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Woopen H, Keller M, Zocholl D, Mittelstadt S, Barretina-Ginesta MP, Heinzelmann-Schwarz V, Lafleur J, Kocián R, Baum J, Krabisch P, Achimas-Cadariu P, Vardar MA, Vergote I, Nasser S, Link T, Gil-Martin M, Zwimpfer TA, Leitner K, Jedryka M, Boxler T, Braicu EI, Sehouli J. Side Effects from Cancer Therapies and Perspective of 1044 Long-Term Ovarian Cancer Survivors-Results of Expression VI-Carolin Meets HANNA-Holistic Analysis of Long-Term Survival with Ovarian Cancer: The International NOGGO, ENGOT, and GCIG Survey. Cancers (Basel) 2023; 15:5428. [PMID: 38001688 PMCID: PMC10670049 DOI: 10.3390/cancers15225428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
The aim of this survey was to increase the knowledge on the characteristics and health concerns of long-term survivors (LTS; survival > 5 years) after ovarian cancer in order to tailor follow-up care. This international survey was initiated by the NOGGO and was made available to members of ENGOT and GCIG. The survey is anonymous and consists of 68 questions regarding sociodemographic, medical (cancer) history, health concerns including distress, long-term side effects, and lifestyle. For this analysis, 1044 LTS from 14 countries were recruited. In total, 58% were diagnosed with FIGO stage III/IV ovarian cancer and 43.4% developed recurrent disease, while 26.0% were receiving cancer treatment at the time of filling in the survey. LTS who survived 5-10 years self-estimated their health status as being significantly worse than LTS who survived more than 10 years (p = 0.034), whereas distress also remained high 10 years after cancer diagnosis. Almost half of the cohort (46.1%) reported still having symptoms, which were mainly lymphedema (37.7%), fatigue (23.9%), pain (21.6%), polyneuropathy (16.9%), gastrointestinal problems (16.6%), and memory problems (15.5%). Almost all patients (94.2%) regularly received follow-up care. Specialized survivorship care with a focus on long-term side effects, lifestyle, and prevention should be offered beyond the typical five years of follow-up care.
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Affiliation(s)
- Hannah Woopen
- Department of Gynecology with Center for Oncological Surgery, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
| | - Maren Keller
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
| | - Dario Zocholl
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
- Institute of Biometry and Clinical Epidemiology, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Suzana Mittelstadt
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
- Department of Women’s Health, University Hospital Tübingen, 72076 Tübingen, Germany
| | - Maria-Pilar Barretina-Ginesta
- Institut Català d’Oncologia, Medical Oncology Department, 17007 Girona, Spain
- Precision Oncology Group, Institut d’Investigació Biomèdica de Girona, 17007 Girona, Spain
- Medical Sciences Department, Universitat de Girona, 17003 Girona, Spain
- Grupo Español de Investigación en Cáncer de Ovario (GEICO), 28003 Madrid, Spain
| | - Viola Heinzelmann-Schwarz
- Department of Gynecology and Gynecologic Oncology, University Hospital of Basel, 4056 Basel, Switzerland
- Swiss GO Trial Group (Swiss-GO), 4031 Basel, Switzerland
| | - Judith Lafleur
- Department of Gynecology and Obstetrics, Ordensklinikum Barmherzige Schwestern Linz, 4020 Linz, Austria
- Arbeitsgemeinschaft Gynaekologische Onkologie Austria (AGO Austria), 6020 Innsbruck, Austria
| | - Roman Kocián
- Department of Gynaecology, Obstetrics and Neonatology First Faculty of Medicine, Charles University and General University Hospital in Prague, 12 108 Prague, Czech Republic
- General University Hospital in Prague, 12 808 Prague, Czech Republic
- Central and Eastern European Gynecologic Oncology Group (CEEGOG), 128 51 Prague, Czech Republic
| | - Joanna Baum
- Department of Gynecology with Center for Oncological Surgery, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
| | - Petra Krabisch
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
- Department of Gynaecology and Obstetrics, Klinikum Chemnitz, 09116 Chemnitz, Germany
| | - Patriciu Achimas-Cadariu
- Institute of Oncology Prof. Dr. I. Chiricuta Cluj-Napoca, University of Medicine and Pharmacy Iuliu Hatieganu, 400015 Cluj-Napoca, Romania
| | - Mehmet Ali Vardar
- Department of Gynecologic Oncology, Cukurova University, 01250 Adana, Turkey
- Turkish Society of Gynecologic Oncology (TRSGO), Ovecler, 06450 Ankara, Turkey
| | - Ignace Vergote
- Division of Gynaecological Oncology, Leuven Cancer Institute, University Hospitals Leuven, 3000 Leuven, Belgium
- Belgium and Luxembourg Gynaecological Oncology Group (BGOG), 3000 Leuven, Belgium
| | - Sara Nasser
- Department of Gynecology with Center for Oncological Surgery, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany
- Pan-Arabian Research Society of Gynecological Oncology (PARSGO), 13353 Berlin, Germany
| | - Theresa Link
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
- Department of Gynecology and Obstetrics, Technische Universität Dresden, 01307 Dresden, Germany
| | - Marta Gil-Martin
- Grupo Español de Investigación en Cáncer de Ovario (GEICO), 28003 Madrid, Spain
- Catalan Institute of Oncology—IDIBELL, L’Hospitalet-Barcelona, 08908 Barcelona, Spain
| | - Tibor A. Zwimpfer
- Department of Gynecology and Gynecologic Oncology, University Hospital of Basel, 4056 Basel, Switzerland
- Swiss GO Trial Group (Swiss-GO), 4031 Basel, Switzerland
| | - Katharina Leitner
- Arbeitsgemeinschaft Gynaekologische Onkologie Austria (AGO Austria), 6020 Innsbruck, Austria
- Department of Obstetrics and Gynecology, Innsbruck Medical University, 6020 Innsbruck, Austria
| | - Marcin Jedryka
- Central and Eastern European Gynecologic Oncology Group (CEEGOG), 128 51 Prague, Czech Republic
- Gynecological Oncology Department, Wroclaw Medical University, 50-367 Wroclaw, Poland
- Oncological Gynecology Department, Lower Silesian Oncology, Pulmonology and Hematology Center, 53-413 Wroclaw, Poland
| | | | - Elena Ioana Braicu
- Department of Gynecology with Center for Oncological Surgery, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
| | - Jalid Sehouli
- Department of Gynecology with Center for Oncological Surgery, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
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Ovarian Cancer and Glutamine Metabolism. Int J Mol Sci 2023; 24:ijms24055041. [PMID: 36902470 PMCID: PMC10003179 DOI: 10.3390/ijms24055041] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 02/24/2023] [Accepted: 03/01/2023] [Indexed: 03/08/2023] Open
Abstract
Cancer cells are known to have a distinct metabolic profile and to exhibit significant changes in a variety of metabolic mechanisms compared to normal cells, particularly glycolysis and glutaminolysis, in order to cover their increased energy requirements. There is mounting evidence that there is a link between glutamine metabolism and the proliferation of cancer cells, demonstrating that glutamine metabolism is a vital mechanism for all cellular processes, including the development of cancer. Detailed knowledge regarding its degree of engagement in numerous biological processes across distinct cancer types is still lacking, despite the fact that such knowledge is necessary for comprehending the differentiating characteristics of many forms of cancer. This review aims to examine data on glutamine metabolism and ovarian cancer and identify possible therapeutic targets for ovarian cancer treatment.
