1
|
Ghosh A, Jaaback K, Boulton A, Wong-Brown M, Raymond S, Dutta P, Bowden NA, Ghosh A. Fusobacterium nucleatum: An Overview of Evidence, Demi-Decadal Trends, and Its Role in Adverse Pregnancy Outcomes and Various Gynecological Diseases, including Cancers. Cells 2024; 13:717. [PMID: 38667331 PMCID: PMC11049087 DOI: 10.3390/cells13080717] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/14/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
Gynecological and obstetric infectious diseases are crucial to women's health. There is growing evidence that links the presence of Fusobacterium nucleatum (F. nucleatum), an anaerobic oral commensal and potential periodontal pathogen, to the development and progression of various human diseases, including cancers. While the role of this opportunistic oral pathogen has been extensively studied in colorectal cancer in recent years, research on its epidemiological evidence and mechanistic link to gynecological diseases (GDs) is still ongoing. Thus, the present review, which is the first of its kind, aims to undertake a comprehensive and critical reappraisal of F. nucleatum, including the genetics and mechanistic role in promoting adverse pregnancy outcomes (APOs) and various GDs, including cancers. Additionally, this review discusses new conceptual advances that link the immunomodulatory role of F. nucleatum to the development and progression of breast, ovarian, endometrial, and cervical carcinomas through the activation of various direct and indirect signaling pathways. However, further studies are needed to explore and elucidate the highly dynamic process of host-F. nucleatum interactions and discover new pathways, which will pave the way for the development of better preventive and therapeutic strategies against this pathobiont.
Collapse
Affiliation(s)
- Arunita Ghosh
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia;
- Drug Repurposing and Medicines Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia;
| | - Ken Jaaback
- Hunter New England Centre for Gynecological Cancer, John Hunter Hospital, Newcastle, NSW 2305, Australia;
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Angela Boulton
- Newcastle Private Hospital, Newcastle, NSW 2305, Australia; (A.B.); (S.R.)
| | - Michelle Wong-Brown
- Drug Repurposing and Medicines Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia;
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Steve Raymond
- Newcastle Private Hospital, Newcastle, NSW 2305, Australia; (A.B.); (S.R.)
| | - Partha Dutta
- Department of Medicine, Division of Cardiology, University of Pittsburgh, Pittsburgh, PA 15261, USA;
- Department of Immunology, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Nikola A. Bowden
- Drug Repurposing and Medicines Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia;
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Arnab Ghosh
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia;
- Drug Repurposing and Medicines Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia;
| |
Collapse
|
2
|
Moloney K, Janda M, Frumovitz M, Leitao M, Abu-Rustum NR, Rossi E, Nicklin JL, Plante M, Lecuru FR, Buda A, Mariani A, Leung Y, Ferguson SE, Pareja R, Kimmig R, Tong PSY, McNally O, Chetty N, Liu K, Jaaback K, Lau J, Ng SYJ, Falconer H, Persson J, Land R, Martinelli F, Garrett A, Altman A, Pendlebury A, Cibula D, Altamirano R, Brennan D, Ind TE, De Kroon C, Tse KY, Hanna G, Obermair A. Development of a surgical competency assessment tool for sentinel lymph node dissection by minimally invasive surgery for endometrial cancer. Int J Gynecol Cancer 2021; 31:647-655. [PMID: 33664126 DOI: 10.1136/ijgc-2020-002315] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 12/09/2020] [Revised: 02/02/2021] [Accepted: 02/04/2021] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION Sentinel lymph node dissection is widely used in the staging of endometrial cancer. Variation in surgical techniques potentially impacts diagnostic accuracy and oncologic outcomes, and poses barriers to the comparison of outcomes across institutions or clinical trial sites. Standardization of surgical technique and surgical quality assessment tools are critical to the conduct of clinical trials. By identifying mandatory and prohibited steps of sentinel lymph node (SLN) dissection in endometrial cancer, the purpose of this study was to develop and validate a competency assessment tool for use in surgical quality assurance. METHODS A Delphi methodology was applied, included 35 expert gynecological oncology surgeons from 16 countries. Interviews identified key steps and tasks which were rated mandatory, optional, or prohibited using questionnaires. Using the surgical steps for which consensus was achieved, a competency assessment tool was developed and subjected to assessments of validity and reliability. RESULTS Seventy percent consensus agreement standardized the specific mandatory, optional, and prohibited steps of SLN dissection for endometrial cancer and informed the development of a competency assessment tool. Consensus agreement identified 21 mandatory and three prohibited steps to complete a SLN dissection. The competency assessment tool was used to rate surgical quality in three preselected videos, demonstrating clear separation in the rating of the skill level displayed with mean skills summary scores differing significantly between the three videos (F score=89.4; P<0.001). Internal consistency of the items was high (Cronbach α=0.88). CONCLUSION Specific mandatory and prohibited steps of SLN dissection in endometrial cancer have been identified and validated based on consensus among a large number of international experts. A competency assessment tool is now available and can be used for surgeon selection in clinical trials and for ongoing, prospective quality assurance in routine clinical care.
