ObjectiveTo determine whether preoperative platelets to lymphocyte ratio (PLR) could predict disease stage, surgical outcome, and survival in patients with epithelial ovarian cancer (EOC).MethodsMedical records of EOC patients who had surgery between January 2004 and December 2010 were reviewed. Clinicopathological and complete blood count data were collected. The optimal predictive value of PLR to predict advanced stage, suboptimal surgery, and survival was determined and compared with those of thrombocytosis (≥400,000 cells/mm3) and neutrophil to lymphocyte ratio (NLR) ≥2.6.ResultsA total of 166 EOC patients were included in the study. PLR of 200 yielded better predictive values than those of thrombocytosis and NLR ≥2.6. The area under curve (AUC), sensitivity, specificity, positive and negative predictive values, and accuracy of PLR to predict advanced stage were: 0.66, 59.0%, 72.7%, 65.7%, 66.7%, and 66.3%, respectively. The corresponding values to predict suboptimal surgery were: 0.70, 70.0%, 69.8%, 50.0%, 84.4%, and 69.9%. The patients who had PLR≥200 had significantly shorter progression-free and overall survivals than those with PLR<200. Stage, grade, surgical outcome, thrombocytosis, and PLR were significant prognostic factors for survivals by univariable analyses while only stage remained significant by multivariable analysis.ConclusionPLR had potential clinical value in predicting advanced stage disease or suboptimal surgery. PLR was a better prognostic indicator for survivals of EOC patients compared to thrombocytosis or NLR>2.6.

Because endometrial cancer (EMC) patients frequently present at an early stage of disease, most have favorable outcomes, thus their quality of life after treatment is as important a consideration as a cure of cancer. This issue is especially important when EMC is encountered in younger or reproductive ages when the afflicted woman has not achieved her fertility function. It is a complicated situation when a physician encounters a request or question from a woman with EMC or her family concerning whether she could conceive a child prior to a definite cancer treatment. Despite being an interesting issue, there are only a few studies with definite treatment guidelines or any evidence-based recommendations concerning conservative treatment for EMC. Thus, we undertook this study to explore various considerations regarding the criteria and caveats for the management of EMC women who desire to preserve their fertility function. An algorithm guideline for conservative fertility treatment for EMC is also presented.

Although estrogen (ER) and progesterone (PR) receptors are well recognized as important prognostic indicators of breast and endometrial cancers, their clinical significance in epithelial ovarian cancer is not clear with the limited data from only few immunohistochemical studies. The aim of this study was to evaluate the expressions of ER and PR in patients with epithelial ovarian cancer who were treated in our institution during the period 1996 to 2003. Their associations with clinicopathologic factors of age, stage, histologic subtypes, and grade and their prognostic role to survivals were also examined. Among 106 subjects included in the study, ER and PR expressions were found in 39.6% and 33.0%, respectively, with the corresponding highest expression in serous and endometrioid carcinomas. Estrogen receptor expression had a significant association with age older than 60 years, non-clear cell carcinomas, and high-grade tumors, whereas PR expression showed a significant association with non-clear cell carcinomas and a better response to first-line chemotherapy. Progesterone receptor expression was a favorable prognostic factor to both progression-free and overall survivals from univariable but not multivariable analyses. Expression of ER or any combination of ER/PR subgroups did not have a significant impact on survivals.

To determine the accuracy of frozen section according to the status of malignancy and the histologic cell type, we reviewed the frozen and permanent pathologic reports of 212 resected ovarian masses in our hospital. The accuracy, sensitivity, specificity, positive, and negative predictive value of frozen section were studied. The overall accuracy to determine the status of malignancy was 90.9%. Sensitivity of the test was highest in the benign groups at 99.1% and lowest in the borderline groups at 50%. All inaccurate diagnoses were in the common epithelial groups. Problems in diagnosis of mucinous tumors and borderline tumors were striking. The accuracy of the test for histologic diagnosis was 91.9%. Most cases of the incorrect diagnosis (81.3%) were common epithelial tumors. In conclusion, the accuracy of frozen section in the diagnosis of ovarian mass was generally high with a few exceptions in large tumors, mucinous, or borderline tumors that yielded lower accuracy, sensitivity, specificity, and positive predictive value. We encourage both the surgeons and the pathologists to be cautious of these limitations. Additional number of frozen section taken for a mass larger than 10 cm may minimize the error in large tumors to some extent.