8%) patients had recurrent.
Thirty-eight (98%) patients retuned to a regular
menstruation after treatment. Eight patients (20%) had
a normal pregnancy. Of the respondents to the given
questions, 10 (44%) patients claimed that their disease
did not have any impact on their desire to have children
and 12 patients (52%) feared that their ovarian disease
could have damage in their reproductive potential. Only
9 patients (39%) had no concerned about the effect of
the treatment they received on the offspring.
Conclusion: Fertility sparing surgery in ovarian cancer
appears to be safe, and a practical treatment option
in selected cases with ovarian cancer diagnosis. Most
patients can have ovarian preservation after treatment
and should not be discouraged from getting pregnant.
Saudi Med J 2011; Vol. 32 (9): 913-918
From the Gynecology Oncology Unit, Obstetrics and Gynecology
Department, Faculty of Medicine, King Abdulaziz University, Jeddah,
Kingdom of Saudi Arabia.
Received 18th May 2011. Accepted 17th July 2011.
Address correspondence and reprint request to: Dr. Khalid H. Sait, Director
of Gynecology Oncology Unit, King Abdulaziz University Hospital, PO
Box 80215, Jeddah, Kingdom of Saudi Arabia. Tel. +966 505693160.
Fax. +966 (2) 6408316. E-mail: khalidsait@yahoo.com
2. 914
Conservative treatment of ovarian cancer in Saudi Arabia … Sait
Saudi Med J 2011; Vol. 32 (9) www.smj.org.sa
Ten to twenty percent of ovarian cancers occur
before the age of 40 years.1
The 5-year survival of
patients with Stage IA, grade 1, epithelial ovarian cancer
treated conservatively is 90%.2
Malignant ovarian germ
cell tumors (MOGCTs) represent approximately 5% of
all ovarian neoplasms observed in Europe and North
America.3
Germ cell tumors represent most (80%) of
the pre-adolescent malignant ovarian neoplasms; the
mean age at diagnosis is 16-20 years and they may
occasionally be diagnosed during pregnancy or the
puerperium.4
In the literature, a 5-year survival rate of
90-100% has been reported with the use of the new
combination chemotherapy regimens.1
Sex cord-stromal
tumors (SCSTs) are rare neoplasms that account for
approximately 3-5% of ovarian malignancies and the
majority of them are functioning tumors with clinical
manifestations.5
These are characterized by 85-100%
long-term survival rates for Stage IA tumors, and a
propensity for late recurrences.6
The juvenile form of
granulose cell tumors occurs before the age of 30 in
97% of cases, and is often associated with precocious
puberty. Almost all tumors are present at Stage I.7,8
Sertoli-Leydig cell tumors account for less than 0.5%
of all ovarian tumors and 75% of these neoplasms are
diagnosed in women younger than 40 years of age.1
Preservation of reproductive ability has become an
important issue in the treatment of young patients
with malignant ovarian tumors, that may be cured and
lead normal lives. A variety of studies9-12
have tried to
document the impact of conservative treatment aimed
at preserving ovarian function and reproductive ability,
little information has been available regarding survivors’
attitudes and emotions, and their choice to have
children. The aim of this study is to evaluate the safety,
ovarian function preservation, reproductive ability, and
emotional attitude after conservative surgery for ovarian
cancer.
