Qiuling Wan, Robin Liu, Y. Zou, Yongde Luo, Jiangyan Zhou, Y. Deng, Xin Zeng, G-D Gao, O. Huang
Objectives: Endometriosis is a common gynecological disease affecting up to ~10% of women at reproductive age. Prior combined studies implied that MARVELD2 might be involved in the pathogenesis of certain malignancies. Here, 211 Han Chinese samples with ovarian endometriosis were analyzed for the presence ofMARVELD2 mutations. Methods: We analyze the potential presence ofMARVELD2 mutations by direct DNA sequencing. Results: A total of 7 variants, 5 missense and 2 synonymous variants, were identified in our 211 ovarian endometriosis samples with different frequencies. Among the 5 missense variant, a missense rare variant p.V198M (c.592G>A), was identified in 10 out of our 211 samples (4.74%). This rare variant was identified with extremely low frequency in 766 control samples from 766 Chinese women without endometriosis (0.13%, 1/766) and control samples in the public databases. The evolutionary conservation analysis results suggested that theMARVELD2 rare variant lead to highly conserved amino acid substitutions among 14 vertebrate species from Human to Snake. Furthermore, both the SIFT and Polyphen-2 programs predicted this rare variant to be ‘disease causing’. However, we failed to observe any statistical significance between the MARVELD2 rare variant and the available clinical data. Conclusions: We identified a potential pathogenic rare variant in the MARVELD2 gene in Chinese samples with ovarian endometriosis, indicating theMARVELD2 rare variant might play an active role in the pathogenesis of endometriosis.
{"title":"A rare variant in the MARVELD2 gene is associated with Chinese samples with ovarian endometriosis","authors":"Qiuling Wan, Robin Liu, Y. Zou, Yongde Luo, Jiangyan Zhou, Y. Deng, Xin Zeng, G-D Gao, O. Huang","doi":"10.31083/j.ejgo4301012","DOIUrl":"https://doi.org/10.31083/j.ejgo4301012","url":null,"abstract":"Objectives: Endometriosis is a common gynecological disease affecting up to ~10% of women at reproductive age. Prior combined studies implied that MARVELD2 might be involved in the pathogenesis of certain malignancies. Here, 211 Han Chinese samples with ovarian endometriosis were analyzed for the presence ofMARVELD2 mutations. Methods: We analyze the potential presence ofMARVELD2 mutations by direct DNA sequencing. Results: A total of 7 variants, 5 missense and 2 synonymous variants, were identified in our 211 ovarian endometriosis samples with different frequencies. Among the 5 missense variant, a missense rare variant p.V198M (c.592G>A), was identified in 10 out of our 211 samples (4.74%). This rare variant was identified with extremely low frequency in 766 control samples from 766 Chinese women without endometriosis (0.13%, 1/766) and control samples in the public databases. The evolutionary conservation analysis results suggested that theMARVELD2 rare variant lead to highly conserved amino acid substitutions among 14 vertebrate species from Human to Snake. Furthermore, both the SIFT and Polyphen-2 programs predicted this rare variant to be ‘disease causing’. However, we failed to observe any statistical significance between the MARVELD2 rare variant and the available clinical data. Conclusions: We identified a potential pathogenic rare variant in the MARVELD2 gene in Chinese samples with ovarian endometriosis, indicating theMARVELD2 rare variant might play an active role in the pathogenesis of endometriosis.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47794957","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}
H. Xiong, Tao Yi, Junmei Hu, H. Zeng, Lingjun Liu, Hong-feng Zhou
Objective: To investigate the characteristics and distribution patterns of clinically metastatic nodes assessed by Computed Tomography (CT) in preoperative cervical cancer patients; to address the importance of obturator and/or inguinal lymph nodes as sentinel lymph nodes. Methods: A total of 217 patients with cervical carcinoma treated by lymph node dissection (LND) between 2009 and 2014 were included. All preoperative CT/MRI (Magnetic Resonance Imaging) imaging data of these patients were reviewed. The relationship of patient characteristics age, tumor stages, and corresponding lymph node metastasis status were analyzed. We put emphasis on the distribution pattern of positive lymph nodes from pre-operative imaging and compared the different frequencies of each regional and non-regional lymph node group respectively. The data of the 5-year survival rate from follow-up was taken into consideration too. SPSS 24.0 (IBM Corp., Chicago, IL, USA) was used for statistical analysis. Results: The overall lymph node metastasis (LNM) rate was 92.6% in 217 cases. When regional nodes were involved, obturator groups were concerned in 154 (76.6%). The inguinal group was involved in 146 (72.6%) in the area of non-regional lymph node. The 5-year survival rates of return visits were 92.6% and 82.1% in stage IB and IIA, respectively. Age distribution was not associated with the International Federation of Gynecology and Obstetrics (FIGO) stage as well as the incidence and patterns of nodal metastasis. Conclusions: obturator and inguinal groups play a decisive role in the metastases process of cervical cancer, and can be regarded as a candidate for sentinel lymph nodes.
