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Biomedical subjects

L D Lagasse

Publications and source records attributed to L D Lagasse.

At least 19 recordsLinked to original sources
PubMed2001

Pattern of lymph node metastases in clinically unilateral stage I invasive epithelial ovarian carcinomas.

PURPOSE: There is controversy regarding the pattern of lymphatic spread in unilateral stage I invasive ovarian carcinomas. The purpose of this study is to describe the incidence and distribution of lymph node (LN) metastases in ovarian carcinomas clinically confined to one ovary. METHODS: Ninety-six patients with disease visibly confined to one ovary were identified. Pathology reports were reviewed to identify metastatic LN involvement, number of involved nodes, and their locations. Patients with gross disease in the pelvis or abdomen or those who had grossly positive LNs removed for debulking were excluded from this review. RESULTS: Fourteen of ninety-six patients (15%) had microscopically positive LNs on pathologic review. All of these 14 patients had grade 3 tumors. Grade 3 tumors were more commonly seen in LN-positive versus LN-negative patients (P < 0.001). Pelvic nodes were positive in 7 patients (50%), paraaortic nodes in 5 patients (36%), and both in 2 patients (14%). Forty-two patients had LN sampling only on the side ipsilateral to the neoplastic ovary, 4 of whom (10%) had LN metastases. Fifty-four patients had bilateral sampling performed, 10 of whom (19%) had LN metastases. Of these 10 patients, isolated ipsilateral LN metastases were seen in 5 (50%) cases. Isolated contralateral LN metastases were seen in 3 (30%) cases, and bilateral metastases were seen in 2 (20%). CONCLUSIONS: In this cohort of patients with clinical stage I ovarian carcinoma with disease limited to one ovary, bilateral LN sampling increased the identification of nodal metastases. Ipsilateral sampling may result in the understaging of patients. Bilateral pelvic and paraaortic LN sampling is recommended to accurately stage ovarian carcinoma.

Aorta, Abdominal↗
PubMed2000

Splenectomy and surgical cytoreduction for ovarian cancer.

OBJECTIVE: The aim of this study was to evaluate the role of splenectomy, as a surrogate marker for aggressive tumor cytoreduction in ovarian cancer, and its impact on patient morbidity and survival. METHODS: A retrospective cohort study of 35 patients who underwent splenectomy for ovarian cancer cytoreduction between August 1986 and May 1998 was performed. Data abstracted from the medical record included patient demographics, preoperative imaging, surgical procedures, tumor distribution, postoperative complications, chemotherapy treatment, and follow-up information. RESULTS: Splenectomy was performed in 13 patients at the time of primary cytoreduction and in 22 patients at the time of secondary cytoreduction. Preoperative diagnosis of splenic involvement was frequently made prior to secondary surgery, 77.3% compared to 15.4% of primary cases. In addition, parenchymal splenic involvement was more commonly observed at recurrence, 59.1% vs 23.1% at initial presentation. Disease distribution in secondary cytoreduction cases tended to be more focal, macronodular, and have no ascites. Cytoreduction to less than 1 cm disease was achieved in 100% of primary patients and 86% of secondary patients. Major morbidity (pneumonia, PE, sepsis, pancreatitis, MI) occurred in 23.1% of primary patients and 28.6% of secondary patients. Combining splenectomy with other cytoreductive procedures may make splenectomy itself seem more morbid. With a 17-month median follow-up, median progression-free interval was 24 months in primary patients and 14 months in secondary patients. Among secondary patients, median survival time after splenectomy and cytoreduction was 41 months. CONCLUSIONS: Splenectomy at the time of primary and secondary cytoreduction for ovarian cancer can be performed with acceptable morbidity. Secondary cytoreduction patients may be selected preoperatively by their progression-free interval, prior degree of cytoreduction, and macronodular tumor involvement on imaging studies. Identification of splenic involvement allows for appropriate counseling and preoperative preparation.

Adult↗
PubMed2000

The significance of atypical glandular cells on routine cervical cytologic testing in a community-based population.

