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1.
Article in English | WPRIM | ID: wpr-764566

ABSTRACT

OBJECTIVE: To investigate the relationship between the precursors of high grade serous ovarian cancer (HGSOC) and the characteristics of patients with a low HGSOC risk in terms of the effects of pregnancy. METHODS: We prospectively examined consecutive cases in which the bilateral fallopian tubes were removed during benign gynecological or obstetric surgery and assessed the relationship between the patient characteristics, including parity and pregnancy, and the incidence of HGSOC precursors. All the fallopian tubes were examined by applying the Sectioning and Extensively Examining the Fimbriated End (SEE-FIM) Protocol. RESULTS: Of the 113 patients enrolled, 67 were gynecological and 46 were obstetric. The p53 signature was identified in 21 patients. No other precursors were identified. In a comparison of the p53 signature-positive and negative groups, parous women and pregnant women were significantly fewer in the p53 signature-positive group (53% vs. 86%, p=0.002, 10% vs. 47%, p=0.001, respectively). Current pregnancy was also associated with a significantly lower incidence of the p53 signature after multivariate adjustment (odds ratio [OR]=0.112; 95% confidence interval [95% CI]=0.017–0.731; p=0.022). Among gynecological patients, parous women were fewer in the p53 signature-positive group on univariate (47% vs. 73%, p=0.047) and multivariate analysis (OR=0.252; 95% CI=0.069–0.911; p=0.036). No other characteristics were associated with p53 signature positivity. CONCLUSIONS: The incidence of the p53 signature was significantly lower in parous women and pregnant women. This decreased incidence of early phase serous carcinogenesis may be one of the possible mechanisms underlying HGSOC risk reduction among parous women.


Subject(s)
Carcinogenesis , Cystadenocarcinoma, Serous , Fallopian Tube Neoplasms , Fallopian Tubes , Female , Humans , Incidence , Multivariate Analysis , Obstetric Surgical Procedures , Ovarian Neoplasms , Parity , Pregnancy , Pregnant Women , Prospective Studies , Risk Reduction Behavior , Tumor Suppressor Protein p53
2.
Rev. méd. hondur ; 86(3/4): 119-122, jul.- dic. 2018. ilus
Article in Spanish | LILACS | ID: biblio-1022264

ABSTRACT

Antecedentes: El cáncer endometrial (CE) según las estadísticas es el tumor ginecológico más frecuente en países desarrollados, donde su incidencia ha ido en aumento. Históricamente, el CE se ha clasificado en dos tipos: Tipo I (endometrioide), representando el 80-90% de los casos; el tipo II (no endometrioide como el de células serosas y claras, carcinomas indiferenciados). Como dato importante, la mayoría de las pacientes son diagnosticadas cuando la enfermedad se encuentra en etapas tempranas o la lesión todavía está confinada al útero. El tratamiento convencional radica en una histerectomía primaria más salpingooforectomía bilateral, según el estadío de la enfermedad. Caso clínico: Paciente de 58 años de edad que ingresa al Hospital de San Marcos, Ocotepeque, con sangrado transvaginal de 1 mes de evolución, hipertensión crónica y obesidad tipo I. En el ultrasonido transvaginal se observó engrosamiento endometrial, pero en la biopsia se diagnosticó Adenocarcinoma Endometrial de tipo Endometroide Grado II-III de la FIGO. Conclusión: Ante la presencia de sangrado uterino anormal en mujeres peri y postmenopáusicas, con factores de riesgos asociados, se debe sospechar cáncer de endometrio...(AU)


Subject(s)
Humans , Female , Middle Aged , Serous Membrane , Carcinoma , Endometrial Neoplasms/diagnosis , Cystadenocarcinoma, Serous
3.
Acta cir. bras ; 33(7): 641-650, July 2018. tab, graf
Article in English | LILACS | ID: biblio-949369

ABSTRACT

Abstract Purpose: To investigate the place of the transcription factor nuclear kappa B (NF-kB), which is a marker of chronic inflammation, in the etiology of the ovarian carcinoma. Methods: NFkB analysis with the immunohistochemical method has been performed. To evaluate immunohistochemical NF-kB expression in the ovarian tissue, the H-score method. H-score = ∑ Pi (i+1), where ''Pi'' is the percentage of stained cells in each intensity category (0-100%) and ''i'' is the intensity indicating weak (i=1), moderate (i=2) or strong staining (i=3). Results: It has been seen that, the mean H score is statistically significantly higher in the patient group with serous and musinous adenocarcinoma diagnosis than the two other patient groups (p<0.005). Conclusions: Factor nuclear kappa B is an important mediator that acts in the chronic inflammation. The highest expression rates are determined by the immunohistochemical method in the ovarian cancer group.


Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Ovarian Neoplasms/etiology , Ovarian Neoplasms/pathology , NF-kappa B/analysis , Cystadenoma, Serous/etiology , Cystadenoma, Serous/pathology , Cystadenocarcinoma, Serous/etiology , Cystadenocarcinoma, Serous/pathology , Ovarian Neoplasms/diagnosis , Ovary/pathology , Reference Values , Immunohistochemistry , Biomarkers, Tumor/analysis , Analysis of Variance , Cystadenoma, Serous/diagnosis , Cystadenocarcinoma, Serous/diagnosis , Statistics, Nonparametric
4.
Rev. chil. obstet. ginecol. (En línea) ; 83(4): 394-401, 2018. ilus
Article in Spanish | LILACS | ID: biblio-978111

ABSTRACT

RESUMEN El cáncer sincrónico endometrial y ovárico (SEOC) representa alrededor de un 5-10% de las neoplasias de endometrio y ovario. Cuando no existe extensión locorregional y presentan un patrón histológico de bajo grado, actúan como si fueran dos tumores primarios independientes, en lugar de comportarse como un cáncer en estadio avanzado. Los mecanismos para diferenciar si su origen es metastásico o por el contrario, son tumores primarios independientes conlleva una gran dificultad y ha generado una importante controversia dentro del estudio de este tipo de neoplasias. En este artículo, exponemos el caso clínico de una paciente de 46 años que presenta un tumor sincrónico de endometrio y ovario en estadio IA, desconocido hasta el estudio histológico de la pieza quirúrgica.


ABSTRACT Endometrial and ovarian synchronous cancer (SEOC) accounts for about 5-10% of endometrial and ovarian neoplasms. When there is no local extension and they present a low-grade histological pattern, they act as if they were two independent primary tumours, instead of behaving as an advanced stage cancer. Therefore, the differentiation of its origin (metastatic or independent primary tumours) is fraught with difficulty and has generated a significant controversy in the study of this type of neoplasms. In this article, we present the clinical case of a 46-year-old patient presenting a synchronous tumor of the endometrium and ovary in IA stage, unknown until the histological study of the surgical sample.


