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Wang J, Du Y, Kang Y. Do survivors of borderline ovarian tumors have susceptibility to secondary primary malignancies? A SEER population-based study. Int J Gynaecol Obstet 2024; 165:1229-1236. [PMID: 38205842 DOI: 10.1002/ijgo.15338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 12/11/2023] [Accepted: 12/14/2023] [Indexed: 01/12/2024]
Abstract
OBJECTIVE To describe the risk of women who have survived borderline ovarian tumors (BOT) developing second primary malignancies (SPM). METHODS This work employed the Surveillance, Epidemiology, and End Results (SEER) Program to conduct a retrospective study of patients diagnosed with BOT. The SEER stat software was used to calculate the standardized incidence ratio (SIR). Cases with pathologic diagnosis and for which information on prognostic factors were available were obtained and analyzed using the Fine and Gray model, with non-SPM death as a competing event. RESULTS The risk of developing SPM among BOT survivors was not elevated compared with that expected in the general population (SIR 0.88, 95% confidence interval [CI] 0.80-0.96) between 1975 and 2017. Of 3661 patients with BOT diagnosed between 1977 and 2000, 477 patients (13.03%) experienced the development of SPM during the median follow up of 19.43 years and the cumulative incidence of SPM over a span of 25 years was 15.52%. Patients with mucinous BOT (P = 0.028), age older than 50 years (P < 0.001), or no lymph node dissection (P = 0.042), had a higher cumulative incidence of SPM in univariate analysis. In the multivariable competing risk analysis, performing lymphadenectomy (subdistribution hazard ratios [sdHR] 0.79, 95% CI 0.64-0.98), age (sdHR 1.03, 95% CI 1.02-1.03) could strongly predict the risk of SPM. CONCLUSION In contrast to ovarian cancer, women with BOT were not more prone to develop SPM.
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Affiliation(s)
- Jing Wang
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Yan Du
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Yu Kang
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
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2
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Talwar V, Dogra A, Goel V, Sekhon R, Rawal S. First-line chemotherapy analysis on survival in carcinoma ovary patients: Data from a Northern Indian cancer center. J Cancer Res Ther 2022; 18:1589-1596. [DOI: 10.4103/jcrt.jcrt_949_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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3
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Analysis of Morbidity, Mortality and Survival Pattern Following Surgery for Borderline Ovarian and Malignant Ovarian Tumour in Tertiary Care Centre. J Obstet Gynaecol India 2021; 71:297-303. [PMID: 34408350 DOI: 10.1007/s13224-020-01425-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 12/29/2020] [Indexed: 12/20/2022] Open
Abstract
Backgrounds To analyse the morbidity, mortality and survival pattern following surgery for borderline ovarian and malignant ovarian tumours. Methods The medical records of 57 consecutive patients with invasive and borderline epithelial ovarian cancer patients registered and operated in our tertiary centre between 2015 to 2017 were reviewed. Patients were followed up for a minimum of 18 months to maximum of 42 months at an interval of 3 months with CA125 values. Various prognostic factors were analysed. The data descriptive statistics of frequency and percentage analysis were used for categorical variables and mean and standard deviation were used for continuous variables. Results The most common age group was 51 years and above with the majority (56.2%) of women belonging to postmenopausal age group (32/57). In our study, 30 out of 57 women (52.6%) had stage III disease, 17 women had stage I disease (29.8%) and 7 women had stage 2 disease (12.3%). Majority of the women had serous epithelial ovarian tumour (47 out of 57 patients), which contributed to 82.4%. Grade 1 and 2 morbidity was encountered in 8 patients. Six patients had wound infection (grade 1), and 2 patients required blood transfusions (grade 2). One patient had grade 3 morbidity requiring re-laparotomy. Borderline tumours and early-stage epithelial ovarian tumours had good prognosis, less morbidity and good survival. The overall median survival was 25 months. Conclusions With meticulous perioperative care, surgery for ovarian cancer in the primary and interval setting can be done with minimal morbidity and no postoperative mortality, especially in patients with co-morbidities. Grade is an important prognostic factor affecting the survival of patients with epithelial ovarian cancers undergoing surgery. Lymph node dissection helps achieve local control but may not improve the survival.
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Clinical Outcomes of Patients with High-Grade Ovarian Carcinoma Arising in Endometriosis Compared to Ovarian High-Grade Serous Carcinoma. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2021. [DOI: 10.1007/s40944-021-00559-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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5
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Kang JH, Lai YL, Cheng WF, Kim HS, Kuo KT, Chen YL, Lee YY. Clinical factors associated with prognosis in low-grade serous ovarian carcinoma: experiences at two large academic institutions in Korea and Taiwan. Sci Rep 2020; 10:20012. [PMID: 33203969 PMCID: PMC7672053 DOI: 10.1038/s41598-020-77075-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 11/02/2020] [Indexed: 01/22/2023] Open
Abstract
Low-grade ovarian serous carcinoma (LGSOC) has clinical features different from high-grade serous ovarian carcinoma (HGSOC) accounting for the majority of epithelial ovarian cancer. Because of its rarity, previous studies have only focused on the high-grade disease without considering the differences between the two subtypes. This study aimed to evaluate the effect of the clinical prognostic factors known for HGSOC on survival in patients with LGSOC. Based on the Federation of Gynecology and Obstetrics (FIGO) stage, progression-free survival (PFS) was markedly decreased in advanced disease compared with early disease. For stage I, patients with stage IC had poorer survival than those with stage IA and IB regardless of the number of cycles of adjuvant chemotherapy. For advanced disease, no gross residual disease after primary cytoreductive surgery was significantly associated with longer PFS when compared with gross residual disease. In multivariate analysis for PFS and overall survival (OS), age, preoperative CA-125, time interval from surgery to chemotherapy, and the number of cycles of adjuvant chemotherapy were not associated with prognosis. Complete cytoreduction was the only independent prognostic factor for PFS (HR 2.45, p = 0.045). Our study revealed that the known prognostic factors in HGSOC did not show any effect on the survival in LGSOC except for FIGO stage and complete cytoreduction.
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Affiliation(s)
- Jun-Hyeok Kang
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, Seoul, Republic of Korea
| | - Yen-Ling Lai
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Wen-Fang Cheng
- Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, 100, Taiwan
| | - Hyun-Soo Kim
- Department of Pathology and Translation Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kuan-Ting Kuo
- Department of Pathology and Graduate Institute of Pathology, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Pathology and Laboratory Medicine, National Taiwan University Hospital, Hsin-Chu Biomedical Park Branch, Hsin-Chu, Taiwan
| | - Yu-Li Chen
- Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, 100, Taiwan.
| | - Yoo-Young Lee
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, Seoul, Republic of Korea.
