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Sánchez-Iglesias JL, Morales-Coma C, Minig L, Lago V, Domingo S, Mancebo G, Siegrist J, Fidalgo García MS, Llueca A, Serra A, Cobas Lozano P, Lekuona Artola A, Gómez-Hidalgo NR, Acosta Ú, Ferrer-Costa R, Bradbury M, Pérez-Benavente A, Gil-Moreno A. Procalcitonin and C-reactive protein as early markers of anastomotic leakage in intestinal resections for advanced ovarian cancer (EDMOCS). Acta Obstet Gynecol Scand 2024. [PMID: 38532280 DOI: 10.1111/aogs.14834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 02/29/2024] [Accepted: 03/02/2024] [Indexed: 03/28/2024]
Abstract
INTRODUCTION Serum levels of procalcitonin and C-reactive protein (CRP) have been used to predict anastomotic leakage after colorectal surgery, but information is scarce in advanced ovarian cancer (AOC) surgery with bowel resection. This study aimed to assess the predictive value of procalcitonin and CRP in detecting anastomotic leakage after AOC surgery with bowel resection. The study also aimed to determine the optimal postoperative reference values and the best day for evaluating these markers. MATERIAL AND METHODS This prospective, observational and multicentric trial included 92 patients with AOC undergoing debulking surgery with bowel resection between 2017 and 2020 in 10 reference hospitals in Spain. Procalcitonin and CRP levels were measured at baseline and on postoperative days 1-6. Receiver operating characteristic analysis was performed to evaluate the predictive value of procalcitonin and CRP at each postoperative day. Sensitivity, specificity, positive and negative predictive values were calculated. RESULTS Anastomotic leakage was detected in six patients (6.5%). Procalcitonin and CRP values were consistently higher in patients with anastomotic leakage at all postoperative days. The maximum area under the curve (AUC) for procalcitonin was observed at postoperative day 1 (AUC = 0.823) with a cutoff value of 3.8 ng/mL (83.3% sensitivity, 81.3% specificity). For CRP, the maximum AUC was found at postoperative day 3 (AUC = 0.833) with a cutoff level of 30.5 mg/dL (100% sensitivity, 80.4% specificity). CONCLUSIONS Procalcitonin and C-reactive protein are potential biomarkers for early detection of anastomotic leakage after ovarian cancer surgery with bowel resection. Further prospective studies with a larger sample size are needed to confirm these findings.
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Affiliation(s)
- José Luis Sánchez-Iglesias
- Department of Gynecologic Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
- Biomedical Research Group in Gynecology, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Clara Morales-Coma
- Breast Pathology Unit, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Lucas Minig
- Department of Gynecologic Oncology, IMED Hospital, Valencia, Spain
- Department of Gynecology, CEU Cardenal Herrera University, Valencia, Spain
| | - Víctor Lago
- Department of Gynecology, CEU Cardenal Herrera University, Valencia, Spain
- Department of Gynecologic Oncology, La Fe University Hospital, Valencia, Spain
| | - Santiago Domingo
- Department of Gynecologic Oncology, La Fe University Hospital, Valencia, Spain
| | - Gemma Mancebo
- Gynecological Cancer Multidisciplinary Unit, Hospital del Mar, Barcelona, Spain
- Department of Gynecology, Universitat Pompeu Fabra, Barcelona, Spain
| | - Jaime Siegrist
- Oncologic Gynecology Unit, Department of Gynecology, La Paz University Hospital, Madrid, Spain
| | | | - Antoni Llueca
- Multidisciplinary Unit of Abdominal Pelvic Oncology Surgery, Hospital General Universitario de Castellon, Castellón, Spain
- Department of Medicine, Universidad Jaume I, Castellón, Spain
| | - Anna Serra
- Multidisciplinary Unit of Abdominal Pelvic Oncology Surgery, Hospital General Universitario de Castellon, Castellón, Spain
- Department of Medicine, Universidad Jaume I, Castellón, Spain
| | - Paloma Cobas Lozano
- Department of Gynecologic Oncology, Hospital Universitario Donostia, OSI Donostialde, Donostia, Spain
| | - Arantza Lekuona Artola
- Department of Gynecologic Oncology, Hospital Universitario Donostia, OSI Donostialde, Donostia, Spain
| | | | - Úrsula Acosta
- Department of Gynecologic Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Roser Ferrer-Costa
- Department of Biochemistry, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Melissa Bradbury
- Department of Gynecologic Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Assumpció Pérez-Benavente
- Department of Gynecologic Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
- Biomedical Research Group in Gynecology, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Antonio Gil-Moreno
- Department of Gynecologic Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
- Biomedical Research Group in Gynecology, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
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Clavero-Rovira L, Gómez-Tomás Á, Bassas-Freixas P, Bodet D, Ferrer B, Hernández-Losa J, Muñoz-Couselo E, Pérez-Benavente A, García-Patos V, Ferrándiz-Pulido C. Mucosal Melanoma Clinical Management and Prognostic Implications: A Retrospective Cohort Study. Cancers (Basel) 2024; 16:227. [PMID: 38201654 PMCID: PMC10778057 DOI: 10.3390/cancers16010227] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/22/2023] [Accepted: 12/25/2023] [Indexed: 01/12/2024] Open
Abstract
Mucosal melanoma (MM) is an uncommon melanoma subtype affecting mucosal surfaces of the head and neck, anorectal region, and vulvovaginal area. We aimed to present our experience at a tertiary-level hospital regarding MM diagnosis, management, monitoring of progression, mutations, and outcome predictors. We performed a registry-based cohort study including MM cases diagnosed from 2012 to 2022 and retrospectively characterized somatic mutations on BRAF, NRAS and c-KIT. We employed Kaplan-Meier curves, log-rank tests, and Cox regression analysis to explore prognostic factors and survival outcomes in a cohort of 35 patients, mainly women (63%) with a median age of 70 years. Predominantly, MM occurred in the vulvovaginal region (48.6%). At diagnosis, 28.6% had lymph node involvement, and 31.4% also had distant metastasis. Mutations in BRAF and c-KIT were identified in 3/35 (9%) and 2/6 patients (33%), respectively. Surgery was performed in 71.4% of patients, and most received systemic treatment (65.7%). Lower disease stage, thinner Breslow depth, and surgical resection were associated with improved overall survival. Notably, age, sex, radiotherapy, and BRAF mutant status did not affect survival. Standard management typically involves immunotherapy. Cases with BRAF or c-KIT mutations may be considered for targeted therapies. Unfortunately, MM prognosis remains unfavorable, with a less than 50% survival rate at 2 years.
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Affiliation(s)
- Laia Clavero-Rovira
- Department of Dermatology, University Hospital Vall d’Hebron, 08035 Barcelona, Spain; (L.C.-R.); (Á.G.-T.); (P.B.-F.); (D.B.); (V.G.-P.)
| | - Álvaro Gómez-Tomás
- Department of Dermatology, University Hospital Vall d’Hebron, 08035 Barcelona, Spain; (L.C.-R.); (Á.G.-T.); (P.B.-F.); (D.B.); (V.G.-P.)
- Facultad de Medicina, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain;
| | - Patricia Bassas-Freixas
- Department of Dermatology, University Hospital Vall d’Hebron, 08035 Barcelona, Spain; (L.C.-R.); (Á.G.-T.); (P.B.-F.); (D.B.); (V.G.-P.)
- Facultad de Medicina, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain;
| | - Domingo Bodet
- Department of Dermatology, University Hospital Vall d’Hebron, 08035 Barcelona, Spain; (L.C.-R.); (Á.G.-T.); (P.B.-F.); (D.B.); (V.G.-P.)
| | - Berta Ferrer
- Department of Pathology, University Hospital Vall d’Hebron, 08035 Barcelona, Spain; (B.F.); (J.H.-L.)
| | - Javier Hernández-Losa
- Department of Pathology, University Hospital Vall d’Hebron, 08035 Barcelona, Spain; (B.F.); (J.H.-L.)
| | - Eva Muñoz-Couselo
- Department of Oncology, University Hospital Vall d’Hebron, 08035 Barcelona, Spain;
| | - Assumpció Pérez-Benavente
- Facultad de Medicina, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain;
- Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, University Hospital Vall d’Hebron, 08035 Barcelona, Spain
| | - Vicente García-Patos
- Department of Dermatology, University Hospital Vall d’Hebron, 08035 Barcelona, Spain; (L.C.-R.); (Á.G.-T.); (P.B.-F.); (D.B.); (V.G.-P.)
- Facultad de Medicina, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain;
| | - Carla Ferrándiz-Pulido
- Department of Dermatology, University Hospital Vall d’Hebron, 08035 Barcelona, Spain; (L.C.-R.); (Á.G.-T.); (P.B.-F.); (D.B.); (V.G.-P.)
