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Author: search.filters.author.Arsovski, OliverSubject: search.filters.subject.uterine cervix

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    Примарен малигнен меланом на грлото на матката - приказ на случај
    (Македонско лекарско друштво = Macedonian medical association, 2001)
    Veljanoska, Slavica
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    Arsovski, Oliver
    ;
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    Tolevska, Cveta
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    Примарниот малигнен меланом на грлото на матката е ретко заболување. Клиничката слика е мошне неспецифична и не се разликува од онаа на вообичаените симптоми на порциото. Се манифестира со контактни, а подоцна во текот на болеста и спонтани вагинални крварења, односно во напреднатите стадиуми и со симптоми од дисеминација на процесот. Самото дијагностицирање на овој ентитет бара огромно внимание, особено во разграничувањето на ПММГМ од метастаза на меланом на грлото на матката. Недвосмислен доказ за постоење на ПММГМ е неговата хистопатолошка верификација во преодниот епител. Кај ПММГМ се јавува и проблем при одредување на стадиумот на болеста, но сепак повеќето автори го користат FIGO системот наспроти критериумите за одредување на стадиумите кај кутаниот малигнен меланом според Clark и Breslow. Радикалната хистеректомија според Wertheim Meigs и адјувантната хемиотерапија се методи на избор во третманот на ПММГМ. Примарниот меланом на вратот на матката кој се дијагностицира во напреднат стадиум на болеста (иноперабилен) покажува резистенција на било каков вид на конзервативна терапија, со тенденција за брза локална и системска прогресија на болеста, што резултира со исклучително лоша прогноза. Primary malignant melanoma of the uterine cervix (PMMUC) is an extremely rare disease. Clinical presentation of PMMUC is not specific and not different from the common cervical malignancies. It presentс with postcoital spotting, spontaneous vaginal bleeding, even with the signs of dissemination in the advanced stages of the disease. The diagnosis is difficult, because it is essential to differentiate PMMUC from secondary malignant melanoma, by the presence of melanocytes in the epithelium and verification of junctional activities. There is a consensus about staging procedure using FIGO criteria, rather than that of Clark and Breslow (TNM clasification, UICC). Radical hysterectomy is accepted as the most important initial approach, while the role of pelvic lymphadenectomy remains unclear. We present a case of PMMUC in advanced, inoperable stage of the disease, treated in our institution by radiotherapy and chemotherapy. There was no response to any available conservative treatment.
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    The implementation of prognostic index and risk grouping in surgically treated cervical carcinoma patients: A prospective validation study.
    (Springer, 2008-05)
    ;
    Prodanova, Irina
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    Kubelka-Sabit, Katerina
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    Veljanovska, Slavica
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    Arsovski, Oliver
    BACKGROUND: The objective of this prospective study was to validate the prognostic criteria defined by the results of our previous study in an independent population of surgically treated cervical carcinoma patients. METHOD: The study group consisted of 340 patients who underwent abdominal hysterectomy with pelvic lymphadenectomy as primary therapy between 2000 and 2005. Based on the scores of the variables (blood vessel invasion, lymph node metastases, tumor diameter, degree of inflammatory reaction at the invasive front, and minimum thickness of uninvolved cervical stroma/parametrial extension) and calculated prognostic index (PI) values, the patients were divided into three prognostic groups. RESULTS: During the follow-up period (range, 1.6–89.7, mean, 39.7±22.2 months) recurrences were observed in 1% (1/97), 12.2% (16/131) and 23.2% (26/112) of the low-, intermediate-, or high-risk group patients, respectively. The 5-year disease-free survival (DFS) rates of the low, intermediate, and high-risk groups were 98.82%, 84.57%, and 74.01%, respectively. The differences in DFS rates were statistically significant (P<0.0001). In order to validate the model from our previous study, we have compared DFS rates between the groups. There was no difference in DFS rate between low-risk groups, in spite of the fact that majority of the patients in this study were not irradiated, while radiotherapy was administrated invariably to all the patients included in the original study. Similarly, DFS did not differ significantly between the intermediate-risk groups from both studies, which could be expected since radiotherapy was administrated to majority of the patients (125/131) in this study. In contrast, the high-risk group patients in this study had significantly higher DFS rate (74.01% vs. 44.24, P=0.0010), probably as the result of the adjuvant chemotherapy administrated to 69% of them. CONCLUSION: PI could be a sound and reliable basis for an appropriate planning of the following therapeutical strategy of the surgically treated cervical cancer patients.