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Lai THT, Lau LSK, Ngu SF, Chu MYM, Chan KKL, Ng EHY, Ngan HYS, Li RHW, Tse KY. Comparison of the multiples of the median of serum anti-müllerian hormone and pregnancy outcomes in patients with gestational trophoblastic disease: A case-control study. Cancer Med 2024; 13:e7134. [PMID: 38545760 PMCID: PMC10973878 DOI: 10.1002/cam4.7134] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 03/04/2024] [Accepted: 03/09/2024] [Indexed: 04/04/2024] Open
Abstract
INTRODUCTION Chemotherapy is crucial in treating gestational trophoblastic neoplasia (GTN), but its impact on gonadotoxicity is unclear. MATERIALS AND METHODS This case-control study included 57 GTN patients and 19 age-matched patients with molar pregnancies (MP) in 2012-2018. Multiples of the median (MoM) of the serum AMH levels were compared between the two groups, and between patients using single-agent and combination chemotherapy, at baseline, 6, 12, and 24 months after treatment. Their pregnancy outcomes were also compared. RESULTS There was no significant difference in the MoM of serum AMH between GTN and MP groups at all time points. Single-agent chemotherapy did not adversely affect the MoM. However, those receiving combination chemotherapy had lower MoM than those receiving single-agent chemotherapy at all time points. The trend of decline from the baseline was marginally significant in patients with combination chemotherapy, but the drop was only significant at 12 months (Z = -2.69, p = 0.007) but not at 24 months (Z = -1.90; p = 0.058). Multivariable analysis revealed that combination chemotherapy did not affect the MoM. There was no significant difference in the 4-year pregnancy rate and the livebirth rate between the single-agent and combination groups who attempting pregnancy, but it took 1 year longer to achieve the first pregnancy in the combination group compared to the single-agent group (2.88 vs. 1.88 years). CONCLUSION This study showed combination chemotherapy led to a decreasing trend of MoM of serum AMH especially at 12 months after treatment, but the drop became static at 24 months. Although pregnancy is achievable, thorough counseling is still needed in this group especially those wish to achieve pregnancy 1-2 years after treatment or with other risk factors.
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Affiliation(s)
| | - Lesley Suk Kwan Lau
- Division of Gynaecological Oncology, Department of Obstetrics and Gynaecology, School of Clinical MedicineHong KongChina
| | - Siew Fei Ngu
- Department of Obstetrics and GynaecologyQueen Mary HospitalHong KongChina
- Division of Gynaecological Oncology, Department of Obstetrics and Gynaecology, School of Clinical MedicineHong KongChina
| | - Man Yee Mandy Chu
- Department of Obstetrics and GynaecologyQueen Mary HospitalHong KongChina
- Division of Gynaecological Oncology, Department of Obstetrics and Gynaecology, School of Clinical MedicineHong KongChina
| | - Karen Kar Loen Chan
- Department of Obstetrics and GynaecologyQueen Mary HospitalHong KongChina
- Division of Gynaecological Oncology, Department of Obstetrics and Gynaecology, School of Clinical MedicineHong KongChina
| | - Ernest Hung Yu Ng
- Department of Obstetrics and GynaecologyQueen Mary HospitalHong KongChina
- Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, School of Clinical MedicineThe University of Hong KongHong KongChina
| | - Hextan Yuen Sheung Ngan
- Department of Obstetrics and GynaecologyQueen Mary HospitalHong KongChina
- Division of Gynaecological Oncology, Department of Obstetrics and Gynaecology, School of Clinical MedicineHong KongChina
| | - Raymond Hang Wun Li
- Department of Obstetrics and GynaecologyQueen Mary HospitalHong KongChina
- Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, School of Clinical MedicineThe University of Hong KongHong KongChina
| | - Ka Yu Tse
- Department of Obstetrics and GynaecologyQueen Mary HospitalHong KongChina
- Division of Gynaecological Oncology, Department of Obstetrics and Gynaecology, School of Clinical MedicineHong KongChina
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Lee EYP, Ip PPC, Tse KY, Chiu KWH, Chu MMY, Chai YK, Wu PY, Law JYP, Kwok ST, Chiu WK, Ngan HYS. Prospective validation of the role of PET/CT in detecting disease after neoadjuvant chemotherapy in advanced ovarian cancer. Eur Radiol 2024:10.1007/s00330-024-10674-y. [PMID: 38460014 DOI: 10.1007/s00330-024-10674-y] [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: 10/26/2023] [Revised: 01/22/2024] [Accepted: 02/14/2024] [Indexed: 03/11/2024]
Abstract
OBJECTIVES The study aimed to compare the diagnostic accuracies of 2-[18F]FDG PET/CT and contrast-enhanced CT (ceCT) after neoadjuvant chemotherapy (NACT) in advanced ovarian cancer (OC). MATERIALS AND METHODS This study consisted historical observational cohort and prospective validation cohort. Patients with newly diagnosed stage III-IV OC scheduled for NACT were recruited, with imaging performed after three to six cycles of NACT before interval debulking surgery. Nineteen regions in the abdominopelvic cavity were scored for the presence and absence of disease, referenced to the intra-operative findings or histological specimens. Diagnostic metrics were compared using McNemar's test. RESULTS In the historical cohort (23 patients, age 58 ± 13), 2-[18F]FDG PET had an overall accuracy (Acc) 82%, sensitivity (Sen) 38%, specificity (Spe) 97%, positive predictive value (PPV) 79% and negative predictive value (NPV) 82%; ceCT had an overall Acc 86%, Sen 64%, Spe 93%, PPV 75% and NPV 89%. In the prospective cohort (46 patients, age 59 ± 9), 2-[18F] FDG PET had an overall Acc 87%, Sen 48%, Spe 98%, PPV 84% and NPV 88%; ceCT had an overall Acc 89%, Sen 66%, Spe 95%, PPV 77% and NPV 91%. No significant difference was demonstrated between the two imaging modalities (p > 0.05). High false-negative rates were observed in the right subdiaphragmatic space, omentum, bowel mesentery and serosa. High omental metabolic uptake after NACT was associated with histological non-responders (p < 0.05). CONCLUSION 2-[18F]FDG PET/CT had no additional value over ceCT with comparable diagnostic accuracy in detecting disease after NACT in advanced OC. CLINICAL RELEVANCE STATEMENT 2-[18F]FDG PET/CT is not superior to contrast-enhanced CT in determining disease after neoadjuvant chemotherapy in advanced ovarian cancer; contrast-enhanced CT should be suffice for surgical planning before interval debulking surgery. KEY POINTS • Additional value of 2-[18F]FDG PET/CT over contrast-enhanced CT is undefined in detecting disease after neoadjuvant chemotherapy. • 2-[18F]FDG PET/CT has comparable diagnostic accuracy compared to contrast-enhanced CT. • Contrast-enhanced CT will be suffice for surgical planning after neoadjuvant chemotherapy.
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Affiliation(s)
- Elaine Yuen Phin Lee
- Department of Diagnostic Radiology, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Room 406, Block K, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, China.
| | - Philip Pun Ching Ip
- Department of Pathology, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Ka Yu Tse
- Department of Obstetrics and Gynaecology, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Keith Wan Hang Chiu
- Department of Diagnostic Radiology, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Room 406, Block K, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, China
| | - Mandy Man Yee Chu
- Department of Obstetrics and Gynaecology, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Yu Ka Chai
- Department of Obstetrics and Gynaecology, United Christian Hospital, Hong Kong, China
| | - Philip Yuguang Wu
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
| | - Jessica Yun Pui Law
- Department of Obstetrics and Gynecology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
| | - Shuk Tak Kwok
- Department of Obstetrics and Gynaecology, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Wan Kam Chiu
- Department of Obstetrics and Gynaecology, United Christian Hospital, Hong Kong, China
| | - Hextan Yuen Sheung Ngan
- Department of Obstetrics and Gynaecology, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China
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Lam EWH, Ngan HYS, Kun KY, Li DFH, Wan WY, Chan PKS. Awareness, perceptions, and acceptance of human papillomavirus vaccination among parents in Hong Kong. Hong Kong Med J 2023; 29:287-294. [PMID: 37409372 DOI: 10.12809/hkmj2210470] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023] Open
Abstract
INTRODUCTION This study investigated the awareness, perceptions, and acceptance of human papillomavirus (HPV) vaccination for children among parents in Hong Kong. It also explored factors associated with, and differences in, vaccine acceptance and hesitancy between parents of girls and boys. METHODS Parents of boys or girls in Primary 5 to 6 were invited to participate in an online survey through an established health and lifestyle e-platform. RESULTS Overall, 851 parents completed the survey: 419 (49.2%) had daughters, 348 (40.9%) had sons, and 84 (9.9%) had children of both genders. Parents who enrolled their children into the Childhood Immunisation Programme were more likely to accept HPV vaccination (79.7% vs 33.7%, odds ratio [OR]=7.70; 95% confidence interval [CI]=5.39-11.01; P<0.001); parents of girls were more likely to accept than parents of boys (86.0% vs 71.8%, OR=2.40; 95% CI=1.67-3.46; P<0.001). Among parents of girls and boys, the main reasons for HPV vaccination acceptance were prevention of cancers (girls: 68.8% and boys: 68.7%), prevention of sexually transmitted diseases (girls: 67.3% and boys: 68.3%), and optimal timing before initiation of sexual activity (girls: 62.8% and boys: 59.8%). Vaccine hesitancy was mainly associated with concerns about serious side-effects (girls: 66.7% and boys: 68.0%) and the belief that their children were too young (girls: 60.0% and boys: 54.0%). CONCLUSION Parents in Hong Kong are hesitant about HPV vaccination for their sons. This barrier could be removed by providing information to correct vaccine safety misconceptions and offering a gender-neutral vaccination programme through the school-based Childhood Immunisation Programme.
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Affiliation(s)
- E W H Lam
- HPV Prevention Alliance, Hong Kong SAR, China
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - H Y S Ngan
- HPV Prevention Alliance, Hong Kong SAR, China
- Department of Obstetrics and Gynaecology, Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - K Y Kun
- HPV Prevention Alliance, Hong Kong SAR, China
| | - D F H Li
- HPV Prevention Alliance, Hong Kong SAR, China
| | - W Y Wan
- HPV Prevention Alliance, Hong Kong SAR, China
| | - P K S Chan
- HPV Prevention Alliance, Hong Kong SAR, China
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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Chan KKL, Chai VYK, Cheung VYT, Choi CKM, Chu MMY, Siu MKY, Tse KY, Ngan HYS. Use of ultrasonographic rules and tumour marker HE4 level to predict malignancy of a pelvic mass: abridged secondary publication. Hong Kong Med J 2022; 28 Suppl 6:4-7. [PMID: 36535789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Affiliation(s)
- K K L Chan
- Department of Obstetrics and Gynaecology, The University of Hong Kong
| | - V Y K Chai
- Department of Obstetrics and Gynaecology, The University of Hong Kong
| | - V Y T Cheung
- Department of Obstetrics and Gynaecology, The University of Hong Kong
| | - C K M Choi
- Department of Obstetrics and Gynaecology, The University of Hong Kong
| | - M M Y Chu
- Department of Obstetrics and Gynaecology, The University of Hong Kong
| | - M K Y Siu
- Department of Obstetrics and Gynaecology, The University of Hong Kong
| | - K Y Tse
- Department of Obstetrics and Gynaecology, The University of Hong Kong
| | - H Y S Ngan
- Department of Obstetrics and Gynaecology, The University of Hong Kong
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Zhang W, Cheon WC, Ngan HYS, Wei Y, Lyu C. Laparoscopic Non-Mesh Cerclage Pectopexy for Pelvic Organ Prolapse. J Vis Exp 2022. [DOI: 10.3791/64388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Lam WL, Wang J, Yeung WF, Cheung CW, Chan KKL, Ngan HYS, Wong CKH, Jiang F, Ma PWS, Leung TW, Leung WC, Liu TC, Chen H, Lao L. A combination of electroacupuncture and auricular acupuncture for postoperative pain after abdominal surgery for gynaecological diseases: A randomized controlled trial. Phytomedicine 2022; 104:154292. [PMID: 35797863 DOI: 10.1016/j.phymed.2022.154292] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 06/04/2022] [Accepted: 06/25/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Postoperative pain following laparotomy for gynaecological diseases is a common problem that requires effective management to ensure patient satisfaction and recovery. Despite the wide use of acupuncture for pain management, knowledge of its efficacy in managing postoperative pain is limited. Previous literature used either acupuncture or auricular acupuncture alone. However, the combined use of acupuncture and auricular acupuncture have not been studied yet. PURPOSE This study examined the efficacy and feasibility of combined electroacupuncture and auricular acupuncture compared to a sham control in reducing pain during 5 days after a laparotomy for gynaecological diseases. This combined therapy was hypothesized to provide greater pain reduction than previous studies with less frequent treatment. STUDY DESIGN Randomized sham-controlled, patient- and- assessor-blinded trial. METHODS This trial recruited 72 patients scheduled for laparotomy in Hong Kong. Either acupuncture (n = 36) or non-invasive sham acupuncture (n = 36) was performed on the patients preoperatively (1 session) and postoperatively (once a day, up to 6 sessions). The primary outcome was pain at rest, measured using a numerical rating scale from postoperative days 0-5. Secondary outcomes such as analgesics consumption were also assessed. A data and safety monitoring board (DSMB) was established. RESULTS All 72 randomized patients were included in the analysis. The acupuncture group had a smaller pain score at rest at 22 hrs (mean = 2.6) than the sham control group (mean = 4.0) (Post hoc intention to treat analysis, Linear regression, mean difference = -1.4, 95% confidence interval = [-0.2] -2.7, p = 0.029). No statistically significant between-group difference was found in other outcomes. No serious adverse event was observed. CONCLUSION Perioperative acupuncture treatments are safe and feasible, but the efficacy of acupuncture is inconclusive.