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Wang Y, Zhang S, Song Z, Ouyang L, Li Y. Anti-Angiogenesis Maintenance Therapy in Newly Diagnosed and Relapsed Ovarian Cancer: A Meta-analysis of Phase III Randomized Controlled Trials. Front Pharmacol 2021; 12:726278. [PMID: 34867330 PMCID: PMC8636101 DOI: 10.3389/fphar.2021.726278] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 10/29/2021] [Indexed: 11/13/2022] Open
Abstract
Aim: Anti-angiogenesis agents have been added as maintenance therapy in ovarian cancer over the past decade. The aim of this meta-analysis was to analyze the efficacy of anti-angiogenesis therapy in newly diagnosed and relapsed ovarian cancer. Methods: PubMed, Embase, and Cochrane databases were searched for all phase III randomized controlled trials (RCTs) that assessed the efficacy and toxicity of anti-angiogenesis agents in ovarian cancer. Overall survival (OS) and progression-free survival (PFS) were used to evaluate the effectiveness of anti-angiogenesis therapy in ovarian cancer. Results: A total of 6097 patients with newly diagnosed ovarian cancer from 5 phase III RCTs and 2943 patients with relapsed ovarian cancer from 6 phase III RCTs were included in this meta-analysis. The pooled results showed that anti-angiogenesis maintenance therapy significantly improved PFS (hazard ratio [HR], 0.84; 95% confidence interval [CI], 0.76-0.93; p = 0.001), but not OS (HR, 0.98; 95% CI, 0.91-1.05; p = 0.49) compared with placebo in patients with newly diagnosed ovarian cancer. In patients with relapsed ovarian cancer, the pooled results showed a significant improvement on OS (HR, 0.89; 95% CI, 0.82-0.98; p = 0.02) and PFS (HR, 0.61; 95% CI, 0.52-0.72; p < 0.001). The pooled results also showed that the anti-angiogenesis agents were associated with an increase in the occurrence of severe hypertension, neutropenia, diarrhea, thrombocytopenia, headache, and bleeding in ovarian cancer. However, infrequent fatal adverse events occurred in the anti-angiogenesis groups. Conclusions: Study results suggest that anti-angiogenesis agents were an effective therapy for newly diagnosed and relapsed ovarian cancer, especially for relapsed ovarian cancer. Anti-angiogenesis agents may be associated with some severe but not fatal adverse events. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42021283647.
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Affiliation(s)
- Yizi Wang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Shitai Zhang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zixuan Song
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ling Ouyang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yan Li
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
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Kajiyama H, Suzuki S, Shimbo A, Utsumi F, Yoshikawa N, Kikkawa F. Survival after Anticancer Treatment of Terminally Ill Patients with Ovarian Carcinoma. J Palliat Med 2020; 23:1060-1065. [PMID: 32293976 DOI: 10.1089/jpm.2019.0456] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: It remains unclear whether the end-of-life (EOL) treatment/environment impacts on survival after anticancer treatment in terminally ill women with ovarian carcinoma (OC). Objective: The aim of this investigation was to clarify how long those women actually survived after their last anticancer treatments and their hallmarks. Setting, Design, and Measurements: Between 2003 and 2011, 79 terminally ill women with OC were retrospectively analyzed as a single institutional study. Postcancer treatment survival (PCS), defined as the duration between the last date of the abovementioned "cancer treatment" and that of death from any cause, was analyzed on stratification by type of supportive care or where patients spend their EOL. Inverse probability of treatment weighting (IPTW)-adjusted Kaplan-Meier and Cox regression analyses were employed to compare PCS between the two groups. Results: The median PCS of patients was 10.8 weeks. In the multivariable analysis, the performance status and EOL place retained their significance as independent prognostic factors of poorer PCS (performance status [2-3/0-1]: hazard ratio [HR] = 3.279 [95% confidence interval; CI 1.967-5.586; p < 0.0001], EOL place [hospital/home hospice]: HR = 0.574 [95% CI 0.355-0.913; p = 0.0188]). In the IPTW-adjusted cohort, the median PCS rates were 15.0 and 9.7 weeks in patients of home/hospice and hospital groups, respectively (p = 0.04). Also in the IPTW cohort, the EOL place retained its significance (IPTW-adjusted: HR [95% CI]: 1.548 [1.009-2.374], p = 0.045, multivariable adjusted with IPTW: HR [95% CI]: 1.670 [1.077-2.588], p = 0.022). Conclusion: Our current data may be hypothesis generating; it is possible that the EOL environment is a crucial prognostic factor for survival after anticancer treatment.
