Objective: It has been found that overexpression of distal-less homeobox 2 (DLX2) is closely correlated with multiple cancers. However, the role of DLX2 in the pathogenesis of ovarian cancers is not known. This study was designed to explore the mechanism of action of DLX2 on cellular proliferation and apoptosis in epithelial ovarian cancers (EOCs). Methods: A total of 119 EOC tissue specimens were analyzed immunohistochemically, and the correlation between DLX2 expressional level and clinicopathological characteristics was determined. Moreover, western blot method was used to measure DLX2 protein in EOC specimen of different grades and EOC cell lines and explore its molecular mechanism of action. Kaplan-Meier survival analysis revealed that overexpression of DLX2 was obviously correlated with an adverse clinical outcome in EOCs (P < 0.01*). Results: DLX2 expressional level had an obvious association with histopathological grade, FIGO stage, ascites and ki-67 expressional level in EOC patients and DLX2 exerted a crucial effect in regulating cellular proliferation in EOCs. Knocking down DLX2 using shRNA-DLX2 reduced the proliferation and enhanced the apoptosis in EOC cells. Conclusion: DLX2 might act as a new prognostic indicator and have an important value for molecular targeted therapeutic drugs in EOCs.
{"title":"Exploration on correlation of high DLX2 expression with poor prognosis and cellular proliferation in epithelial ovarian cancers","authors":"Menghui Huang, Yu-Wen Han, Qinghua Xi, Yunfeng Jin, Ying-lei Liu, Yunhe Han, Hai-Li Kai, Qian Zhang, Yan-Li Zheng","doi":"10.31083/J.EJGO.2021.03.2093","DOIUrl":"https://doi.org/10.31083/J.EJGO.2021.03.2093","url":null,"abstract":"Objective: It has been found that overexpression of distal-less homeobox 2 (DLX2) is closely correlated with multiple cancers. However, the role of DLX2 in the pathogenesis of ovarian cancers is not known. This study was designed to explore the mechanism of action of DLX2 on cellular proliferation and apoptosis in epithelial ovarian cancers (EOCs). Methods: A total of 119 EOC tissue specimens were analyzed immunohistochemically, and the correlation between DLX2 expressional level and clinicopathological characteristics was determined. Moreover, western blot method was used to measure DLX2 protein in EOC specimen of different grades and EOC cell lines and explore its molecular mechanism of action. Kaplan-Meier survival analysis revealed that overexpression of DLX2 was obviously correlated with an adverse clinical outcome in EOCs (P < 0.01*). Results: DLX2 expressional level had an obvious association with histopathological grade, FIGO stage, ascites and ki-67 expressional level in EOC patients and DLX2 exerted a crucial effect in regulating cellular proliferation in EOCs. Knocking down DLX2 using shRNA-DLX2 reduced the proliferation and enhanced the apoptosis in EOC cells. Conclusion: DLX2 might act as a new prognostic indicator and have an important value for molecular targeted therapeutic drugs in EOCs.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42122038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-15DOI: 10.31083/J.EJGO.2021.03.2338
Di Wu, Yanqin Zhang, Jinwei Miao
Objective: Malignant pleural effusion (MPE) is a major problem associated with late phase of epithelial ovarian cancer for which an optimum treatment consensus has yet to be determined. Although bevacizumab (Bev), a VEGF ligand inhibitor, has been shown to effectively control MPE, the clinical benefit of half-dose Bev treatment to control MPE remains unclear. Methods: We describe a patient with platinum-sensitive ovarian clear cell cancer (OCCC) and symptomatic MPE for whom tumor markers increased after one cycle of paclitaxel and carboplatin chemotherapy. After switching to five cycles of Bev plus paclitaxel/carboplatin chemotherapy, we observed the disappearance of MPE. Conclusion: The half-dose Bev therapy may be an effective treatment for MPE in OCCC. However, further investigation is still warranted to evaluate the therapeutic effectiveness of Bev.