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Affiliation(s)
- Wing Lok Lam
- School of Chinese Medicine, The University of Hong Kong, Hong Kong, China
| | - Jingxuan Wang
- Department of Statistics and Actuarial Science, The University of Hong Kong, Hong Kong, China
| | - Wing Fai Yeung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Chi Wai Cheung
- Department of Anaesthesiology, Queen Mary Hospital, Hong Kong, China
| | - Karen Kar Loen Chan
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Hong Kong, China
| | | | - Carlos King Ho Wong
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
| | - Fei Jiang
- Department of Statistics and Actuarial Science, The University of Hong Kong, Hong Kong, China
| | - Paulin Wai Sze Ma
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, Hong Kong, China
| | - Tsin Wah Leung
- Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Hong Kong, China
| | - Wing Cheong Leung
- Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Hong Kong, China
| | - Tak Chiu Liu
- Department of Anaesthesiology, Kwong Wah Hospital, Hong Kong, China
| | - Haiyong Chen
- School of Chinese Medicine, The University of Hong Kong, Hong Kong, China
| | - Lixing Lao
- School of Chinese Medicine, The University of Hong Kong, Hong Kong, China.
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Kwong A, Ho CYS, Shin VY, Au CH, Luk WP, Fung LH, Chan TL, Chan KKL, Ngan HYS, Ma ESK. Germline mutations in Chinese ovarian cancer with or without breast cancer. Mol Genet Genomic Med 2022; 10:e1940. [PMID: 35608067 PMCID: PMC9266594 DOI: 10.1002/mgg3.1940] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 02/08/2022] [Accepted: 02/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ovarian and breast cancers are known to have significant genetic components. Considering the differences in the mutation spectrum across ethnicity, it is important to identify hereditary breast and ovarian cancer (HBOC) genes mutation in Chinese for clinical management. METHODS Two cohorts of 451 patients with ovarian cancer only (OV) and 93 patients with both breast and ovarian (BROV) cancers were initially screened for BRCA1, BRCA2, TP53, and PTEN. 109 OV and 43 BROV patients with extensive clinical risk and were being tested negative, were then further characterized by 30-gene panel analysis. RESULTS Pathogenic BRCA1/2 variants were identified in 45 OV patients and 33 BROV patients, giving a prevalence of 10% and 35.5%, respectively. After the extended screening, mutations in other HBOC genes were identified in an additional 12.8% (14/109) of the OV cohort and 14% (6/43) in the BROV cohort. The most commonly mutated genes in the OV cohort were MSH2 (4.6%) while in the BROV cohort were MSH2 (4.7%) and PALB2 (4.7%). With this extended multigene testing strategy, pathogenic mutations were detected in 12.8% of OV patients (BRCAs: 10%; additional genes: 12.8%) and 40.9% (BRCAs: 35.5%; additional genes: 14%) of BROV patients. CONCLUSION Extended characterization of the contributions of HBOC genes to OV and BROV patients has significant impacts on further management in patients and their families, expanding the screening net for more asymptomatic individuals.
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Affiliation(s)
- Ava Kwong
- Department of Surgery, The University of Hong Kong, Pofulam, Hong Kong SAR.,Department of Surgery, University of Hong Kong-Shenzhen Hospital, Shenzhen, China.,Department of Surgery, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong SAR.,Hong Kong Hereditary Breast Cancer Family Registry, Shau Kei Wan, Hong Kong SAR
| | - Cecilia Yuen Sze Ho
- Department of Molecular Pathology, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong SAR
| | - Vivian Yvonne Shin
- Department of Surgery, The University of Hong Kong, Pofulam, Hong Kong SAR
| | - Chun Hang Au
- Department of Molecular Pathology, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong SAR
| | - Wing Pan Luk
- Department of Medical Physics and Research, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong SAR
| | - Ling Hiu Fung
- Department of Medical Physics and Research, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong SAR
| | - Tsun-Leung Chan
- Hong Kong Hereditary Breast Cancer Family Registry, Shau Kei Wan, Hong Kong SAR.,Department of Molecular Pathology, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong SAR
| | - Karen Kar Loen Chan
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Pofulam, Hong Kong SAR
| | - Hextan Yuen Sheung Ngan
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Pofulam, Hong Kong SAR
| | - Edmond Shiu Kwan Ma
- Hong Kong Hereditary Breast Cancer Family Registry, Shau Kei Wan, Hong Kong SAR.,Department of Molecular Pathology, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong SAR
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Lee EYP, Hui ESK, Ngan HYS. Functional tumour volume and peritoneal carcinomatosis to identify suitable candidates for cytoreductive surgery in ovarian carcinoma: abridged secondary publication. Hong Kong Med J 2022; 28 Suppl 1:14-16. [PMID: 35260509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Affiliation(s)
- E Y P Lee
- Department of Diagnostic Radiology, The University of Hong Kong
| | - E S K Hui
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University
| | - H Y S Ngan
- Department of Obstetrics and Gynaecology, The University of Hong Kong
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Lam WL, Ngan HYS, Chan KKL, Chen H, Cheung CW, Jiang F, Wong CKH, Yeung WF, Leo L. Combined electroacupuncture and auricular acupuncture to alleviate pain after gynaecological abdominal surgery: a randomised sham-controlled trial (abridged secondary publication). Hong Kong Med J 2022; 28 Suppl 1:27-30. [PMID: 35260513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Affiliation(s)
- W L Lam
- School of Chinese Medicine, The University of Hong Kong
| | - H Y S Ngan
- Department of Obstetrics and Gynaecology, The University of Hong Kong
| | - K K L Chan
- Department of Obstetrics and Gynaecology, The University of Hong Kong
| | - H Chen
- School of Chinese Medicine, The University of Hong Kong
| | - C W Cheung
- Department of Anaesthesiology, The University of Hong Kong
| | - F Jiang
- Department of Statistics and Actuarial Science, The University of Hong Kong
| | - C K H Wong
- Department of Family Medicine and Primary Care, The University of Hong Kong
| | - W F Yeung
- School of Nursing, The Hong Kong Polytechnic University
| | - L Leo
- School of Chinese Medicine, The University of Hong Kong
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Fan HSL, Choi EPH, Ko RWT, Kwok JYY, Wong JYH, Fong DYT, Shek NWM, Ngan HYS, Li J, Huang YY, Ouyang YQ, Lok KYW. COVID-19 related fear and depression of pregnant women and new mothers. Public Health Nurs 2021; 39:562-571. [PMID: 34902184 DOI: 10.1111/phn.13035] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/15/2021] [Accepted: 11/28/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To explore factors associated with depression and COVID-19 related fear among pregnant women and new mothers. DESIGN A cross-sectional survey was conducted in China from July 2020 to July 2021. SAMPLE A total of 3027 pregnant and new mothers were recruited. MEASUREMENT Sociodemographic characteristics and the perceptions of the COVID-19 pandemic were collected. The Patient Health Questionnaire-9 (PHQ-9) and the Fear Scale was used to assess the depressive and fear level towards the COVID-19 pandemic, respectively. RESULTS Approximately 17.2% of the participants had depression (PHQ-9 ≥10). In Hong Kong, participants who perceived that they have increased knowledge to prevent infection were less likely to have depression (adjusted odds ratio [aOR] = 0.83; 95% confidence interval [CI] = 0.74-0.94). There was no association between perceived severity if infected and severity of spread and the depression level in our sample. An inverse relationship was found between the COVID-19 related fear level and perceived knowledge to prevent infection (Beta-coefficient [β] = -0.20; 95% CI = -0.38 to -0.02). CONCLUSION Public health nurses need to promote accurate and up to date COVID-19 related information at clinical and community settings and implement effective screening for depression and fear symptoms to identify these high-risk groups to improve women's psychological well-being.
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Affiliation(s)
- Heidi Sze Lok Fan
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Edmond Pui Hang Choi
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Rachel Wai Tung Ko
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Jojo Yan Yan Kwok
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Janet Yuen Ha Wong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Noel Wan Man Shek
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, Hong Kong
| | - Hextan Yuen Sheung Ngan
- Department of Obstetrics and Gynecology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong
| | - Junyan Li
- Department of Nursing, School of Health Sciences, Wuhan University, Wuhan, China
| | - Yi-Yan Huang
- Department of Nursing, School of Health Sciences, Wuhan University, Wuhan, China
| | - Yan-Qiong Ouyang
- Department of Nursing, School of Health Sciences, Wuhan University, Wuhan, China
| | - Kris Yuet Wan Lok
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
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Chan KKL, Ngu SF, Chu MMY, Tse KY, Ngan HYS. Tamoxifen use in recurrent ovarian cancer in a Chinese population: A 15 -year clinical experience in a tertiary referral center. Asia Pac J Clin Oncol 2020; 17:338-342. [PMID: 33079469 PMCID: PMC8359459 DOI: 10.1111/ajco.13478] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 09/05/2020] [Indexed: 12/30/2022]
Abstract
Aim To review the clinical use and the effectiveness of tamoxifen in patients with advanced or recurrent ovarian cancer. Methods A retrospective review of clinical records was conducted in patients who received tamoxifen for the treatment of ovarian cancer between 2002 and 2016. We reviewed the clinical setting that it was given, duration of use, patients' tolerability, clinical benefit and progression‐free survival. We also attempted to identify predictive markers for response. Results A total of 92 patients received tamoxifen during this 15‐year period. The patients received a median of 2.5 lines of chemotherapy before switching to tamoxifen, and they remained on tamoxifen for a median of 5.6 months (range 0–85 months), with 24 patients receiving it for more than 12 months. Seventy‐six patients continued on tamoxifen for more than 2 months. In this group, 75 patients had an evaluable response, either by CA 125 or clinically and clinical benefit rate (defined as complete, partial response and static disease) was seen in 42 patients (56%), with majority of patients having static disease. The median progression‐free survival was 5.3 months (95% confidence interval, 2.6–8.1). Tamoxifen was well tolerated. Hormone receptor status was not demonstrated to predict response. Conclusion Patients with advanced ovarian cancer who have failed previous lines of chemotherapy may achieve static disease with tamoxifen with minimal side effects. Tamoxifen may still have a role in the era of molecular target therapy.
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Affiliation(s)
- Karen Kar Loen Chan
- Department of Obstetrics and Gynaecology, University of Hong Kong, Professorial Block, Queen Mary Hospital, Hong Kong
| | - Siew Fei Ngu
- Department of Obstetrics and Gynaecology, University of Hong Kong, Professorial Block, Queen Mary Hospital, Hong Kong
| | - Mandy Man Yee Chu
- Department of Obstetrics and Gynaecology, University of Hong Kong, Professorial Block, Queen Mary Hospital, Hong Kong
| | - Ka Yu Tse
- Department of Obstetrics and Gynaecology, University of Hong Kong, Professorial Block, Queen Mary Hospital, Hong Kong
| | - Hextan Yuen Sheung Ngan
- Department of Obstetrics and Gynaecology, University of Hong Kong, Professorial Block, Queen Mary Hospital, Hong Kong
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Garland SM, Pitisuttithum P, Ngan HYS, Cho CH, Lee CY, Chen CA, Yang YC, Chu TY, Twu NF, Samakoses R, Takeuchi Y, Cheung TH, Kim SC, Huang LM, Kim BG, Kim YT, Kim KH, Song YS, Lalwani S, Kang JH, Sakamoto M, Ryu HS, Bhatla N, Yoshikawa H, Ellison MC, Han SR, Moeller E, Murata S, Ritter M, Sawata M, Shields C, Walia A, Perez G, Luxembourg A. Efficacy, Immunogenicity, and Safety of a 9-Valent Human Papillomavirus Vaccine: Subgroup Analysis of Participants From Asian Countries. J Infect Dis 2019; 218:95-108. [PMID: 29767739 PMCID: PMC5989602 DOI: 10.1093/infdis/jiy133] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 03/16/2018] [Indexed: 01/17/2023] Open
Abstract
Background A 9-valent human papillomavirus-6/11/16/18/31/33/45/52/58 (9vHPV) vaccine extends coverage to 5 next most common oncogenic types (31/33/45/52/58) in cervical cancer versus quadrivalent HPV (qHPV) vaccine. We describe efficacy, immunogenicity, and safety in Asian participants (India, Hong Kong, South Korea, Japan, Taiwan, and Thailand) from 2 international studies: a randomized, double-blinded, qHPV vaccine-controlled efficacy study (young women aged 16–26 years; NCT00543543; Study 001); and an immunogenicity study (girls and boys aged 9–15 years; NCT00943722; Study 002). Methods Participants (N = 2519) were vaccinated at day 1 and months 2 and 6. Gynecological samples (Study 001 only) and serum were collected for HPV DNA and antibody assessments, respectively. Injection-site and systemic adverse events (AEs) were monitored. Data were analyzed by country and vaccination group. Results 9vHPV vaccine prevented HPV-31/33/45/52/58–related persistent infection with 90.4%–100% efficacy across included countries. At month 7, ≥97.9% of participants seroconverted for each HPV type. Injection-site AEs occurred in 77.7%–83.1% and 81.9%–87.5% of qHPV and 9vHPV vaccine recipients in Study 001, respectively, and 62.4%–85.7% of girls/boys in Study 002; most were mild to moderate. Conclusions The 9vHPV vaccine is efficacious, immunogenic, and well tolerated in Asian participants. Data support 9vHPV vaccination programs in Asia. Clinical Trials Registration NCT00543543; NCT00943722.