Subject(s)
Humans , Female , Middle Aged , Ovarian Neoplasms/diagnosis , Adenocarcinoma, Papillary/diagnosis , Endometrial Neoplasms/diagnosis , Carcinoma, Endometrioid/diagnostic imaging , Adenocarcinoma, Papillary/pathology , Endometrial Neoplasms/pathology , Cystadenocarcinoma, Serous/diagnosis , Adenocarcinoma, Clear Cell , Neoplasms, Multiple Primary
5.
São Paulo; s.n; 2018. 110 p. figuras.
Thesis in Portuguese | LILACS, Inca | ID: biblio-1099811

ABSTRACT

Introdução: O tratamento do câncer epitelial de ovário é baseado na combinação de cirurgia e quimioterapia (principalmente carboplatina e paclitaxel). Embora o tratamento seja eficiente em 80% dos casos, a taxa de sobrevida de 5 anos é baixa devido à alta taxa de recorrência e resistência ao tratamento medicamentoso. Os processos moleculares que influenciam na resposta terapêutica e mecanismos que acarretam na sobrevida das pacientes ainda não são completamente compreendidos, e por este motivo, torna-se necessário a identificação de moléculas que possibilitem a melhor compreensão. Muitos estudos relatam a importância dos miRNAs no desenvolvimento e progressão do câncer de ovário, entretanto, tendo em vista a heterogeneidade do câncer ovariano, este estudo se diferencia por selecionar uma casuística clinicamente homogênea. Neste contexto, o objetivo do presente estudo foi caracterizar o perfil da expressão de miRNAs em amostras clinicamente homogêneas de adenocarcinoma seroso de alto grau, a fim de identificar miRNAs que estão envolvidos no processo de resistência ao tratamento quimioterápico e capazes de diferenciar pacientes com distintas evoluções clínicas. Metodologia: Foram selecionadas trinta e três amostras de adenocarcinoma seroso de ovário de alto grau, provenientes do banco de tumores do A.C.Camargo Cancer Center, oriundas de cirurgia com ressecção ótima cujas pacientes tinham estadiamento III e passaram por acompanhamento clínico mínimo de 2 anos. Destas 25 amostras foram provenientes de tumor primário, 8 de metástases primárias pareadas de pacientes que apresentaram recidiva e 5 amostras de epitélio de tuba de falópio de pacientes sem histórico de câncer como controle normal. A identificação dos miRNAs diferencialmente expressos nas pacientes com distintos desfechos clínicos foi realizada através da plataforma de larga escala de expressão de miRNAs humanos (G4870A ­ ID 031181; 8x60K, Agilent Tecnologies). As probes foram filtradas e normalizadas utilizando o software BRB ArrayTool (v. 4.4.0). Os alvos foram preditos usando miRWalk 2.0 (http://www.umm.uni-heidelberg.de/apps/zmf/mirwalk/custom.html), em quatr diferentes algoritmos (miRWalk, RNA22, miRanda and Targetscan). Para a análise do perfil entre miRNAs e transcritos codificadores, 415 amostras foram obtidas do The Cancer Genome Atlas (TCGA) (http://tcga-data.nci.nih.gov/tcga/) e essa interação foi submetida a um teste de correlação de Pearson. Os miRNAs diferencialmente expressos em diferentes desfechos clínicos foram validados pela técnica de in situ hybridization (ISH) em 114 amostras de adenocarcinoma seroso de alto grau incluídas no TMA proveniente do departamento de Anatomina Patologica do Hospital AC Camargo e em diferentes amostras provenientes do TCGA. Os alvos dos miRNAs validados foram associados a sobrevida global e livre de doença em amostras do TCGA e confirmados em amostras contidas no TMA da casuística interna através da técnica de Imuno-histoquímica. Resultados: A análise de comparação da expressão diferencial de miRNAs entre controle normal e de seroso de alto grau seroso demonstrou que 365 miRNAs foram diferencialmente expressos e foram encontradas 613 interações inversamente correlacionadas. Os miRNAs miR-934 e miR-143 foram associados a pior sobrevida global em nossa casuística, o miR-503-5p com resistência a quimioterapia. Apenas o miR-934 foi validado no TCGA e pela técnica de ISH. O alvo FZD3 foi predito para o miR-934 e miR-143 e foi negativamente correlacionado com ambos miRNAs em células tumorais de ovário. A expressão da proteína FZD3 por imuno-histoquímica demonstrou que esse receptor não foi expresso na membrana celular e sim no citoplasma e núcleo nos tumores de alto grau seroso. Conclusão: Diversos miRNAs tem participação na progressão do tumor de ovário. O miR-934 foi encontrado aumentado nas amostras metastática e em tumores primários e foi associado a pior sobrevida global, bem como o aumento citoplasmático de FZD3, alvo do miR-934, contudo este não foi associado a expressão de Beta-catenina. Sugere-se assim que outras vias de sinalização possam estar envolvidas neste contexto (AU)


