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[PMID]:25423710
[Au] Autor:Ki EY; Park JS; Mun JB; Hur SY
[Ti] Título:Primary ovarian malignant mixed mesodermal tumor: report of four cases.
[So] Source:Eur J Gynaecol Oncol;35(5):584-8, 2014.
[Is] ISSN:0392-2936
[Cp] País de publicação:Italy
[La] Idioma:eng
[Ab] Resumo:Malignant mixed mesodermal tumors (MMMTs) are highly aggressive and usually diagnosed at advanced stages. MMMT originates from either the ovary or the uterus. Because this disease is relatively rare, an optimal treatment modality has not yet been established. The authors report four cases of ovarian MMMT (one heterologous MMMT and three homologous MMMTs) during 1990-2011. The patients underwent operation immediately after histopathologically confirmation and were treated with platinum-based combination chemotherapy. The extent of operation, the outcomes of radiation therapy, and the proper chemotherapeutic regimen are still controversial. The authors report herein four cases of ovarian MMMTs alone with a brief literature review.
[Mh] Termos MeSH primário: Tumor Mesodérmico Misto/terapia
Neoplasias Ovarianas/terapia
[Mh] Termos MeSH secundário: Idoso
Terapia Combinada
Feminino
Seres Humanos
Meia-Idade
Tumor Mesodérmico Misto/patologia
Neoplasias Ovarianas/patologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1412
[Cu] Atualização por classe:141126
[Lr] Data última revisão:
141126
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:141127
[St] Status:MEDLINE


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[PMID]:25003226
[Au] Autor:Pavlidou A; Vlahos NF
[Ad] Endereço:Second Department of Obstetrics and Gynecology University of Athens Medical School Aretaieion Hospital, Athens, Greece - thani_pavlidou@yahoo.gr.
[Ti] Título:Endometriosis and ovarian cancer: clinical and molecular aspects.
[So] Source:Minerva Endocrinol;39(3):155-65, 2014 Sep.
[Is] ISSN:0391-1977
[Cp] País de publicação:Italy
[La] Idioma:eng
[Ab] Resumo:Endometriosis is one of the most commonly encountered benign problems in gynecology. Even though endometriosis appears to predispose to ovarian cancer the progression from atypical epithelial proliferation (atypical endometriosis and metaplasia), to the formation of well-defined borderline tumors and finally to endometrioid ovarian cancer will take several years. To elaborate on the concept of endometriosis as a precursor of some types of ovarian cancer, we present an overview of the pathophysiological and genetic characteristics, common in those two conditions. Furthermore, we present the genetic mutations found in ovarian cancers and we outline the common genetic alterations of endometriosis and ovarian cancer, focusing on the PI3K/Akt/mTOR-signaling pathway.
[Mh] Termos MeSH primário: Endometriose/patologia
Neoplasias Ovarianas/patologia
Lesões Pré-Cancerosas/patologia
[Mh] Termos MeSH secundário: Carcinoma/patologia
Carcinoma Endometrioide/patologia
Transformação Celular Neoplásica/genética
Progressão da Doença
Suscetibilidade a Doenças
Endometriose/fisiopatologia
Feminino
Instabilidade Genômica
Seres Humanos
Tumor Mesodérmico Misto/patologia
Mutação
Proteínas de Neoplasias/fisiologia
Oncogenes
Neoplasias Ovarianas/genética
Neoplasias Ovarianas/fisiopatologia
Lesões Pré-Cancerosas/fisiopatologia
Proteínas Quinases/fisiologia
Transdução de Sinais/genética
Transdução de Sinais/fisiologia
Microambiente Tumoral
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Neoplasm Proteins); EC 2.7.- (Protein Kinases)
[Em] Mês de entrada:1501
[Cu] Atualização por classe:140729
[Lr] Data última revisão:
140729
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:140709
[St] Status:MEDLINE


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[PMID]:24070713
[Au] Autor:Osman S; Lehnert BE; Elojeimy S; Cruite I; Mannelli L; Bhargava P; Moshiri M
[Ad] Endereço:Department of Radiology, University of Washington School of Medicine, Seattle, WA. Electronic address: sfosman@uw.edu.
[Ti] Título:A comprehensive review of the retroperitoneal anatomy, neoplasms, and pattern of disease spread.
[So] Source:Curr Probl Diagn Radiol;42(5):191-208, 2013 Sep-Oct.
