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Update:received results Update:received results

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  #1  
Unread 02-22-2003, 10:41 AM
Update:received results

Update: 2-21-03
I went to have a CT scan and 2 blood screening testes Feb. 17th. I saw my gyn. that day also. She said that it looked like I was healing up very nicely. Then she told me of my results from the CT scan. Everything looked good. My limfnodes looked fine and they couldn’t see any signs of cancer on any of my organs in the abdomen area. (That was the area they did the scan on.) The cyst, she had thought was on my cecum, didn’t seem to be attached to it, or any of my organs. I asked if it had a blood source, and she said “no”. I guess it’s just kinda hang’in out in there.
On Fri. (the 21st) I found out that both blood testes came back negative. THANK GOD!!!! As of now Feb. 28th is the tentative date in which I will be having a total hysterectomy. She will remove my appendix and drain the cyst at that time also.
When I went in I had a page of questions for her. She smiled at me and said that it was noticeable that I help teach children. I had to laugh, because we do ask our students a lot of questions! I guess I didn’t realize it became a habit of mine. She told me that my cancer is borderline (a stage one cancer). The way the cancer was found on the left ovary was rare. The growth was attached to the outside of the ovary and there were no signs of cancer on the inside. This happens 3% of the time when finding ovarian cancer, she said. She showed us color pictures of the ovary and the growth. (I knew there was a good reason I didn’t become a med.type person!! YUK)
I asked my Dr. for some info on hormone treatments. This is another area I know very little about. I really had no need to pay much attention to this subject before now. Well now, all I do know is that estrogen isn’t the greatest thing to take, and that scares me.
Thank you for your input on my case. I learned some new things from all of you! I need to ask this, however, how do I do a search on LMP?
Thanks again,
Erica
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  #2  
Unread 02-22-2003, 01:40 PM
Update:received results

s Erica

It sounds like so far so good!!!
Here is some info for you from the cancer.gov web site.
For some reason I could not copy the web address, but here is the info it contained.
I would suggest a google search, just type in the words low malignant potential ovarian cancer or borderline ovarian cancer.
Best wishes to you.





Ovarian Low Malignant Potential Tumors
General Information



General Information
Tumors of low malignant potential (borderline tumors) account for 15% of all epithelial ovarian cancers. Nearly 75% of these are stage I at the time of diagnosis. These tumors must be recognized, since their prognosis and treatment is clearly different from the frankly malignant invasive carcinomas. A review of 22 series (953 patients) with a mean follow-up of 7 years revealed a survival rate of 92% for advanced stage tumors if patients with so-called invasive implants were excluded. The cause of death was determined to be benign complications of disease (e.g., small bowel obstruction), complications of therapy, and only rarely (0.7%), malignant transformation.[1] In one series, the 5-, 10-, 15-, and 20-year survival rates of patients with low malignant potential tumors (all stages), as demonstrated by clinical life table analysis, were 97%, 95%, 92%, and 89%.[2] In this series, mortality was stage dependent: 0.7%, 4.2%, and 26.8% of patients with stages I, II, and III respectively, died of disease.[2] One large study showed early stage, serous histology, and younger age to be associated with a more favorable prognosis.[3] In contrast to the excellent survival rates for early stage disease generally reported, the FIGO Annual Report (#21) included 529 stage I tumors with a 5-year actuarial survival rate of 89.1%. Similarly good survival was found in a large prospective study.[4] Nonetheless, these survival rates are clearly in contrast with the 30% survival rate for invasive tumors (all stages). The less common endometrioid tumor of low malignant potential should not be regarded as malignant since it seldom, if ever, metastasizes. Malignant transformation can, however, occur and may be associated with a similar tumor outside of the ovary; such tumors are the result of either a second primary or rupture of the primary endometrial tumor.[5]

