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He S, Zhao X, Mu R, Pan Z, Mai J. XRCC1 and hOGG1 polymorphisms and endometrial carcinoma: A meta-analysis. Open Med (Wars) 2024; 19:20240913. [PMID: 38463515 PMCID: PMC10921453 DOI: 10.1515/med-2024-0913] [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: 07/03/2023] [Revised: 12/23/2023] [Accepted: 01/22/2024] [Indexed: 03/12/2024] Open
Abstract
Endometrial carcinoma's (EC) etiology is complex and involves DNA repair gene polymorphisms like XRCC1-Arg399Gln and hOGG1-Ser326Cys, but their association with the disease is unclear. Following PRISMA, we conducted a systematic review and meta-analysis, collecting data from four databases. The studies needed to be population-based case-control studies examining the association between the named polymorphisms and EC. Quality was assessed with the Newcastle-Ottawa Scale. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated, and subgroup analyses were conducted based on ethnicity. Seven studies were included. Both polymorphisms were found to significantly increase EC risk, particularly in Caucasians. XRCC1-Arg399Gln showed a dominant model OR of 1.14 (95% CI: 1.01-1.29) and a homozygous model OR of 1.59 (95% CI: 1.12-2.25). The heterozygote model OR for hOGG1-Ser326Cys was 1.29 (95% CI: 1.02-1.63), and the allele OR was 1.31 (95% CI: 1.07-1.60). XRCC1-Arg399Gln and hOGG1-Ser326Cys may increase EC risk, primarily in Caucasian women, emphasizing the role of DNA repair in disease susceptibility. More extensive studies are needed to validate these findings in diverse ethnicities and investigate other DNA repair gene polymorphisms.
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Affiliation(s)
- Shengke He
- Department of Pathology, Danzhou People’s Hospital, Nada Town, Danzhou, Hainan, 571799, China
| | - Xiujuan Zhao
- Department of Gynaecology and Obstetrics, Danzhou People’s Hospital, Nada Town, Danzhou, Hainan, 571799, China
| | - Ruifang Mu
- Department of Gynaecology and Obstetrics, Danzhou People’s Hospital, Nada Town, Danzhou, Hainan, 571799, China
| | - Zhongjun Pan
- Department of Pathology, Danzhou People’s Hospital, Nada Town, Danzhou, Hainan, 571799, China
| | - Jinglan Mai
- Occupational Physical Examination Outpatient, Haikou Center for Disease Control and Prevention, No. 56 Yehai Avenue, Qiongshan District, Haikou, Hainan, 570203, China
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Vanbraband J, Van Damme N, Silversmit G, De Geyndt A, Bouche G, Jacomen G, de Jonge E, Goffin F, Denys H, Amant F. Practice patterns, time trends and quality of care of uterine cancer in Belgium: An analysis of the EFFECT database. Gynecol Oncol 2024; 180:70-78. [PMID: 38086166 DOI: 10.1016/j.ygyno.2023.11.015] [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: 07/20/2023] [Revised: 11/07/2023] [Accepted: 11/13/2023] [Indexed: 02/18/2024]
Abstract
OBJECTIVES To investigate the practice patterns and quality of care for uterine cancer on a national level in Belgium, including trends in practice over the period 2012-2016. METHODS Quality indicators were measured using the EFFectiveness of Endometrial Cancer Treatment (EFFECT) database. Multivariable logistic mixed regression was used to test for associations between the quality indicators and year of diagnosis, adjusted for potential confounders and intra-cluster correlations. RESULTS The EFFECT database includes 4178 patients diagnosed with uterine cancer in the period 2012-2016. Minimally invasive surgery (laparoscopic or robotic-assisted) was applied in 61.6% of patients who had surgery for clinical stage I endometrial carcinoma (EC), increasing from 52.9% in 2012 to 66.4% in 2016. At least pelvic lymph node staging was performed in 69.0% of patients with clinical stage I, high-grade EC; and in 63.9% of patients with clinical stage I-II serous carcinoma, clear cell carcinoma or carcinosarcoma. The latter increased from 48.8% in 2012 to 77.2% in 2016. Adjuvant radiotherapy (external beam and/or brachytherapy) was offered to 33.5% of patients who had surgery without lymph node staging for pathological stage I EC at high-intermediate or high risk of recurrence. Adjuvant chemotherapy was administered to 64.4% of patients with pathological stage III-IVA EC. CONCLUSIONS Study results indicate an overall good quality of care for patients with uterine cancer in Belgium. Treatment areas with potential room for improvement include the use of minimally invasive surgery, comprehensive surgical staging and adjuvant therapy, which confirms the remaining controversies in uterine cancer treatment and the need for further research.