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Affiliation(s)
- S M Garland
- Western Pacific Regional HPV Labnet Reference Laboratory, Department of Infectious Disease and Microbiology, Royal Women's Hospital, Murdoch Children's Research Institute, Royal Children's Hospital and Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia
| | | | - H Y S Ngan
- Department of Obstetrics and Gynaecology, the University of Hong Kong, China
| | - C-H Cho
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu, South Korea
| | - C-Y Lee
- Department of Gynecology, Chang Gung Memorial Hospital, Chiayi Branch, Taipei
| | - C-A Chen
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei
| | - Y C Yang
- MacKay Memorial Hospital, Taipei
| | - T-Y Chu
- Tzu Chi Medical Center, Hualien
| | - N-F Twu
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - R Samakoses
- Department of Pediatrics, Phramongkutklao Hospital, Bangkok, Thailand
| | | | - T H Cheung
- Department of Obstetric and Gynaecology, Chinese University of Hong Kong, China
| | - S C Kim
- Division of Gynecologic Oncology, Ewha Womans University Mokdong Hospital, School of Medicine Ewha Womans University, Seoul, South Korea
| | - L-M Huang
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - B-G Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Y-T Kim
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asian Medical Center, Seoul, South Korea
| | - K-H Kim
- Department of Pediatrics and Center for Vaccine Evaluation and Study, Ewha Womans University College of Medicine, Seoul, South Korea
| | - Y-S Song
- Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul, South Korea
| | - S Lalwani
- Bharati Vidyapeeth Deemed University Medical College and Hospital, Pune, India
| | - J-H Kang
- Department of Pediatrics, Seoul St. Mary's Hospital, College of Medicine, the Catholic University of Korea, South Korea
| | - M Sakamoto
- Department of Gynaecology, Sasaki Foundation Kyoundo Hospital and Department of Obstetrics and Gynaecology, School of Medicine, the Jikei University, Tokyo, Japan
| | - H-S Ryu
- Department of Obstetrics and Gynecology, School of Medicine, Ajou University, Suwon, South Korea
| | - N Bhatla
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - H Yoshikawa
- Ibaraki Prefectural Central Hospital, Kasama, Ibaraki, Japan
| | | | | | - E Moeller
- Merck & Co., Inc., Kenilworth, New Jersey
| | | | - M Ritter
- Merck & Co., Inc., Kenilworth, New Jersey
| | | | - C Shields
- Merck & Co., Inc., Kenilworth, New Jersey
| | - A Walia
- Merck & Co., Inc., Kenilworth, New Jersey
| | - G Perez
- Merck & Co., Inc., Kenilworth, New Jersey
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Wong OGW, Ngan HYS, Cheung ANY. Placental biology of Down syndrome in relation to increased gene dosage. Hong Kong Med J 2019; 25 Suppl 5:33-35. [PMID: 31416985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Affiliation(s)
- O G W Wong
- Department of Pathology, Queen Mary Hospital, The University of Hong Kong
| | - H Y S Ngan
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong
| | - A N Y Cheung
- Department of Pathology, Queen Mary Hospital, The University of Hong Kong
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Wan KT, Leung THY, Siu MKY, Ngan HYS. Abstract 1710: Role of Nurr1 in cervical cancer pathogenic pathway. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-1710] [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: 11/16/2022]
Abstract
Abstract
Aims: To study the oncogenic role of Nurr1 in cervical cancer and elucidate the underlying mechanism.
Background: Orphan nuclear receptor related-1 protein (Nurr1) belonging to the NR4A family is important for carcinogenesis in multiple biological processes such as cell proliferation and apoptosis. It has been reported that the expression of Nurr1 is significantly correlated with various types of cancer, such as prostate and breast cancer. However, the significance of Nurr1 in cervical cancer etiology remains poorly understood.
Methods: Primary cancer cells were established from tumor tissues resected from cervical cancer patients. Six pairs of attached and spheroid cells derived from primary cervical cancer tissues were established namely CP-1A/CP-1S, CP-2A/CP-2S, CP-3A/CP-3S, CP-4A/CP-4S, CP-5A/CP-5S and CP-6A/CP-6S. A microarray was performed to identify differentially expressed genes in two pairs of attached and sphere cells, followed by validation with qPCR. Stable clones of cervical cancer cell lines with Nurr1 overexpression and knock-down were generated. The role of the selected gene was then functionally characterized by XTT assay, migration assay, spheroid formation assay, apoptosis assay, in vitro and in vivo tumorigenicity assay in cervical cancer cell lines. Downstream proteins of Nurr1 were detected by western blot.
Results: Microarray analysis showed that Nurr1 was highly expressed in sphere cells as compared with attached cells. Relative expression of Nurr1 mRNA in sphere cells was approximately 200-fold more than that in attached cells in qPCR validation. Cancer cell lines, in which Nurr1 was transiently knocked down by siRNA demonstrated an attenuation in proliferation rate, migration, spheroid formation and colony formation. By flow cytometric analysis, more cells were detected in early apoptotic stage with Nurr1 siRNA transfection as compared with NTC siRNA transfected cells, suggesting the role of Nurr1 in preventing cervical cancer cells from apoptosis. Western blotting also demonstrated that there was an increased expression of Bim and p21 in Nurr1 silenced cells. This may indicate the involvement of Nurr1 in modulating the transcription of pro-apoptotic and tumor suppressor genes.
Conclusion: Nurr1 is a potential oncogenic target in cervical cancer pathogenic pathway. Suppression of Nurr1 expression attenuated cancer progression and promoted apoptosis.
Citation Format: Kok Ting Wan, Thomas Ho Yin Leung, Michelle Kwan Yee Siu, Hextan Yuen Sheung Ngan. Role of Nurr1 in cervical cancer pathogenic pathway [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 1710.
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Wong JH, Sze SCW, Ng TB, Cheung RCF, Tam C, Zhang KY, Dan X, Chan YS, Shing Cho WC, Ng CCW, Waye MMY, Liang W, Zhang J, Yang J, Ye X, Lin J, Ye X, Wang H, Liu F, Chan DW, Ngan HYS, Sha O, Li G, Tse R, Tse TF, Chan H. Apoptosis and Anti-cancer Drug Discovery: The Power of Medicinal Fungi and Plants. Curr Med Chem 2019; 25:5613-5630. [DOI: 10.2174/0929867324666170720165005] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 05/16/2017] [Accepted: 05/16/2017] [Indexed: 01/21/2023]
Abstract
The purpose of this account is to review the compounds capable of eliciting
mitochondria-mediated apoptosis in cancer cells produced by medicinal fungi and plants.
The medicinal fungi discussed encompass Cordyceps, Ganoderma species, Coriolus versicolor
and Hypsizygus marmoreus. The medicinal plants discussed comprise Astragalus
complanatus, Dendrobium spp, Dioscorea spp, Glycyrrhiza spp, Panax notoginseng,
Panax ginseng, and Momordica charantia. These compounds have the potential of development
into anticancer drugs.
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Affiliation(s)
- Jack Ho Wong
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Stephen Cho Wing Sze
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Sassoon Road, Hong Kong, China
| | - Tzi Bun Ng
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Randy Chi Fai Cheung
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Chit Tam
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Kalin Yanbo Zhang
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Sassoon Road, Hong Kong, China
| | - Xiuli Dan
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Yau Sang Chan
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - William Chi Shing Cho
- Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong, China
| | | | - Mary Miu Yee Waye
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Weicheng Liang
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Jinfang Zhang
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China
| | - Jie Yang
- Fujian Key Laboratory of Marine Enzyme Engineering, Fuzhou University, Fuzhou 350116, Fujian, China
| | - Xiuyun Ye
- Fujian Key Laboratory of Marine Enzyme Engineering, Fuzhou University, Fuzhou 350116, Fujian, China
| | - Juan Lin
- Fujian Key Laboratory of Marine Enzyme Engineering, Fuzhou University, Fuzhou 350116, Fujian, China
| | - Xiujuan Ye
- Key Laboratory of Biopesticide and Chemical Biology, Ministry of Education, and Key Laboratory of Plant Virology of Fujian Province, Institute of Plant Virology, Fujian Agriculture and Forestry University, Fuzhou, Fujian 350002, China
| | - Hexiang Wang
- State Key Laboratory for Agrobiotechnology and Department of Microbiology, China Agricultural University, Beijing 100193, China
| | - Fang Liu
- Department of Microbiology, College of Life Science, Nankai University, Tianjin 300071, China
| | - David Wai Chan
- Department of Obstetrics and Gynaecology, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam Road, Hong Kong, China
| | - Hextan Yuen Sheung Ngan
- Department of Obstetrics and Gynaecology, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam Road, Hong Kong, China
| | - Ou Sha
- Department of Anatomy, Histology and Embryology, School of Basic Medical Sciences, Shenzhen University Health Science Center, Shenzhen, China
| | - Guohui Li
- Vita Green Pharmaceuticals (HK) Ltd, Vita Green Health Products (HK) Ltd Genning Partners Company Limited, and Hong Kong Institute of Medical Research, Hong Kong, China
| | - Ryan Tse
- Vita Green Pharmaceuticals (HK) Ltd, Vita Green Health Products (HK) Ltd Genning Partners Company Limited, and Hong Kong Institute of Medical Research, Hong Kong, China
| | - Tak Fu Tse
- Vita Green Pharmaceuticals (HK) Ltd, Vita Green Health Products (HK) Ltd Genning Partners Company Limited, and Hong Kong Institute of Medical Research, Hong Kong, China
| | - Helen Chan
- Vita Green Pharmaceuticals (HK) Ltd, Vita Green Health Products (HK) Ltd Genning Partners Company Limited, and Hong Kong Institute of Medical Research, Hong Kong, China
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Tse KY, Chiu KWH, Chan KKL, Chu MMY, Ngu SF, Cheung ANY, Ngan HYS, Ip PPC. A Case Series of Five Patients With Pure or Mixed Gestational Epithelioid Trophoblastic Tumors and a Literature Review on Mixed Tumors. Am J Clin Pathol 2018; 150:318-332. [PMID: 29897391 DOI: 10.1093/ajcp/aqy039] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To review the clinicopathologic features of five patients with epithelioid trophoblastic tumor (ETT). METHODS Characteristics of patients diagnosed with ETT in 2000 to 2012 were reviewed. RESULTS Among 190 patients with gestational trophoblastic neoplasia (GTN), two had pure ETT and three had mixed ETT and choriocarcinoma. The median age was 32.5 years. All the patients had localized disease in the uterus. One patient with pure ETT had a recurrence in the ureter 6 years after the initial treatment. Another patient with pure ETT had two full-term deliveries after fertility-sparing surgery. The three patients with mixed tumors had chemotherapy for GTN before their diseases were completely treated by hysterectomy. At a median follow-up of 102 months, all patients survived. CONCLUSIONS ETT is indolent. Recurrence can happen, but the risk factors are not clear. When patients with GTN fail to respond to chemotherapy, the possibility of mixed GTN should be considered.
