Risk-based stratification of carcinomas concurrently involving the endometrium and ovary.

Abstract:

OBJECTIVE:Determining whether carcinomas concurrently involving endometrium and ovary are independent primary tumors (IPTs) or endometrial carcinomas with ovarian metastases (at least stage IIIA endometrial cancers, IIIA-EC) using clinicopathologic criteria is often challenging. Recent genomic studies showed that most such tumors are clonally related. We sought to identify clinicopathologic features associated with clinical outcomes, and to separate women with these tumors into clinically low-risk and high-risk groups. METHODS:We reviewed clinical and pathologic data from 74 women who, between 1993 and 2014, underwent primary surgery for endometrial cancer and had concurrent ovarian involvement. RESULTS:The endometrial carcinomas were endometrioid (EECs, n = 41) or non-endometrioid (ENECs, n = 33). Nineteen (26%) cases were originally classified as IPTs using clinicopathologic criteria. Multivariate analysis revealed that lymph node involvement (hazard ratio (HR) = 2.38, 95% CI 1.13-5.02, p = 0.023) and non-endometrioid endometrial tumor histology (HR = 6.27, 95% CI 2.6-15.13, p < 0.001) were associated with poorer progression-free survival (PFS). Multivariate analysis of 65 women with known lymph node status revealed two prognostically distinct groups: a high-risk group comprising ENECs with ≥50% myometrial invasion irrespective of lymph node status (n = 21; median PFS 12.7 months, 95% CI, 9.24-19.8); and a low-risk group consisting of all EECs, as well as lymph node-negative ENECs with <50% myometrial invasion (n = 44, median PFS not reached). The risk-based classification was superior to the original classification of endometrial cancers as IPTs vs. IIIA-EC for predicting PFS (log-rank test, p < 0.001 vs. p = 0.07). CONCLUSION:Our proposed risk-based stratification enables categorization of women with concurrent endometrial and ovarian tumors according to their likely clinical outcomes.

journal_name

Gynecol Oncol

journal_title

Gynecologic oncology

authors

Turashvili G,Gómez-Hidalgo NR,Flynn J,Gonen M,Leitao MM Jr,Soslow RA,Murali R

doi

10.1016/j.ygyno.2018.10.033

subject

Has Abstract

pub_date

2019-01-01 00:00:00

pages

38-45

issue

1

eissn

0090-8258

issn

1095-6859

pii

S0090-8258(18)31315-5

journal_volume

152

pub_type

杂志文章
  • Clear cell carcinoma of the ovary: a report from the first Ovarian Clear Cell Symposium, June 24th, 2010.

    abstract:OBJECTIVES:Recent literature has highlighted histological types of ovarian carcinoma as distinct diseases, each with unique clinical and molecular features. Historically, the diagnosis of ovarian clear cell carcinoma (CCC) has been of concern to both patients and physicians due to reports that CCC is associated with a ...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章,评审

    doi:10.1016/j.ygyno.2011.01.005

    authors: Anglesio MS,Carey MS,Köbel M,Mackay H,Huntsman DG,Vancouver Ovarian Clear Cell Symposium Speakers.

    更新日期:2011-05-01 00:00:00

  • Management of malignant, mixed mesodermal tumors of the uterus.

    abstract::Forty-two patients with malignant, mixed mesodermal tumors of the uterus were identified by retrospective chart review. Only 2 patients were premenopausal at the time of diagnosis. Six of the patients had previously received pelvic radiotherapy. Surgical/pathologic findings were inconsistent with clinical staging in 1...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/s0090-8258(89)80041-1

    authors: Podczaski ES,Woomert CA,Stevens CW Jr,Manetta A,Larson JE,Zaino RJ,Mortel R

    更新日期:1989-02-01 00:00:00

  • Synchronous primary neoplasms of the female reproductive tract.

    abstract::A histopathologic review of synchronous primary neoplasms of the female reproductive tract is presented. During a 30-year period, 3863 patients with female genital malignancies were accessioned to the UCLA Tumor Registry: 958 had ovarian cancer, 776 endometrial cancer, 1556 cervical cancer, and 573 other gynecologic m...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/0090-8258(89)90523-4

    authors: Eisner RF,Nieberg RK,Berek JS

    更新日期:1989-06-01 00:00:00

  • Cytoreduction of diaphragmatic metastasis from ovarian cancer with involvement of the liver using a ventral liver mobilization technique.