- Facultad de Medicina, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain;
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Luzarraga Aznar A, Pérez-Benavente A, Cabrera S, Bebia V, Gil-Moreno A, Angeles MA. Inguinofemoral lymphadenectomy technique in 10 steps. Int J Gynecol Cancer 2023; 33:1823-1824. [PMID: 37491110 DOI: 10.1136/ijgc-2023-004765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023] Open
Affiliation(s)
| | - Assumpció Pérez-Benavente
- Gynecologic Oncology Unit, Gynecology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Silvia Cabrera
- Gynecologic Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Vicente Bebia
- Gynecologic Oncology, Hospital Vall d'Hebron, Barcelona, Spain
| | - Antonio Gil-Moreno
- Gynecologic Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Martina Aida Angeles
- Department of Gynecological Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
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Luzarraga Aznar A, Bebia V, López-Gil C, Giraldo A, Montoya MP, Verges R, Jauregui A, Castellvi J, Pérez-Benavente A, Colás E, Gil-Moreno A, Cabrera S. Endometrial adenocarcinoma recurring in the lung: impact of molecular profile and role of local therapies on prognosis. Int J Gynecol Cancer 2023; 33:1564-1571. [PMID: 37726197 DOI: 10.1136/ijgc-2023-004534] [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: 09/21/2023] Open
Abstract
OBJECTIVES The objective of our study was to describe the characteristics of patients with endometrial cancer diagnosed with a first recurrence involving the lung, and to describe the prognostic role of the molecular profile. We also aimed to describe the prognostic outcomes after local treatment of recurrence (resection of lung metastases or stereotactic body radiation therapy) in a group of patients with isolated lung recurrence. METHODS This was a retrospective, single-center study between June 1995 and July 2021. The study included patients diagnosed with a first recurrence of endometrial cancer involving the lung. We defined two groups of patients: patients with isolated lung recurrence (confined to the lung) and patients with multisystemic recurrence (in the lung and other locations). RESULTS Among 1413 patients diagnosed with endometrial cancer in stage IA to IVA of the International Federation of Gynecology and Obstetrics (FIGO) 2009, 64 (4.5%) patients had a first recurrence involving the lung. Of these, 15 (39.1%) were of a non-specific molecular profile, 16 (25%) were p53-abnormal, 15 (23.4%) were mismatch-repair deficient, and 0% POLE-mutated. P53-abnormal patients had the shortest 3 year progression-free survival after recurrence and those with mismatch-repair deficient had the longest 3 year progression-free survival (14.3% (range; 1.6-40.3) and 47.6% (range; 9.1-79.5) respectively, p=0.001). We found no differences on overall survival after recurrence by molecular profile. Thirty-one of 64 (48.4%) patients had an isolated recurrence in the lung, and 16 (25%) patients received local treatment. When comparing patients with isolated lung recurrence, locally treated patients had a longer median progression-free survival than patients treated systemically (41.9 (range, 15.4-NA) vs 7.8 (range, 7.2-10.6) months respectively, p=0.029), a complete response rate of 80% for stereotactic body radiation therapy and a complete resection of 90.9% for surgery. CONCLUSION Although few patients will benefit from local treatment (stereotactic body radiation therapy or resection) after a recurrence involving the lung, local therapies might be considered as an option in oligometastatic lung recurrences as they achieve high local control rates and better oncological outcomes than systemic treatment alone.
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Affiliation(s)
- Ana Luzarraga Aznar
- Gynecologic Oncology, Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain
| | - Vicente Bebia
- Gynecologic Oncology, Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain
| | | | - Alexandra Giraldo
- Oncologic Radiotherapy, Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain
| | - M P Montoya
- Thoracic Surgery, Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain
| | - Ramona Verges
- Oncologic Radiotherapy, Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain
| | - Alberto Jauregui
- Thoracic Surgery, Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain
| | - Josep Castellvi
- Pathological Anatomy, Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain
| | | | - Eva Colás
- Gynecologic Oncology, Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Antonio Gil-Moreno
- Gynecology Department, Universitat Autonoma de Barcelona, Barcelona, Catalunya, Spain
| | - Silvia Cabrera
- Gynecologic Oncology, Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
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Angeles MA, Spagnolo E, Cabarrou B, Pérez-Benavente A, Gil Moreno A, Guyon F, Rychlik A, Migliorelli F, Bataillon G, Navarro AS, Betrian S, Ferron G, Hernández A, Martinez A. Impact of pattern of recurrence on post-relapse survival according to surgical timing in patients with advanced ovarian cancer. Int J Gynecol Cancer 2023; 33:50-56. [PMID: 36446410 DOI: 10.1136/ijgc-2022-003985] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Our study aimed to evaluate the association between timing of cytoreductive surgery and pattern of presentation of the first recurrence in patients with advanced ovarian cancer. We also aimed to assess the impact of the pattern of recurrence on post-relapse overall survival according to surgical timing. METHODS This retrospective multicenter study evaluated patients with International Federation of Gynecology and Obstetrics (FIGO) stage IIIC-IV ovarian cancer. Patients had undergone either primary debulking surgery, early interval debulking surgery after 3-4 cycles of neoadjuvant chemotherapy, or delayed debulking surgery after 6 cycles, with minimal or no residual disease, between January 2008 and December 2015. Survival analyses were conducted using the Log-rank test and the Cox model. Cumulative incidences of the different patterns of recurrence were estimated using a competing risks methodology. RESULTS A total of 549 patients were included: 175 (31.9%) patients had primary, 224 (40.8%) early interval, and 150 (27.3%) delayed debulking surgery. The cumulative incidence of peritoneal recurrences at 2 years was higher with increasing neoadjuvant cycles (24.4%, 30.9% and 39.2%; p=0.019). For pleural or pulmonary recurrences, it was higher after early interval surgery (9.9%, 13.0% and 4.1%; p=0.022). Median post-relapse overall survival was 33.5 months (95% confidence interval (CI) (24.3 to 44.2)), 26.8 months (95% CI (22.8 to 32.6)), and 24.5 months (95% CI (18.6 to 29.4)) for primary, early interval, and delayed debulking surgery groups, respectively (p=0.025). The pattern of recurrence in a lymph node (hazard ratio (HR) 0.42, 95% CI (0.27 to 0.64)), delayed surgery (HR 1.53, 95% CI (1.11 to 2.13)) and time to first recurrence (HR 0.95, 95% CI (0.93 to 0.96)) were associated with post-relapse overall survival. For primary and early interval surgery, lymph node recurrences were associated with significantly longer post-relapse overall survival. CONCLUSIONS The pattern of first recurrence was associated with timing of surgery, with peritoneal recurrences being more frequent with the increasing number of cycles of neoadjuvant chemotherapy. Lymph node recurrences were associated with better prognosis, having higher post-relapse overall survival. This improved prognosis of lymphatic recurrences was not observed in patients who underwent delayed surgery.
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Affiliation(s)
- Martina Aida Angeles
- Department of Surgical Oncology, Institut Claudius Regaud, Toulouse, Occitanie, France
| | - Emanuela Spagnolo
- Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain
| | - Bastien Cabarrou
- Biostatistics Unit, Institut Claudius Regaud, Toulouse, Occitanie, France
| | - Assumpció Pérez-Benavente
- Gynecologic Oncology Unit, Gynecology Department, Hospital Vall d'Hebron, Barcelona, Catalunya, Spain
| | - Antonio Gil Moreno
- Gynecology, Vall d'Hebron Hospital, SANT CUGAT DEL VALLÉS, Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Agnieszka Rychlik
- Maria Sklodowska-Curie National Research Institute of Oncology in Warsaw, Warszawa, Poland
| | - Federico Migliorelli
- Institut Clínic de Ginecologia, Obstetrícia i Neonatologia, BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Barcelona, Spain
| | - Guillaume Bataillon
- Department of Anatomopathology, Institut Claudius Regaud, Toulouse, Occitanie, France
| | - Anne-Sophie Navarro
- Department of Surgical Oncology, Institut Claudius Regaud, Toulouse, Occitanie, France
| | - Sarah Betrian
- Department of Medical Oncology, Institut Claudius Regaud, Toulouse University Cancer 32 Institute (IUCT), Oncopole, Toulouse, France
| | - Gwenael Ferron
- Department of Surgical Oncology, Institut Claudius Regaud, Toulouse, Occitanie, France
| | - Alicia Hernández
- Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain
| | - Alejandra Martinez
- Department of Surgical Oncology, Institut Claudius Regaud, Toulouse, Occitanie, France
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Bradbury M, Borràs E, Vilar M, Castellví J, Sánchez-Iglesias JL, Pérez-Benavente A, Gil-Moreno A, Santamaria A, Sabidó E. A combination of molecular and clinical parameters provides a new strategy for high-grade serous ovarian cancer patient management. J Transl Med 2022; 20:611. [PMID: 36544142 PMCID: PMC9773449 DOI: 10.1186/s12967-022-03816-7] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND High-grade serous carcinoma (HGSC) is the most common and deadly subtype of ovarian cancer. Although most patients will initially respond to first-line treatment with a combination of surgery and platinum-based chemotherapy, up to a quarter will be resistant to treatment. We aimed to identify a new strategy to improve HGSC patient management at the time of cancer diagnosis (HGSC-1LTR). METHODS A total of 109 ready-available formalin-fixed paraffin-embedded HGSC tissues obtained at the time of HGSC diagnosis were selected for proteomic analysis. Clinical data, treatment approach and outcomes were collected for all patients. An initial discovery cohort (n = 21) were divided into chemoresistant and chemosensitive groups and evaluated using discovery mass-spectrometry (MS)-based proteomics. Proteins showing differential abundance between groups were verified in a verification cohort (n = 88) using targeted MS-based proteomics. A logistic regression model was used to select those proteins able to correctly classify patients into chemoresistant and chemosensitive. The classification performance of the protein and clinical data combinations were assessed through the generation of receiver operating characteristic (ROC) curves. RESULTS Using the HGSC-1LTR strategy we have identified a molecular signature (TKT, LAMC1 and FUCO) that combined with ready available clinical data (patients' age, menopausal status, serum CA125 levels, and treatment approach) is able to predict patient response to first-line treatment with an AUC: 0.82 (95% CI 0.72-0.92). CONCLUSIONS We have established a new strategy that combines molecular and clinical parameters to predict the response to first-line treatment in HGSC patients (HGSC-1LTR). This strategy can allow the identification of chemoresistance at the time of diagnosis providing the optimization of therapeutic decision making and the evaluation of alternative treatment strategies. Thus, advancing towards the improvement of patient outcome and the individualization of HGSC patients' care.
