Cancer Research and Treatment

Original Articles

Gynecologic cancer

Effect of BRCA1/2 Mutational Status on Survival Outcomes According to Secondary Cytoreductive Surgery and Maintenance Therapy in Platinum-Sensitive Relapsed Ovarian Cancer: A Real-World Evidence Study: Se Ik Kim, Hyunji Lim, Hee Seung Kim, Hyun Hoon Chung, Jae-Weon Kim, Noh Hyun Park, Yong-Sang Song, Maria Lee; Cancer Res Treat. 2023;55(1):245-257. Published online July 19, 2022; DOI: https://doi.org/10.4143/crt.2022.232

Abstract PDF Supplementary Material PubReader ePub: Purpose
This study aimed to investigate the impact of BRCA1/2 mutational status on survival outcomes in patients with platinum-sensitive relapsed (PSR) epithelial ovarian cancer (EOC).
Materials and Methods
We retrospectively identified patients who received secondary treatment for PSR EOC at our institution between January 2007 and June 2021 and who underwent BRCA1/2 gene testing by either germline or somatic methods. The association between BRCA1/2 mutational status and survival outcomes was evaluated. Both secondary cytoreductive surgery (CRS) and maintenance therapy were stratified considering real-world clinical practice.
Results
Of 262 patients, 91 (34.7%) and 171 (65.3%) were assigned to BRCA1/2 mutation and wild-type groups, respectively. The two groups had similar proportions of patients undergoing secondary CRS (26.4% vs. 32.7%, p=0.286) and maintenance therapy (54.9% vs. 46.2%, p=0.178). Overall, no differences in progression-free survival (PFS; median, 19.7 vs. 15.1 months, p=0.120) and overall survival (OS; p=0.400) were observed between the two groups. In multivariate analyses, BRCA1/2 mutational status was not associated with PFS (adjusted hazard ratio, 0.816; 95% confidence interval, 0.596 to 1.119; p=0.207). BRCA1/2 mutational status did not affect PFS among patients who underwent secondary CRS (n=80) and among those who did not (n=182) (p=0.074 and p=0.222, respectively). PFS did not differ in the BRCA1/2 mutational status among the patients who received bevacizumab maintenance (n=90, p=0.992).
Conclusion
In this real-world evidence study, BRCA1/2 mutational status itself was not associated with PFS and OS in PSR EOC, which was consistent with whether secondary CRS or not and with bevacizumab maintenance.

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Germline and Somatic BRCA1/2 Gene Mutational Status and Clinical Outcomes in Epithelial Peritoneal, Ovarian, and Fallopian Tube Cancer: Over a Decade of Experience in a Single Institution in Korea: Se Ik Kim, Maria Lee, Hee Seung Kim, Hyun Hoon Chung, Jae-Weon Kim, Noh Hyun Park, Yong-Sang Song; Cancer Res Treat. 2020;52(4):1229-1241. Published online July 27, 2020; DOI: https://doi.org/10.4143/crt.2020.557

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to present a single institutional experience with BRCA1/2 gene tests and the effects of pathogenic mutations in epithelial peritoneal, ovarian, and fallopian tube cancer (POFTC) on survival outcomes.
Materials and Methods
We identified patients with epithelial POFTCs who underwent BRCA1/2 gene testing by either germline or somatic methods between March 2007 and March 2020. Based on the BRCA1/2 test results, patients were divided into BRCA mutation and wild-type groups, followed by comparisons of clinicopathologic characteristics and survival outcomes after primary treatment.
Results
The annual number of POFTC patients who received BRCA1/2 gene tests increased gradually. In total, 511 patients were included and BRCA1/2 mutations were observed in 143 (28.0%). Among 57 patients who received both germline and somatic tests, three (5.3%) showed discordant results from the two tests. Overall, no differences in progression-free survival (PFS; p=0.467) and overall survival (p=0.641) were observed between the BRCA mutation and wild-type groups; however, multivariate analyses identified BRCA1/2 mutation as an independent favorable prognostic factor for PFS (adjusted hazard ratio [aHR], 0.765; 95% confidence interval [CI], 0.593 to 0.987; p=0.040). In 389 patients with International Federation of Gynecology and Obstetrics stage III-IV, different results were shown depending on primary treatment strategy: while BRCA1/2 mutation significantly improved PFS in the subgroup of neoadjuvant chemotherapy (aHR, 0.619; 95% CI, 0.385 to 0.995; p=0.048), it did not affect patient PFS in the subgroup of primary debulking surgery (aHR, 0.759; 95% CI, 0.530 to 1.089; p=0.135).
Conclusion
BRCA1/2 mutations are frequently observed in patients with epithelial POFTCs, and such patients showed better PFS than did those harboring wild-type BRCA1/2.

