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Objective: This multicenter, open-label, phase II study aimed to evaluate the efficacy and safety of paclitaxel-carboplatin, bevacizumab, and bevacizumab-based maintenance therapy for metastatic, recurrent, and persistent uterine cervical cancer., Methods: Patients with measurable diseases that were not adapted to regional therapies, such as surgery or radiotherapy, and were systematic chemotherapy-naïve were eligible. The participants received paclitaxel (175 mg/m 2 ), carboplatin (AUC 5), and bevacizumab (15 mg/m 2 ) every three weeks until disease progression or unacceptable adverse events occurred. The primary endpoint was progression-free survival (PFS). The secondary endpoints were overall response rate (ORR), overall survival (OS), safety, and time to treatment failure., Results: Sixty-nine patients were analyzed using our protocol. The median paclitaxel- carboplatin therapy duration was six cycles; 40% of patients received bevacizumab maintenance therapy. The median PFS was 11.3 months. The median OS was not reached; the median time to treatment failure was 5.9 months. The ORR was 79.7% [95% confidence interval (CI) 63.8-88.4]; 16 patients (23.2%) showed complete response (CR) and 39 patients (56.5%) showed partial response (PR). The median PFS was 14.3 months (95% CI 7.3-17 months) for the 25 patients who received maintenance therapy and 7.4 months (95% CI 6.1-11 months) for nonrecipients (p = 0.0449). Gastrointestinal perforation/fistulas occurred in four patients (5.6%), all of whom had a history of radiation therapy., Conclusions: Paclitaxel-carboplatin and bevacizumab therapy is an acceptable and tolerable treatment for advanced or recurrent cervical cancer., Competing Interests: Declaration of Competing Interest None of the authors reports that they have any conflict of interest to disclose., (Copyright © 2022 Elsevier Inc. All rights reserved.)

A 46-year-old woman with stage IV "high-grade" endometrial stromal sarcoma presented with massive uterine bleeding and dyspnea. Her WHO performance status was grade 4. After chemotherapy consisting of ifosfamide, Adriamycin, and cisplatin, the uterus shrank from 20 x 15 x 15 to 6 x 6 x 8 cm and multiple pulmonary nodules almost completely disappeared. The PO2 increased from 57.8 to 89.3 mmHg and her performance status improved to grade 0, making it possible for pelvic surgery to be performed. At 10 months postoperatively, there was no evidence of disease. This case suggests that IAP might be effective chemotherapy for patients with high-grade endometrial stromal sarcoma.

Peritoneal cytology was obtained in 374 patients with carcinoma of the uterine cervix (stage IB-IIB) in whom gross intraperitoneal disease was absent at the time of radical hysterectomy and node dissections. The relevance of positive peritoneal cytology in relation to the cell type of the tumor was examined. An exceedingly small rate of peritoneal cytologic positivity was found in patients with squamous cell carcinoma (1.7%, 4/242). One of the four patients with positive cytology developed a lung recurrence. On the other hand, the incidence of positive peritoneal cytology in patients with adenocarcinoma and adenosquamous carcinoma was 11.4% (15/132). The 3-year disease-free survival rate in patients having adenocarcinoma and adenosquamous carcinoma with positive peritoneal cytology was 57.8%, while it was 80.7% in patients with negative peritoneal cytology. However, this factor was closely associated with other adverse prognostic factors. A multivariate analysis revealed that positive peritoneal cytology was not an independent prognostic factor in patients with adenocarcinoma and adenosquamous carcinoma. In addition, intraperitoneal recurrence was not correlated with the presence of cancer cells in the peritoneal fluid. The series indicates that peritoneal cytology in cervical cancer is of little value in treatment planning.

A 62-year-old female presented with a pelvic mass and ascites. The Papanicolaou vaginal smear showed an unusual maturation, maturation index being 0/80/20. The serum level of estradiol was 48.7 pg/ml. The preoperative checkup suggested a pelvic malignancy with a differential diagnosis of hormone-secreting ovarian tumor. On surgical exploration, she had a hemangioma of the ovary without malignant cytology in the ascitic fluid. Histologically, this tumor was associated with stromal luteinization. This is the first case, reported in the literature, possessing ovarian hemangioma with stromal luteinization accompanying massive ascites. It should be noted that an ovarian hemangioma can be associated with stromal luteinization and ascites, and that MR imaging is sometimes of value for making a preoperative diagnosis of ovarian hemangioma.