Showing papers by "Seiji Isonishi published in 2015"
TL;DR: The good overall concordance between INV and BICR assessments, as well as HR and P value consistency, supports the reliability of investigator-assessed PFS as the primary endpoint in AGO-OVAR16.
27 citations
TL;DR: Tumor debulking surgery with diaphragmatic surgery with DS resulted in controllable blood loss, and OS was successful in all patients without severe complications or postoperative treatment delay.
Abstract: In advanced epithelial ovarian and peritoneal cancer, residual tumor diameter correlates with prognosis; therefore, maximum debulking and optimal surgery (OS) for residual tumors <1 cm is warranted. Here, we clarified the efficacy of tumor debulking with diaphragmatic surgery (DS). In 45 patients with epithelial ovarian or peritoneal cancer who underwent DS (ten, full-thickness resection; 35, stripping) between January 2010 and December 2013 at two related institutions, we retrospectively evaluated OS safety and success by surgical duration, blood loss, complications, hospitalization stay, and residual tumor diameter and site. Blood loss was 4,090.8 and 2,847.9 mL; surgical duration was 485.2 and 479.5 min; hospitalization stay was 21.7 and 24.8 days; and complications included intraoperative thoracotomy in 17 and 7 patients, unexpected thoracotomy in 11 and 3, chest drain insertion in one and three, and pleural effusion in 14 and 7, in the primary debulking surgery (PDS) and interval debulking surgery (IDS) groups, respectively. OS was successful in all patients with complete surgery (CS: no residual tumor) achieved in 16 (50.0 %) and 9 (69.2 %), residual tumor diameter < 5 mm in 11 (34.4 %) and 2 (15.4 %), and residual tumor diameter < 1 cm in 5 (15.6 %) and 2 (15.4 %) in the PDS and IDS groups, respectively. Tumor debulking surgery with DS resulted in controllable blood loss, and OS was successful in all patients without severe complications or postoperative treatment delay. Currently, OS is considered to have very few benefits over CS; thus, the success rate of CS rate should be improved while maintaining safety.
10 citations
07 Jan 2015
TL;DR: This study investigated AFP-producing ovarian pure clear cell carcinoma without any components differentiating it to yolk sac tumor or hepatoid carcinoma in a 51-year-old Japanese woman who presented with lower-abdominal distension and died from uncontrollable massive ascites.
Abstract: Epithelial ovarian tumor with elevated alpha-fetoprotein (AFP) is extremely rare and eventually needs differential diagnosis. This study investigated AFP-producing ovarian pure clear cell carcinoma without any components differentiating it to yolk sac tumor or hepatoid carcinoma. A 51-year-old Japanese woman presented with lower-abdominal distension continued for 6 months and was found to have a huge lower-abdominal mass on pelvic examination and MRI scan. Laboratory tests showed serum AFP 31533 ng/ml, CA125 456 U/ml, and LDH 485 IU/l. Bilateral salpingo-oophorectomy, total hysterectomy and omentectomy were performed with <1 cm residual macroscopic tumor. Microscopically, the tumor was characterized by typical clear cell carcinoma without any differentiating components. Pathologic stage was pT3cNxM0. Tumor cells were diffusely immunoreactive for AFP with more prominent staining on cell block cytology from ascites than surgical specimen. The patient was treated by 6 cycles of chemotherapy composed of dose-dense paclitaxel with intraperitoneal carboplatin, producing normalization of both AFP and CA125 without any evidence of the disease. After 11 months, she showed remarkable increase in CA125 to 1365 u/ml, with normal level of AFP. The recurrent tumor was resected and she received chemotherapy with gemcitabine and carboplatin, producing stabilization of the disease without any fluctuations in CA125 level. Eight months after, she showed slight increase of AFP to 29 ng/ml with uncontrollable massive ascites which was out of control resulting in her death.