Abstract:
OBJECTIVE:Epithelial ovarian cancer (EOC) spreads intra-abdominally and to the retroperitoneal lymph nodes. A greater number of distant metastases are revealed by (18)F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) compared to conventional imaging methods. We aimed to investigate the presence and anatomic distribution of supradiaphragmatic lymph node metastasis (LNM) detected with pretreatment FDG PET/CT. METHODS:Thirty women with advanced stage (IIC-IV) EOC were scanned with whole body contrast-enhanced FDG PET/CT prior to surgery/neoadjuvant chemotherapy. We performed PET/CT analysis qualitatively and quantitatively. Additionally, contrast-enhanced CT was analyzed blinded to PET/CT scan. Intra-abdominal dissemination was verified by surgery and histopathology. Metabolically active lymph nodes were biopsied when possible. The clinical characteristics of patients with and without supradiaphragmatic LNM were compared. RESULTS:In 20/30 patients (67%) FDG PET/CT detected supradiaphragmatic LNM in one or more locations, whereas conventional CT found LNM in 10 patients (33%). Fourteen patients had parasternal, 14 cardiophrenic, 8 other mediastinal, 6 axillar, and 1 subclavian LNM. Microscopy of all four biopsied lymph nodes (three axillar and one subclavian) confirmed metastatic dissemination. The patients with supradiaphragmatic LNM had significantly more ascites (p<0.01), higher CA 125 levels, and more frequent subdiaphragmal carcinomatosis (p<0.03) compared to patients without supradiaphragmatic LNM in preoperative FDG PET/CT. CONCLUSIONS:A significant number of patients with advanced EOC showed supradiaphragmatic LNM in pre-treatment PET/CT. Our findings suggest that the route of EOC cells from the peritoneal cavity to the lymphatic system permeates the diaphragm mainly to the cardiophrenic and continues to parasternal lymph nodes.
journal_name
Gynecol Oncoljournal_title
Gynecologic oncologyauthors
Hynninen J,Auranen A,Carpén O,Dean K,Seppänen M,Kemppainen J,Lavonius M,Lisinen I,Virtanen J,Grénman Sdoi
10.1016/j.ygyno.2012.04.023subject
Has Abstractpub_date
2012-07-01 00:00:00pages
64-8issue
1eissn
0090-8258issn
1095-6859pii
S0090-8258(12)00278-8journal_volume
126pub_type
临床试验,杂志文章abstract:OBJECTIVE:Our goal was to pragmatically describe patient reported outcomes (PROs) in a typical clinic population of vulvar cancer patients, as prior studies of vulvar cancer PROs have examined clinical trial participants. METHODS:A prospective PRO program was implemented in the Gynecologic Oncology clinic of a tertiar...
journal_title:Gynecologic oncology
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abstract::Many malignancies appear to occur with increased frequency and aggressive patterns of spread in patients seropositive for human immunodeficiency virus (HIV). The relationship between HIV infection and cervical neoplasia suggests that these patients present with more advanced disease and demonstrate poor response to th...
journal_title:Gynecologic oncology
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doi:10.1006/gyno.1993.1224
更新日期:1993-09-01 00:00:00
abstract:OBJECTIVE:Ovarian cancer is the leading cause of death from gynecologic malignancies in the Western world. Fibroblast growth factor receptor (FGFR) signaling has been implicated to play a role in ovarian tumorigenesis. Mutational activation of one member of this receptor family, FGFR2, is a frequent event in endometrio...
journal_title:Gynecologic oncology
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journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章
doi:10.1006/gyno.1995.1241
更新日期:1995-09-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to evaluate the impact of introducing HR-HPV testing in cytology regarding cervical cancer screening practice. METHODS:A pooled analysis of liquid-based cytology (LBC) and HR-HPV testing using data from 13 population-based cervical cancer screening studies conducted in China w...
journal_title:Gynecologic oncology
pub_type: 杂志文章,meta分析
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更新日期:2014-05-01 00:00:00
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doi:10.1016/0090-8258(86)90034-x
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abstract:OBJECTIVES:To compare complete hydatidiform mole (CHM) clinical presentation and risk factors associated with GTN development between North American and South American adolescents. METHODS:This non-concurrent cohort study was undertaken including adolescents with CHM referred to centers in North America (New England T...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2016.07.002
更新日期:2016-09-01 00:00:00
abstract:OBJECTIVE:Difficulties in detecting cervical adenocarcinoma early are well known. We report a detailed pathology review of cervical adenocarcinoma subtypes, comparing growth patterns and appearance of non-neoplastic epithelium to inform possible clues for disease progression and early detection. METHODS:This analysis ...
journal_title:Gynecologic oncology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ygyno.2006.03.049
更新日期:2006-11-01 00:00:00
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pub_type: 杂志文章
doi:10.1006/gyno.2001.6184
更新日期:2001-06-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2007.12.030
更新日期:2008-04-01 00:00:00
abstract::The standard management of advanced-stage ovarian cancer has been a subject of debate, and much controversy remains as to whether patients should have primary cytoreductive surgery followed by chemotherapy or neoadjuvant chemotherapy followed by interval cytoreductive surgery. In addition, there is increasing evidence...
journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1016/j.ygyno.2015.03.049
更新日期:2015-06-01 00:00:00
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doi:10.1016/j.ygyno.2005.01.007
更新日期:2005-05-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1995.1260
更新日期:1995-10-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1006/gyno.1997.4727
更新日期:1997-07-01 00:00:00
abstract:BACKGROUND:Brain metastases (BM) from epithelial ovarian cancer (EOC) are considered a rare and unfavourable event. There is no consensus regarding the best management of these patients. METHODS:A multicenter retrospective analysis of patients with BM from EOC treated between 1997 and 2014 in 18 institutions of the MI...
journal_title:Gynecologic oncology
pub_type: 杂志文章,多中心研究
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更新日期:2005-01-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章
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更新日期:2012-06-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2007-12-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2007.10.022
更新日期:2008-02-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.ygyno.2011.10.030
更新日期:2012-03-01 00:00:00
abstract:OBJECTIVE:To assess the treatment and outcome of patients with endometrial cancer following isolated pulmonary relapse. METHODS:Between 1984 and 1996, 82 of 1109 patients undergoing surgery for primary endometrial cancer experienced a primary pulmonary recurrence, 28 of which were solitary. Median follow up of censore...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2007.06.030
更新日期:2007-11-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ygyno.2010.08.016
更新日期:2010-12-01 00:00:00
abstract:OBJECTIVE:Although the relationship between human papilloma virus (HPV) and cervical cancer is well established, the prognostic value of HPV status has not been determined, largely because previous studies have yielded conflicting results. This study aimed to investigate the prognostic value of pre-treatment HPV DNA fo...
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doi:10.1016/j.ygyno.2017.11.003
更新日期:2018-01-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ygyno.2015.08.005
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVE:Aberrant expression of HER2/neu and PIK3CA gene products secondary to amplification/mutations are common in high-grade-serous-endometrial (USC) and ovarian-cancers (HGSOC). Because scant information is currently available in the literature on the potential negative effect of PIK3CA mutations on the activity o...
journal_title:Gynecologic oncology
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journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.ygyno.2015.10.009
更新日期:2015-12-01 00:00:00