目的:探讨宫颈癌患者术前CT临床转移淋巴结的特征及分布规律;探讨闭孔淋巴结和/或腹股沟淋巴结作为前哨淋巴结的重要性。方法:选取2009 ~ 2014年行淋巴结清扫术(LND)治疗的宫颈癌患者217例。回顾所有患者术前CT/MRI(磁共振成像)成像资料。分析患者特征、年龄、肿瘤分期及相应淋巴结转移情况的关系。我们重点分析术前影像阳性淋巴结的分布规律，并分别比较各区域和非区域淋巴结组的不同频率。随访的5年生存率也被考虑在内。采用SPSS 24.0 (IBM Corp.， Chicago, IL, USA)进行统计分析。结果:217例患者总淋巴结转移率为92.6%。当局部淋巴结受累时，154例(76.6%)涉及闭孔组。腹股沟组有146例(72.6%)受累于非区域淋巴结。IB期和IIA期复诊5年生存率分别为92.6%和82.1%。年龄分布与国际妇产科联合会(FIGO)分期以及淋巴结转移的发生率和模式无关。结论:闭孔组和腹股沟组在宫颈癌转移过程中起决定性作用，可作为前哨淋巴结的候选者。
{"title":"A survey of lymph node involvement under preoperative medical imaging in cervical cancer patients","authors":"H. Xiong, Tao Yi, Junmei Hu, H. Zeng, Lingjun Liu, Hong-feng Zhou","doi":"10.31083/j.ejgo4301011","DOIUrl":"https://doi.org/10.31083/j.ejgo4301011","url":null,"abstract":"Objective: To investigate the characteristics and distribution patterns of clinically metastatic nodes assessed by Computed Tomography (CT) in preoperative cervical cancer patients; to address the importance of obturator and/or inguinal lymph nodes as sentinel lymph nodes. Methods: A total of 217 patients with cervical carcinoma treated by lymph node dissection (LND) between 2009 and 2014 were included. All preoperative CT/MRI (Magnetic Resonance Imaging) imaging data of these patients were reviewed. The relationship of patient characteristics age, tumor stages, and corresponding lymph node metastasis status were analyzed. We put emphasis on the distribution pattern of positive lymph nodes from pre-operative imaging and compared the different frequencies of each regional and non-regional lymph node group respectively. The data of the 5-year survival rate from follow-up was taken into consideration too. SPSS 24.0 (IBM Corp., Chicago, IL, USA) was used for statistical analysis. Results: The overall lymph node metastasis (LNM) rate was 92.6% in 217 cases. When regional nodes were involved, obturator groups were concerned in 154 (76.6%). The inguinal group was involved in 146 (72.6%) in the area of non-regional lymph node. The 5-year survival rates of return visits were 92.6% and 82.1% in stage IB and IIA, respectively. Age distribution was not associated with the International Federation of Gynecology and Obstetrics (FIGO) stage as well as the incidence and patterns of nodal metastasis. Conclusions: obturator and inguinal groups play a decisive role in the metastases process of cervical cancer, and can be regarded as a candidate for sentinel lymph nodes.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43716675","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}
Mourad Assidi, M. Jafri, M. Abu-Elmagd, S. Saddick, S. Messaoudi, M. Rasool, J. Al-Maghrabi, N. Anfinan, H. Chelbi, M. Sait, Abdelfatteh El Omri, H. Sait, Hussain Basalamah, K. Sait, A. Buhmeida
Objective: Matrix metalloproteinase 2 (MMP2) has been associated with tumor development and invasion; however, the information available regarding its prognostic value in ovarian cancer (OC), especially in the Arabian Peninsula, is limited. The aim of this retrospective study was to analyze MMP2 protein expression and assess its prognostic value. Methods: In total, 245 formalin-fixed and paraffin-embedded (FFPE) primary OC tissue samples were randomly collected from patients with available clinicopathological data, including disease of all stages and all histological subtypes. MMP2 protein expression was measured using automated tissue microarray and immunohistochemistry techniques. Statistical analyses were performed using SPSS, with p < 0.05 considered statistically significant. Results: Cytoplasmic MMP2 protein expression patterns were higher in 53% of all tumor samples. The MMP2 expression profile was not significantly correlated with most clinicopathological features including age, tumor site, size, grade, and lymph node status (p > 0.05). However, when adjusted according to the disease stage or patient age, MMP2 overexpression showed a significant indication of a poor outcome and recurrence as evaluated using univariate Kaplan–Meier analysis for disease-free survival (DFS) (p = 0.04 and p = 0.03, respectively, log-rank test), but not for disease-specific survival (DSS) (p > 0.05, log-rank test). Conclusion: This study showed that MMP2 protein overexpression was a negative prognosticator in Saudi OC patients with advanced stage and/or young age. These results could pave the way towards more effective and personalized detection, prognosis, and management of OC.
