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Green RW, Fischerová D, Testa AC, Franchi D, Frühauf F, Lindqvist PG, di Legge A, Cibula D, Fruscio R, Haak LA, Opolskiene G, Vidal Urbinati AM, Timmerman D, Bourne T, van den Bosch T, Epstein E. Sonographic, Demographic, and Clinical Characteristics of Pre- and Postmenopausal Women with Endometrial Cancer; Results from a Post Hoc Analysis of the IETA4 (International Endometrial Tumor Analysis) Multicenter Cohort. Diagnostics (Basel) 2023; 14:1. [PMID: 38201310 PMCID: PMC10802150 DOI: 10.3390/diagnostics14010001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/01/2023] [Accepted: 12/10/2023] [Indexed: 01/12/2024] Open
Abstract
In this study, we conducted a comparative analysis of demographic, histopathological, and sonographic characteristics between pre- and postmenopausal women diagnosed with endometrial cancer, while also examining sonographic and anthropometric features in 'low' and 'intermediate/high-risk' cases, stratified by menopausal status. Our analysis, based on data from the International Endometrial Tumor Analysis (IETA) 4 cohort comprising 1538 women (161 premenopausal, 1377 postmenopausal) with biopsy-confirmed endometrial cancer, revealed that premenopausal women, compared to their postmenopausal counterparts, exhibited lower parity (median 1, IQR 0-2 vs. 1, IQR 1-2, p = 0.001), a higher family history of colon cancer (16% vs. 7%, p = 0.001), and smaller waist circumferences (median 92 cm, IQR 82-108 cm vs. 98 cm, IQR 87-112 cm, p = 0.002). Premenopausal women more often had a regular endometrial-myometrial border (39% vs. 23%, p < 0.001), a visible endometrial midline (23% vs. 11%, p < 0.001), and undefined tumor (73% vs. 84%, p = 0.001). Notably, despite experiencing a longer duration of abnormal uterine bleeding (median 5 months, IQR 3-12 vs. 3 months, 2-6, p < 0.001), premenopausal women more often had 'low' risk disease (78% vs. 46%, p < 0.001). Among sonographic and anthropometric features, only an irregular endometrial-myometrial border was associated with 'intermediate/high' risk in premenopausal women. Conversely, in postmenopausal women, multiple features correlated with 'intermediate/high' risk disease. Our findings emphasize the importance of considering menopausal status when evaluating sonographic features in women with endometrial cancer.
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Affiliation(s)
- Rasmus W. Green
- Department of Clinical Science and Education, Karolinska Institute, Södersjukhuset, Sjukhusbacken 10, 118 83 Stockholm, Sweden; (P.G.L.)
| | - Daniela Fischerová
- Department of Gynaecology, Obstetrics and Neonatology, General University Hospital and First Faculty of Medicine, Charles University, Apolinářská 18, 128 51 Prague, Czech Republic; (D.F.); (F.F.); (D.C.)
| | - Antonia C. Testa
- Department of Women and Child Health, Division of Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy;
- Department of Life Science and Public Health, Catholic University of Sacred Heart Largo Agostino Gemelli, 00168 Rome, Italy
| | - Dorella Franchi
- Department of Gynecological Oncology, European Institute of Oncology (IEO) IRCCS, 20141 Milan, Italy; (D.F.); (A.M.V.U.)
| | - Filip Frühauf
- Department of Gynaecology, Obstetrics and Neonatology, General University Hospital and First Faculty of Medicine, Charles University, Apolinářská 18, 128 51 Prague, Czech Republic; (D.F.); (F.F.); (D.C.)
| | - Pelle G. Lindqvist
- Department of Clinical Science and Education, Karolinska Institute, Södersjukhuset, Sjukhusbacken 10, 118 83 Stockholm, Sweden; (P.G.L.)
- Department of Obstetrics and Gynecology, Södersjukhuset, 118 83 Stockholm, Sweden
| | - Alessia di Legge
- Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, 00168 Rome, Italy;
| | - David Cibula
- Department of Gynaecology, Obstetrics and Neonatology, General University Hospital and First Faculty of Medicine, Charles University, Apolinářská 18, 128 51 Prague, Czech Republic; (D.F.); (F.F.); (D.C.)
| | - Robert Fruscio
- UO Gynecology, Department of Medicine and Surgery, IRCCS San Gerardo, University of Milan Bicocca, 20126 Milan, Italy;
| | - Lucia A. Haak
- Institute for the Care of Mother and Child, Prague and Third Faculty of Medicine, Charles University, 147 00 Prague, Czech Republic
| | - Gina Opolskiene
- Center of Obstetrics and Gynecology, Faculty of Medicine, Vilnius University Hospital, 08661 Vilnius, Lithuania;
| | - Ailyn M. Vidal Urbinati
- Department of Gynecological Oncology, European Institute of Oncology (IEO) IRCCS, 20141 Milan, Italy; (D.F.); (A.M.V.U.)
| | - Dirk Timmerman
- Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium; (D.T.); (T.v.d.B.)
- Department of Obstetrics and Gynecology, University Hospital Leuven, 3000 Leuven, Belgium
| | - Tom Bourne
- Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium; (D.T.); (T.v.d.B.)