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Affiliation(s)
- Hiroaki Kajiyama
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shiro Suzuki
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akiko Shimbo
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Fumi Utsumi
- Department of Obstetrics and Gynecology, Bantane Hospital, Fujita Health University, Nagoya, Japan
| | - Nobuhisa Yoshikawa
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Fumitaka Kikkawa
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Shimbo A, Kajiyama H, Tamauchi S, Yoshikawa N, Ikeda Y, Nishino K, Suzuki S, Niimi K, Sakata J, Kikkawa F. Expression of connective tissue growth factor as a prognostic indicator and its possible involvement in the aggressive properties of epithelial ovarian carcinoma. Oncol Rep 2019; 42:2323-2332. [PMID: 31578579 PMCID: PMC6826307 DOI: 10.3892/or.2019.7352] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 09/03/2019] [Indexed: 12/27/2022] Open
Abstract
Recently, connective tissue growth factor (CTGF) was demonstrated to be associated with aggressive characteristics, including proliferation, invasion and metastasis, in a number of malignancies. Here, we investigated the expression and function of CTGF in epithelial ovarian carcinoma (EOC) to clarify its molecular mechanism and clinical significance. Paraffin sections from clinical samples of EOC (N=104) were immunostained with the CTGF antibody, and then the staining positivity was semiquantitatively examined. Moreover, we explored the role of CTGF expression in the migration-promoting effect on and chemoresistance of EOC cells. The results revealed that of the 104 EOC patients, the low and high CTGF staining expression rates were 65 (62.5%) and 39 (37.5%), respectively. Patients belonging to the higher-level CTGF group showed poorer progression-free (PFS) and overall survival (OS) rates than those in the lower-level group [PFS (log-rank: P=0.0076) and OS (log-rank: P=0.0078), respectively]. Multivariable analysis showed that CTGF expression was a significant predictor of poorer PFS and OS [PFS: HR (high vs. low): 1.837, 95% CI: 1.023–3.289 (P=0.0418); OS: HR: 2.141, 95% CI: 1.077–4.296 (P=0.0300)]. In in vitro studies, in acquired paclitaxel (PTX)-resistant EOC cells, the silencing of CTGF expression led to the restoration of PTX sensitivity. Furthermore, we confirmed that the TGF-β-dependent migration-promoting effect on these CTGF-depleted cells was completely inhibited. In conclusion, the results of the present study suggest the possible involvement of CTGF in the migration-promoting effect and chemoresistance of EOC, suggesting that it may be a target for overcoming the malignant properties of EOC.
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Affiliation(s)
- Akiko Shimbo
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Nagoya, Aichi 466‑8550, Japan
| | - Hiroaki Kajiyama
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Nagoya, Aichi 466‑8550, Japan
| | - Satoshi Tamauchi
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Nagoya, Aichi 466‑8550, Japan
| | - Nobuhisa Yoshikawa
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Nagoya, Aichi 466‑8550, Japan
| | - Yoshiki Ikeda
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Nagoya, Aichi 466‑8550, Japan
| | - Kimihiro Nishino
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Nagoya, Aichi 466‑8550, Japan
| | - Shiro Suzuki
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Nagoya, Aichi 466‑8550, Japan
| | - Kaoru Niimi
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Nagoya, Aichi 466‑8550, Japan
| | - Jun Sakata
- Department of Gynecology, Graduate School of Medicine, Aichi Cancer Center Hospital, Nagoya, Aichi 464‑8681, Japan
| | - Fumitaka Kikkawa
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Nagoya, Aichi 466‑8550, Japan
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Canaz E, Grabowski J, Richter R, Braicu E, Chekerov R, Sehouli J. Survival and prognostic factors in patients with recurrent low-grade epithelial ovarian cancer: An analysis of five prospective phase II/III trials of NOGGO metadata base. Gynecol Oncol 2019; 154:539-546. [DOI: 10.1016/j.ygyno.2019.06.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 06/03/2019] [Accepted: 06/13/2019] [Indexed: 12/18/2022]
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Le Saux O, Decullier E, Freyer G, Glehen O, Bakrin N. Long-term survival in patients with epithelial ovarian cancer following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). Int J Hyperthermia 2018; 35:652-657. [PMID: 30295114 DOI: 10.1080/02656736.2018.1518544] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE Despite a high response rate to first-line therapy, prognosis of epithelial ovarian carcinoma (EOC) remains poor. The objective of the present study was to evaluate the frequency of long-term survivors and to identify the prognostic factors associated with long-term survival in a French cohort of 566 patients. METHODS Patients treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for EOC in 13 French centers between 1991 and 2010 were included. Long-term survivors were defined as patients who survived more than 5 years after HIPEC and CRS, irrespective of relapse. RESULTS Seventy-eight long-term survivors were analyzed. The median follow-up was 74 months. Median age at the time of first HIPEC was 55.4 years (range [22.6-77.6]. Seven patients had advanced EOC and 71 patients had recurrent EOC (37 patients had platinum-resistant EOC and 32 had platinum-sensitive disease). More than half of the long-term survivors had high-grade serous ovarian cancer (HGSOC). In univariate analysis, age ≥50 years (p = .004), peritoneal cancer index (PCI) ≤ 8 (p = .049) and CA-125 < 100 (p = .02) were associated with long-term survival. There was a trend towards an association between higher CC-score and long-term survival (p = .057). CONCLUSION Age ≥50 years, PCI ≤8 and CA125 < 100 were associated with long-term survival in univariate analysis. There was a trend towards the significance of CC-score. Platinum-status was not associated with long-term survival.