{"title":"Bevacizumab for malignant pleural effusion in ovarian clear cell carcinoma: a case report","authors":"Di Wu, Yanqin Zhang, Jinwei Miao","doi":"10.31083/J.EJGO.2021.03.2338","DOIUrl":"https://doi.org/10.31083/J.EJGO.2021.03.2338","url":null,"abstract":"Objective: Malignant pleural effusion (MPE) is a major problem associated with late phase of epithelial ovarian cancer for which an optimum treatment consensus has yet to be determined. Although bevacizumab (Bev), a VEGF ligand inhibitor, has been shown to effectively control MPE, the clinical benefit of half-dose Bev treatment to control MPE remains unclear. Methods: We describe a patient with platinum-sensitive ovarian clear cell cancer (OCCC) and symptomatic MPE for whom tumor markers increased after one cycle of paclitaxel and carboplatin chemotherapy. After switching to five cycles of Bev plus paclitaxel/carboplatin chemotherapy, we observed the disappearance of MPE. Conclusion: The half-dose Bev therapy may be an effective treatment for MPE in OCCC. However, further investigation is still warranted to evaluate the therapeutic effectiveness of Bev.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42208991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-15DOI: 10.31083/J.EJGO.2021.03.2210
P. Economopoulou, I. Kotsantis, A. Bamias
Advanced (FIGO stages III and IV) epithelial ovarian cancer (aEOC) accounts for the majority of deaths from gynecological cancers in western countries. Although the prognosis of this disease has been considerably improved in the last two decades, the majority of women will still die from progression of EOC. Optimal cytoreductive surgery and cytotoxic chemotherapy remains the mainstay of treatment in the front-line setting. Approximately 18% of EOCs harbor germline mutations of the tumor suppressor genes Breast Cancer Susceptibility Gene 1 (BRCA1) and 2 (BRCA2), while another 3–6% of these tumors have somatic mutations of these genes. These mutations lead to increased predisposition of multiple cancers. In addition, BRCA1 and BRCA2 genes encode proteins that are implicated in the Homologous Recombination (HR) mechanism, which is responsible for the repair of DNA Double Strand Breaks (DSBs), which is a common mechanism of action of chemotherapy. The incorporation of BRCA-targeted therapies, such as poly ADP ribose polymerase (PARP) inhibitors in the treatment algorithm of advanced EOC has further improved outcomes and represents a successful strategy of individualization of treatment in EOC. In this review, we summarize current treatment recommendations for patients with EOC and a BRCA1/2 mutation.
{"title":"BRCA-guided therapy of ovarian cancer","authors":"P. Economopoulou, I. Kotsantis, A. Bamias","doi":"10.31083/J.EJGO.2021.03.2210","DOIUrl":"https://doi.org/10.31083/J.EJGO.2021.03.2210","url":null,"abstract":"Advanced (FIGO stages III and IV) epithelial ovarian cancer (aEOC) accounts for the majority of deaths from gynecological cancers in western countries. Although the prognosis of this disease has been considerably improved in the last two decades, the majority of women will still die from progression of EOC. Optimal cytoreductive surgery and cytotoxic chemotherapy remains the mainstay of treatment in the front-line setting. Approximately 18% of EOCs harbor germline mutations of the tumor suppressor genes Breast Cancer Susceptibility Gene 1 (BRCA1) and 2 (BRCA2), while another 3–6% of these tumors have somatic mutations of these genes. These mutations lead to increased predisposition of multiple cancers. In addition, BRCA1 and BRCA2 genes encode proteins that are implicated in the Homologous Recombination (HR) mechanism, which is responsible for the repair of DNA Double Strand Breaks (DSBs), which is a common mechanism of action of chemotherapy. The incorporation of BRCA-targeted therapies, such as poly ADP ribose polymerase (PARP) inhibitors in the treatment algorithm of advanced EOC has further improved outcomes and represents a successful strategy of individualization of treatment in EOC. In this review, we summarize current treatment recommendations for patients with EOC and a BRCA1/2 mutation.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44570525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-15DOI: 10.31083/J.EJGO.2021.03.2287