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6
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Tang M, O'Connell RL, Amant F, Beale P, McNally O, Sjoquist KM, Grant P, Davis A, Sykes P, Mileshkin L, Moujaber T, Kennedy CJ, deFazio A, Tan K, Antill Y, Goh J, Bonaventura T, Scurry J, Friedlander M. PARAGON: A Phase II study of anastrozole in patients with estrogen receptor-positive recurrent/metastatic low-grade ovarian cancers and serous borderline ovarian tumors. Gynecol Oncol 2019; 154:531-538. [DOI: 10.1016/j.ygyno.2019.06.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 06/04/2019] [Accepted: 06/08/2019] [Indexed: 12/22/2022]
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8
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Sun Q, Zhao H, Zhang C, Hu T, Wu J, Lin X, Luo D, Wang C, Meng L, Xi L, Li K, Hu J, Ma D, Zhu T. Gene co-expression network reveals shared modules predictive of stage and grade in serous ovarian cancers. Oncotarget 2018; 8:42983-42996. [PMID: 28562334 PMCID: PMC5522121 DOI: 10.18632/oncotarget.17785] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 04/15/2017] [Indexed: 01/10/2023] Open
Abstract
Serous ovarian cancer (SOC) is the most lethal gynecological cancer. Clinical studies have revealed an association between tumor stage and grade and clinical prognosis. Identification of meaningful clusters of co-expressed genes or representative biomarkers related to stage or grade may help to reveal mechanisms of tumorigenesis and cancer development, and aid in predicting SOC patient prognosis. We therefore performed a weighted gene co-expression network analysis (WGCNA) and calculated module-trait correlations based on three public microarray datasets (GSE26193, GSE9891, and TCGA), which included 788 samples and 10402 genes. We detected four modules related to one or more clinical features significantly shared across all modeling datasets, and identified one stage-associated module and one grade-associated module. Our analysis showed that MMP2, COL3A1, COL1A2, FBN1, COL5A1, COL5A2, and AEBP1 are top hub genes related to stage, while CDK1, BUB1, BUB1B, BIRC5, AURKB, CENPA, and CDC20 are top hub genes related to grade. Gene and pathway enrichment analyses of the regulatory networks involving hub genes suggest that extracellular matrix interactions and mitotic signaling pathways are crucial determinants of tumor stage and grade. The relationships between gene expression modules and tumor stage or grade were validated in five independent datasets. These results could potentially be developed into a more objective scoring system to improve prediction of SOC outcomes.
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Affiliation(s)
- Qian Sun
- Cancer Biology Research Center, Key Laboratory of the Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Haiyue Zhao
- Cancer Biology Research Center, Key Laboratory of the Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Cong Zhang
- Cancer Biology Research Center, Key Laboratory of the Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Ting Hu
- Cancer Biology Research Center, Key Laboratory of the Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Jianli Wu
- Cancer Biology Research Center, Key Laboratory of the Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Xingguang Lin
- Cancer Biology Research Center, Key Laboratory of the Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Danfeng Luo
- Cancer Biology Research Center, Key Laboratory of the Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Changyu Wang
- Cancer Biology Research Center, Key Laboratory of the Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Li Meng
- Cancer Biology Research Center, Key Laboratory of the Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Ling Xi
- Cancer Biology Research Center, Key Laboratory of the Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Kezhen Li
- Cancer Biology Research Center, Key Laboratory of the Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Junbo Hu
- Cancer Biology Research Center, Key Laboratory of the Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Ding Ma
- Cancer Biology Research Center, Key Laboratory of the Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Tao Zhu
- Cancer Biology Research Center, Key Laboratory of the Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
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9
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Xu Y, Bi R, Xiao Y, Tu X, Li M, Li A, Shan L, Zhou S, Yang W. Low frequency of BRAF and KRAS mutations in Chinese patients with low-grade serous carcinoma of the ovary. Diagn Pathol 2017; 12:87. [PMID: 29273082 PMCID: PMC5741942 DOI: 10.1186/s13000-017-0679-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Accepted: 12/13/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mounting evidence has shown that KRAS and BRAF are somatic mutations associated with low grade serous carcinoma (LGSC) of the ovary. However, the frequency of KRAS or BRAF mutation was variable in literatures, with a frequency of 16-54% for KRAS mutation and 2-33% for BRAF mutation. Meanwhile, the prognostic significance of KRAS or BRAF mutation remains controversial. METHODS Codons 12 and 13 of exon 2 of KRAS gene and exon 15 of BRAF gene were analyzed using direct Sanger sequencing in 32 cases of LGSC of the ovary. The associations between KRAS or BRAF mutation and clinicopathological characteristics, overall survival (OS) and disease-free survival (DFS) were statistically analyzed. RESULTS KRAS mutation was observed in nine cases (9/32, 28%) and BRAF mutation in two cases (2/32, 6%). KRAS and BRAF mutations were mutually exclusive. Neither KRAS nor BRAF mutation was statistically associated with OS or DFS in our cohort, although there was a favorable prognostic trend in patients with KRAS G12D mutation than those with KRAS G12 V mutation or wild-type KRAS for OS. CONCLUSIONS The present study indicated a low frequency of BRAF or KRAS mutation in Chinese patients with LGSC of the ovary, and neither KRAS nor BRAF mutation is a prognostic factor.