    abstract:OBJECTIVE:Upper abdominal spreading of advanced-stage ovarian cancer often involves the diaphragm. In addition, bulky diaphragmatic tumors occasionally infiltrate the liver. Here, we describe our early experiences with a ventral liver mobilization technique to remove diaphragmatic tumors with liver involvement. METHOD...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/j.ygyno.2016.01.017

    authors: Kato K,Katsuda T,Takeshima N

    更新日期:2016-03-01 00:00:00

  • ras oncogene product p21 expression and prognosis of human ovarian tumors.

    abstract::Monoclonal antibody rp-28 directed against the ras gene product p21 has been studied to evaluate ras p21 expression in malignant and benign ovarian tissues. Some ovarian carcinomas of serous and mucinous cystadenocarcinomas, undifferentiated adenocarcinomas, and clear cell carcinomas demonstrated intense staining of r...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/0090-8258(92)90194-n

    authors: Yaginuma Y,Yamashita K,Kuzumaki N,Fujita M,Shimizu T

    更新日期:1992-07-01 00:00:00

  • Vulvar reconstruction using a mons pubis pedicle flap.

    abstract::The treatment of early vulvar carcinoma has moved toward less radical surgery with reconstruction. This report describes our preliminary experience with a mons pubis flap that is simple and appears safe, reliable, and gives excellent cosmetic and functional results following radical hemivulvectomy. Four patients have ...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1006/gyno.1994.1240

    authors: Potkul RK,Barnes WA,Barter JF,Delgado G,Spear SL

    更新日期:1994-10-01 00:00:00

  • Analysis of disease recurrence and survival for women with uterine malignancies undergoing robotic surgery.

    abstract:OBJECTIVES:To evaluate recurrence-free survival (RFS) and overall survival (OS) for patients who underwent robotic-assisted laparoscopic hysterectomy (RALH) for uterine malignancies. METHODS:Medical records from 372 patients with uterine malignancies who underwent RALH from 3/06 to 3/09 at two institutions were review...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/j.ygyno.2012.11.005

    authors: Brudie LA,Backes FJ,Ahmad S,Zhu X,Finkler NJ,Bigsby GE 4th,Cohn DE,O'Malley D,Fowler JM,Holloway RW

    更新日期:2013-02-01 00:00:00

  • The presence of tumor-infiltrating FOXP3+ lymphocytes correlates with intratumoral angiogenesis in endometrial cancer.

    abstract:OBJECTIVES:CD4(+)CD25(+) regulatory T-cells (Tregs), that express the transcription factor FOXP3, suppress effector T-cell populations and can enable tumour cells to evade the host immune response. In this study, we investigated the numbers of FOXP3(+) Tregs in the normal and malignat endometrium and examined potential...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/j.ygyno.2008.04.021

    authors: Giatromanolaki A,Bates GJ,Koukourakis MI,Sivridis E,Gatter KC,Harris AL,Banham AH

    更新日期:2008-08-01 00:00:00

  • Clinical and pathologic findings of prophylactic salpingo-oophorectomies in 159 BRCA1 and BRCA2 carriers.

    abstract:OBJECTIVE:To estimate the likelihood of occult cancer diagnosis at prophylactic oophorectomy in BRCA1 and BRCA2 carriers in different age groups and to determine the histopathology of these lesions. METHODS:We describe a series of 159 female BRCA1 or BRCA2 carriers who underwent prophylactic oophorectomy at the Univer...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/j.ygyno.2005.06.065

    authors: Finch A,Shaw P,Rosen B,Murphy J,Narod SA,Colgan TJ

    更新日期:2006-01-01 00:00:00

  • Role of PET or PET/CT in the post-therapy surveillance of uterine sarcoma.

    abstract:OBJECTIVE:To evaluate the clinical accuracy and clinical impact of positron emission tomography (PET) or positron emission tomography/computed tomography (PET/CT) in detecting and treating tumor recurrence in patients with treated uterine sarcoma. METHODS:Results of 36 patients who underwent PET or PET/CT in post-ther...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/j.ygyno.2008.01.030

    authors: Park JY,Kim EN,Kim DY,Suh DS,Kim JH,Kim YM,Kim YT,Nam JH

    更新日期:2008-05-01 00:00:00

  • Gene expression profiling of in vitro radiation resistance in cervical carcinoma: a feasibility study.