S. Lacin, G. E. Tasar, A. Usubutun, Z. Arık, D. Yuce, M. Salman, A. Kars
Department of Medical Oncology, Yeditepe University, Faculty of Medicine, Koşuyolu Mah. Koşuyolu Cad. No:168 34718 Kadıköy/İstanbul, Turkey Department of Pathology, Hacettepe University, Faculty of Medicine, 06100 Altındağ, Ankara, Turkey Department of Medical Oncology, Hacettepe University, Cancer Institute, 06100 Altındağ, Ankara, Turkey Department of Preventive Oncology, Hacettepe University, Hacettepe Cancer Institute, 06100 Altındağ, Ankara, Turkey Department of Obstetrics and Gynecology, Hacettepe University, Faculty of Medicine, 06100 Altındağ, Ankara, Turkey
{"title":"The prognostic significance of microsatellite status and its relationship with tumor-infiltrating lymphocyte in endometrial cancer","authors":"S. Lacin, G. E. Tasar, A. Usubutun, Z. Arık, D. Yuce, M. Salman, A. Kars","doi":"10.31083/J.EJGO.2021.03.2287","DOIUrl":"https://doi.org/10.31083/J.EJGO.2021.03.2287","url":null,"abstract":"Department of Medical Oncology, Yeditepe University, Faculty of Medicine, Koşuyolu Mah. Koşuyolu Cad. No:168 34718 Kadıköy/İstanbul, Turkey Department of Pathology, Hacettepe University, Faculty of Medicine, 06100 Altındağ, Ankara, Turkey Department of Medical Oncology, Hacettepe University, Cancer Institute, 06100 Altındağ, Ankara, Turkey Department of Preventive Oncology, Hacettepe University, Hacettepe Cancer Institute, 06100 Altındağ, Ankara, Turkey Department of Obstetrics and Gynecology, Hacettepe University, Faculty of Medicine, 06100 Altındağ, Ankara, Turkey","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44817068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-15DOI: 10.31083/j.ejgo.2021.03.2240
Xiao-juan Wang, K. Hua
Objective: To describe the incidence, timing, and risk factors of venous thromboembolism (VTE) after surgery for gynecological cancer and to evaluate its effects of these events on survival. Methods: This was a retrospective analysis from January 2008 through December 2016 at a single center. Data were recorded on surgical procedures, patient demographic characteristics, type of malignancy and VTE, and mortality outcomes within 30 days after surgery. Significant variables related to VTE were evaluated using bivariate analysis, and Logistic regression models were used to assess risk factors for VTE. Results: The overall rate of postoperative VTE was 0.899% (36/4005) within 30 days after surgery. Of these rates, the rate in abdominal surgery was 1.56% (19/1220), and the rate in minimally invasive surgery (MIS) was 0.6% (17/2785). The median time from surgery to diagnosis was 8.5 days. In univariate analysis, VTE was statistically significantly associated with ovarian and fallopian cancer (P < 0.05), older age (P = 0.001), and blood transfusion (P < 0.001). A multivariate logistic regression model was used to adjust for variables with P < 0.2 in univariate analysis and found that except for age, the other variables continued to have a significant association with VTE. Conclusion: The second week after surgery might be high-risk period of VTE occuring, and ovarian and fallopian tube cancer, abdominal surgery, and blood transfusion might be significant risk factors for developing VTE.
