Background and purpose: Ovarian cancer is the most common cause of death in gynecological malignancy. For patients in the early stage, the value of lymphadenectomy remains a question. This study demonstrated the relationship between lymphadenectomy and the progression-free survival outcomes of patients with early stage ovarian cancer. Methods: The information of 246 patients with International Federation of Gynecology and Obstetrics (FIGO) stage ⅠC-ⅡA ovarian cancer treated from 2001 to 2019 was collected from Fudan University Shanghai Cancer Center. The patients were divided into two groups according to the type of surgery, the pathological staging group (n=123) and the clinical staging group (n=123). And survival analysis was performed to evaluate the prognosis of patients. Multivariable regression analysis was conducted to explore the association between overall survival (OS) or progression-free survival and other variables. Meanwhile, t-test was used to compare the average operative duration, average hospitalization and the average blood loss between the pathological staging group and the clinical staging group , to explore the effect of lymphadenectomy on postoperative complications. Results: There was no significant difference in the clinical characteristics between the two groups. The 3-year, 5-year and 10-year OS rates were 91.78%, 80.77% and 45.45% in pathological staging group, and were 90.91%, 81.43% and 42.86% in the clinical staging group, respectively. Kaplan–Meier method and log-rank test demonstrated that there was no significant difference in progression-free survival (P=0.194) and OS (P=0.184) between these two groups. All patients received platinum-based adjuvant chemotherapy. The patients who received CBP+taxol for 6 courses were the most (103/246, 41.87%), and the median course of chemotherapy was 6. A total of 85 patients developed recurrent metastasis, and 78 (78/85, 91.76%) of them had metastasis in the pelvic and peritoneal cavity. During the follow-up of the patients in the pathological staging group, we found two patients with retroperitoneal lymph node metastasis while there were 3 patients in clinical staging group. Furthermore, the median operating time was longer in the pathological staging group than in clinical staging group (P<0.001). And the mean time of hospitalization was also significantly longer in the pathological staging group than in clinical staging group (P=0.016). Four patients in the pathological staging group developed postoperative complications (4/123, 3.25%), whereas only one patient in the clinical staging group developed postoperative complications (1/123, 0.81%). In the multivariate analysis model, we found that the FIGO stage was an independent predictive factor for OS, while the grade of tumor was an independent prognostic factor for both progression-free survival and OS. Lymphadenectomy was not associated with progression-free survival and OS. Conclusion: The use of lymphadenectomy did not improve the prognosis of patients. Moreover, it may increase the risk of postoperative complications due to its prolonged operating time.

Background and purpose: Small cell carcinoma of the ovary, hypercalcemic type (SCCOHT) is a rare gynecological malignancy with poor prognosis, which mostly occurs in young women. This study analyzed clinical characteristics and treatment of 11 patients with SCCOHT, then clinical manifestations, treatment patterns and prognostic factors were summarized through literature review. Methods: A retrospective study was conducted on clinical data of 11 cases diagnosed with SCCOHT from Jan. 2000 to Dec. 2019 in Fudan University Shanghai Cancer Center. Results: The median age of 11 patients was 31 years (from 22 to 40 years). The main clinical presentations were abdominal pain (63.7%) and pelvic mass (36.4%). According to 2019 International Federation of Gynecology and Obstetrics (FIGO) staging system for ovarian cancer, stage Ⅰ included 4 cases, stage Ⅲ consisted of 1 case and stage Ⅳ had 6 cases. Four (36.4%) patients had elevated serum calcium. All patients were administered with surgery followed by adjuvant chemotherapy. Nine (81.8%) cases died within 1 year from initial diagnosis, and the median survival time was 6 months. In this cohort, 6-month survival rate was 45.5%, and 10-month survival rate was 13.6%. Conclusion: SCCOHT occurs in younger patients and is difficult to deal with due to its significantly aggressive behavior. Surgery combined with adjuvant chemotherapy is first-line treatment strategy. Pelvis and abdomen are the most common recurrence sites. Targeted therapy and immunotherapy are promising for SCCOHT.

Primary female genital tract malignant melanoma (PFGMM) is a rare mucosal malignant melanoma with poor prognosis. Surgery has remained the first-line therapeutic option for early-stage PFGMM, but the treatment for patient with advanced or recurrent disease is challenging. Currently, systemic chemotherapy is widely adopted. However, it shows limited effect. New targeted therapy and immunotherapy are worth exploring. Notably, the development and progression of melanoma may correlate with c-kit gene alterations with a mutation rate of about 18.5% for PFGMM. Therefore, c-kit gene is expected to become a new target. In this article, we briefly reviewed the role of c-kit in the occurrence, development, treatment and prognosis of PFGMM.

我国已经步入老龄化社会[1],老年人随着年龄增长常多病共存,常会出现多种老年综合征与慢性疾病叠加、多重用药等问题[2].国外研究数据表明,超过半数老年患者合并3种或更多的慢性疾病[3],如何综合管理老年患者已成为目前老年病科医师、全科医师面临的极大挑战.本文对1例卵巢腺癌合并腹腔转移和多器官功能衰竭高龄患者的综合管理进行了报道.