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Affiliation(s)
- Olivia Le Saux
- a Medical oncology department , Hospices Civils de Lyon, Université de Lyon , Lyon , France
| | | | - Gilles Freyer
- a Medical oncology department , Hospices Civils de Lyon, Université de Lyon , Lyon , France
| | - Olivier Glehen
- c Department of General and Digestive Surgery , Centre Hospitalier Lyon Sud, Lyon 1 University , Lyon , France
| | - Naoual Bakrin
- c Department of General and Digestive Surgery , Centre Hospitalier Lyon Sud, Lyon 1 University , Lyon , France
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Liu W, Kajiyama H, Shibata K, Koya Y, Senga T, Kikkawa F. Hematopoietic lineage cell-specific protein 1 immunoreactivity indicates an increased risk of poor overall survival in patients with ovarian carcinoma. Oncol Lett 2018; 15:9406-9412. [PMID: 29805664 DOI: 10.3892/ol.2018.8493] [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: 12/30/2016] [Accepted: 10/13/2017] [Indexed: 01/26/2023] Open
Abstract
Hematopoietic lineage cell-specific protein 1 (HS1) is a 75-kDa intracellular protein that is expressed primarily in hematopoietic cells. Several previous studies have demonstrated the association between HS1 expression and a poor prognosis in hematopoietic malignancies; however, in solid tumors, no studies not been reported. The present study examined the distribution and expression of HS1 in human epithelial ovarian carcinoma (EOC) to determine its clinical significance. Paraffin sections were obtained from EOC tissues and immunostained with HS1 antibody, and then the staining intensities were evaluated. Overall survival (OS) was determined using the Kaplan-Meier estimator method, and multivariate analysis was performed using the Cox proportional hazards analysis. In total, 195 patients with EOC (median age, 56 years) were enrolled into the present study. HS1 immunoreactivity was categorized based on expression levels: Low (89/195; 45.6%) and high (106/195; 54.4%). Results demonstrated no association between expression level(s) and any clinicopathological parameter including age, International Federation of Gynecology and Obstetrics (FIGO) staging, type of chemotherapy or type of surgery received. The 5-year OS rates of patients who demonstrated low (n=89) and high (n=106) HS1 expression were 90.4 and 66.7%, respectively. The OS times for patients with high HS1 expression were significantly shorter compared with those for patients exhibiting low HS1 expression (P=0.0065). Results obtained from the multivariate analysis demonstrated that the FIGO stage and the amount of HS1 expressed were significant independent prognostic markers for poorer OS (hazard ratio, 3.539; 95% confidence interval, 1.221-12.811; P=0.0187). High HS1 expression levels may serve as a useful biomarker in patients with EOC who are likely to exhibit an unfavorable clinical outcome.
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Affiliation(s)
- Wenting Liu
- Bell Research Center for Reproductive Health and Cancer, Nagoya University Graduate School of Medicine, Nagoya, Aichi 4668550, Japan.,Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Aichi 4668550, Japan
| | - Hiroaki Kajiyama
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Aichi 4668550, Japan
| | - Kiyosumi Shibata
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Aichi 4668550, Japan
| | - Yoshihiro Koya
- Bell Research Center for Reproductive Health and Cancer, Nagoya University Graduate School of Medicine, Nagoya, Aichi 4668550, Japan.,Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Aichi 4668550, Japan
| | - Takeshi Senga
- Division of Cancer Biology, Nagoya University Graduate School of Medicine, Nagoya, Aichi 4668550, Japan
| | - Fumitaka Kikkawa
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Aichi 4668550, Japan
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Hoppenot C, Eckert MA, Tienda SM, Lengyel E. Who are the long-term survivors of high grade serous ovarian cancer? Gynecol Oncol 2017; 148:204-212. [PMID: 29128106 DOI: 10.1016/j.ygyno.2017.10.032] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 10/25/2017] [Accepted: 10/26/2017] [Indexed: 12/30/2022]
Abstract
Although the median survival for epithelial ovarian cancer (EOC) is <5years, approximately 15% of patients will survive for >10years. A better understanding of these exceptional responders could reveal opportunities to improve the dismal prognosis of most EOC patients. In this review, we examine the clinical and genomic features that have been associated with long-term survival, which is generally defined as survival of >7-10years after initial diagnosis. Clinical features influencing long-term survival have been best reported in large retrospective population-based studies. These studies find that long-term survival is associated with previously validated prognostic factors, including younger age at diagnosis, earlier clinicopathologic stage, lower grade, non-serous histology, absence of ascites, primary debulking surgery, and optimal cytoreduction at primary surgery. Duration of survival after a recurrence also contributes to long-term survival and depends both on recurrence location and response to subsequent chemotherapy or surgery. Germline BRCA mutations, although associated with short-term chemosensitivity, do not appear to improve long-term survival. Unfortunately, the relative lack of recurrent somatic mutations in EOC has made the identification of genomic signatures associated with long-term survival difficult. Although six independent gene expression analyses of long-term survivors (LTS) have identified signatures associated with prolonged survival, different gene sets are identified in each study. Genes differentially expressed in tumors of LTS are broadly involved in cell proliferation, tumor-stromal interactions, the cytoskeleton, metabolism of nutrients, and immune/stress response. We anticipate that consistent selection of control and LTS groups, combined with the use of emerging transcriptomic, epigenomic, and proteomic platforms, is likely to identify conserved features associated with long-term survival. Further elucidating the factors contributing to long-term survival has the potential to contribute to our understanding of the biology of ovarian cancer, with the goal of improving the survival of all EOC patients.