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Affiliation(s)
- Ka Yu Tse
- Department of Obstetrics and Gynaecology, the University of Hong Kong
| | | | | | - Mandy Man Yee Chu
- Department of Obstetrics and Gynaecology, the University of Hong Kong
| | - Siew Fei Ngu
- Department of Pathology, the University of Hong Kong
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Lam WL, Yeung WF, Wong MK, Cheung CW, Chan KKL, Ngan HYS, Wong CKH, Chen HY, Lao L. Combined electroacupuncture and auricular acupuncture for postoperative pain after abdominal surgery for gynecological diseases: study protocol for a randomized controlled trial. Trials 2018; 19:8. [PMID: 29301556 PMCID: PMC5755011 DOI: 10.1186/s13063-017-2359-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 11/28/2017] [Indexed: 01/06/2023] Open
Abstract
Background Postoperative pain is a major complaint following abdominal surgery for gynecological diseases. Effective postoperative pain control after abdominal surgery is particularly important for patient recovery, mobility, and satisfaction. Acupuncture has been commonly used for pain management. However, its efficacy in postoperative pain control is inconclusive and health economic evaluation is limited. Methods A randomized, sham-controlled, patient- and- assessor-blind trial is designed to evaluate the efficacy and safety of acupuncture in managing postoperative pain following abdominal surgery of gynecological diseases. Patients who are eligible for laparotomy with a midline incision for gynecological neoplasia, including ovarian mass, uterine mass, and cervical lesions, will be recruited. Seventy-two participants will be randomly allocated to an acupuncture or non-invasive sham control in a 1:1 ratio. Treatment will be done within 2 h before operation, upon arrival to the ward and once daily for 5 days. The Pain Numerical Rating Scale (NRS) on the first 5 days during hospitalization will be the primary outcome and will be analyzed using the area-under-the-curve (AUC) method. The secondary outcome measures include frequency of rescue analgesic use during hospital stay, cumulative morphine consumption; quality of recovery as measured by time to recovery variables and the Quality of Recovery-9 (QoR-9); quality of life as measured by the Short Form-6 dimension (SF-6D) and EuroQol-5 Dimension-5 Level (EQ-5D-5 L). The incremental cost-effectiveness ratio of acupuncture vs sham acupuncture will be calculated. Discussion This study protocol provides an example of integrative medicine practice in a hospital setting for the management of postoperative pain using acupuncture treatment. The acupuncture treatment protocol, if proven to be effective, can be implemented in routine settings to play a role in postoperative pain management for patients who have undergone abdominal surgery for gynecological diseases. Trial registration ClinicalTrials.gov, ID: NCT02851186. Registered on 19 July 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2359-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Wing Lok Lam
- School of Chinese Medicine, The University of Hong Kong, 10 Sassoon Road, Pokfulam, Hong Kong, Special Administrative Region of China
| | - Wing Fai Yeung
- School of Nursing, the Hong Kong Polytechnic University, Kowloon, Hong Kong, Special Administrative Region of China
| | - Mei Kuen Wong
- School of Chinese Medicine, The University of Hong Kong, 10 Sassoon Road, Pokfulam, Hong Kong, Special Administrative Region of China
| | - Chi Wai Cheung
- Department of Anesthesiology, The University of Hong Kong, 4/F, K Block, Queen Mary Hospital, 102 Pokfulam Road, Pokfulam, Hong Kong, Special Administrative Region of China
| | - Karen Kar Loen Chan
- Department of Obstetrics and Gynecology, The University of Hong Kong, 6/F, Professorial Block, Queen Mary Hospital, 102 Pokfulam Road, Pokfulam, Hong Kong, Special Administrative Region of China
| | - Hextan Yuen Sheung Ngan
- Department of Obstetrics and Gynecology, The University of Hong Kong, 6/F, Professorial Block, Queen Mary Hospital, 102 Pokfulam Road, Pokfulam, Hong Kong, Special Administrative Region of China
| | - Carlos King Ho Wong
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F, Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Pokfulam, Hong Kong, Special Administrative Region of China
| | - Hai Yong Chen
- School of Chinese Medicine, The University of Hong Kong, 10 Sassoon Road, Pokfulam, Hong Kong, Special Administrative Region of China
| | - Lixing Lao
- School of Chinese Medicine, The University of Hong Kong, 10 Sassoon Road, Pokfulam, Hong Kong, Special Administrative Region of China.
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Xiang L, Jiang W, Ye S, He T, Pei X, Li J, Chan DW, Ngan HYS, Li F, Tao P, Shen X, Zhou X, Wu X, Yang G, Yang H. ERBB2 mutation: A promising target in non-squamous cervical cancer. Gynecol Oncol 2017; 148:311-316. [PMID: 29279289 DOI: 10.1016/j.ygyno.2017.12.023] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 12/14/2017] [Accepted: 12/19/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE ERBB2 mutations have been found in a subset of invasive cervical cancer (ICC). Nevertheless, the prevalence, mutation spectrum, clinicopathological relevance, human papillomavirus (HPV)-genotype association and prognostic significance of ERBB2-mutated ICCs have not been well established. METHODS In this study, ICC samples (N=1015) were assessed for mutations in ERBB2, KRAS, and PIK3CA by cDNA-based Sanger sequencing. RESULTS Somatic ERBB2 mutations were detected in 3.15% patients. The ERBB2 mutation rate was significantly higher in adenocarcinoma (4.52%, 7/155), adenosquamous carcinoma (7.59%, 6/79) and neuroendocrine carcinoma (10.34%, 3/29) than that in squamous carcinoma (2.14%, 16/749) (P=0.004, Fisher exact test). In addition, 18.75% of the patients carrying ERBB2 mutations concomitantly harbored PIK3CA or KRAS mutations. Patients with ERBB2-mutated ICCs tended to have a worse prognosis than those with wild-type or PIK3CA-mutated ICCs but a better prognosis than those with KRAS-mutated ICCs. CONCLUSIONS This study provided a promising rationale for the clinical investigation of tyrosine kinase inhibitors for the treatment of cervical cancer with ERBB2 mutations. Patients with non-squamous cell carcinomas have priority as candidates for ERBB2-targeted therapy. Concurrent PIK3CA/RAS mutations should be considered in the design of clinical trials.
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Affiliation(s)
- Libing Xiang
- Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Wei Jiang
- Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Shuang Ye
- Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Tiancong He
- Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Xuan Pei
- Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Jiajia Li
- Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - David Wai Chan
- Department of Obstetrics and Gynecology, LKS Faculty of Medicine, The University of Hong Kong, L747 Laboratory Block, 21 Sassoon Road, Hong Kong, China
| | - Hextan Yuen Sheung Ngan
- Department of Obstetrics and Gynecology, LKS Faculty of Medicine, The University of Hong Kong, L747 Laboratory Block, 21 Sassoon Road, Hong Kong, China.
| | - Fang Li
- Department of Gynecology, Maternal and Child Health Hospital of Jiading District, Shanghai 201821, China
| | - Pingping Tao
- Department of Obstetrics and Gynecology, Shanghai Pudong New Area People's Hospital, Shanghai 201299, China
| | - Xuxia Shen
- Department of Pathology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Xiaoyan Zhou
- Department of Pathology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Xiaohua Wu
- Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Gong Yang
- Cancer Institute, Fudan University Shanghai Cancer Center, Department of Oncology, Fudan University Shanghai Medical College, Shanghai 200032, China; Central Laboratory, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai 200240, China.
| | - Huijuan Yang
- Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
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Tse KY, Cheung VYT, Lam C, Lee EYP, Khong PL, Ngan HYS. Successful Treatment of a Pararenal Pregnancy Using High-Dose Methotrexate Regimen: A Case Report. J Reprod Med 2016; 61:592-594. [PMID: 30226730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Upper abdominal pregnancy is rare. Most patients present with hemoperitoneum, requiring emergency laparotomy. CASE A 32-year-old woman presented with acute abdominal pain and an elevated beta-human chorionic gonadotropin (β-hCG) level. Ultrasound, computerized tomography (CT) scans, and laparoscopy failed to locate the source of elevated hCG. Subsequent positron emission tomography (PET)-CT demonstrated a cystic mass in the left pararenal region with no increased uptake. Repeated ultrasound scan revealed a live fetus implanted laterally to the abdominal aorta. After failing to respond to methotrexate at the usual dosage, a regimen used in gestational trophoblastic neoplasia was given. The pregnancy underwent miscarriage afterwards, and the hCG level gradually returned to normal. CONCLUSION The site of an ectopic pregnancy should be sought thoroughly to avoid missing an abdominal pregnancy and hence disastrous hemoperitoneum. While medical therapy with high-dose methotrexate is not a standard treatment, it can be considered after failing the traditional therapy, provided that there is adequate treatment monitoring and expertise in handling the side effects of the medication.
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Chu MMY, Tse KY, Chan KKL, Cheung ANY, Ngan HYS. Placental Site Trophoblastic Tumor: A Distinct Entity of Gestational Trophoblastic Disease Experience from a Tertiary Referral Center in Hong Kong. J Reprod Med 2016; 61:351-356. [PMID: 30408381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To review the clinical and pathological characteristics of patients with placental site trophoblastic tumor (PS TT) managed in a tertiary referral center in Hong Kong. STUDY DESIGN Patients with a diagnosis of PSTT from 1995 to 2012 were identified from a computer database. Clinical and patho- logical data were obtained from medical records and the electronic database. RESULTS Ten patients with PSTT were identified. Only 4 patients (40%) had disease confined to the uterus at presentation (Stage I). The most common site of metastasis was the lung. Four patients had pretreatment serum hCG levels <1,000 IU/L, and all of them had disease 'confined to the uterus. Of the 4 patients with Stage I disease 3 had hysterectomy only and 1 had both hysterectomy and chemotherapy. All 4 patients achieved complete remission; although 1 of them had a recurrence successfully treated with che- motherapy. For patients with Stage III/IV disease most of them had both hysterectomy and chemotherapy. Only 1 patient (20%) was alive without evidence of disease. CONCLUSION Patients with Stage I disease have excellent prognosis after hysterectomy, and adjuvant treatment is not recommended. A low pretreatment serum hCG level (<1,000 IU/L) was a good predictor of early stage disease. The prognosis for patients with metastatic disease was poor despite surgery and com- bination chemotherapy.
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Chuang LT, Temin S, Camacho R, Dueñas-Gonzalez A, Feldman S, Gultekin M, Gupta V, Horton S, Jacob G, Kidd EA, Lishimpi K, Nakisige C, Nam JH, Ngan HYS, Small W, Thomas G, Berek JS. Management and Care of Women With Invasive Cervical Cancer: American Society of Clinical Oncology Resource-Stratified Clinical Practice Guideline. J Glob Oncol 2016; 2:311-340. [PMID: 28717717 PMCID: PMC5493265 DOI: 10.1200/jgo.2016.003954] [Citation(s) in RCA: 110] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Purpose To provide evidence-based, resource-stratified global recommendations to clinicians and policymakers on the management and palliative care of women diagnosed with invasive cervical cancer. Methods ASCO convened a multidisciplinary, multinational panel of cancer control, medical and radiation oncology, health economic, obstetric and gynecologic, and palliative care experts to produce recommendations reflecting resource-tiered settings. A systematic review of literature from 1966 to 2015 failed to yield sufficiently strong quality evidence to support basic- and limited-resource setting recommendations; a formal consensus-based process was used to develop recommendations. A modified ADAPTE process was also used to adapt recommendations from existing guidelines. Results Five existing sets of guidelines were identified and reviewed, and adapted recommendations form the evidence base. Eight systematic reviews, along with cost-effectiveness analyses, provided indirect evidence to inform the consensus process, which resulted in agreement of 75% or greater. Recommendations Clinicians and planners should strive to provide access to the most effective evidence-based antitumor and palliative care interventions. If a woman cannot access these within her own or neighboring country or region, she may need to be treated with lower-tier modalities, depending on capacity and resources for surgery, chemotherapy, radiation therapy, and supportive and palliative care. For women with early-stage cervical cancer in basic settings, cone biopsy or extrafascial hysterectomy may be performed. Fertility-sparing procedures or modified radical or radical hysterectomy may be additional options in nonbasic settings. Combinations of surgery, chemotherapy, and radiation therapy (including brachytherapy) should be used for women with stage IB to IVA disease, depending on available resources. Pain control is a vital component of palliative care. Additional information is available at www.asco.org/rs-cervical-cancer-treatment-guideline and www.asco.org/guidelineswiki. It is the view of ASCO that health care providers and health care system decision makers should be guided by the recommendations for the highest stratum of resources available. The guideline is intended to complement but not replace local guidelines.
