Treatment and prognosis of epithelial ovarian cancer in Iran

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Background: Ovarian cancer is the most lethal gynecologic malignancy in the US, with 14,500 women dying of this disease annually. The aims of this study are to describe brief epidemiologic variations, response rate for usual chemotherapy regimen and progression free survival analysis in Iranian patients. Patients and Methods: 98 women with confirmed ovarian cancer who have been undergone surgery followed by chemotherapy at three hospitals in Tehran (Iran) between 1997 and 2003 were enrolled in this retrospective study. FIGO staging system has been applied. We have collected data regarding age, pathologic variations, surgical procedure (complete, partial, biopsy), chemotherapy, response rate, and time to progression of disease. Results: From a total of 98 patients, there were 80 (81.6%) epithelial, 12 (12.2%) germ cell, 5 (5.1%) granulosa cell tumors and one case of lymphoma. Response rate have been evaluated for 60 patients with epithelial cancer. Overall mean age was 46.7 and average age for epithelial tumors and non-epithelial tumors were 49.6 and 34.3 respectively. Complete surgical procedure with staging and optimal residue had been performed for 18 patients. Stage III was the most common stage (46.1%). In 78.3% of patients complete or partial response were seen, while 21.7% of patients showed stable or progressive disease. The most important prognostic factors were stage, and extent of surgical procedure. Median progression-free survival was 24.2 months. Conclusion: Overall average-age of our patients is lower than expected. Besides, a large proportion of the patients are referred in advanced stages. Although, higher response rate has been produced by taxane-based regimen in comparison of traditional chemotherapy; but it was not statistically significant. Retrospective evaluation, low number of the patients, non-uniform usage of chemotherapy regimen could influence our results.

No significant financial relationships to disclose.

Heterogeneity in disease-free survival in breast cancer patients

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Background: Breast cancer is the most common cancer and women’s health problems in Iran. There are some known prognostic factors for occurrence of metastasis after surgery. However, there are some other unknown factors affect the risk of metastasis. The purpose of this study was to determine the value of known prognostic factors by accounting for patient-specific effect, the rate metastasis in breast cancer patients who received surgical treatment followed by adjuvant treatment in Iran. Methods: Among 174 women whom have been undergone surgery followed by adjuvant therapy at three hospitals in Tehran, Iran during 3 years 117 have met the including criteria. Women with defined breast cancer with no distant metastases in time of diagnosis whom have been undergone MRM or BCS were enrolled. Tumors were classified according to the TNM system of the American Joint Committee on cancer (AJCC). Grading was performed according to Scarff-Bloom-Richardson method. ER and C-erb2 was measured by immunohistochemistry (IHC) method. The patients have been followed regularly by routine clinical, lab profile, serologic markers (CEA,CA15–3) and Para clinical examinations. Results: The median relapse- free survival for patients in study was 49.6 month. The median time to experience second metastasis was 22.5 month. 44 (38% ) patients developed metastasis. 20 (45%) of those experienced second metastasis. the Frailty model showed that age, size of tumor, number of positive lymph nodes and histologic grade had a significant effect on the risk of metastasis (p<.05) and there was a heterogeneity between patients after adjusting for covariates. Conclusion: Many patients who referred to cancer centers were not detected at early stage and they will meet more risk for relapse. The known risk factors describe the risk of metastasis partly and other unknown or unmeasured factors, such as environmental or genetics, are important to describe the risk of metastasis in breast cancer. Family history has no significant effect on event- free survival.

No significant financial relationships to disclose.