- Department of Obstetrics and Gyneacology, Queen Charlotte’s and Chelsea Hospital, Imperial College London, London W12 0HS, UK
| | - Thierry van den Bosch
- Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium; (D.T.); (T.v.d.B.)
- Department of Obstetrics and Gynecology, University Hospital Leuven, 3000 Leuven, Belgium
| | - Elisabeth Epstein
- Department of Clinical Science and Education, Karolinska Institute, Södersjukhuset, Sjukhusbacken 10, 118 83 Stockholm, Sweden; (P.G.L.)
- Department of Obstetrics and Gynecology, Södersjukhuset, 118 83 Stockholm, Sweden
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Green RW, Valentin L, Alcazar JL, Chiappa V, Erdodi B, Franchi D, Frühauf F, Fruscio R, Guerriero S, Graupera B, Jakab A, di Legge A, Ludovisi M, Mascilini F, Pascual MA, van den Bosch T, Epstein E. Endometrial cancer off-line staging using two-dimensional transvaginal ultrasound and three-dimensional volume contrast imaging: Intermethod agreement, interrater reliability and diagnostic accuracy. Gynecol Oncol 2018; 150:438-445. [DOI: 10.1016/j.ygyno.2018.06.027] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 05/30/2018] [Accepted: 06/24/2018] [Indexed: 12/14/2022]
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Lorusso D, Scambia G, Amadio G, di Legge A, Pietragalla A, De Vincenzo R, Masciullo V, Di Stefano M, Mangili G, Lambiase A, Bordignon C. NGR-hTNF and doxorubicin in relapsed ovarian cancer (OC). J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.5059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5059 Background: NGR-hTNF (asparagine-glycine-arginine human tumor necrosis factor) is able to promote antitumor immune responses and to improve the intratumoral doxorubicin (D) uptake by selectively damaging tumor vessels. Methods: OC patients (pts) with progressive disease (PD) after ≥ 1 platinum/taxane regimen and with a platinum free interval lower than 6 months (PFI <6) or ranging from 6 to 12 months (PFI 6-12) received NGR-hTNF (N) 0.8 µg/m2 and D 60 mg/m2 on day 1 every 3 weeks. Primary endpoint of this phase 2 trial was response rate by RECIST criteria with a target of ≥ 6/37 responding pts. Secondary aims were progression free survival (PFS) and overall survival (OS). Results: 37 pts (median age 57 years; PS 0/1 32/5; PFI < 6/6-12 25/12; prior regimens 1-5) were enrolled. Median baseline peripheral blood lymphocyte count (PBLC) was 1.6/mL (interquartile range 1.2-2.1). In all, 177 cycles were given, with 18 pts (49%) receiving ≥ 6 cycles and 12 pts (32%) 8 cycles. Neither grade 3/4 adverse events (AEs) related to N nor increase of D-related AEs were noted. Common grade 1/2 AEs included chills (65%). Eight pts (23%; 95% CI 12-39) had partial response (PR; 2 with PFI < 6 and 6 with PFI 6-12; median duration: 8.2 months). Fifteen pts had stable disease (SD, 43%; 10 with PFI < 6 and 5 with PFI 6-12; median duration: 4.9 months) for an overall disease control (DC, PR+SD) rate of 66%. Mean changes from baseline in target tumor size after 2, 4, 6, and 8 cycles were 2%, -54%, -69%, and -77%, respectively. Median PFS was 5.0 months (95% CI 3.1-6.9) and median OS was 17.0 months (10.4-23.6). In pts with PFI < 6 or 6-12, median PFS were 3.8 and 7.8 months (p=.03) and median OS were 14.3 and 20.1 months (p=.14), respectively. Pts with DC had longer median OS than those with early PD (24.0 and 4.9 months, respectively, p=.02). Longer PFI (p=.03) and higher PBLC (p=.01) were associated with better PFS, while OS correlated only with PBLC (p=.001). In the subset with PFI < 6, pts with PBLC ≥ or < 1.2/mL (1st quartile) had median PFS of 4.9 and 2.6 months (p=.02) and median OS of 15.8 and 4.3 months (p=.0001), respectivel Conclusions: A randomized phase II trial is currently testing D ± NGR-hTNF in pts with PFI < 6 (refractory/resistant). The role of PBLC as blood-based biomarker deserves further investigation.
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Affiliation(s)
- Domenica Lorusso
- Department of Gynecologic Oncology, National Cancer Institute, Milan, Italy
| | - Giovanni Scambia
- Department of Gynecologic Oncology, Catholic University, Rome, Italy
| | - Giulia Amadio
- Department of Gynecologic Oncology, Catholic University, Rome, Italy
| | - Alessia di Legge
- Department of Gynecologic Oncology, Catholic University, Rome, Italy
| | | | - Rosa De Vincenzo
- Department of Gynecologic Oncology, Catholic University, Rome, Italy
| | - Valeria Masciullo
- Department of Gynecologic Oncology, Catholic University, Rome, Italy
| | | | - Giorgia Mangili
- Department of Gynecologic Oncology, Istituto Scientifico San Raffaele, Milan, Italy
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