Abstract:
OBJECTIVE:To determine if tumor-free distance (TFD) from the uterine serosa predicts surgicopathologic factors and outcome in surgically staged endometrial cancer, and to compare TFD with the traditional estimate of depth of myometrial invasion (DOI). METHODS:Patients who underwent complete surgical staging for primary endometrial cancer at a single institution were identified from 2002-2005. During this time, TFD was prospectively measured at the time of pathologic evaluation of the uterine specimen. Tumor-free distance (TFD) was defined as distance from deepest myometrial invasion to the serosal surface, whereas DOI was defined as the distance between the endomyometrial junction and deepest myometrial invasion. DOI and TFD were shown as continuous variables and compared to traditional surgicopathologic factors and evaluated for their ability to predict recurrence and death from disease. Univariate and multivariate analysis were used to examine the data. Receiver-operator characteristic curve was created to evaluate optimal TFD. RESULTS:We identified 99 patients that met the study criteria. Mean DOI was 0.6 cm and mean TFD was 1.3 cm. 77 patients were stage I, 11 were stage II, and 11 were stage III. Tumor grade was distributed as 68, 21 and 10 for grades 1, 2, and 3 respectively. Median follow up time was 2.7 years (1002 days) with 9 episodes of recurrence and 7 deaths. Univariate analysis demonstrated DOI to be a significant predictor of death, grade, lymph node metastasis, lymphovascular space involvement (LVSI), stage, lower uterine segment (LUS) involvement and adnexal involvement. TFD significantly predicted lymph node metastasis, LVSI, and grade. Using Cox proportional hazards model, DOI more significantly predicted recurrence (hazard ratio 3.11, p=0.0007). Both DOI and TFD predicted death from disease (hazard ratio 3.58, p=0.0006 and 0.22, p=0.0365, respectively). Although the performance characteristics of TFD were modest, the balance of sensitivity and specificity for TFD in predicting recurrence was 1 cm. CONCLUSIONS:TFD, like DOI, is predictive of many surgicopathological variables and patient outcome in surgically staged endometrial cancer. Although the performance characteristics may not be as powerful as DOI, the ease and reproducibility of this measurement may justify its inclusion in synoptic reporting of endometrial cancer.
journal_name
Gynecol Oncoljournal_title
Gynecologic oncologyauthors
Schwab KV,O'Malley DM,Fowler JM,Copeland LJ,Cohn DEdoi
10.1016/j.ygyno.2008.09.009subject
Has Abstractpub_date
2009-01-01 00:00:00pages
146-9issue
1eissn
0090-8258issn
1095-6859pii
S0090-8258(08)00724-5journal_volume
112pub_type
杂志文章abstract:PURPOSE:Racial genetic admixture (RGA), a measure to account for ancestral genetic background that correlates with individual's racial classification, could provide insights on causation of racial disparity in endometrial cancer (EC). Our objective is to evaluate the association of RGA with EC outcomes. METHODS:EC pat...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2015.11.018
更新日期:2016-02-01 00:00:00
abstract::Of a group of 68 patients treated with standard polychemotherapy (CAP-5), 52 were evaluated by an early second-look laparotomy, preferably after three cycles of treatment. Of 21 patients with initial tumor residuals smaller than 2 cm, only 5 had residual tumor, and of 31 patients with tumor larger than 2 cm, 27 had re...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(89)90055-3
更新日期:1989-11-01 00:00:00
abstract:OBJECTIVE:In advanced ovarian cancer, patients cytoreduced to no visible disease appear to have improved survival compared to patients with visible residual tumor < or = 10 mm. It remains unresolved whether this is due to better chemotherapy response and/or simply "re-setting the clock," such that patients with less re...
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
abstract::Transvaginal sonography (TVS) has been shown to be the most effective means to screen for ovarian cancer. TVS is associated with a high sensitivity and specificity. However, the positive predictive value associated with TVS in the diagnosis of malignancy is low. A morphologic scoring index for use with TVS has been us...
journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1006/gyno.1994.1273
更新日期:1994-11-01 00:00:00
abstract:INTRODUCTION:The ability to minimize residual disease during primary cytoreductive surgery is the strongest predictor for improved overall survival in advanced ovarian cancer. But while the probability to achieve a macroscopic complete resection increases if surgery is preceded by neoadjuvant chemotherapy (NACT), survi...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2019.02.019
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVE:We wished to compare the cost-effectiveness of three chemotherapy regimens for treatment of recurrent platinum-sensitive ovarian cancer. METHODS:A Markov decision tree was constructed comparing three chemotherapy regimens: (1) carboplatin alone (C); (2) paclitaxel/carboplatin (PC); (3) gemcitabine/carboplati...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2007.06.029
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:According to current treatment guidelines, comprehensive surgical staging procedures in endometrial cancer confined to the uterus depend on uterine risk factors: a systematic lymph node dissection (LND) is recommended in high risk patients and should be omitted in low risk patients. Its role in intermediate ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2019.04.002
更新日期:2019-07-01 00:00:00
abstract::Management of younger patients with early stage ovarian endodermal sinus tumor who desire to have children can be a challenging problem. However, after an adequate and thorough staging procedure for the patient's tumor status, a Stage Iai endodermal sinus tumor may be treated with conservative surgery only, followed b...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(84)90184-7
更新日期:1984-10-01 00:00:00
abstract:OBJECTIVE:The goal of this work was to determine the cellular content of inhibin and p53 in granulosa cell tumors (GCTs). METHODS:Clinical records of 47 patients (mean age, 54 years; range, 20-85 years) presenting with GCT surgically managed at our institution were abstracted. International Federation of Gynecology st...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.2000.5774
更新日期:2000-05-01 00:00:00
abstract:OBJECTIVE:Comorbidities are known to increase endometrial cancer risk, but the separate and combined impact of these risk factors on endometrial cancer survival remains unclear. This study aimed to determine the associations between metabolic syndrome and its components with disease-free survival, overall survival, end...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2020.06.488
更新日期:2020-09-01 00:00:00
abstract::Pelvic washings for cytologic analysis have become an accepted diagnostic procedure in the management of endometrial carcinoma. A retrospective study was performed in 163 consecutive patients with FIGO Stage I and II endometrial carcinoma to assess the significance and value of the washings. Abnormal results were obta...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/s0090-8258(87)80008-2
更新日期:1987-09-01 00:00:00
abstract:OBJECTIVES:The goal of this work was to test the hypotheses that S-phase fraction (SPF) by DNA labeling index (SPF-LI) would predict the course of the disease for ovarian/peritoneal carcinomas and that SPF-LI would correlate better with pathologic classification and outcome than SPF by DNA flow cytometry (SPF-F). METH...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.2001.6184
更新日期:2001-06-01 00:00:00
abstract:OBJECTIVES:The objectives of this study were to estimate the clinical response rate and toxicity of daily tamoxifen combined with intermittent weekly medroxyprogesterone acetate (MPA). METHODS:This study reports the results of 61 patients with measurable advanced or recurrent endometrial carcinoma enrolled on this stu...
journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.ygyno.2003.09.018
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVE:PTEN, a tumor suppressor gene shown to be frequently mutated in endometrial cancers, has been suggested to be a target of microsatellite instability (MSI)-driven mutagenesis. We set out to investigate the relationship between MSI and PTEN mutation in a large series of primary endometrial carcinomas. METHODS:...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.2000.5900
更新日期:2000-10-01 00:00:00
abstract:OBJECTIVES:The role of MDR1 in clinical paclitaxel resistance remains poorly characterized. This study sought to identify the incidence and significance of P-glycoprotein (P-gp) over-expression on survival, tumor response to paclitaxel and the effect of prior cytotoxic exposure on P-gp expression in patients with paire...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2003.11.053
更新日期:2004-04-01 00:00:00
abstract:OBJECTIVE:Ovarian cancer is most frequently diagnosed at a late stage with a poor prognosis. No markers for early diagnosis have been established. Aberrantly methylated DNA appears as a promising molecular cancer marker. The aim of this study was to analyze the methylation status of the proapoptotic cancer related gene...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2010.11.018
更新日期:2011-04-01 00:00:00
abstract::A new cell line, CUMC-3, has been derived from an invasive nonkeratinizing squamous cell carcinoma of the uterine cervix in a 32-year-old patient. It has been maintained in long-term culture for 59 months, and passaged over 310 times. Monolayer-cultured cells were polygonal in shape, showing a pavement-like arrangemen...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1995.1098
更新日期:1995-04-01 00:00:00
abstract::Pretreatment serum levels of the tumor-associated antigens CA-125, tissue polypeptide antigen (TPA), carcinoembryonic antigen (CEA), and placental alkaline phosphatase (PLAP) were analyzed in 142 patients with epithelial ovarian carcinoma, and related to clinical and histopathological parameters. In a linear multiple ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(90)90394-z
更新日期:1990-10-01 00:00:00
abstract:OBJECTIVE:We compared the self-sampling performance of the newly designed HerSwab™ device with a physician-collected cervical sample and another self-sample using the cobas® PCR Female swab for the detection of cervical intraepithelial neoplasia (CIN) and cancer. METHODS:Women referred for colposcopy at McGill Univers...