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Affiliation(s)
- Yan Xu
- Department of Pathology, Fudan University Shanghai Cancer Center, 270 Dongan Road, Xuhui District, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Department of Pathology, Tongji University Shanghai East Hospital, 1800 Yuntai Road, Pudong New District, Shanghai, 200120, China
| | - Rui Bi
- Department of Pathology, Fudan University Shanghai Cancer Center, 270 Dongan Road, Xuhui District, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yaoxing Xiao
- Department of Pathology, Fudan University Shanghai Cancer Center, 270 Dongan Road, Xuhui District, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xiaoyu Tu
- Department of Pathology, Fudan University Shanghai Cancer Center, 270 Dongan Road, Xuhui District, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Ming Li
- Department of Pathology, Fudan University Shanghai Cancer Center, 270 Dongan Road, Xuhui District, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Anqi Li
- Department of Pathology, Fudan University Shanghai Cancer Center, 270 Dongan Road, Xuhui District, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Ling Shan
- Department of Pathology, Fudan University Shanghai Cancer Center, 270 Dongan Road, Xuhui District, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Shuling Zhou
- Department of Pathology, Fudan University Shanghai Cancer Center, 270 Dongan Road, Xuhui District, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Wentao Yang
- Department of Pathology, Fudan University Shanghai Cancer Center, 270 Dongan Road, Xuhui District, Shanghai, 200032, China. .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
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10
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Liu D, Zhang L, Indima N, Peng K, Li Q, Hua T, Tang G. CT and MRI findings of type I and type II epithelial ovarian cancer. Eur J Radiol 2017; 90:225-233. [PMID: 28583639 DOI: 10.1016/j.ejrad.2017.02.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 01/28/2017] [Accepted: 02/13/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To assess whether types I and II epithelial ovarian cancer (EOC) differ in CT and MRI imaging features. METHODS For this retrospective study, we enrolled 65 patients with 68 ovarian lesions that have been pathologically proven to be EOC. Of these patients, 38 cases underwent MR examinations only, 15 cases underwent CT examinations only, and 12 cases completed both examinations. The clinical information [age, CA-125, menopausal status, and Ki-67] and imaging findings were compared between two types of EOCs. The diagnostic performance of image findings were assessed by receiver-operating characteristic curve(ROC) analysis. The association between EOC type and imaging features was assessed by multivariate logistic regression analysis. The random forest approach was used to build a classifier in differential diagnosis between two types of EOCs. RESULTS Of the 68 EOC lesions, 24 lesions were categorized as types I and other 44 lesions as type II based on the immunohistochemical results, respectively. Patients in type I EOCs were more likely to involve menopausal women and showed lower CA-125 and Ki-67 values (Ki-67<30%) than patients in type II EOCs. The imaging characteristics of type II EOCs frequently demonstrated a solid or predominantly solid mass (38.6% vs. 12.5%, P<0.05), smaller lesions (diameter <6cm; 27.3% vs. 4.2%, P<0.05), absence of mural nodules (65.9% vs. 25.9%, P=0.001), and mild enhancement (84.1% vs. 54.2%, P<0.05) compared to type I EOCs. Combination of tumor size, morphology, mural nodule, enhancement degrees (AUC=0.808) has a higher specificity (87.50%) and positive predictive value (90.0%) than any single image finding alone in differential diagnosis between two types of EOCs. The multivariate logistic regression analysis showed that enhancement degrees(OR 0.200, P<0.05),mural nodule(OR 0.158, P<0.05) significantly influence EOC classification. Random forests model identified both as the most important discriminating variables. The diagnostic accuracy of the classifier was 73.53%. CONCLUSIONS Differences in imaging characteristics existed between two types of EOCs. Combination of several image findings improved the preoperative diagnostic performance, which is helpful for the clinical treatment and prognosis evaluation.
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Affiliation(s)
- Dong Liu
- Department of Radiology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, 200072, China; Department of Radiology, Qingdao Hiser Medical Center of Medical College of Qingdao University, 266033, China.
| | - Lin Zhang
- Department of Radiology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, 200072, China.
| | - Nekitsing Indima
- Department of Radiology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, 200072, China.
| | - Kun Peng
- Department of Radiology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, 200072, China.
| | - Qianyu Li
- Department of Pathology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, 200072, China.
| | - Ting Hua
- Department of Radiology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, 200072, China.
| | - Guangyu Tang
- Department of Radiology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, 200072, China.
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11
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Feng Z, Wen H, Ju X, Bi R, Chen X, Yang W, Wu X. Expression of hypothalamic-pituitary-gonadal axis-related hormone receptors in low-grade serous ovarian cancer (LGSC). J Ovarian Res 2017; 10:7. [PMID: 28122595 PMCID: PMC5264293 DOI: 10.1186/s13048-016-0300-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 12/19/2016] [Indexed: 02/07/2023] Open
Abstract
Background The aim of our study was to investigate the clinical features and expression levels of hypothalamic-pituitary-gonadal axis-related hormone receptors in low-grade serous ovarian cancer (LGSC). Methods We retrospectively investigated the clinical features of 26 consecutive patients with LGSC who underwent primary staging or debulking surgery between April 2005 and June 2013 in our center; concomitant primary high-grade serous ovarian cancer (HGSC) patients were randomly selected at a 2:1 ratio for comparison. Tissue microarrays were constructed from the LGSC and HGSC specimens, and the expression levels of six hormone receptors in the hypothalamic pituitary-gonadal axis were analyzed by immunohistochemistry. Results The median (range) age of patients with LGSC was 54 (27–77) years. According to the FIGO staging system, the cases were distributed as follows: stage I, 6 (23.1%); stage II, 0 (0%); stage III, 19 (73.1%); and stage IV, 1 (3.8%). The 2-year and 5-year overall survival rates for LGSC were 91.8% and 67.5%, respectively. The expression levels of the hormone receptors were as follows: ER, 80.8%; PR, 34.6%; AR, 53.8%; FSHR, 84.0%; LHR, 65.4%; and GnRHR, 100%. Hormone receptor-positive patients had a better prognosis compared with hormone receptor-negative patients, but the difference was not significant. Conclusions Our study presented a higher overall survival rate and distinctive hormone receptor expression levels of LGSC patients compared with the HGSC cohort. Patients with positive hormone receptor expression tended to have a better prognosis than the corresponding hormone receptor negative patients. Electronic supplementary material The online version of this article (doi:10.1186/s13048-016-0300-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Zheng Feng
- Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, 270 Dong-an Road, Shanghai, 200032, China
| | - Hao Wen
- Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, 270 Dong-an Road, Shanghai, 200032, China
| | - Xingzhu Ju
- Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, 270 Dong-an Road, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Rui Bi
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.,Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
| | - Xiaojun Chen
- Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, 270 Dong-an Road, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Wentao Yang
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.,Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
| | - Xiaohua Wu
- Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, 270 Dong-an Road, Shanghai, 200032, China. .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
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12
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13
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Neo-adjuvant chemotherapy does not increase the rate of complete resection and does not significantly reduce the morbidity of Visceral–Peritoneal Debulking (VPD) in patients with stage IIIC–IV ovarian cancer. Gynecol Oncol 2015; 138:252-8. [DOI: 10.1016/j.ygyno.2015.05.010] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 05/14/2015] [Indexed: 12/28/2022]
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14
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Goundiam O, Gestraud P, Popova T, De la Motte Rouge T, Fourchotte V, Gentien D, Hupé P, Becette V, Houdayer C, Roman-Roman S, Stern MH, Sastre-Garau X. Histo-genomic stratification reveals the frequent amplification/overexpression of CCNE1 and BRD4 genes in non-BRCAness high grade ovarian carcinoma. Int J Cancer 2015; 137:1890-900. [PMID: 25892415 DOI: 10.1002/ijc.29568] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 03/13/2015] [Accepted: 03/27/2015] [Indexed: 01/08/2023]
Abstract
The treatment of epithelial ovarian cancer (EOC) is narrowly focused despite the heterogeneity of this disease in which outcomes remain poor. To stratify EOC patients for targeted therapy, we developed an approach integrating expression and genomic analyses including the BRCAness status. Gene expression and genomic profiling were used to identify genes recurrently (>5%) amplified and overexpressed in 105 EOC. The LST (Large-scale State Transition) genomic signature of BRCAness was applied to define molecular subgroups of EOC. Amplified/overexpressed genes clustered mainly in 3q, 8q, 19p and 19q. These changes were generally found mutually exclusive. In the 85 patients for which the genomic signature could be determined, genomic BRCAness was found in 52 cases (61.1%) and non-BRCAness in 33 (38.8%). A striking mutual exclusivity was observed between BRCAness and amplification/overexpression data. Whereas 3q and 8q alterations were preferentially observed in BRCAness EOC, most alterations on chromosome 19 were in non-BRCAness cases. CCNE1 (19q12) and BRD4 (19p13.1) amplification/overexpression was found in 19/33 (57.5%) of non-BRCAness cases. Such disequilibrium was also found in the TCGA EOC data set used for validation. Potential target genes are frequently amplified/overexpressed in non-BRCAness EOC. We report that BRD4, already identified as a target in several tumor models, is a new potential target in high grade non-BRCAness ovarian carcinoma.