{"title":"Prognostic value of matrix metalloproteinase 2 protein expression in ovarian cancer is age- and stage-dependent","authors":"Mourad Assidi, M. Jafri, M. Abu-Elmagd, S. Saddick, S. Messaoudi, M. Rasool, J. Al-Maghrabi, N. Anfinan, H. Chelbi, M. Sait, Abdelfatteh El Omri, H. Sait, Hussain Basalamah, K. Sait, A. Buhmeida","doi":"10.31083/j.ejgo4301010","DOIUrl":"https://doi.org/10.31083/j.ejgo4301010","url":null,"abstract":"Objective: Matrix metalloproteinase 2 (MMP2) has been associated with tumor development and invasion; however, the information available regarding its prognostic value in ovarian cancer (OC), especially in the Arabian Peninsula, is limited. The aim of this retrospective study was to analyze MMP2 protein expression and assess its prognostic value. Methods: In total, 245 formalin-fixed and paraffin-embedded (FFPE) primary OC tissue samples were randomly collected from patients with available clinicopathological data, including disease of all stages and all histological subtypes. MMP2 protein expression was measured using automated tissue microarray and immunohistochemistry techniques. Statistical analyses were performed using SPSS, with p < 0.05 considered statistically significant. Results: Cytoplasmic MMP2 protein expression patterns were higher in 53% of all tumor samples. The MMP2 expression profile was not significantly correlated with most clinicopathological features including age, tumor site, size, grade, and lymph node status (p > 0.05). However, when adjusted according to the disease stage or patient age, MMP2 overexpression showed a significant indication of a poor outcome and recurrence as evaluated using univariate Kaplan–Meier analysis for disease-free survival (DFS) (p = 0.04 and p = 0.03, respectively, log-rank test), but not for disease-specific survival (DSS) (p > 0.05, log-rank test). Conclusion: This study showed that MMP2 protein overexpression was a negative prognosticator in Saudi OC patients with advanced stage and/or young age. These results could pave the way towards more effective and personalized detection, prognosis, and management of OC.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45430771","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}
G. Marino, T. Grassi, G. Di Martino, G. Trezzi, M. Adorni, L. Bazzurini, F. Landoni
Endometrial carcinoma is the most common gynecological cancer in Europe, with 130,000 new cases per year, and the incidence has been rising with aging and increased obesity of the population. Most women with endometrial cancer will present with early-stage disease, with a tumor confined to the uterus and without metastasis, and the first approach is surgery. Approximately 10% to 15% of these patients have a metastatic nodal disease, which is why guidelines have always emphasized the importance of lymphadenectomy to stratify the risk and tailor adjuvant treatment. However, comprehensive lymphadenectomy is related to significant morbidity and seems not to improve either progression-free or overall survival in these patients. Lymphatic mapping with sentinel lymph node biopsy has emerged as an alternative and an optimal compromise instead of systematic lymphadenectomy. This review presents the current evidence supporting sentinel lymph node biopsy in patients with endometrial cancer.
{"title":"Role of sentinel lymph node in endometrial cancer: rationale and surgical aspects, a review of the literature","authors":"G. Marino, T. Grassi, G. Di Martino, G. Trezzi, M. Adorni, L. Bazzurini, F. Landoni","doi":"10.31083/j.ejgo4301014","DOIUrl":"https://doi.org/10.31083/j.ejgo4301014","url":null,"abstract":"Endometrial carcinoma is the most common gynecological cancer in Europe, with 130,000 new cases per year, and the incidence has been rising with aging and increased obesity of the population. Most women with endometrial cancer will present with early-stage disease, with a tumor confined to the uterus and without metastasis, and the first approach is surgery. Approximately 10% to 15% of these patients have a metastatic nodal disease, which is why guidelines have always emphasized the importance of lymphadenectomy to stratify the risk and tailor adjuvant treatment. However, comprehensive lymphadenectomy is related to significant morbidity and seems not to improve either progression-free or overall survival in these patients. Lymphatic mapping with sentinel lymph node biopsy has emerged as an alternative and an optimal compromise instead of systematic lymphadenectomy. This review presents the current evidence supporting sentinel lymph node biopsy in patients with endometrial cancer.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":"1 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42925213","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}
Objective: Huwe1 is critical for promoting the progression of a range of malignancies including ovarian cancer. Still, its role in ovarian cancermetastasis has not been reported. The goal of our studywas to evaluate a correlation betweenHuwe1 and ovarian cancer metastasis. Methods: The mouse ovary surface epithelium (MOSE) cells isolated from Huwe1 mice were identified by flow cytometry assay. Cell migration and invasion were analyzed by transwell system. The molecular mechanism of Huwe1 in ovarian cancer migration and invasion was explored by analyzing the difference of RNAseq data between MOSE-Huwe1-CreER and MOSE-Huwe1-Cre cells. Results: Huwe1 deletion significantly promoted tumor migration and invasion in ovarian cancer cells. Moreover, tumor cells were more frequently detected in the blood when the mice bearing allografts were treated with tamoxifen. Transcriptome analysis indicated that this phenotype may be due to the alteration in cell adhesion caused by the Huwe1 knockout. Conclusion: Huwe1 inactivation promoted ovarian cancer metastasis by the extracellular matrix (ECM) deregulation.
