Incidence trends for epithelial peritoneal, ovarian, and fallopian tube cancer during 1999-2016: a retrospective study based on the Korean National Cancer Incidence Database

Incidence and survival of gynecologic cancer including cervical, uterine, ovarian, vaginal, vulvar cancer and gestational trophoblastic neoplasia in Korea, 1999-2019: Korea Central Cancer Registry

OBJECTIVE

To investigate the incidence, trends, and survival rates of all gynecologic cancers using the Korea Central Cancer Registry (KCCR) database from 1999-2019.

METHODS

Gynecologic cancer data were obtained from the KCCR database between 1999 and 2019. Age-standardized incidence rates (ASRs), annual percentage changes, and average annual percentage changes (AAPCs) were calculated. The relative survival rate (RSR) was reported by age group, stage, and 6-year period (I: 1999-2005, II: 2006-2012, III: 2013- 2019).

RESULTS

The gynecologic cancer ASRs were 26.2 and 24.9 per 100,000 individuals in 1999 and 2019, respectively. Trends of incidence in gynecologic cancer revealed a decrease in cervical cancer and gestational trophoblastic neoplasia (GTN) with AAPCs of -3.4 and -4.3, respectively. Conversely, the incidence of uterine, ovarian, and vulvar cancers increased with AAPCs of 4.7, 2.3, and 2.1, respectively. AAPC for vaginal cancer showed no change. The 5-year survival rate was highest for GTN (90.5%) and lowest for vaginal cancer (56.6%). An increase in age was correlated with poorer survival rates across all gynecologic cancers, excluding vaginal cancer. For all gynecologic cancer types, the prognosis deteriorates with advancing cancer stages. The RSR of uterine cancer improved consistently across all periods. The ovarian cancer RSR improved more in period III than in periods I or II. Additionally, the vulvar cancer RSR improved more in periods II and III than in period I.

CONCLUSION

In Korea, the incidence of cervical cancer and GTN decreased, whereas the incidence of uterine, ovarian, and vulvar cancer increased from 1999 to 2019. The RSR for uterine, ovarian, and vulvar cancers showed consistent improvements over different periods. Effective screening programs and the adoption of advanced treatments may be necessary to further reduce the burden of gynecologic cancer.

Identifying Serum Small Extracellular Vesicle MicroRNA as a Noninvasive Diagnostic and Prognostic Biomarker for Ovarian Cancer

There remains a lack of effective and noninvasive methods for the diagnosis and prognosis prediction of epithelial ovarian carcinoma (EOC). Here, we investigated the possibility of serum-derived small extracellular vesicle (sEV) microRNAs (miRNAs) as potential biomarkers for distinguishing between benign and malignant adnexal masses and predicting the prognosis of EOC patients. A serum sEV miRNA model for identifying the EOC (sEVmiR-EOC) was successfully established in the training cohort. Furthermore, the sEVmiR-EOC model was confirmed in the testing cohort and validation cohort, demonstrating robust diagnostic accuracy. The sEVmiR-EOC model showed better performance than carbohydrate antigen 125 (CA125) in discriminating patients with stage I EOC from benign patients. Using EOC samples and follow-up data, we identified miR-141-3p and miR-200c-3p as potential prognostic predictors. Finally, we confirmed the change of the sEVmiR-EOC RiskScore between the preoperative and postoperative samples and found that the sEVmiR-EOC model could predict the prognosis of EOC patients.

HOXA‑AS3 induces tumor progression through the epithelial‑mesenchymal transition pathway in epithelial ovarian cancer

HOXA cluster antisense RNA 3 (HOXA‑AS3) is considered to be involved in several malignancies, however, its biological function in the progression of epithelial ovarian cancer (EOC) remains unclear. The present study compared the expression of HOXA‑AS3 in ovarian cancer and normal ovarian tissues and analyzed the association between the expression of HOXA‑AS3 and the survival outcomes of patients with ovarian cancer. RNA interference was used to suppress HOXA‑AS3 expression in ovarian cancer cell lines in order to demonstrate the function of HOXA‑AS3 in ovarian cancer progression. The associations between HOXA‑AS3 and epithelial‑mesenchymal transition (EMT) markers were explored to verify the mechanism of action of HOXA‑AS3 in ovarian cancer. The results of the present study revealed that ovarian cancer tissues exhibited higher HOXA‑AS3 expression than normal ovarian tissues. Clinical data indicated that HOXA‑AS3 was a significant predictor of progression‑free survival and overall survival. Patients with high HOXA‑AS3 expression had a poorer prognosis than patients with low HOXA‑AS3 expression. In vitro experiments using HOXA‑AS3‑knockdown ovarian cancer cell lines demonstrated that HOXA‑AS3 knockdown inhibited cell proliferation and migration. HOXA‑AS3 was a potent inducer and modulator of the expression of EMT pathway‑related markers and interacted with both the mRNA and protein forms of HOXA3. Collectively, the findings of the present study demonstrated that HOXA‑AS3 expression is associated with ovarian cancer progression and thus, may be employed as a prognostic marker and therapeutic target in EOC.

Second Primary Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancers after Breast Cancer Diagnosis: Korea Central Cancer Registry

Purpose

A prior history of breast cancer is a risk factor for the subsequent development of primary peritoneal, epithelial ovarian, and fallopian tubal (POFT) cancers. This study aimed to estimate the incidence of secondary POFT malignancy in breast cancer patients and the clinical outcomes of primary and secondary POFT cancer.

Materials and Methods

We searched the Korea Central Cancer Registry to find patients with primary and secondary POFT cancer who had breast cancer in 1999–2017. The incidence rate and standardized incidence ratio were calculated. Additionally, we compared the overall survival of patients with primary and secondary POFT cancer.

Results

Based on the age-standardized rate, the incidence of second primary POFT cancer after breast cancer was 0.0763 per 100,000 women, which increased in Korea between 1999 and 2017. Among the 30,366 POFT cancer patients, 25,721 were primary POFT cancer only, and 493 had secondary POFT cancer after a breast cancer diagnosis. Second primary POFT cancer patients were older at the time of diagnosis (55 vs. 53, p < 0.001) and had a larger proportion of serous histology (68.4% vs. 51.2%, p < 0.001) than patients with primary POFT. There were no differences between the two groups in tumor stage at diagnosis. The 5-year overall survival rates were 60.2% and 56.3% for primary and secondary POFT cancer, respectively (p=0.216).

Conclusion

The incidence of second primary POFT cancer after breast cancer increased in Korea between 1999 and 2017. Besides, second primary POFT cancer patients were diagnosed at older ages and had more serous histology.