{"title":"Incidence and predictors of venous thromboembolism after surgery for gynecologic cancer","authors":"Xiao-juan Wang, K. Hua","doi":"10.31083/j.ejgo.2021.03.2240","DOIUrl":"https://doi.org/10.31083/j.ejgo.2021.03.2240","url":null,"abstract":"Objective: To describe the incidence, timing, and risk factors of venous thromboembolism (VTE) after surgery for gynecological cancer and to evaluate its effects of these events on survival. Methods: This was a retrospective analysis from January 2008 through December 2016 at a single center. Data were recorded on surgical procedures, patient demographic characteristics, type of malignancy and VTE, and mortality outcomes within 30 days after surgery. Significant variables related to VTE were evaluated using bivariate analysis, and Logistic regression models were used to assess risk factors for VTE. Results: The overall rate of postoperative VTE was 0.899% (36/4005) within 30 days after surgery. Of these rates, the rate in abdominal surgery was 1.56% (19/1220), and the rate in minimally invasive surgery (MIS) was 0.6% (17/2785). The median time from surgery to diagnosis was 8.5 days. In univariate analysis, VTE was statistically significantly associated with ovarian and fallopian cancer (P < 0.05), older age (P = 0.001), and blood transfusion (P < 0.001). A multivariate logistic regression model was used to adjust for variables with P < 0.2 in univariate analysis and found that except for age, the other variables continued to have a significant association with VTE. Conclusion: The second week after surgery might be high-risk period of VTE occuring, and ovarian and fallopian tube cancer, abdominal surgery, and blood transfusion might be significant risk factors for developing VTE.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42032478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-15DOI: 10.31083/J.EJGO.2021.03.2173
Shun Zhang, Ya-Qin Wang, Jing-hua Zhang, Jiwei Hu, Jie Ma, Z. Gu, Yu Wang, Jingjing Chen
Objective: This study was conducted to determine the relationship between p16 gene methylation and expression of relevant receptors in breast cancer (BC) for subtyping the disease. Methods: Methylationspecific PCR (MSP) was carried out to detect the methylation status of p16 gene in 240 tissue samples and 205 serum samples from BC patients treated at our hospital. Immunohistochemistry was used to determine the expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2). Receiver operating characteristics (ROC) curve was analyzed for diagnostic value based on methylation status for triple-negative (TN) BC. Results: The overall methylation rates of the p16 gene were 36.7% (88/240) and 35.1% (72/205) in the tissue and serum samples, respectively. In patients with ER, PR and HER2-TNBC, the methylation rate of the p16 gene was significantly higher than that in non-triple negative patients (84.9%, 62/73) vs (25.9%, 35/135, P<0.01). The methylation of p16 gene was negatively associated with the expression of ER, PR and HER2 (r = -0.661, -0.694 and -0.765, respectively, P < 0.05), but it was not correlated with the pathological characteristics of BC, such as tumor grade and lymph-node metastasis. Receiver operator characteristic (ROC) curve analysis showed that p16 gene methylation had a significant diagnostic value for TNBC with an AUC of 0.815. Therefore, p16 gene methylation is associated with the subtype of TNBC and can be used as an easy and non-invasive approach to screen patients for TNBC.
{"title":"Methylated p16 gene is associated with negative expression of estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 in breast cancer","authors":"Shun Zhang, Ya-Qin Wang, Jing-hua Zhang, Jiwei Hu, Jie Ma, Z. Gu, Yu Wang, Jingjing Chen","doi":"10.31083/J.EJGO.2021.03.2173","DOIUrl":"https://doi.org/10.31083/J.EJGO.2021.03.2173","url":null,"abstract":"Objective: This study was conducted to determine the relationship between p16 gene methylation and expression of relevant receptors in breast cancer (BC) for subtyping the disease. Methods: Methylationspecific PCR (MSP) was carried out to detect the methylation status of p16 gene in 240 tissue samples and 205 serum samples from BC patients treated at our hospital. Immunohistochemistry was used to determine the expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2). Receiver operating characteristics (ROC) curve was analyzed for diagnostic value based on methylation status for triple-negative (TN) BC. Results: The overall methylation rates of the p16 gene were 36.7% (88/240) and 35.1% (72/205) in the tissue and serum samples, respectively. In patients with ER, PR and HER2-TNBC, the methylation rate of the p16 gene was significantly higher than that in non-triple negative patients (84.9%, 62/73) vs (25.9%, 35/135, P<0.01). The methylation of p16 gene was negatively associated with the expression of ER, PR and HER2 (r = -0.661, -0.694 and -0.765, respectively, P < 0.05), but it was not correlated with the pathological characteristics of BC, such as tumor grade and lymph-node metastasis. Receiver operator characteristic (ROC) curve analysis showed that p16 gene methylation had a significant diagnostic value for TNBC with an AUC of 0.815. Therefore, p16 gene methylation is associated with the subtype of TNBC and can be used as an easy and non-invasive approach to screen patients for TNBC.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46112395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-15DOI: 10.31083/J.EJGO.2021.03.2253
B. Kasprzak, Przemysław Zgórecki
Prophylactic mastectomy and ovariectomy doesn't seem to be a religious problem at first, therefore not much research on the subject has been done so far. As the awareness of the problem of breast and ovarian cancer threat and subsequently of the issue of prophylactic procedures for BRCA carriers is growing among general public, it is worth to ask the question if and in what way religion itself as well as religious communities may help. The article explores the impact of religious perspective on both physicians and patients as they face these problems. The issue is discussed from physicians' and chaplains' perspective. In the context of this discussion the question of involvement of religious communities in providing better information and support to patients-members of these communities is asked. The aim of the research done here is to open discussion on the possibility of providing better medical and spiritual help, with greater respect and empathy to every patient, no matter their religious and/or cultural background, by involving religious perspective in the process.