Introduction: The treatment of epithelial ovarian cancer is based on the combination of surgery and chemotherapy (mainly carboplatin and Plactaxel). Although treatment is effective in 80% of cases, the 5 year survival rate is low due to the high recurrence rate and drug treatment resistance. The molecular processes that influence the therapeutic response and mechanisms that lead to the patient's survival are not yet fully understood, and for this reason, it becomes necessary to identify molecules that allow the best understanding. Many studies report the importance of miRNAs in the development and progression of ovarian cancer, however, in view of the heterogeneity of ovarian cancer, this study differs by selecting a clinically homogeneous casuistic. In this context, the objective of the present study was to characterize the profile of the expression of miRNAs in clinically homogeneous samples of high-grade serous adenocarcinoma, in order to identify miRNAs that are involved in the process of resistance to chemotherapic treatment and able to differentiate patients with different clinical developments. Methodology: A total of 33 specimens of high-grade ovary adenocarcinoma were selected from the tumor Bank of the A C Camargo Cancer Center, extracted from surgery with optimal resection whose patients had staging III and passed through clinical accompaniment of at least 2 years. Of these 25 samples were derived from primary tumor, 8 from primary metastasis of relapsed patients (paired) and 5 samples from fallopian epithelium tube of patients with no history of cancer as normal control. The identification of MiRNAs differentially expressed in patients with different clinical outturns was performed through the large-scale human miRNAs expression platform (G4870A ­ ID 031181; 8x60K, Agilent Technologies). The probes have been filtered and normalized using the BRB ArrayTool Software (v. 4.4.0). The targets were predicted using MiRWalk 2.0 (http://www.umm.uni-heidelberg.de/apps/zmf/mirwalk/custom.html), in four different algorithms (MiRWalk, RNA22, MiRanda and Targetscan). For the profile analysis between MiRNAs and transcribed coders, 415 samples were obtained from the Cancer Genome Atlas (TCGA) (http://tcga-data.nci.nih.gov/tcga/) and this interaction was subjected to a Pearson correlation test. The MiRNAs differentially expressed in different clinical outcomes were validated by the in situ hybridization (ISH) technique in 114 samples of high-grade serous adenocarcinoma included in the TMA from the Department of Anatomina Patologica A.C.Camargo Hospital and in different samples from the TCGA. The targets of the validated miRNAs were associated with global survival and disease-free in samples of the TCGA and confirmed in samples contained in the TMA of the internal casuistic through the technique of Imunohistoquimica. Results: The comparison analysis between normal control and high degree serous demonstrated that 365 miRNAs were differentially expressed and were found 613 interactions inversely correlated. The MiRNAs mir-934 and mir-143 were associated with worse global survival in our casuistic, the mir-503-5p with chemotherapy resistance. Only the MiR-934 was validated in TCGA and ISH technique. The FZD3 target was predicted for the mir-934 and mir-143 and was negatively correlated with both miRNAs in ovarian tumor cells. The expression of the FZD3 protein by Imunohistoquimica demonstrated that this receptor was not expressed in the cellular membrane but in the cytoplasm and nucleus in the high-degree serous tumors. Conclusion: Several miRNAs have participation in the ovarian tumor progression. The mir-934 was found increased in the metastatic samples and in primary tumors and was associated with worse global survival, as well as the cytoplasmic increase of FZD3, target of the MiR-934, however this was not associated with the expression of Beta-catenin. It is suggested, thus, that other pathways may be involved in this context (AU)


Subject(s)
Ovarian Neoplasms , Recurrence , Cystadenocarcinoma, Serous , MicroRNAs , Drug Therapy, Combination , Clinical Evolution
6.
São Paulo; s.n; 2018. 110 p. figuras.
Thesis in Portuguese | LILACS, Inca | ID: biblio-1099982

ABSTRACT

Introdução: O tratamento do câncer epitelial de ovário é baseado na combinação de cirurgia e quimioterapia (principalmente carboplatina e paclitaxel). Embora o tratamento seja eficiente em 80% dos casos, a taxa de sobrevida de 5 anos é baixa devido à alta taxa de recorrência e resistência ao tratamento medicamentoso. Os processos moleculares que influenciam na resposta terapêutica e mecanismos que acarretam na sobrevida das pacientes ainda não são completamente compreendidos, e por este motivo, torna-se necessário a identificação de moléculas que possibilitem a melhor compreensão. Muitos estudos relatam a importância dos miRNAs no desenvolvimento e progressão do câncer de ovário, entretanto, tendo em vista a heterogeneidade do câncer ovariano, este estudo se diferencia por selecionar uma casuística clinicamente homogênea. Neste contexto, o objetivo do presente estudo foi caracterizar o perfil da expressão de miRNAs em amostras clinicamente homogêneas de adenocarcinoma seroso de alto grau, a fim de identificar miRNAs que estão envolvidos no processo de resistência ao tratamento quimioterápico e capazes de diferenciar pacientes com distintas evoluções clínicas. Metodologia: Foram selecionadas trinta e três amostras de adenocarcinoma seroso de ovário de alto grau, provenientes do banco de tumores do A.C.Camargo Cancer Center, oriundas de cirurgia com ressecção ótima cujas pacientes tinham estadiamento III e passaram por acompanhamento clínico mínimo de 2 anos. Destas 25 amostras foram provenientes de tumor primário, 8 de metástases primárias pareadas de pacientes que apresentaram recidiva e 5 amostras de epitélio de tuba de falópio de pacientes sem histórico de câncer como controle normal. A identificação dos miRNAs diferencialmente expressos nas pacientes com distintos desfechos clínicos foi realizada através da plataforma de larga escala de expressão de miRNAs humanos (G4870A ­ ID 031181; 8x60K, Agilent Tecnologies). As probes foram filtradas e normalizadas utilizando o software BRB ArrayTool (v. 4.4.0). Os alvos foram preditos usando miRWalk 2.0 (http://www.umm.uni-heidelberg.de/apps/zmf/mirwalk/custom.html), em quatr diferentes algoritmos (miRWalk, RNA22, miRanda and Targetscan). Para a análise do perfil entre miRNAs e transcritos codificadores, 415 amostras foram obtidas do The Cancer Genome Atlas (TCGA) (http://tcga-data.nci.nih.gov/tcga/) e essa interação foi submetida a um teste de correlação de Pearson. Os miRNAs diferencialmente expressos em diferentes desfechos clínicos foram validados pela técnica de in situ hybridization (ISH) em 114 amostras de adenocarcinoma seroso de alto grau incluídas no TMA proveniente do departamento de Anatomina Patologica do Hospital AC Camargo e em diferentes amostras provenientes do TCGA. Os alvos dos miRNAs validados foram associados a sobrevida global e livre de doença em amostras do TCGA e confirmados em amostras contidas no TMA da casuística interna através da técnica de Imuno-histoquímica. Resultados: A análise de comparação da expressão diferencial de miRNAs entre controle normal e de seroso de alto grau seroso demonstrou que 365 miRNAs foram diferencialmente expressos e foram encontradas 613 interações inversamente correlacionadas. Os miRNAs miR-934 e miR-143 foram associados a pior sobrevida global em nossa casuística, o miR-503-5p com resistência a quimioterapia. Apenas o miR-934 foi validado no TCGA e pela técnica de ISH. O alvo FZD3 foi predito para o miR-934 e miR-143 e foi negativamente correlacionado com ambos miRNAs em células tumorais de ovário. A expressão da proteína FZD3 por imuno-histoquímica demonstrou que esse receptor não foi expresso na membrana celular e sim no citoplasma e núcleo nos tumores de alto grau seroso. Conclusão: Diversos miRNAs tem participação na progressão do tumor de ovário. O miR-934 foi encontrado aumentado nas amostras metastática e em tumores primários e foi associado a pior sobrevida global, bem como o aumento citoplasmático de FZD3, alvo do miR-934, contudo este não foi associado a expressão de Beta-catenina. Sugere-se assim que outras vias de sinalização possam estar envolvidas neste contexto