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Affiliation(s)
- Oumou Goundiam
- Department of Biopathology, Institut Curie, Paris, France.,EA4340-BCOH, Versailles Saint-Quentin-en-Yvelines University, Guyancourt, France.,Department of Translational Research, Institut Curie, Paris, France
| | - Pierre Gestraud
- Bioinformatics and Computational Systems Biology of Cancer, Institut Curie, Paris, France.,Mines Paris Tech, Paris, France.,Inserm U900, Paris, France
| | | | | | - Virginie Fourchotte
- Department of Surgery, and on behalf of the Gynecologic Study Group, Institut Curie, Paris, France
| | - David Gentien
- Department of Translational Research, Institut Curie, Paris, France
| | - Philippe Hupé
- Bioinformatics and Computational Systems Biology of Cancer, Institut Curie, Paris, France.,Mines Paris Tech, Paris, France.,Inserm U900, Paris, France.,CNRS UMR 144
| | | | - Claude Houdayer
- Department of Biopathology, Institut Curie, Paris, France.,Inserm U830 Institut Curie, Paris, France.,Université Paris Descartes, Sciences Pharmaceutiques et Biologiques, Sorbonne Paris Cité, Paris, France
| | | | - Marc-Henri Stern
- Department of Biopathology, Institut Curie, Paris, France.,Inserm U830 Institut Curie, Paris, France
| | - Xavier Sastre-Garau
- Department of Biopathology, Institut Curie, Paris, France.,EA4340-BCOH, Versailles Saint-Quentin-en-Yvelines University, Guyancourt, France
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15
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Veskimäe K, Staff S, Tabaro F, Nykter M, Isola J, Mäenpää J. Microarray analysis of differentially expressed genes in ovarian and fallopian tube epithelium from risk-reducing salpingo-oophorectomies. Genes Chromosomes Cancer 2015; 54:276-87. [PMID: 25706666 DOI: 10.1002/gcc.22241] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Accepted: 01/02/2015] [Indexed: 11/11/2022] Open
Abstract
Mutations in the BRCA1 and BRCA2 genes confer an increased lifetime risk for breast and ovarian cancer. Ovarian cancer risk can be decreased by risk-reducing salpingo-oophorectomy (RRSO). Studies on RRSO material have altered the paradigm of serous ovarian cancer pathogenesis. The purpose of this study was to identify candidate genes possibly involved in the pathogenesis of serous ovarian cancer by carrying out a microarray analysis of differentially expressed genes in BRCA1/2- mutation positive ovarian and fallopian tube epithelium derived from RRSO surgery. Freshly frozen ovarian and fallopian tube samples from nine BRCA1/2 mutation carriers scheduled for RRSO were prospectively collected together with five mutation-negative control patients undergoing salpingo-oophorectomy for benign indications. Microarray analysis of genome-wide gene expression was performed on ovarian and fallopian tube samples from the BRCA1/2 and control patients. The validation of microarray data was performed by quantitative real-time polymerase chain reaction (qRT-PCR) in selected cases of RRSO samples and also in high grade serous carcinoma samples collected from patients with a BRCA phenotype. From 22,733 genes, 454 transcripts were identified that were differentially expressed in BRCA1/2 mutation carriers when compared with controls, pooling all ovarian and fallopian tube samples together. Of these, 299 genes were statistically significantly downregulated and 155 genes upregulated. Differentially expressed genes in BRCA1/2 samples reported here might be involved in serous ovarian carcinogenesis and provide interesting targets for further studies.
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Affiliation(s)
- Kristina Veskimäe
- Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland
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16
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Oh JW, Rha SE, Oh SN, Park MY, Byun JY, Lee A. Diffusion-weighted MRI of epithelial ovarian cancers: correlation of apparent diffusion coefficient values with histologic grade and surgical stage. Eur J Radiol 2015; 84:590-5. [PMID: 25623826 DOI: 10.1016/j.ejrad.2015.01.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Revised: 11/26/2014] [Accepted: 01/06/2015] [Indexed: 01/27/2023]
Abstract
OBJECTIVE The purpose of this article is to correlate the apparent diffusion coefficient (ADC) values of epithelial ovarian cancers with histologic grade and surgical stage. MATERIALS AND METHODS We enrolled 43 patients with pathologically proven epithelial ovarian cancers for this retrospective study. All patients underwent preoperative pelvic magnetic resonance imaging (MRI) including diffusion-weighted images with b value of 0 and 1000 s/mm2 at 3.0-T unit. The mean ADC values of the solid portion of the tumor were measured and compared among different histologic grades and surgical stages. RESULTS The mean ADC values of epithelial ovarian cancers differed significantly between grade 1 (well-differentiated) and grade 2 (moderately-differentiated) (P=0.013) as well as between grade 1 and grade 3 (poorly-differentiated) (P=0.01); however, no statistically significant difference existed between grade 2 and grade 3 (P=0.737). The receiver-operating characteristic analysis indicated that a cutoff ADC value of less than or equal to 1.09×10(-3)mm2/s was associated with 94.4% sensitivity and 85.7% specificity in distinguishing grade 1 and grade 2/3 cancer. The difference in mean ADC values was statistically significant for early stage (FIGO stage I) and advanced stage (FIGO stage II-IV) cancer (P=0.011). The interobserver agreement for the mean ADC values of epithelial ovarian cancers was excellent. CONCLUSION The mean ADC values of the solid portion of epithelial ovarian cancers negatively correlated to histologic grade and surgical stage. The mean ADC values may be useful imaging biomarkers for assessment of tumor grade of epithelial ovarian cancer.
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Affiliation(s)
- Ji-Won Oh
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 137-701, Republic of Korea.
| | - Sung Eun Rha
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 137-701, Republic of Korea.
| | - Soon Nam Oh
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 137-701, Republic of Korea.
| | - Michael Yong Park
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 137-701, Republic of Korea.
| | - Jae Young Byun
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 137-701, Republic of Korea.
| | - Ahwon Lee
- Department of Hospital Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 137-701, Republic of Korea.