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Affiliation(s)
- Linus T Chuang
- , Icahn School of Medicine at Mt Sinai, New York, NY; , American Society of Clinical Oncology, Alexandria, VA; , retired, Mallorca, Spain; , Instituto Nacional de Cancerologia, Mexico City, Mexico; , Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA; , Turkish Ministry of Health, Ankara, Turkey; , patient representative, V Care Foundation, Mumbai, India; , University of Waterloo, Waterloo; , Sunnybrook Odette Cancer Centre and University of Toronto, Toronto, Ontario, Canada; , Instituto Nacional de Cancerologia, Buenos Aires, Argentina; and , Stanford Comprehensive Cancer Institute, Stanford, CA; , Cancer Diseases Hospital, Lusaka, Zambia; , Mulago Hospital, Kampala, Uganda; , Asan Medical Center, Seoul, South Korea; , University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China; and , Cardinal Bernardin Cancer Center, Stritch School of Medicine, Loyola University, Chicago, IL
| | - Sarah Temin
- , Icahn School of Medicine at Mt Sinai, New York, NY; , American Society of Clinical Oncology, Alexandria, VA; , retired, Mallorca, Spain; , Instituto Nacional de Cancerologia, Mexico City, Mexico; , Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA; , Turkish Ministry of Health, Ankara, Turkey; , patient representative, V Care Foundation, Mumbai, India; , University of Waterloo, Waterloo; , Sunnybrook Odette Cancer Centre and University of Toronto, Toronto, Ontario, Canada; , Instituto Nacional de Cancerologia, Buenos Aires, Argentina; and , Stanford Comprehensive Cancer Institute, Stanford, CA; , Cancer Diseases Hospital, Lusaka, Zambia; , Mulago Hospital, Kampala, Uganda; , Asan Medical Center, Seoul, South Korea; , University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China; and , Cardinal Bernardin Cancer Center, Stritch School of Medicine, Loyola University, Chicago, IL
| | - Rolando Camacho
- , Icahn School of Medicine at Mt Sinai, New York, NY; , American Society of Clinical Oncology, Alexandria, VA; , retired, Mallorca, Spain; , Instituto Nacional de Cancerologia, Mexico City, Mexico; , Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA; , Turkish Ministry of Health, Ankara, Turkey; , patient representative, V Care Foundation, Mumbai, India; , University of Waterloo, Waterloo; , Sunnybrook Odette Cancer Centre and University of Toronto, Toronto, Ontario, Canada; , Instituto Nacional de Cancerologia, Buenos Aires, Argentina; and , Stanford Comprehensive Cancer Institute, Stanford, CA; , Cancer Diseases Hospital, Lusaka, Zambia; , Mulago Hospital, Kampala, Uganda; , Asan Medical Center, Seoul, South Korea; , University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China; and , Cardinal Bernardin Cancer Center, Stritch School of Medicine, Loyola University, Chicago, IL
| | - Alfonso Dueñas-Gonzalez
- , Icahn School of Medicine at Mt Sinai, New York, NY; , American Society of Clinical Oncology, Alexandria, VA; , retired, Mallorca, Spain; , Instituto Nacional de Cancerologia, Mexico City, Mexico; , Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA; , Turkish Ministry of Health, Ankara, Turkey; , patient representative, V Care Foundation, Mumbai, India; , University of Waterloo, Waterloo; , Sunnybrook Odette Cancer Centre and University of Toronto, Toronto, Ontario, Canada; , Instituto Nacional de Cancerologia, Buenos Aires, Argentina; and , Stanford Comprehensive Cancer Institute, Stanford, CA; , Cancer Diseases Hospital, Lusaka, Zambia; , Mulago Hospital, Kampala, Uganda; , Asan Medical Center, Seoul, South Korea; , University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China; and , Cardinal Bernardin Cancer Center, Stritch School of Medicine, Loyola University, Chicago, IL
| | - Sarah Feldman
- , Icahn School of Medicine at Mt Sinai, New York, NY; , American Society of Clinical Oncology, Alexandria, VA; , retired, Mallorca, Spain; , Instituto Nacional de Cancerologia, Mexico City, Mexico; , Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA; , Turkish Ministry of Health, Ankara, Turkey; , patient representative, V Care Foundation, Mumbai, India; , University of Waterloo, Waterloo; , Sunnybrook Odette Cancer Centre and University of Toronto, Toronto, Ontario, Canada; , Instituto Nacional de Cancerologia, Buenos Aires, Argentina; and , Stanford Comprehensive Cancer Institute, Stanford, CA; , Cancer Diseases Hospital, Lusaka, Zambia; , Mulago Hospital, Kampala, Uganda; , Asan Medical Center, Seoul, South Korea; , University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China; and , Cardinal Bernardin Cancer Center, Stritch School of Medicine, Loyola University, Chicago, IL
| | - Murat Gultekin
- , Icahn School of Medicine at Mt Sinai, New York, NY; , American Society of Clinical Oncology, Alexandria, VA; , retired, Mallorca, Spain; , Instituto Nacional de Cancerologia, Mexico City, Mexico; , Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA; , Turkish Ministry of Health, Ankara, Turkey; , patient representative, V Care Foundation, Mumbai, India; , University of Waterloo, Waterloo; , Sunnybrook Odette Cancer Centre and University of Toronto, Toronto, Ontario, Canada; , Instituto Nacional de Cancerologia, Buenos Aires, Argentina; and , Stanford Comprehensive Cancer Institute, Stanford, CA; , Cancer Diseases Hospital, Lusaka, Zambia; , Mulago Hospital, Kampala, Uganda; , Asan Medical Center, Seoul, South Korea; , University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China; and , Cardinal Bernardin Cancer Center, Stritch School of Medicine, Loyola University, Chicago, IL
| | - Vandana Gupta
- , Icahn School of Medicine at Mt Sinai, New York, NY; , American Society of Clinical Oncology, Alexandria, VA; , retired, Mallorca, Spain; , Instituto Nacional de Cancerologia, Mexico City, Mexico; , Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA; , Turkish Ministry of Health, Ankara, Turkey; , patient representative, V Care Foundation, Mumbai, India; , University of Waterloo, Waterloo; , Sunnybrook Odette Cancer Centre and University of Toronto, Toronto, Ontario, Canada; , Instituto Nacional de Cancerologia, Buenos Aires, Argentina; and , Stanford Comprehensive Cancer Institute, Stanford, CA; , Cancer Diseases Hospital, Lusaka, Zambia; , Mulago Hospital, Kampala, Uganda; , Asan Medical Center, Seoul, South Korea; , University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China; and , Cardinal Bernardin Cancer Center, Stritch School of Medicine, Loyola University, Chicago, IL
| | - Susan Horton
- , Icahn School of Medicine at Mt Sinai, New York, NY; , American Society of Clinical Oncology, Alexandria, VA; , retired, Mallorca, Spain; , Instituto Nacional de Cancerologia, Mexico City, Mexico; , Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA; , Turkish Ministry of Health, Ankara, Turkey; , patient representative, V Care Foundation, Mumbai, India; , University of Waterloo, Waterloo; , Sunnybrook Odette Cancer Centre and University of Toronto, Toronto, Ontario, Canada; , Instituto Nacional de Cancerologia, Buenos Aires, Argentina; and , Stanford Comprehensive Cancer Institute, Stanford, CA; , Cancer Diseases Hospital, Lusaka, Zambia; , Mulago Hospital, Kampala, Uganda; , Asan Medical Center, Seoul, South Korea; , University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China; and , Cardinal Bernardin Cancer Center, Stritch School of Medicine, Loyola University, Chicago, IL
| | - Graciela Jacob
- , Icahn School of Medicine at Mt Sinai, New York, NY; , American Society of Clinical Oncology, Alexandria, VA; , retired, Mallorca, Spain; , Instituto Nacional de Cancerologia, Mexico City, Mexico; , Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA; , Turkish Ministry of Health, Ankara, Turkey; , patient representative, V Care Foundation, Mumbai, India; , University of Waterloo, Waterloo; , Sunnybrook Odette Cancer Centre and University of Toronto, Toronto, Ontario, Canada; , Instituto Nacional de Cancerologia, Buenos Aires, Argentina; and , Stanford Comprehensive Cancer Institute, Stanford, CA; , Cancer Diseases Hospital, Lusaka, Zambia; , Mulago Hospital, Kampala, Uganda; , Asan Medical Center, Seoul, South Korea; , University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China; and , Cardinal Bernardin Cancer Center, Stritch School of Medicine, Loyola University, Chicago, IL
| | - Elizabeth A Kidd
- , Icahn School of Medicine at Mt Sinai, New York, NY; , American Society of Clinical Oncology, Alexandria, VA; , retired, Mallorca, Spain; , Instituto Nacional de Cancerologia, Mexico City, Mexico; , Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA; , Turkish Ministry of Health, Ankara, Turkey; , patient representative, V Care Foundation, Mumbai, India; , University of Waterloo, Waterloo; , Sunnybrook Odette Cancer Centre and University of Toronto, Toronto, Ontario, Canada; , Instituto Nacional de Cancerologia, Buenos Aires, Argentina; and , Stanford Comprehensive Cancer Institute, Stanford, CA; , Cancer Diseases Hospital, Lusaka, Zambia; , Mulago Hospital, Kampala, Uganda; , Asan Medical Center, Seoul, South Korea; , University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China; and , Cardinal Bernardin Cancer Center, Stritch School of Medicine, Loyola University, Chicago, IL
| | - Kennedy Lishimpi
- , Icahn School of Medicine at Mt Sinai, New York, NY; , American Society of Clinical Oncology, Alexandria, VA; , retired, Mallorca, Spain; , Instituto Nacional de Cancerologia, Mexico City, Mexico; , Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA; , Turkish Ministry of Health, Ankara, Turkey; , patient representative, V Care Foundation, Mumbai, India; , University of Waterloo, Waterloo; , Sunnybrook Odette Cancer Centre and University of Toronto, Toronto, Ontario, Canada; , Instituto Nacional de Cancerologia, Buenos Aires, Argentina; and , Stanford Comprehensive Cancer Institute, Stanford, CA; , Cancer Diseases Hospital, Lusaka, Zambia; , Mulago Hospital, Kampala, Uganda; , Asan Medical Center, Seoul, South Korea; , University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China; and , Cardinal Bernardin Cancer Center, Stritch School of Medicine, Loyola University, Chicago, IL
| | - Carolyn Nakisige
- , Icahn School of Medicine at Mt Sinai, New York, NY; , American Society of Clinical Oncology, Alexandria, VA; , retired, Mallorca, Spain; , Instituto Nacional de Cancerologia, Mexico City, Mexico; , Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA; , Turkish Ministry of Health, Ankara, Turkey; , patient representative, V Care Foundation, Mumbai, India; , University of Waterloo, Waterloo; , Sunnybrook Odette Cancer Centre and University of Toronto, Toronto, Ontario, Canada; , Instituto Nacional de Cancerologia, Buenos Aires, Argentina; and , Stanford Comprehensive Cancer Institute, Stanford, CA; , Cancer Diseases Hospital, Lusaka, Zambia; , Mulago Hospital, Kampala, Uganda; , Asan Medical Center, Seoul, South Korea; , University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China; and , Cardinal Bernardin Cancer Center, Stritch School of Medicine, Loyola University, Chicago, IL
| | - Joo-Hyun Nam
- , Icahn School of Medicine at Mt Sinai, New York, NY; , American Society of Clinical Oncology, Alexandria, VA; , retired, Mallorca, Spain; , Instituto Nacional de Cancerologia, Mexico City, Mexico; , Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA; , Turkish Ministry of Health, Ankara, Turkey; , patient representative, V Care Foundation, Mumbai, India; , University of Waterloo, Waterloo; , Sunnybrook Odette Cancer Centre and University of Toronto, Toronto, Ontario, Canada; , Instituto Nacional de Cancerologia, Buenos Aires, Argentina; and , Stanford Comprehensive Cancer Institute, Stanford, CA; , Cancer Diseases Hospital, Lusaka, Zambia; , Mulago Hospital, Kampala, Uganda; , Asan Medical Center, Seoul, South Korea; , University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China; and , Cardinal Bernardin Cancer Center, Stritch School of Medicine, Loyola University, Chicago, IL
| | - Hextan Yuen Sheung Ngan
- , Icahn School of Medicine at Mt Sinai, New York, NY; , American Society of Clinical Oncology, Alexandria, VA; , retired, Mallorca, Spain; , Instituto Nacional de Cancerologia, Mexico City, Mexico; , Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA; , Turkish Ministry of Health, Ankara, Turkey; , patient representative, V Care Foundation, Mumbai, India; , University of Waterloo, Waterloo; , Sunnybrook Odette Cancer Centre and University of Toronto, Toronto, Ontario, Canada; , Instituto Nacional de Cancerologia, Buenos Aires, Argentina; and , Stanford Comprehensive Cancer Institute, Stanford, CA; , Cancer Diseases Hospital, Lusaka, Zambia; , Mulago Hospital, Kampala, Uganda; , Asan Medical Center, Seoul, South Korea; , University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China; and , Cardinal Bernardin Cancer Center, Stritch School of Medicine, Loyola University, Chicago, IL
| | - William Small
- , Icahn School of Medicine at Mt Sinai, New York, NY; , American Society of Clinical Oncology, Alexandria, VA; , retired, Mallorca, Spain; , Instituto Nacional de Cancerologia, Mexico City, Mexico; , Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA; , Turkish Ministry of Health, Ankara, Turkey; , patient representative, V Care Foundation, Mumbai, India; , University of Waterloo, Waterloo; , Sunnybrook Odette Cancer Centre and University of Toronto, Toronto, Ontario, Canada; , Instituto Nacional de Cancerologia, Buenos Aires, Argentina; and , Stanford Comprehensive Cancer Institute, Stanford, CA; , Cancer Diseases Hospital, Lusaka, Zambia; , Mulago Hospital, Kampala, Uganda; , Asan Medical Center, Seoul, South Korea; , University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China; and , Cardinal Bernardin Cancer Center, Stritch School of Medicine, Loyola University, Chicago, IL
| | - Gillian Thomas
- , Icahn School of Medicine at Mt Sinai, New York, NY; , American Society of Clinical Oncology, Alexandria, VA; , retired, Mallorca, Spain; , Instituto Nacional de Cancerologia, Mexico City, Mexico; , Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA; , Turkish Ministry of Health, Ankara, Turkey; , patient representative, V Care Foundation, Mumbai, India; , University of Waterloo, Waterloo; , Sunnybrook Odette Cancer Centre and University of Toronto, Toronto, Ontario, Canada; , Instituto Nacional de Cancerologia, Buenos Aires, Argentina; and , Stanford Comprehensive Cancer Institute, Stanford, CA; , Cancer Diseases Hospital, Lusaka, Zambia; , Mulago Hospital, Kampala, Uganda; , Asan Medical Center, Seoul, South Korea; , University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China; and , Cardinal Bernardin Cancer Center, Stritch School of Medicine, Loyola University, Chicago, IL
| | - Jonathan S Berek
- , Icahn School of Medicine at Mt Sinai, New York, NY; , American Society of Clinical Oncology, Alexandria, VA; , retired, Mallorca, Spain; , Instituto Nacional de Cancerologia, Mexico City, Mexico; , Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA; , Turkish Ministry of Health, Ankara, Turkey; , patient representative, V Care Foundation, Mumbai, India; , University of Waterloo, Waterloo; , Sunnybrook Odette Cancer Centre and University of Toronto, Toronto, Ontario, Canada; , Instituto Nacional de Cancerologia, Buenos Aires, Argentina; and , Stanford Comprehensive Cancer Institute, Stanford, CA; , Cancer Diseases Hospital, Lusaka, Zambia; , Mulago Hospital, Kampala, Uganda; , Asan Medical Center, Seoul, South Korea; , University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China; and , Cardinal Bernardin Cancer Center, Stritch School of Medicine, Loyola University, Chicago, IL
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22
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Park JY, Ngan HYS, Park W, Cao Z, Wu X, Ju W, Chung HH, Chang SJ, Park SY, Ryu SY, Kim JH, Cho CH, Lee KH, Lee JW, Kumarasamy S, Kim JW, Wilailak S, Kim BG, Kim DY, Konishi I, Lee JK, Wang KL, Nam JH. Asian Society of Gynecologic Oncology International Workshop 2014. J Gynecol Oncol 2015; 26:68-74. [PMID: 25609163 PMCID: PMC4302288 DOI: 10.3802/jgo.2015.26.1.68] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 12/13/2014] [Indexed: 01/05/2023] Open
Abstract
The Asian Society of Gynecologic Oncology International Workshop 2014 on gynecologic oncology was held in Asan Medical Center, Seoul, Korea on the 23rd to 24th August 2014. A total of 179 participants from 17 countries participated in the workshop, and the up-to-date findings on the management of gynecologic cancers were presented and discussed. This meeting focused on the new trends in the management of cervical cancer, fertility-sparing management of gynecologic cancers, surgical management of gynecologic cancers, and recent advances in translational research on gynecologic cancers.