Introduction: The treatment of epithelial ovarian cancer is based on the combination of surgery and chemotherapy (mainly carboplatin and Plactaxel). Although treatment is effective in 80% of cases, the 5 year survival rate is low due to the high recurrence rate and drug treatment resistance. The molecular processes that influence the therapeutic response and mechanisms that lead to the patient's survival are not yet fully understood, and for this reason, it becomes necessary to identify molecules that allow the best understanding. Many studies report the importance of miRNAs in the development and progression of ovarian cancer, however, in view of the heterogeneity of ovarian cancer, this study differs by selecting a clinically homogeneous casuistic. In this context, the objective of the present study was to characterize the profile of the expression of miRNAs in clinically homogeneous samples of high-grade serous adenocarcinoma, in order to identify miRNAs that are involved in the process of resistance to chemotherapic treatment and able to differentiate patients with different clinical developments. Methodology: A total of 33 specimens of high-grade ovary adenocarcinoma were selected from the tumor Bank of the A C Camargo Cancer Center, extracted from surgery with optimal resection whose patients had staging III and passed through clinical accompaniment of at least 2 years. Of these 25 samples were derived from primary tumor, 8 from primary metastasis of relapsed patients (paired) and 5 samples from fallopian epithelium tube of patients with no history of cancer as normal control. The identification of MiRNAs differentially expressed in patients with different clinical outturns was performed through the large-scale human miRNAs expression platform (G4870A ­ ID 031181; 8x60K, Agilent Technologies). The probes have been filtered and normalized using the BRB ArrayTool Software (v. 4.4.0). The targets were predicted using MiRWalk 2.0 (http://www.umm.uni-heidelberg.de/apps/zmf/mirwalk/custom.html), in four different algorithms (MiRWalk, RNA22, MiRanda and Targetscan). For the profile analysis between MiRNAs and transcribed coders, 415 samples were obtained from the Cancer Genome Atlas (TCGA) (http://tcga-data.nci.nih.gov/tcga/) and this interaction was subjected to a Pearson correlation test. The MiRNAs differentially expressed in different clinical outcomes were validated by the in situ hybridization (ISH) technique in 114 samples of high-grade serous adenocarcinoma included in the TMA from the Department of Anatomina Patologica A.C.Camargo Hospital and in different samples from the TCGA. The targets of the validated miRNAs were associated with global survival and disease-free in samples of the TCGA and confirmed in samples contained in the TMA of the internal casuistic through the technique of Imunohistoquimica. Results: The comparison analysis between normal control and high degree serous demonstrated that 365 miRNAs were differentially expressed and were found 613 interactions inversely correlated. The MiRNAs mir-934 and mir-143 were associated with worse global survival in our casuistic, the mir-503-5p with chemotherapy resistance. Only the MiR-934 was validated in TCGA and ISH technique. The FZD3 target was predicted for the mir-934 and mir-143 and was negatively correlated with both miRNAs in ovarian tumor cells. The expression of the FZD3 protein by Imunohistoquimica demonstrated that this receptor was not expressed in the cellular membrane but in the cytoplasm and nucleus in the high-degree serous tumors. Conclusion: Several miRNAs have participation in the ovarian tumor progression. The mir-934 was found increased in the metastatic samples and in primary tumors and was associated with worse global survival, as well as the cytoplasmic increase of FZD3, target of the MiR-934, however this was not associated with the expression of Beta-catenin. It is suggested, thus, that other pathways may be involved in this context


Subject(s)
Humans , Ovarian Neoplasms , Recurrence , Clinical Evolution , Cystadenocarcinoma, Serous , MicroRNAs , Drug Therapy, Combination
7.
Chinese Medical Journal ; (24): 280-287, 2017.
Article in English | WPRIM | ID: wpr-303159

ABSTRACT

<p><b>BACKGROUND</b>Ovarian serous adenocarcinoma can be divided into low- and high-grade tumors, which exhibit substantial differences in pathogenesis, clinicopathology, and prognosis. This study aimed to investigate the differences in the PH domain leucine-rich repeat protein phosphatase (PHLPP), forkhead homeobox type O 3a (FoxO3a), and RAD51 protein expressions, and their associations with prognosis in patients with low- and high-grade ovarian serous adenocarcinomas.</p><p><b>METHODS</b>The PHLPP, FoxO3a, and RAD51 protein expressions were examined in 94 high- and 26 low-grade ovarian serous adenocarcinomas by immunohistochemistry. The differences in expression and their relationships with pathological features and prognosis were analyzed.</p><p><b>RESULTS</b>In high-grade serous adenocarcinomas, the positive rates of PHLPP and FoxO3a were 24.5% and 26.6%, while in low-grade tumors, they were 23.1% and 26.9%, respectively (P < 0.05 vs. the control specimens; low- vs. high-grade: P > 0.05). The positive rates of RAD51 were 70.2% and 65.4% in high- and low-grade serous adenocarcinomas, respectively (P < 0.05 vs. the control specimens; low- vs. high-grade: P > 0.05). Meanwhile, in high-grade tumors, Stage III/IV tumors and lymph node and omental metastases were significantly associated with lower PHLPP and FoxO3a and higher RAD51 expression. The 5-year survival rates of patients with PHLPP- and FoxO3a-positive high-grade tumors (43.5% and 36.0%) were significantly higher than in patients with PHLPP-negative tumors (5.6% and 7.2%, respectively; P< 0.05). Similarly, the 5-year survival rate of RAD51-positive patients (3.0%) was significantly lower than in negative patients (42.9%; P< 0.05). In low-grade tumors, the PHLPP, FoxO3a, and RAD51 expressions were not significantly correlated with lymph node metastasis, omental metastasis, Federation of Gynecology and Obstetrics stage, or prognosis.</p><p><b>CONCLUSIONS</b>Abnormal PHLPP, FoxO3a, and RAD51 protein expressions may be involved in the development of high- and low-grade ovarian serous adenocarcinomas, suggesting common molecular pathways. Decreased PHLPP and FoxO3a and increased RAD51 protein expression may be important molecular markers for poor prognosis, and RAD51 may be an independent prognosis factor, of high-grade, but not low-grade, ovarian serous adenocarcinomas.</p>


Subject(s)
Adult , Aged , Biomarkers, Tumor , Metabolism , Cystadenocarcinoma, Serous , Metabolism , Pathology , Female , Forkhead Box Protein O3 , Metabolism , Humans , Immunohistochemistry , Lymphatic Metastasis , Middle Aged , Neoplasm Staging , Nuclear Proteins , Metabolism , Ovarian Neoplasms , Metabolism , Pathology , Phosphoprotein Phosphatases , Metabolism , Prognosis , Rad51 Recombinase , Metabolism
8.
Rev. chil. obstet. ginecol ; 81(6): 507-510, dic. 2016. tab
Article in Spanish | LILACS | ID: biblio-844524

ABSTRACT

La hiponatremia es la alteración electrolítica más frecuente en el medio hospitalario, y en un 30% de los casos se debe a un síndrome de secreción inapropiada de vasopresina (SIADH). El SIADH está descrito como cuadro paraneoplásico endocrinológico en múltiples tumores, entre los que excepcionalmente se encuentra el de ovario y las neoplasias ginecológicas en general. Presentamos un caso de SIADH paraneoplásico por un citoadenocarcinoma seroso de ovario de alto grado, estadio IV. Se trata del primer caso de SIADH crónico por cáncer de ovario tratado con Tolvaptán. En el presente caso el objetivo de eunatremia se alcanzó con una dosis baja de acuarético, lo que apoya la elevada sensibilidad, ya previamente documentada, de los SIADH tumorales al tratamiento con Tolvaptán.