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Affiliation(s)
- Melissa Bradbury
- grid.473715.30000 0004 6475 7299Centre de Regulació Genòmica, Barcelona Institute of Science and Technology (BIST), Dr Aiguader 88, 08003 Barcelona, Spain ,grid.5612.00000 0001 2172 2676Universitat Pompeu Fabra, Dr Aiguader 88, 08003 Barcelona, Spain ,grid.7080.f0000 0001 2296 0625Biomedical Research Group in Gynecology, Vall d’Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Vall, d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain ,grid.411083.f0000 0001 0675 8654Department of Gynecology, Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - Eva Borràs
- grid.473715.30000 0004 6475 7299Centre de Regulació Genòmica, Barcelona Institute of Science and Technology (BIST), Dr Aiguader 88, 08003 Barcelona, Spain ,grid.5612.00000 0001 2172 2676Universitat Pompeu Fabra, Dr Aiguader 88, 08003 Barcelona, Spain
| | - Marta Vilar
- grid.473715.30000 0004 6475 7299Centre de Regulació Genòmica, Barcelona Institute of Science and Technology (BIST), Dr Aiguader 88, 08003 Barcelona, Spain ,grid.7080.f0000 0001 2296 0625Biomedical Research Group in Gynecology, Vall d’Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Vall, d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - Josep Castellví
- grid.411083.f0000 0001 0675 8654Department of Pathology, Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - José Luis Sánchez-Iglesias
- grid.7080.f0000 0001 2296 0625Biomedical Research Group in Gynecology, Vall d’Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Vall, d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain ,grid.411083.f0000 0001 0675 8654Department of Gynecology, Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - Assumpció Pérez-Benavente
- grid.7080.f0000 0001 2296 0625Biomedical Research Group in Gynecology, Vall d’Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Vall, d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain ,grid.411083.f0000 0001 0675 8654Department of Gynecology, Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - Antonio Gil-Moreno
- grid.7080.f0000 0001 2296 0625Biomedical Research Group in Gynecology, Vall d’Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Vall, d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain ,grid.411083.f0000 0001 0675 8654Department of Gynecology, Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red (CIBERONC), Instituto de Salud Carlos III, Avenida de Monforte de Lemos 3-5, 28029 Madrid, Spain
| | - Anna Santamaria
- grid.7080.f0000 0001 2296 0625Biomedical Research Group in Gynecology, Vall d’Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Vall, d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain ,grid.7080.f0000 0001 2296 0625Cell Cycle and Cancer Laboratory, Biomedical Research Group in Urology, Vall Hebron Institut de Recerca, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - Eduard Sabidó
- grid.473715.30000 0004 6475 7299Centre de Regulació Genòmica, Barcelona Institute of Science and Technology (BIST), Dr Aiguader 88, 08003 Barcelona, Spain ,grid.5612.00000 0001 2172 2676Universitat Pompeu Fabra, Dr Aiguader 88, 08003 Barcelona, Spain
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Betrian S, Angeles MA, Gil Moreno A, Cabarrou B, Deslandres M, Ferron G, Mery E, Floquet A, Guyon F, Pérez-Benavente A, Spagnolo E, Rychlik A, Gladieff L, Hernández Gutiérrez A, Martinez A. Survival impact of histological response to neoadjuvant chemotherapy according to number of cycles in patients with advanced ovarian cancer. Int J Gynecol Cancer 2022; 32:ijgc-2021-003313. [PMID: 35858711 DOI: 10.1136/ijgc-2021-003313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE We sought to evaluate the impact of chemotherapy response score according to the number of cycles of neoadjuvant chemotherapy, on disease-free survival and overall survival, in patients with advanced epithelial ovarian cancer ineligible for primary debulking surgery. METHODS This multicenter retrospective study included patients with International Federation of Gynecology and Obstetrics (FIGO) stage IIIC-IV epithelial ovarian cancer who underwent 3-4 or 6 cycles of a platinum and taxane-based neoadjuvant chemotherapy, followed by complete cytoreduction surgery (CC-0) or cytoreduction to minimal residual disease (CC-1), between January 2008 and December 2015, in four institutions. Disease-free survival and overall survival were assessed according to the histological response to chemotherapy defined by the validated chemotherapy response score. RESULTS A total of 365 patients were included: 219 (60.0%) received 3-4 cycles of neoadjuvant chemotherapy, and 146 (40.0%) had 6 cycles of neoadjuvant chemotherapy before cytoreductive surgery. There were no significant differences in early relapses, disease-free survival, and overall survival according to the number of neoadjuvant chemotherapy cycles. However, regardless of the number cycles of neoadjuvant chemotherapy, persistent extensive histological disease (chemotherapy response score 1-2) was significantly associated with a higher peritoneal cancer index, minimal residual disease (CC-1), and early relapses. Median disease-free survival in patients with complete or near-complete response (score 3) was 28.3 months (95% CI 21.6 to 36.8), whereas it was 16.3 months in patients with chemotherapy response score 1-2 (95% CI 14.7 to 18.0, p<0.001). CONCLUSION In our cohort, the number of neoadjuvant chemotherapy cycles was not associated with disease-free survival or overall survival. Chemotherapy response score 3 improved oncological outcome regardless of the number of neoadjuvant chemotherapy cycles.
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Affiliation(s)
- Sarah Betrian
- Department of Medical Oncology, Institut Universitaire du Cancer de Toulouse, Toulouse, France
| | - Martina Aida Angeles
- Surgical Oncology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - Antonio Gil Moreno
- Gynecology, Vall d'Hebron Hospital, Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Bastien Cabarrou
- Biostatistics Unit, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - Marion Deslandres
- Department of Medical Oncology, Institut Universitaire du Cancer de Toulouse, Toulouse, France
| | - Gwenael Ferron
- Surgical Oncology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - Eliane Mery
- Pathology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - Anne Floquet
- Medical Oncology Department, Institut Bergonié, Bordeaux, France
| | | | | | - Emanuela Spagnolo
- Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain
| | - Agnieszka Rychlik
- Maria Sklodowska-Curie National Research Institute of Oncology in Warsaw, Warszawa, Poland
| | - Laurence Gladieff
- Department of Medical Oncology, Institut Universitaire du Cancer de Toulouse, Toulouse, France
| | | | - Alejandra Martinez
- Surgical Oncology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
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Bradbury M, Rabasa J, Murcia MT, Dinarès MC, Sainz A, Castellet C, Pérez-Benavente A, Gil-Moreno A, Centeno C. Can We Reduce Overtreatment of Cervical High-Grade Squamous Intraepithelial Lesions? J Low Genit Tract Dis 2022; 26:20-26. [PMID: 34928250 DOI: 10.1097/lgt.0000000000000635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 12/29/2022]
Abstract
OBJECTIVE The aim was to evaluate the cytology, colposcopic, and pathological factors associated with the absence of high-grade squamous intraepithelial lesion (HSIL)/cervical intraepithelial neoplasia (CIN) 2-3 lesion on loop electrosurgical excision procedure (LEEP) specimens in women with high-grade cytology and/or HSIL/CIN 2-3 biopsy and the risk of disease persistence/recurrence. MATERIALS AND METHODS Two-center retrospective study of women undergoing LEEP for high-grade cervical disease between January 2014 and December 2019. Clinical, cytology, colposcopy, and pathology results were evaluated to identify independent predictive factors associated with CIN 1/negative LEEP results. Univariate and multivariate logistic regression models were performed. Follow-up data was evaluated to assess the risk of HSIL/CIN 2-3 persistence/recurrence. RESULTS Six hundred thirty-nine of 801 women (79.8%) had high-grade cytology and 631 (78.8%) HSIL/CIN 2-3 biopsy. High-risk human papillomavirus test was positive in 98% of women. Loop electrosurgical excision procedure specimen showing CIN 1 or less was found in 27%-31%. Normal/low-grade colposcopy (odds ratio [OR] = 2.17, CI = 1.39-3.39, p = .001) and CIN 1/negative biopsy (OR = 3.25, CI = 2.12-4.99, p < .001) were predictors of negative/CIN 1 LEEP result in women with high-grade cytology. Normal/low-grade cytology (OR = 1.77, CI = 1.19-2.64, p = .005), normal/low-grade colposcopy (OR = 1.66, CI = 1.11-2.49, p = .013), and CIN 2 biopsy (OR = 2.75, CI = 1.73-4.39, p < .001) were predictors in women with HSIL/CIN 2-3 biopsy. Women with a negative/CIN 1 LEEP had lower recurrence/persistence than those with confirmed HSIL/CIN 2-3(1 vs 31, p = .002). Positive endocervical margin (OR = 2.85, CI = 1.10-7.36, p = .03) and high-risk human papillomavirus persistence (OR = 41.3, CI = 16-106.7, p < .01) were predictors of HSIL/CIN 2-3 persistence/recurrence. CONCLUSIONS A CIN 1/negative LEEP specimen in women with high-grade cytology and/or HSIL/CIN 2-3 biopsy is associated with negative/low-grade cytology, normal/low-grade colposcopic findings and CIN 2 biopsy result before treatment. The HSIL/CIN 2-3 disease persistence/recurrence is low when LEEP specimen does not confirm HSIL/CIN 2-3.