{"title":"Prophylactic mastectomy and ovariectomy—a religious perspective","authors":"B. Kasprzak, Przemysław Zgórecki","doi":"10.31083/J.EJGO.2021.03.2253","DOIUrl":"https://doi.org/10.31083/J.EJGO.2021.03.2253","url":null,"abstract":"Prophylactic mastectomy and ovariectomy doesn't seem to be a religious problem at first, therefore not much research on the subject has been done so far. As the awareness of the problem of breast and ovarian cancer threat and subsequently of the issue of prophylactic procedures for BRCA carriers is growing among general public, it is worth to ask the question if and in what way religion itself as well as religious communities may help. The article explores the impact of religious perspective on both physicians and patients as they face these problems. The issue is discussed from physicians' and chaplains' perspective. In the context of this discussion the question of involvement of religious communities in providing better information and support to patients-members of these communities is asked. The aim of the research done here is to open discussion on the possibility of providing better medical and spiritual help, with greater respect and empathy to every patient, no matter their religious and/or cultural background, by involving religious perspective in the process.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46204780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-15DOI: 10.31083/j.ejgo.2021.03.2310
L. Harbin, L. Berry, A. Wahlquist, J. Richmond, W. Graybill, M. Kohler, W. Creasman
Objective: Determine if tumor distance from serosal surface is an independent prognostic factor for disease recurrence and survival in stage 1 endometrial cancer. Methods: 747 patients diagnosed with stage 1 endometrial cancer between 1984 and 2015 were identified from an institutional database. This retrospective cohort was evaluated to assess di ferences in tumor distance from the serosal surface, histologic subtype, histologic grade, use of adjuvant treatment, recurrence rates and overall survival. Cox proportional hazard models were used to determine if variables of interest were related to recurrence and overall survival. Concordance correlation coe ficients were used to compare our model to the 2009 International Federation of Gynecology andObstetrics (FIGO) staging. Results: Tumor distance from serosal surface ranged from 0mm–21mm. 47 (8.7%) patients experienced recurrence. Patients with tumors located 5mmor less from the serosal surface were 2.24 times more likely to experience recurrent disease (HR 2.24, 95% CI: 1.16 to 4.31, p = 0.02). Concordance rates for disease recurrence were 0.573 and 0.583 for our tumor distance model compared to the 2009 FIGO staging (95% CI: 0.568 to 0.579 and 95% CI: 0.577 to 0.589). Conclusions: Our study demonstrates that patients with tumors located 5 mm or less from the serosal surface have a two-fold increased risk of recurrence. Concordance ratesarevery similarbetweenourmodelandthe2009FIGO staging suggesting comparable predictability; these rates suggest there is roomfor improvement inbothmethods topredict disease recurrence and survival.