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Affiliation(s)
- Joren Vanbraband
- Unit of Gynecologic Oncology, Department of Oncology, KU Leuven, Campus Gasthuisberg, ON4 Herestraat 49, Box 1045, 3000 Leuven, Belgium.
| | - Nancy Van Damme
- Belgian Cancer Registry, Koningsstraat 215, Box 7, 1210 Brussels, Belgium.
| | - Geert Silversmit
- Belgian Cancer Registry, Koningsstraat 215, Box 7, 1210 Brussels, Belgium.
| | - Anke De Geyndt
- Belgian Cancer Registry, Koningsstraat 215, Box 7, 1210 Brussels, Belgium.
| | - Gauthier Bouche
- The Anticancer Fund, Brusselsesteenweg 11, 1860 Meise, Belgium.
| | - Gerd Jacomen
- Laboratory of Pathological Anatomy, AZ Sint-Maarten, Liersesteenweg 435, 2800 Mechelen, Belgium.
| | - Eric de Jonge
- Department of Obstetrics and Gynecology, Ziekenhuis Oost-Limburg, Campus Sint-Jan, Synaps Park 1, 3600 Genk, Belgium.
| | - Frédéric Goffin
- Department of Obstetrics and Gynecology, CHU de Liège et Hôpital de La Citadelle, Boulevard du 12e de Ligne 1, 4000 Liège, Belgium.
| | - Hannelore Denys
- Department of Medical Oncology, University Hospital Ghent, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
| | - Frédéric Amant
- Unit of Gynecologic Oncology, Department of Oncology, KU Leuven, Campus Gasthuisberg, ON4 Herestraat 49, Box 1045, 3000 Leuven, Belgium; Department of Surgery, Netherlands Cancer Institute, Plesmanlaan 121, 1066CX Amsterdam, The Netherlands; Department of Gynecologic Oncology, UZ Leuven, Campus Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium.
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Xu J, Tan C. Interaction between CYP1A1 gene polymorphism and environment factors on risk of endometrial cancer. Environ Health Prev Med 2024; 29:54. [PMID: 39384367 PMCID: PMC11473388 DOI: 10.1265/ehpm.24-00007] [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: 01/09/2024] [Accepted: 07/26/2024] [Indexed: 10/11/2024] Open
Abstract
BACKGROUND The purpose of this study was to investigate the impact of single nucleotide polymorphisms (SNPs) of the CYP1A1 gene and the gene-environment interaction on the susceptibility to endometrial cancer in Chinese women. METHOD Logistic regression was performed to investigate the association between the four SNPs of the CYP1A1 gene and the risk of endometrial cancer. Generalized multifactor dimensionality reduction (GMDR) was employed to analyze the gene-environmental interaction. RESULTS A total of 934 women with a mean age of 61.7 ± 10.5 years were selected, including 310 endometrial cancer patients and 624 normal controls. The frequency of rs4646421- T allele was higher in endometrial cancer patients than normal controls, the T allele of rs4646421 was 28.1% in endometrial cancer patients and 21.0% in normal controls (p < 0.001). Logistic regression analysis showed that the rs4646421 - T allele was associated with increased risk of endometrial cancer, OR (95% CI) were 1.52 (1.11-1.97) and 1.91 (1.35-2.52), respectively. GMDR analysis found a significant two-locus model (p = 0.0107) involving rs4646421 and abdominal obesity (defined by waist circumference), indicating a potential gene-environment interaction between rs4646421 and abdominal obesity. Abdominal obese subjects with rs4646421- CT or TT genotype have the highest risk of endometrial cancer, compared to non-abdominal obese subjects with the rs4646421- CC genotype, the OR (95%CI) was 2.23 (1.62-2.91). CONCLUSIONS Both the rs4646421- T allele and the interaction between rs4646421 and abdominal obesity were associated with increased risk of endometrial cancer.
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Affiliation(s)
- Jian Xu
- Department of Oncology, the second people's hospital of Nantong, Affiliated Nantong Rehabilitation Hospital of Nantong University, Nantong City, Jiangsu Province, China, 226002
| | - Cheng Tan
- Department of Radiotherapy, Nantong Tumor Hospital, Tumor Hospital Affiliated to Nantong University, Nantong City, Jiangsu Province, China, 226300
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Bozkurt S, Toptas T, Aydin HA, Simsek T, Yavuz Y. A nomogram for decision-making of completion surgery in endometrial cancer diagnosed after hysterectomy. Arch Gynecol Obstet 2019; 300:693-701. [PMID: 31250198 DOI: 10.1007/s00404-019-05223-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 06/19/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Extrauterine tumor spread is one of the essential determinants of disease outcome in endometrial cancer. However; more than 30% of patients still undergo incomplete surgery at the initial attempt. Strategies regarding the management of patients with incompletely staged early-stage disease or patients with undebulked advanced-stage disease remain controversial. Depending on postoperative uterine features and findings on imaging, patients may be put on observation or receive adjuvant therapy or undergo re-staging or debulking surgery followed by adjuvant therapy. To identify patients who would most benefit from a completion surgery, either for restaging or for cytoreduction, we developed a nomogram for estimation of extrauterine disease based on findings of final hysterectomy specimen. METHODS Data of 336 patients whose extrauterine disease status was known were analyzed. A nomogram was constructed using patient characteristics including age, grade, myometrial invasion, lymphovascular space involvement, cervical involvement, and peritoneal cytology. The nomogram was internally validated in terms of discrimination, calibration and overall performance. RESULTS The nomogram showed good performance accuracy with an area under the receiver operating characteristic curve of 0.870, a specificity of 95.5%, and a positive predictive value of 73.9%. Decision curve analysis revealed that the use of the nomogram in decision-making for completion surgery leads to the equivalent of a net 18 true-positive results per 100 patients without an increase in the number of false-positive results. CONCLUSIONS Estimation of extrauterine disease from final hysterectomy specimen is possible with high predictive performance using the nomogram developed. The nomogram may help clinicians in decision-making for management of incomplete surgeries.