Collapse
Affiliation(s)
- Kristen Moloney
- Gynaecologic Oncology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Monika Janda
- Centre for Health Services Research, The University of Queensland Faculty of Medicine, Brisbane, Queensland, Australia
| | - Michael Frumovitz
- Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Mario Leitao
- Gynecology Service Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Nadeem R Abu-Rustum
- Gynecology Service Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Emma Rossi
- Obstetrics and Gynecology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - James L Nicklin
- Gynaecological Oncology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.,Faculty of Medicine, The University of Queensland, St Lucia, Queensland, Australia
| | - Marie Plante
- Gynecology Oncology Service, Centre Hospitalier Universitaire de Québec-Université Laval, Quebec, Quebec, Canada
| | - Fabrice R Lecuru
- Surgical Oncology, Institute Curie, Paris, France.,Surgical Oncology Department for Breast and Gynecology, Universite de Paris, Paris, Île-de-France, France
| | - Alessandro Buda
- Department of Obstetrics and Gynecology, Università degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy.,Division of Gynecologic Oncology Italy, Ospedale Michele e Pietro Ferrero, Verduno (CN), Italy
| | - Andrea Mariani
- Gynecologic Surgery, Department of Obstetrics and Gynecology, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | - Yee Leung
- Obstetrics and Gynaecology, The University of Western Australia Faculty of Health and Medical Sciences, Perth, Western Australia, Australia
| | - Sarah Elizabeth Ferguson
- Gynecologic Oncology, University Health Network, Toronto, Ontario, Canada.,Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada
| | - Rene Pareja
- Gynecologic Oncology, Instituto Nacional de Cancerologia, Bogota, Colombia.,Gynecologic Oncology, Clínica De Oncología Astorga, Medellín, Colombia
| | - Rainer Kimmig
- Gynecology and Obstetrics, University of Essen, Essen, Germany
| | | | - Orla McNally
- Obstetrics and Gynaecology, Royal Women's Hospital, Parkville, Victoria, Australia.,Victorian Comprehensive Cancer Centre, University of Melbourne, Parkville, Victoria, Australia
| | - Naven Chetty
- Gynaecologic Oncology, Mater Health Services Brisbane, South Brisbane, Queensland, Australia
| | - Kaijiang Liu
- Gynecology and Obstetrics, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, China
| | - Ken Jaaback
- Gynaecologic Oncology, John Hunter Hospital, New Lambton Heights, New South Wales, Australia
| | - Julio Lau
- Gynecology Oncology, Hospital General San Juan de Dios, Guatemala, Guatemala.,Gynecology Oncology, University of San Carlos de Guatemala Faculty of Medical Sciences, Guatemala, Guatemala
| | | | - Henrik Falconer
- Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.,Women's and Children's Health, Karolinska University Hospital, Stockholm, Sweden
| | - Jan Persson
- Obstetrics and Gynaecology, Skanes Universitetssjukhus Lund, Lund, Skåne, Sweden.,Clinical Sciences, Obstetrics and Gynaecology, Lund University Faculty of Medicine, Lund, Sweden
| | - Russell Land
- Gynaecologic Oncology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.,Faculty of Medicine, The University of Queensland, St Lucia, Queensland, Australia
| | - Fabio Martinelli
- Gynaecologic Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Andrea Garrett
- Gynaecologic Oncology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Alon Altman
- Gynecologic Oncology, University of Manitoba, Winnipeg, Manitoba, Canada.,Gynecologic Oncology, CancerCare Manitoba, Winnipeg, Manitoba, Canada
| | - Adam Pendlebury
- Gynaecological Oncology, Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - David Cibula
- Gynecology and Obstetrics, Charles University First Faculty of Medicine, Praha, Praha, Czech Republic.,Gynecology and Obstetrics, General University Hospital in Prague, Praha, Czech Republic
| | - Roberto Altamirano
- Gynecology Oncology, Universidad de Chile, Santiago de Chile, Chile.,Gynecology Oncology, Hospital Clinico San Borja Arriaran, Santiago, Chile
| | - Donal Brennan
- Gynaecology Oncology, Mater Misericordiae University Hospital, Dublin, Ireland.,School of Medicine, University College Dublin, Dublin, Ireland