{"title":"Tumor proximity to serosal surface as an independent prognostic factor in FIGO stage 1 endometrial cancer","authors":"L. Harbin, L. Berry, A. Wahlquist, J. Richmond, W. Graybill, M. Kohler, W. Creasman","doi":"10.31083/j.ejgo.2021.03.2310","DOIUrl":"https://doi.org/10.31083/j.ejgo.2021.03.2310","url":null,"abstract":"Objective: Determine if tumor distance from serosal surface is an independent prognostic factor for disease recurrence and survival in stage 1 endometrial cancer. Methods: 747 patients diagnosed with stage 1 endometrial cancer between 1984 and 2015 were identified from an institutional database. This retrospective cohort was evaluated to assess di ferences in tumor distance from the serosal surface, histologic subtype, histologic grade, use of adjuvant treatment, recurrence rates and overall survival. Cox proportional hazard models were used to determine if variables of interest were related to recurrence and overall survival. Concordance correlation coe ficients were used to compare our model to the 2009 International Federation of Gynecology andObstetrics (FIGO) staging. Results: Tumor distance from serosal surface ranged from 0mm–21mm. 47 (8.7%) patients experienced recurrence. Patients with tumors located 5mmor less from the serosal surface were 2.24 times more likely to experience recurrent disease (HR 2.24, 95% CI: 1.16 to 4.31, p = 0.02). Concordance rates for disease recurrence were 0.573 and 0.583 for our tumor distance model compared to the 2009 FIGO staging (95% CI: 0.568 to 0.579 and 95% CI: 0.577 to 0.589). Conclusions: Our study demonstrates that patients with tumors located 5 mm or less from the serosal surface have a two-fold increased risk of recurrence. Concordance ratesarevery similarbetweenourmodelandthe2009FIGO staging suggesting comparable predictability; these rates suggest there is roomfor improvement inbothmethods topredict disease recurrence and survival.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42378467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-15DOI: 10.31083/J.EJGO.2021.03.2254
N. Giannakopoulos, Ivana Virijevic, Merit Kullinger
Objectives: Our objective is to report a case of isolated vulvar metastasis after robot-assisted laparoscopic hysterectomy for early-stage endometrial adenocarcinoma and to conduct a systematic review of the related literature to determine the frequency of this rare metastasis. Methods: We present a case-report of a rare vulvar metastasis and conduct a systematic review of the English literature. Results: A 74-year-old woman with suspected uterine malignancy underwent a total laparoscopic hysterectomy with specimen removal through the vagina. Pathology revealed endometrioid carcinoma (WHO-World Health Organization-categorization of endometrial cancer histology) stage IA, grade 1 (FIGO-International Federation of Gynecology and Obstetrics-categorization). Upon a 12-month clinical examination after surgery, an isolated metastasis of the initial endometrial carcinoma was observed in the vulva and required surgical excision. Two and a half years later, the patient remains disease-free. Eleven articles consisting of 22 cases of metastatic endometrial carcinoma to the vulva have been reported in the English literature. To our knowledge, this is only the second case of developing isolated vulvar metastasis after minimal invasive surgery for low risk gynecological cancer described in literature. Conclusion: The hereby presented case report aims to raise awareness, among surgeons, regarding lesions that can be developed in the vulva after minimally invasive surgery of even low-risk, well differentiated EAC, which may represent recurrence of the primary cancer.