Hyponatremia is the most common electrolyte disturbance in hospitals, and 30% of cases are due to syndrome of inappropriate secretion of antidiuretic hormone (SIADH). SIADH is described as an endocrine paraneoplastic syndrome in multiple tumors including, ovary and gynecological malignancies in general, although these are exceptional. We report a case of paraneoplastic SIADH for high-grade serous ovarian cystoadenocarcinoma stage IV. This is the first case of chronic SIADH for ovarian cancer treated with Tolvaptan. In this case the target of eunatremia was reached with a low dose of aquaretic, which supports the high sensitivity, as previously documented, of paraneoplasic SIADH to Tolvaptan.


Subject(s)
Humans , Female , Adult , Benzazepines/therapeutic use , Hyponatremia/drug therapy , Inappropriate ADH Syndrome/complications , Inappropriate ADH Syndrome/drug therapy , Antidiuretic Hormone Receptor Antagonists/therapeutic use , Cystadenocarcinoma, Serous/complications , Hyponatremia/etiology , Ovarian Neoplasms/complications
9.
Yonsei Medical Journal ; : 872-878, 2016.
Article in English | WPRIM | ID: wpr-63338

ABSTRACT

PURPOSE: Lymphatic invasion (LI) is regarded as a predictor of the aggressiveness of ovarian cancer (OC). However, LI is not always the major determinant of long-term patient survival. To establish proper diagnosis and treatment for OC, we analyzed differentially expressed genes (DEGs) for patients with serous epithelial OC, with or without LI, who did or did not survive for 5 years. MATERIALS AND METHODS: Gene expression data from 63 patients with OC and LI, and 35 patients with OC but without LI, were investigated using an Affymetrix Human Genome U133 Array and analyzed using The Cancer Genome Atlas (TCGA) database. Among these 98 patients, 16 survived for 5 years or more. DEGs were identified using the Bioconductor R package, and their functions were analyzed using the DAVID web tool. RESULTS: We found 55 significant DEGs (p<0.01) from the patients with LI and 20 highly significant DEGs (p<0.001) from those without it. Pathway analysis showed that DEGs associated with carbohydrate metabolism or with renal cell carcinoma pathways were enriched in the patients with and without LI, respectively. Using the top five prognostic marker genes, we generated survival scores that could be used to predict the 5-year survival of patients with OC without LI. CONCLUSION: The DEGs identified in this study could be used to elucidate the mechanism of tumor progression and to guide the prognosis and treatment of patients with serous OC but without LI.


Subject(s)
Cystadenocarcinoma, Serous/genetics , Databases, Genetic , Female , Gene Expression Regulation, Neoplastic , Humans , Microarray Analysis , Middle Aged , Ovarian Neoplasms/genetics , Prognosis , Regression Analysis , Retrospective Studies , Survival Rate
11.
Chinese Medical Journal ; (24): 1316-1321, 2016.
Article in English | WPRIM | ID: wpr-290078

ABSTRACT

<p><b>BACKGROUND</b>Ovarian cancer is the most common cause of gynecological cancer-associated death. Iatrogenic menopause might adversely affect the quality of life and health outcomes in young female cancer survivors. We evaluated whether postoperative hormone replacement therapy (HRT) had a negative influence on the progression-free survival (PFS) of patients with papillary serous ovarian cancer (SOC).</p><p><b>METHODS</b>We retrospectively reviewed the medical records of patients with papillary SOC, treated from January 1980 to December 2009, who suffered from menopause with or without HRT. Clinical characteristics of patients were compared between the two groups (HRT and non-HRT). Blood samples were collected from all the participants to detect serum cancer antigen (CA) 125. Hazard ratios with 95% confidential intervals for each variable were calculated by univariable and multivariable conditional Logistic regression analyses.</p><p><b>RESULTS</b>Among 112 identified patients, 31 were HRT users and 81 were not. The two groups did not significantly differ in median age at diagnosis (t = 0.652, P = 0.513), International Federation of Gynecology and Obstetrics (FIGO) stage (χ2 = 0.565, P = 0.754), differentiation (χ2 = 1.728, P = 0.422), resection status (χ2 = 0.070, P = 0.791), relapse (χ2 = 0.109, P = 0.741), chemotherapy course (t = -1.079, P = 0.282), follow-up interval (t = 0.878, P = 0.382), or PFS (t = 0.580, P = 0.562). Median Kupperman score at the onset of HRT was 30.81 and 12.19 after the therapy (t = 3.302, P = 0.001). According to the analysis, the strongest independent variables in predicting PFS were FIGO stage and disease that was not optimally debulked.</p><p><b>CONCLUSIONS</b>Postoperative HRT is not a prognostic factor for PFS of patients with papillary SOC. However, multicenter studies are needed to verify and extend our findings.</p>


Subject(s)
Adult , CA-125 Antigen , Blood , Cystadenocarcinoma, Serous , Blood , Drug Therapy , General Surgery , Disease-Free Survival , Female , Hormone Replacement Therapy , Methods , Humans , Membrane Proteins , Blood , Middle Aged , Ovarian Neoplasms , Blood , Drug Therapy , General Surgery , Prognosis , Proportional Hazards Models , Retrospective Studies , Young Adult
12.
Article in Chinese | WPRIM | ID: wpr-289886