{"title":"Huwe1 inactivation promotes ovarian cancer metastasis by extracellular matrix deregulation","authors":"Fujuan Zhang, Jing Guo, Shuaishuai Yu, Xudong Zhao, Yongxin Ma, Dong Yang","doi":"10.31083/j.ejgo4301013","DOIUrl":"https://doi.org/10.31083/j.ejgo4301013","url":null,"abstract":"Objective: Huwe1 is critical for promoting the progression of a range of malignancies including ovarian cancer. Still, its role in ovarian cancermetastasis has not been reported. The goal of our studywas to evaluate a correlation betweenHuwe1 and ovarian cancer metastasis. Methods: The mouse ovary surface epithelium (MOSE) cells isolated from Huwe1 mice were identified by flow cytometry assay. Cell migration and invasion were analyzed by transwell system. The molecular mechanism of Huwe1 in ovarian cancer migration and invasion was explored by analyzing the difference of RNAseq data between MOSE-Huwe1-CreER and MOSE-Huwe1-Cre cells. Results: Huwe1 deletion significantly promoted tumor migration and invasion in ovarian cancer cells. Moreover, tumor cells were more frequently detected in the blood when the mice bearing allografts were treated with tamoxifen. Transcriptome analysis indicated that this phenotype may be due to the alteration in cell adhesion caused by the Huwe1 knockout. Conclusion: Huwe1 inactivation promoted ovarian cancer metastasis by the extracellular matrix (ECM) deregulation.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48148998","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}
R. Saadeh, Angélique Berthet, Séverine Marchant, François Kraus, Othman Aissaoui, F. Narducci, É. Leblanc, D. Hudry
Objective: To evaluate the morbidity of total parietal peritonectomy (TPP) during cytoreduction surgery, and its impact on the site of recurrence of different peritoneal surface malignancies (PSM). Methods: We led a retrospective study in a French tertiary cancer institution (Centre Oscar Lambret Lille) experienced in treating PSM over a 6-year period from 2012 to 2018. All patients underwent a total parietal peritonectomy during a debulking surgery for PSM including ovarian cancer, appendiceal pseudomyxoma peritonei or peritoneal mesothelioma. Results: Among the 61 patients included in this study, 49 patients(80.3%) had an ovarian cancer. The rate of complete tumor resection reached 86.9% with almost 69% of surgeries being highly complex. 73.8% were transfused during the surgical procedure. The median length of hospital stay was 10 days including 7 days in Intensive Care Unit. Overall, 19 patients (31.1%) had an early postoperative complication, including 3 with a grade IIIB complication of Clavien Dindo classification. With a median follow-up of 30 months, the estimated disease-free survival in the ovarian cancer subgroup who had an initial peritonectomy (n = 42) was 84.7% at 1 year and 12.0% at 3 year. The main site of first and second recurrence was peritoneal (42% and 14%). Conclusion: TPP is a safe surgical procedure to treat peritoneal surface malignancies and their recurrences with a low rate of grade IIIB morbidity and no treatment-related death and allow optimal surgery. In this study there is no atypical recurrence site, such as abdominal muscle involvement.
目的:探讨全腹膜壁切除术(TPP)在细胞减少术中的发病率及其对不同腹膜表面恶性肿瘤(PSM)复发部位的影响。方法:我们在2012年至2018年的6年时间里，在法国一家有治疗PSM经验的三级癌症机构(Centre Oscar Lambret Lille)领导了一项回顾性研究。所有患者在PSM(包括卵巢癌、阑尾假性黏液瘤腹膜或腹膜间皮瘤)减体积手术期间均行全腹膜壁切除术。结果:本研究纳入的61例患者中，49例(80.3%)存在卵巢癌。肿瘤全切率达86.9%，其中近69%的手术高度复杂。73.8%在手术过程中输血。住院时间中位数为10天，其中重症监护室7天。总体而言，19例患者(31.1%)出现术后早期并发症，其中3例为Clavien Dindo分级IIIB级并发症。中位随访时间为30个月，初次行腹膜切除术的卵巢癌亚组(n = 42) 1年和3年的无病生存率分别为84.7%和12.0%。第一次和第二次复发的主要部位为腹膜(分别为42%和14%)。结论:TPP是一种治疗腹膜表面恶性肿瘤及其复发率低、IIIB级发病率低、无治疗相关死亡和最佳手术的安全手术方法。本研究未发现不典型复发部位，如累及腹肌。
{"title":"Total parietal peritonectomy for 61 patients: a retrospective study","authors":"R. Saadeh, Angélique Berthet, Séverine Marchant, François Kraus, Othman Aissaoui, F. Narducci, É. Leblanc, D. Hudry","doi":"10.31083/j.ejgo4301009","DOIUrl":"https://doi.org/10.31083/j.ejgo4301009","url":null,"abstract":"Objective: To evaluate the morbidity of total parietal peritonectomy (TPP) during cytoreduction surgery, and its impact on the site of recurrence of different peritoneal surface malignancies (PSM). Methods: We led a retrospective study in a French tertiary cancer institution (Centre Oscar Lambret Lille) experienced in treating PSM over a 6-year period from 2012 to 2018. All patients underwent a total parietal peritonectomy during a debulking surgery for PSM including ovarian cancer, appendiceal pseudomyxoma peritonei or peritoneal mesothelioma. Results: Among the 61 patients included in this study, 49 patients(80.3%) had an ovarian cancer. The rate of complete tumor resection reached 86.9% with almost 69% of surgeries being highly complex. 