Old versus new FIGO staging systems in predicting overall survival in patients with uterine leiomyosarcoma: a study of 86 cases

OBJECTIVES

Uterine leiomyosarcoma (uLMS) was staged using the FIGO system for endometrial cancers. The new FIGO system takes into consideration tumor size disregarding myometrial and cervical involvement. We aimed to compare the two systems and see which more accurately predicts overall survival (OS).

METHODS

86 patients with uLMS (1984-2010) were retrospectively staged using both FIGO systems. Mean OS rates were estimated using the Kaplan-Meier method.

RESULTS

More patients had stage-I disease by the new FIGO system (42 versus 33). Five versus 18 and 27 versus 5 had old and new stage-II and III diseases respectively. Five and 4 patients with old stage II and III uLMS respectively were downstaged to stage I while 18 with old stage III were downstaged to stage II. Median follow-up was 23.5 months with a median OS of 114 (95% CI, 61-166) months. Although patients with stage I tumors had a higher mean OS rate compared to those with higher stage disease by either system, patients with old stage II-IV disease showed similar mean OS rates, with stage III-IV patients having a slightly better mean OS and a similar trend was observed with the new system. Patients with new FIGO stage III had a higher mean OS rate than those with stage II or IV disease (37.6 versus 28.1 and 34.3 months). Nonetheless, no statistical significant differences were seen in OS according to stage using either system (p=0.786 and p=0.400 respectively).

CONCLUSION

Neither FIGO staging system is ideal in classifying patients into four clinically significant stages.

The commercial production of chemicals using pathway engineering

Integration of metabolic pathway engineering and fermentation production technologies is necessary for the successful commercial production of chemicals. The 'toolbox' to do pathway engineering is ever expanding to enable mining of biodiversity, to maximize productivity, enhance carbon efficiency, improve product purity, expand product lines, and broaden markets. Functional genomics, proteomics, fluxomics, and physiomics are complementary to pathway engineering, and their successful applications are bound to multiply product turnover per cell, channel carbon efficiently, shrink the size of factories (i.e., reduce steel in the ground), and minimize product development cycle times to bring products to market.

Effect of warning on feigned malingering on the WAIS-R in college samples

Research indicates claimant malingering of cognitive deficits to be common in personal injury litigation. Efforts have been made to either detect such tendencies or deter efforts at malingering. The present study examined whether warning people that feigned malingering efforts would be detected results in more valid profiles on the Wechsler Adult Intelligence Scale-Revised. Undergraduates (N = 48) were randomly assigned to one of three conditions: feigned malingerers without warning, feigned malingerers with warning, and controls. Analysis indicated both feigned malingerer groups performed significantly worse than the control group; however, feigned malingerers with warning did not perform significantly better than those without warning. Unlike previous research using the Wechsler Memory Scale-Revised, results did not support effectiveness of warning in reducing feigned malingering scores.