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Affiliation(s)
| | - Jordi Rabasa
- Department of Gynecology and Obstetrics, Hospital Universitari Sagrat Cor, Barcelona, Spain
| | - Maria Teresa Murcia
- Gynecological Oncology Unit, Department of Gynecology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Maria Carme Dinarès
- Department of Pathology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Alex Sainz
- Gynecological Oncology Unit, Department of Gynecology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Cristina Castellet
- Department of Gynecology and Obstetrics, Hospital Universitari Sagrat Cor, Barcelona, Spain
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Moreno-Sepulveda J, Romeral C, Niño G, Pérez-Benavente A. The Effect of Laparoscopic Endometrioma Surgery on Anti-Müllerian Hormone: A Systematic Review of the Literature and Meta-Analysis. JBRA Assist Reprod 2021; 26:88-104. [PMID: 34755503 PMCID: PMC8769171 DOI: 10.5935/1518-0557.20210060] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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] [Indexed: 11/20/2022] Open
Abstract
Objective This study aimed to assess the effect of endometrioma surgery on ovarian reserve by measuring anti-Müllerian hormone (AMH) levels. Methods This systematic review and meta-analysis included observational studies and randomized clinical trials published in English referenced in MEDLINE, SCOPUS and Cochrane (1982-2019). We included studies that reported AMH levels in the pre and post-operative period of patients undergoing laparoscopic surgery for endometrioma. Preoperative AMH was defined as the baseline AMH; short term AMH was measured no later than a month after surgery; medium term AMH was measured between one and six months after surgery; and long-term AMH was measured six or more months after surgery. Results Thirty-six studies met the inclusion criteria. A significant decrease was observed in short, medium and long-term post-operative AMH levels when compared with baseline AMH. However, there were no differences between short and long-term post-operative AMH levels, suggesting a non-significant recovery after one year of follow-up. A significant decrease in post-operative AMH was observed in bilateral endometriomas compared with unilateral cases. In addition, patients with endometriomas presented a significant decline in post-operative AMH compared with patients with other benign ovarian conditions. The decrease in post-operative AMH was significantly greater in bilateral cystectomy when compared with vaporization with bipolar energy or laser. We also observed a greater decrease in post-operative AMH with bipolar energy hemostasis compared with suture and hemostatic agents. These results should be taken with caution due to the high heterogeneity of the studies analyzed. Conclusions Endometrioma surgery has a deleterious effect on short, medium, and long-term post-operative AMH levels. Bilateral endometriomas and endometriomas greater than 7 cm have been associated with greater decreases in AMH. The mechanical resection of healthy tissue and the inflammatory damage on the ovarian cortex might explain the diminishing of ovarian reserve.
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Affiliation(s)
- José Moreno-Sepulveda
- Obstetrics and Gynecology Department, Universitat Autònoma de Barcelona Campus Universitario UAB, 08193 Bellaterra, Cerdanyola del Vallès, Spain.,Clínica de la Mujer Medicina Reproductiva Alejandro Navarrete 2606, Viña del Mar, Chile
| | - Carolina Romeral
- Obstetrics and Gynecology Department, Universitat Autònoma de Barcelona Campus Universitario UAB, 08193 Bellaterra, Cerdanyola del Vallès, Spain.,Obstetrics and Gynecology Department, Hospital de Manacor Carretera Manacor Alcudia, s/n, 07500 Manacor, Spain
| | - Geraldine Niño
- Hospital Carlos Van Buren San Ignacio 725, Valparaíso, Chile
| | - Assumpció Pérez-Benavente
- Obstetrics and Gynecology Department, Universitat Autònoma de Barcelona Campus Universitario UAB, 08193 Bellaterra, Cerdanyola del Vallès, Spain.,Gynecologic Oncology Unit, Vall d'Hebron University Hospital, Passeig de la Vall d'Hebron, 119, 08035, Barcelona, Spain
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Bradbury M, Borràs E, Pérez-Benavente A, Gil-Moreno A, Santamaria A, Sabidó E. Proteomic Studies on the Management of High-Grade Serous Ovarian Cancer Patients: A Mini-Review. Cancers (Basel) 2021; 13:cancers13092067. [PMID: 33922979 PMCID: PMC8123279 DOI: 10.3390/cancers13092067] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 03/17/2021] [Revised: 04/14/2021] [Accepted: 04/22/2021] [Indexed: 01/23/2023] Open
Abstract
High-grade serous ovarian cancer (HGSC) remains the most common and deadly subtype of ovarian cancer. It is characterized by its late diagnosis and frequent relapse despite standardized treatment with cytoreductive surgery and platinum-based chemotherapy. The past decade has seen significant advances in the clinical management and molecular understanding of HGSC following the publication of the Cancer Genome Atlas (TCGA) researchers and the introduction of targeted therapies with anti-angiogenic drugs and poly(ADP-ribose) polymerase inhibitors in specific subgroups of patients. We provide a comprehensive review of HGSC, focusing on the most important molecular advances aimed at providing a better understanding of the disease and its response to treatment. We emphasize the role that proteomic technologies are now playing in these two aspects of the disease, through the identification of proteins and their post-translational modifications in ovarian cancer tumors. Finally, we highlight how the integration of proteomics with genomics, exemplified by the work performed by the Clinical Proteomic Tumor Analysis Consortium (CPTAC), can guide the development of new biomarkers and therapeutic targets.
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Affiliation(s)
- Melissa Bradbury
- Centre de Regulació Genòmica, Barcelona Institute of Science and Technology (BIST), Dr Aiguader 88, 08003 Barcelona, Spain; (M.B.); (E.B.)
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Dr Aiguader 88, 08003 Barcelona, Spain
- Biomedical Research Group in Gynecology, Vall d’Hebron Institut de Recerca, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (A.P.-B.); (A.G.-M.)
- Gynecologic Oncology Unit, Department of Gynecology, Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - Eva Borràs
- Centre de Regulació Genòmica, Barcelona Institute of Science and Technology (BIST), Dr Aiguader 88, 08003 Barcelona, Spain; (M.B.); (E.B.)
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Dr Aiguader 88, 08003 Barcelona, Spain
| | - Assumpció Pérez-Benavente
- Biomedical Research Group in Gynecology, Vall d’Hebron Institut de Recerca, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (A.P.-B.); (A.G.-M.)
- Gynecologic Oncology Unit, Department of Gynecology, Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - Antonio Gil-Moreno
- Biomedical Research Group in Gynecology, Vall d’Hebron Institut de Recerca, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (A.P.-B.); (A.G.-M.)
- Gynecologic Oncology Unit, Department of Gynecology, Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red (CIBERONC), Instituto de Salud Carlos III, Avenida de Monforte de Lemos 3-5, 28029 Madrid, Spain
| | - Anna Santamaria
- Biomedical Research Group in Gynecology, Vall d’Hebron Institut de Recerca, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (A.P.-B.); (A.G.-M.)
- Cell Cycle and Cancer Laboratory, Biomedical Research Group in Urology, Vall Hebron Institut de Recerca, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain
- Correspondence: (A.S.); (E.S.)
| | - Eduard Sabidó
- Centre de Regulació Genòmica, Barcelona Institute of Science and Technology (BIST), Dr Aiguader 88, 08003 Barcelona, Spain; (M.B.); (E.B.)
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Dr Aiguader 88, 08003 Barcelona, Spain
- Correspondence: (A.S.); (E.S.)
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Bradbury M, Centeno C, Pérez-Benavente A, Gil-Moreno A. Clinical Challenges in Managing Cervical Intraepithelial Neoplasia 2: A Report From a Cross-sectional Survey. J Low Genit Tract Dis 2021; 25:119-125. [PMID: 33631780 DOI: 10.1097/lgt.0000000000000594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aims of the study were to determine the management strategies offered to women with cervical intraepithelial neoplasia 2 (CIN 2) and the attitude of colposcopists toward its histological diagnosis and to identify the criteria used to select women for conservative management. METHODS Colposcopists working in Spain were invited to participate in an online questionnaire via the Spanish Gynecology and Colposcopy Societies. The survey included 42 questions covering the 3 objectives of the study. One hundred eighty-two colposcopists representing all autonomous regions in Spain responded. The response rate was 26.2%, considering the total number of members. RESULTS Most colposcopists offer conservative management in selected cases (153/182). The preferred follow-up interval is 6 months (65%), followed by 3-4 months (30%). Observation was considered no longer appropriate after 24 months (29.5%) and 12 months (26.3%), and 24.3% expressed that it depended on women's plan to conceive. During conservative management, 93.9% always perform a cytology, 62.7% human papillomavirus testing, 96.8% colposcopy, 47.9% cervical biopsy, and 28.1% endocervical curettage. Forty-five percent consider that CIN 2 merely represents a misclassified CIN 1 or CIN 3, whereas 46.2% think that CIN 2 lesions are unlikely to regress. Most respondents considered that age older than 40 years (81.3%), human papillomavirus 16 infection (62.1%), HIV infection (76.8%), positive p16 immunostaining (60.2%), a large lesion occupying more than 50% of the cervix (87%), endocervical involvement (91.6%), and previous treatment for CIN 2-3 (77%) are contraindications for conservative management. CONCLUSIONS Management of CIN 2 remains challenging for colposcopists, and a lack of consensus still exists in clinical practice. A better understanding of the natural history of CIN 2 and its clinical outcomes is still necessary to guide clinicians in its management.