73.8% were transfused during the surgical procedure. The median length of hospital stay was 10 days including 7 days in Intensive Care Unit. Overall, 19 patients (31.1%) had an early postoperative complication, including 3 with a grade IIIB complication of Clavien Dindo classification. With a median follow-up of 30 months, the estimated disease-free survival in the ovarian cancer subgroup who had an initial peritonectomy (n = 42) was 84.7% at 1 year and 12.0% at 3 year. The main site of first and second recurrence was peritoneal (42% and 14%). Conclusion: TPP is a safe surgical procedure to treat peritoneal surface malignancies and their recurrences with a low rate of grade IIIB morbidity and no treatment-related death and allow optimal surgery. In this study there is no atypical recurrence site, such as abdominal muscle involvement.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48243324","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}
L. van Wagensveld, G. Sonke, K. K. Van de Vijver, H. Horlings, R. Kruitwagen, M. van der Aa
Objective: Despite optimal treatment with debulking surgery and chemotherapy, the majority of patients with advanced stage epithelial ovarian cancer (EOC) die within five years. Survival beyond eight years is rare and the mechanisms that lead to such favorable outcomes are incompletely understood. We aimed to identify characteristics associated with long-term survival (LTS) in a population-based cohort of patients with advanced stage EOC.Methods: Patients with advanced stage (FIGO IIB-IV) EOC diagnosed between 2008 and 2012 were identified from the Netherlands Cancer Registry. LTS was defined as survival for more than eight years after diagnosis, based on 20% survival within this cohort. Patient, tumor, and treatment characteristics were analyzed using multivariable logistic regression to find predictors for LTS. Results: We identified 2744 eligible patients of whom 571 were long-term survivors (survival longer than eight years). Younger age, lower tumor stage, low-grade histology, FIGO IV based on extra-abdominal lymph node compared to pleural metastasis, primary debulking surgery vs neo-adjuvant chemotherapy followed by interval debulking surgery, residual disease less than one cm or nomacroscopic disease, and ascites less than 100mLwere associated with LTS. Furthermore, less than six chemotherapy cycles compared to six, and carboplatin plus paclitaxel combined with other chemotherapy agents compared to carboplatin plus paclitaxel, were associated with a lower odds of LTS. Conclusion: Characteristics of the tumor, patient and treatment play a substantial role in respect to the prognosis of advanced stage EOC, and can assist in the prediction of LTS.
{"title":"Characteristics of long-term survival in advanced stage ovarian cancer: a nationwide cohort in the Netherlands","authors":"L. van Wagensveld, G. Sonke, K. K. Van de Vijver, H. Horlings, R. Kruitwagen, M. van der Aa","doi":"10.31083/j.ejgo4301007","DOIUrl":"https://doi.org/10.31083/j.ejgo4301007","url":null,"abstract":"Objective: Despite optimal treatment with debulking surgery and chemotherapy, the majority of patients with advanced stage epithelial ovarian cancer (EOC) die within five years. Survival beyond eight years is rare and the mechanisms that lead to such favorable outcomes are incompletely understood. We aimed to identify characteristics associated with long-term survival (LTS) in a population-based cohort of patients with advanced stage EOC.Methods: Patients with advanced stage (FIGO IIB-IV) EOC diagnosed between 2008 and 2012 were identified from the Netherlands Cancer Registry. LTS was defined as survival for more than eight years after diagnosis, based on 20% survival within this cohort. Patient, tumor, and treatment characteristics were analyzed using multivariable logistic regression to find predictors for LTS. Results: We identified 2744 eligible patients of whom 571 were long-term survivors (survival longer than eight years). Younger age, lower tumor stage, low-grade histology, FIGO IV based on extra-abdominal lymph node compared to pleural metastasis, primary debulking surgery vs neo-adjuvant chemotherapy followed by interval debulking surgery, residual disease less than one cm or nomacroscopic disease, and ascites less than 100mLwere associated with LTS. Furthermore, less than six chemotherapy cycles compared to six, and carboplatin plus paclitaxel combined with other chemotherapy agents compared to carboplatin plus paclitaxel, were associated with a lower odds of LTS. Conclusion: Characteristics of the tumor, patient and treatment play a substantial role in respect to the prognosis of advanced stage EOC, and can assist in the prediction of LTS.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44491008","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}