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Affiliation(s)
- Claire Hoppenot
- Department of Obstetrics and Gynecology, Section of Gynecologic Oncology, University of Chicago, Chicago, IL 60637, USA
| | - Mark A Eckert
- Department of Obstetrics and Gynecology, Section of Gynecologic Oncology, University of Chicago, Chicago, IL 60637, USA
| | - Samantha M Tienda
- Department of Obstetrics and Gynecology, Section of Gynecologic Oncology, University of Chicago, Chicago, IL 60637, USA
| | - Ernst Lengyel
- Department of Obstetrics and Gynecology, Section of Gynecologic Oncology, University of Chicago, Chicago, IL 60637, USA.
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Sakata J, Kajiyama H, Suzuki S, Utsumi F, Niimi K, Sekiya R, Shibata K, Senga T, Kikkawa F. Impact of positive ZEB1 expression in patients with epithelial ovarian carcinoma as an oncologic outcome-predicting indicator. Oncol Lett 2017; 14:4287-4293. [PMID: 28943941 DOI: 10.3892/ol.2017.6658] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 06/02/2017] [Indexed: 01/17/2023] Open
Abstract
Several previous studies have revealed that the expression of zinc finger E-box binding homeobox 1 (ZEB1) in solid malignancies has an important significance on the clinical outcome of patients. However, the association between ZEB1 expression and survival in patients with epithelial ovarian carcinoma (EOC) remains unclear. The objective of the present study was to examine the extent of ZEB1 expression in EOC using immunohistochemical staining and investigate its association with patient outcome. A total of 40 patients with EOC initially treated with cytoreductive surgery and systematic chemotherapy were enrolled. ZEB1 expression was immunohistochemically categorized as negative, weak, moderate and strong according to the size of the staining area, and intensity. Subsequently, the associations between ZEB1 expression and recurrence/progression-free survival (RFS) rate were examined. The median age of patients in the current study was 54 years old (range, 22-72 years old). Among these patients, 15 (37.5%) exhibited International Federation of Gynecology and Obstetrics stage I disease, and 10 (25.0%), 13 (32.5%), and 2 (5%) had stage II, III, and IV disease, respectively. No patients with negative expression of ZEB1 experienced recurrence. In addition, ZEB1 expression was identified to be a significant predictor of a poorer RFS rate compared with negative expression (negative vs. weak, moderate and strong, P=0.0126). Furthermore, multivariate analyses revealed that moderate and strong ZEB1 expression levels were significant prognostic indicators of a poorer RFS rate in patients with EOC (hazard ratio, 2.265; 95% confidence interval, 1.072-8.021; P=0.0349). Confining analysis to patients with the clear-cell/mucinous histological type, those with moderate/strong ZEB1 expression demonstrated a significantly poorer RFS rate (P=0.0025). Positive ZEB1 expression may be an indicator to predict unfavorable RFS in patients with EOC.
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Affiliation(s)
- Jun Sakata
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Nagoya 466-8550, Japan
| | - Hiroaki Kajiyama
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Nagoya 466-8550, Japan
| | - Shiro Suzuki
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Nagoya 466-8550, Japan
| | - Fumi Utsumi
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Nagoya 466-8550, Japan
| | - Kaoru Niimi
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Nagoya 466-8550, Japan
| | - Ryuichiro Sekiya
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Nagoya 466-8550, Japan
| | - Kiyosumi Shibata
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Nagoya 466-8550, Japan
| | - Takeshi Senga
- Division of Tumor Biology, Graduate School of Medicine, Nagoya University, Nagoya 466-8550, Japan
| | - Fumitaka Kikkawa
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Nagoya 466-8550, Japan
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11
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Koya Y, Kajiyama H, Liu W, Shibata K, Senga T, Kikkawa F. Murine Experimental Model of Original Tumor Development and Peritoneal Metastasis via Orthotopic Inoculation with Ovarian Carcinoma Cells. J Vis Exp 2016. [PMID: 28060250 DOI: 10.3791/54353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Epithelial ovarian carcinoma (EOC) is associated with a poor prognosis because it shows peritoneal dissemination. To improve the prognosis, it is important to control peritoneal dissemination. However, it is still unclear how tumor cells detach from primary lesions and attach to the mesothelium. The establishment of an appropriate animal model is needed to gain an understanding of the mechanism of peritoneal dissemination in vivo. In the current study, we introduce the process from the local injection of EOC cells into the murine ovarian surface to the development of metastasis, including the peritoneum and distant organs. Female nude mice (BALB/c nu/nu) at 8 weeks of age were used. Under a microscopic field of view, EOC cells (1 x 105 cells/µl of medium-extracellular matrix (ECM)-based hydrogel/unilateral ovary/mouse) were injected into murine ovaries through a retroperitoneal approach from the dorsal flank. This proposed method is a less invasive procedure for the mouse and minimizes damage to the ovary. Here, we describe the methodological steps in the development of the original and metastatic tumor formation of EOC.