目的:我们的目的是报道一例机器人辅助腹腔镜子宫切除术后早期子宫内膜腺癌的孤立外阴转移，并对相关文献进行系统回顾，以确定这种罕见的转移的频率。方法:我们报告一例罕见的外阴转移病例，并对英文文献进行系统复习。结果:一位74岁的怀疑子宫恶性肿瘤的妇女接受了全腹腔镜子宫切除术，并通过阴道切除标本。病理显示子宫内膜样癌(WHO-World Health organization - classification of endometrioid cancer组织学)IA期，1级(FIGO-International Federation of Gynecology and obstetrics - classification)。在术后12个月的临床检查中，在外阴观察到原发性子宫内膜癌的孤立转移，需要手术切除。两年半后，病人仍然没有患病。11篇文章包括22例转移到外阴的子宫内膜癌已被报道在英文文献。据我们所知，这是文献中报道的第二例低风险妇科癌症微创手术后发生孤立外阴转移的病例。结论:本病例报告旨在提高外科医生对低风险、分化良好的EAC微创手术后可能在外阴发生病变的认识，这些病变可能代表原发癌的复发。
{"title":"Isolated vulvar metastasis after robot-assisted laparoscopic hysterectomy for low grade, early stage endometrial cancer: a case report and review of the literature","authors":"N. Giannakopoulos, Ivana Virijevic, Merit Kullinger","doi":"10.31083/J.EJGO.2021.03.2254","DOIUrl":"https://doi.org/10.31083/J.EJGO.2021.03.2254","url":null,"abstract":"Objectives: Our objective is to report a case of isolated vulvar metastasis after robot-assisted laparoscopic hysterectomy for early-stage endometrial adenocarcinoma and to conduct a systematic review of the related literature to determine the frequency of this rare metastasis. Methods: We present a case-report of a rare vulvar metastasis and conduct a systematic review of the English literature. Results: A 74-year-old woman with suspected uterine malignancy underwent a total laparoscopic hysterectomy with specimen removal through the vagina. Pathology revealed endometrioid carcinoma (WHO-World Health Organization-categorization of endometrial cancer histology) stage IA, grade 1 (FIGO-International Federation of Gynecology and Obstetrics-categorization). Upon a 12-month clinical examination after surgery, an isolated metastasis of the initial endometrial carcinoma was observed in the vulva and required surgical excision. Two and a half years later, the patient remains disease-free. Eleven articles consisting of 22 cases of metastatic endometrial carcinoma to the vulva have been reported in the English literature. To our knowledge, this is only the second case of developing isolated vulvar metastasis after minimal invasive surgery for low risk gynecological cancer described in literature. Conclusion: The hereby presented case report aims to raise awareness, among surgeons, regarding lesions that can be developed in the vulva after minimally invasive surgery of even low-risk, well differentiated EAC, which may represent recurrence of the primary cancer.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46530266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-15DOI: 10.31083/J.EJGO.2021.03.2021
L. B. Mainar
Marta Lamarca Ballestero*, Leticia Álvarez Sarrado, Javier Navarro Sierra, Yasmina José Gutiérrez, Isabel Negredo Quintana, Miguel Angel Ruiz Conde Department of Gynecology, Miguel Servet University Hospital, Paseo Isabel la Católica 1-3, 50009 Zaragoza, Spain. * m.lamarca@yahoo.es Objectives: To describe the clinical findings, treatment, and outcome of borderline ovarian tumors in 32 premenopausal patients admitted to the Miguel Servet University Hospital over a 17-year period. Methods: Thirty-two premenopausal patients diagnosed and treated from 2003 to 2020 for borderline ovarian tumors were retrospectively evaluated. Results: The 32 borderline included 12 serous, 19 mucinous, and 1 endometrioid tumors, 2 of them were of stage more than I. The average age of the patients was 34.5 years (14–45), 22 were symptomatic, pain being the most frequent symptom (68.8%). 8 patients were operated on primarily by laparoscopy and 24 by laparotomy. In the laparoscopy group, median tumor diameter was smaller (7.5 versus 14.7 cm, p = 0.019) and surgeries were less extensive, without hysterectomy, as compared to the laparotomy group. There were 21 fertility-sparing surgeries, 7 patients attempted a subsequent pregnancy and in 6 cases a pregnancy with a healthy child was obtained (2 using assisted reproductive techniques). During the 7–108 months follow-up time, there were 3 relapses: 2 borderline tumors (treated surgically and desease free) and 1 carcinoma treated with surgery and chemotherapy that ended in death due to cancer. Discussion: In our study, only 6.25% of the borderline tumors were of stage more than I, whereas other studies report a higher proportion of more advanced stages (7.5–18.5%). As borderline ovarian tumors more often arise in young women, in whom malignancy is less common and who wish to preserve their fertility, their initial surgery is often laparoscopy. Conclusions: Borderline ovarian tumors have an excellent prognosis. Good results are provided in young patients wishing to preserve fertility.