Objective: Cervical cancer is an serious healthcare problem with a high mortality rate. High-risk Human papillomavirus (HPV) genotypes, especially HPV 16, 31, 33, and 18, are the leading cause of cervical cancer and cervical intraepithelial neoplasia. Cervical cancer screening programs, especially ones that are HPV-based, have gained prominence in many countries. Herein, we evaluated the effect of other high-risk (hr) HPV types (HPV 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68) with normal cytology on cervical intraepithelial neoplasia and cancer. Methods: 9015 patients were screened via HPV typing and cytology. 520 patients with high-risk HPV positivity, aged 25–65, and unvaccinated for HPV were included in the study. Patients with high-risk HPV DNA positivity and cytologic abnormality, HPV 16–18 positivity, or with high-risk HPV DNA positivity and normal cytology or with postcoital bleeding and/or suspicious appearance of the cervix underwent colposcopy and colposcopic-directed biopsy. Results: Of the 520 women included in the study, the prevalence of the hr-HPV types is as follows: HPV 16 (29%), HPV 18 (13.7%), other high-risk HPV (43.8%), and HPV 16 or 18 plus other hr-HPV (13.5%). Among patients diagnosed with ≥ CIN2, 36.3% had HPV 16 positivity, 21.8% had HPV 18, 24.2% had other hr-HPV and 17.7% had co-infection with HPV type 16 and 18 and other hr-HPV types. HPV 16 (Odds Ratio (OR) = 3.099, 95% Confidence Interval (CI) = 1.933–4.968), HPV 18 (OR = 4.834, 95% CI = 2.715–8.608), and co-infection with HPV 16 or 18 with other hr-HPV types (OR = 3.324, 95% CI = 1.851–5.969) were statistically significantly associated ≥ CIN2 on biopsy. Among patietns with normal cytology and positive for other hr-HPV types CIN2+ was detected in 10.3% of patients who underwent biopsy, but only 1.5% had CIN3 and no cancers were detected. Conclusion: Consistent with our national screening guidelines, the risk for CIN3+ for women with normal cytology but positive for hr-HPV types other than 16 and 18 is low. Re-testing these patients in one year appears acceptable.
{"title":"The effect of other high-risk HPV types on cervical intraepithelial neoplasia and cancer","authors":"S. Aker, B. Bakırarar, A. Tinelli, F. Ortaç","doi":"10.31083/j.ejgo4301008","DOIUrl":"https://doi.org/10.31083/j.ejgo4301008","url":null,"abstract":"Objective: Cervical cancer is an serious healthcare problem with a high mortality rate. High-risk Human papillomavirus (HPV) genotypes, especially HPV 16, 31, 33, and 18, are the leading cause of cervical cancer and cervical intraepithelial neoplasia. Cervical cancer screening programs, especially ones that are HPV-based, have gained prominence in many countries. Herein, we evaluated the effect of other high-risk (hr) HPV types (HPV 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68) with normal cytology on cervical intraepithelial neoplasia and cancer. Methods: 9015 patients were screened via HPV typing and cytology. 520 patients with high-risk HPV positivity, aged 25–65, and unvaccinated for HPV were included in the study. Patients with high-risk HPV DNA positivity and cytologic abnormality, HPV 16–18 positivity, or with high-risk HPV DNA positivity and normal cytology or with postcoital bleeding and/or suspicious appearance of the cervix underwent colposcopy and colposcopic-directed biopsy. Results: Of the 520 women included in the study, the prevalence of the hr-HPV types is as follows: HPV 16 (29%), HPV 18 (13.7%), other high-risk HPV (43.8%), and HPV 16 or 18 plus other hr-HPV (13.5%). Among patients diagnosed with ≥ CIN2, 36.3% had HPV 16 positivity, 21.8% had HPV 18, 24.2% had other hr-HPV and 17.7% had co-infection with HPV type 16 and 18 and other hr-HPV types. HPV 16 (Odds Ratio (OR) = 3.099, 95% Confidence Interval (CI) = 1.933–4.968), HPV 18 (OR = 4.834, 95% CI = 2.715–8.608), and co-infection with HPV 16 or 18 with other hr-HPV types (OR = 3.324, 95% CI = 1.851–5.969) were statistically significantly associated ≥ CIN2 on biopsy. Among patietns with normal cytology and positive for other hr-HPV types CIN2+ was detected in 10.3% of patients who underwent biopsy, but only 1.5% had CIN3 and no cancers were detected. Conclusion: Consistent with our national screening guidelines, the risk for CIN3+ for women with normal cytology but positive for hr-HPV types other than 16 and 18 is low. Re-testing these patients in one year appears acceptable.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49558261","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}
