Rakchai Buhachat

Impact of appendectomy of a grossly normal appendix on the survival outcomes of mucinous ovarian carcinomas in a tertiary hospital

AbstractObjectiveTo evaluate the survival outcomes of appendectomy for a grossly normal appendix in patients with mucinous ovarian carcinomas.MethodsRetrospective cohort study. Patients with mucinous ovarian carcinomas with grossly normal appendices who underwent primary surgery between 2002 and 2022 were enrolled. The overall survival (OS) and progression‐free survival (PFS) of appendectomy and non‐appendectomy groups were analyzed using the Kaplan–Meier method and compared using the log‐rank test. Univariate and multivariate Cox regression analyses were used to determine the independent factors associated with OS and PFS.ResultsOf 192 patients, appendectomy was performed in 138 (71.9%). Three (1.6%) patients had primary appendiceal tumors and two (1.0%) had appendiceal metastases of ovarian origin. The median follow‐up time was 68.8 months. The OS and PFS were better in patients in the appendectomy group than in those in the non‐appendectomy group (5‐year OS: 80.72% vs. 65.05%, P = 0.012; 5‐year PFS: 76.32% vs. 58.60%, P = 0.020). Independent factors associated with poor OS and PFS were no omentectomy, peritoneal seeding, and advanced International Federation of Gynecology and Obstetrics (FIGO) stage.ConclusionAppendectomy of a grossly normal appendix was not an independent prognostic factor for OS and PFS in patients with mucinous ovarian carcinomas.

Pretreatment lymphocyte count as independent prognostic factor in patients with locally advanced cervical cancer treated with concurrent chemoradiotherapy

AbstractObjectiveTo evaluate the association between pretreatment total lymphocyte counts (TLC) and survival outcome in locally advanced cervical cancer (LACC) patients treated with definite concurrent chemoradiotherapy (CCRT).MethodsWe retrospectively reviewed the data of 789 patients diagnosed with cervical cancer stage IIB to IVA treated with CCRT between January 2011 and December 2015. We assessed the association of pretreatment TLC with 5‐year disease‐free survival (DFS) and overall survival (OS) rates.ResultsFifty‐two patients had pretreatment TLC < 1000 cells/mm3. The median pretreatment TLC in TLC groups <1000 cell/mm3 and ≥1000 cell/mm3 were 573.9 cells/mm3 (range, 350.9–827.7 cells/mm3) and 2211.3 cells/mm3 (range, 1751.3–2785.8 cells/mm3), respectively. Patients in pretreatment TLC < 1000 cell/mm3 group had a lower number of treatment responses. The 5‐year DFS and OS rates were significantly higher in patients with pretreatment TLC ≥ 1000 cells/mm3 than their counterparts (67.7% vs. 35.4% [P < 0.0001] and 57.6% vs. 25.7% [P < 0.0001], respectively). In multivariate analysis, pretreatment TLC ≥ 1000 cells/mm3 was an independent predictor of DFS (HR, 0.39; 95% confidence interval [CI] 0.26–0.59, P < 0.001) and OS (HR, 0.59; 95% CI 0.42–0.84, P = 0.006).ConclusionPretreatment TLC was associated with treatment response and survival outcome in patients with LACC treated with definite CCRT.