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Overview of Molecular Diagnostics in Irish Clinical Oncology
Tyler Medina, Seán O. Hynes, Maeve Lowery, Paddy Gillespie, Walter Kolch, Cathal Seoighe
HRB Open Research.2024; 7: 16. CrossRef
Trends in the Incidence and Survival Rates of Primary Ovarian Clear Cell Carcinoma Compared to Ovarian Serous Carcinoma in Korea
Se Ik Kim, Hyeong In Ha, Kyung Jin Eoh, Jiwon Lim, Young-Joo Won, Myong Cheol Lim
Frontiers in Oncology.2022;[Epub] CrossRef
Characteristics of homologous recombination repair pathway genes mutation in ovarian cancers
Zongbi Yi, Min Chen, Shaoxing Sun, Chunxu Yang, Zijie Mei, Hui Yang, Qingming Xiang, Hui Qiu
Cancer Innovation.2022; 1(3): 220. CrossRef

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Development of Web-Based Nomograms to Predict Treatment Response and Prognosis of Epithelial Ovarian Cancer: Se Ik Kim, Minsun Song, Suhyun Hwangbo, Sungyoung Lee, Untack Cho, Ju-Hyun Kim, Maria Lee, Hee Seung Kim, Hyun Hoon Chung, Dae-Shik Suh, Taesung Park, Yong-Sang Song; Cancer Res Treat. 2019;51(3):1144-1155. Published online November 20, 2018; DOI: https://doi.org/10.4143/crt.2018.508

Abstract PDF Supplementary Material PubReader ePub

Purpose
Discovery of models predicting the exact prognosis of epithelial ovarian cancer (EOC) is necessary as the first step of implementation of individualized treatment. This study aimed to develop nomograms predicting treatment response and prognosis in EOC.
Materials and Methods
We comprehensively reviewed medical records of 866 patients diagnosed with and treated for EOC at two tertiary institutional hospitals between 2007 and 2016. Patients’ clinico-pathologic characteristics, details of primary treatment, intra-operative surgical findings, and survival outcomes were collected. To construct predictive nomograms for platinum sensitivity, 3-year progression-free survival (PFS), and 5-year overall survival (OS), we performed stepwise variable selection by measuring the area under the receiver operating characteristic curve (AUC) with leave-one-out cross-validation. For model validation, 10-fold cross-validation was applied.
Results
The median length of observation was 42.4 months (interquartile range, 25.7 to 69.9 months), during which 441 patients (50.9%) experienced disease recurrence. The median value of PFS was 32.6 months and 3-year PFS rate was 47.8% while 5-year OS rate was 68.4%. The AUCs of the newly developed nomograms predicting platinum sensitivity, 3-year PFS, and 5-year OS were 0.758, 0.841, and 0.805, respectively. We also developed predictive nomograms confined to the patients who underwent primary debulking surgery. The AUCs for platinum sensitivity, 3-year PFS, and 5-year OS were 0.713, 0.839, and 0.803, respectively.
Conclusion
We successfully developed nomograms predicting treatment response and prognosis of patients with EOC. These nomograms are expected to be useful in clinical practice and designing clinical trials.

