2 articles
Borderline ovarian tumors (BOTs) represent an intermediate entity between benign and malignant ovarian neoplasms, frequently affecting young women. Surgical treatment, either conservative or radical, must be tailored based on age, disease stage, and fertility desires.
A retrospective-prospective cohort study was conducted on 156 patients surgically treated for BOTs. The types of surgical interventions, the use of adjuvant chemotherapy, and their distribution based on clinico-morphological parameters were analyzed.
Radical surgery was performed in 78.8% of cases, and conservative surgery in 21.2%. Radical procedures included total hysterectomy with bilateral adnexectomy and omentectomy. Adjuvant chemotherapy was administered in 50% of patients, mainly using CP or CAP regimens.
Therapeutic decision-making in BOTs should consider patient age, fertility preservation, and recurrence risk. In the absence of firm international consensus on chemotherapy, a standardized algorithm is needed to guide safe conservative approaches.
The gastrointestinal tract (GIT) is the most common site of extranodal primary non-Hodgkin lymphoma (NHL), accounting for 20% to 40% of all extranodal lymphomas. The advanced stages at diagnosis and complications remain significant issues in NHL management, imposing a substantial disease burden on patients and healthcare systems.
Material and methods
We performed a descriptive cross-sectional and cohort study of patients with gastrointestinal NHL and a narrative review of the literature in the Discussion section. This study included 50 prospective and retrospective patients with NHL treated between 2015-2024 in the Institute of Oncology in Moldova. A bibliographic search was conducted using databases such as PubMed, Hinari, SpringerLink, the National Center for Biotechnology Information, and Medline. The final bibliography included 18 relevant sources deemed to be representative of the literature published on the topic of this article.
According to the International Clinical Classification, most patients (22, 44.0%) were diagnosed with clinical stage IV. B symptoms occurred in 38 (76.0%) patients. The overwhelming predominance of diffuse large B-cell lymphomas (46 cases - 90.2%) was observed. The complete blood count, bone marrow aspiration and biopsy of the iliac crest did not detect any specific changes in cases without bone marrow involvement, with the exception of a decrease in hemoglobin and erythrocyte counts observed in cases of posthemorrhagic anemia. The overall survival (OS) of all patients with gastrointestinal NHL was 78.1% at 1 year, 59.4% at 3 years, and 35.9% at 5 years. In patients with stage IE NHL, the 1-, 3-, and ≥5-year OS was 93.4%, 76.5%, and 69.9%, respectively. In patients with stage IIE, the OS was 91.2% at 1 year, 71.4% at 3 years, and 63.8% at ≥5 years. In patients with stage IIIE-IV, the OS was 75.1% at 1 year, 54.8% at 3 years, and 28.5% at ≥5 years with combined chemotherapy.
Our study demonstrated that non-Hodgkin lymphomas with primary involvement of the gastrointestinal tract exhibited distinct histopathological, clinical-evolutionary and hematological features, which influenced treatment outcomes. The aggressive histological types and the advanced stages IIIE and IV prevailed within the structure of non-Hodgkin lymphomas with primary gastrointestinal involvement, and, thus, negatively impacted the survival and prognosis.