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Gil-Moreno A, Alonso-Alconada L, Díaz-Feijoo B, Domingo S, Vilar A, Hernández A, Gilabert J, Llueca A, Torné A, de Santiago J, Carbonell-Socias M, Lago V, Arias E, Sampayo V, Siegrist J, Chipirliu A, Sánchez-Iglesias JL, Pérez-Benavente A, Padilla-Iserte P, Santacana M, Matias-Guiu X, Abal M, Lopez-Lopez R. M-TRAP: Safety and performance of metastatic tumor cell trap device in advanced ovarian cancer patients. Gynecol Oncol 2021; 161:681-686. [PMID: 33795131 DOI: 10.1016/j.ygyno.2021.03.022] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 03/19/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Despite radical surgery and chemotherapy, most patients with ovarian cancer die due to disease progression. M-Trap is an implantable medical device designed to capture peritoneal disseminated tumor cells with the aim to focalize the disease. This trial analyzed the safety and performance of the device. METHODS This first-in-human prospective, multi-center, non-blinded, single-arm study enrolled 23 women with high-grade serous advanced ovarian cancer. After primary or interval debulking surgery, 3 M-Trap devices were placed in the peritoneum of the abdominal cavity. 18-months post-implantation or at disease progression, devices were initially removed by laparoscopy. The primary safety endpoint was freedom from device and procedure-related major adverse events (MAEs) through 6-months post-implantation compared to an historical control. The primary performance endpoint was histopathologic evidence of tumor cells capture. RESULTS Only one major adverse event was attributable to the device. 18 women were free of device and procedure related MAEs (78.3%). However, the primary safety endpoint was not achieved (p = 0.131), primarily attributable to the greater surgical complexity of the M-Trap patient population. 62% of recurrent patients demonstrated tumor cell capture in at least one device with a minimal tumor cell infiltration. No other long-term device-related adverse events were reported. The secondary performance endpoint demonstrated a lack of disease focalization. CONCLUSIONS The M-Trap technology failed to meet its primary safety objective, although when adjusted for surgical complexity, the study approved it. Likewise, the devices did not demonstrate the anticipated benefits in terms of tumor cell capture and disease focalization in recurrent ovarian cancer.
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Affiliation(s)
- Antonio Gil-Moreno
- Department of Gynecologic Oncology, Vall d'Hebron University Hospital, Barcelona, Spain; Biomedical Research Group in Gynecology, Vall Hebron Research Institute (VHIR), Universitat Autonoma de Barcelona, CIBERONC, Barcelona, Spain.
| | | | - Berta Díaz-Feijoo
- Department of Gynecologic Oncology, Vall d'Hebron University Hospital, Barcelona, Spain; Biomedical Research Group in Gynecology, Vall Hebron Research Institute (VHIR), Universitat Autonoma de Barcelona, CIBERONC, Barcelona, Spain
| | - Santiago Domingo
- Department of Gynecology Oncology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Ana Vilar
- Department of Gynecology, University Hospital of Santiago de Compostela, Spain
| | - Alicia Hernández
- Department of Gynecology, University Hospital La Paz, Madrid, Spain
| | - Juan Gilabert
- Department of Obstetrics and Gynecology, Hospital General Universitario de Valencia, Universidad de Valencia, Valencia, Spain
| | - Antoni Llueca
- Department of Obstetrics and Gynecology, Hospital General Universitari de Castelló, Castelló de la Plana, Spain
| | - Aureli Torné
- Institute Clinic of Gynecology, Obstetrics and Neonatology, Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | | | - Melchor Carbonell-Socias
- Department of Gynecologic Oncology, Vall d'Hebron University Hospital, Barcelona, Spain; Biomedical Research Group in Gynecology, Vall Hebron Research Institute (VHIR), Universitat Autonoma de Barcelona, CIBERONC, Barcelona, Spain
| | - Víctor Lago
- Department of Gynecology Oncology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Efigenia Arias
- Department of Gynecology, University Hospital of Santiago de Compostela, Spain
| | - Victoria Sampayo
- Department of Gynecology, University Hospital of Santiago de Compostela, Spain
| | - Jaime Siegrist
- Department of Gynecology, University Hospital La Paz, Madrid, Spain
| | - Anca Chipirliu
- Department of Obstetrics and Gynecology, Hospital General Universitario de Valencia, Universidad de Valencia, Valencia, Spain
| | - Jose Luis Sánchez-Iglesias
- Department of Gynecologic Oncology, Vall d'Hebron University Hospital, Barcelona, Spain; Biomedical Research Group in Gynecology, Vall Hebron Research Institute (VHIR), Universitat Autonoma de Barcelona, CIBERONC, Barcelona, Spain
| | - Assumpció Pérez-Benavente
- Department of Gynecologic Oncology, Vall d'Hebron University Hospital, Barcelona, Spain; Biomedical Research Group in Gynecology, Vall Hebron Research Institute (VHIR), Universitat Autonoma de Barcelona, CIBERONC, Barcelona, Spain
| | - Pablo Padilla-Iserte
- Department of Gynecology Oncology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Maria Santacana
- Department of Pathology and Molecular Genetics and Research Laboratory, Hospital Universitari Arnau de Vilanova, University of Lleida, IRBLleida, CIBERONC, Lleida, Spain
| | - Xavier Matias-Guiu
- Department of Pathology and Molecular Genetics and Research Laboratory, Hospital Universitari Arnau de Vilanova, University of Lleida, IRBLleida, CIBERONC, Lleida, Spain
| | - Miguel Abal
- Nasasbiotech, S.L., A Coruña, Spain; Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela (SERGAS), CIBERONC, Santiago de Compostela, Spain
| | - Rafael Lopez-Lopez
- Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela (SERGAS), CIBERONC, Santiago de Compostela, Spain.
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Díaz-Feijoo B, Bebia V, Hernández A, Gilabert-Estalles J, Franco-Camps S, de la Torre J, Segrist J, Chipirliu A, Cabrera S, Pérez-Benavente A, Gil-Moreno A. Surgical complications comparing extraperitoneal vs transperitoneal laparoscopic aortic staging in early stage ovarian and endometrial cancer. Gynecol Oncol 2020; 160:83-90. [PMID: 33160695 DOI: 10.1016/j.ygyno.2020.10.038] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 10/29/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To determine whether the extraperitoneal approach for paraaortic staging lymphadenectomy results in a lower rate of surgical complications compared to the transperitoneal approach, without compromising oncological outcomes. METHODS Prospective randomized multicenter study of patients with early endometrial or ovarian cancer undergoing paraaortic lymphadenectomy in 2010-2019. Patients were randomized to minimally invasive surgery (laparoscopy or robotic-assisted) using an extraperitoneal or a transperitoneal approach. The primary end point measure was a composite outcome that included developing one or more of the following surgical complications: bleeding during paraaortic lymphadenectomy ≥500 mL, any intraoperative complication related to paraaortic lymphadenectomy, severe postoperative complication (Dindo ≥ IIIA), impossibility to complete the procedure, or conversion to laparotomy. RESULTS There were 103 patients in the extraperitoneal group and 100 in the transperitoneal group. Differences in the composite outcome (transperitoneal 26.0% vs, extraperitoneal 18.4%; P = 0.195) were not found. Differences in the operative time, conversion to laparotomy, intraoperative bleeding, or survival were not observed. A higher number of lymph nodes were retrieved through the extraperitoneal approached (median, interquartile range [IQR] 12 [7-17] vs, 14 [10-19]: P = 0.026). Older age and greater body mass index (BMI) or waist-to-hip ratio (WHR) increased the risk for surgical complications independently of the laparoscopic approach. CONCLUSIONS The extraperitoneal approach did not show differences regarding surgical and oncological parameters compared with the transperitoneal approach, although the number of aortic nodes retrieved was higher. The decision to use one or another laparoscopic route is a matter of the surgeon preference. Trial registration ClinicalTrials.gov.identifier: NCT02676726.