[Is] ISSN:1535-6302
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:A clear understanding of the normal anatomy and pattern of disease spread is important in evaluating many retroperitoneal disorders. Primary retroperitoneal tumors are uncommon, accounting for 0.1%-0.2% of all malignancies in the body; 80%-90% of all primary retroperitoneal tumors are malignant. The primary retroperitoneal neoplasms can be divided into solid or cystic masses. The solid neoplasms can be classified according to their tissue of origin into 3 main categories: mesodermal tumors, neurogenic tumors, and extragonadal germ cell tumors. Computed tomography and magnetic resonance imaging play a vital role in the localization, characterization, evaluation of the extent of local invasion, assessment of metastases, and determination of treatment response for these tumors. The diagnosis of a primary retroperitoneal malignancy is often challenging owing to overlap of imaging findings. A definitive diagnosis can be established only at histopathologic analysis. However, knowledge of the important tumor characteristics, growth pattern, and vascularity can assist in narrowing the differential diagnosis.
[Mh] Termos MeSH primário: Imagem por Ressonância Magnética
Tumor Mesodérmico Misto/patologia
Neoplasias Embrionárias de Células Germinativas/patologia
Neoplasias Retroperitoneais/patologia
Tomografia Computadorizada por Raios X
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Masculino
Tumor Mesodérmico Misto/diagnóstico por imagem
Invasividade Neoplásica
Neoplasias Embrionárias de Células Germinativas/diagnóstico por imagem
Neoplasias Retroperitoneais/diagnóstico por imagem
Espaço Retroperitoneal/patologia
Carga Tumoral
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1405
[Cu] Atualização por classe:161125
[Lr] Data última revisão:
161125
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:130928
[St] Status:MEDLINE


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[PMID]:23126058
[Au] Autor:Sentija K; Bolanca IK; Simon SK; Kukura V; Skrtic A; Gasparov S
[Ad] Endereço:Merkur University Hospital, Department of Clinical Cytology and Cytogenetics, Division of Gynecological Cytology and Cytogenetics, Zagreb, Croatia. ksentija@yahoo.com
[Ti] Título:[Primary ovarian malignant mixed mesodermal tumor (MMMT) as a second primary tumor in a patient with invasive breast carcinoma--case report].
[Ti] Título:Maligni mijesani mezodermalni tumor jajnika (MMMT)--drugi primarni tumor u bolesnice s invazivnim karcinomom dojke..
[So] Source:Acta Med Croatica;65 Suppl 1:229-34, 2011 Sep.
[Is] ISSN:1330-0164
[Cp] País de publicação:Croatia
[La] Idioma:hrv
[Ab] Resumo:Malignant mixed mesodermal tumor (MMMT) of the ovary is a rare aggressive tumor that consists of an epithelial (carcinoma) and a stromal (sarcoma) component. MMMT accounts for less than 2% of ovarian cancers and has a very poor prognosis. We present a case and difficulties of diagnosing an ovarian MMMT in a postmenopausal woman with a history of invasive breast carcinoma treated postoperatively with radiotherapy and tamoxifen. A 52-year-old patient presented with unilateral ovarian tumor and moderately elevated CA125 (107 U/mL) and underwent laparotomy. Fine needle aspiration of the ovary and ascites for cytologic analysis, and tumor biopsy for histopathology were performed intraoperatively. Intraoperative cytologic sample showed necrotic background with rare single malignant cells with pale, abundant cytoplasm and conspicuous nucleoli suggesting clear cell carcinoma. Ascites sample showed inflammatory and reactive background with suspected papillary formations mimicking adenocarcinoma. Postoperatively, cytochemical PAS staining and immunocytologic staining with epithelial antigen (EA), cytokeratin (CK)7 and vimentin showed EA and PAS positivity for ovarian tumor, and EA and CK7 for ascites, suggesting a clear cell carcinoma. Histology revealed ovarian clear cell carcinoma. Three months later, the patient underwent hemicolectomy because of tumors on the right large bowel serosa with intraoperative morphological finding of metastatic malignant tumor without other specific features. Postoperative morphological analysis and immunohistochemical staining of the tumor revealed two malignant components, epithelial and stromal one. Repeat histologic analysis of the ovarian tumor confirmed ovarian MMMT (with a clear cell carcinoma component). Other studies of breast cancer emphasize that patients with invasive breast cancer and mutations of BRCA1 and BRCA2 genes are at an increased risk of primary ovarian cancer. Our study confirmed it and suggested considering a second primary malignant tumor of ovarian origin in patients with a history of breast carcinoma, postoperatively treated with radiotherapy and tamoxifen. Although rare, second primary ovarian tumors may present as MMMT.