journal_title:Gynecologic oncology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ygyno.2018.04.004
更新日期:2018-06-01 00:00:00
abstract::In an attempt to establish a blood-based biochemical index for diagnosis of cervical cancer and treatment monitoring of patients suffering from the disease, serum levels of total sialic acid (TSA), lipid-bound sialic acid (LSA), and lactate dehydrogenase were estimated by highly specific spectrophotometric methods. Se...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1993.1214
更新日期:1993-09-01 00:00:00
abstract:OBJECTIVE:In cervical cancer patients, dose-volume relationships have been demonstrated for tumor and organs-at-risk, but not for pathologic nodes. The nodal control probability (NCP) according to dose/volume parameters was investigated. MATERIAL AND METHODS:Patients with node-positive cervical cancer treated curative...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2017.12.028
更新日期:2018-03-01 00:00:00
abstract::Endometrial adenocarcinoma in young women below the age of 45 years and in a functioning endometrium is rare. We present the case of a 41-year-old woman, who without clinical risk factors, was found to have a focal well-differentiated endometrial adenocarcinoma in the background of a histologically secretory endometri...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1993.1122
更新日期:1993-05-01 00:00:00
abstract:OBJECTIVES:To identify angiogenic biomarkers associated with tumor angiogenesis and clinical outcome in high-grade serous ovarian cancer (HGSC). METHODS:51 HGSC samples were analyzed using Affymetrix HG-U133A microarray. Microvessel density (MVD) counts were determined using CD31 and CD105. Associations between mRNA e...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2015.08.001
更新日期:2015-10-01 00:00:00
abstract::Verrucous carcinoma is a rare variant of epidermoid carcinoma with distinct clinical and histopathologic features. To date, 31 cases have been reported in the cervix. They are typically slow-growing, locally invasive tumors with low potential for lymphatic metastasis and appear to be radioresistant. We report a case w...
journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1016/0090-8258(90)90185-n
更新日期:1990-02-01 00:00:00
abstract::A 20 year old with recurrent low-grade serous carcinoma (LGSC) is discussed. The differential diagnosis, pathology, epidemiology, treatment options are discussed. Focus on the molecular pathways of LGSC and the implications of the diagnosis on fertility are highlighted. ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2017.01.023
更新日期:2017-03-01 00:00:00
abstract:OBJECTIVE:To determine if lymphadenectomy, chemotherapy and radiotherapy are associated with survival benefit among women with stage I uterine carcinosarcoma. METHODS:Women with stage I uterine carcinosarcoma (n=5614) were identified from the 1998-2013 National Cancer Data Base. Kaplan-Meier survival estimates and Cox...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2017.01.010
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:A LEEP-Cone may not be necessary for all patients with traditional cone indications. This study defines populations where a single pass technique with the LEEP is appropriate. METHODS:We retrospectively reviewed patients undergoing LEEP-Cone procedures performed at the University of Oklahoma Health Science C...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2005.09.015
更新日期:2006-02-01 00:00:00
abstract:OBJECTIVE:Small cell carcinoma (SmCC) of the female genital tract constitutes a diagnostic and clinical challenge given its rarity and the lack of standardized therapeutic approaches. Here we review the morphological, clinical and molecular features of gynecologic SmCCs and discuss potential areas for future research. ...
journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1016/j.ygyno.2014.05.017
更新日期:2014-08-01 00:00:00
abstract:OBJECTIVE:To review the literature on fertility-sparing options for women with early stage cervical cancer and outline patient selection criteria, operative, oncologic, and pregnancy outcomes. METHODS:The literature was searched using MEDLINE (OVID: 1950 through October 2009) and EMBASE (OVID: 1988 through October 200...
journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1016/j.ygyno.2010.01.039
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVE:While there is ample literature on prognostic factors for uterine cancer, currently there are nomeans to estimate an individual's risk for recurrence or to differentiate the risk of loco-regional recurrence from distant recurrence. We addressed this gap by developing nomograms to individualize the risk of rec...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2012.02.022
更新日期:2012-06-01 00:00:00