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Affiliation(s)
- Yoshihiro Koya
- Bell Research Center for Reproductive Health and Cancer; Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine;
| | - Hiroaki Kajiyama
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine;
| | - Wenting Liu
- Bell Research Center for Reproductive Health and Cancer; Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine
| | - Kiyosumi Shibata
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine
| | - Takeshi Senga
- Department of Cancer Biology, Nagoya University Graduate School of Medicine
| | - Fumitaka Kikkawa
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine
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12
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Li X, Shen B, Chen Q, Zhang X, Ye Y, Wang F, Zhang X. Antitumor effects of cecropin B-LHRH' on drug-resistant ovarian and endometrial cancer cells. BMC Cancer 2016; 16:251. [PMID: 27021903 PMCID: PMC4809036 DOI: 10.1186/s12885-016-2287-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 03/22/2016] [Indexed: 01/09/2023] Open
Abstract
Background Luteinizing hormone-releasing hormone receptor (LHRHr) represents a promising therapeutic target for treating sex hormone-dependent tumors. We coupled cecropin B, an antimicrobial peptide, to LHRH’, a form of LHRH modified at carboxyl-terminal residues 4–10, which binds to LHRHr without interfering with luteinizing hormone (LH) and follicle-stimulating hormone (FSH) secretion. This study aimed to assess the antitumor effects of cecropin B-LHRH’ (CB-LHRH’) in drug-resistant ovarian and endometrial cancers. Methods To evaluate the antitumor effects of CB-LHRH’, three drug resistant ovarian cancer cell lines (SKOV-3, ES-2, NIH:OVCAR-3) and an endometrial cancer cell line (HEC-1A) were treated with CB-LHRH’. Cell morphology changes were assessed using inverted and electron microscopes. In addition, cell growth and cell cytotoxicity were measured by MTT assay and LDH release, respectively. In addition, hemolysis was measured. Furthermore, radioligand receptor binding, hypersensitization and minimal inhibitory concentrations (against Staphylococcus aureus, Klebsiella pneumoniae, Escherichia coli, Enterobacter cloacae, Pseudomonas aeruginosa, and Acinetobacter baumannii) were determined. Finally, the impact on tumor growth in BALB/c-nu mice was assessed in an ES-2 xenograft model. Results CB-LHRH’ bound LHRHr with high-affinity (dissociation constant, Kd = 0.252 ± 0.061nM). Interestingly, CB-LHRH’ significantly inhibited the cell viability of SKOV-3, ES-2, NIH:OVCAR-3 and HEC-1A, but not that of normal eukaryotic cells. CB-LHRH’ was active against bacteria at micromolar concentrations, and caused no hypersensitivity in guinea pigs. Furthermore, CB-LHRH’ inhibited tumor growth with a 23.8 and 20.4 % reduction in tumor weight at 50 and 25 mg/kg.d, respectively. Conclusions CB-LHRH’ is a candidate for targeted chemotherapy against ovarian and endometrial cancers.
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Affiliation(s)
- Xiaoyong Li
- Department of Gynecology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Bo Shen
- Institute of Radiation Medicine, Fudan University, Shanghai, China
| | - Qi Chen
- Central Laboratory, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaohui Zhang
- Department of Women Health Care, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yiqing Ye
- Pharmacy Division, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Fengmei Wang
- Pharmacy Division, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xinmei Zhang
- Department of Gynecology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
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13
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Yuan L, Sheng X, Willson AK, Roque DR, Stine JE, Guo H, Jones HM, Zhou C, Bae-Jump VL. Glutamine promotes ovarian cancer cell proliferation through the mTOR/S6 pathway. Endocr Relat Cancer 2015; 22:577-91. [PMID: 26045471 PMCID: PMC4500469 DOI: 10.1530/erc-15-0192] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/04/2015] [Indexed: 12/17/2022]
Abstract
Glutamine is one of the main nutrients used by tumor cells for biosynthesis. Therefore, targeted inhibition of glutamine metabolism may have anti-tumorigenic implications. In the present study, we aimed to evaluate the effects of glutamine on ovarian cancer cell growth. Three ovarian cancer cell lines, HEY, SKOV3, and IGROV-1, were assayed for glutamine dependence by analyzing cytotoxicity, cell cycle progression, apoptosis, cell stress, and glucose/glutamine metabolism. Our results revealed that administration of glutamine increased cell proliferation in all three ovarian cancer cell lines in a dose dependent manner. Depletion of glutamine induced reactive oxygen species and expression of endoplasmic reticulum stress proteins. In addition, glutamine increased the activity of glutaminase (GLS) and glutamate dehydrogenase (GDH) by modulating the mTOR/S6 and MAPK pathways. Inhibition of mTOR activity by rapamycin or blocking S6 expression by siRNA inhibited GDH and GLS activity, leading to a decrease in glutamine-induced cell proliferation. These studies suggest that targeting glutamine metabolism may be a promising therapeutic strategy in the treatment of ovarian cancer.
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Affiliation(s)
- Lingqin Yuan
- Department of Gynecologic OncologyShanDong Tumor Hospital and Cancer Institute, Jinan University, Jinan 250117, People's Republic of ChinaDivision of Gynecologic OncologyUniversity of North Carolina at Chapel Hill, CB #7572, Physicians Office Building Rm #B105, Chapel Hill, North Carolina 27599, USALineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA Department of Gynecologic OncologyShanDong Tumor Hospital and Cancer Institute, Jinan University, Jinan 250117, People's Republic of ChinaDivision of Gynecologic OncologyUniversity of North Carolina at Chapel Hill, CB #7572, Physicians Office Building Rm #B105, Chapel Hill, North Carolina 27599, USALineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Xiugui Sheng
- Department of Gynecologic OncologyShanDong Tumor Hospital and Cancer Institute, Jinan University, Jinan 250117, People's Republic of ChinaDivision of Gynecologic OncologyUniversity of North Carolina at Chapel Hill, CB #7572, Physicians Office Building Rm #B105, Chapel Hill, North Carolina 27599, USALineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Adam K Willson