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Affiliation(s)
- Berta Díaz-Feijoo
- Gynecological Oncology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain; Institute Clinic of Gynecology, Obstetrics and Neonatology, Hospital Clinic de Barcelona Institut d'Investigacions Biome'diques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.
| | - Vicente Bebia
- Gynecological Oncology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alicia Hernández
- Department of Gynecology, Hospital Universitario La Paz, Madrid, Spain
| | | | - Silvia Franco-Camps
- Gynecological Oncology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Javier de la Torre
- Gynecological Oncology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jaime Segrist
- Department of Gynecology, Hospital Universitario La Paz, Madrid, Spain
| | - Anca Chipirliu
- Department of Gynecology, Hospital General Universitario de Valencia, Valencia, Spain
| | - Silvia Cabrera
- Gynecological Oncology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Assumpció Pérez-Benavente
- Gynecological Oncology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Antonio Gil-Moreno
- Gynecological Oncology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer, CIBERONC, Madrid, Spain
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Bebia V, Monreal-Clua S, Pérez-Benavente A, Franco-Camps S, Díaz-Feijoo B, Gil-Moreno A. Potential strategies for prevention of tumor spillage in minimally invasive radical hysterectomy. J Gynecol Oncol 2020; 31:e73. [PMID: 32808499 PMCID: PMC7440988 DOI: 10.3802/jgo.2020.31.e73] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 05/04/2020] [Accepted: 05/17/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE The publication of a prospective [1] and several retrospective [2,3] studies describing a worse prognosis in patients affected with early-stage cervical cancer who underwent a minimally invasive radical hysterectomy has raised a high concern in what measures should be undertaken in order to revert these results. Potential strategies [4] to prevent tumor spillage have been previously proposed. METHODS In this video, we describe nine strategies that should be addressed in future trials regarding this procedure. RESULTS These strategies are: 1. Fallopian tubes should be coagulated prior to start the surgery. 2. All sentinel lymph nodes and lymphadenectomy specimens should be obtained without lymph nodes fragmentation. 3. All surgical specimens should be extracted within a containment bag. 4. Uterine manipulators must never be used. 5. Prior to vaginal section, a closed knotted ligature should be placed around the vagina, proximal to the section line, and the remaining vaginal cavity profusely washed. 6. Once the vagina is opened, the surgical specimen should be extracted vaginally within a specimen retrieval bag. 7. After surgery, the pelvic cavity is profusely washed with physiological serum, and the vagina should be washed with iodopovidone diluted to 10% [5]. 8. Port-site metastasis prevention measures should be performed. 9. Every action made to prevent tumor spillage should be recorded in the surgical report. CONCLUSION As there is a biological rationale in these measures that would prevent tumor spillage and seeding, there is a need of prospectively exploring them within appropriate studies in order to determine their own oncological outcome.
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Affiliation(s)
- Vicente Bebia
- Gynecologic Oncology Unit, Vall d'Hebron University Hospital, Barcelona, Spain.
| | - Sonia Monreal-Clua
- Gynecologic Oncology Unit, Vall d'Hebron University Hospital, Barcelona, Spain
| | | | - Silvia Franco-Camps
- Gynecologic Oncology Unit, Vall d'Hebron University Hospital, Barcelona, Spain
| | | | - Antonio Gil-Moreno
- Gynecologic Oncology Unit, Vall d'Hebron University Hospital, Barcelona, Spain
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Cabrera S, Bebia V, Franco-Camps S, Forcada C, Villasboas-Rosciolesi D, Navales I, Pérez-Benavente A, Gil-Moreno A. Technetium-99m-indocyanine green versus technetium-99m-methylene blue for sentinel lymph node biopsy in early-stage endometrial cancer. Int J Gynecol Cancer 2020; 30:311-317. [PMID: 31992599 DOI: 10.1136/ijgc-2019-000923] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 09/14/2019] [Revised: 12/12/2019] [Accepted: 12/19/2019] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION The low accuracy of pre-operative imaging techniques for prediction of nodal status strengthens the relevance of sentinel lymph node (SLN) biopsy in endometrial cancer, although the optimal method for its detection is still under investigation. The increasing use of indocyanine green (ICG) has aroused concern about its enhanced visualization of lymphatic channels, which could lead to a specimen that is thought to be nodal tissue not subsequently yielding a lymph node on pathologic analysis ('empty node packet'). Our main objective was to compare the overall and bilateral detection rates for SLN biopsy using two combined techniques: technetium-99m-ICG (Tc-99m-ICG) versus technetium-99m-methylene blue (Tc-99m-MB). Our secondary aim was to compare the 'empty node packet' rates between the two cohorts. METHODS A prospective, non-randomized, single-center trial including patients diagnosed with endometrial cancer (any grade or histology) in pre-operative early stage, and operated on between February 2017 and July 2019. All tracers were injected intracervically. Pelvic and aortic lymphadenectomy were performed on patients at intermediate or high risk of recurrence pre-operatively. All SLNs were sent for intra-operative frozen section and afterwards processed following an ultrastaging protocol. RESULTS Eighty-four patients were included, 58% (n=49) in the Tc-99m-MB group and 42% (n=35) in the Tc-99m-ICG group. Overall detection rate was 93% and was not statistically different between the two groups. A better bilateral detection rate was observed among Tc-99m-ICG patients (69% vs 41%, p=0.012). The 'empty node packet' rate was 4% in the Tc-99m-ICG cohort and 0% in the Tc-99m-MB cohort (p=0.032). DISCUSSION Tc-99m-ICG is a feasible, safe technique for SLN biopsy in early-stage endometrial cancer, and appears to be superior in terms of bilateral detection to Tc-99m-MB. The addition of Tc-99m to ICG could decrease the rate of 'empty node packets' and better define the anatomic location of SLNs in patients with endometrial cancer.
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Affiliation(s)
- Silvia Cabrera
- Gynecologic Oncology Unit, Gynecology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain .,Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Vicente Bebia
- Gynecologic Oncology Unit, Gynecology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Silvia Franco-Camps
- Gynecologic Oncology Unit, Gynecology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Cristina Forcada
- Gynecologic Oncology Unit, Gynecology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Diego Villasboas-Rosciolesi
- Nuclear Medicine Department, Institut de Diagnòstic per Ia Imatge, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Ignacio Navales
- Nuclear Medicine Department, Institut de Diagnòstic per Ia Imatge, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Assumpció Pérez-Benavente
- Gynecologic Oncology Unit, Gynecology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Antonio Gil-Moreno
- Gynecologic Oncology Unit, Gynecology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
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Rabasa J, Bradbury M, Sanchez-Iglesias JL, Guerrero D, Forcada C, Alcalde A, Pérez-Benavente A, Cabrera S, Ramon-Cajal S, Hernandez J, Dinares C, García A, Centeno C, Gil-Moreno A. Evaluation of the intraoperative human papillomavirus test as a marker of early cure at 12 months after electrosurgical excision procedure in women with cervical high-grade squamous intraepithelial lesion: a prospective cohort study. BJOG 2019; 127:99-105. [PMID: 31502397 DOI: 10.1111/1471-0528.15932] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To evaluate if the intraoperative human papillomavirus (IOP-HPV) test has the same prognostic value as the HPV test performed at 6 months after treatment of high-grade squamous intraepithelial lesion (HSIL) to predict treatment failure. DESIGN Prospective cohort study. SETTING Barcelona, Spain. POPULATION A cohort of 216 women diagnosed with HSIL and treated with loop electrosurgical excision procedure (LEEP). METHODS After LEEP, an HPV test was performed using the Hybrid Capture 2 system. If this was positive, genotyping was performed with the CLART HPV2 technique. The IOP-HPV test was compared with HPV test at 6 months and with surgical margins. MAIN OUTCOME MEASURE Treatment failure. RESULTS Recurrence rate of HSIL was 6%. There was a strong association between a positive IOP-HPV test, a positive 6-month HPV test, positive HPV 16 genotype, positive surgical margins and HSIL recurrence. Sensitivity, specificity, and positive and negative predictive values of the IOP-HPV test were 85.7, 80.8,24.0 and 98.8% and of the HPV test at 6 months were 76.9, 75.8, 17.2 and 98.0%. CONCLUSION Intraoperative HPV test accurately predicts treatment failure in women with cervical intraepithelial neoplasia grade 2/3. This new approach may allow early identification of patients with recurrent disease, which will not delay the treatment. Genotyping could be useful in detecting high-risk patients. TWEETABLE ABSTRACT IOP-HPV test accurately predicts treatment failure in women with CIN 2/3.