Methods. This is a retrospective study of women
conservatively treated for primary ovarian cancer
between January 2000 and December 2010 at King
Abdulaziz University Hospital (KAUH), Gynecology
Oncology Unit, Jeddah, Saudi Arabia. Patients were
identified using the KAUH database. All stages and all
histopathological type of ovarian cancer conservative
surgery comprised of tumor excision with preservation
of the uninvolved ovarian tissue or unilateral salping-
oophrectomy (USO) were included. Low malignant
potential (LMP) were excluded. Tumors were staged
according to the International Federation of Gynecology
and Obstetrics (FIGO) classification system.13
All patients underwent conservative surgery for
primary treatment. Preoperative informed consent
were obtained from the patient or patient’s parents
if she was under 18. Surgical staging was performed
with peritoneal washing, omentectomy, multiple
peritoneal biopsies, retroperitoneal lymphadnectomy
and debulking if required with conservation of the
uterus and the other ovary. Patients’ charts were
reviewed for histopathological type and type of surgery
requirement of adjuvant chemotherapy and recurrent as
well as menstrual history, pregnancy, and deliveries after
treatment. Information was obtained from the patient
directly by inquiring 3 questions about their emotional
attitude toward their disease. These questions were
extrapolated from the questionnaire sent to the patients
belonging to the Cleveland Clinic foundation tumor
registry, and presented in the paper by Shover et al14
to
evaluate survivors, attitude, and emotional choices with
regards to having children.
All participants were verbally informed by the
interviewers that the information obtained by them
were kept confidential and will be further collected
and analyzed by the research team. Respondents were
ensured about the confidentiality, they were briefed that
their participation is voluntary and they have full right
to withdraw from the study at any point. This procedure
were approved by the Unit of Biomedical Ethics, Faculty
of Medicine, King Abdulaziz University, Jeddah, Saudi
Arabia.
Data were entered and analyzed using SPSS version
17.0. We used simple percentage for the analysis.
Results. Of the 39 patients in the study, 16 were
married and 23 were single with a mean age of 22 years
(range 4-35). Only 4 patients had 1 and/or 2 children,
with a mean follow up of 51 months and range of 12-90
(Table 1). Thirty-one (80%) patients were presented with
Disclosure. Authors have no conflict of interests, and
the work was not supported or funded by any drug
company.
Table 1 - Characteristics of who had undergone conservative surgery for
ovarian cancer (N=39).
Characteristics N
Age (years)
Mean
Range
Marital status
Married
Single
Parity
1
>1
Follow up (months)
Median
Range
22
4-35
16
23
2
2
51
12-90
3. 915www.smj.org.sa Saudi Med J 2011; Vol. 32 (9)
Conservative treatment of ovarian cancer in Saudi Arabia … Sait
stage I and 8 (20%) patients with more than stage I.
Germ cell tumor was the most common histopathology
in the study populations (20 [52%]), 15 (39%) patients
received initial chemotherapy after primary surgery, and
5 of them had an advanced epithelial ovarian cancer
that treated conservatively. They received taxotair and
carboplatin for 6 cycles after an informed consent and
for patient who refuse complete surgery, no patient
with high risk stage I in the study group. Nine
patients received chemotherapy in form of Bleomycine,
Etoposide, Cisplatin (BEP) for 4 cycles, 4 with stage III
MOGCTs and 5 with high risk MOGCTs stage I, one
with stage Ic dysgerminoma, one with Ia mixed germ
cell tumor and 3 were stage Ia endodermal sinus tumor.
One patient with stage Ic and Sertoli-Leydig cell tumor
received chemotherapy (Table 2). Three patients had
conservative ovarian surgery, recurred with a recurrence
rate of 8%.
Table 3 summarize the patients with recurrences
after conservative surgery for ovarian cancer. One
patient recurred after completing chemotherapy for
Stage III with an ovarian epithelial carcinoma, treated
with complete surgery followed by a second line
chemotherapy; hence, she is alive and doing well.
Two patients recurred with MOGCTs. One
recurred in the upper abdominal after unilateral
salpigoophrectomy for immature teratoma. Four years
after the initial surgery, the tumor was excised with
no residual disease taken from the remaining ovary,
and the uterus were free of tumor. The other one was
advanced mixed germ cell tumor treated conservatively
with de-bulking, received 4 cycles of BEP, had tumor
recurrence within <6 months and after the second
line chemotherapy the patient died from intracranial
hemorrhage as a result of thrombocytopenia, a
complication of chemotherapy.
Table 4 shows the reproductive ability after
conservative surgery in patient with ovarian cancer.
Patients who received chemotherapy or not as an initial
Table 4 - Ovarian preservation - reproductive ability after conservative surgery for ovarian cancer.
