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Leone Roberti Maggiore U, Spanò Bascio L, Alboni C, Chiarello G, Savelli L, Bogani G, Martinelli F, Chiappa V, Ditto A, Raspagliesi F. Sentinel lymph node biopsy in endometrial cancer: When, how and in which patients. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024; 50:107956. [PMID: 38286085 DOI: 10.1016/j.ejso.2024.107956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 12/27/2023] [Accepted: 01/08/2024] [Indexed: 01/31/2024]
Abstract
The role of nodal dissection in patients with endometrial cancer has been intensively studied in several studies. Historically, systematic pelvic and para-aortic lymphadenectomy represented the gold standard surgical treatment to assess potential nodal involvement and consequently define the appropriate stage of the tumor. Over the last years, sentinel node biopsy (SLNB) has been introduced as a more targeted alternative to lymph node dissection for lymph node staging and it has become popular among gynecologic oncologists. However, no level A evidence is still available, and several features of the SLNB technique have been matter of discussion among clinicians and a universally accepted methodology is still not currently available. This narrative review aims to summarize the body of knowledge on SLNB to offer the reader a complete picture about the evolution of this technique over the last decades.
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Affiliation(s)
| | - Ludovica Spanò Bascio
- Obstetrics and Gynecology, Policlinico Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - Carlo Alboni
- Obstetrics and Gynecology, Policlinico Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - Giulia Chiarello
- Department of Biomedical Sciences and Human Oncology, University of Bari, Italy
| | - Luca Savelli
- Obstetrics and Gynecology Unit, Morgagni-Pierantoni Hospital, Forlì, Italy
| | - Giorgio Bogani
- Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Fabio Martinelli
- Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Valentina Chiappa
- Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Antonino Ditto
- Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Francesco Raspagliesi
- Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
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Ercolin ACM, Uchôa AS, Aires LPN, Gomes DR, Tinto ST, Feliciano GSM, Feliciano MAR. Use of New Ultrasonography Methods for Detecting Neoplasms in Dogs and Cats: A Review. Animals (Basel) 2024; 14:312. [PMID: 38275771 PMCID: PMC10812759 DOI: 10.3390/ani14020312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/21/2023] [Accepted: 12/27/2023] [Indexed: 01/27/2024] Open
Abstract
The aim of this literature review was to present the novel imaging modalities elastography and contrast-enhanced ultrasonography. We provided an overview of the concepts and applications of each technique for the investigation of neoplastic and metastatic tumors in dogs and cats. Studies on elastography are based on the elasticity and deformation of the evaluated tissue. The information obtained from the different types of elastography can aid in the detection and differentiation of malignant and benign structures. Descriptions of elastography studies in several organs and tissue in veterinary medicine reported that, in general, malignant tumors tend to be more rigid and, therefore, less deformable than benign lesions or in comparison to the healthy parenchyma. Contrast-enhanced ultrasonography is based on the intravenous injection of contrast media constituted by microbubbles. This imaging modality can be performed in nonsedated animals and provides information on the tissue perfusion, allowing the investigation of macro- and micro-circulation. Studies on different organs and tissues were performed in dogs and cats and revealed a tendency of malignant tumors to present faster transit of the contrast media (time to wash-in, peak and wash-out). These advanced techniques can be associated with other imaging modalities, aiding important information to the well-established exams of B-mode and Doppler ultrasonography. They can be used as screening tests, potentially representing an alternative to the invasive sampling methods required for cytological and histopathological analysis.
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Affiliation(s)
- Anna Carolina Mazeto Ercolin
- Laboratory of Veterinary, Faculty of Animal Science and Food Engineering, Sao Paulo University, Sao Paulo 13635-900, Brazil; (A.C.M.E.); (A.S.U.); (D.R.G.); (S.T.T.); (G.S.M.F.)
| | - Alex Silveira Uchôa
- Laboratory of Veterinary, Faculty of Animal Science and Food Engineering, Sao Paulo University, Sao Paulo 13635-900, Brazil; (A.C.M.E.); (A.S.U.); (D.R.G.); (S.T.T.); (G.S.M.F.)
| | - Luiz Paulo Nogueira Aires
- Department of Veterinary Clinic and Surgery, School of Agricultural and Veterinarian Sciences, Sao Paulo State University “Júlio de Mesquita Filho”, Sao Paulo 14884-900, Brazil;
| | - Diego Rodrigues Gomes
- Laboratory of Veterinary, Faculty of Animal Science and Food Engineering, Sao Paulo University, Sao Paulo 13635-900, Brazil; (A.C.M.E.); (A.S.U.); (D.R.G.); (S.T.T.); (G.S.M.F.)
| | - Stefany Tagliatela Tinto
- Laboratory of Veterinary, Faculty of Animal Science and Food Engineering, Sao Paulo University, Sao Paulo 13635-900, Brazil; (A.C.M.E.); (A.S.U.); (D.R.G.); (S.T.T.); (G.S.M.F.)
| | - Giovanna Serpa Maciel Feliciano
- Laboratory of Veterinary, Faculty of Animal Science and Food Engineering, Sao Paulo University, Sao Paulo 13635-900, Brazil; (A.C.M.E.); (A.S.U.); (D.R.G.); (S.T.T.); (G.S.M.F.)
| | - Marcus Antônio Rossi Feliciano
- Laboratory of Veterinary, Faculty of Animal Science and Food Engineering, Sao Paulo University, Sao Paulo 13635-900, Brazil; (A.C.M.E.); (A.S.U.); (D.R.G.); (S.T.T.); (G.S.M.F.)