Marta Lamarca Ballestero*、LeticiaÁlvarez Sarrado、Javier Navarro Sierra、Yasmina JoséGutiérrez、Isabel Negredo Quintana、Miguel Angel Ruiz Conde妇科，Miguel Servet大学医院，Paseo Isabel la Católica 1-350009，西班牙萨拉戈萨。*m.lamarca@yahoo.es目的：描述Miguel Servet大学医院17年来收治的32名绝经前患者的交界性卵巢肿瘤的临床表现、治疗和结果。方法：对2003年至2020年诊断和治疗的32例绝经前交界性卵巢肿瘤患者进行回顾性评价。结果：32例交界性肿瘤包括12例浆液性肿瘤、19例粘液性肿瘤和1例子宫内膜样肿瘤，其中2例超过I期。患者平均年龄34.5岁（14-45岁），22例有症状，疼痛是最常见的症状（68.8%）。8例主要通过腹腔镜手术，24例通过剖腹手术。与剖腹手术组相比，腹腔镜组的中位肿瘤直径较小（7.5与14.7 cm，p=0.019），手术范围较小，无子宫切除术。有21例保留生育能力的手术，7例患者尝试了后续妊娠，6例患者获得了健康孩子的妊娠（2例使用辅助生殖技术）。在7-108个月的随访时间内，有3例复发：2例交界性肿瘤（手术治疗且无病）和1例接受手术和化疗的癌症，最终因癌症死亡。讨论：在我们的研究中，只有6.25%的交界性肿瘤的分期高于I期，而其他研究报告的晚期肿瘤比例更高（7.5-18.5%）。由于交界性卵巢肿瘤更常见于年轻女性，她们的恶性肿瘤不太常见，并且希望保持生育能力，因此她们最初的手术通常是腹腔镜手术。结论：卵巢交界性肿瘤预后良好。在希望保持生育能力的年轻患者中提供了良好的结果。
{"title":"Proceedings of Asociación Aragonesa de Ginecología y Obstetricia (AGOA) 2021 congress","authors":"L. B. Mainar","doi":"10.31083/J.EJGO.2021.03.2021","DOIUrl":"https://doi.org/10.31083/J.EJGO.2021.03.2021","url":null,"abstract":"Marta Lamarca Ballestero*, Leticia Álvarez Sarrado, Javier Navarro Sierra, Yasmina José Gutiérrez, Isabel Negredo Quintana, Miguel Angel Ruiz Conde Department of Gynecology, Miguel Servet University Hospital, Paseo Isabel la Católica 1-3, 50009 Zaragoza, Spain. * m.lamarca@yahoo.es Objectives: To describe the clinical findings, treatment, and outcome of borderline ovarian tumors in 32 premenopausal patients admitted to the Miguel Servet University Hospital over a 17-year period. Methods: Thirty-two premenopausal patients diagnosed and treated from 2003 to 2020 for borderline ovarian tumors were retrospectively evaluated. Results: The 32 borderline included 12 serous, 19 mucinous, and 1 endometrioid tumors, 2 of them were of stage more than I. The average age of the patients was 34.5 years (14–45), 22 were symptomatic, pain being the most frequent symptom (68.8%). 8 patients were operated on primarily by laparoscopy and 24 by laparotomy. In the laparoscopy group, median tumor diameter was smaller (7.5 versus 14.7 cm, p = 0.019) and surgeries were less extensive, without hysterectomy, as compared to the laparotomy group. There were 21 fertility-sparing surgeries, 7 patients attempted a subsequent pregnancy and in 6 cases a pregnancy with a healthy child was obtained (2 using assisted reproductive techniques). During the 7–108 months follow-up time, there were 3 relapses: 2 borderline tumors (treated surgically and desease free) and 1 carcinoma treated with surgery and chemotherapy that ended in death due to cancer. Discussion: In our study, only 6.25% of the borderline tumors were of stage more than I, whereas other studies report a higher proportion of more advanced stages (7.5–18.5%). As borderline ovarian tumors more often arise in young women, in whom malignancy is less common and who wish to preserve their fertility, their initial surgery is often laparoscopy. Conclusions: Borderline ovarian tumors have an excellent prognosis. Good results are provided in young patients wishing to preserve fertility.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46566576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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