Treatment types N (%) Return normal
menstruation
Attempt
pregnancy
Pregnancy Pregnancy
outcome
Conservative surgery plus
chemotherapy
15 (38) 14 (36)* 4 (10) 2 (5) Term normal baby
Conservative surgery alone 24 (62) 24 (62) 5 (13) 6 (15) Term normal baby
Total 39 (100) 38 (98) 9 (23) 8 (20)
*One patient recur before get normal period. Actual pregnancy rate 89%
Table 2 - Recurrences after conservative surgery for ovarian cancer.
Histopathology
types
Stage
n (%)
Initially required
chemotherapy
Recurrence
I > I All
EOC 9 (23) 5 (13) 14 (36) 5 (13)* 1 (3)
GCT 17 (44) 3 (7) 20 (51) 9 (23)† 2 (5)
SSCT 5 (13) 0 (0) 5 (13) 1 (3)‡ 0 (0)
Total 31 (80) 8 (20) 39 (100) 15 (39) 3 (8)
EOC - epithelial ovarian cancer, GCT - germ cell tumor,
SSCT - stromal-sex cord tumor. *More than stage I, †Five cases with stage I and 4 cases with more than stage I,
‡
Case with stage I c (Sertoli-Leydig cell tumor)
Table 3 - Summary of patients with recurrences after conservative surgery for ovarian cancer.
Case Age Pathology Initial Surgery Stage Initial
chemotherapy
Treatment of
recurrence
Alive
1 22 EOC USO and Debulking IIIC Yes TAH BSO and
chemotherapy
Yes
2 18 MGCT USO and Debulking III Yes chemotherapy Died
3 35 Immature teratoma USO ? I No Removal of abdominal
tumor and chemotherapy
Yes
EOC - epithelial ovarian cancer, MGCT - mixed germ cell tumor, USO - unilateral salping-oophrectomy,
TAH - Total abdominal hystrectomy, BSO - Bilateral salping-oophrectomy
4. 916
Conservative treatment of ovarian cancer in Saudi Arabia … Sait
Saudi Med J 2011; Vol. 32 (9) www.smj.org.sa
treatment result in return of normal menstrual cycles.
Twenty percent had an attempted pregnancy.
Table 5 shows the emotional attitude of patients who
undergone conservative surgery for ovarian cancer. Of
the 39 patients, 23 responded to the direct questions
during the follow up either in the clinic or by phone
conversation. Ten patients (44%) responded that their
disease did not have any impact on their desire to have
children. Whereas, 12 (52%) patients fear that their
ovarian disease could have damage on their reproductive
potential. Only 9 (39%) patients were not concerned
about the effect of the treatment they received on the
offspring.
Discussion. Too often in the past, children and
young women affected by ovarian tumors have been
unnecessarily treated with radical surgery due to
the suspected risk of microscopic involvement of a
seemingly normal contra-lateral ovary and uterus.8
Most Stage I epithelial ovarian cancer, Stage I SCSTs
and MOGCTs are unilateral, with the exception of
pure dysgerminomas, which are bilateral in 10-15% of
cases.3,15-17
Bilateral involvement with tumors may also
occur in cases of advanced-stage MOGCTs tumors, in
which there is metastasis from one ovary to the other.18
For the latter, the availability of effective chemotherapy
that may sterilize microscopic or macroscopic foci of
a tumor in the residual gonad, without the need to
remove the contra-lateral ovary, has changed the surgical
approach toward this disease.
The type of surgery is presently decided depending
mainlyontheageofthepatientandthedesireforfertility
preservation. Surgical staging should be performed in
all cases to evaluate the extent of disease, to determine
prognosis, and to guide postoperative management.