[Mh] Termos MeSH primário: Neoplasias da Mama/patologia
Tumor Mesodérmico Misto/diagnóstico
Segunda Neoplasia Primária/patologia
Neoplasias Ovarianas/diagnóstico
[Mh] Termos MeSH secundário: Neoplasias do Colo/secundário
Feminino
Seres Humanos
Meia-Idade
Tumor Mesodérmico Misto/patologia
Tumor Mesodérmico Misto/secundário
Neoplasias Ovarianas/patologia
[Pt] Tipo de publicação:CASE REPORTS; ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Mês de entrada:1211
[Cu] Atualização por classe:121106
[Lr] Data última revisão:
121106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:121107
[St] Status:MEDLINE


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[PMID]:22053671
[Au] Autor:Maeda M; Mabuchi S; Matsumoto Y; Hisamatsu T; Ohashi H; Kimura T
[Ad] Endereço:Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
[Ti] Título:Activity of pegylated liposomal doxorubicin for extragenital mullerian adenosarcoma with sarcomatous overgrowth: a case report and a review of the literature.
[So] Source:Eur J Gynaecol Oncol;32(5):542-6, 2011.
[Is] ISSN:0392-2936
[Cp] País de publicação:Italy
[La] Idioma:eng
[Ab] Resumo:A 47-year-old woman was diagnosed with extragenital mullerian adenosarcoma with sarcomatous overgrowth. One month after her initial surgery, the patient developed pelvic recurrence, which was completely excised by surgery. However, one month later, the patient developed further recurrences in her pelvis and upper abdomen. A clinical complete response was achieved with three cycles of liposomal doxorubicin and is currently clinically free of disease. So far, including the present case, 23 cases of extragenital mulleian adenosarcoma have been reported in the English literature. Because of the rarity of the reported cases, there are no treatment guidelines based on a good level of evidence. In the current report, through a literature review, we provide information on the activity of pegylated liposomal doxorubicin for extragenital mullerian adenosarcoma with sarcomatous overgrowth.
[Mh] Termos MeSH primário: Neoplasias Abdominais/tratamento farmacológico
Adenossarcoma/tratamento farmacológico
Doxorrubicina/análogos & derivados
Tumor Mesodérmico Misto/tratamento farmacológico
Neoplasias Pélvicas/tratamento farmacológico
Polietilenoglicóis/uso terapêutico
[Mh] Termos MeSH secundário: Neoplasias Abdominais/patologia
Adenossarcoma/patologia
Doxorrubicina/uso terapêutico
Feminino
Seres Humanos
Meia-Idade
Tumor Mesodérmico Misto/patologia
Neoplasias Pélvicas/patologia
Sarcoma/patologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (liposomal doxorubicin); 30IQX730WE (Polyethylene Glycols); 80168379AG (Doxorubicin)
[Em] Mês de entrada:1112
[Cu] Atualização por classe:151119
[Lr] Data última revisão:
151119
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:111108
[St] Status:MEDLINE


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[PMID]:21968895
[Au] Autor:Günthert AR
[Ad] Endereço:Kliniken und Poliklinik für Frauenheilkunde, Inselspital, Bern. andreas.guenthert@insel.ch
[Ti] Título:[Sarcomas and mixed mesodermal tumors of the uterus].
[Ti] Título:Mesenchymale Tumoren des Uterus..
[So] Source:Ther Umsch;68(10):559-64, 2011 Oct.