OBJECTIVES: We sought to determine the follow-up rate of women with glandular atypia on routine Papanicolaou smears in a community-based population and to describe the associated pathologic findings. STUDY DESIGN: Over a 12-month period, all patients with Papanicolaou smears with atypical glandular cells of undetermined significance were reviewed for demographic and clinical characteristics and followed up for a period of 12 to 24 months. RESULTS: Of the 48,890 Papanicolaou smears examined, 141 (0.29%) were diagnosed with atypical glandular cells of undetermined significance. Of these, 22 (17.6%) had no record of any subsequent investigation, and only 64 (51.2%) were monitored with both colposcopy and biopsy. Of the 64 biopsy specimens, 39 (60.9%) were positive for disease. Twenty-six (66.7%) were of squamous origin, with the most advanced lesion being cervical intraepithelial neoplasia 3. An additional patient had a combined cervical intraepithelial neoplasia and adenocarcinoma in situ lesion. Four (10.3%) additional patients had glandular cervical lesions, 2 benign polyps and 2 adenocarcinoma in situ lesions. Seven (17.9%) patients had endometrial lesions (benign polyps, 2 patients; complex atypical endometrial hyperplasia, 1 patient; and endometrial carcinoma, 4 patients). One patient had ovarian cystadenocarcinoma. Postmenopausal women were 5 times more likely to have a glandular lesion. Women with abnormal vaginal bleeding were also more likely to have a glandular lesion. These same patient groups were also more likely to have endometrial disease. CONCLUSION: The incidence of atypical glandular cells of undetermined significance on Papanicolaou smears in this community-based population was 0.29%, which is consistent with estimates from institution-based populations. Nearly 50% of women studied were not followed up with tissue biopsy. Of those with a tissue biopsy, 61% had positive findings, including 5 with cancer. Although postmenopausal status and abnormal vaginal bleeding were associated with endometrial or glandular disease, studies of larger patient populations should be conducted to examine potential risk factors for these conditions.

Adult↗
PubMed1999

Survival impact of surgical cytoreduction in stage IV epithelial ovarian cancer.

OBJECTIVE: The aim of this study was to evaluate the influence of surgical cytoreduction on survival in patients with Stage IV epithelial ovarian cancer and to determine the survival impact of debulking extrahepatic disease in the subgroup of patients with liver metastasis. METHODS: Medical records were retrospectively reviewed for all women with International Federation of Gynecology and Obstetrics Stage IV ovarian cancer treated between 1/1/82 and 12/31/94. Clinical information abstracted included age at diagnosis, performance status, histologic subtype, tumor grade, Stage IV criteria, ascites volume, predominant peritoneal tumor pattern, surgical procedures performed, hepatic tumor residuum, extrahepatic tumor residuum, and postoperative complications. Optimal surgical status was defined as residual disease </=1 cm. Chemotherapy treatment and follow-up were recorded. Survival analysis and comparisons were performed using the Kaplan-Meier method and the log-rank test. The Cox proportional hazards regression model was used to identify independent variables associated with an improved survival rate. RESULTS: There were 84 women with Stage IV ovarian cancer and complete operative and postoperative information available. Median age at diagnosis was 61 years (range 26-85 years). Performance status was </=2 in 83% of patients (70/84). Papillary serous histology was found in 44/84 patients (52%) and 55 patients (65%) had grade 3 tumors. Thirty-seven of 84 patients (44%) had parenchymal liver metastasis and 32/84 (38%) had malignant pleural effusion. Overall median survival was 18.1 months and was highly correlated with performance status (P = 0.002), predominant peritoneal tumor pattern (P = 0.0002), and the number of chemotherapy regimens received (P = 0.0039). Primary surgical cytoreduction was attempted in all patients and 25/84 (30%) achieved optimal status. Median survival of optimally cytoreduced patients was 38.4 months, compared to 10.3 months for patients with suboptimal residual disease (P = 0.0004). In patients with liver metastasis, optimal extrahepatic cytoreduction was achieved in 46% (17/37). Six of 37 patients (16%) underwent optimal resection of both extrahepatic and hepatic disease and had a median survival of 50.1 months, compared to a median survival of 27.0 months for the 11 patients (30%) with optimal extrahepatic disease but suboptimal residual hepatic tumor. Twenty patients (54%) were left with both suboptimal residual extrahepatic and hepatic disease and had a median survival of 7.6 months (P = 0.0001). Optimal debulking surgery and performance status retained significance as independent predictors of survival on multivariate analysis. CONCLUSIONS: Optimal surgical debulking and performance status appear to be important determinants of survival in patients with Stage IV epithelial ovarian cancer. Even in patients with unresectable liver metastasis, optimal debulking of extrahepatic disease is associated with a significant survival advantage.