- Department of Gynecologic OncologyShanDong Tumor Hospital and Cancer Institute, Jinan University, Jinan 250117, People's Republic of ChinaDivision of Gynecologic OncologyUniversity of North Carolina at Chapel Hill, CB #7572, Physicians Office Building Rm #B105, Chapel Hill, North Carolina 27599, USALineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Dario R Roque
- Department of Gynecologic OncologyShanDong Tumor Hospital and Cancer Institute, Jinan University, Jinan 250117, People's Republic of ChinaDivision of Gynecologic OncologyUniversity of North Carolina at Chapel Hill, CB #7572, Physicians Office Building Rm #B105, Chapel Hill, North Carolina 27599, USALineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jessica E Stine
- Department of Gynecologic OncologyShanDong Tumor Hospital and Cancer Institute, Jinan University, Jinan 250117, People's Republic of ChinaDivision of Gynecologic OncologyUniversity of North Carolina at Chapel Hill, CB #7572, Physicians Office Building Rm #B105, Chapel Hill, North Carolina 27599, USALineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Hui Guo
- Department of Gynecologic OncologyShanDong Tumor Hospital and Cancer Institute, Jinan University, Jinan 250117, People's Republic of ChinaDivision of Gynecologic OncologyUniversity of North Carolina at Chapel Hill, CB #7572, Physicians Office Building Rm #B105, Chapel Hill, North Carolina 27599, USALineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA Department of Gynecologic OncologyShanDong Tumor Hospital and Cancer Institute, Jinan University, Jinan 250117, People's Republic of ChinaDivision of Gynecologic OncologyUniversity of North Carolina at Chapel Hill, CB #7572, Physicians Office Building Rm #B105, Chapel Hill, North Carolina 27599, USALineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Hannah M Jones
- Department of Gynecologic OncologyShanDong Tumor Hospital and Cancer Institute, Jinan University, Jinan 250117, People's Republic of ChinaDivision of Gynecologic OncologyUniversity of North Carolina at Chapel Hill, CB #7572, Physicians Office Building Rm #B105, Chapel Hill, North Carolina 27599, USALineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Chunxiao Zhou
- Department of Gynecologic OncologyShanDong Tumor Hospital and Cancer Institute, Jinan University, Jinan 250117, People's Republic of ChinaDivision of Gynecologic OncologyUniversity of North Carolina at Chapel Hill, CB #7572, Physicians Office Building Rm #B105, Chapel Hill, North Carolina 27599, USALineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA Department of Gynecologic OncologyShanDong Tumor Hospital and Cancer Institute, Jinan University, Jinan 250117, People's Republic of ChinaDivision of Gynecologic OncologyUniversity of North Carolina at Chapel Hill, CB #7572, Physicians Office Building Rm #B105, Chapel Hill, North Carolina 27599, USALineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Victoria L Bae-Jump
- Department of Gynecologic OncologyShanDong Tumor Hospital and Cancer Institute, Jinan University, Jinan 250117, People's Republic of ChinaDivision of Gynecologic OncologyUniversity of North Carolina at Chapel Hill, CB #7572, Physicians Office Building Rm #B105, Chapel Hill, North Carolina 27599, USALineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA Department of Gynecologic OncologyShanDong Tumor Hospital and Cancer Institute, Jinan University, Jinan 250117, People's Republic of ChinaDivision of Gynecologic OncologyUniversity of North Carolina at Chapel Hill, CB #7572, Physicians Office Building Rm #B105, Chapel Hill, North Carolina 27599, USALineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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14
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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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15
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Kajiyama H, Mizuno M, Shibata K, Umezu T, Suzuki S, Yamamoto E, Mitsui H, Sekiya R, Niimi K, Kawai M, Nagasaka T, Kikkawa F. Oncologic outcome after recurrence in patients with stage I epithelial ovarian cancer: are clear-cell and mucinous histological types a different entities? Eur J Obstet Gynecol Reprod Biol 2014; 181:305-10. [DOI: 10.1016/j.ejogrb.2014.07.046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 07/27/2014] [Accepted: 07/29/2014] [Indexed: 01/18/2023]
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16
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Panici PB, Marchetti C, Salerno L, Musella A, Vertechy L, Palaia I, Perniola G, Ruscito I, Boni T, Angioli R, Muzii L. Dualistic classification of epithelial ovarian cancer: surgical and survival outcomes in a large retrospective series. Ann Surg Oncol 2014; 21:3036-41. [PMID: 24770721 DOI: 10.1245/s10434-014-3714-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Indexed: 12/25/2022]
Abstract
BACKGROUND Ovarian cancers have been recently categorized into types I and II according to a dualistic model of tumorigenesis. Data on the correlation between this classification and clinical outcome are still scarce and controversial. METHODS A retrospective analysis of patients with ovarian cancer treated from 1998 to 2013 and operated by the same surgeon was conducted. Patients were classified into two groups: type I (125 patients), including low-grade serous, mucinous, endometrioid, and clear cell tumors; and type II (286 patients), including high-grade serous tumors, unspecified adenocarcinomas, and undifferentiated carcinomas. RESULTS Type II patients had a significantly higher incidence of advanced disease than type I (88.4 vs. 65.6 %, P = 0.0001) and required more aggressive surgical procedures. Rates of optimal tumor debulking were almost similar between groups (92.6 vs. 91.7 %, type I vs. II, P = NS). After a median follow-up of 41 months, 207 patients (50.4 %) were alive and 204 (49.6 %) were dead; 79 type I patients (63.8 %) and 237 type II patients (82.7 %) experienced relapse (P = 0.02). Progression-free survival was significantly different between groups: 25 months for type I vs. 17 months for type II (P = 0.023). Overall survival was not significantly different between groups, with a median overall survival of 75 months for type I vs. 62 months for type II (P = 0.116). CONCLUSIONS The dualistic histotype-based classification into types I and II of ovarian cancer does not seem to correlate with prognosis. Different molecular characteristics of type I and II tumors may have therapeutic implications and should be deeply investigated.