Citations

Citations to this article as recorded by

Comprehensive analyses of mitophagy-related genes and mitophagy-related lncRNAs for patients with ovarian cancer
Jianfeng Zheng, Shan Jiang, Xuefen Lin, Huihui Wang, Li Liu, Xintong Cai, Yang Sun
BMC Women's Health.2024;[Epub] CrossRef
Peripheral and tumor‐infiltrating immune cells are correlated with patient outcomes in ovarian cancer
Weiwei Zhang, Yawen Ling, Zhidong Li, Xingchen Peng, Yazhou Ren
Cancer Medicine.2023; 12(8): 10045. CrossRef
Nonalcoholic fatty liver disease and early prediction of gestational diabetes mellitus using machine learning methods
Seung Mi Lee, Suhyun Hwangbo, Errol R. Norwitz, Ja Nam Koo, Ig Hwan Oh, Eun Saem Choi, Young Mi Jung, Sun Min Kim, Byoung Jae Kim, Sang Youn Kim, Gyoung Min Kim, Won Kim, Sae Kyung Joo, Sue Shin, Chan-Wook Park, Taesung Park, Joong Shin Park
Clinical and Molecular Hepatology.2022; 28(1): 105. CrossRef
Toward More Comprehensive Homologous Recombination Deficiency Assays in Ovarian Cancer Part 2: Medical Perspectives
Stanislas Quesada, Michel Fabbro, Jérôme Solassol
Cancers.2022; 14(4): 1098. CrossRef
Construction and validation of a transcription factors-based prognostic signature for ovarian cancer
Qingyuan Cheng, Liman Li, Mingxia Yu
Journal of Ovarian Research.2022;[Epub] CrossRef
Predicting preterm birth through vaginal microbiota, cervical length, and WBC using a machine learning model
Sunwha Park, Jeongsup Moon, Nayeon Kang, Young-Han Kim, Young-Ah You, Eunjin Kwon, AbuZar Ansari, Young Min Hur, Taesung Park, Young Ju Kim
Frontiers in Microbiology.2022;[Epub] CrossRef
Prognostic nomogram that predicts progression-free survival and overall survival of patients with ovarian clear cell carcinoma
Jiayi Li, Dongyan Cao
Frontiers in Oncology.2022;[Epub] CrossRef
Recent Advances and Future Directions of Diagnostic and Prognostic Prediction Models in Ovarian Cancer
Judan Zeng, Wenjiao Cao, Lihua Wang
Journal of Shanghai Jiaotong University (Science).2021; 26(1): 10. CrossRef
Sphingolipids as multifaceted mediators in ovarian cancer
MelissaR Pitman, Martin K. Oehler, Stuart M. Pitson
Cellular Signalling.2021; 81: 109949. CrossRef
Development and validation for prognostic nomogram of epithelial ovarian cancer recurrence based on circulating tumor cells and epithelial–mesenchymal transition
Jiani Yang, Jun Ma, Yue Jin, Shanshan Cheng, Shan Huang, Nan Zhang, Yu Wang
Scientific Reports.2021;[Epub] CrossRef
Prediction Models for the Clinical Severity of Patients With COVID-19 in Korea: Retrospective Multicenter Cohort Study
Bumjo Oh, Suhyun Hwangbo, Taeyeong Jung, Kyungha Min, Chanhee Lee, Catherine Apio, Hyejin Lee, Seungyeoun Lee, Min Kyong Moon, Shin-Woo Kim, Taesung Park
Journal of Medical Internet Research.2021; 23(4): e25852. CrossRef
Development of Machine Learning Models to Predict Platinum Sensitivity of High-Grade Serous Ovarian Carcinoma
Suhyun Hwangbo, Se Ik Kim, Ju-Hyun Kim, Kyung Jin Eoh, Chanhee Lee, Young Tae Kim, Dae-Shik Suh, Taesung Park, Yong Sang Song
Cancers.2021; 13(8): 1875. CrossRef
M2 Macrophage-Based Prognostic Nomogram for Gastric Cancer After Surgical Resection
Jianwen Hu, Yongchen Ma, Ju Ma, Yanpeng Yang, Yingze Ning, Jing Zhu, Pengyuan Wang, Guowei Chen, Yucun Liu
Frontiers in Oncology.2021;[Epub] CrossRef
Prognosis for intrahepatic cholangiocarcinoma patients treated with postoperative adjuvant transcatheter hepatic artery chemoembolization
Ji-Bin Liu, Kai-Jian Chu, Chang-Chun Ling, Ting-Miao Wu, Hui-Min Wang, Yi Shi, Zhi-Zhen Li, Jing-Han Wang, Zhi-Jun Wu, Xiao-Qing Jiang, Gao-Ren Wang, Yu-Shui Ma, Da Fu
Current Problems in Cancer.2020; 44(6): 100612. CrossRef
Can we predict who lives long with ovarian cancer?
Michael A. Bookman
Cancer.2019; 125(S24): 4578. CrossRef

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An Alternative Triage Strategy Based on Preoperative MRI for Avoiding Trimodality Therapy in Stage IB Cervical Cancer: Jung-Yun Lee, Jina Youm, Jae Weon Kim, Kidong Kim, Hak Jae Kim, Jeong Yeon Cho, Min A Kim, Noh Hyun Park, Yong-Sang Song; Cancer Res Treat. 2016;48(1):259-265. Published online March 20, 2015; DOI: https://doi.org/10.4143/crt.2014.370