Adenocarcinoma↗
PubMed1998

Resection of a giant aggressive angiomyxoma in the Philippines.

INTRODUCTION: Medicine for Humanity is a multidisciplinary team of health care professionals, travelling to developing areas throughout the world on medical missions. The following is one of many technically challenging and unique cases presented for treatment. CASE: A 38-year-old woman gradually developed a giant mass arising from the right labium majus, extending into the retroperitoneum. Surgical resection was performed by abdominal and perineal teams. Intraoperative blood loss was approximately 10,000 ml, requiring 18 units of whole blood transfusion-including 6 units acutely donated by members of the surgical team. A "pack and go back" technique was used for hemostasis. The tumor weighed 19.8 kg. Final histology confirmed an aggressive angiomyxoma. CONCLUSION: This patient had the largest, histologically confirmed, aggressive angiomyxoma described to date. The surgical management of this case followed the principles in treating hemorrhagic shock, but required modifications based on availability of resources in Cebu City, Philippines.

Adult↗
PubMed1996

Secondary surgical cytoreduction for advanced epithelial ovarian cancer. Patient selection and review of the literature.

BACKGROUND: Standard therapy for advanced epithelial ovarian cancer now includes primary cytoreductive surgery followed by combination chemotherapy. Optimal primary debulking is associated with improved clinical response rates to primary chemotherapy as well as longer overall survival. The benefits of secondary cytoreductive surgery for persistent or recurrent ovarian cancer have not been as clearly established as those of primary surgery. METHODS: The English language literature was searched, using a MEDLINE database, to identify all clinical investigations pertaining to secondary cytoreductive surgery for epithelial ovarian cancer. Additional sources were found in reference lists from original research and review articles. Particular emphasis was placed on those studies allowing secondary operations for ovarian cancer to be grouped into four clinical scenarios: (1) recurrent disease, (2) second-look laparotomy (SLL), (3) interval cytoreduction, and (4) progressive disease. RESULTS: Patients with recurrent disease, particularly after a prolonged disease free interval, may derive a significant survival benefit from optimal debulking. The available data also indicate that patients whose disease is in complete clinical remission, with macroscopic disease detected at the time of SLL, benefit from cytoreduction to microscopic disease residual. Cytoreduction that leaves SLL patients with a small amount of macroscopic disease may provide some survival benefit, but the degree of that benefit is unclear. Patients who undergo suboptimal primary debulking and later demonstrate a favorable response to induction chemotherapy may derive a modest survival advantage from an optimal interval cytoreductive procedure. CONCLUSIONS: Proper selection of patients with recurrent or initially suboptimally resected ovarian cancer is essential to maximize the potential therapeutic benefit of secondary cytoreductive surgery.

Female↗
PubMed1996

What is the role of reassessment laparoscopy in the management of gynecologic cancers in 1995?