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Affiliation(s)
- J Rabasa
- Department of Gynaecology and Obstetrics, Vall d'Hebron University Hospital, Barcelona, Spain
| | - M Bradbury
- Department of Gynaecology and Obstetrics, Vall d'Hebron University Hospital, Barcelona, Spain
| | - J L Sanchez-Iglesias
- Department of Gynaecology and Obstetrics, Vall d'Hebron University Hospital, Barcelona, Spain
| | - D Guerrero
- Department of Gynaecology and Obstetrics, Vall d'Hebron University Hospital, Barcelona, Spain
| | - C Forcada
- Department of Gynaecology and Obstetrics, Vall d'Hebron University Hospital, Barcelona, Spain
| | - A Alcalde
- Department of Gynaecology and Obstetrics, Vall d'Hebron University Hospital, Barcelona, Spain
| | - A Pérez-Benavente
- Department of Gynaecology and Obstetrics, Vall d'Hebron University Hospital, Barcelona, Spain
| | - S Cabrera
- Department of Gynaecology and Obstetrics, Vall d'Hebron University Hospital, Barcelona, Spain
| | - S Ramon-Cajal
- Department of Pathology, Vall d'Hebron University Hospital, Barcelona, Spain.,Spanish Biomedical Research Network Centre In Oncology (CIBERONC), Barcelona, Spain
| | - J Hernandez
- Department of Pathology, Vall d'Hebron University Hospital, Barcelona, Spain.,Spanish Biomedical Research Network Centre In Oncology (CIBERONC), Barcelona, Spain
| | - C Dinares
- Department of Pathology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - A García
- Department of Pathology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - C Centeno
- Department of Gynaecology and Obstetrics, Vall d'Hebron University Hospital, Barcelona, Spain
| | - A Gil-Moreno
- Department of Gynaecology and Obstetrics, Vall d'Hebron University Hospital, Barcelona, Spain.,Spanish Biomedical Research Network Centre In Oncology (CIBERONC), Barcelona, Spain
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Gil-Moreno A, Carbonell-Socias M, Salicrú S, Bradbury M, García Á, Vergés R, Puig OP, Sánchez-Iglesias JL, Cabrera-Díaz S, de la Torre J, Gómez-Hidalgo NR, Pérez-Benavente A, Díaz-Feijoo B. Nerve-sparing versus non-nerve-sparing radical hysterectomy: surgical and long-term oncological outcomes. Oncotarget 2019; 10:4598-4608. [PMID: 31360307 PMCID: PMC6642047 DOI: 10.18632/oncotarget.27078] [Citation(s) in RCA: 4] [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: 04/16/2019] [Accepted: 06/29/2019] [Indexed: 02/01/2023] Open
Abstract
Objectives There are controversies regarding the long-term oncological safety of preservation of pelvic innervation during radical hysterectomy (RH). This study aimed to analyze the feasibility and safety of nerve-sparing radical hysterectomy (NSRH) for cervical cancer compared with non-NSRH following 17 years of experience in a tertiary cancer referral center. Materials and Methods Between May 1999 and June 2016, all patients who underwent RH for cervical cancer were followed-up prospectively. Comparison analyses regarding surgical outcomes, complications, overall survival (OS), disease-free survival (DFS), and cancer-specific survival (CSS) were performed between patients treated with NSRH and non-NSRH. Results A total of 188 patients were included (113 non-NSRH and 75 NSRH). The median follow-up was 112 months. Estimated blood loss and hospital stay were all significantly lower in the NSRH group. Overall intraoperative complication rate (p = 0.02) and need for transfusion (p = 0.016) were lower in the NSRH group. There were no differences in the median operation time, OS, DFS, CSS, or recurrence rates between the NSRH and non-NSRH group. Conclusions Our study provides a wide perspective on the developments of nerve-sparing procedures for the management of women with early-stage cervical cancer. Our results suggest that NSRH is a feasible and safe procedure, with reduced morbidity outcomes.
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Affiliation(s)
- Antonio Gil-Moreno
- Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Melchor Carbonell-Socias
- Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sabina Salicrú
- Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Melissa Bradbury
- Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ángel García
- Department of Pathology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ramona Vergés
- Radiotherapy Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Oriol Puig Puig
- Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José Luís Sánchez-Iglesias
- Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Silvia Cabrera-Díaz
- Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Javier de la Torre
- Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Natalia R Gómez-Hidalgo
- Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Assumpció Pérez-Benavente
- Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Berta Díaz-Feijoo
- Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
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Gil-Moreno A, Carbonell-Socias M, Salicrú S, Centeno-Mediavilla C, Franco-Camps S, Colas E, Oaknin A, Pérez-Benavente A, Díaz-Feijoo B. Radical Hysterectomy: Efficacy and Safety in the Dawn of Minimally Invasive Techniques. J Minim Invasive Gynecol 2018; 26:492-500. [PMID: 29908339 DOI: 10.1016/j.jmig.2018.06.007] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [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: 03/28/2018] [Revised: 06/02/2018] [Accepted: 06/05/2018] [Indexed: 12/27/2022]
Abstract
STUDY OBJECTIVE To analyze the effect that the introduction of minimally invasive procedures has had on surgical and oncologic outcomes when compared with conventional open radical hysterectomy (ORH) in a national reference cancer after 17 years of experience in radical hysterectomy. DESIGN A prospective controlled study (Canadian Task Force classification II-2). SETTING A university teaching hospital. PATIENTS All patients who underwent radical hysterectomy as primary treatment for cervical cancer in our institution between May 1999 and June 2016, with a total of 188 patients. INTERVENTIONS Patients underwent ORH or minimally invasive surgery (MIS) (i.e., laparoscopic or robotically assisted radical hysterectomy). MEASUREMENTS AND MAIN RESULTS Seventy-six patients underwent ORH, 90 laparoscopic radical hysterectomy, and 22 robotically assisted radical hysterectomy. Blood loss and hospital stay were inferior in the MIS group (p <.0001). The laparotomic group presented shorter operation times (p = .0001). With a median follow-up of 112.4 months, a total of 156 patients (83%) were alive and free of disease at the time of the data analysis. Overall survival was higher in the MIS group when compared with the ORH group (91 vs 78.9, p = .026). There were no differences regarding recurrence rates between the surgical approaches. CONCLUSION With 1 of the largest follow-up periods in the literature, this study provides added evidence that MIS could become the preferable surgical approach for early-stage cervical cancer since it appears to reduce morbidity without affecting oncologic results.
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Affiliation(s)
- Antonio Gil-Moreno
- Department of Obstetrics and Gynecology (Drs. Gil-Moreno, Carbonell-Socias, Salicrú, Centeno-Mediavilla, Franco-Camps, Pérez-Benavente, and Díaz-Feijoo), Biomedical Research Group in Gynecology (Dr. Colas), and Department of Medical Oncology (Dr. Oaknin), Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Melchor Carbonell-Socias
- Department of Obstetrics and Gynecology (Drs. Gil-Moreno, Carbonell-Socias, Salicrú, Centeno-Mediavilla, Franco-Camps, Pérez-Benavente, and Díaz-Feijoo), Biomedical Research Group in Gynecology (Dr. Colas), and Department of Medical Oncology (Dr. Oaknin), Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sabina Salicrú
- Department of Obstetrics and Gynecology (Drs. Gil-Moreno, Carbonell-Socias, Salicrú, Centeno-Mediavilla, Franco-Camps, Pérez-Benavente, and Díaz-Feijoo), Biomedical Research Group in Gynecology (Dr. Colas), and Department of Medical Oncology (Dr. Oaknin), Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Cristina Centeno-Mediavilla
- Department of Obstetrics and Gynecology (Drs. Gil-Moreno, Carbonell-Socias, Salicrú, Centeno-Mediavilla, Franco-Camps, Pérez-Benavente, and Díaz-Feijoo), Biomedical Research Group in Gynecology (Dr. Colas), and Department of Medical Oncology (Dr. Oaknin), Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Silvia Franco-Camps
- Department of Obstetrics and Gynecology (Drs. Gil-Moreno, Carbonell-Socias, Salicrú, Centeno-Mediavilla, Franco-Camps, Pérez-Benavente, and Díaz-Feijoo), Biomedical Research Group in Gynecology (Dr. Colas), and Department of Medical Oncology (Dr. Oaknin), Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Eva Colas
- Department of Obstetrics and Gynecology (Drs. Gil-Moreno, Carbonell-Socias, Salicrú, Centeno-Mediavilla, Franco-Camps, Pérez-Benavente, and Díaz-Feijoo), Biomedical Research Group in Gynecology (Dr. Colas), and Department of Medical Oncology (Dr. Oaknin), Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ana Oaknin
- Department of Obstetrics and Gynecology (Drs. Gil-Moreno, Carbonell-Socias, Salicrú, Centeno-Mediavilla, Franco-Camps, Pérez-Benavente, and Díaz-Feijoo), Biomedical Research Group in Gynecology (Dr. Colas), and Department of Medical Oncology (Dr. Oaknin), Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Assumpció Pérez-Benavente
- Department of Obstetrics and Gynecology (Drs. Gil-Moreno, Carbonell-Socias, Salicrú, Centeno-Mediavilla, Franco-Camps, Pérez-Benavente, and Díaz-Feijoo), Biomedical Research Group in Gynecology (Dr. Colas), and Department of Medical Oncology (Dr. Oaknin), Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Berta Díaz-Feijoo
- Department of Obstetrics and Gynecology (Drs. Gil-Moreno, Carbonell-Socias, Salicrú, Centeno-Mediavilla, Franco-Camps, Pérez-Benavente, and Díaz-Feijoo), Biomedical Research Group in Gynecology (Dr. Colas), and Department of Medical Oncology (Dr. Oaknin), Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
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Capote S, Sánchez-Iglesias JL, Cubo-Abert M, De la Torre J, Centeno-Mediavilla C, Pérez-Benavente A, Gil-Moreno A. Myeloid sarcoma as a simulator of advanced ovarian cancer: A case report. Eur J Obstet Gynecol Reprod Biol 2018; 225:259-260. [PMID: 29666016 DOI: 10.1016/j.ejogrb.2018.03.056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 03/22/2018] [Accepted: 03/27/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Sira Capote
- Department of Gynecologic Oncology, Hospital Materno-Infantil Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain.