| | - Thomas Edward Ind
- Gynaecological Oncology, Royal Marsden NHS Foundation Trust, London, UK.,Gynaecology, St George's University of London, London, UK
| | - Cornelis De Kroon
- Gynecology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
| | - Ka Yu Tse
- Obstetrics and Gynaecology, University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, Hong Kong
| | - George Hanna
- Surgery and Cancer, Imperial College London, London, UK
| | - Andreas Obermair
- Center for Clinical Research, Faculty of Medicine, University of Queensland, Herston, Queensland, Australia .,Queensland Centre for Gynaecologic Cancer Research, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| |
Collapse
|
3
|
Sykes P, Eva L, van der Griend R, McNally O, Blomfield P, Brand A, Tristram A, Bergzoll C, Petrich S, Kenwright D, Payne K, Kellow M, Innes C, Harker D, Perrin L, Cohen P, Jaaback K, Simcock B. Pathological process has a crucial role in sentinel node biopsy for vulvar cancer. Gynecol Oncol 2019; 153:292-296. [PMID: 30814024 DOI: 10.1016/j.ygyno.2019.02.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 12/16/2018] [Revised: 02/14/2019] [Accepted: 02/16/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To report the interim findings of an audit of the outcomes of sentinel node (SN) biopsy performed as a replacement for groin node dissection in women with early stage vulvar cancer in routine clinical practice in Australia and New Zealand. METHODS A prospective multi-center study in 8 participating centers. Eligible patients had squamous cell carcinomas clinically restricted to the vulva <4 cm in diameter. SN procedures and pathological assessment were to be performed in accordance with the methods published by the GROINSS-V collaboration [1]. RESULTS 130 women with apparent early stage vulvar cancer were enrolled. Seventeen women subsequently did not meet the eligibility criteria and were excluded. SNs were identified in 111/113 of the remaining women. Twenty-two women had positive nodes. Sixteen of these women had at least 12 months follow up and 7 (44%) had recurrent disease. Eighty-nine women had only negative nodes. Seventy-four of these women had at least 12 months follow up and 6 (8%) had recurrent disease (including 2 [2.7%] with recurrence in the groin). On subsequent review of the two women with negative SNs who had groin recurrences, it was found that the recommended pathology protocol had not been followed. In both cases, SN metastases were identified following serial sectioning of the nodes. CONCLUSIONS SN biopsy is feasible in routine clinical practice. However, undetected metastases in a removed SN may be associated with groin recurrence. To ensure patient safety, strict adherence to the pathology protocol is an essential component in the utilization of the sentinel lymph node technique in vulvar cancer.
Collapse
Affiliation(s)
- Peter Sykes
- Department of Obstetrics and Gynaecology, University of Otago, Christchurch, New Zealand; Christchurch Women's Hospital, Christchurch, New Zealand.
| | - Lois Eva
- National Women's Health, Auckland District Health Board, Auckland, New Zealand
| | | | - Orla McNally
- Royal Women's Hospital, Melbourne, Australia; Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia
| | - Penelope Blomfield
- Royal Hobart Hospital, Hobart, Australia; School of Medicine, University of Tasmania, Tasmania, Australia
| | | | | | | | | | | | - Kathryn Payne
- LabPlus, Auckland District Health Board, Auckland, New Zealand
| | - Mayada Kellow
- LabPlus, Auckland District Health Board, Auckland, New Zealand
| | - Carrie Innes
- Department of Obstetrics and Gynaecology, University of Otago, Christchurch, New Zealand
| | - Dianne Harker
- Department of Obstetrics and Gynaecology, University of Otago, Christchurch, New Zealand
| | - Lewis Perrin
- Mater Hospital, Brisbane, Australia; Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Paul Cohen
- St John of God Subiaco Hospital, Perth, Australia; Division of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Western Australia, Australia
| | | | - Bryony Simcock
- Department of Obstetrics and Gynaecology, University of Otago, Christchurch, New Zealand; Christchurch Women's Hospital, Christchurch, New Zealand
| |
Collapse
|