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Prahm KP, Karlsen MA, Høgdall E, Scheller NM, Lundvall L, Nedergaard L, Christensen IJ, Høgdall C. The prognostic value of dividing epithelial ovarian cancer into type I and type II tumors based on pathologic characteristics. Gynecol Oncol 2014; 136:205-11. [PMID: 25546113 DOI: 10.1016/j.ygyno.2014.12.029] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 12/13/2014] [Accepted: 12/16/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate the prognostic significance of dividing epithelial ovarian cancer (EOC) in type I and type II tumors based on pathologic variables. METHODS We used the Danish Gynecologic Cancer Database to identify all patients diagnosed with EOC from 2005 to 2012. Information on histologic type and grade were used to classify tumors as either type I or type II. Death, and several prognostic factors were used in the multivariate Cox regression, and Landmark analysis was used to estimate hazard ratios of all-cause mortality. RESULTS Among 2660 patients diagnosed with EOC, 735 were categorized as type I tumors, and 1925 as type II tumors. Patients with type II EOC were more frequently diagnosed in late FIGO stages (stages III-IV) than patients with type I EOC (78.1% vs. 32.1% respectively; P<0.001). Time dependent multivariate Cox analysis, adjusted for known prognostic variables, showed no significant difference in survival within the first two years after diagnosis, however, after 730days of follow-up a significantly increased overall survival for type I tumors was observed (hazard ratio 1.72, 95% confidence interval: 1.28-2.31, P<0.001). Similarly the Landmark analysis for survival confirmed the increased overall survival for type I tumors after two years of follow-up (hazard ratio: 1.85, 95% confidence interval: 1.35-2.54, P<0.001). CONCLUSION Classification of EOC in type I and type II tumors based on pathologic variables was associated with an increased risk of death for type II tumors after two years of follow-up, while no increased risk was seen during the first two years of follow-up.
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Affiliation(s)
- Kira Philipsen Prahm
- Dept. of Gynecology, Juliane Marie Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
| | - Mona Aarenstrup Karlsen
- Molecular Unit, Dept. of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Estrid Høgdall
- Molecular Unit, Dept. of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | | | - Lene Lundvall
- Dept. of Gynecology, Juliane Marie Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Lotte Nedergaard
- Dept. of Pathology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Ib Jarle Christensen
- Finsen Laboratory, Copenhagen Biocenter, University of Copenhagen, Copenhagen, Denmark
| | - Claus Høgdall
- Dept. of Gynecology, Juliane Marie Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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18
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Della Pepa C, Tonini G, Santini D, Losito S, Pisano C, Di Napoli M, Cecere SC, Gargiulo P, Pignata S. Low Grade Serous Ovarian Carcinoma: from the molecular characterization to the best therapeutic strategy. Cancer Treat Rev 2014; 41:136-43. [PMID: 25573350 DOI: 10.1016/j.ctrv.2014.12.003] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 12/06/2014] [Accepted: 12/08/2014] [Indexed: 11/17/2022]
Abstract
Low Grade Serous Ovarian Carcinoma, LGSOC, is certainly a rare disease, accounting for only a small proportion of all ovarian carcinomas, nevertheless in the last decade we have acquired many data about its molecular and clinical features and it has been largely accepted that it has distinct pathogenesis, genetic aberrations and clinical behavior compared to High Grade Serous Ovarian Carcinoma, HGSOC, which is the most common ovarian cancer histotype. A large number of series pointed out the high rate of KRAS and BRAF mutations in LGSOCs and Serous Borderline Tumors, SBLTs, in contrast with their rarity in HGSOC. Such finding, together with the recurrent observation of focus of LGSOC associated with areas of SBLT in the same lesion, led to abandon the traditional histology classification, defining three types of serous carcinomas, in favor of a new dualistic grading system which recognizes only LG and HG carcinomas corresponding to distinct tumorigenesis pathways, the former based on KRAS/BRAF mutations and alteration of the MAP/ERK signaling, the latter characterized by early genetic instability and wild type status of KRAS and BRAF. LGSOC shows favorable overall survival, compared to general ovarian cancer population, but worrying resistance to conventional treatments. MEK inhibitors are emerging as active agents and may well represent an effective therapeutic strategy in the near future.
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Affiliation(s)
- Chiara Della Pepa
- Department of Medical Oncology, Campus Bio-Medico University of Rome, Via Alvaro Del Portillo, 200, 00128 Rome, Italy.
| | - Giuseppe Tonini
- Department of Medical Oncology, Campus Bio-Medico University of Rome, Via Alvaro Del Portillo, 200, 00128 Rome, Italy
| | - Daniele Santini
- Department of Medical Oncology, Campus Bio-Medico University of Rome, Via Alvaro Del Portillo, 200, 00128 Rome, Italy
| | - Simona Losito
- Surgical Pathology Unit, Istituto Nazionale Tumori "Fondazione G. Pascale", IRCCS, Via Mariano Semmola, 52, 80131 Naples, Italy
| | - Carmela Pisano
- Department of Urology and Gynecology, Istituto Nazionale Tumori "Fondazione G. Pascale", IRCCS, Via Mariano Semmola, 52, 80131 Naples, Italy
| | - Marilena Di Napoli
- Department of Urology and Gynecology, Istituto Nazionale Tumori "Fondazione G. Pascale", IRCCS, Via Mariano Semmola, 52, 80131 Naples, Italy
| | - Sabrina Chiara Cecere
- Department of Urology and Gynecology, Istituto Nazionale Tumori "Fondazione G. Pascale", IRCCS, Via Mariano Semmola, 52, 80131 Naples, Italy
| | - Piera Gargiulo
- Department of Clinical Medicine and Surgery, School of Medicine, University of Naples "Federico II", 80131 Napoli, Italy
| | - Sandro Pignata
- Department of Urology and Gynecology, Istituto Nazionale Tumori "Fondazione G. Pascale", IRCCS, Via Mariano Semmola, 52, 80131 Naples, Italy
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19
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Ezzati M, Abdullah A, Shariftabrizi A, Hou J, Kopf M, Stedman JK, Samuelson R, Shahabi S. Recent Advancements in Prognostic Factors of Epithelial Ovarian Carcinoma. INTERNATIONAL SCHOLARLY RESEARCH NOTICES 2014; 2014:953509. [PMID: 27382614 PMCID: PMC4897239 DOI: 10.1155/2014/953509] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 08/26/2014] [Indexed: 01/03/2023]
Abstract
Ovarian cancer remains the most common cause of gynecologic cancer-related death among women in developed countries. Nevertheless, subgroups of ovarian cancer patients experience relatively longer survival. Efforts to identify prognostic factors that characterize such patients are ongoing, with investigational areas including tumor characteristics, surgical management, inheritance patterns, immunologic factors, and genomic patterns. This review discusses various demographic, clinical, and molecular factors implicating longevity and ovarian cancer survival. Continued efforts at identifying these prognosticators may result in invaluable adjuncts to the treatment of ovarian cancer, with the ultimate goal of advancing patient care.
