No abstract

Rationale: The Sister Mary Joseph's nodule is an umbilical nodule resulting from the metastasis of malignant tumors in the pelvic and/or abdominal cavity. Sister Mary Joseph's nodules are very rare, and the morphology of the skin lesions is not specific and is easily misdiagnosed. Here, we report a case of cutaneous manifestations of metastatic ovarian cancer.Patient concerns: The patient was admitted to our hospital because of abdominal distention, and a nodule was found in the umbilicus. A computerized tomography scan of the entire abdomen showed nodular soft tissue in the subcutaneous fat space of the umbilical area and multiple pelvic masses, which were suspected metastases of peritoneal and omentum ovarian cancer.Interventions: To confirm the pathological diagnosis, posterior fornix puncture was performed. Pathological biopsy showed adenocarcinoma. Histological examination revealed a mass arising from high-grade serous carcinoma of the ovary. The patient received 2 cycles of chemotherapy with paclitaxel liposomes and carboplatin and underwent interval debulking surgery. Postoperative pathology was consistent with high-grade serous carcinoma of the ovary. Cancer involvement was observed in umbilical lesions. After the operation, the patient was given 6 cycles of chemotherapy with paclitaxel liposomes and carboplatin.Outcomes: The patient underwent follow-up until October 2020. A computerized tomography scan of the entire abdomen showed that the lymph nodes in the abdominal cavity were larger than before, suggesting a platinum-sensitive relapse. After receiving the same regimen of chemotherapy, carbohydrate antigen 125 dropped to the normal range, and consolidated treatment was administered for 3 cycles. Owing to her BRCA1 mutations, olaparib was administered for maintenance treatment. Until now, she had been in the outpatient clinic for regular follow-up visits.Lessons: The umbilicus remains an infrequently examined area, which cannot be underestimated and warrants careful clinical follow-up and histological evaluation, as appropriate.

Objective: To explore the association between visceral obesity and short-term postoperative complications in patients with advanced ovarian cancer undergoing cytoreductive surgery. Methods: Medical records were reviewed for patients with advanced epithelial ovarian cancer. Visceral fat area, subcutaneous fat area and total fat area were measured on a single slice at the level of L3/4 of a preoperative CT scan. The Receiver Operating Characteristic (ROC) curve was used to calculate the optimal cut-off value for visceral fat area. Relationships between visceral fat area and characteristics of ovarian cancer patients were analyzed. Univariable and multivariable Logistic regression analyseswere performed to investigate the value of perioperative characteristics of patients on short-term complications. Results: According to the ROC curve, the best cut-off value of VFA was 93 cm². Of the 130 patients, 53.8% (70/130) were presented visceral obesity. Patients with visceral obesity were older than those with non-visceral obesity (58.4 years old vs. 52.1 years old, p < 0.001). The proportion of patients with hypertension was higher (35.7% vs. 13.3%, p = 0.003). The total fat area and subcutaneous fat area were higher in patients with visceral obesity (294.3 ± 75.5 vs. 176.2 ± 68.7, p < 0.001; 158.9 ± 54.7 vs. 121.7 ± 52.6, p < 0.001). Compared with patients in the non-visceral obese group, patients in the visceral obese group were more likely to have postoperative fever (21/70 30.0% vs. 8/60 1.25%, p = 0.023), leading to a longer length of hospital stay (21 days vs. 17 days, p = 0.009). Time from surgery to adjuvant chemotherapy for patients with visceral obesity has been delayed (24 days vs. 19 days, p = 0.037). Multivariate analysis showed that visceral obesity (OR = 6.451, p < 0.001) and operation time (OR = 1.006, p < 0.001) were independent predictors of postoperative complications. Conclusion: Visceral obesity is an important risk factor for short-term postoperative complications in patients with advanced ovarian cancer undergoing cytoreductive surgery.

>50% and unknown in 5, 1 and 1 patients, respectively. There was 1 complete response, 1 partial response, 3 with stable disease, 2 with disease progression. No treatment related toxicities of grade 3 occurred. Conclusion: The trial continues enrollment. Updated results and immunological correlates will be presented at ASTRO.