One hundred fifty-four patients with a diagnosis of ovarian, primary peritoneal, or fallopian tube carcinoma underwent 181 reassessment procedures to detect persistent or recurrent disease between January 1, 1989 and December 31, 1994 at Cedars-Sinai Medical Center. One hundred four laparoscopic procedures were performed. Eleven of these procedures were converted to laparotomy due to severe adhesions. Therefore, a total of 88 reassessment laparotomies were performed during the study period. Fifty-seven of 93 laparoscopies and 69 of 88 laparotomies were done as second-look procedures. There was no significant difference between the two groups with respect to patient age, tumor histology, degree of primary cytoreduction, and tumor stage or grade. Significant differences were found between laparoscopy and laparotomy groups in the following outcome variables evaluated: estimated blood loss (33.9 ml vs 164.9 ml, P = 0.0001), operative time (81.3 min vs 130.4 min, P = 0.0001), days of hospitalization (0.3 days vs 6.8 days, P = 0.0001), and direct cost/case ($2765 vs $5420, P = 0.0001). Despite obtaining 50% fewer biopsies with laparoscopy than laparotomy, the ability to detect disease was similar between these two groups: 47.3% vs 55.7% for all procedures and 52.6% vs 53.6% in the patients undergoing second-look procedures. Major complications in the laparoscopy group included transverse colon perforation (1), small bowel perforation (2), enterocutaneous fistula (1), and a retroperitoneal hematoma (1). Major complications in the laparotomy group included cystotomy (1), left ureteral injury (1), enterotomy (2), and SBO (4). Laparoscopy, when technically feasible, appears equally as effective as laparotomy in detecting persistent or recurrent malignant disease with less blood loss, less days spent in the hospital, less financial burden, and no increase in patient morbidity.

Evaluation Studies as Topic↗
PubMed1996

Successful treatment of neuroendocrine small cell carcinoma of the cervix metastatic to regional lymph nodes.

Neuroendocrine small cell carcinoma of the cervix is an aggressive tumor that is associated with a poor prognosis. No reports have described a patient with metastatic spread who has had long-term survival. A patient with neuroendocrine small cell carcinoma of the cervix metastatic to regional lymph nodes who is free of disease 92 months after multimodality treatment with radiation, surgery, and chemotherapy is described in this paper.

Adult↗
PubMed1995

Secreted ovarian stromal substance inhibits ovarian epithelial cell proliferation.

OBJECTIVE: Determine the effects of factors secreted by normal human ovarian stroma on the proliferation of benign and malignant ovarian epithelia, in vitro. METHODS: Primary cultures of normal human ovarian surface epithelium (HOSE), human ovarian stromal tissue (HOST), and epithelial ovarian carcinomas (CSOC) were established from surgical specimens and characterized immunohistochemically using anti-cytokeratin, vimentin, and Factor VIII antibodies. Stroma-conditioned media (SCM) were collected over 3 days from confluent HOST cultures. The SCM were dialyzed, lyophilized, resuspended, and added to HOSE, CSOC, SKOV-3, and Caov-3 ovarian cancer cell cultures and growth inhibitory effects were assayed by MTS and [3H]thymidine uptake. RESULTS: SCM inhibited the growth and DNA synthesis of normal HOSE cells and cancer cells by 79-99% in > 10-cell lines studied to date. The inhibitory effect was rapid in onset with 31-82% reduction in DNA synthesis at 1 hr and approximately 50% return of activity by 23 hr following a 1-hr SCM pulse treatment. The SCM inhibitory activity was not abolished by boiling or by absorption with heparin-agarose. Size exclusion filtration places the molecular weight of the inhibitory substance between 1 and 3 kDa. Neither trypsin nor proteinase K treatments altered the inhibitory activity of SCM, while a Bligh-Dyer organic extraction placed the activity in the aqueous phase. CONCLUSION: A heat-stable, non-heparin-binding, low-molecular-weight, water-soluble substance secreted by normal ovarian stroma significantly inhibits HOSE and ovarian cancer cell proliferation. Derangements in normal ovarian stroma-epithelial interactions may contribute to growth dysregulation of the surface epithelia and result in ovarian carcinogenesis.

Biological Factors↗
PubMed1995

Steroid hormone effects on the proliferation of human ovarian surface epithelium in vitro.