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Affiliation(s)
- Jeong Yeol Park
- Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hextan Yuen Sheung Ngan
- Department of Obstetrics and Gynecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Won Park
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Zeyi Cao
- Obstetrics and Gynecology Center, Tsinghua University School of Medicine, Beijing, China
| | - Xiaohua Wu
- Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Woong Ju
- Department of Obstetrics and Gynecology, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hyun Hoon Chung
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Suk Joon Chang
- Gynecologic Cancer Center, Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Korea
| | - Sang Yoon Park
- Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Sang Young Ryu
- Department of Obstetrics and Gynecology, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, Seoul, Korea
| | - Jae Hoon Kim
- Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Chi Heum Cho
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu, Korea
| | - Keun Ho Lee
- Department of Obstetrics and Gynecology, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Jeong Won Lee
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | | | - Jae Weon Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Sarikapan Wilailak
- Department of Obstetrics and Gynecology, Ramathibodi Hospital, Mahidol University Faculty of Medicine, Bangkok, Thailand
| | - Byoung Gie Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dae Yeon Kim
- Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ikuo Konishi
- Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Jae Kwan Lee
- Department of Obstetrics and Gynecology, Korea University Medical Center, Seoul, Korea
| | - Kung Liahng Wang
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Mackay Medical College, Taipei, Taiwan.; Department of Nursing, Mackay Junior College of Medicine Nursing, and Management, Taipei, Taiwan
| | - Joo Hyun Nam
- Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Cheung ANY, Wong OG, Chan KKY, Yang MS, Tsang CH, Ji SL, Lo CK, Szeto E, Wong E, Ngan HYS. Integrated human papillomavirus analysis as an adjunct for triage of atypical cervical cytology. Hong Kong Med J 2014; 20 Suppl 6:44-47. [PMID: 25482973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Affiliation(s)
- A N Y Cheung
- Department of Pathology, The University of Hong Kong, Queen Mary Hospital
| | - O G Wong
- Department of Pathology, The University of Hong Kong, Queen Mary Hospital
| | - K K Y Chan
- Department of Pathology, The University of Hong Kong, Queen Mary Hospital
| | - M S Yang
- Department of Biology and Chemistry, City University of Hong Kong
| | - C H Tsang
- Department of Biology and Chemistry, City University of Hong Kong
| | - S L Ji
- Department of Biology and Chemistry, City University of Hong Kong
| | - C K Lo
- Department of Pathology, The University of Hong Kong, Queen Mary Hospital
| | - E Szeto
- Department of Pathology, The University of Hong Kong, Queen Mary Hospital
| | - E Wong
- Department of Pathology, The University of Hong Kong, Queen Mary Hospital
| | - H Y S Ngan
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital
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24
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Cheung ANY, Guan XY, Ngan HYS. Cervical cancer screening by enhanced cytology: application of novel markers. Hong Kong Med J 2014; 20 Suppl 6:39-43. [PMID: 25482972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Affiliation(s)
- A N Y Cheung
- Department of Pathology, The University of Hong Kong, Queen Mary Hospital
| | - X Y Guan
- Department of Clinical Oncology,The University of Hong Kong, Queen Mary Hospital
| | - H Y S Ngan
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital
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25
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Liu SS, Chan KKY, Leung RCY, Yip AMW, Lau LSK, Liao XY, Jiang LL, Luk MHM, Lo SST, Fong DYT, Cheung ANY, Lin ZQ, Ngan HYS. Human papillomavirus status in southern Chinese women. Hong Kong Med J 2014; 20 Suppl 6:35-38. [PMID: 25482971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Affiliation(s)
- S S Liu
- Department of Obstetrics and Gynaecology, Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - K K Y Chan
- Department of Pathology, Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - R C Y Leung
- Department of Obstetrics and Gynaecology, Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - A M W Yip
- Department of Obstetrics and Gynaecology, Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - L S K Lau
- Department of Obstetrics and Gynaecology, Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - X Y Liao
- Department of Pathology, Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - L L Jiang
- Department of Pathology, Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - M H M Luk
- Department of Obstetrics and Gynaecology, The Second Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - S S T Lo
- Family Planning Association of Hong Kong, Hong Kong
| | - D Y T Fong
- School of Nursing, Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - A N Y Cheung
- Department of Pathology, Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Z Q Lin
- Department of Obstetrics and Gynaecology, The Second Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - H Y S Ngan
- Department of Obstetrics and Gynaecology, Faculty of Medicine, The University of Hong Kong, Hong Kong
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26
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Lee EYP, Yu X, Chu MMY, Ngan HYS, Siu SWK, Soong IS, Chan Q, Khong PL. Perfusion and diffusion characteristics of cervical cancer based on intraxovel incoherent motion MR imaging-a pilot study. Eur Radiol 2014; 24:1506-13. [DOI: 10.1007/s00330-014-3160-7] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 02/23/2014] [Accepted: 03/20/2014] [Indexed: 01/22/2023]
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27
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Zang R, Wu L, Zhu J, Kong B, Kim BG, Yao Y, Yin R, Liu J, Wu Q, Ngan HYS, Xie X, Wang KL, Li X, Yen MS, Wei L, Wang Q, Mitrica I, Carpenter C, Zhang P. Pazopanib (Paz) monotherapy in Asian women who have not progressed after first-line chemotherapy for advanced ovarian, Fallopian tube, or primary peritoneal carcinoma. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.5512] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
5512 Background: Paz, an oral multikinase inhibitor of VEGF, PDGF and c-Kit has showed activity in advanced ovarian cancer. This study evaluated paz as maintenance therapy in Asian women with advanced ovarian cancer. Methods: Subjects with FIGO stage II, III, or IV ovarian, fallopian tube, or primary peritoneal cancer whose disease had not progressed after debulking surgery and followed by chemotherapy were randomized 1:1 to paz 800 mg once daily or placebo for up to 24 months. Primary endpoint was PFS by RECIST v1.0 based on visit date. If a progression occurred between the 2 scheduled visits (6 mos apart), progression was considered to have occurred at the next scheduled scan date. This minimized potential bias due to any imbalance of visit frequency between the arms. Results: 145 Asian subjects were randomized; 144 were treated. Mean age was 52.9 years. At diagnosis 17% were FIGO stage II, 73% stage III and 10% stage IV. After debulking surgery, 30% (n = 44) had no residual disease and 41% (n = 59) had. 47% (28/59) had residual disease ≤1cm. Prior to randomization, all subjects received median 8 cycles of chemotherapy; all subjects received platinum and taxane. At randomization 81% had ECOG status 0, 97% were disease free and all had normal CA-125. At clinical data cut-off median PFS was 18.1 months in both arms. Because of the small sample size a HR was not calculated but the KM curves indicated a trend in favor of paz from 6 to 18 mos; the curves crossed after 18 mos. The adverse event (AE) profile for paz was similar to previous reports except rates of hypertension and neutropenia were higher. The most frequent AEs (≥ 20%) on the paz arm were hypertension (76%), neutropenia (64%), leucopenia (53%), diarrhea (47%), hair color changes (40%), palm-plantar erythrodysaethesia syndrome (29%), ALT increase (28%), thrombocytopenia (24%), AST increase (22%) and TSH increase (21%). Most of these AEs were Grade 1-2. Conclusions: The results of this study alone cannot confirm the efficacy of paz maintenance treatment in Asian women with ovarian cancer, but should be interpreted in conjunction of AGO-OVAR16 study. Clinical trial information: NCT01227928.
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Affiliation(s)
| | | | | | - Beihua Kong
- Shandong University Qi Lu Hospital, Jinan, China
| | - Byoung-Gie Kim
- Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea
| | | | - Rutie Yin
- West China Hospital, Sichuan University, Chengdu, China
| | - Jihong Liu
- Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Qiang Wu
- Cancer Hospital of Jiangsu Province, Nanjing, China
| | | | - Xing Xie
- Women’s Hospital School of Medicine, Zhejiang University, Hangzhou, China
| | | | - Xiuqin Li
- Huaxiang Branch, Shengjing Hospital of China Medical University, Shenyang, China
| | | | - Lihui Wei
- People's Hospital of Peking University, Beijing, China
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Liu SS, Chan KYK, Leung RCY, Chan KKL, Tam KF, Luk MHM, Lo SST, Fong DYT, Cheung ANY, Lin ZQ, Ngan HYS. Prevalence and risk factors of Human Papillomavirus (HPV) infection in southern Chinese women - a population-based study. PLoS One 2011; 6:e19244. [PMID: 21559276 PMCID: PMC3086888 DOI: 10.1371/journal.pone.0019244] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2010] [Accepted: 03/29/2011] [Indexed: 12/18/2022] Open
Abstract
Background Persistent high-risk type Human papillomavirus (HPV) infection is recognized as a necessary cause of cervical cancer. This study aimed to compare the HPV prevalence and risk factors between women residing in Hong Kong (HK) and Guangzhou (GZ) region of China. Methodology/Principal Findings A total of 1,570 and 1,369 women were recruited from HK and GZ, respectively. The cytology samples were collected and tested for HPV infection. The overall and type-specific HPV prevalence and the potential risk factors for acquisition of HPV infection were studied. Women with normal cytology in the GZ cohort had significantly higher HPV prevalence (10%) than those in the HK cohort (6.2%, p<0.001). The patterns of the age-specific HPV prevalence were also different between the two cohorts. In the HK cohort, women at the age of 20–29 years old had the highest prevalence and a second peak was observed in the age of ≥60 years old. In the GZ cohort, the highest HPV prevalence was also observed in 20–29 years old but declined as the age increased and a second peak was not seen. HPV16 and HPV52 were the most common high-risk types found in the HK and GZ cohorts, respectively. Age was the most consistently observed independent risk factor for HPV infection in the HK, while the number of sexual partners had association in the GZ cohort. Conclusions/Significance Our study provides the current status and the epidemiological characteristics of HPV prevalence in Southern Chinese women. The results strongly suggested that population education and the effective cervical cancer screening would be vital in the prevention of cervical cancer.