Unilateral salpingo-oophorectomy with preservation of
the contra-lateral ovary and the uterus is now considered
the most appropriate surgical treatment for patients
with Stage IA grade 1 epithelial ovarian cancer, Stage
I SCSTs, and MOGCTs, even in the case of advanced
germcelldisease,particularly,ifthecontra-lateralovaryis
normal.9,19-21
There is evidence that showed an equivalent
cure rate after fertility-sparing surgery compared with a
non-conservative procedure.9-11,17-21
In this study, 3 of
our patient recur with over all recurrence rate of 8%,
and one patient died from the disease, the pathology
was mixed germ cell tumor, which was chemotherapy
resistance. The availability of effective chemotherapy
and the improvement of surgical technique allow the
survival of the majority of patients with recurrence
of MOGCTs, irrespective of primary conservative or
radical surgery. Because of the increasing frequency of
long-term survivors, attention has focused on a variety of
late sequelae of surgery and chemotherapy. One aspect
of quality of life for cancer survivors is the preservation
of reproductive–endocrine function and fertility.
The specific effects of cancer therapy on reproductive
function are not as well understood, and there is no test
for fertility except for a resulting pregnancy proving
that fertility is maintained. Morice et al2
reported on
25 patients treated conservatively for epithelial ovarian
cancer, Among the 18 patients who were alive without
recurrent disease, one developed early menopause and
another one had irregular menses. Only 4 pregnancies
in 4 patients were obtained and 3 normal infants
were born. Zanetta et al22
reported on 56 women
treated conservatively for Stage I ovarian carcinoma;
of the 51 women who had their fertility preserved,
20 (39%) conceived, with 17 normal pregnancies.
Perrin et al23
reported on 45 patients with MOGCTs
treated conservatively. Adjuvant chemotherapy was
administered in 29 patients. Ninety-six percent
resumed normal menstrual function on completion of
treatment. Seven healthy babies were recorded in the
chemotherapy group and no birth defect occurred in
any of these. There were 4 recurrences and 2 deaths. In
the present study, in agreement with these data, most
(98%) of the patients had regular menses at the time
of interview; one patient recurred before getting the
menstrual period. In addition, we found that 9 patients
attempted pregnancies, 8 of them had successful
pregnancy with healthy babies (pregnancy rate of 20%
and actual pregnancy rate of 89%). The reason given of
not having children for the rest of the patients were 9,
still not married 2, for personal choices and the rest, no
information was received. Our questionnaire returned
rate was 23 (59%) in agreement with the response rates
reported in the literature.12,14,24-27
The fact that only
23% of patients attempted pregnancy and 44% patients
think that the treatment has an impact on their desire
to have children, and 52% had fear that treatment
could damage their reproductive potential, these rise
the question whether they had been educated about the
Table 5 - Emotional attitude on patient undergone conservative surgery
for ovarian cancer (23 patients responded).
Questions Yes No I don’t know
Do you think the treatment
will have impact of your
desire to have children in
future?
10 (44) 10 (44) 3 (12)
Are you afraid that the
treatment could damage
your reproductive potential?
12 (52) 5 (22) 6 (26)
Are you concern that the
treatment will affect on your
offspring?
2 (9) 9 (39) 12 (52)
Data are expressed as number and percentage (%)
5. 917www.smj.org.sa Saudi Med J 2011; Vol. 32 (9)
Conservative treatment of ovarian cancer in Saudi Arabia … Sait
reproductive impact of cancer treatment. Therefore, this
observation underlines the need for health care providers
to educate the patient about their disease and the impact
that cancer treatment may have on reproduction.
Given the small sample size and various diagnoses,
the comparison between different cancers or types
of treatment is not feasible. However, based on the
distribution by histology, it seems that the worse
diagnosis had any impact on our patients’ desire to have
children.Ourresultsonpatients’attitudeandknowledge
about their cancer treatment is way behind and is in
disagreement with the finding reported by Schover
et al14
as 80% of the sample viewed themselves very
positively as potential parents. Another major finding
is that our survivor (39%) do not seem to be concerned
about the potential risks to their children having birth
defects as related to the mother’s cancer treatment.
However, this has great limitation for this survey
because 52% answered that they “do not know”. This
has some agreement with the survey results published
by Schover et al14
which showed that cancer survivor
were quite concern and uncertain about healthy risks
to the offspring. This result disagreed with the recently
published study12
in which 76% were not concern.
