mitra moddares gilani

Context: Pelvic masses are a prevalent cause for referral to gynecologic oncology departments to evaluate the possibility of benign or malignant conditions. Pelvic mass often was found in pelvic examinations among females with ovarian. Tumor markers are advantageous biomarker in tumor diagnosis. Evidence Acquisition: We performed a computerized search in Medline/PubMed databases and Google Scholar with key words: “Cancer antigen 125 (CA125), Human epididymis protein 4 (HE4), risk of ovarian malignancy algorithm (ROMA), Risk of malignancy index (RMI), and Pelvic mass”. The usage of tumor marker CA125 alone is associated with serious limitations like low sensitivity for early or stage I disease and lack of specificity especially in pre-menopausal women. Serum HE4 is a good biomarker for discriminating ovarian cancer from benign pelvic disease, but could be affected by several factors including pregnancy, age, and smoking. ROMA has a high sensitivity, specificity, and negative predictive value to predict the presence of ovarian cancer in women with a pelvic mass. RMI could differentiate between benign and malignant pelvic masses, but RMI expression was higher in women with 55 years or more. According to the results of this study, combination of these biomarkers or at least 2 or 3 biomarkers are suggested for early stage diagnosis of pelvic mass with high sensitivity and specificity.

Epithelial ovarian cancer (EOC) is the fifth leading cause of cancer death in women. Primary surgery, followed by adjuvant chemotherapy is the basis of treatment for this disease. A standard treatment includes primary surgery and if possible optimal debulking surgery (tumor residue of <; 1 cm), followed by a chemotherapy; paclitaxel-carboplatin is the standard regimen in ovarian cancer. Given that the main method of spreading this disease is in the peritoneal cavity, the systemic chemotherapy brings about numerous complications; moreover, as the method of prescribing a drug inside the peritoneum causes a high drug concentration in the peritoneal cavity, conducting an intraperitoneal chemotherapy has been examined clinically. In cases of ovarian cancer recurrence, performing a secondary cytoreductive surgery, in addition to hyperthermic intraperitoneal chemotherapy (HIPEC), has led to a good survival among patients. Currently, studies are ongoing to better explain the effects of this treatment method compared to previous methods.