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Affiliation(s)
- Stephanie Si Liu
- Department of Obstetrics & Gynaecology, The University of Hong Kong, Hong Kong
| | | | | | - Karen Kar Loen Chan
- Department of Obstetrics & Gynaecology, The University of Hong Kong, Hong Kong
| | - Kar Fai Tam
- Department of Obstetrics & Gynaecology, The University of Hong Kong, Hong Kong
| | - May Hiu Mei Luk
- Department of Obstetrics & Gynaecology, The Second Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | | | | | | | - Zhong Qiu Lin
- Department of Obstetrics & Gynaecology, The Second Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- * E-mail: (HYSN); (ZQL)
| | - Hextan Yuen Sheung Ngan
- Department of Obstetrics & Gynaecology, The University of Hong Kong, Hong Kong
- * E-mail: (HYSN); (ZQL)
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Chan KKL, Yao TJ, Jones B, Zhao JF, Ma FK, Leung CY, Lau SK, Yip MW, Ngan HYS. The use of Chinese herbal medicine to improve quality of life in women undergoing chemotherapy for ovarian cancer: a double-blind placebo-controlled randomized trial with immunological monitoring. Ann Oncol 2011; 22:2241-9. [PMID: 21355071 DOI: 10.1093/annonc/mdq749] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND This study aimed to evaluate traditional Chinese medicine (TCM) in improving quality of life (QOL), reducing chemotoxicity and modulating immune function in patients undergoing chemotherapy. PATIENTS AND METHODS Patients with ovarian cancer were randomized to receive either TCM or placebo in addition to standard chemotherapy. The primary outcome was global health status (GHS) score, assessed by European Organization for Research and Treatment of Cancer questionnaire, while the secondary outcomes were other QOL items, chemotoxicity according to World Health Organization criteria and alterations in immune function as measured by immune cells count and the numbers of cytokines-secreting cells. RESULTS There was no significant difference in the GHS between the two groups. With adjustment for stage, chemotherapy type, disease status, age and baseline value, emotional function, cognitive function and nausea and vomiting were found to be worse or less improved in the TCM group compared with placebo group after six cycles of chemotherapy. The TCM group had less neutropenia after three cycles (0% grade 4 neutropenia versus 28.6%). There were no other significant differences in terms of chemotoxicity. Lymphocyte counts and cytokine activities decreased less in the TCM group. CONCLUSIONS TCM did not improve QOL but did have some effects in terms of maintaining immune function.
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Affiliation(s)
- K K L Chan
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, Hong Kong.
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Cheung LWT, Mak ASC, Cheung ANY, Ngan HYS, Leung PCK, Wong AST. P-cadherin cooperates with insulin-like growth factor-1 receptor to promote metastatic signaling of gonadotropin-releasing hormone in ovarian cancer via p120 catenin. Oncogene 2011; 30:2964-74. [PMID: 21317933 DOI: 10.1038/onc.2011.7] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Gonadotropin-releasing hormone (GnRH) is a potent prometastatic factor in ovarian cancer, but the intracellular signaling events are not well understood. The classical Gα(q)-phospholipase C signal transduction pathway known to operate in the pituitary is not involved in GnRH actions at non-pituitary targets. Here we showed that GnRH treatment of ovarian cancer cells led to a rapid and remarkable tyrosine phosphorylation of p120 catenin (p120(ctn)), which was mediated by P-cadherin. The use of P-cadherin small interfering RNA or neutralizing antibodies to inhibit P-cadherin expression and function resulted in diminished p120(ctn) activation, confirming that the effect was P-cadherin specific. On exploring how P-cadherin, which lacks intrinsic kinase activity, might regulate the activation of p120(ctn), we found that P-cadherin could induce the ligand-independent activation of insulin-like growth factor-1 receptor (IGF-1R). Inhibition of IGF-1R expression or its activity significantly inhibited GnRH-induced p120(ctn) activation, and the subsequent cell migration and invasion. In addition, we showed that IGF-1R regulation by P-cadherin was associated with complex formation between IGF-1R and P-cadherin, and this regulation was also observed to be in vivo correlated with metastasis. Furthermore, using a mouse model of ovarian cancer metastasis, GnRH receptor knockdown was shown to diminish peritoneal dissemination of tumors and ascites formation. These findings suggest for the first time that GnRH can initiate an outside-in p120(ctn) signal transduction through the cross-talk between P-cadherin and IGF-1R, thus providing a novel molecular mechanism by which GnRH may control the high level of aggressiveness and invasion and metastasis potential that are characteristic of ovarian cancer.
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Affiliation(s)
- L W T Cheung
- School of Biological Sciences, University of Hong Kong, Hong Kong, Hong Kong
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Tam KF, Cheung ANY, Szeto E, Ngan HYS. Atypical glandular cells diagnosed during pregnancy and the postpartum period: a retrospective analysis. Eur J Obstet Gynecol Reprod Biol 2011; 155:213-6. [PMID: 21227567 DOI: 10.1016/j.ejogrb.2010.12.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Revised: 11/09/2010] [Accepted: 12/14/2010] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The objective of the study was to determine the prevalence and clinical significance of atypical glandular cells (AGC) or atypical glandular cells of undetermined significance (AGUS) diagnosed in pregnant and postpartum women. STUDY DESIGN Smears having a diagnosis of AGC or AGUS, taken from pregnant and postpartum (within six weeks after delivery) women between 1995 and 2008 were reviewed and subclassified according to the Bethesda 2001 classification. Case records were then reviewed and a second cytology review was performed after disclosure of the follow-up data. RESULTS Among 91,133 smears taken from pregnant and postpartum women, 70 had AGC or AGUS (0.07%) diagnosed. Follow-up data were available in 40 cases, with mean duration of follow-up being 43 months. Among the 40 patients with follow-up data, nineteen had smears with coexisting squamous abnormalities. Thirty patients had positive pathology, including 18 (45%) cervical intraepithelial neoplasia III (CIN III), four (10%) cervical adenocarcinoma-in situ, three (7.5%) squamous cell carcinoma of cervix, four (10%) condylomas and one (2.5%) hydatidiform mole. On review, 24 out of 32 smears with AGC 'not otherwise specified' ('NOS') had significant pathology. CONCLUSIONS AGC found on cervical smears during pregnancy and the postpartum period is uncommon. The chance of having significant cervical pathology, however, is high and colposcopy should be performed.
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Affiliation(s)
- K F Tam
- Department of Obstetrics & Gynaecology, University of Hong Kong, Hong Kong.
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Chow SN, Soon R, Park JS, Pancharoen C, Qiao YL, Basu P, Ngan HYS. Knowledge, attitudes, and communication around human papillomavirus (HPV) vaccination amongst urban Asian mothers and physicians. Vaccine 2010. [PMID: 20347631 DOI: 10.1016/j.vaccine.2010.03.027.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
To determine why HPV vaccination uptake is low in Asia, we surveyed attitudes, knowledge and communication about cervical cancer and HPV vaccination amongst 480 physicians and 1617 randomly selected urban mothers who could afford HPV vaccines in Korea, Malaysia, Taiwan and Thailand. HPV vaccine rejection by mothers was linked with poor knowledge and low perceptions of self-relevance. Physicians' likelihood of raising the subject and/or recommending vaccination was linked to how proactively they advocate preventive health, their attitude to the subject's sensitivity and their knowledge levels. Because most Asian mothers seek doctors' advice and prefer them to take the initiative, physicians should be more proactive in discussing and recommending HPV vaccination.
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Affiliation(s)
- Song-Nan Chow
- Department of Obstetrics & Gynecology, National Taiwan University Hospital, 7, Chung-Shan South Road, Taipei 100, Taiwan.
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Chow SN, Soon R, Park JS, Pancharoen C, Qiao YL, Basu P, Ngan HYS. Knowledge, attitudes, and communication around human papillomavirus (HPV) vaccination amongst urban Asian mothers and physicians. Vaccine 2010; 28:3809-17. [DOI: 10.1016/j.vaccine.2010.03.027] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2009] [Revised: 03/01/2010] [Accepted: 03/15/2010] [Indexed: 10/19/2022]
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Basu P, Ngan HYS, Hseon TE. HPV vaccination in women over 25 years of age: Asian Cervical Cancer Prevention Advisory Board recommendations. J Obstet Gynaecol Res 2009; 35:712-6. [PMID: 19751332 DOI: 10.1111/j.1447-0756.2009.01022.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Cervical cancer is the second most common cancer among women worldwide and is responsible for more than 270 000 deaths every year, the majority of which occur in Asia. The Asian Cervical Cancer Prevention Advisory Board (ACCPAB) was established in 2005 with a mission to raise awareness of the significant disease burden of cervical cancer in Asia and the strategies for its prevention. Persistent infection with oncogenic subtypes of human papillomavirus (HPV) is the necessary cause of cervical cancer. Vaccines against the two most carcinogenic subtypes of HPV (HPV 16 and 18) are available and have the potential to prevent cervical cancer in 70-80% of HPV- naïve women. HPV vaccines have been first licensed for use in girls and women aged 9-26 years. However, women over 25 years of age are also vulnerable to HPV infection and are likely to benefit from vaccination. Current evidence shows that even women previously infected with HPV who have subsequently cleared the infection can obtain complete protection against the HPV types contained in the vaccines. Therefore, vaccinating sexually active women aged over 25 years offers significant benefits and may be expected to decrease the incidence of cervical cancer. The ACCPAB advocates the adoption of preventive measures against HPV infection, including vaccination, with a view to protecting women of all ages from developing cervical cancer.
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Affiliation(s)
- Partha Basu
- Chittaranjan National Cancer Institute, Department of Gynaecologic Oncology, Kolkata, India.
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Yu SYM, Chan DW, Liu VWS, Ngan HYS. Inhibition of cervical cancer cell growth through activation of upstream kinases of AMP-activated protein kinase. Tumour Biol 2009; 30:80-5. [PMID: 19407487 DOI: 10.1159/000216843] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2008] [Accepted: 02/27/2009] [Indexed: 11/19/2022] Open
Abstract
AMP-activated protein kinase (AMPK) is a critical energy-balancing sensor in the regulation of cellular metabolism in response to external stimuli. Emerging evidence has suggested that AMPK is a potential therapeutic target for human cancers. AICAR, one of the pharmacological AMPK activators, has been widely used to suppress cancer cell growth through activation of LKB1, an upstream kinase of AMPK. However, frequent mutations and deletions of LKB1 found in some cancer cells limit the application of AICAR as an efficient therapeutic drug. Here we show that an alternative pharmacological AMPK activator, A23187, was able to inhibit cervical cancer cell growth through activation of Ca(2+)/calmodulin-dependent protein kinase kinase beta, another upstream kinase of AMPK. Using cervical cancer cell models, we found that HeLa (LKB1-deficient cell) responded less to the anti-proliferative effect exerted by AICAR treatment (p < 0.001) compared with CaSki and C41 (LKB1-expressing cells). Conversely, the anti-proliferative effect was increased significantly in HeLa but not in CaSki and C41 cells under treatment by A23187 (p < 0.001). Moreover, co-treatment of AICAR and A23187 was able to further enhance the inhibitory effect on cell growth of Hela, CaSki and C41 cells. Notably, both AICAR and A23187 exerted the anti-proliferative effect on cervical cancer cells by suppressing AMPK/mTOR signalling activity. These data suggest that A23187 could be an alternative potential therapeutic drug used for anti-proliferation in LKB1-deficient cancer cells.
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Affiliation(s)
- Sandy Yee Man Yu
- Department of Obstetrics and Gynaecology, University of Hong Kong, Hong Kong, China
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Kwan TTC, Chan KKL, Yip AMW, Tam KF, Cheung ANY, Lo SST, Lee PWH, Ngan HYS. Acceptability of human papillomavirus vaccination among Chinese women: concerns and implications. BJOG 2009; 116:501-10. [DOI: 10.1111/j.1471-0528.2008.01988.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Tse KY, Liu VWS, Chan DW, Chiu PM, Tam KF, Chan KKL, Liao XY, Cheung ANY, Ngan HYS. Epigenetic Alteration of the Metallothionein 1E Gene in Human Endometrial Carcinomas. Tumour Biol 2009; 30:93-9. [DOI: 10.1159/000218032] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2008] [Accepted: 03/10/2009] [Indexed: 11/19/2022] Open
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Chan HY, Siu MKY, Zhang HJ, Wong ESY, Ngan HYS, Chan KYK, Cheung ANY. Activated Stat3 expression in gestational trophoblastic disease: correlation with clinicopathological parameters and apoptotic indices. Histopathology 2008; 53:139-46. [PMID: 18752497 DOI: 10.1111/j.1365-2559.2008.03089.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS To assess the expression profile of the activated form of signal transducer and activator of transcription (Stat)3 in gestational trophoblastic disease (GTD) and correlate the findings with clinicopathological parameters. METHODS AND RESULTS By immunohistochemistry, both cytoplasmic and nuclear expression of p-Stat3-Ser(727) was demonstrated in 88 trophoblastic tissues, including placentas and GTD. Nuclear immunoreactivity of p-Stat3-Ser(727) was significantly higher in hydatidiform mole (HM) (P < 0.001) and choriocarcinoma (P = 0.009) when compared with normal placentas. Placental site trophoblastic tumours (PSTT) and epithelioid trophoblastic tumours (ETT) also demonstrated higher nuclear p-Stat3-Ser(727) expression than their normal trophoblast counterparts. Higher p-Stat3-Ser(727) expression was confirmed in choriocarcinoma cell lines, JEG-3 and JAR, than in a normal trophoblast cell line, with both nuclear and cytoplasmic fractions demonstrated by immunoblotting. Spontaneously regressed HM showed significantly increased nuclear and cytoplasmic p-Stat3-Ser(727) immunoreactivity over those that developed gestational trophoblastic neoplasia (GTN) (P = 0.013, P = 0.039). There was a significant positive and inverse correlation between nuclear p-Stat3-Ser(727) immunoreactivity and apoptotic indices [terminal deoxynucleotidyl transferase (TdT)-mediated deoxyuridine triphosphate (dUTP) nick end labelling and M30 CytoDeath antibody] (P = 0.001, P < 0.001, Spearman's rho test) and Bcl-2 expression (P = 0.034), respectively. CONCLUSIONS p-Stat3-Ser(727) plays a role in the pathogenesis of GTD, probably through the regulation of apoptosis. p-Stat3-Ser(727) immunoreactivity is a potential marker in predicting GTN in HM.