In summary, fertility sparing surgery in ovarian
cancer appears to be safe and a practical treatment
option in selected cases with ovarian cancer diagnosis.
Most patients can have ovarian preservation after
treatment and they should not be discouraged from
getting pregnant. Though, preliminary survey provides
insight into the attitudes and experiences of young
women of ovarian cancer survivors regarding fertility.
Future studies need to examine attitudes and choices
with regard to having children prospectively; beginning
at the time of the initial treatment, and in trying to
assess the influence of particular diagnoses or treatment
protocols. Most importantly, health care provider need
to work together to spent more time to educate patients
about their disease and encourage a positive attitude.
Asourstudyrepresentsasingleinstitution’sstudyand
survey, it remains to be validated through a prospective
multi-institutional or national Saudi registry.
Acknowledgment. I would like to express my sincere thanks
and appreciation to Dr. Ahmad Al-Marastani for his great help and
effort in collecting the data. Special thanks to my colleague Dr. Nisrin
Anfinan for her support and help.
References
1. Pecorelli S, FIGO Committee of Gynecologic Oncology.
25th annual report on the results of treatment in gynecological
cancer. Int J Gynaecol Obstet 2003; 3: 203-211.
2. Morice P, Wicart-Poque F, Rey A, El-Hassan J, Pautier P,
Lhommé C, et al. Results of conservative treatment in epithelial
ovarian carcinoma. Cancer 2001; 92: 2412-2418.
3. Talerman A. Blaunstein’s pathology of the female genital
tract. Germ cell tumors of the ovary. In: Kurman JK, editor.
Blaunstein’s Pathology of the Female Genital Tract. New York
(NY): Springer; 2002. p. 967-1033.
4. Di Saia P, Cresman WT. Clinical gynecological oncology. 7th
ed. Philadelphia (PA): Saunders Elsevier; 2007. p. 381-390.
5. Young RH, Scully RE. Ovarian sex cord-stromal tumours:
recent advances and current status. Clin Obstet Gynaecol 1984;
11: 93-134.
6. Colombo N, Sessa C, Landoni F, Sartori E, Pecorelli S,
Mangioni C. Cisplatin, vinblastine, and bleomycin combination
chemotherapy in metastatic granulosa cell tumor of the ovary.
Obstet Gynecol 1986; 67: 265-268.
7. Powell JL, Connor GP, Henderson GS. Management of
recurrent juvenile granulosa cell tumor of the ovary. Gynecol
Oncol 2001; 81: 113-116.
8. Bridgewater JA, Rustin GJ. Management of non-epithelial
ovarian tumours. Oncology 1999; 57: 89-98.
9. Morice P, Camatte S, Wicart-Poque F, Atallah D, Rouzier R,
Pautier P, et al. Results of conservative management of epithelial
malignant and borderline ovarian tumours. Hum Reprod
Update 2003; 9: 185-192.
10. Tangir J, Shwartz PE. Fertility preservation in the management
of germ cell ovarian cancer. CME J GynecolOncol 2003; 8: 117-
120.
11. Duska LR, Chang YC, Flynn CE, Chen AH, Goodman A,
Fuller AF et al. Epithelial ovarian carcinoma in the reproductive
age group. Cancer 1999; 85: 2623-2629.
12. Zanagnolo V, Sartori E, Trussardi E, Pasinetti B, Maggino
T. Preservation of ovarian function, reproductive ability and
emotional attitudes in patients with malignant ovarian tumors.
Eur J Obstet Gynecol Reprod Biol 2005; 123: 235-243.
13. International Federation of Gynecology and Obtetrics. Changes
in definition of clinical staging for carcinoma of the cervix and
ovary. Am J Obst Gynecol 1987; 156: 263-264.
14. Schover LR, Rybicki LA, Martin BA, Bringelsen KA. Having
children after cancer. A pilot survey of survivors’ attitudes and
experiences. Cancer 1999; 86: 697-709.