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Affiliation(s)
- Mohammad Ezzati
- Department of Obstetrics and Gynecology, Washington Hospital Center, 110 Irving Street NW, Washington, DC 20010, USA
- Department of Obstetrics and Gynecology, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
| | - Amer Abdullah
- Department of Obstetrics, Gynecology and Reproductive Biology, Danbury Hospital, 24 Hospital Avenue, Danbury, CT 06810, USA
| | - Ahmad Shariftabrizi
- Department of Pathology and Laboratory Medicine, School of Medicine, Tufts University, 800 Washington Street, Boston, MA 02111, USA
| | - June Hou
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology and Women's Health, Albert Einstein College of Medicine and Montefiore Medical Center, Montefiore Centennial, 3332 Rochambeau Avenue, Bronx, NY 10467-2836, USA
| | - Michael Kopf
- Department of Medicine, Danbury Hospital, 24 Hospital Avenue, Danbury, CT 06810, USA
| | - Jennifer K. Stedman
- Department of Obstetrics, Gynecology and Reproductive Biology, Danbury Hospital, 24 Hospital Avenue, Danbury, CT 06810, USA
| | - Robert Samuelson
- Department of Obstetrics, Gynecology and Reproductive Biology, Danbury Hospital, 24 Hospital Avenue, Danbury, CT 06810, USA
| | - Shohreh Shahabi
- Department of Obstetrics, Gynecology and Reproductive Biology, Danbury Hospital, 24 Hospital Avenue, Danbury, CT 06810, USA
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20
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Chen M, Jin Y, Bi Y, Yin J, Wang Y, Pan L. A survival analysis comparing women with ovarian low-grade serous carcinoma to those with high-grade histology. Onco Targets Ther 2014; 7:1891-9. [PMID: 25342912 PMCID: PMC4206388 DOI: 10.2147/ott.s67812] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Ovarian low-grade serous carcinoma (LGSC) and high-grade serous carcinoma have distinct molecular profiles, clinical behaviors, and treatment responses. The survival advantage for patients with low-grade carcinoma compared with patients with high-grade histology remains controversial. We retrospectively reviewed the medical charts of 381 patients with ovarian serous carcinoma at Peking Union Medical College Hospital from 2007 to 2010. Patients were classified into two groups according to MD Anderson two-tier system: 35 (9.2%) cases with LGSC and 346 with high-grade serous carcinoma. Patients with low-grade serous ovarian cancer had a significantly younger age at diagnosis (46 versus 56 years, P=0.046), and their median progression-free survival (PFS) and overall survival values were 35.0 and 54.0 months, respectively. A multivariate analysis showed that, for serous ovarian cancer, the histological grade was a significant prognostic factor for PFS but not for overall survival (P=0.022 and P=0.0566, respectively). When stratified by the existence of a residual disease, patients with low-grade disease who underwent cytoreductive surgery without macroscopic residual disease (>1 cm) had a significantly improved median PFS time (36.0 months) compared with that of patients with high-grade carcinoma who received optimal cytoreductive surgery (16.0 months, P=0.017). Conversely, patients with low-grade and high-grade carcinoma who were left with macroscopic residue (>1 cm) experienced a similarly shorter median PFS (10.0 and 13.0 months, respectively, P=0.871). The International Federation of Gynecology and Obstetrics stage and residual disease were significant prognostic factors of low-grade carcinoma, while positive ascites was associated with a worse PFS value. Our data showed that LGSC is a different entity from high-grade carcinoma and that LGSC was associated with improved PFS after optimal cytoreductive surgery but not suboptimal operation.
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Affiliation(s)
- Ming Chen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Ying Jin
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Yalan Bi
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Jie Yin
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Yongxue Wang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Lingya Pan
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
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21
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Abstract
Epithelial ovarian cancer is the commonest cause of gynaecological cancer-associated death. The disease typically presents in postmenopausal women, with a few months of abdominal pain and distension. Most women have advanced disease (International Federation of Gynecology and Obstetrics [FIGO] stage III), for which the standard of care remains surgery and platinum-based cytotoxic chemotherapy. Although this treatment can be curative for most patients with early stage disease, most women with advanced disease will develop many episodes of recurrent disease with progressively shorter disease-free intervals. These episodes culminate in chemoresistance and ultimately bowel obstruction, the most frequent cause of death. For women whose disease continues to respond to platinum-based drugs, the disease can often be controlled for 5 years or more. Targeted treatments such as antiangiogenic drugs or poly (ADP-ribose) polymerase inhibitors offer potential for improved survival. The efficacy of screening, designed to detect the disease at an earlier and curable stage remains unproven, with key results expected in 2015.
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Affiliation(s)
- Gordon C Jayson
- Institute of Cancer Studies, Christie Hospital and University of Manchester, Wilmslow Road, Withington, Manchester, UK.
| | - Elise C Kohn
- Center for Cancer Research, National Cancer Institute, Bethesda MD, USA
| | - Henry C Kitchener
- Institute of Cancer Studies, St Marys Hospital and University of Manchester, Manchester, UK
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22
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Hannibal CG, Vang R, Junge J, Frederiksen K, Kjaerbye-Thygesen A, Andersen KK, Tabor A, Kurman RJ, Kjaer SK. A nationwide study of serous "borderline" ovarian tumors in Denmark 1978-2002: centralized pathology review and overall survival compared with the general population. Gynecol Oncol 2014; 134:267-73. [PMID: 24924123 DOI: 10.1016/j.ygyno.2014.06.002] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 05/28/2014] [Accepted: 06/03/2014] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To describe the study population and estimate overall survival of women with a serous "borderline" ovarian tumor (SBT) in Denmark over 25 years relative to the general population. METHODS The Danish Pathology Data Bank and the Danish Cancer Registry were used to identify 1487 women diagnosed with SBTs from 1978 to 2002. The histologic slides were collected from Danish pathology departments and reviewed by expert pathologists and classified as SBT/atypical proliferative serous tumor (APST) or noninvasive low-grade serous carcinoma (LGSC). Associated implants were classified as noninvasive or invasive. Medical records were collected from hospital departments and reviewed. Data were analyzed using Kaplan-Meier and relative survival was estimated with follow-up through September 2, 2013. RESULTS A cohort of 1042 women with a confirmed SBT diagnosis was identified. Women with stage I had an overall survival similar to the overall survival expected from the general population (p=0.3), whereas women with advanced stage disease had a poorer one (p<0.0001). This was evident both in women with noninvasive (p<0.0001) and invasive implants (p<0.0001). Only among women with advanced stage, overall survival of women with SBT/APST (p<0.0001) and noninvasive LGSC (p<0.0001) was poorer than expected from the general population. CONCLUSIONS To date this is the largest nationwide cohort of SBTs where all tumors have been verified by expert pathologists. Only in women with advanced stage SBT, overall survival is poorer than in the general population which applies both to women with noninvasive and invasive implants as well as to women with SBT/APST and noninvasive LGSC.
