Surgical management of women with ovarian cancer

Production of IL1-beta by ovarian cancer cells induces mesothelial cell beta1-integrin expression facilitating peritoneal dissemination

Background

A crucial step in the metastatic spread of ovarian cancer (OC) is the adhesion and implantation of tumor cells to the peritoneal mesothelium. In order to study this step in the cascade, we derived a pro-metastatic human ovarian carcinoma cell line (MFOC3) from the non-metastatic FOC3 line.

Methods

Molecular profiling of the isogeneic lines identified differentially expressed genes, and investigation for a role in dissemination for specific factors was achieved by development of a co-culture adhesion assay utilizing monolayers of human mesothelial cells.

Results

After murine intraperitoneal inoculation, the FOC3 cell line formed no metastases, but the MFOC3 subline formed metastases in > 80% of SCID mice. MFOC3 cells also adhered 2-3 times more avidly to mesothelial monolayers. This adhesion was inhibited by neutralizing antibodies to IL-1β and enhanced by recombinant IL-1β (p < 0.01). IL-1β induced mesothelial cell β1-integrin, and an antibody to this subunit also inhibited the adhesion of MFOC3 to mesothelial cells in vitro and significantly reduced metastases in vivo. Immunohistochemical analysis of a cohort of 96 ovarian cancer cases showed that negative IL-1β expression was significantly associated with an improved overall survival rate.

Conclusions

These results suggest that a IL-1β/β1-integrin axis plays a role in ovarian tumor cell adhesion to mesothelia, a crucial step in ovarian cancer dissemination.

Molecular characterization of a new ovarian cancer cell line, YDOV-151, established from mucinous cystadenocarcinoma

Ovarian cancer is a leading cause of death among gynecological malignancies. Established cancer cell lines are useful tools for clinical and basic researches. We have therefore established a new human ovarian cancer cell line, YDOV-151, derived from the mucinous cystadenocarcinoma and characterized it by the microarray analyses. A mucinous origin of the YDOV-151 was evident from light microscopy, and its epithelial-like character was confirmed with electron microscopy. No pathogenic mutations were found in the BRCA1 and BRCA2 genes. The subcutaneous transplantation of YDOV-151 cells into nude mice successfully induced the tumor mass after 3 weeks. cDNA microarray analysis revealed 1,926 genes (> 2-fold differences, P < 0.05) that distinguished the YDOV-151 from human ovarian surface epithelial (HOSE) cells. To identify candidate biomarkers, we selected five genes (SFN, RGC32, CDCA7, LAMP3, and SLCO4A1), each of which was up-regulated (> 7-fold) in YDOV-151 and had an available antibody assay for further validation. In SYBR Green real-time PCR, the relative expression levels of RGC32 (651-fold), LAMP3 (1,930-fold), and SLCO4A1 (20,598-fold) were significantly higher in YDOV-151 than in HOSEs (P < 0.001). RGC32 may be involved in cell cycle regulation, LAMP3 may promote metastasis, and SLCO4A1 is a member of anion-transporting polypeptides. The newly established ovarian cancer cell line, YDOV-151, would be a useful model for elucidating the biology and the pathogenesis of mucinous cystadenocarcinoma. In addition, the identification and validation of up-regulated genes may provide a genetic approach for identifying biomarkers in ovarian cancer.

Salvage gastrectomy following a combination of biweekly paclitaxel and S-1 for stage IV gastric cancer

BACKGROUND AND AIM

We investigated the clinical benefits of salvage gastrectomy for stage IV gastric cancer patients whose distant lesions showed complete response after chemotherapy.

METHODS

We enrolled 18 stage IV gastric cancer patients whose distant metastases had disappeared or were controlled by a combination of biweekly paclitaxel (PTX) and S-1. After chemotherapy, these patients received gastrectomy with lymph node dissection. The postoperative outcome was analyzed with respect to both the histological effects of chemotherapy and tumor behavior.

RESULTS

Of the 18 patients, 8 had distant lymph node metastases, 9 had peritoneal dissemination, and five had multiple liver metastases prior to chemotherapy. Fourteen patients received curative surgery (R0). No severe postoperative complications were encountered. Pathological evaluation revealed grade 3 and grade 2 tumor regression in the primary lesion in one and five patients, respectively, and grade 3 and grade 2 tumor regression in the lymph nodes in one and six patients, respectively. Univariate analysis of the patients' prognosis identified R number, gross tumor type, histological grade of tumor regression, and gender as significant factors. Multivariate analysis showed that only the R number was an independent prognostic factor.

CONCLUSION

R0 salvage gastrectomy following a combination of biweekly PTX and S-1 may have significant clinical efficacy for advanced gastric cancer patients.