15. Williams SD. Ovarian germ cell tumors: an update. SeminOncol
1998; 25: 407-413.
16. Gordon A, Lipton D, Woodruff JD. Dysgerminoma: a review
of 158 cases from the Emil Novak Ovarian Tumor Registry.
Obstet Gynecol 1981; 58: 497-504.
17. Mueller CW, Topkins P, Lapp WA. Dysgerminoma of the ovary:
an analysis of 427 cases. Am J Obstet Gynecol 1950; 60: 153-
159.
18. Lu KH, Gershenson DM. Update on the management of
ovarian germ cell tumors. J Reprod Med 2005; 50: 417-425.
19. Zanetta G, Bonazzi C, Cantu M, Binidagger S, Locatelli A,
Bratina G, et al. Survival and reproductive function after
treatment of malignant germ cell ovarian tumors, J ClinOncol
2001; 19: 1015-1020.
20. Brewe M, Gershenson DM, Herzog CE, Mitchell MF, Silva
EG, Wharton JT. Outcome and reproductive function after
chemotherapy for ovarian dysgerminoma. J ClinOncol 1999;
17: 2670-2675.
21. Low JJ, Perrin LC, Grandon AJ, Hacker NF. Conservative
surgery to preserve ovarian function in patients with malignant
ovarian germ cell tumors. A review of 74 cases. Cancer 2000;
89: 391-398.
22. Zanetta G, Chiari S, Rota S, Bratina G, Maneo A, Torri V,
Mangioni C.Conservative surgery for stage I ovarian carcinoma
in women of childbearing age. Br J ObstetGynaecol 1997; 104:
1030-1035.
6. 918
Conservative treatment of ovarian cancer in Saudi Arabia … Sait
Saudi Med J 2011; Vol. 32 (9) www.smj.org.sa
23. Perrin LC, Low J, Nicklin JL, Ward BG, Crandon AJ. Fertility
and ovarian function after conservative surgery for germ cell
tumours of the ovary. Aust N Z J Obstet Gynaecol 1999; 39:
243-245.
24. Avery AJ, Betts DS, Whittington A, Heron TB, Wilson SH,
Reeves JP. The mental and physical health of miners following
the 1992 national pit closure programme: a crosssectional survey
using General Health Questionnaire GHQ-12 and Short Form
SF-36. Public Health 1998; 112: 169-173.
25. Hill A, Roberts J, Ewings P, Gunnell D. Non-response bias in a
lifestyle survey. J Public Health Med 1997; 19: 203-207.
26. Perneger TV, Leplège A, Etter JF, Rougemont A. Validation of
a French-language version of the MOS 36-Item Short Form
Health Survey (SF-36) in young healthy adults. J ClinEpidemiol
1995; 48: 1051-1060.
27. Eaker S, Bergström R, Bergström A, Adami HO, Nyren
O. Response rate to mailed epidemiologic quetionnaires: a
population-based randomized trial of variations in design and
mailing routines. Am J Epidemiol 1998; 147: 74-82.
Related topics
Abdelkarem HM, Abd El-Kader MM, Kasem SA. Manipulation of flaxseed inhibits tumor
necrosis factor-alpha and interleukin-6 production in ovarian-induced osteoporosis.
Saudi Med J 2011; 32: 369-375.
Al-Rayyan ES, Duqoum WJ, Sawalha MS, Nascimento MC, Pather S, Dalrymple CJ,
Carter JR. Secondary malignancies in ovarian dermoid cyst. Saudi Med J 2009; 30:524-
8.
Li W, Wu X, Fang C, Yao J, Guo Y, Zhang S. Prognostic factors in adult granulosa cell
tumor of the ovary. Saudi Med J 2009; 30: 247-252.
Khodabakhshi R, Yahyazadeh-Jabbari SH, Gohari MR, Shahidi J, Ameri A. Treatment
and prognosis of epithelial ovarian cancer: five year multi-center study. Saudi Med J
2008; 29: 1735-1738.