    abstract:OBJECTIVE(S):To determine the feasibility of integrating an in vitro chemo-radiation response assay (IVRRA) with a gene microarray system to investigate the molecular patterns of expression that contribute to radiation resistance in cervical cancer. METHODS:Viable primary untreated cervical cancer specimens were obtai...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/j.ygyno.2005.05.043

    authors: Tewari D,Monk BJ,Al-Ghazi MS,Parker R,Heck JD,Burger RA,Fruehauf JP

    更新日期:2005-10-01 00:00:00

  • Advanced vulvar carcinoma treated with internal iliac arterial embolization therapy after radiotherapy.

    abstract::Two patients with vulvar carcinoma are reported who were treated with internal iliac transcatheter arterial embolization and radiotherapy. Patient 1 had T3N3M0 vulvar carcinoma. The lesion remaining after radiotherapy was treated by bilateral internal iliac arterial embolization. Vulvectomy was then performed, and the...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/0090-8258(90)90407-c

    authors: Harima Y,Shiraishi T,Harima K,Tanaka Y

    更新日期:1990-10-01 00:00:00

  • MRP2 (ABCC2) and cisplatin sensitivity in hepatocytes and human ovarian carcinoma.

    abstract:OBJECTIVE:The ABC transporter MRP2 (ABCC2) can mediate cisplatin efflux, and over-expression of MRP2 has been associated with cisplatin resistance in cancer cell lines. The aim of this study was to determine the role of MRP2 in modulating cisplatin cytotoxicity in normal cells as well as the relationship between MRP2 e...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/j.ygyno.2005.08.046

    authors: Guminski AD,Balleine RL,Chiew YE,Webster LR,Tapner M,Farrell GC,Harnett PR,Defazio A

    更新日期:2006-02-01 00:00:00

  • Symptoms, coping strategies, and timing of presentations in patients with newly diagnosed ovarian cancer.

    abstract:OBJECTIVE:The purpose was to explore whether health education on symptoms of ovarian cancer would aid in early detection, by examining the relationship between symptoms, coping strategies, and timing of presentation in patients with newly diagnosed ovarian cancer. METHODS:Eighty women were included. A questionnaire co...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/s0090-8258(03)00394-9

    authors: Chan YM,Ng TY,Lee PW,Ngan HY,Wong LC

    更新日期:2003-09-01 00:00:00

  • Oncolytic adenovirus Ad5/3-delta24 and chemotherapy for treatment of orthotopic ovarian cancer.

    abstract:OBJECTIVE:Oncolytic adenoviruses capable of replication selectively in tumor cells are an appealing approach for the treatment of neoplastic diseases refractory to conventional therapies. The aim of this study was to evaluate the effect of dose and scheduling of a tropism-modified, adenovirus serotype 3 receptor-target...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/j.ygyno.2007.09.013

    authors: Raki M,Särkioja M,Desmond RA,Chen DT,Bützow R,Hemminki A,Kanerva A

    更新日期:2008-01-01 00:00:00

  • Alterations in SPARC and VEGF immunoreactivity in epithelial ovarian cancer.

    abstract:OBJECTIVE:Secreted protein, acidic and rich in cysteine (SPARC), is a matricellular protein that modulates cell adhesion and growth. It is thought to play a decisive role in tissue remodeling and angiogenesis. Alterations in SPARC expression have been observed in a variety of solid tumors; however, no consistent patter...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1006/gyno.2000.5894

    authors: Paley PJ,Goff BA,Gown AM,Greer BE,Sage EH

    更新日期:2000-09-01 00:00:00

  • Ki67 antigen immunostaining (MIB 1 monoclonal antibody) in serous ovarian tumors: index of proliferative activity with prognostic significance.

    abstract::The purpose of this study was to evaluate the biological significance of Ki67 antigen expression in serous ovarian tumors, through the analysis of MIB 1 monoclonal antibody reactivity in cystoadenomas, borderline tumors, and invasive cystoadenocarcinomas; the correlation between this index of cell proliferation and cl...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1006/gyno.1995.1026

    authors: Garzetti GG,Ciavattini A,Goteri G,De Nictolis M,Stramazzotti D,Lucarini G,Biagini G