OBJECTIVE: The histologically bland-appearing epithelium of the human ovary is responsible for approximately 90% of ovarian cancers. Capitalizing on our ability to propagate this tissue in vitro, we have begun to characterize the steroid hormone responsiveness of the human ovarian surface epithelium. STUDY DESIGN: Primary cultures of the human ovarian surface epithelium are characterized as normal epithelium on the basis of morphologic features, normal karyotype, and immunohistochemistry demonstrating AE1/AE3 cytokeratin positivity and factor VIII negativity. Estrogen and progestin receptors were quantitatively analyzed with a standard receptor-ligand binding assay. Cellular proliferation in response to 1 x 10(-7) mol/L 17 beta-estradiol, progesterone, dihydrotestosterone, and dexamethasone were assessed by means of cell counts and a tetrazolium-based colorimetric assay. RESULTS: Scatchard analyses identified 8.8 x 10(3) estrogen receptors per cell in the premenopausal human ovarian surface epithelium cells, whereas the postmenopausal cells were negative for estrogen receptors. A total of 3.2 to 13.0 x 10(3) progestin receptors per cell was identified, with variable progestin receptor expression in the postmenopausal cells. No significant effect on cell growth could be demonstrated as a result of any of the steroid hormones investigated under the study conditions. CONCLUSIONS: Expression of estrogen and progestin receptors in human ovarian surface epithelium cells may be related to menopausal status. Steroid hormones, however, did not influence cell proliferation under these experimental conditions.

Cell Division↗
PubMed1995

HER-2/neu, p53, and DNA analyses as prognosticators for survival in endometrial carcinoma.

OBJECTIVE: To compare the prognostic importance of certain molecular biologic characteristics (HER-2/neu and p53 gene overexpression, DNA ploidy, and the S-phase fraction) to standard clinical-pathologic factors used to predict survival in patients with endometrial carcinoma. METHODS: We reviewed archival specimens from 128 patients with endometrial cancer diagnosed during the period 1985-1987. One hundred four cases were eligible for inclusion in the study. Immunohistochemistry was used to detect p53 and HER-2/neu overexpression. We used flow cytometry to calculate DNA ploidy and the S-phase fraction. Life-table analysis and Cox multiple regression were used to analyze clinical and molecular data with respect to survival. RESULTS: International Federation of Obstetrics and Gynecology stage, nuclear grade, lymph-vascular space invasion, and adverse histopathologic features each significantly correlated with poor outcome (each at P < or = .001). Overexpression of p53 was demonstrated in 15% of the tumors and was associated with a 12% probability of 5-year survival, compared to a 90% probability of 5-year survival for the p53-negative cohort (P = .0001). Thirty percent of the tumors were aneuploid, which was also associated with poor prognosis (P = .0003). HER-2/neu overexpression and an S-phase fraction greater than 10% showed similar trends, but were not statistically significant. On multivariate analysis, p53 overexpression was the strongest independent prognosticator of survival (P = .0001). CONCLUSION: Molecular characteristics provide objective data that may be useful in predicting prognosis in patients with endometrial cancer. Further investigation of molecular and genetic characteristics are needed to refine our diagnostic and treatment modalities.

Aged↗
PubMed1994

Conservative and individualized surgery for early squamous carcinoma of the vulva: the treatment of choice for stage I and II (T1-2N0-1M0) disease.