Abstract PDF PubReader ePub

Purpose
Adjuvant chemoradiation following primary surgery is frequently indicated in patients with stage IB cervical cancer. The aim of this study is to evaluate the role of a magnetic resonance imaging (MRI)-based strategy in avoiding trimodality therapy.
Materials and Methods
We retrospectively reviewed all patients with stage IB cervical cancer treated initially with primary surgery at Seoul National University Hospital. We suggest an alternative triage strategy in which the primary treatment modality is determined based on preoperative MRI findings. Using this strategy, primary surgery is only indicated when there is no evidence of parametrial involvement (PMI) and lymph node metastasis (LNM) in the MRI results; when there is evidence of either or both of these factors, primary chemoradiation is selected. Assuming that this strategy is applied to our cohort, we evaluate how the rate of trimodality therapy is affected.
Results
Of the 254 patients in our sample, 77 (30.3%) had at least one category 1 risk factor (PMI, LNM, positive resection margin) upon pathologic examination. If the MRI-based strategy had been applied to our cohort, 168 patients would have undergone primary surgery and 86 would have undergone primary chemoradiation. Only 25 patients (9.8%) would have required trimodality therapy based on an indication of at least one category 1 pathologic risk factor following radical hysterectomy.
Conclusion
The inclusion of MRI in the decision-making process for primary treatment modality could have reduced the number of patients requiring trimodality therapy based on the indication of a category 1 risk factor from 30.3% to 9.8% in our cohort.

Citations

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Deep-learning-based radiomics of intratumoral and peritumoral MRI images to predict the pathological features of adjuvant radiotherapy in early-stage cervical squamous cell carcinoma
Xue-Fang Zhang, Hong-yuan Wu, Xu-Wei Liang, Jia-Luo Chen, Jianpeng Li, Shihao Zhang, Zhigang Liu
BMC Women's Health.2024;[Epub] CrossRef
Definitive Chemoradiotherapy versus Radical Hysterectomy Followed by Tailored Adjuvant Therapy in Women with Early-Stage Cervical Cancer Presenting with Pelvic Lymph Node Metastasis on Pretreatment Evaluation: A Propensity Score Matching Analysis
Jongmoo Park, Yeon-Joo Kim, Mi-Kyung Song, Joo-Hyun Nam, Sang-Yoon Park, Young-Seok Kim, Joo-Young Kim
Cancers.2021; 13(15): 3703. CrossRef
Quality of life among survivors of early-stage cervical cancer in Taiwan: an exploration of treatment modality differences
Chia-Chun Li, Ting-Chang Chang, Yun-Fang Tsai, Lynn Chen
Quality of Life Research.2017; 26(10): 2773. CrossRef
Parametrial Involvement on Magnetic ResonanceImaging Has No Effect on the Survival of Early-StageCervical Cancer Patients
Kyungmi Yang, Won Park, Seung Jae Huh, Byung Kwan Park, Chan Kyo Kim, Byoung-Gie Kim, Duk-Soo Bae, Jeong-Won Lee
International Journal of Gynecological Cancer.2017; 27(3): 507. CrossRef
Treatment strategies for stage IB cervical cancer: A cost-effectiveness analysis from Korean, Canadian and US perspectives
Jung-Yun Lee, Janice S. Kwon, David E. Cohn, Younhee Kim, Blair Smith, Tae-Jin Lee, Jae-Weon Kim
Gynecologic Oncology.2016; 140(1): 83. CrossRef

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Safety of Fertility-Sparing Surgery in Primary Mucinous Carcinoma of the Ovary: Jung-Yun Lee, Yu Ri Jo, Tae Hun Kim, Hee Seung Kim, Min A Kim, Jae Weon Kim, Noh Hyun Park, Yong-Sang Song; Cancer Res Treat. 2015;47(2):290-305. Published online August 29, 2014; DOI: https://doi.org/10.4143/crt.2014.004

