TFI has predictive value for response to chemotherapy and prognosis of patients with recurrent cervical cancer after definitive CCRT.

Our study suggests that by separately evaluating lymphatic invasion and blood vessel invasion in endometrial cancer cases, useful information for predicting lymph node metastasis and recurrence sites as well as prognostic information can be obtained.

Background Steroid cell tumor (SCT) not otherwise specified (NOS) is rare and recurrence and metastasis rarely occurs; therefore, reports regarding its treatment are limited. We report a case of recurrent SCT-NOS treated with gonadotropin releasing hormone agonist (GnRHa) and successful. Case A 50-year-old woman underwent a staging laparotomy and diagnosed as SCT-NOS. Multiple liver tumors and intraperitoneal dissemination were detected 5 years 10 months after the initial surgery. As the immunohistochemical analysis showed positive staining for GnRH receptor, GnRHa was attempted. After the first cycle the serum testosterone level was normalized and after six cycles CT scan confirmed reduction of the tumor size. Conclusion Some ovarian SCT-NOS have GnRH receptors; thus, GnRHa may have a reducing effect for these tumors without major adverse event.

Background/Aim: We conducted a phase II study of neoadjuvant chemotherapy followed by extended field concurrent chemoradiotherapy in patients with cervical cancer with para-aortic node metastasis. Patients and Methods: Thirty-seven women with stage IB1-IVA cervical cancer were enrolled. Results: The median age was 52 years. Thirty-four patients other than 3 progressive disease, proceeded to extended field concurrent chemoradiotherapy. The 3-year overall survival and progression-free survival rates were 70.1% and 48.5%, respectively. The 3-year overall survival according to stages was significantly worse in stage IIIB. Twelve of the 17 patients with stage IIIB died of the disease. Conclusion: Neoadjuvant chemotherapy followed by extended field concurrent chemoradiotherapy may improve the prognosis of patients with stages IB and II cervical cancer with positive para-aortic node. However, new strategies should be investigated to improve a poor prognosis in stage IIIB disease with positive para-aortic node.It is currently accepted that para-aortic lymph nodes (PAN) metastasis is an important prognostic factor in patients with locally advanced cervical cancer and the existence of such is clinically very important in choosing the appropriate therapy (1). According to a Gynecologic Oncology Group (GOG) study, PAN involvement confirmed by biopsy was found in 5% of patients with the International Federation of Gynecology and Obstetrics (FIGO) stage IB, 17% of patients with stage IIB, and 25% of patients with stage IIIB. Poor survival rates were reported in these patients (2).Optimal treatment is required for cure in patients with locally advanced cervical cancer with positive PAN at the time of initial diagnosis. Several studies reported encouraging results of extended field radiotherapy for treating PAN metastasis with a 5-year overall survival ranging from 29%-50% and tolerable side effects (3-6). However, these studies warranted more research on multimodalities to further improve the prognostic results. The impact of extended field concurrent chemoradiotherapy (EF-CCRT) was studied in a few trials, with 5-year overall survival varying from 29%-39% (7-10). Some patients who underwent EF-CCRT achieved long-term remission. This is because PAN metastasis is different from other distant metastases in systemic diseases. Studies also confirmed the safety of this treatment and acceptable late toxicities despite increased acute toxicities (7). However, patients with locally advanced cervical cancer with PAN metastasis still have poor prognoses when compared with those without PAN metastasis.We conducted phase II study of neoadjuvant chemotherapy followed by EF-CCRT in patients with locally advanced cervical cancer with PAN and/or common iliac lymph nodes.