[Is] ISSN:0040-5930
[Cp] País de publicação:Switzerland
[La] Idioma:ger
[Ab] Resumo:Malignant mesodermal tumors of the uterus are an inhomogenous group of uterine malignancies with different pathogenesis, clinical presentation and prognosis. These rare tumors represent approximately 1 % of all uterine malignancies. The aggressive carcinosarcomas or mixed muellerian tumors are defined by mixed malignant epithelial and malignant mesodermal histopathology and are of the same precursor cell origin like endometrial cancer. Thus, carcinosarcomas were reclassified by the FIGO as an aggressive type of endometrial cancer and treated like type II endometrial cancer. Adenosarcomas are also mixed tumors with benign epithelial proliferation and malignant mesodermal cell growth, have a good prognosis and represent less than 5 % of all mesodermal uterine malignancies. Besides carcinosarcomas, the pure mesodermal leiomyosarcomas are the most common mesodermal malignancies. Patients with leiomyosarcamos are usually perimenopausal, and although more than half of the patients present with symptoms, diagnosis occurs incidentally in most cases in final histopathologic workup of an excised putative myoma or uterus. Adequate anamnesis, gynecologic examination and careful imaging by transvaginal ultrasound in the preoperative setting might hint to correct differential diagnosis in many cases. Overall the prognosis of uterine leiomyomas is poor. Malignancies of the endometrial stroma are very rare and divided in two subgroups, the mostly estrogen receptor positive endometrial stromal sarcoma, which occur preferably in premenopausal women and show a favorable prognosis, and the very aggressive undifferentiated endometrial sarcomas. The more rare undifferentiated endometrial sarcomas occur in postmenopausal women and most patients die in the first two years after diagnosis. Risk stratification of preoperative differential diagnosis requires improvements and the correct histopathologic workup of mesodermal uterine malignancies is still a challenge for pathologists.
[Mh] Termos MeSH primário: Neoplasias Uterinas/cirurgia
[Mh] Termos MeSH secundário: Adenossarcoma/diagnóstico
Adenossarcoma/patologia
Adenossarcoma/cirurgia
Carcinossarcoma/diagnóstico
Carcinossarcoma/patologia
Carcinossarcoma/cirurgia
Tumores do Estroma Endometrial/diagnóstico
Tumores do Estroma Endometrial/patologia
Tumores do Estroma Endometrial/cirurgia
Endossonografia
Feminino
Seres Humanos
Histerectomia
Laparoscopia
Leiomioma/diagnóstico
Leiomioma/patologia
Leiomioma/cirurgia
Leiomiossarcoma/diagnóstico
Leiomiossarcoma/patologia
Leiomiossarcoma/cirurgia
Meia-Idade
Tumor Mesodérmico Misto/diagnóstico
Tumor Mesodérmico Misto/patologia
Tumor Mesodérmico Misto/cirurgia
Tumor Mulleriano Misto/diagnóstico
Tumor Mulleriano Misto/patologia
Tumor Mulleriano Misto/cirurgia
Estadiamento de Neoplasias
Neoplasias Peritoneais/patologia
Neoplasias Peritoneais/secundário
Prognóstico
Ultrassonografia Doppler em Cores
Neoplasias Uterinas/diagnóstico
Neoplasias Uterinas/patologia
[Pt] Tipo de publicação:CASE REPORTS; ENGLISH ABSTRACT; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1201
[Cu] Atualização por classe:111004
[Lr] Data última revisão:
111004
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:111005
[St] Status:MEDLINE
[do] DOI:10.1024/0040-5930/a000214


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[PMID]:20407321
[Au] Autor:Mott RT; Murphy BA; Geisinger KR
[Ad] Endereço:Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA. rmott@wfubmc.edu
[Ti] Título:Ovarian malignant mixed mesodermal tumor with neuroectodermal differentiation: a multifaceted evaluation.
[So] Source:Int J Gynecol Pathol;29(3):234-8, 2010 May.
[Is] ISSN:1538-7151
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Malignant mixed mesodermal tumors (MMMTs) of the ovary are rare, highly aggressive neoplasms that arise most commonly in postmenopausal women. Histologically, they consist of a mixed population of malignant epithelial and mesenchymal elements. Neuroectodermal differentiation in ovarian MMMTs is exceedingly uncommon, with only a few case reports in the literature. We present a case of an ovarian MMMT with neuroectodermal differentiation in a 78-year-old female patient. Histologically, the tumor was composed of epithelial, mesenchymal, and neuroectodermal elements. The neuroectodermal component was predominantly that of a medulloepithelioma, with scattered areas displaying features of an anaplastic astrocytoma, including rare ganglion cell differentiation. The neuroectodermal component showed immunoreactivity for glial fibrillary acidic protein, synaptophysin, and S100 protein. Ultrastructurally, the neuroectodermal component was populated by cells with irregular nuclei, finely dispersed chromatin, rudimentary cell junctions, and a delicate basement membrane, all of which have been described in medulloepitheliomas. DNA ploidy analysis was also performed on the various components of the tumor and compared with 3 additional cases of MMMT without neuroectodermal differentiation and 2 ovarian immature teratomas. Our findings suggest that the neuroectodermal component may arise from a separate clone or at least evolves at an earlier stage of tumor development.