Abstract PDF PubReader ePub

Purpose
The aim of this study is to evaluate the safety of fertility-sparing surgery as the treatment for patients with primary mucinous epithelial ovarian cancer.
Materials and Methods
A retrospective study of patients with mucinous ovarian cancer between 1991 and 2010 was performed. The demographics and survival outcomes were compared between patients who underwent fertility-sparing surgery and those who underwent radical surgery.
Results
A total of 110 patients underwent primary surgery. At the time of surgery, tumors appeared to be grossly confined to the ovaries in 90 patients, and evidence of metastasis was definite in 20 patients. Of the 90 patients with tumors that appeared to be grossly confined to the ovaries at surgical exploration, 35 (38.9%) underwent fertility-sparing surgery. The Kaplan- Meier curve and the log rank test showed no difference in either recurrence-free survival (p=0.792) or disease-specific survival (p=0.706) between the two groups. Furthermore, there was no significant difference in recurrence-free survival (p=0.126) or disease-specific survival (p=0.377) between the two groups, even when the analysis was limited to women below the age of 40. In a multivariate Cox model, fertility-sparing surgery had no effect on either recurrence-free survival (recurrence hazard ratio [HR], 1.20; 95% confidence interval [CI], 0.25 to 5.71) or disease-specific survival (death HR, 0.88; 95% CI, 0.17 to 4.60).
Conclusion
Fertility-sparing surgery in primary mucinous cancer grossly confined to the ovaries may be a safe option and one not associated with an increase in recurrence or mortality.