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Affiliation(s)
- Charlotte Gerd Hannibal
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | - Russell Vang
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Gynecology & Obstetrics, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jette Junge
- Department of Pathology, Copenhagen University Hospital, Kettegård Allé 30, 2650 Hvidovre, Denmark
| | - Kirsten Frederiksen
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | - Anette Kjaerbye-Thygesen
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | - Klaus Kaae Andersen
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | - Ann Tabor
- Center of Fetal Medicine, Department of Obstetrics, Juliane Marie Centre, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Robert J Kurman
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Gynecology & Obstetrics, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Susanne K Kjaer
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark; Gynecologic Clinic, Juliane Marie Centre, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark.
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23
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Wang Y, Li L, Qu Z, Li R, Bi T, Jiang J, Zhao H. The expression of miR-30a* and miR-30e* is associated with a dualistic model for grading ovarian papillary serious carcinoma. Int J Oncol 2014; 44:1904-14. [PMID: 24676806 DOI: 10.3892/ijo.2014.2359] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Accepted: 12/27/2013] [Indexed: 11/06/2022] Open
Abstract
Histological grade has already been recognized as a very important prognostic factor for ovarian papillary serous carcinoma (OPSC). On the basis of pathogenetic mechanisms, recent findings suggest a dualistic model of OPSC consisting of types I (low-grade) and II (high-grade) cancers. High-grade OPSC is responsible for most ovarian cancer deaths. The goal of our investigation was to identify the differences in key miRNAs and possible regulators through miRNA microarray chip analysis, as well as functional target prediction and clinical outcome between the low and high-grade OPSC patients. The pathogenic basis in differentiation of ovarian cancer subtypes was studied to provide insight into diagnosis and therapy for high-grade cases. Through microarray analysis, we found that miR-30a* and miR-30e* were the top 2 significantly different miRNAs between type I and type II OPSC patients, and both were remarkably downregulated in the latter type. ATF3 and MYC were indicated as potential co-targets of miR-30a* and miR-30e*, and showed a significant upregulation in type II patients. As ATF3 and MYC are often associated with aggressive behavior and poor differentiation, especially in human cancers, these results are in good agreement with our findings and point toward a regulating differentiation function of the miR-30a* and miR-30e* genes. Further analysis using leave‑one-out cross predictions and Kaplan-Meier survival analysis strongly suggested that miR-30a* and miR-30e* can be used as biomarkers to tailor histological grade before starting the regimen, and they showed important roles in ovarian cancer differentiation resulting in poorer prognosis. In general, miR-30a* and miR-30e* coupled with expression data that reveal pathogenic regulation to predict histological differentiation, may operate to direct the formation of early detection and therapeutic approaches to individual OPSC patients, especially differentiation therapy to high-grade cases.
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Affiliation(s)
- Yan Wang
- Laboratory Center, Second Affiliated Hospital of Dalian Medical University, Dalian, P.R. China
| | - Lv Li
- Department of Pathology, Second Affiliated Hospital of Dalian Medical University, Dalian, P.R. China
| | - Zhenyun Qu
- Department of Pathophysiology, Dalian Medical University, Dalian, P.R. China
| | - Ruomeng Li
- Department of Anesthesiology, Second Affiliated Hospital of Dalian Medical University, Dalian, P.R. China
| | - Tie Bi
- Obstetrics and Gynecology Hospital, Dalian, P.R. China
| | - Jiyong Jiang
- Obstetrics and Gynecology Hospital, Dalian, P.R. China
| | - Henan Zhao
- Department of Pathophysiology, Dalian Medical University, Dalian, P.R. China
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24
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Zhu YF, He LS, Zhang ZD, Huang QS. Expression of serum human epididymal secretory protein E4 at low grade and high grade serous carcinomas. ASIAN PAC J TROP MED 2013. [PMID: 23199707 DOI: 10.1016/s1995-7645(12)60175-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To investigate the value of serum human epididymis protein 4 (HE4) in differential diagnosis of patients with low-grade serous (LGSC) and high-grade serous carcinoma (HGSC) serous ovarian cancer. METHODS LGSC and HGSC serous ovarian cancer were diagnosed by the two-tier grade system, serum levels of HE4 and carbohydrate antigen 125 (CA125) were measured by ELISA and radioisotope method, respectively in 60 serous ovarian cancer patients. HE4 and TP53 protein in cancer tissue were measured by immunohistochemical method. RESULTS The difference in density of HE4 and TP53 protein was significant between LGSC and HGSC tissue, while serum CA125 did not show significant difference between different serum samples. There was significant difference in serum HE4 levels between LGSC and HGSC, and the result was different within FIGO (I+II) stage, suggesting HE4 was not a reliable biomarker for the discrimination between LGSC and HGSC. HE4 had potential as a biomarker for the discrimination between LGSC and HGSC but the role in early diagnosis was limited. CONCLUSIONS HE4 may be a reliable marker for differential diagnosis of LGSC and HGSC. But its role in early diagnosis of LGSC and HGSC need to be confirmed from the perspective of two-tier grade system.
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Affiliation(s)
- Ya-Fei Zhu
- Department of Gynaecology and Obstetrics, First Affiliated Hospital of Nanchang University, No. 17. Yongwaizheng Street, Donghu District, Nanchang, Jiangxi Province, China.
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25
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Yu X, Zhang X, Bi T, Ding Y, Zhao J, Wang C, Jia T, Han D, Guo G, Wang B, Jiang J, Cui S. MiRNA expression signature for potentially predicting the prognosis of ovarian serous carcinoma. Tumour Biol 2013; 34:3501-8. [PMID: 23836287 DOI: 10.1007/s13277-013-0928-3] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 06/12/2013] [Indexed: 01/23/2023] Open
Abstract
One of the best prognostic predictors for patients with epithelial ovarian cancer is the Federation of Obstetrics and Gynecology (FIGO) stage at diagnosis. Advanced-stage ovarian serous carcinoma (OSC) generally have poor prognosis. The goal of this study is to develop and validate a miRNA expression profile that can differentiate the OSC at early and advanced stages and study its correlation with the prognosis of OSC. To identify a unique microRNA (miRNA) pattern associated with the progression of OSC at early and advanced stages, a miRNA microarray was performed using Chinese tumor bank specimens of patients with OSC stage I or III in a retrospective analysis. The expression of four dysregulated miRNAs was validated using quantitative real-time polymerase chain reaction (qRT-PCR) in an external cohort of 51 cases of OSC samples at stages I and III. Kaplan-Meier analysis was performed to analyze the correlation between the expression of some miRNAs and prognosis. Of the 768 miRNAs analyzed in the microarray, 26 miRNAs were significantly either up- or downregulated, with at least a 2-fold difference, in OSC stage I compared with stage III. The qRT-PCR results showed that miR-510, miR-509-5p, and miR-508-3p were significantly downregulated and that miR-483-5p was upregulated in stage III OSC compared with stage I, which was consistent with the microarray results. Kaplan-Meier analysis showed low miR-510 expression, low miR-509-5p expression, and advanced FIGO stage, and chemotherapy resistance were significantly associated with poorer overall survival (P < 0.05). Our results suggest that miRNAs may play a role in the progression of OSC, and miR-510 and miR-509-5p may be considered novel-candidate clinical biomarkers for predicting OSC outcome.
