Neoadjuvant chemotherapy (NACT), which can reduce the size and therefore increase the resectability of tumors, has recently evolved as a treatment for locally advanced cervical cancer. NACT has been reported to decrease the risk of pathologic factors related to prognosis of cervical cancer. To further assess the effects of NACT on surgery and the pathologic characteristics of cervical cancer, we reviewed 110 cases of locally advanced cervical cancer treated with radical hysterectomy with or without NACT at the People's Hospital of Peking University between January 2006 and December 2010. Of 110 patients, 68 underwent platinum-based NACT prior to surgery (NACT group) and 42 underwent primary surgery treatment (PST group). Our results showed 48 of 68 (70.6%) patients achieved a complete response or partial response to NACT. Estimated blood loss, operation time, and number of removed lymph nodes during surgery, as well as complication rates during and after surgery were not significantly different between the NACT group and the PST group. The rates of deep stromal invasion, positive parametria, positive surgical vaginal margins, and lymph node metastasis were not significantly different between the two groups. However, the rate of lymph-vascular space involvement (LVSI) was significantly lower in the NACT group than in the PST group (P = 0.021). In addition, the response rate of NACT was significantly higher in the patients with chemotherapeutic drugs administrated via artery than via vein. Our results suggest that NACT is a safe and effective treatment for locally advanced cervical cancer and significantly decreases the rate of LVSI.

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With any unusual epithelioid neoplasm displaying some or all of the morphologic features described above, epithelioid angiosarcoma should be included in the differential diagnosis. In such an instance, endothelial markers should be incorporated in the immunohistochemical analysis to avoid misdiagnosis, particularly with limited sampling.

ObjectiveTo clarify the clinical and pathological characteristics of atypical polypoid adenomyoma (APA) in order to improve the criteria used to diagnose and treat this disease.Study designIn 39 cases of APA, retrospective analysis was performed of theclinical data, pathological characteristics, and the follow-up findings in patients admitted to the Peking University People's Hospital from 2007 to 2019.ResultsThe median age was 39.6 years (range 24–60 years). Thirty seven patients were premenopausal (i.e.94.9 ​%) and eighteen patients were nullipara (i.e. 46.2 ​%). Abnormal uterine bleeding was the most common presenting symptom. Hysteroscopic transcervical resection (i.e.TCR) identified lesions in 35 cases whereas: a) hysterectomy identified them in 3 cases; b) dilatation and curettage (D&C) identified them in 1 case. Immunohistochemical analysis was performed on 24 samples. In the glandular component, hormone receptors were positively expressed. In all cases, Ki67 expression was detectable in approximately 50 ​% of the cases. In those samples, its presence was definitive in eighteen of the nineteen cases (94.7 ​%,18/19), p53 positive expression was present in most cases (68.8 ​%,11/16), and PTEN positive expression was detected in 40 ​% (4/10). Stroma immunophenotype expression was exhibited as follows: a)CD10-(12/12), Desmin +(6/7); b) Vimentin +(4/4); c) α-SMA+ (3/3) and; d) p16 positve staining in of 80 ​%(4/5).The concurrent amount of atypical endometrial hyperplasia with atypical polypoid adenomyoma was 23.1 ​%(9/39), while its concurrent level of endometrial carcinoma with atypical polypoid adenomyoma was 7.7 ​% (3/39). Fertility preserving treatments were performed in 20 patients with strong childbearing desires. Their pregnancy success was 15 ​%(3/20) and the live birth frequency was 10 ​%(2/10). Follow-up findings were available in 36 cases (92.3 ​%) with a medial follow-up of 48.1 months (range 4–122 months). Its pathological recurrence and frequency of progression into endometrial carcinoma were both 5 ​%(1/20). One case died of another type of malignancy, while the other patients were alive.ConclusionsAPA occurs mostly during the years of a women's reproductive period. Its diagnosis is based on the analysis of pathological and immunohistochemical findings. Individuals diagnosed with APA are at risk to coexist with endometrial carcinoma and atypical endometrial hyperplasia. For those individuals who desire retaining fertility, the treatment strategy involves performing TCR completely remove the lesions and close follow-up for surveillance of possible progressive APA recurrence. For those individuals who have no fertility desire, hysterectomy may be a preferred option.

BackgroundThis study aimed at identifying risk factors of recurrence for completely resected pathologic T1aN0M0 lung adenocarcinomas.MethodsWe reviewed the records of 177 T1aN0M0 invasive adenocarcinoma patients, and re-classified achieved surgical specimens according to the new International Association for the Study of Lung Cancer, American Thoracic Society, and European Respiratory Society (IASLC/ATS/ERS) lung adenocarcinoma classification. Impact on recurrence-free survival (RFS) for age, gender, smoking history, lymphovascular invasion (LVI) and new classification was analyzed by log-rank test and Cox regression. Two existing prognostic grouping schemes of new classification were compared, and subsequently, the correlation of high-grade group in the better prognostic grouping model with clinical data was investigated statistically.ResultsThe 5-year recurrence-free rate was 83.7%. The LVI and new adenocarcinoma classification were significantly associated with 5-year RFS (P = 0.012; P = 0.022, respectively). The designation of papillary predominant subtype in the low-grade group, along with lepidic- and acinar predominant subtype had more prognostic significance than the model of combining papillary-, solid- and micropapillary predominant subtypes as the high-grade group (P = 0.005 versus P = 0.181). This high-grade group has increased risk of recurrence in a multivariate Cox regression (adjusted HR 2.815, 95% CI: 1.239 to 6.397, P = 0.013), and is associated significantly more with male gender (adjusted OR 2.214, 95% CI: 1.050 to 4.668, P = 0.037), and, with borderline significance, the presence of LVI (adjusted OR 2.091, 95% CI: 0.938 to 4.662, P = 0.071).ConclusionsOur results showed that the solid- and micropapillary predominant subtype of IASLC/ATS/ERS classification remains the only risk factor for post-operative recurrence of T1aN0M0 adenocarcinomas, suggesting that they can be indicators of aggressive tumor behaviors.