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Affiliation(s)
- Pierluigi Benedetti Panici
- Department of Gynecological and Obstetrical Sciences and Urological Sciences, Sapienza University of Rome, Rome, Italy
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17
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Clinical features of long-term survivors of recurrent epithelial ovarian cancer. Int J Clin Oncol 2014; 20:143-9. [PMID: 24664306 DOI: 10.1007/s10147-014-0687-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 03/12/2014] [Indexed: 01/24/2023]
Abstract
BACKGROUND Although recurrent epithelial ovarian cancer (EOC) is generally regarded as an incurable disease, some patients survive more than 5 years after the first recurrence. The aim of this study was to evaluate the clinical features of patients with recurrent EOC who achieve long-term survival. METHODS We retrospectively reviewed the medical records of 164 patients with recurrent EOC and analyzed the clinical stage, histologic subtype, primary treatment, disease-free interval (DFI), recurrence site, secondary treatment, and overall survival from the time of the first recurrence (R-OS), using the Kaplan-Meier method and the log-rank test. RESULTS The median R-OS for all 164 patients was 25 months and the 5-year R-OS rate was 25.4 %. There were no significant differences in R-OS according to the disease stage. The median R-OS was significantly shorter in the 6-12-month DFI group (23 months) than in the ≥12-month DFI group (61 months) (p = 0.0002), while there was no significant difference between the 6-12 and 3-6-month DFI groups (20 months) (p = 0.161). Of the 164 patients, only 14 survived >5 years after the first recurrence. Most of them underwent surgery and/or radiotherapy in combination with chemotherapy and underwent >18 cycles of platinum-based chemotherapy throughout their treatments (median 22 cycles; range 4-44). CONCLUSIONS If high sensitivity to platinum is maintained, patients with recurrent EOC may have prolonged survival following repeated platinum-based chemotherapy cycles. Moreover, their prognosis improves when chemotherapy is combined with secondary cytoreductive surgery and/or irradiation.
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18
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Kajiyama H, Shibata K, Mizuno M, Umezu T, Suzuki S, Sekiya R, Niimi K, Mitsui H, Yamamoto E, Kawai M, Nagasaka T, Kikkawa F. Survival benefit of taxane plus platinum in recurrent ovarian cancer with non-clear cell, non-mucinous histology. J Gynecol Oncol 2014; 25:43-50. [PMID: 24459580 PMCID: PMC3893674 DOI: 10.3802/jgo.2014.25.1.43] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 09/05/2013] [Accepted: 09/06/2013] [Indexed: 11/30/2022] Open
Abstract
Objective This study was conducted to examine the effects of front-line chemotherapy on overall survival (OS) and postrecurrence survival (PRS) of patients with recurrent ovarian cancer, when stratifying the histologic type. Methods Five hundred and seventy-four patients with recurrent ovarian cancer with sufficient clinical information, including front-line chemotherapy, were analyzed. The pathologic slides were evaluated by central pathologic review. The patients were divided into two groups: group A (n=261), who underwent taxane plus platinum, and group B (n=313), who underwent conventional platinum-based chemotherapy without taxanes. Results The median age was 54 years (range, 14 to 89 years). Group A had significantly better median OS (45.0 months vs. 30.3 months, p<0.001) and PRS (23.0 months vs. 13.0 months, p<0.001) compared to group B. The OS and PRS were similar between the groups in patients with clear cell or mucinous histology. In contrast, among patients with non-clear cell, non-mucinous histologies, the OS and PRS of group A were significantly better than those of group B (OS, p<0.001; PRS, p<0.001). Multivariable analyses revealed that, among patients with non-clear cell, non-mucinous histologies, chemotherapy including taxane and platinum was an independent predictor of favorable survival outcomes. Conversely, in patients with clear cell or mucinous histology, taxane-including platinum-based combination chemotherapy did not improve the OS and PRS compared to a conventional platinum-based regimen which did not include taxanes. Conclusion Since the emergence of taxane plus platinum, the prognosis of patients with recurrent ovarian cancer has improved. However, we here demonstrate that this improvement is limited to patients with non-clear cell, non-mucinous histologies.
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Affiliation(s)
- Hiroaki Kajiyama
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kiyosumi Shibata
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mika Mizuno
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tomokazu Umezu
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shiro Suzuki
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ryuichiro Sekiya
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kaoru Niimi
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroko Mitsui
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Michiyasu Kawai
- Department of Obstetrics and Gynecology, Toyohashi Municipal Hospital, Toyohashi, Japan
| | - Tetsuro Nagasaka
- Department of Medical Laboratory Sciences, Nagoya University Graduate School of Medicine, School of Health Science, Nagoya, Japan
| | - Fumitaka Kikkawa
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Cao Z, Yu D, Fu S, Zhang G, Pan Y, Bao M, Tu J, Shang B, Guo P, Yang P, Zhou Q. Lycorine hydrochloride selectively inhibits human ovarian cancer cell proliferation and tumor neovascularization with very low toxicity. Toxicol Lett 2013; 218:174-85. [PMID: 23376478 DOI: 10.1016/j.toxlet.2013.01.018] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Revised: 01/18/2013] [Accepted: 01/23/2013] [Indexed: 01/02/2023]
Abstract
Uncontrolled tumor cell proliferation and robust neovascularization are prominent features of aggressive ovarian cancers. Although great efforts in anti-ovarian cancer therapy have been made in the past 4 decades, the 5-year survival rates for ovarian cancer patients are still poor, and effective drugs to cure ovarian cancer patients are absent. In this study, we evaluated the anti-cancer effects of lycorine hydrochloride (LH), a novel anti-ovarian cancer agent, using the highly-invasive ovarian cancer cell line, Hey1B, as a model. Our data showed that LH effectively inhibited mitotic proliferation of Hey1B cells (half maximal inhibitory concentration=1.2μM) with very low toxicity, resulting in cell cycle arrest at the G2/M transition through enhanced expression of the cell cycle inhibitor p21 and marked down-regulation of cyclin D3 expression. Moreover, LH suppressed both the formation of capillary-like tubes by Hey1B cells cultured in vitro and the ovarian cancer cell-dominant neovascularization in vivo when administered to Hey1B-xenotransplanted mice. LH also suppressed the expression of several key angiogenic genes, including VE-cadherin, vascular endothelial growth factor, and Sema4D, and reduced Akt phosphorylation in Hey1B cells. These results suggest that LH selectively inhibits ovarian cancer cell proliferation and neovascularization and is a potential drug candidate for anti-ovarian cancer therapy.
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Affiliation(s)
- Zhifei Cao
- Cyrus Tang Hematology Center, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Key Laboratory of Thrombosis and Hemostasis, Ministry of Health, Soochow University, Suzhou, Jiangsu 215006, China
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