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Palliative Chemotherapien der dritten oder vierten Linie beim Ovarial-und Endometriumkarzinom weisen selten Remissionsraten > 20 % auf. Sie sind häufig mit belastender Toxizität und hohen Therapiekosten behaftet. Alternativen sind notwendig. Ziel der vorliegenden Zusammenstellung war es, den möglichen Nutzen einer Goserelintherapie beim fortgeschrittenen Ovarial-und Endometriumkarzinom im eigenen Krankengut retrospektiv zu untersuchen. Prädiktive klinische Faktoren für das Erreichen eines klinischen Nutzens (= Stabilisation ³ 6 Monate) sollten definiert werden. Material und Methodik: Zwischen 2000 und 2003 wurden insgesamt 51 konsekutive Patientinnen mit fortgeschrittenem Ovarial-oder Endometriumkarzinom an unserer Klinik einer monatlichen palliativen Goserelintherapie (3,6 mg s. c.) unterzogen. Alle Patientinnen wurden monatlich hinsichtlich der Tumorsymptomatik evaluiert. 3-monatlich oder bei klinischen Zeichen einer Progression erfolgten eine gynäkologische Untersuchung und abdominale bzw. vaginale Sonographie. Auûerdem wurden monatlich die CA-125-Werte bestimmt. Auf der Basis dieser Befunde wurde das klinische Ansprechen beurteilt. Eine klinische Stabilisation ³ 6 Monate wurde als ¹klinischer Nutzenª eingestuft. Ergebnisse: Die Rate an klinischem Nutzen betrug 24% (12 von 51 Patientinnen). Bei den potenziellen prädiktiven Faktoren ergab sich für keinen der untersuchten Parameter wie Tumorentität, Alter, Grading, Anzahl der vorausgegangenen Chemothera-Abstract Purpose: Third or fourth line palliative chemotherapy in ovarian or endometrial cancer usually leads to remission rates of less than 20%. However, it is often associated with significant toxicity and high treatment costs. Alternatives are needed. The aim of this study was to retrospectively analyze the therapeutic results of the gonadotrophin-releasing hormone analogue goserelin in the treatment of advanced ovarian and endometrial cancer at our institution. Predictive factors for a clinical benefit (= stabilization for ³ 6 months) were supposed to be identified. Material and Methods: Between 2000 and 2003, a total of 51 consecutive patients with advanced ovarian or endometrial cancer were treated with monthly cycles of goserelin (3.6 mg s. c.). Patients were clinically evaluated on a monthly basis regarding their tumor-related symptoms. Patients underwent a gynecologic exam, abdominal and/or vaginal sonography at 3-month intervals or if signs of clinical progression were present; CA-125 levels were also evaluated monthly. On the basis of these findings, the clinical benefit was stated. Results: Overall, the rate of clinical benefit was 24% (12 out of 51 patients). With regard to potential predictive factors, neither tumor entity nor age and the other factors analyzed were predictive of a ªresponseº. Conclusion: The antihormonal therapy with monthly goserelin represents a minimally toxic form of palliative therapy. Goserelin leads to clinical benefit in 20 to 25% of patients. Thus, goserelin fulfils the patients preference for continuation of systemic ther

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Dermatofibrosarcoma protuberans (DFSP) is a low-grade to intermediate-grade well-differentiated sarcoma of dermal origin. Local recurrence rates are high but distant metastases are rare. This report describes a case of vulvar DFSP requiring four resections for primary clearance. A 56-year-old woman referred after excision of a vulvar tumour and histology had DFSP extending to the resection margins. Two more extended excisions again yielded a specimen with positive margins. The last excision was performed with intraoperative frozen section analysis of the margins. Frozen section analysis of the resected specimen revealed clear margins and this was confirmed by final pathology. The postoperative course was uneventful. The patient has been without recurrence for 15 months. A wide and deep local excision is recommended for both primary and recurrent lesions. The patient had three resections before clear surgical margins were achieved. Intraoperative frozen section analysis is helpful in assessing resection margins.