We studied the outcome of patients undergoing radical local excision (modified radical vulvectomy) with inguinal-femoral lymphadenectomy through separate groin incisions for stage I and II invasive squamous carcinoma of the vulva. The purpose was to determine whether less radical and more individualized surgery is consistent with local control and cure. We have reported previously our experience using radical local excision and modified radical vulvectomy in stage I disease (Obstet. Gynecol. 63, 155 (1984)) and with separate groin incisions (Obstet. Gynecol. 58, 574 (1981)). This current report expands our experience with stage I and adds stage II patients treated over the past decade. Seventy-four patients were studied retrospectively over the 5-year period ending in January 1990. Reviews of both patient charts and histopathology reports were correlated with recurrence and survival. Factors analyzed included FIGO stage and grade, histology, lesion size and depth of invasion, surgical procedure, radiotherapy, lymph node status, interval to and site of recurrence, and survival. Thirty-nine patients had stage I disease and 35 had stage II. The primary operation was a radical local excision (modified radical vulvectomy) in 56 patients and radical vulvectomy in 18 patients; 13 underwent ipsilateral inguinal-femoral lymphadenectomy and 58 bilateral lymphadenectomy, each through separate groin incisions. The survival of those treated conservatively (97 and 90% for stages I and II, respectively) is the same as those undergoing a radical vulvectomy (100 and 75% for stages I and II, respectively) with only the presence of inguinal-femoral lymph node metastases impacting negatively on survival. In the entire group, the survival for negative and positive nodes was 98 and 45%, respectively. In conclusion, conservative, modified, and individualized vulvectomy in both stage I and II disease is associated with the same outcome and survival as radical vulvectomy, and lymph node status is the most important prognostic factor.

Carcinoma, Squamous Cell↗
PubMed1994

Glucocorticoids stabilize HER-2/neu messenger RNA in human epithelial ovarian carcinoma cells.

Recent evidence suggests that HER-2/neu oncogene overexpression may have a direct role in the pathogenesis of ovarian cancer rather than being merely a prognosticator of poor disease outcome. The mechanisms regulating expression of the p185HER-2/neu growth factor receptor protein are poorly understood. Glucocorticoid receptors are present in tumor cells of almost 90% of ovarian cancers, and these hormones inhibit ovarian cancer cell growth. Glucocorticoid regulation of HER-2/neu expression was investigated using the SK-OV-3 human epithelial ovarian cancer cell line in which the HER-2/neu gene is amplified five- to eightfold. Cells cultured in the presence of 10(-9)-10(-5) M dexamethasone or hydrocortisone displayed a dose-dependent increase in HER-2/neu mRNA. To determine if this effect was due to stabilization of existing HER-2/neu transcripts or to new mRNA synthesis, cells were treated with actinomycin D and cycloheximide once steady-state levels of HER-2/neu mRNA had been reached. These studies demonstrated prolongation of the half-life of existing HER-2/neu transcripts in the presence of dexamethasone. No concomitant increase in the p185HER-2/neu receptor protein in response to dexamethasone could be demonstrated by Western blot or immunohistochemical analyses. Cellular proliferation was inhibited approximately 20% by the presence of dexamethasone. These data suggest that post-transcriptional regulatory mechanisms may play a role in modulating some of the biologic effects of the HER-2/neu oncogene.

Cell Division↗
PubMed1994

The influence of tumor grade, distribution, and extent of carcinomatosis in minimal residual stage III epithelial ovarian cancer after optimal primary cytoreductive surgery.

The purpose of this study was to determine the influence of tumor grade, distribution, and extent of carcinomatosis in minimal residual epithelial ovarian cancer after primary optimal cytoreductive surgery. Between 1978 and 1990, 112 patients with stage III epithelial ovarian cancer underwent primary cytoreductive surgery and had minimal residual disease, i.e., < 5 mm maximum diameter of residual tumor nodules. Seventy-eight patients (70%) had operative reports that contained sufficient detail to be included in this study. We retrospectively reviewed histopathological reports to determine tumor grade, operative and clinical notes to determine one predominant distribution pattern of residual metastases (pelvic/omental, diaphragmatic, or intestinal/mesenteric), and the approximate extent of residual disease (no gross disease, scattered nodules, or extensive carcinomatosis). Standard actuarial survival analysis was performed, and the log-rank chi 2 was used. At the mean follow-up time of 24.4 months, survival was 65% for grade 2 or 3 disease versus 93% for grade 1 (log-rank P < 0.01). Survival was 66% for residual disease in the intestines/mesentery versus 70 and 81% for residual disease in the diaphragm and pelvis/omentum, respectively (log-rank P < 0.03). Survival was 48% for residual extensive carcinomatosis versus 76 and 93% for minimal residual nodules and no gross residual, respectively (log-rank P < 0.001). In conclusion, in women who have minimal residual ovarian cancer after primary cytoreductive surgery, tumor grade and the distribution and extent of carcinomatosis can independently affect survival. The shortest survival correlated with high-grade tumor and extensive carcinomatosis predominantly involving the intestines and mesentery.