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Affiliation(s)
- H Y Chan
- Department of Pathology, University of Hong Kong, Hong Kong, Special Administrative Region of China
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Ngan HYS, Tam KF, Ng TY. Prevention of lymphoedema using omentoplasty after pelvic lymphadenectomy: a prospective randomised controlled trial. Hong Kong Med J 2008; 14:43-46. [PMID: 18941275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Affiliation(s)
- H Y S Ngan
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, University of Hong Kong, Hong Kong SAR, China.
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Chan DW, Yu SYM, Chiu PM, Yao KM, Liu VWS, Cheung ANY, Ngan HYS. Over-expression of FOXM1 transcription factor is associated with cervical cancer progression and pathogenesis. J Pathol 2008; 215:245-52. [PMID: 18464245 DOI: 10.1002/path.2355] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The Forkhead Box M1 (FOXM1) transcription factor plays a crucial role in regulating expression of cell cycle genes which are essentially involved in cell proliferation, differentiation and transformation. Recent studies have reported that aberrant expression of FOXM1 in a variety of human cancers is associated with their aggressive behaviour. However, the functional significance of FOXM1 in human cervical cancer is not known. We have shown that FOXM1 was significantly over-expressed in cervical squamous cell carcinoma (SCC) compared to normal cervical epithelium immunohistochemically (p < 0.001). In addition, intratumoural FOXM1 positivity was increased in cervical intraepithelial neoplasia (CIN) and carcinoma, compared with that in normal epithelium, indicating that FOXM1 is involved in tumour progression. Indeed, this is supported by clinicopathological analysis that the over-expression of FOXM1 was significantly associated with tumour late stage (p = 0.012) and cell proliferation marker, Ki67 (p < 0.001). Functionally, enforced expression of FOXM1c in FOXM1-deficient cervical cancer cells (C33A) remarkably enhanced cell proliferation and anchorage-independent growth ability. Conversely, depletion of FOXM1 by RNA interference in FOXM1-over-expressing cervical cancer cells (SiHa) caused significant inhibition on cell proliferation and anchorage-independent growth ability on soft agar. This inhibitory phenomenon was associated with the reduced expressions of cyclin B1, cyclinD1 and cdc25B but increased expression of p27(Kip1) and p21(Cip1). Our findings suggest a role for FOXM1 in the development and pathogenesis of human cervical SCC.
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Affiliation(s)
- D W Chan
- Department of Obstetrics and Gynaecology, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, People's Republic of China
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Tam KF, Lam KW, Chan KK, Ngan HYS. Natural history of pelvic lymphocysts as observed by ultrasonography after bilateral pelvic lymphadenectomy. Ultrasound Obstet Gynecol 2008; 32:87-90. [PMID: 18548478 DOI: 10.1002/uog.5345] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVES To determine, in patients who have undergone bilateral pelvic lymphadenectomy for gynecological cancer, the incidence of lymphocyst formation, their change in size with time, risk factors and correlation with symptoms. METHODS This was a prospective observational study of 108 patients undergoing bilateral pelvic lymphadenectomy for gynecological cancer in our unit. We performed serial three-dimensional (3D) ultrasound assessment at 2 and 6 weeks and 3, 6, 9 and 12 months after surgery. Before each ultrasound assessment, symptoms were recorded and a physical examination was performed. RESULTS Forty-eight (44.4%) patients had unilateral or bilateral lymphocysts detected during the follow-up period; 26 were on the left side, 16 were on the right side and six were bilateral. In 39 (81.2%) of the patients, the lymphocysts were first noted 2 weeks after the operation. In nine (18.8%) the lymphocysts persisted until 12 months after surgery. There was no association between lymphocyst formation and diagnosis, type of operation performed, surgeon, operative blood loss, adjuvant radiotherapy and number of lymph nodes removed. Four lymphocysts were detected by physical examination before the ultrasound diagnosis. There was no association between lymphocyst and symptoms, including pain over the abdomen, pelvis, thigh, legs or back, lymphedema, fever or symptoms of cystitis. Only one patient developed an infection of the lymphocyst, which required surgical intervention. CONCLUSION Lymphocyst formation is common following bilateral pelvic lymphadenectomy. Most patients with lymphocysts are asymptomatic and the development of major complications is rare.
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Affiliation(s)
- K F Tam
- Department of Obstetrics and Gynaecology, Gynaecological Oncology Division, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China.
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Kwan TTC, Chan KKL, Yip AMW, Tam KF, Cheung ANY, Young PMC, Lee PWH, Ngan HYS. Barriers and facilitators to human papillomavirus vaccination among Chinese adolescent girls in Hong Kong: a qualitative-quantitative study. Sex Transm Infect 2008; 84:227-32. [DOI: 10.1136/sti.2007.029363] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Chan KKL, Ip P, Kwong P, Tam KF, Ngan HYS. A combination of chemoirradiation and chemotherapy for treatment of advanced clear cell adenocarcinoma of the cervix. Int J Gynecol Cancer 2008; 18:559-63. [PMID: 17692092 DOI: 10.1111/j.1525-1438.2007.01037.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Clear cell adenocarcinoma of the cervix (CCAC) is an uncommon tumor. No good treatment option has been reported for advanced disease, and the prognosis is generally poor. We report a case of a 14-year-old girl with stage III CCAC. She was given whole-pelvic external irradiation (40 Gy in 20 daily fractions) and high–dose rate brachytherapy with concurrent weekly cisplatin (40 mg/m2), followed by further external irradiation to the parametria with central shield (14 Gy in seven daily fractions). She then received one cycle of carboplatin (area under the curve [AUC] 6) with paclitaxel (175 mg/m2) and two cycles of carboplatin (AUC 4) with gemcitabine (1000 mg/m2 on days 1 and 8) because she developed anaphylactic shock to paclitaxel. Chemotherapy was stopped after the third cycle due to initial poor general condition. However, she gradually improved while on palliative care. Reassessment 6 months later showed no evidence of residual disease, and she remained disease free during a follow-up of 1 year. The complete response in this case suggests that chemoirradiation followed by combination chemotherapy may be a treatment option for advanced CCAC.
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Affiliation(s)
- K K L Chan
- Department of Obstetrics and Gynaecology, University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
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Feng HC, Tsao SW, Ngan HYS, Xue WC, Kwan HS, Siu MKY, Liao XY, Wong E, Cheung ANY. Overexpression of prostate stem cell antigen is associated with gestational trophoblastic neoplasia. Histopathology 2007; 52:167-74. [DOI: 10.1111/j.1365-2559.2007.02925.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Liao XY, Xue WC, Shen DH, Ngan HYS, Siu MK, Cheung AN. p63 expression in ovarian tumours: a marker for Brenner tumours but not transitional cell carcinomas. Histopathology 2007; 51:477-83. [PMID: 17880529 DOI: 10.1111/j.1365-2559.2007.02804.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS To investigate p63 expression in ovarian neoplasms. METHODS AND RESULTS Immunohistochemistry using an antibody that detects all p63 isoforms was performed on 103 primary ovarian neoplasms of different histological types. Diffuse nuclear immunoreactivity of p63 was demonstrated in the 17 benign and five borderline Brenner tumours. Only one of the six malignant Brenner tumours displayed p63 expression. p63 immunoreactivity was absent in all the ovarian transitional cell carcinomas (TCC), but was demonstrated extensively in TCCs of the urinary bladder. Besides focal p63 expression in epidermal basal cells of immature and mature teratomas, all other ovarian lesions were devoid of p63 expression. p63 expression was also demonstrated in cervical transitional cell metaplasia and Walthard cell nests of fallopian tubes. CONCLUSIONS Expression of p63 protein is apparently cell lineage specific and in ovarian neoplasms is confined to benign and borderline Brenner tumours. The loss of expression in malignant Benner tumours suggests a role for p63 in Brenner carcinogenesis. The distinct patterns of p63 expression in TCCs in the ovary and urinary bladder may help in their differential diagnosis.
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Affiliation(s)
- X Y Liao
- Department of Pathology, University of Hong Kong, Queen Mary Hospital, Hong Kong
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Abstract
OBJECTIVE To investigate whether the use of an antibacterial vaginal pessary containing tetracycline and amphotericin B would reduce complications from large loop excision of the transformation zone (LLETZ). DESIGN Prospective randomised controlled trial. SETTING Department of Obstetrics and Gynaecology, University of Hong Kong. POPULATION A total of 321 women who underwent LLETZ. METHODS Women were randomised to either receiving an antimicrobial vaginal pessary twice a day for 14 days after LLETZ or no medication. Before LLETZ, endocervical and high vaginal swabs were taken for the detection of Chlamydia and other pathogens. All women were given a diary to record the degree of symptoms, such as vaginal discharge, bleeding and pain for 3 weeks. These were then compared between the two groups. MAIN OUTCOME MEASURES Bleeding, vaginal discharge and pain after LLETZ. RESULTS There was no significant difference in the total bleeding, vaginal discharge and pain scores between the two groups. However, for women who had positive endocervical or high vaginal swabs, the treatment group had significantly less bleeding in the second week (Z=-2.083, P= 0.037) and less overall vaginal discharge (Z=-2.024, P= 0.043). CONCLUSIONS An antimicrobial vaginal pessary containing tetracycline and amphotericin B did not provide any significant benefit after LLETZ, except for a subgroup of women with positive vaginal or endocervical swabs. Given that this group of women cannot be identified before the procedure since swabs are not routinely taken, the use of routine prophylactic topical antibiotics cannot be recommended for the general population.
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Affiliation(s)
- K K L Chan
- Department of Obstetrics and Gynaecology, University of Hong Kong, Queen Mary Hospital, Hong Kong.
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Beller U, Quinn MA, Benedet JL, Creasman WT, Ngan HYS, Maisonneuve P, Pecorelli S, Odicino F, Heintz APM. Carcinoma of the vulva. FIGO 26th Annual Report on the Results of Treatment in Gynecological Cancer. Int J Gynaecol Obstet 2007; 95 Suppl 1:S7-S27. [PMID: 17161169 DOI: 10.1016/s0020-7292(06)60028-3] [Citation(s) in RCA: 115] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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48
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Heintz APM, Odicino F, Maisonneuve P, Quinn MA, Benedet JL, Creasman WT, Ngan HYS, Pecorelli S, Beller U. Carcinoma of the ovary. FIGO 26th Annual Report on the Results of Treatment in Gynecological Cancer. Int J Gynaecol Obstet 2007; 95 Suppl 1:S161-S192. [PMID: 17161157 DOI: 10.1016/s0020-7292(06)60033-7] [Citation(s) in RCA: 748] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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49
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Beller U, Benedet JL, Creasman WT, Ngan HYS, Quinn MA, Maisonneuve P, Pecorelli S, Odicino F, Heintz APM. Carcinoma of the vagina. FIGO 26th Annual Report on the Results of Treatment in Gynecological Cancer. Int J Gynaecol Obstet 2007; 95 Suppl 1:S29-S42. [PMID: 17161165 DOI: 10.1016/s0020-7292(06)60029-5] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Tse KY, Chan KKL, Tam KF, Ngan HYS. 20-year experience of managing profuse bleeding in gestational trophoblastic disease. J Reprod Med 2007; 52:397-401. [PMID: 17583238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
OBJECTIVE To review the outcomes of different methods in the treatment of severe bleeding or acute abdomen in gestational trophoblastic disease (GTD). STUDY DESIGN In a tertiary referral center, the records of patients diagnosed with GTD and presenting with heavy vaginal bleeding or acute abdomen between January 1986 and December 2005 were retrieved. RESULTS Seventeen patients presenting with heavy bleeding or acute abdomen and requiring emergency management were identified. Ten patients had heavy vaginal bleeding, and 7 had shock or signs of hemoperitoneum. Eleven patients had total abdominal hysterectomy with or without bilateral salpingo-oophorectomy (TAH +/- BSO), 2 had arterial ligation, 3 had embolization, and 1 had suturing of a vaginal defect due to a metastatic nodule. The median ages of the patients having TAH +/- BSO and other conservative treatments were 37 (21-52) and 32.5 (26-48), respectively. Fifteen patients received chemotherapy after surgical treatment. All patients survived except 1, who died of concurrent disease. CONCLUSION Profuse bleeding in GTD is rare. Hysterectomy, arterial ligation and angiographic embolization can effectively treat this condition. With more experience, angiographic embolization should be the treatment of choice, especially for those who are hemodynamically stable and wish to retain their fertility potential.
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Affiliation(s)
- Ka Yu Tse
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, University of Hong Kong, 102, Pokfulam Road, Hong Kong, SAR.
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