ABSTRACT

<p><b>OBJECTIVE</b>To study the expression of P53 protein in the advanced ovarian serous adenocarcinoma and explore its potential correlation with the clinicopathological features and prognosis of ovarian cancer.</p><p><b>METHODS</b>The immunohistochemical staining was used to detect the expression of P53 protein in 183 patients with advanced ovarian serous adenocarcinoma. The correlation of P53 protein with the clinicopathological features and its significance in the assessment of prognosis were explored.</p><p><b>RESULTS</b>The P53 protein expression was positive in 62.8% of the patients. Chi-square test showed that the overexpression of P53 protein was positively correlated with the elevation of serum CA125 and the two-tier grading of ovarian serous adenocarcinoma (P<0.001, P=0.038). Univariate analysis suggested that the prognosis of patients was associated with two-tier grading (P=0.007), lymph node metastasis (P=0.036), preoperative serum CA125 level (P=0.002), and P53 overexpression (P<0.001). Multivariate analysis showed that the International Federation of Gynecology and Obstetrics stage (P=0.038), lymph node metastasis (P=0.002), and overexpression of P53 (P=0.001) were independent prognostic factors.</p><p><b>CONCLUSION</b>The P53 protein expression is closely related to the prognosis of advanced ovarian serous adenocarcinoma and can be used as an important indicator for predicting the prognosis.</p>


Subject(s)
CA-125 Antigen , Blood , Cystadenocarcinoma, Serous , Metabolism , Pathology , Female , Humans , Lymphatic Metastasis , Membrane Proteins , Blood , Neoplasm Grading , Neoplasm Staging , Neoplasms, Glandular and Epithelial , Metabolism , Pathology , Ovarian Neoplasms , Metabolism , Pathology , Prognosis , Tumor Suppressor Protein p53 , Metabolism
13.
Article in English | WPRIM | ID: wpr-21469

ABSTRACT

OBJECTIVE: We aimed to evaluate the prognostic and predictive value of the nucleotide excision repair-related gene GTF2H5, which is localized at the 6q24.2-26 deletion previously reported by our group to predict longer survival of high-grade serous ovarian cancer patients. METHODS: In order to test if protein levels of GTF2H5 are associated with patients' outcome, we performed GTF2H5 immunohistochemical staining in 139 high-grade serous ovarian carcinomas included in tissue microarrays. Upon stratification of cases into high- and low-GTF2H5 staining categories (> and < or = median staining, respectively) Kaplan-Meier and log-rank test were used to estimate patients' survival and assess statistical differences. We also evaluated the association of GTF2H5 with survival at the transcriptional level by using the on-line Kaplan-Meier plotter tool, which includes gene expression and survival data of 855 high-grade serous ovarian cancer patients from 13 different datasets. Finally, we determined whether stable short hairpin RNA-mediated GTF2H5 downregulation modulates cisplatin sensitivity in the SKOV3 and COV504 cell lines by using cytotoxicity assays. RESULTS: Low expression of GTF2H5 was associated with longer 5-year survival of patients at the protein (hazard ratio [HR], 0.52; 95% CI, 0.29 to 0.93; p=0.024) and transcriptional level (HR, 0.80; 95% CI, 0.65 to 0.97; p=0.023) in high-grade serous ovarian cancer patients. We confirmed the association with 5-year overall survival (HR, 0.55; 95% CI, 0.38 to 0.78; p=0.0007) and also found an association with progression-free survival (HR, 0.72; 95% CI, 0.54 to 0.96; p=0.026) in a homogenous group of 388 high-stage (stages III-IV using the International Federation of Gynecology and Obstetrics staging system), optimally debulked high-grade serous ovarian cancer patients. GTF2H5-silencing induced a decrease of the half maximal inhibitory concentration upon cisplatin treatment in GTF2H5-silenced ovarian cancer cells. CONCLUSION: Low levels of GTF2H5 are associated with enhanced prognosis in high-grade serous ovarian cancer patients and may contribute to cisplatin sensitization.


Subject(s)
Adult , Aged , Aged, 80 and over , Biomarkers, Tumor/biosynthesis , Cystadenocarcinoma, Serous/genetics , Female , Gene Expression Regulation, Neoplastic , Humans , Kaplan-Meier Estimate , Middle Aged , Neoplasm Grading , Neoplasm Proteins/biosynthesis , Neoplasms, Glandular and Epithelial/genetics , Ovarian Neoplasms/genetics , Prognosis , Transcription Factors/biosynthesis , Tumor Cells, Cultured
14.
Article in English | WPRIM | ID: wpr-21467

ABSTRACT

OBJECTIVE: To investigate trends in the incidence of epithelial ovarian cancer (EOC), according to histologic subtypes, in Korean women between 1999 and 2012. METHODS: Data from the Korea Central Cancer Registry recorded between 1999 and 2012 were evaluated. The incidences of EOC histologic subtypes were counted. Age-standardized incidence rates (ASRs) and annual percentage changes (APCs) in incidence rates were calculated. Patient data were divided into three groups based on age (59 years), and age-specific incidence rates were compared. RESULTS: Overall, the incidence of EOC has increased. Annual EOC cases increased from 922 in 1999 to 1,775 in 2012. In 1999, the ASR was 3.52 per 100,000 and increased to 4.79 per 100,000 in 2012 (APC, 2.53%; p<0.001). The ASRs in 2012 and APCs between 1999 and 2012 for the four major histologic subtypes were as follows (in order of incidence): serous carcinoma (ASR, 2.32 per 100,000; APC, 4.34%; p<0.001), mucinous carcinoma (ASR, 0.73 per 100,000; APC, -1.05%; p=0.131), endometrioid carcinoma (ASR, 0.51 per 100,000; APC, 1.48%; p=0.032), and clear cell carcinoma (ASR, 0.50 per 100,000; APC, 8.13%; p<0.001). In the sub-analyses based on age, clear cell carcinoma was confirmed as the histologic subtype whose incidence had increased the most since 1999. CONCLUSION: The incidence of EOC is increasing in Korea. Among the histologic subtypes, the incidence of clear cell carcinoma has increased markedly across all age groups since 1999.