[Mh] Termos MeSH primário: Tumor Mesodérmico Misto/patologia
Tumores Neuroectodérmicos/patologia
Neoplasias Ovarianas/patologia
[Mh] Termos MeSH secundário: Idoso
Diferenciação Celular/fisiologia
DNA de Neoplasias/genética
Feminino
Seres Humanos
Imuno-Histoquímica
Microscopia Eletrônica de Transmissão
Tumor Mesodérmico Misto/genética
Tumor Mesodérmico Misto/terapia
Tumor Mesodérmico Misto/ultraestrutura
Tumores Neuroectodérmicos/genética
Tumores Neuroectodérmicos/terapia
Tumores Neuroectodérmicos/ultraestrutura
Neoplasias Ovarianas/genética
Neoplasias Ovarianas/terapia
Neoplasias Ovarianas/ultraestrutura
Ploidias
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (DNA, Neoplasm)
[Em] Mês de entrada:1007
[Cu] Atualização por classe:100421
[Lr] Data última revisão:
100421
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:100422
[St] Status:MEDLINE
[do] DOI:10.1097/PGP.0b013e3181bd413c


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[PMID]:17292457
[Au] Autor:Crotzer DR; Wolf JK; Gano JB; Gershenson DM; Levenback C
[Ad] Endereço:The University of Texas M. D. Anderson Cancer Center, Department of Gynecologic Oncology, Unit 1362, P.O. Box 301439, Houston, TX 77230-1439, USA. David.Crotzer@nmhs.org
[Ti] Título:A pilot study of cisplatin, ifosfamide and mesna in the treatment of malignant mixed mesodermal tumors of the ovary.
[So] Source:Gynecol Oncol;105(2):399-403, 2007 May.
[Is] ISSN:0090-8258
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To evaluate the efficacy and toxicity of cisplatin and ifosfamide in the treatment of patients with malignant mixed mesodermal tumor (MMMT) of the ovary. METHODS: Ten patients with histologically confirmed primary MMMT of the ovary diagnosed between 1993 and 2001 were enrolled in the study. Treatment consisted of cisplatin 75 mg/m2 on day 1, followed by ifosfamide 2.0 g/m2 over 24 h on days 1, 2 and 3. Mesna, 400 mg/m2, was given IV immediately prior to and 4 and 8 h after the start of each ifosfamide infusion. Chemotherapy was repeated on a 28-day cycle if blood counts permitted. Standard response criteria were used. Nine patients were evaluable for response. RESULTS: Eight of the nine patients responded to therapy, with 7 complete responses (78%) and 1 partial response. Seven of the eight responders (87.5%) eventually recurred. The median progression-free survival was 10 months (range 0-94.4 months). The median overall survival was 17.1 months (range 8-125.5 months). One patient remained free of disease 94.4 months after diagnosis, and one patient remained alive with recurrence 125.5 months following diagnosis. There were 13 grade 3 toxicities and 4 grade 4 toxicities. Four patients had grade 4 and three had grade 3 neutropenia, all of which required dose reductions. CONCLUSION: The combination of cisplatin and ifosfamide/mesna demonstrated activity against MMMT of the ovary. Response durations were short, however, and the regimen was associated with significant toxicity. Novel agents with activity against MMMT of the ovary and acceptable toxicity are needed.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Tumor Mesodérmico Misto/tratamento farmacológico
Neoplasias Ovarianas/tratamento farmacológico
[Mh] Termos MeSH secundário: Idoso
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
Cisplatino/administração & dosagem
Cisplatino/efeitos adversos
Terapia Combinada
Feminino
Seres Humanos
Ifosfamida/administração & dosagem
Ifosfamida/efeitos adversos
Mesna/administração & dosagem
Mesna/efeitos adversos
Meia-Idade
Tumor Mesodérmico Misto/patologia
Tumor Mesodérmico Misto/cirurgia
Estadiamento de Neoplasias
Neoplasias Ovarianas/patologia
Neoplasias Ovarianas/cirurgia
Projetos Piloto
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Nome de substância:
NR7O1405Q9 (Mesna); Q20Q21Q62J (Cisplatin); UM20QQM95Y (Ifosfamide)
[Em] Mês de entrada:0705
[Cu] Atualização por classe:131121
[Lr] Data última revisão:
131121
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:070213
[St] Status:MEDLINE


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[PMID]:16445619
[Au] Autor:Gari A; Souhami L; Arseneau J; Stanimir G
[Ad] Endereço:Department of Gynecology, McGill University, Montreal, Quebec, Canada.