Citations

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A Complex Case: Solid Unilateral Ovarian Mucinous Carcinoma Masquerading as Leiomyosarcoma in Postmenopausal Women
Naina Kumar, Immanuel Pradeep, Mishu Mangla, Annapurna Srirambhatla
Current Womens Health Reviews.2025;[Epub] CrossRef
Prognosis of stage-I ovarian mucinous tumors according to expansile and infiltrative types
Malek Bouhani, Stéphanie Schérier, Catherine Genestie, Mojgan Devouassoux-Shisheboran, Amandine Maulard, Francois Zaccarini, Alexandra Leary, Patricia Pautier, Philippe Morice, Sébastien Gouy
International Journal of Gynecological Cancer.2025; : 101641. CrossRef
Controversies in the management of mucinous ovarian tumors
Félix Blanc-Durand, Alexandra Leary
International Journal of Gynecological Cancer.2025; 35(3): 101679. CrossRef
Safety of fertility-sparing surgery in young women with stage I endometrioid epithelial and mucinous ovarian cancer: A population-based analysis
Jing Li, Huimin Qiao, Yunyun Liu, Chunxian Huang, Aoshuang Cheng, Zhongqiu Lin, Lijuan Wang, Huaiwu Lu
European Journal of Surgical Oncology.2024; 50(1): 107276. CrossRef
Mucinous ovarian carcinoma: A survey of practice in Australia and New Zealand
Niveditha Rajadevan, Ariane Flinkier, Hugo Saunders, Yeh Chen Lee, Clare Scott, Pearly Khaw, Prue Allan, Claire Davies, John Andrews, Michelle Wilson, Janine M Lombard, Michelle Harrison, Heshani Nesfield, Anna DeFazio, Tarek Meniawy, Kylie L Gorringe
Australian and New Zealand Journal of Obstetrics and Gynaecology.2024; 64(4): 319. CrossRef
Evaluation of Outcomes of Mucinous Ovarian Cancer Treated at a Tertiary Care Cancer Hospital in Pakistan
Syed Abdul Mannan Hamdani, Musa Azhar, Abdul Wahab, Tahira Yasmeen, Neelam Siddiqui
South Asian Journal of Cancer.2023; 12(01): 081. CrossRef
Update on Prognostic and Predictive Markers in Mucinous Ovarian Cancer
Fulvio Borella, Marco Mitidieri, Stefano Cosma, Chiara Benedetto, Luca Bertero, Stefano Fucina, Isabelle Ray-Coquard, Annalisa Carapezzi, Domenico Ferraioli
Cancers.2023; 15(4): 1172. CrossRef
Safety of fertility sparing management in invasive mucinous ovarian carcinoma
Soyoun Rachel Kim, Ainhoa Madariaga, Liat Hogen, Danielle Vicus, Allan Covens, Carlos Parra-Herran, Stephanie Lheureux, Lilian T. Gien
Gynecologic Oncology.2023; 174: 129. CrossRef
Rare Epithelial Ovarian Cancers: Low Grade Serous and Mucinous Carcinomas
Olivia Craig, Abhimanyu Nigam, Genevieve V. Dall, Kylie Gorringe
Cold Spring Harbor Perspectives in Medicine.2023; 13(9): a038190. CrossRef
Oncological and Reproductive Outcomes After Fertility-Sparing Surgery for Stage I Mucinous Ovarian Carcinoma
Wei Lin, Dongyan Cao, Xiaohua Shi, Yan You, Jiaxin Yang, Keng Shen
Frontiers in Oncology.2022;[Epub] CrossRef
Surgical treatment for clinical early-stage expansile and infiltrative mucinous ovarian cancer: can staging surgeries safely be omitted?
Marc D. Algera, Willemien J. van Driel, Koen K. van de Vijver, Roy F.P.M. Kruitwagen, Christianne A.R. Lok
Current Opinion in Oncology.2022; 34(5): 497. CrossRef
Primary mucinous ovarian cancer: options for surgery and chemotherapy
Katherine C Kurnit, Michael Frumovitz
International Journal of Gynecological Cancer.2022; 32(11): 1455. CrossRef
Outcomes after Fertility-sparing Surgery for Women with Ovarian Cancer: A Systematic Review of the Literature
Alexandra Bercow, Roni Nitecki, Paula C. Brady, J.Alejandro Rauh-Hain
Journal of Minimally Invasive Gynecology.2021; 28(3): 527. CrossRef
Fertility preserving surgery in carcinoma ovary: a single institution experience
T. Subramanyeshwar Rao, KVVN Raju, Vikas Gupta, R. Rajagopalan Iyer
Indian Journal of Gynecologic Oncology.2021;[Epub] CrossRef
Fertility-Sparing Surgery in Gynecologic Cancer: A Systematic Review
Teska Schuurman, Sanne Zilver, Sanne Samuels, Winnie Schats, Frédéric Amant, Nienke van Trommel, Christianne Lok
Cancers.2021; 13(5): 1008. CrossRef
Fertility preservation in rare ovarian tumors
Anca Chelariu-Raicu, Lauren P Cobb, David M Gershenson
International Journal of Gynecological Cancer.2021; 31(3): 432. CrossRef
Oncologic outcomes of uterine preservation for pre-menopausal patients with stage II epithelial ovarian carcinoma
Dimitrios Nasioudis, Lakeisha Mulugeta-Gordon, Erin McMinn, Maureen Byrne, Emily M Ko, Lori Cory, Ashley F Haggerty, Nawar A Latif
International Journal of Gynecological Cancer.2021; 31(3): 480. CrossRef
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Geoffroy Canlorbe, Nathalie Chabbert-Buffet, Catherine Uzan
Journal of Clinical Medicine.2021; 10(18): 4235. CrossRef
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M. Bartoletti, L. Musacchio, G. Giannone, V. Tuninetti, A. Bergamini, G. Scambia, D. Lorusso, G. Valabrega, G. Mangili, F. Puglisi, S. Pignata
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Options for the Treatment of Mucinous Ovarian Carcinoma
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Fertility sparing surgery vs radical surgery for epithelial ovarian cancer: a meta-analysis of overall survival and disease-free survival
Denghua Liu, Jing Cai, Aiwei Gao, Zehua Wang, Liqiong Cai
BMC Cancer.2020;[Epub] CrossRef
Fertility‐sparing treatment for early‐stage epithelial ovarian cancer: Contemporary oncologic, reproductive and endocrinologic perspectives
Rachel S. Mandelbaum, Maximilian Klar, Tsuyoshi Takiuchi, Liat Bainvoll, Shinya Matsuzaki, Richard J. Paulson, Koji Matsuo
Journal of Obstetrics and Gynaecology Research.2020; 46(8): 1263. CrossRef
Impact of uterus‐preserving surgery on Stage I primary mucinous epithelial ovarian carcinoma: A multi‐institutional study with propensity score‐weighted analysis
Masato Yoshihara, Hiroaki Kajiyama, Satoshi Tamauchi, Shohei Iyoshi, Akira Yokoi, Shiro Suzuki, Michiyasu Kawai, Tetsuro Nagasaka, Kunihiko Takahashi, Shigeyuki Matsui, Fumitaka Kikkawa
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New England Journal of Medicine.2019; 380(13): 1256. CrossRef
Early stage mucinous ovarian cancer: A review
Erin K. Crane, Jubilee Brown
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Sebastien Gouy, Marine Saidani, Amandine Maulard, Slim Bach-Hamba, Enrica Bentivegna, Alexandra Leary, Patricia Pautier, Mojgan Devouassoux-Shisheboran, Catherine Genestie, Philippe Morice
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Long-term results of fertility-sparing treatment compared with standard radical surgery for early-stage epithelial ovarian cancer
Robert Fruscio, Lorenzo Ceppi, Silvia Corso, Francesca Galli, Tiziana Dell'Anna, Federica Dell'Orto, Daniela Giuliani, Annalisa Garbi, Stefania Chiari, Costantino Mangioni, Rodolfo Milani, Irene Floriani, Nicoletta Colombo, Cristina Maria Bonazzi
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E. Bentivegna, S. Gouy, A. Maulard, P. Pautier, A. Leary, N. Colombo, P. Morice
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Patterns of Failure after Postoperative Radiation Therapy for Endometrial Carcinoma: Suzy Kim, Hong-Gyun Wu, Hyo-Pyo Lee, Soon-Beom Kang, Yong-Sang Song, Noh-Hyun Park, Sung Whan Ha; Cancer Res Treat. 2006;38(3):133-138. Published online June 30, 2006; DOI: https://doi.org/10.4143/crt.2006.38.3.133