Subject(s)
Adenocarcinoma, Clear Cell/epidemiology , Adenocarcinoma, Mucinous/epidemiology , Adult , Age Distribution , Aged , Carcinoma, Endometrioid/epidemiology , Cystadenocarcinoma, Serous/epidemiology , Databases, Factual , Female , Humans , Incidence , Middle Aged , Neoplasms, Glandular and Epithelial/epidemiology , Ovarian Neoplasms/epidemiology , Registries , Republic of Korea/epidemiology
15.
Rev. Assoc. Med. Bras. (1992) ; 61(3): 234-239, May-Jun/2015. tab
Article in English | LILACS | ID: lil-753176

ABSTRACT

Summary Objectives: to analyze factors that might indicate familial predisposition for ovarian cancer in patients diagnosed with this disease. Methods: in a prospective single center cohort study at the Institute of Cancer of the State of São Paulo (ICESP), 51 women diagnosed with ovarian cancer were included. Familial predisposition for ovarian cancer was defined as having a higher than 10% chance of having a BRCA1/2 mutation according to the Manchester scoring system, a validated method to assess the likelihood of mutation detection. Each patient was interviewed with a standardized questionnaire on established risk factors for ovarian cancer and other factors that might influence the risk to develop ovarian cancer. Logistic regression analyses were performed to estimate the impact of the evaluated factors on the likelihood of mutation detection, by calculating odds ratios and 95% confidence intervals. Results: seventeen out of 51 patients had a family history of breast and/or ovarian cancer, four patients had a history of breast or endometrial cancer, 11 were diagnosed before the age of 50, and 12 presented a risk of familial predisposition to ovarian cancer higher than 10%. Patients with comorbidities, such as hypertension, diabetes, hormonal disorders, dyslipidemia and psychiatric conditions, presented a lower chance of having a familial predisposition for ovarian cancer (OR: 0.22; 95% CI: 0.06-0.88; p=0.03). Conclusion: in this study, having comorbidities was associated with a lower risk of having a familial predisposition for ovarian cancer. Other factors associated with the risk of ovarian cancer did not have an impact on this predisposition. .


Resumo Objetivos: analisar fatores que possam indicar uma predisposição familiar ao câncer de ovário em pacientes com este diagnóstico. Métodos: em estudo de coorte prospectiva realizado no Instituto do Câncer do Estado de São Paulo (ICESP), foram incluídas 51 mulheres diagnosticadas com câncer de ovário entre janeiro de 2009 e dezembro de 2011. Predisposição familiar para câncer de ovário foi definida como um risco maior de 10% de apresentar uma mutação em BRCA1/2, de acordo com o sistema de pontes de Manchester, um método validado para avaliar a probabilidade de detecção de mutação nesses genes. Cada paciente foi entrevistada com um questionário padronizado, abordando fatores de risco para câncer de ovário e outros fatores que pudessem influenciar o risco de desenvolver a doença. O impacto dos fatores avaliados na probabilidade de detecção da mutação foi avaliado com regressões logísticas. Resultados: dezessete das 51 pacientes referiram história familiar de câncer de mama e/ou ovário, quatro pacientes apresentavam antecedente pessoal de câncer de mama ou endométrio, 11 haviam sido diagnosticadas antes dos 50 anos e 12 apresentaram um risco maior que 10% de predisposição familiar a câncer de ovário. Pacientes com comorbidades como hipertensão, diabetes, disfunções hormonais, dislipidemia e distúrbios psiquiátricos apresentaram menor risco de predisposição familiar ao câncer de ovário (OR: 0.22; IC 95%: 0.06-0.88; p=0.03). Conclusão: neste estudo, apresentar alguma comorbidade foi associado a um menor risco de ter uma predisposição familiar ao câncer de ovário. Outros fatores associados ao risco de câncer de ovário não tiveram nenhum impacto sobre esta predisposição. .


Subject(s)
Adult , Aged , Female , Humans , Middle Aged , Cystadenocarcinoma, Serous/genetics , Genetic Predisposition to Disease , Hereditary Breast and Ovarian Cancer Syndrome/genetics , Hypertension/genetics , Ovarian Neoplasms/genetics , Age Factors , Body Mass Index , Cohort Studies , Comorbidity , Genes, BRCA1 , Life Style , Prospective Studies , Risk Factors , Surveys and Questionnaires
16.
Chinese Journal of Pathology ; (12): 874-878, 2015.
Article in Chinese | WPRIM | ID: wpr-278509

ABSTRACT

<p><b>OBJECTIVE</b>To study the diagnostic value of HNF-1β and Napsin A for ovarian clear cell carcinomas, serous carcinomas, endometrioid adenocarcinomas and metastatic Krukenberg tumors.</p><p><b>METHODS</b>Immunohistochemical EnVision method was used to detect the expression of HNF-1β and Napsin A in 38 cases of ovarian clear cell carcinoma, 30 cases of high-grade serous carcinoma, 22 cases of endometrioid adenocarcinoma and 16 cases of metastatic Krukenberg tumor. Expression of HNF-1β and Napsin A were compared, and sensitivity and specificity of clear cell carcinoma of the ovary were analysed.</p><p><b>RESULTS</b>The positive rate of HNF-1β in the ovarian clear cell carcinoma was 100%(38/38), higher than those in high-grade serous carcinoma and endometrioid adenocarcinoma (P<0.05), although significant difference was not observed from that of metastatic Krukenberg tumor (P>0.05). Napsin A expressed in 97.4% (37/38) of ovarian clear cell carcinoma, 6.7% (2/30) of high-grade serous carcinoma, 22.7% (5/22) of endometrioid adenocarcinoma. Napsin A expression in clear cell carcinoma was higher than those in high-grade serous carcinoma and endometrioid adenocarcinoma (P<0.01), and no expression of Napsin A was seen in metastatic Krukenberg tumor (P>0.05). The sensitivity and specificity of HNF-1β in the diagnosis of ovarian clear cell carcinoma were 100% and 52.9%, those of Napsin A were 97.4% and 91.2%, those of both HNF-1β and Napsin A were 97.4% and 91.2%, respectively. The sensitivity and specificity of HNF-1β or Napsin A in the diagnosis of ovarian clear cell carcinoma were 100% and 52.9%, respectively.</p><p><b>CONCLUSIONS</b>HNF-1β is a more sensitive marker for the diagnosis of ovarian clear cell carcinoma, whereas Napsin A is a more specific marker. The combined detection of HNF-1β and Napsin A may be helpful for the diagnosis of clear cell carcinoma of the ovary.</p>


Subject(s)
Adenocarcinoma, Clear Cell , Diagnosis , Aspartic Acid Endopeptidases , Genetics , Biomarkers, Tumor , Genetics , Carcinoma, Endometrioid , Diagnosis , Cystadenocarcinoma, Serous , Diagnosis , Female , Hepatocyte Nuclear Factor 1-alpha , Genetics , Humans , Immunohistochemistry , Krukenberg Tumor , Diagnosis , Ovarian Neoplasms , Diagnosis , Sensitivity and Specificity
17.
Chinese Journal of Cancer ; (12): 28-40, 2015.
Article in English | WPRIM | ID: wpr-349614

