Showing papers by "Seiji Isonishi published in 2009"

Alpha-fetoprotein (AFP)-producing ovarian tumor in an elderly woman.

Abstract: Apart from typical yolk sac tumors, ovarian tumors with elevated alfa-fetoprotein (AFP) are uncommon and the differential diagnosis needs to consider the hepatoid pattern of a yolk sac tumor, hepatocellular carcinoma metastatic to the ovary, hepatoid carcinoma, and other epithelial ovarian tumors. We report here an AFP-producing ovarian tumor with uncertain pathological diagnosis, which was extremely responsive to chemotherapy. A 59-year-old Japanese woman presented with lower abdominal distension and was found to have a left ovarian mass on pelvic examination and magnetic resonance imaging (MRI) scan. Laboratory tests showed serum AFP, 73 687 ng/ml; carbohydrate antigen 125 (CA125), 1599 U/ml; and carcinoembryonic antigen (CEA), 13.9 ng/ml. Total hysterectomy with bilateral salpingo-oophorectomy, partial omentectomy, and low anterior resection of the rectum was performed, without any residual macroscopic tumor. Microscopically, the tumor was characterized by a hepatoid carcinomatous component composed of solid sheets of large eosinophilic cells with pleomorphic nuclei. The pathological stage was pT2N0M0. Tumor cells were diffusely immunoreactive for AFP and cytokeratin (CAM5.2), but monoclonal CEA and CA19-9 were focally positive in the cytoplasm, while CA125 was negative. The patient was treated postoperatively with three cycles of chemotherapy consisting of bleomycin, etoposide, and cisplatin; with this regimen, serum AFP decreased to 16 ng/ml from 12 600 ng/ml just before the initiation of chemotherapy. The patient received secondary cytoreductive surgery of systemic lymphadenectomy, which revealed no evidence of residual tumor.

Effects of weekly bevacizumab and pegylated liposomal doxorubicin in heavily pretreated patients with recurrent or progressed ovarian cancer

Abstract: 5547 Background: Vascular endothelial growth factor (VEGF) plays a central role in tumor angiogenesis and is regarded a promising therapeutic target. Bevacizumab (A) has significant antitumor activ...

Favourable prognosis with modified dosing of docetaxel and cisplatin in Japanese patients with ovarian cancer.

Abstract: Background: The long-term efficacy and safety of docetaxel/cisplatin as first-line chemotherapy in Japanese patients was evaluated in order to find an optional regimen for ovarian cancer. Patients and Methods: Women with surgically resected stage Ic-IV epithelial ovarian cancer were treated with docetaxel 70 mg/m 2 and cisplatin 60 mg/m 2 every 4 weeks. Results: Ninety women were enrolled of whom 89 (median age, 54 years) received a median of 6 cycles (range 1 to 9). With a median 38 months' follow-up, median progression-free survival was 28 months (95% lower confidence interval, 24 months) in 60 patients with stage III- IV disease. The overall response rate for 20 patients was 45% . Neutropenia was the most common (67% ) grade 3/4 toxicity. Major grade 3/4 nonhaematological toxicities were gastrointestinal toxicities (≤11% ) and fatigue (8% ). No grade 3/4 neurotoxicity was observed. Conclusion: The combination of docetaxel/cisplatin is a regimen with favourable progression-free survival for ovarian cancer. Combination therapy with paclitaxel and a platinum-agent has become first-line treatment for advanced ovarian cancer following the results of phase III studies (1-5). However, side-effects associated with the paclitaxel/carboplatin regimen, such as thrombocytopenia and neurotoxicity, remain a concern (3-5). A new cisplatin-based regimen is essential as an optional therapy for ovarian cancer. Previous phase III studies comparing paclitaxel/cisplatin and paclitaxel/carboplatin showed non-inferiority for the carboplatin regimen. Therefore paclitaxel/cisplatin has not been used in recent studies due to hydration requirements with cisplatin and gastrointestinal toxicity (3-5). Moreover, the paclitaxel/cisplatin combination was more inconvenient due to the 24-hour continuous infusion required for administration. Considering that taxane/platinum combinations have become the standard regimen for advanced ovarian cancer, evaluation of alternative taxanes such as docetaxel combined with cisplatin is needed in order to broaden treatment options. Previously, two phase II studies of docetaxel/cisplatin for ovarian cancer were conducted in the UK and France, showing that progression-free survival (PFS) and overall survival (OS) were modest (6, 7). However, accurate effects of docetaxel/cisplatin on survival are still unclear as PFS or OS were not evaluated as primary endpoints. Moreover, 33% of patients were not able to complete the planned 6 cycles of docetaxel (75-85 mg/m 2 ) and cisplatin (75 mg/m 2 ) in the UK