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Chen J, Liang S, He M, Wang Z, Deng H, Zhang G, Yang X, Liang X, Sun X, Zhou R, Li X, Li Y, Wang J. Comparison of sentinel lymph node distribution and lymphatic drainage pathway between high- and low-risk endometrial cancers. Arch Gynecol Obstet 2023; 308:1641-1647. [PMID: 37430177 DOI: 10.1007/s00404-023-07111-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 06/13/2023] [Indexed: 07/12/2023]
Abstract
PURPOSE This study aimed to compare the distribution and drainage pathway of sentinel lymph nodes between high- and low-risk endometrial cancers. METHODS In total, 429 patients with endometrial cancer who underwent sentinel lymph node biopsy in Peking University People's Hospital from July 2015 to April 2022 were retrospectively enrolled. There were 148 patients in the high-risk group and 281 patients in the low-risk group. RESULTS The unilateral and bilateral detection rates of sentinel lymph nodes were 86.5% and 55.9%, respectively. The highest detection rate was achieved in the subgroup with a combined use of indocyanine green (ICG) and carbon nanoparticles (CNP) (94.4% for unilateral detection and 66.7% for bilateral detection). The upper paracervical pathway (UPP) was detected in 93.3% of cases in the high-risk group and 96.0% of cases in the low-risk group (p = 0.261). The lower paracervical pathway (LPP) was detected in 10.0% of cases in the high-risk group and 17.9% of cases in the low-risk group (p = 0.048). Remarkably increased detection rates of SLN in the common iliac (7.5%) and para-aortic or precaval areas (2.9%) were observed in the high-risk group. In contrast, a markedly decreased detection rate of SLN in the internal iliac area (1.9%) was observed in the high-risk group. CONCLUSION The highest detection rate of SLN was observed in the subgroup with a combined use of ICG and CNP. The detection of UPP is important for both high-risk and low-risk cases, while LPP detection plays a more important role in the low-risk group. Lymphadenectomy in the common iliac and para-aortic or precaval areas is essential for patients with high-risk EC. Removal of internal iliac lymph nodes is essential for patients with low-risk EC, in case of ineffective SLN mapping.
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Affiliation(s)
- Jiayu Chen
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
- Department of Obstetrics and Gynecology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Sichen Liang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
| | - Miao He
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
| | - Zhiqi Wang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
| | - Hao Deng
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
| | - Guo Zhang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
| | - Xin Yang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
| | - Xudong Liang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
| | - Xiuli Sun
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
| | - Rong Zhou
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
| | - Xiaowei Li
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
| | - Yi Li
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
| | - Jianliu Wang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China.
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Qin M, Zhang C, Li Y. Circular RNAs in gynecologic cancers: mechanisms and implications for chemotherapy resistance. Front Pharmacol 2023; 14:1194719. [PMID: 37361215 PMCID: PMC10285541 DOI: 10.3389/fphar.2023.1194719] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/30/2023] [Indexed: 06/28/2023] Open
Abstract
Chemotherapy resistance remains a major challenge in the treatment of gynecologic malignancies. Increasing evidence suggests that circular RNAs (circRNAs) play a significant role in conferring chemoresistance in these cancers. In this review, we summarize the current understanding of the mechanisms by which circRNAs regulate chemotherapy sensitivity and resistance in gynecologic malignancies. We also discuss the potential clinical implications of these findings and highlight areas for future research. CircRNAs are a novel class of RNA molecules that are characterized by their unique circular structure, which confers increased stability and resistance to degradation by exonucleases. Recent studies have shown that circRNAs can act as miRNA sponges, sequestering miRNAs and preventing them from binding to their target mRNAs. This can lead to upregulation of genes involved in drug resistance pathways, ultimately resulting in decreased sensitivity to chemotherapy. We discuss several specific examples of circRNAs that have been implicated in chemoresistance in gynecologic cancers, including cervical cancer, ovarian cancer, and endometrial cancer. We also highlight the potential clinical applications of circRNA-based biomarkers for predicting chemotherapy response and guiding treatment decisions. Overall, this review provides a comprehensive overview of the current state of knowledge regarding the role of circRNAs in chemotherapy resistance in gynecologic malignancies. By elucidating the underlying mechanisms by which circRNAs regulate drug sensitivity, this work has important implications for improving patient outcomes and developing more effective therapeutic strategies for these challenging cancers.
