Sarita Kumari

Quality of Life Measurement in PARP Inhibitor Trials of Epithelial Ovarian Cancer – What Do We Know?

Epithelial ovarian cancer (EOC), dominated by high-grade serous carcinoma, continues to impose a heavy global burden, particularly in low- and middle-income countries. Although advances in surgery and chemotherapy have extended survival, relapse within 2 years remains common, underscoring the need for novel strategies. Poly adenosine diphosphate ribose polymerase inhibitors (PARPi) have transformed maintenance therapy by prolonging progression-free survival, yet their influence on health-related quality of life (HRQoL) is less well characterized. Patient-reported outcomes (PROs) serve as key tools for evaluating the impact of treatment on physical, emotional, and social well-being. Trials including SOLO1, NOVA, and ARIEL3 demonstrate the increasing recognition of QoL endpoints, though heterogeneity in tools and endpoints limits cross-trial comparisons. Several gaps persist including limited data collection beyond disease progression. This review integrates evidence from published studies, highlights methodological challenges, and proposes directions for future work, emphasizing the centrality of patient-centered outcomes in advancing precision medicine for ovarian cancer. The evidence underscores the imperative of designing trials that incorporate QoL as a core endpoint, ensuring meaningful benefits for patients in both clinical and real-world settings.

Borderline tumours of ovary and fertility preservation–Outcomes from a tertiary care center in India

Borderline ovarian tumors (BOT) are characterized by atypical epithelial proliferation without stromal invasion and majority are diagnosed in women of reproductive age group desirous of fertility preservation. A retrospective review of medical records of patients diagnosed with BOT and on regular follow up at the All India Institute of Medical Sciences New Delhi, during a nine-year study period from March 2014 to March 2023 was performed. Surgical treatment was classified as radical or fertility sparing surgery (FSS). Surgical staging was defined as complete, partial or un-staged. Median age of 91 women was 34 years. Follow up period ranged from 4 to 222 months (median 77 months). Among 68 premenopausal women, 31 (46 %) underwent radical surgery and FSS in 37 (54 %) cases. Median time to conception in 29 women with future fertility wishes was 13 months (range, 4 to38 m). Seven of 29 cases (29 %) required ovulation induction. The pregnancy rate was 82.7 % and live birth rate was 80 %. Eight cases (8.7 %) had a recurrence (7- un-staged, 1- partially staged) and median time to recur was 36 months. There was no significant difference in recurrence between cystectomy/oophorectomy. Ovary was the site of recurrence in all surgically salvaged cases except peritoneal cavity in 1 case with mortality. Relapse free survival at 5 and 10 years in FSS and radical surgery group were similar. FSS is a safe procedure and should be considered in young patients desirous of future fertility along with a comprehensive peritoneal staging. Reproductive outcomes are excellent.

A case of mature ovarian teratoma harboring intestine

Malignant peripheral nerve sheath tumour (MPNST) of the cervix: differential diagnosis and a favourable oncological outcome with multimodality treatment

Malignant peripheral nerve sheath tumours (MPNSTs) are aggressive sarcomas that occur rarely in the cervix. Considering the varied clinical features and the absence of a pathognomonic immunohistochemical marker, it is always challenging to diagnose these tumours. Treatment has not been standardised as yet, but a combination of surgery, radiotherapy and chemotherapy is used to treat MPNSTs of the cervix. Here, we report a case of a woman in her 40s with a 10×7 cm polypoidal lesion in the cervix, diagnosed as an MPNST. She was treated with surgery, ifosfamide-based chemotherapy and external beam radiotherapy before developing pulmonary metastases. She was treated with stereotactic body radiotherapy for the pulmonary metastases, and the patient has been on follow-up since then. We are also summarising the clinicopathological findings, surgical treatment and follow-up of all reported cases of cervical MPNSTs to date.

Late and unusual recurrences after minimally invasive cervical cancer surgery

Extrarenal rhabdoid tumour of the vulva: diagnostic and management challenges

Extrarenal rhabdoid tumour (ERT) of vulva is a rare gynaecological neoplasm with an aggressive course and no clear management guidelines. We present the case of a 25-year-old woman with a rapidly increasing mass in right vulva suggestive of sarcoma. Wide local excision was done. Histopathology examination revealed ERT of vulva. Six weeks later she manifested lung metastases. Despite adjuvant chemotherapy, the disease progressed and she died 8 months later. We review the literature and briefly discuss the epidemiology, treatment approaches, prognostic factors and expected outcomes of this rare disease.

Complete double ureter in a case of carcinoma cervix: incidental intraoperative diagnosis and implications

Abdominal cocoon in carcinoma of the ovary: a deceptive presentation