    更新日期:1995-02-01 00:00:00

  • Urolithiasis following formation of a continent urostomy: case report and review of the literature.

    abstract:BACKGROUND:Formation of urinary stones in a continent urostomy (Indiana pouch) has been described as a late complication. Management of a patient with symptomatic multiple large stones and review of the literature are outlined. CASE REPORT:A 32-year-old woman presented with recurrent urinary tract infections and pyelo...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章,评审

    doi:10.1006/gyno.2000.5750

    authors: Sait K,Stuart G,Nation J,Ghatage P

    更新日期:2000-05-01 00:00:00

  • Phase 2 trial of single-agent gemcitabine in platinum-paclitaxel refractory ovarian cancer.

    abstract:OBJECTIVE:There is a need to find agents with activity in platinum and taxane refractory ovarian cancer to be employed as second-line therapy in the malignancy. Limited clinical trial experience has suggested that gemcitabine possesses activity in this clinical setting. We wished to further define the level of activity...

    journal_title:Gynecologic oncology

    pub_type: 临床试验,杂志文章

    doi:10.1016/s0090-8258(03)00399-8

    authors: Markman M,Webster K,Zanotti K,Kulp B,Peterson G,Belinson J

    更新日期:2003-09-01 00:00:00

  • The cost-effectiveness of selective lymphadenectomy based on a preoperative prediction model in patients with endometrial cancer: insights from the US and Korean healthcare systems.

    abstract:OBJECTIVE:The aim of this study was to determine the cost-effectiveness of selective lymphadenectomy using a preoperative prediction model compared to routine lymphadenectomy for patients undergoing surgery for endometrial cancer in the US and Korea. METHODS:We used a modified Markov model to estimate clinical and eco...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/j.ygyno.2014.09.020

    authors: Lee JY,Cohn DE,Kim Y,Lee TJ,Barnett JC,Kim JW,Jeon YW,Kim K,Park SM,Kang S

    更新日期:2014-12-01 00:00:00

  • The "real-life" variability of CA-125 in ovarian cancer patients.

    abstract:BACKGROUND:The serum CA-125 antigen value has proven to be useful in predicting changes that affect prognosis and management of ovarian cancer; however, interpreting variations in the tumor marker is still not well-defined. Our goal was to further understand the analytical variability of CA-125 in a conventional hospit...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/j.ygyno.2006.02.010

    authors: Tso E,Elson P,Vanlente F,Markman M

    更新日期:2006-10-01 00:00:00

  • Prognostic factors in patients with bulky stage IB or IIA cervical carcinoma undergoing neoadjuvant chemotherapy and radical hysterectomy.

    abstract::All patients with bulky (> or =4 cm) Stage Ib or IIa cervical carcinoma treated at Chang Gung Memorial Hospital between August 1988 and December 1991 using a strategy of neoadjuvant chemotherapy with cisplatin, vincristine, and bleomycin and radical hysterectomy were reviewed. Fifty-nine evaluable patients received 1 ...

    journal_title:Gynecologic oncology

    pub_type: 临床试验,杂志文章

    doi:10.1006/gyno.1996.4603

    authors: Lai CH,Hsueh S,Chang TC,Tseng CJ,Huang KG,Chou HH,Chen SM,Chang MF,Shum HC

    更新日期:1997-03-01 00:00:00

  • Stage II-B carcinoma of the cervix complicated by bilateral pelvic kidneys.

    abstract:BACKGROUND:The simultaneous occurrence of advanced cervical cancer and a pelvic kidney is uncommonly reported. It is an interesting clinical problem because the pelvic kidney lies within the radiation field. CASE:A patient found to have bilateral pelvic kidneys and stage II-B cervical cancer underwent an anterior exen...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/j.ygyno.2003.09.033

    authors: Roth TM,Woodring CT,McGehee RP

    更新日期:2004-01-01 00:00:00

  • Melanoma of the vulva: an update.