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Ah-Thiane L, Rousseau C, Aumont M, Cailleteau A, Doré M, Mervoyer A, Vaugier L, Supiot S. The Sentinel Lymph Node in Treatment Planning: A Narrative Review of Lymph-Flow-Guided Radiotherapy. Cancers (Basel) 2023; 15:2736. [PMID: 37345071 DOI: 10.3390/cancers15102736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/09/2023] [Accepted: 05/11/2023] [Indexed: 06/23/2023] Open
Abstract
The sentinel lymph node technique is minimally invasive and used routinely by surgeons, reducing the need for morbid extensive lymph node dissections, which is a significant advantage for cancer staging and treatment decisions. The sentinel lymph node could also help radiation oncologists to identify tumor drainage for each of their patients, leading to a more personalized radiotherapy, instead of a probabilistic irradiation based on delineation atlases. The aim is both to avoid recurrence in unexpected areas and to limit the volume of irradiated healthy tissues. The aim of our study is to evaluate the impact of sentinel lymph node mapping for radiation oncologists. This concept, relying on sentinel lymph node mapping for treatment planning, is known as lymph-flow-guided radiotherapy. We present an up-to-date narrative literature review showing the potential applications of the sentinel lymph node technique for radiotherapy, as well as the limits that need to be addressed before its routine usage.
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Affiliation(s)
- Loic Ah-Thiane
- Department of Radiotherapy, ICO René Gauducheau, Boulevard Jacques Monod, 44800 St-Herblain, France
| | - Caroline Rousseau
- Department of Nuclear Medicine, ICO René Gauducheau, Boulevard Jacques Monod, 44800 St-Herblain, France
- CRCI2NA, UMR 1307 Inserm-UMR 6075 CNRS, Nantes University, 44000 Nantes, France
| | - Maud Aumont
- Department of Radiotherapy, ICO René Gauducheau, Boulevard Jacques Monod, 44800 St-Herblain, France
| | - Axel Cailleteau
- Department of Radiotherapy, ICO René Gauducheau, Boulevard Jacques Monod, 44800 St-Herblain, France
| | - Mélanie Doré
- Department of Radiotherapy, ICO René Gauducheau, Boulevard Jacques Monod, 44800 St-Herblain, France
| | - Augustin Mervoyer
- Department of Radiotherapy, ICO René Gauducheau, Boulevard Jacques Monod, 44800 St-Herblain, France
| | - Loig Vaugier
- Department of Radiotherapy, ICO René Gauducheau, Boulevard Jacques Monod, 44800 St-Herblain, France
| | - Stéphane Supiot
- Department of Radiotherapy, ICO René Gauducheau, Boulevard Jacques Monod, 44800 St-Herblain, France
- CRCI2NA, Inserm UMR 1232, CNRS ERL 6001, Nantes University, 44000 Nantes, France
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Zhang M, Li R, Zhang S, Xu X, Liao L, Yang Y, Guo Y. Analysis of prognostic factors of metastatic endometrial cancer based on surveillance, epidemiology, and end results database. Front Surg 2023; 9:1001791. [PMID: 36684133 PMCID: PMC9852622 DOI: 10.3389/fsurg.2022.1001791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 10/24/2022] [Indexed: 01/08/2023] Open
Abstract
Objective To explore the risk factors for survival and prognosis of patients with metastatic endometrial cancer and to build and verify a reliable prediction model. Methods We retrospectively analyzed patients diagnosed with metastatic endometrial cancer in the US Surveillance, Epidemiology, and End Results (SEER) database between January 2010 and December 2015. Univariate and multivariate Cox regression analyses were used to assess clinical variables impact on survival and to construct nomograms. The results of the consistency index (C-index), subject operating characteristic (ROC) curve, and calibration curve were used to evaluate the predictive ability of the nomogram. Results This study included 3,878 patients with metastatic endometrial cancer. In the univariate analysis, variables associated with overall survival (OS) and cancer-specific survival (CSS) included age, race, marital status, pathological type, pathological grade, T-stage, N-stage, surgery, radiotherapy, chemotherapy, bone metastasis, brain metastasis, liver metastasis, and lung metastasis. In the multivariate analysis, age, race, pathological type, pathological grade, T-stage, N-stage, surgery, radiotherapy, chemotherapy, brain metastasis, liver metastasis, and lung metastasis were independent risk factors for OS and CSS (all P < 0.05). Combined with the results of the multiple factors, the 1-, 3-, 5-, and 8-year nomograms were constructed. For OS and CSS, T-stage had the greatest impact on the adverse prognosis of patients with metastatic endometrial cancer. The C-indexes of the OS and CSS nomograms in the training cohort were 0.749 (95% CI, 0.739-0.760) and 0.746 (95% CI, 0.736-0.756), respectively. The C-indices of OS and CSS in the validation cohort were 0.730 (95% CI, 0.714-0.746) and 0.728 (95% CI, 0.712-0.744), respectively. The ROC curve revealed our model's good prediction accuracy and clinical practicability. The calibration curve also confirmed the consistency between the model and actual existence. The Kaplan-Meier curves revealed statistically significant differences between the risk subgroups (P < 0.05). Conclusion Our SEER-based nomograms for predicting survival in patients with metastatic endometrial cancer were helpful for the clinical evaluation of patient prognosis.
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