In early stage disease (stage I/II), no additional treatment is indicated for a completely resected tumor of low malignant potential.[6] When it is desirable to retain childbearing potential, a unilateral salpingo-oophorectomy is adequate therapy.[3,7] In the presence of bilateral ovarian cystic neoplasms, or a single ovary, partial oophorectomy can be employed when fertility is desired by the patient.[8] Some stress the importance of limiting ovarian cystectomy to stage IA patients in whom the margins of the cystectomy specimens are free of tumor.[9] In one large series, the relapse rate was higher with more conservative surgery (cystectomy >unilateral oophorectomy >TAH, BSO); differences, however, were not statistically significant and survival was nearly 100% for all groups.[2,10] When childbearing is not a consideration, a total abdominal hysterectomy and bilateral salpingo-oophorectomy is appropriate therapy. Once a woman has completed her family, most, but not all,[9] physicians favor removal of remaining ovarian tissue as it is at risk of recurrence of a borderline tumor, or even rarely, a carcinoma.[3,11]

The value of complete staging has not been demonstrated for early stage cases, but the opposite ovary should be carefully evaluated for evidence of bilateral disease. Although the impact of surgical staging on therapeutic management is not defined, in one study 7 of 27 patients with presumed localized disease were upstaged following complete surgical staging.[12] In two other studies, 16% and 18% of patients with presumed localized tumors of low malignant potential were upstaged as a result of a staging laparotomy.[11,13] In one of these studies, the yield for serous tumors was 30.8% (4/13) compared to 0% (0/12) for mucinous tumors.[9] In yet another study, patients with localized intraperitoneal disease and negative lymph nodes had a low incidence of recurrence (5%), whereas patients with localized intraperitoneal disease and positive lymph nodes had a statistically significantly higher incidence of recurrence (50%).[2]

Patients with advanced disease should undergo a total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, node sampling, and aggressive cytoreductive surgery. Patients with stage II/III disease with no gross residual tumor have had a 100% survival rate in some series regardless of the follow-up duration.[14,15] The 7-year survival rate of patients with gross residual disease was only 69% in one large series,[2] and appears to be inversely proportional to the length of follow-up.[2]

For patients with more advanced stage disease and microscopic or gross residual disease, chemotherapy and/or radiation therapy are not indicated. There is scant evidence that postoperative chemotherapy or radiation therapy alters the course of this disease in any beneficial way.[2,10,14,16,17] In one study of 364 patients without residual tumor, adjuvant therapy had no effect on disease- free or corrected survival when stratified for disease stage.[3] Patients without residual tumor who received no adjuvant treatment had a survival rate equal to or greater than the treated groups. There have been no controlled studies comparing postoperative treatment with no treatment.

In a review of 150 patients with borderline ovarian tumors, the survival of patients with a residual tumor of less than 2 centimeters was significantly better than those with a residual tumor from 2 to 5 centimeters and greater than 5 centimeters.[18] Whether invasive implants imply a worse prognosis remains an unsettled question. Some investigators have correlated invasive implants with poor prognosis [19] while others have not.[15,20] Some studies have suggested that it may be possible to use DNA ploidy of the tumors to identify those patients who will develop aggressive disease.[21,22] A study could not correlate DNA ploidy of the primary serous tumor with survival but found that aneuploid invasive implants were associated with a poor prognosis.[23] There is no evidence that treatment of patients with aneuploid tumors would have an impact on survival. No significant association was found between p53 and Her-2/neu overexpression and tumor recurrence or survival.[24]

In the face of clinical progression, further tumor reductive surgery followed by chemotherapy is certainly indicated. If the symptom-free interval is long, using chemotherapy after a secondary cytoreductive procedure is not advisable. If, on the other hand, the disease symptomatically recurs rapidly, chemotherapy may be beneficial. Reports have surgically documented the efficacy of chemotherapy on some patients with microscopic or gross residual disease.[25,26] A Gynecologic Oncology Group study used melphalan chemotherapy for patients with progressive disease, with cisplatin for melphalan failures.[27]

karenann
  #3  
Unread 02-23-2003, 09:50 AM
Update:received results

{{Erica}}

Great news so far!!! Sounds like you have a great Dr taking very good care of you!!!

Sending lots of prayers and positive thoughts your way for your upcoming surgery. May it be swift and uneventful.

If you're wanting to also do some reading on past posts here regarding LMP, at the top of the screen there's different sections noted, you'll most likely need to scroll over to see them all. Click on the "search" one and then type in "low malignant potential". This should bring up some of the past discussions on this type of tumor.

Please let us know how everything goes when you are able.

{{hugs}}

Vicki
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