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2 results

  • Debate 26B - What is the Best Management Strategy for Recurrent Granulosa Cell Tumor?

  • from Section III - Ovarian Cancer
  • Edited by Dennis S. Chi, Memorial Sloan-Kettering Cancer Center, New York, Nisha Lakhi, Richmond University Medical Center, Staten Island, Nicoletta Colombo, University of Milan-Bicocca
  • Book:
    50 Big Debates in Gynecologic Oncology
    Published online:
    20 July 2023
    Print publication:
    03 August 2023, pp 155-157

  • Summary

    Patients with early-stage granulosa cell tumors (IA or IB) may be treated with surgical therapy alone and expect an excellent prognosis. Patients with stage IC or greater disease, recurrent granulosa cell tumors, and sub-optimally reduced disease may benefit from adjuvant chemotherapy. The type of adjuvant chemotherapy has been controversial and varies based on clinical guidelines. The National Comprehensive Cancer Network (NCCN) guidelines recommend platinum-based chemotherapy and endorses paclitaxel and carboplatin (PC), etoposide and cisplatin, or bleomycin, etoposide, cisplatin (BEP). In this debate the following article, we prefer the authors support the use of paclitaxel plus carboplatin based on (1) BEP lacks durable activity, (2) PC demonstrates favorable outcomes in a retrospective analysis, (3) PC has a better safety profile compared to BEP, (4) the dosing regimen for PC is more convenient, and (5) there is insufficient data comparing PC to BEP.

  • Quality of life in young patients after cone reconstruction for Ebstein anomaly

  • Kristen L. Sessions, Charlotte Van Dorn, Joseph A. Dearani, Simrit Warring, Kaitlin Leopold, Philip L. Wackel, Frank Cetta, Jonathan N. Johnson
  • Journal:
    Cardiology in the Young / Volume 29 / Issue 6 / June 2019
    Published online by Cambridge University Press:
    14 June 2019, pp. 756-760
  • Objective:

    To evaluate the health status and quality of life of young patients who had cone reconstruction for Ebstein anomaly.

    Methods:

    We reviewed all patients who had cone reconstruction from 2007 to 2016 at our institution. Prospective surveys were mailed to all eligible patients. Quality of life was assessed using the PedsQL 4.0 Generic Core Scales, including four domains: physical, emotional, social, and school functioning.

    Results:

    Of 116 eligible patients, 72 (62%) responded. About 96% reported their health as excellent or good, and 52% were symptom-free. Only 37% of patients were taking any medications, the most common of which was aspirin (30%). Only 19% had been hospitalised for cardiac reasons following cone reconstruction. The average self-reported quality of life was 85.3/100, whereas the average parent proxy-reported quality of life was 81.8/100. There was no difference by self or parent proxy-report in quality of life between cone reconstruction patients and healthy children; however, quality of life was significantly better compared with children with other chronic health conditions. By self-report and parent proxy-report, 15.1 and 16.7% of patients were deemed “at risk” for reduced quality of life, respectively. Socially, 63/64 (98%) patients over 5 years old were either full-time students or working full-time.

    Conclusion:

    Children with Ebstein anomaly following cone reconstruction have excellent quality of life comparable with healthy peers and significantly better than other children with chronic health conditions. Families of children with Ebstein anomaly can expect excellent quality of life, long-term health status, and social functioning following cone reconstruction.