The incidence of peritoneal recurrence in advanced epithelial ovarian cancer (EOC) is high and could be attributed to the high prevalence of occult disease the persists despite complete cytoreductive surgery (CRS) and systemic chemotherapy. Several therapeutic approaches have been used to address such occult disease. Hyperthermic intraperitoneal chemotherapy (HIPEC) acts on microscopic disease as well as free intraperitoneal cancer cells shed during surgery, thus, reducing the risk of recurrence. Maintenance therapies like Poly ADPRibosyl Polymerase (PARP) inhibitors and the anti-angiogenic agent bevacizumab are used as maintenance therapies to delay recurrence. The most definitive way to eradicate such occult disease completely is resection of the peritoneum. The high preponderance of occult disease in the parietal peritoneum and some regions of the visceral peritoneum has led some surgeons to investigate the role of a total parietal peritonectomy (TPP) performed along with wide resection of the visceral peritoneum as a strategy for addressing occult disease. The mechanism of action differs from that of HIPEC and systemic therapies. It is possible that the benefit of each of these therapies is additive. EOC is a heterogeneous disease with a number of clinicopathological and molecular factors influencing the prognosis. There are likely to be different subgroups of patients that benefit from each of these 4 therapies or a combination of these. In this manuscript, we review the rationale and current evidence for the use of each of these therapies and discuss the potential role of a TPP in light of other
{"title":"Surgical and systemic therapies for addressing occult disease in advanced epithelial ovarian cancer","authors":"A. Bhatt, S. Sinukumar, P. Kammar, S. Mehta","doi":"10.31083/j.ejgo4301005","DOIUrl":"https://doi.org/10.31083/j.ejgo4301005","url":null,"abstract":"The incidence of peritoneal recurrence in advanced epithelial ovarian cancer (EOC) is high and could be attributed to the high prevalence of occult disease the persists despite complete cytoreductive surgery (CRS) and systemic chemotherapy. Several therapeutic approaches have been used to address such occult disease. Hyperthermic intraperitoneal chemotherapy (HIPEC) acts on microscopic disease as well as free intraperitoneal cancer cells shed during surgery, thus, reducing the risk of recurrence. Maintenance therapies like Poly ADPRibosyl Polymerase (PARP) inhibitors and the anti-angiogenic agent bevacizumab are used as maintenance therapies to delay recurrence. The most definitive way to eradicate such occult disease completely is resection of the peritoneum. The high preponderance of occult disease in the parietal peritoneum and some regions of the visceral peritoneum has led some surgeons to investigate the role of a total parietal peritonectomy (TPP) performed along with wide resection of the visceral peritoneum as a strategy for addressing occult disease. The mechanism of action differs from that of HIPEC and systemic therapies. It is possible that the benefit of each of these therapies is additive. EOC is a heterogeneous disease with a number of clinicopathological and molecular factors influencing the prognosis. There are likely to be different subgroups of patients that benefit from each of these 4 therapies or a combination of these. In this manuscript, we review the rationale and current evidence for the use of each of these therapies and discuss the potential role of a TPP in light of other","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49330751","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}
Dong-jin Wu, Lihua Zhang, Nitish Beharee, Li Yang, Yinan Wu, Yingchun Wang, Mengmeng Lv, Jin Lu, Jinhua Wang
Objective: To compare the incidence of ovarian metastasis (OM) in early stage adenocarcinoma (AC) and squamous cell carcinoma (SCC) of the cervix, evaluate the overall survival with ovarian preservation and determine risk factors of OM for early stage AC. Data sources, methods of study selection: We searched the Cochranes database, Embase, and PubMed for publications to November 2020. The articles reporting the incidence, risk factors and overall survival of OM in AC were included. Articles that lacked sufficient data of the odds ratios (ORs) and 95% confidence intervals (CIs) were excluded. A fixed effects model was used to calculate OR and 95% CIs. Eggers test and Funnel plot were used to test the publication bias. Forest plots was used to present and synthesise results. Tabulation, integration and results: In the meta-analysis, the incidence of OM of AC was higher than that of SCC (OR 5.68, 95% CI 4.40–7.32, I = 28.1%) in stage IA-IIB. The incidence of OM was 0% in stage IA, 2.72% in stage IB, 5.95% in stage IIA, and 12.86% in stage IIB AC. Ovarian preservation was not significantly associated with OS (OR 0.53, 95% CI 0.35–0.80, I = 37.8%) in early stage of AC. We found seven risk factors for OM: deep stromal invasion (OR 8.80, 95% CI 3.20–24.23, I = 0%), corpus uteri invasion (OR 6.29, 95% CI 3.36–11.77, I = 21.8%), tumor size>4 cm (OR 3.78, 95% CI 1.86–7.69, I = 30.5%), FIGO stage IIA (OR 3.67, 95% CI 1.98–6.81, I = 0%), FIGO stage IIB (OR 4.31, 95% CI 2.74–6.77, I = 0%), FIGO stage II (OR 3.99, 95% CI 2.49–6.41, I = 0%) and lympho-vascular space invasion (OR 2.90, 95% CI 1.36–6.17, I = 0%). Conclusions: Ovarian preservation is only recommended in stage IA and stage IB AC without risk factors, but not reasonable for stage IIA and IIB AC. Both stage IIA and IIB are risk factors for OM in early stage AC.
