Peritoneal cancer after bilateral mastectomy, hysterectomy, and bilateral salpingo-oophorectomy with a poor prognosis: A case report and review of the literature

BACKGROUND Primary peritoneal cancer(PPC)patients with BRCA mutations have a good prognosis;however,for patients with BRCA mutations who are diagnosed with PPC after prophylactic salpingo-oophorectomy(PSO),the prognosis is poor,and survival information is scarce.CASE SUMMARY We treated a 56-year-old woman with PPC after bilateral mastectomy,hysterectomy,and bilateral salpingo-oophorectomy.This patient had primary drug resistance and died 12 mo after the diagnosis of PPC.The genetic test performed on this patient indicated the presence of a germline BRCA1 mutation.We searched the PubMed,Scopus,and Cochrane databases and extracted studies of patients with BRCA mutations who developed PPC after PSO.After a detailed literature search,we found 30 cases,7 of which had a history of breast cancer,14 of which had no history of breast cancer,and 9 of which had an unknown history.The average age of PSO patients was 48.86 years old(range,31-64 years).The average time interval between the diagnosis of PPC and preventive surgery was 61.03 mo(range,12-292 mo).The 2-year survival rate for this patient population was 78.26%(18/23),the 3-year survival rate was 50.00%(9/18),and the 5-year survival rate was 6.25%(1/16).CONCLUSION Patients with BRCA mutations who are diagnosed with PPC after preventative surgery have a poor prognosis.Prevention measures and treatments for these patients need more attention.

Correlations between alterations of T-helper 17 cells and treatment efficacy after concurrent radiochemotherapy in locally advanced cervical cancer (stage IIB-IIIB): a 3-year prospective study

Background::Recently,T-helper 17(Th17)cells have been proved to play an important role in promoting cervical cancer.But,till now,few study has been carried out to understand the involvement of these cells in efficacy of anti-tumor treatments.This study aimed to investigate the alterations in the percentage of circulating Th17 cells and related cytokines in locally advanced cervical cancer(LACC)patients before and after concurrent chemoradiotherapy(cCRT)and to analyze the correlations between the alterations in Th17 cells and treatment efficacy.Methods::A prospective study with 49 LACC(International federation of gynecology and obstetrics[FIGO]stage IIB-IIIB)patients and 23 controls was conducted.Patients received the same cCRT schedule and were followed up for 3 years.Circulating Th17 cells(CD3+CD8-interleukin[IL]-17+T cells)and related cytokines IL-17,transforming growth factor-β(TGF-β),IL-10,IL-23,IL-6,and IL-22 were detected before and after cCRT.Correlations between alterations of circulating Th17 cells and treatment efficacy were analyzed.Kaplan-Meier analysis was used for overall survival(OS)and progression-free survival(PFS).Results::We found that 40 patients finished the entire cCRT schedule and met the endpoint of this study.The percentage of circulating Th17 cells in the LACC patients was higher than that in the controls,and it significantly decreased after cCRT(P<0.05).After cCRT,patients were divided into two groups based on the average of the Th17 cells declined.The subgroup of patients with a prominent decrease in circulating Th17 cells after cCRT had a higher treatment efficacy and longer PFS and OS times.Compared with the control patients,LACC patients had higher IL-6,IL-10,IL-22,TGF-βlevels and a lower IL-23 level(P<0.05).After cCRT,IL-6,IL-10,IL-17,IL-23 level significantly increased and TGF-βlevel significantly decreased compared with the levels before cCRT(P<0.05).Conclusion::Circulating Th17 cells in the LACC patients(FIGO stage IIB-IIIB)were higher than those in the controls,but they generally decreased after cCRT.A more pronounced decrease in circulating Th17 cells after cCRT was correlated with better therapeutic effect and longer PFS and OS times.

Clinical study on bladder function recovery of 360 cases after radical hysterectomy treated by acupuncture

Objective:To analysis the clinical curative effect on bladder function recovery after radical hysterectomy with acupuncture and acu-physiotherapy.Methods:A total of 564 cervical cancer patients in the gynecology department who received radical hysterectomy from January 2011 to December 2017 in Qilu Hospital of Shandong University were collected.According to the inclusion and exclusion criteria,we studied 360 case records at last,with 120 cases respectively.Patients got treatment of acupuncture[acupuncture at Zhongwan(中脘CV12),Tianshu(天枢ST25),Shuidao(水道ST28),TAichong(太冲LI3),Sanyinjiao(三阴交SP6),Zusanli(足三里ST36)and Yinlingquan(阴陵泉SP9)],or acu-physiotherapy with two large-size electrodes placed on the bladder area above the pubic symphysis besides acupuncture,from the 3 rd day after operation once a day till the14 th day that removing the indwelling catheter.And the blank group got no other auxiliary treatment except scrubbed the meatus orifice with iodophor twice a day.We tested the residual urine volume 6 h later after removement of indwelling catheter.Residual urine volume more than 100 mL was defined as urinary retention,and the volume less than 50 mL was defined as adequate bladder emptying.Results:We analyzed patients’age,the International Federation of Gynecology and Obstetrics(FIGO)stage,operation duration,amount of hemorrhage,depth of myometrium infiltration,cancer embolus,parametrium invasion,lymphatic metastasis,treating methods and residual urine volume recorded in case records,and there was no significant difference between every two groups(P>0.05).The incidences of urinary retention of the acupuncture group,the acu-physiotherapy group and the blank group were 24.17%,21.67%,and 44.17%,indicating that both treating methods have significant effects(P<0.05),and acupuncture group was a little better than acu-physiotherapy group.The bladder function recovery rates of the 3 groups were 44.17%,56.67%,and 40.83%correspondingly,which had significant difference between acu-physiotherapy group and blank group(P<0.05).Both acupuncture and acu-physiotherapy could reduce the incidence of urinary retention for the patients of Ibl and IIal stages(P<0.01),whilst for patients of Ib2 and IIa2 stages,neither of the two methods was effective(P>0.05).Conclusion:Both acupuncture and acu-physiotherapy could prevent urinary retention after radical hysterectomy for local early cervical cancer(Ibl and IIal stages)effectively,and acupuncture was a little more effective than acu-physiotherapy group.Acupuncture together with modulated medium frequency eletro-therapy could improve the cure rate of bladder function and minimize the residual urine volume.