[Ti] Título:Primary malignant mesodermal ovarian sarcomas.
[So] Source:Int J Gynecol Cancer;16(1):106-9, 2006 Jan-Feb.
[Is] ISSN:1048-891X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Primary malignant mesodermal ovarian sarcomas are rare tumors and have a poor prognosis. The disease is usually diagnosed at a late stage and 5-year survivals are uncommon. Most patients are treated with debulking surgery followed by adjuvant chemotherapy. We report ten patients treated at a single institution. All patients underwent surgery and 90% received adjuvant chemotherapy. The median survival was 20 months, and only one patient survived beyond 5 years. Newer treatment strategies are urgently needed in the management of this disease.
[Mh] Termos MeSH primário: Causas de Morte
Tumor Mesodérmico Misto/mortalidade
Tumor Mesodérmico Misto/patologia
Neoplasias Ovarianas/mortalidade
Neoplasias Ovarianas/patologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Quimioterapia Adjuvante
Estudos de Coortes
Terapia Combinada
Feminino
Seres Humanos
Imuno-Histoquímica
Meia-Idade
Tumor Mesodérmico Misto/terapia
Estadiamento de Neoplasias
Neoplasias Ovarianas/terapia
Ovariectomia/métodos
Prognóstico
Medição de Risco
Análise de Sobrevida
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:0605
[Cu] Atualização por classe:061107
[Lr] Data última revisão:
061107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:060201
[St] Status:MEDLINE


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[PMID]:15863170
[Au] Autor:Kanjeekal S; Chambers A; Fung MF; Verma S
[Ad] Endereço:University of Ottawa, Ottawa, Ontario, Canada. ccopgi@mcmaster.ca
[Ti] Título:Systemic therapy for advanced uterine sarcoma: a systematic review of the literature.
[So] Source:Gynecol Oncol;97(2):624-37, 2005 May.
[Is] ISSN:0090-8258
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To conduct a systematic review of the literature regarding the systemic treatment of advanced uterine sarcoma and provide an evidence-based summary of the available literature. METHODS: MEDLINE, EMBASE, and the Cochrane Library databases were searched. "Uterine sarcoma," "leiomyosarcoma," "mixed mesodermal tumor," "chemotherapy," and "systemic therapy" were combined with the search terms for study designs. RESULTS: Three randomized controlled trials and 24 prospective phase II trials were included in the systematic review. In a randomized trial of doxorubicin versus doxorubicin plus cyclophosphamide for advanced or recurrent uterine sarcoma, doxorubicin produced an overall response rate (RR) of 19% and median survival of 11.6 months, which was similar to the response with combination chemotherapy (RR 19%, median survival 10.9 months). A randomized trial comparing ifosfamide plus cisplatin versus ifosfamide alone in mixed mesodermal tumors showed a significant improvement in RR and progression-free survival with the combination compared with ifosfamide alone, however, the combination was associated with increased toxicity including death. A randomized trial comparing doxorubicin to doxorubicin with dacarbazine in women with advanced or recurrent uterine sarcoma demonstrated a significantly higher RR with the combination (P < 0.05), but no significant difference in survival. CONCLUSIONS: Offering palliative chemotherapy to patients with advanced, unresectable uterine sarcoma who are symptomatic from this disease is a reasonable decision. Doxorubicin is an option for women with advanced uterine sarcoma. The combination of cisplatinum and ifosfamide is also an option for women with metastatic mixed mesodermal tumors; however, this combination is associated with significant toxicity when compared to ifosfamide alone.
[Mh] Termos MeSH primário: Tumor Mesodérmico Misto/tratamento farmacológico
Sarcoma do Estroma Endometrial/tratamento farmacológico
Neoplasias Uterinas/tratamento farmacológico
[Mh] Termos MeSH secundário: Ensaios Clínicos Fase II como Assunto
Feminino
Seres Humanos
Leiomiossarcoma/tratamento farmacológico
Ensaios Clínicos Controlados Aleatórios como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Em] Mês de entrada:0507
[Cu] Atualização por classe:071115
[Lr] Data última revisão:
071115
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:050503
[St] Status:MEDLINE



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