    abstract::During the time interval 1950 through 1980, 48 patients having a mean age of 60.2 years were treated primarily for melanoma of the vulva. In all but one patient, a surgical therapeutic approach was selected, including 40 modified Basset procedures and 23 pelvic lymphadenectomies. The 5-year survival rate of the eligib...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/0090-8258(83)90090-2

    authors: Podratz KC,Gaffey TA,Symmonds RE,Johansen KL,O'Brien PC

    更新日期:1983-10-01 00:00:00

  • Adenovirus-mediated thymidine kinase gene therapy in combination with topotecan for patients with recurrent ovarian cancer: 2.5-year follow-up.

    abstract:OBJECTIVE:Patients with recurrent ovarian cancer were treated intraperitoneally (ip) with a replication-deficient recombinant adenovirus (ADV) containing the herpes simplex virus thymidine kinase gene. Vector delivery was followed by intravenous administration of an antiherpetic prodrug and a topoisomerase I inhibitor....

    journal_title:Gynecologic oncology

    pub_type: 临床试验,杂志文章

    doi:10.1006/gyno.2001.6442

    authors: Hasenburg A,Tong XW,Fischer DC,Rojas-Martinez A,Nyberg-Hoffman C,Kaplan AL,Kaufman RH,Ramzy I,Aguilar-Cordova E,Kieback DG

    更新日期:2001-12-01 00:00:00

  • HPV status in sentinel nodes might be a prognostic factor in cervical cancer.

    abstract:OBJECTIVE:Although there have been studies that focused on the correlation between the HPV presence of pelvic lymph nodes and pathological metastasis in patients with cervical cancer, the biologic role of HPV DNA in lymph nodes still remains uncertain. We performed this study to investigate the correlation between the ...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/j.ygyno.2006.12.016

    authors: Lee YS,Rhim CC,Lee HN,Lee KH,Park JS,Namkoong SE

    更新日期:2007-05-01 00:00:00

  • Anti-Yo positive paraneoplastic cerebellar degeneration associated with ovarian carcinoma: case report and review of the literature.

    abstract::Paraneoplastic cerebellar degeneration (PCD) is a rare nonmetastatic neurological complication in cancer patients. Anti-Yo is one of the anti-onconeural antibodies found in PCD patients. It is believed that anti-Yo occurs almost always in women and is most likely associated with gynecologic or breast cancers, although...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章,评审

    doi:10.1006/gyno.1999.5553

    authors: Cao Y,Abbas J,Wu X,Dooley J,van Amburg AL

    更新日期:1999-10-01 00:00:00

  • CHEK2 variants predispose to benign, borderline and low-grade invasive ovarian tumors.

    abstract:OBJECTIVE:Three founder alleles of the CHEK2 gene have been associated with predisposition to a range of cancer types in Poland. Two founder alleles (1100delC and IVS2 + 1G >A) result in a truncated CHEK2 protein and the other is a missense substitution, leading to the replacement of a threonine with an isoleucine (I15...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/j.ygyno.2006.05.040

    authors: Szymanska-Pasternak J,Szymanska A,Medrek K,Imyanitov EN,Cybulski C,Gorski B,Magnowski P,Dziuba I,Gugala K,Debniak B,Gozdz S,Sokolenko AP,Krylova NY,Lobeiko OS,Narod SA,Lubinski J

    更新日期:2006-09-01 00:00:00

  • Mullerian inhibiting substance reduction of colony growth of human gynecologic cancers in a stem cell assay.

    abstract::Mullerian Inhibiting Substance (MIS), a fetal testicular product that causes regression of the Mullerian duct in the male mammalian embryo, was evaluated for its antitumor effect on the premise that a substance active against this genital precursor in the fetus might also be active against tumors derived from these ti...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/0090-8258(85)90019-8

    authors: Fuller AF Jr,Krane IM,Budzik GP,Donahoe PK

    更新日期:1985-10-01 00:00:00

  • The prognostic significance of thrombocytosis in epithelial ovarian carcinoma.

    abstract:OBJECTIVE:The objective of this study was to determine the incidence of thrombocytosis in epithelial ovarian carcinoma and examine associations with clinico-pathologic features. Thrombocytosis (platelet counts >400 x 10(9)/l) has been identified as a poor prognostic factor in many cancers. Platelet-secreted factors may...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/j.ygyno.2003.09.002

    authors: Li AJ,Madden AC,Cass I,Leuchter RS,Lagasse LD,Karlan BY

    更新日期:2004-01-01 00:00:00