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Affiliation(s)
- Xiaotang Yu
- Department of Histology and Embryology, Dalian Medical University, No 9 LvShun South Road-W, 116044, Dalian, China
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Nodin B, Zendehrokh N, Sundström M, Jirström K. Clinicopathological correlates and prognostic significance of KRAS mutation status in a pooled prospective cohort of epithelial ovarian cancer. Diagn Pathol 2013; 8:106. [PMID: 23800114 PMCID: PMC3722044 DOI: 10.1186/1746-1596-8-106] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 06/12/2013] [Indexed: 01/09/2023] Open
Abstract
Background Activating KRAS mutations are common in ovarian carcinomas of low histological grade, less advanced clinical stage and mucinous histological subtype, and form part of the distinct molecular alterations associated with type I tumors in the dualistic model of ovarian carcinogenesis. Here, we investigated the occurrence, clinicopathological correlates and prognostic significance of specific KRAS mutations in tumours from 153 epithelial ovarian cancer (EOC) cases from a pooled, prospective cohort. Methods KRAS codon 12,13 and 61 mutations were analysed by pyrosequencing in tumours from 163 incident EOC cases in the Malmö Diet and Cancer Study and Malmö Preventive Project. Associations of mutational status with clinicopathological and molecular characteristics were assessed by Pearson Chi Square test. Ovarian cancer-specific survival (OCSS) according to mutational status was explored by Kaplan-Meier analysis and Cox proportional hazards modelling. KRAS-mutation status was also analysed in 28 concomitantly sampled benign-appearing fallopian tubes. Results Seventeen (11.1%) EOC cases harboured mutations in the KRAS gene, all but one in codon 12, and one in codon 13. No KRAS mutations were found in codon 61 and all examined fallopian tubes were KRAS wild-type. KRAS mutation was significantly associated with lower grade (p = 0.001), mucinous histological subtype (p = < 0.001) and progesterone receptor expression (p = 0.035). Kaplan-Meier analysis revealed a significantly improved OCSS for patients with KRAS-mutated compared to KRAS wild-type tumours (p = 0.015). These associations were confirmed in unadjusted Cox regression analysis (HR = 2.51; 95% CI 1.17-5.42) but did not remain significant after adjustment for age, grade and clinical stage. The beneficial prognostic impact of KRAS mutation was ony evident in tumours of low-intermediate differentiation grade (p = 0.023), and in a less advanced clinical stage (p = 0.014). Moreover, KRAS mutation was associated with a significantly improved OCSS in the subgroup of endometroid carcinomas (p = 0.012). Conclusions The results from this study confirm previously demonstrated associations of KRAS mutations with well-differentiated and mucinous ovarian carcinomas. Moreover, KRAS-mutated tumours had a significantly improved survival in unadjusted, but not adjusted, analysis. A finding that merits further study is the significant prognostic impact of KRAS mutation in endometroid carcinomas, potentially indicating that response to Ras/Raf/MEK/ERK-targeting therapies may differ by histological subtype. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1788330379100147
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Affiliation(s)
- Björn Nodin
- Department of Clinical Sciences, Division of Pathology, Lund University, Skåne University Hospital, Lund, Sweden.
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Gershenson DM. The life and times of low-grade serous carcinoma of the ovary. Am Soc Clin Oncol Educ Book 2013:0011300e195. [PMID: 23714500 DOI: 10.14694/edbook_am.2013.33.e195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
For the past several years, all women with epithelial ovarian cancer have been treated identically, whether in a clinical trial or off protocol. Over the past decade, we have come to appreciate the magnitude of the heterogeneity of ovarian cancer. The development of the binary grading system for serous carcinoma was a major advance, leading to separate clinical trials for patients with this subtype, originating from the Gynecologic Oncology Group's Rare Tumor Committee. The mitogen-activated protein kinase (MAPK) pathway appears to play a prominent role in the pathogenesis of this subtype. Approximately 20% to 40% of low-grade serous carcinomas have a KRAS mutation, while BRAF mutations are rare-approximately 5%. In genomic profiling studies, these tumors appear to cluster with serous tumors of low malignant potential. Compared with high-grade serous carcinomas, low-grade serous carcinomas are also characterized by a low frequency of p53 mutations, greater expression of ER and PR, and greater expression of PAX2 and IGF-1. Primary treatment of low-grade serous carcinoma includes surgery plus platinum-based chemotherapy (either adjuvant or neoadjuvant). Clinical behavior is characterized by young age at diagnosis, relative chemoresistance, and prolonged overall survival. Current options for treatment of relapsed disease include secondary cytoreduction in selected patients, salvage chemotherapy, or hormone therapy. A recently completed trial of a MEK inhibitor for women with recurrent disease demonstrated promising activity. Future directions will include further investigations of the molecular biology and biomarker-driven clinical trials with targeted agent monotherapy and combinations.
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MESH Headings
- Biomarkers, Tumor/analysis
- Biomarkers, Tumor/genetics
- Carcinoma/chemistry
- Carcinoma/classification
- Carcinoma/genetics
- Carcinoma/mortality
- Carcinoma/pathology
- Carcinoma/secondary
- Carcinoma/therapy
- Disease Progression
- Disease-Free Survival
- Female
- Humans
- Neoplasm Grading
- Neoplasm Recurrence, Local
- Neoplasms, Cystic, Mucinous, and Serous/chemistry
- Neoplasms, Cystic, Mucinous, and Serous/classification
- Neoplasms, Cystic, Mucinous, and Serous/genetics
- Neoplasms, Cystic, Mucinous, and Serous/mortality
- Neoplasms, Cystic, Mucinous, and Serous/pathology
- Neoplasms, Cystic, Mucinous, and Serous/secondary
- Neoplasms, Cystic, Mucinous, and Serous/therapy
- Ovarian Neoplasms/chemistry
- Ovarian Neoplasms/classification
- Ovarian Neoplasms/genetics
- Ovarian Neoplasms/mortality
- Ovarian Neoplasms/pathology
- Ovarian Neoplasms/therapy
- Risk Assessment
- Risk Factors
- Time Factors
- Treatment Outcome
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Affiliation(s)
- David M Gershenson
- From the Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
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Diaz-Padilla I, Malpica AL, Minig L, Chiva LM, Gershenson DM, Gonzalez-Martin A. Ovarian low-grade serous carcinoma: A comprehensive update. Gynecol Oncol 2012; 126:279-85. [DOI: 10.1016/j.ygyno.2012.04.029] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Revised: 04/23/2012] [Accepted: 04/23/2012] [Indexed: 12/28/2022]
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