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Affiliation(s)
- Selen Bozkurt
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA.,Department of Biostatistics and Medical Informatics, Akdeniz University School of Medicine, Antalya, Turkey
| | - Tayfun Toptas
- Department of Gynecologic Oncology, Saglik Bilimleri University Antalya Research and Training Hospital, C-Blok, K:2, 07100, Antalya, Turkey.
| | - Hulya Ayik Aydin
- Department of Gynecologic Oncology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Tayup Simsek
- Department of Gynecologic Oncology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Yasemin Yavuz
- Department of Biostatistics, Ankara University School of Medicine, Ankara, Turkey
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Candido EC, Rangel Neto OF, Toledo MCS, Torres JCC, Cairo AAA, Braganca JF, Teixeira JC. Systematic lymphadenectomy for intermediate risk endometrial carcinoma treatment does not improve the oncological outcome. Eur J Obstet Gynecol Reprod Biol X 2019; 3:100020. [PMID: 31403112 PMCID: PMC6687380 DOI: 10.1016/j.eurox.2019.100020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 03/20/2019] [Accepted: 04/09/2019] [Indexed: 12/31/2022] Open
Abstract
Objective To evaluate the indication and performance of systematic lymphadenectomy (SL) in Stage I endometrioid endometrial carcinoma (EEC), at intermediate risk (FIGO IAG2/G3, IBG1/G2) on recurrence, disease-free survival (DFS) and survival. Study design 194 women underwent hysterectomies by laparotomy, with SL (n = 95) or without SL (n = 99) between 1990 and 2014 was evaluated. Diagnosis period, age, BMI, comorbidities, stage, and adjuvant radiotherapy were analyzed. DFS and cancer-specific survival were analyzed by Kaplan-Meier and log-rank test, and recurrences by Cox regression. Results SL was performed in 93% (41/44) of women managed before 1998 and decreasing after that (p < 0.001). SL was also more frequent if BMI under 35.0 kg/m2 (p < 0.001) and in women without comorbidities (p = 0.017). Distribution of age, stage and postoperative radiotherapy were not different between groups. There were 14 recurrences (7.4%), concentrated in the SL group (12 cases) and associated with Stage IAG3 (35.7%, p = 0.009). Longitudinal evaluation exhibited 95% of 5-year cancer-specific survival rate for non-SL group vs. 88% for the SL group (p = 0.039), and DFS rate was 97% for the non-SL group vs. 85% for the SL group (p = 0.004). Cox regression analyses exhibited Stage IAG3 (HR 6.48, IC95% 1.88–22.39; p = 0.003) associated with less DFS. Conclusion SL in surgical staging of EEC at intermediate risk presented no benefits regarding recurrences, DFS, and cancer-specific survival rate when compared to patients not submitted to complete surgical staging. Stage IAG3 had poor prognosis regardless treatment modality. Our results provide further evidence to support the current trend to avoid SL in the surgical approach to selected women.
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Affiliation(s)
- Elaine C Candido
- Department of Obstetrics and Gynecology, University of Campinas (UNICAMP), Rua Alexander Fleming, 101, Cidade Universitaria, Campinas, SP, 13083-881, Brazil
| | - Osmar F Rangel Neto
- Department of Obstetrics and Gynecology, University of Campinas (UNICAMP), Rua Alexander Fleming, 101, Cidade Universitaria, Campinas, SP, 13083-881, Brazil
| | - Maria Carolina S Toledo
- Department of Obstetrics and Gynecology, University of Campinas (UNICAMP), Rua Alexander Fleming, 101, Cidade Universitaria, Campinas, SP, 13083-881, Brazil
| | - José Carlos C Torres
- Department of Obstetrics and Gynecology, University of Campinas (UNICAMP), Rua Alexander Fleming, 101, Cidade Universitaria, Campinas, SP, 13083-881, Brazil
| | - Aurea A A Cairo
- Department of Obstetrics and Gynecology, Pontifical Catholic University of Campinas, Av. John Boyd Dunlop, s/n - Jd. Ipaussurama, Campinas, SP, 13060-904 Brazil
| | - Joana F Braganca
- Department of Obstetrics and Gynecology, University of Campinas (UNICAMP), Rua Alexander Fleming, 101, Cidade Universitaria, Campinas, SP, 13083-881, Brazil
| | - Julio C Teixeira
- Department of Obstetrics and Gynecology, University of Campinas (UNICAMP), Rua Alexander Fleming, 101, Cidade Universitaria, Campinas, SP, 13083-881, Brazil
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