Abstract PDF PubReader ePub

Purpose

We tried to investigate the outcome and patterns of failure of endometrial cancer patients who were treated with surgery and postoperative radiation therapy (RT).

Materials and Methods

Eighty-three patients with endometrial cancer who received postoperative RT between May 1979 and August 2000 were included in this retrospective study. Forty-one patients received total abdominal hysterectomy, 41 patients received Wertheim's operation and 1 underwent vaginal hysterectomy. Pelvic lymph node dissection or pelvic lymph node sampling was done in 56 patients and peritoneal cytology was done in 35. All the patients were staged according to 1988 FIGO (International Federation of Gynecology and Obstetrics) staging system; 2 were stage IA, 23 were stage IB, 20 were stage IC, 4 were stage IIA, 5 were stage IIB, 9 were stage IIIA, 2 were stage IIIB and 18 were stage IIIC. The histologic diagnoses were adenocarcinoma in seventy-four patients (89%). The histologic grades were Grade 1, 2 and 3 in 21 (25%), 43 (52%) and 10 (12%) patients, respectively. All the patients received external beam RT (EBRT) with a median dose of 5,040 cGy (range: 4,500~5,075 cGy) to the whole pelvis. Five patients with pathologically confirmed paraaortic lymph node metastasis received 4500 cGy to the paraaortic lymph nodes. Fifteen patients received low-dose intracavitary brachytherapy after their EBRT. A total dose of 7,500~9,540 cGy (median dose: 8511) was prescribed to the vaginal surface.

Results

Overall, 11 patients (13%) experienced disease relapse: 4 with initial stage I or II disease and 7 with initial stage III disease. Among the 54 stage I or II patients, 1 (2%) relapsed in the pelvis only, 2 (4%) relapsed in the vagina and distant organs, and 1 (2%) relapsed in the paraaortic lymph nodes (PANs). Among the 29 stage III patients, 1 (3%) relapsed in the vagina. The most common sites of failure for the stage III patients were the peritoneum (3 patients, 10%), PANs (2 patients, 7%), and lung (2 patients, 7%). With a median follow-up period of 86 months, the overall survival (OS) and disease-free survival (DFS) rates at 5 years were 87% for both. The five-year DFS rate was 93%, 100% and 74% for the stage I, II and III patients, respectively. Three patients experienced severe radiation-related late complications: RTOG (Radiation Therapy Oncology Group) grade 3 radiation cystitis was seen in one patient, and grade 3 bowel obstruction was seen in two patients.

Conclusions

Postoperative RT was useful for controlling pelvic disease. The major patterns of failure for stage III patients were peritoneal seeding and distant metastasis. Selective use of whole abdominal radiotherapy or adjuvant chemotherapy may improve the therapeutic outcome of these patients.

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Pattern of care and clinical outcome of patients with carcinoma endometrium and the impact of central histopathological review on management: A tertiary cancer centre experience
Rakhi Verma, Ajeet K. Gandhi, Madhup Rastogi, Vachaspati K. Mishra, Vikas Sharma, Akash Agarwal, Saumya Shukla, Rohini Khurana, Rahat Hadi, Anoop K. Srivastava, Nuzhat Husain
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