Carcinoma↗
PubMed1994

Development of endometrial cancer in women on estrogen and progestin hormone replacement therapy.

The presenting symptoms, hormonal regimens, treatment modalities, tumor pathology, and follow-up of 25 women developing endometrial cancer while receiving postmenopausal estrogen and progestin therapy were investigated retrospectively. Patients were interviewed and hormone therapies were confirmed through medical records. Pathology specimens were reviewed. Patients received conjugated estrogens (n = 20) or another estrogen (n = 5). For those on conjugated estrogens, the mean daily dose was 0.68 mg, monthly duration was 24.9 days, and monthly dose was 17.0 mg. Women also received medroxyprogesterone acetate (n = 23) or norethindrone acetate (n = 2). The most common regimen was sequential medroxyprogesterone acetate, at a mean daily dose of 7.5 mg, monthly duration of 9.3 days, and monthly dose of 68 mg (mean duration = 5.7 years). Most tumors were low stage and grade, with few demonstrating grade 3 disease (n = 2) or greater than 50% myometrial invasion (n = 2). Twenty-three (92%) had disease limited to the uterus, while two had stage IIIA disease. All are alive and disease-free after a median follow-up of 26 months. Estrogen and progestin therapy does not prevent endometrial cancer in all patients. Women who developed this tumor on sequential therapy in general received less than the recommended guidelines for daily dosage and monthly duration of progestin. Most patients had early-stage and low-grade disease. Continued vigilance in the care of women on hormone replacement therapy is necessary even when combination therapy is prescribed.

Aged↗
PubMed1994

Steroid hormonal independence of HER-2/neu mRNA expression in four human ovarian carcinoma cell lines.

Overexpression of HER-2/neu, a 185-kDa tyrosine kinase growth factor receptor, in human ovarian cancers has been correlated with a poor prognosis for survival of the disease. Previous studies have demonstrated that dexamethasone (Dex) induces a dose-dependent increase in HER-2/neu mRNA levels in the ovarian cancer cell line SK-OV-3 by stabilizing the HER-2/neu message. We extended these studies to test whether estrogen (Es), progesterone (Pr), and Dex were capable of regulating HER-2/neu mRNA levels in the human ovarian cancer cell lines NIH:OVCAR-3, SW 626, OVCA 433, and Caov-3. Southern blotting demonstrated that all four cell lines contained a single copy of the 12.5-kb HER-2/neu gene. Blotting techniques demonstrated low to barely detectable levels of HER-2/neu mRNA and protein in these cell lines. To determine whether steroids regulated HER-2/neu expression, all four ovarian cancer cell lines were cultured in the presence of 1 x 10(-7) M Es, Pr, or Dex and Northern blotting was completed. Unlike SK-OV-3 cells, the cell lines tested did not respond to the steroid treatments with alterations in their HER-2/neu mRNA levels. In conclusion, neither Es, Pr, nor Dex regulates HER-2/neu mRNA levels in NIH:OVCAR-3, SW 626, OVCA 433, and Caov-3 ovarian cancer cells. Future therapeutic manipulations of HER-2/neu should not involve hormonal intervention.

Adenocarcinoma↗
PubMed1994

Advanced-stage ovarian carcinoma presenting during infertility evaluation.

Fecundity has been extended to the menopause by advances in assisted reproductive techniques. The incidence of ovarian cancer increases with age, and an increased risk of ovarian cancer has been associated with incessant ovulation and infertility. The increased risk of ovarian cancer in older infertility patients must be kept in mind when evaluating these patients so that this diagnosis is not overlooked or delayed.

Adenocarcinoma, Papillary↗