ABSTRACT

Metastasis is the main cause of cancer mortality. One of the initiating events of cancer metastasis of epithelial tumors is epithelial-to-mesenchymal transition (EMT), during which cells dedifferentiate from a relatively rigid cell structure/morphology to a flexible and changeable structure/morphology often associated with mesenchymal cells. The presence of EMT in human epithelial tumors is reflected by the increased expression of genes and levels of proteins that are preferentially present in mesenchymal cells. The combined presence of these genes forms the basis of mesenchymal gene signatures, which are the foundation for classifying a mesenchymal subtype of tumors. Indeed, tumor classification schemes that use clustering analysis of large genomic characterizations, like The Cancer Genome Atlas (TCGA), have defined mesenchymal subtype in a number of cancer types, such as high-grade serous ovarian cancer and glioblastoma. However, recent analyses have shown that gene expression-based classifications of mesenchymal subtypes often do not associate with poor survival. This "paradox" can be ameliorated using integrated analysis that combines multiple data types. We recently found that integrating mRNA and microRNA (miRNA) data revealed an integrated mesenchymal subtype that is consistently associated with poor survival in multiple cohorts of patients with serous ovarian cancer. This network consists of 8 major miRNAs and 214 mRNAs. Among the 8 miRNAs, 4 are known to be regulators of EMT. This review provides a summary of these 8 miRNAs, which were associated with the integrated mesenchymal subtype of serous ovarian cancer.


Subject(s)
Cystadenocarcinoma, Serous , Genetics , Pathology , Epithelial-Mesenchymal Transition , Female , Humans , MicroRNAs , Physiology , Ovarian Neoplasms , Genetics , Pathology
18.
Chinese Journal of Cancer ; (12): 50-55, 2015.
Article in English | WPRIM | ID: wpr-349612

ABSTRACT

Ovarian tumors comprise a heterogeneous group of lesions, displaying distinct tumor pathology and oncogenic potentiel. These tumors are subdivided into three main categories: epithelial, germ cell, and sex-cord stromal tumors. We report herein the newly described molecular abnormalities in epithelial ovarian cancers (carcinomas). Immunohistochemistry and molecular testing help pathologists to decipher the significant heterogeneity of this disease. Our better understanding of the molecular basis of ovarian carcinomas represents the first step in the development of targeted therapies in the near future.


Subject(s)
Carcinoma, Endometrioid , Pathology , Cystadenocarcinoma, Mucinous , Pathology , Cystadenocarcinoma, Serous , Pathology , Female , Humans , Mixed Tumor, Malignant , Pathology , Neoplasms, Glandular and Epithelial , Pathology , Ovarian Neoplasms , Genetics , Pathology
19.
Article in English | WPRIM | ID: wpr-27946

ABSTRACT

OBJECTIVE: In this study we utilized the Surveillance, Epidemiology and End-Results (SEER) registry to identify risk factors for lymphatic spread and determine the incidence of pelvic and para-aortic lymph node metastases in patients with uterine papillary serous carcinoma (UPSC) and uterine clear cell carcinoma (UCCC) who underwent complete surgical staging and lymph node dissection. METHODS: Nine hundred seventy-two eligible patients diagnosed between 1998 to 2009 with International Federation of Gynecology and Obstetrics (FIGO) 1988 stage IA-IVA UPSC (n=685) or UCCC (n=287) were identified for analysis. Binomial logistic regression was used to determine risk factors for lymph node metastasis, with the incidence of pelvic and para-aortic lymph node metastases reported for each FIGO primary tumor stage. The Cox proportional hazards regression model was used to determine factors associated with overall survival. RESULTS: FIGO primary tumor stage was the only independent risk factor for lymph node metastasis (p60 years (HR, 1.70; 95% CI, 1.21 to 2.41; p<0.01), and advanced FIGO primary tumor stage (p<0.01). Tumor grade, histologic subtype, and patient race did not predict for either lymph node metastasis or overall survival. CONCLUSION: There is a high incidence of both pelvic and para-aortic lymph node metastases for FIGO stages IC and above uterine papillary serous and clear cell carcinomas, suggesting a potential role for lymph node-directed therapy for these patients.


Subject(s)
Adenocarcinoma, Clear Cell/epidemiology , Adult , Aged , Aged, 80 and over , Aorta, Abdominal , Cystadenocarcinoma, Papillary/epidemiology , Cystadenocarcinoma, Serous/epidemiology , Female , Humans , Incidence , Kaplan-Meier Estimate , Lymph Node Excision , Lymphatic Metastasis , Middle Aged , Neoplasm Grading , Neoplasm Staging , Pelvis , SEER Program , United States/epidemiology , Uterine Neoplasms/epidemiology
20.
Article in English | WPRIM | ID: wpr-27945

ABSTRACT

OBJECTIVE: Despite the rarity of uterine papillary serous carcinoma (UPSC) and uterine clear cell carcinoma (UCCC), they contribute disproportionately to endometrial cancer deaths. Sufficient clinical information regarding treatment and prognosis is lacking. The aim of this study is to evaluate treatment outcomes in a rare cancer cohort based on the experience at two tertiary care cancer centers. METHODS: Clinicopathologic data were retrospectively collected on 279 patients with UPSC and UCCC treated between 1995 to 2011. Mode of surgery, use of adjuvant treatment, and dissection of paraaoritc lymph nodes were evaluated for their association with overall survival (OS) and progression-free survival (PFS). RESULTS: 40.9% of patients presented with stage I disease, 6.8% of patients presented with stage II disease and 52.3% of patients presented with stages III and IV. Median follow-up was 31 months (range, 1 to 194 months). OS and PFS at 5 years were 63.0% and 51.9%, respectively. OS and PFS were not affected by mode of surgery (open vs. robotic approach; OS: hazard ratio [HR], 0.68; 95% confidence interval [CI], 0.28 to 1.62; PFS: HR, 0.78; 95% CI, 0.40 to 1.56). Adjuvant treatment was associated with improved OS in stages IB-II (HR, 0.14; 95% CI, 0.02 to 0.78; p=0.026) but not in stage IA disease. There was no difference in OS or PFS based on the performance of a paraaoritc lymph node dissection. CONCLUSION: Minimally invasive surgical staging appears a reasonable strategy for patients with non-bulky UPSC and UCCC and was not associated with diminished survival. Adjuvant treatment improved 5-year survival in stages IB-II disease.


Subject(s)
Adenocarcinoma, Clear Cell/pathology , Aged , Chemotherapy, Adjuvant , Cystadenocarcinoma, Papillary/pathology , Cystadenocarcinoma, Serous/pathology , Female , Humans , Lymph Node Excision , Lymphatic Metastasis , Middle Aged , Neoplasm Staging , Professional Practice , Radiotherapy, Adjuvant , Retrospective Studies , Robotic Surgical Procedures , Survival Analysis , Treatment Outcome , Uterine Neoplasms/pathology
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