目的:比较早期宫颈腺癌(AC)和鳞状细胞癌(SCC)卵巢转移(OM)的发生率，评估保留卵巢的总生存率，确定早期AC卵巢转移的危险因素。数据来源、研究选择方法:我们检索Cochranes数据库、Embase和PubMed，检索截至2020年11月的出版物。纳入了报道AC中OM的发病率、危险因素和总生存率的文章。排除了缺乏足够的比值比(ORs)和95%置信区间(ci)数据的文章。采用固定效应模型计算OR和95% ci。采用Eggers检验和Funnel图检验发表偏倚。森林样地用于呈现和综合结果。表列、整合和结果:在meta分析中，在IA-IIB期，AC的OM发生率高于SCC (OR 5.68, 95% CI 4.40-7.32, I = 28.1%)。卵巢癌在IA期的发生率为0%，IB期为2.72%，IIA期为5.95%，IIB期为12.86%。在AC早期，卵巢保留与OS无显著相关性(OR 0.53, 95% CI 0.35-0.80, I = 37.8%)。我们发现卵巢癌的7个危险因素:深间质浸润(OR 8.80, 95% CI 3.20-24.23, I = 0%)、子宫浸润(OR 6.29, 95% CI 3.36-11.77, I = 21.8%)、肿瘤大小bbbb4 cm (OR 3.78, 95% CI 1.86-7.69, I = 30.5%)、FIGO分期IIA (OR 3.67, 95% CI 1.98-6.81, I = 0%)、FIGO分期IIB (OR 4.31, 95% CI 2.74-6.77, I = 0%)、FIGO分期II (OR 3.99, 95% CI 2.49-6.41, I = 0%)和淋巴血管间隙浸润(OR 2.90, 95% CI 1.36-6.17, I = 0%)。结论:卵巢保留仅在无危险因素的IA期和IB期AC中推荐，而在IIA期和IIB期AC中不合理。IIA期和IIB期都是早期AC发生OM的危险因素。
{"title":"The incidence and risk factors for ovarian metastasis and overall survival with ovarian preservation for early-stage adenocarcinoma of the cervix-A meta-analysis","authors":"Dong-jin Wu, Lihua Zhang, Nitish Beharee, Li Yang, Yinan Wu, Yingchun Wang, Mengmeng Lv, Jin Lu, Jinhua Wang","doi":"10.31083/j.ejgo4301006","DOIUrl":"https://doi.org/10.31083/j.ejgo4301006","url":null,"abstract":"Objective: To compare the incidence of ovarian metastasis (OM) in early stage adenocarcinoma (AC) and squamous cell carcinoma (SCC) of the cervix, evaluate the overall survival with ovarian preservation and determine risk factors of OM for early stage AC. Data sources, methods of study selection: We searched the Cochranes database, Embase, and PubMed for publications to November 2020. The articles reporting the incidence, risk factors and overall survival of OM in AC were included. Articles that lacked sufficient data of the odds ratios (ORs) and 95% confidence intervals (CIs) were excluded. A fixed effects model was used to calculate OR and 95% CIs. Eggers test and Funnel plot were used to test the publication bias. Forest plots was used to present and synthesise results. Tabulation, integration and results: In the meta-analysis, the incidence of OM of AC was higher than that of SCC (OR 5.68, 95% CI 4.40–7.32, I = 28.1%) in stage IA-IIB. The incidence of OM was 0% in stage IA, 2.72% in stage IB, 5.95% in stage IIA, and 12.86% in stage IIB AC. Ovarian preservation was not significantly associated with OS (OR 0.53, 95% CI 0.35–0.80, I = 37.8%) in early stage of AC. We found seven risk factors for OM: deep stromal invasion (OR 8.80, 95% CI 3.20–24.23, I = 0%), corpus uteri invasion (OR 6.29, 95% CI 3.36–11.77, I = 21.8%), tumor size>4 cm (OR 3.78, 95% CI 1.86–7.69, I = 30.5%), FIGO stage IIA (OR 3.67, 95% CI 1.98–6.81, I = 0%), FIGO stage IIB (OR 4.31, 95% CI 2.74–6.77, I = 0%), FIGO stage II (OR 3.99, 95% CI 2.49–6.41, I = 0%) and lympho-vascular space invasion (OR 2.90, 95% CI 1.36–6.17, I = 0%). Conclusions: Ovarian preservation is only recommended in stage IA and stage IB AC without risk factors, but not reasonable for stage IIA and IIB AC. Both stage IIA and IIB are risk factors for OM in early stage AC.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43705388","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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