| | - José-Luis Sánchez-Iglesias
- Department of Gynecologic Oncology, Hospital Materno-Infantil Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain
| | - Montserrat Cubo-Abert
- Department of Minimally Invasive Gynecology, Hospital Materno-Infantil Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain
| | - Javier De la Torre
- Department of Gynecologic Oncology, Hospital Materno-Infantil Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain
| | - Cristina Centeno-Mediavilla
- Department of Gynecologic Oncology, Hospital Materno-Infantil Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain
| | - Assumpció Pérez-Benavente
- Department of Gynecologic Oncology, Hospital Materno-Infantil Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain
| | - Antonio Gil-Moreno
- Department of Gynecologic Oncology, Hospital Materno-Infantil Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain
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Burgos R, Sanchez- Iglesias J, Cardenas G, Pérez-Benavente A, Segurola H, Manrique S, Puiggros C, Carbonell M, Aviles V, Gil-Moreno A. MON-P240: Enhanced Recovery after Surgery Protocol (ERAS) for Advanced Gynecological Cancer. Preliminary Results. Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30874-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Díaz-Feijoo B, Correa-Paris A, Pérez-Benavente A, Franco-Camps S, Sánchez-Iglesias JL, Cabrera S, de la Torre J, Centeno C, Puig OP, Gil-Ibañez B, Colas E, Magrina J, Gil-Moreno A. Prospective Randomized Trial Comparing Transperitoneal Versus Extraperitoneal Laparoscopic Aortic Lymphadenectomy for Surgical Staging of Endometrial and Ovarian Cancer: The STELLA Trial. Ann Surg Oncol 2016; 23:2966-74. [DOI: 10.1245/s10434-016-5229-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Indexed: 11/18/2022]
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Bradbury M, Cabrera S, García-Jiménez A, Franco-Camps S, Sánchez-Iglesias JL, Díaz-Feijoo B, Pérez-Benavente A, Gil-Moreno A, Centeno-Mediavilla C. Vulvar intraepithelial neoplasia: clinical presentation, management and outcomes in women infected with HIV. AIDS 2016; 30:859-68. [PMID: 26959352 DOI: 10.1097/qad.0000000000000984] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Immunocompromised patients are at increased risk of developing preinvasive lesions of the lower genital tract. There are a limited number of studies on vulvar intraepithelial neoplasia (VIN) in HIV-positive women. We aimed to review the clinical presentation of VIN, management and survival outcomes in this group of patients. DESIGN Observational cohort study. METHODS Data was collected from women diagnosed with VIN at the Hospital Vall d'Hebron between September 1994 and October 2011. The main outcome measures were recurrence-free survival (RFS) and progression-free survival (PFS). Risk factors for recurrence and progression were assessed using univariate and multivariate analyses. RESULTS Thirty-seven out of 107 women were HIV positive (34.6%). The median follow-up time was 32 (range 12-179) months. Compared with the HIV-negative group, HIV-positive women were younger (median age 37 vs. 44 years, P = 0.003) and presented with multifocal and multicentric disease more frequently (63.6 vs. 22.2% and 84.8 vs. 43.3%, respectively, P < 0.0001). RFS and PFS were lower in the HIV-positive group (42.4 vs. 71.4% P = 0.043 and 69.7 vs. 95.2% P = 0.006, respectively). RFS was significantly associated to multicentric and multifocal disease on multivariate analysis. PFS was associated to HIV infection on univariate analysis. CONCLUSION HIV-positive women are at increased risk of developing VIN and frequently present at a younger age with multifocal and multicentric disease. They have shorter RFS and PFS compared with HIV-negative women. Close surveillance of the lower genital tract is mandatory to enable early recognition and treatment of any suspicious lesions. Close follow-up after treatment of VIN is essential to exclude early recurrence or progression.
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Lanau L, Rigau M, Majem B, Altadill T, Castellví J, Sánchez-Iglesias JL, Pérez-Benavente A, Cabrera S, García A, Xercavins J, Campo JMD, Gil-Moreno A, Ruiz A, Reventós J, Llauradó M. Abstract B15: Unveiling the mechanism of ovarian cancer dissemination through a comparative study among primary tumors, ascites and metastases. Clin Cancer Res 2013. [DOI: 10.1158/1078-0432.ovca13-b15] [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
Introduction & Objectives: Epithelial ovarian cancer (OC) is the most lethal gynecological malignancy and the fifth cause of cancer deaths in women in the western world. Largely asymptomatic, OC is frequently detected at late stage (75-80%). Five-year survival rate for women with advanced stage disease is less than 20%, while the cure rate is almost 90% when are diagnosed at early stages. Epithelial OC metastasizes by direct extension from the ovary seeding the cells into the peritoneal wall and to neighbouring organs. Our aim is to study the OC dissemination comparing human paired ovarian primary tumors, ascites and metastases.
Material & Methods: Fresh ovarian primary tumor, ascites and peritoneal metastases from patients suffering advanced serous OC were collected at the surgery room and processed for further analysis. Formalin-fixed paraffin-embedded (FFPE) tissues were collected from the Pathology Department for further immunohistochemical analysis. Discovery phase: We determined the global gene expression profile of 5 fresh-paired samples (primary tumor, ascites and metastases) by microarray analysis. Validation phase: We analysed mRNA and protein levels from 10 unpaired fresh samples by RTqPCR and Western-blot, respectively. We further evaluated protein expression by immunohistochemistry from 10-paired tumor and metastasis FFPE-samples.
Results: GREM1 was shown to be upregulated in metastases versus ascites and in metastases versus primary tumors. FABP4 and INHBA were significantly overexpressed in metastases when compared to primary tumors. INHBA and FABP4 were validated at RNA and protein level, whereas GREM1 only at RNA level.
Conclusions: The present study highlights the role of previously unknown candidates in OC dissemination that might be used as tumor biomarkers, to clinically monitor the progression of the disease, or as target therapies, to block the OC dissemination.
Citation Format: Lucia Lanau, Marina Rigau, Blanca Majem, Tatiana Altadill, Josep Castellví, José-Luis Sánchez-Iglesias, Assumpció Pérez-Benavente, Silvia Cabrera, Angel García, Jordi Xercavins, Josep-Maria Del Campo, Antonio Gil-Moreno, Anna Ruiz, Jaume Reventós, Marta Llauradó. Unveiling the mechanism of ovarian cancer dissemination through a comparative study among primary tumors, ascites and metastases. [abstract]. In: Proceedings of the AACR Special Conference on Advances in Ovarian Cancer Research: From Concept to Clinic; Sep 18-21, 2013; Miami, FL. Philadelphia (PA): AACR; Clin Cancer Res 2013;19(19 Suppl):Abstract nr B15.
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Affiliation(s)
- Lucia Lanau
- 1Research Unit in Biomedicine and Translational Oncology, Research Institute Vall d'Hebron University, Barcelona, Barcelona, Spain,
| | - Marina Rigau
- 1Research Unit in Biomedicine and Translational Oncology, Research Institute Vall d'Hebron University, Barcelona, Barcelona, Spain,
| | - Blanca Majem
- 1Research Unit in Biomedicine and Translational Oncology, Research Institute Vall d'Hebron University, Barcelona, Barcelona, Spain,
| | - Tatiana Altadill
- 1Research Unit in Biomedicine and Translational Oncology, Research Institute Vall d'Hebron University, Barcelona, Barcelona, Spain,
| | - Josep Castellví
- 2Department of Pathology, Vall d'Hebron University Hospital, Barcelona, Barcelona, Spain,
| | | | - Assumpció Pérez-Benavente
- 3Department of Gynecological Oncology, Vall d'Hebron University Hospital, Barcelona, Barcelona, Spain,
| | - Silvia Cabrera
- 3Department of Gynecological Oncology, Vall d'Hebron University Hospital, Barcelona, Barcelona, Spain,
| | - Angel García
- 2Department of Pathology, Vall d'Hebron University Hospital, Barcelona, Barcelona, Spain,
| | - Jordi Xercavins
- 3Department of Gynecological Oncology, Vall d'Hebron University Hospital, Barcelona, Barcelona, Spain,
| | - Josep-Maria Del Campo
- 4Department of Medical Oncology, Vall d'Hebron Institute of Oncology, Barcelona, Barcelona, Spain
| | - Antonio Gil-Moreno
- 3Department of Gynecological Oncology, Vall d'Hebron University Hospital, Barcelona, Barcelona, Spain,
| | - Anna Ruiz
- 1Research Unit in Biomedicine and Translational Oncology, Research Institute Vall d'Hebron University, Barcelona, Barcelona, Spain,
| | - Jaume Reventós
- 1Research Unit in Biomedicine and Translational Oncology, Research Institute Vall d'Hebron University, Barcelona, Barcelona, Spain,
| | - Marta Llauradó
- 1Research Unit in Biomedicine and Translational Oncology, Research Institute Vall d'Hebron University, Barcelona, Barcelona, Spain,
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Altadill T, Rigau M, Majem B, Lanau L, Castellví J, García Á, Pérez-Benavente A, Sánchez JL, Cabrera S, Xercavins J, Campo JMD, Gil-Moreno A, Llauradó M, Reventós J. Abstract A28: Analyses of FOXM1 isoforms in ovarian cancer. Clin Cancer Res 2013. [DOI: 10.1158/1078-0432.ovca13-a28] [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
Introduction & Objectives: Epithelial ovarian cancer (OC) is the most lethal gynaecological malignancy and the fifth leading cause of cancer death in women in the Western world. Forkhead box M1 (FOXM1) transcription factor was already been described to be overexpressed in various malignancies, playing a key role in cell-cycle progression, chromosomal segregation and genomic stability, and oxidative stress. Moreover, it can also promote drug resistance to herceptin, paclitaxel and cisplatin in breast cancer cells. A recent report from our group has shown, for the first time, that FOXM1 is also overexpressed in OC, being associated with tumor grade. This result seem to indicate an interesting role of this molecule in the progression and resistance to therapy in OC. Our aim is to characterize FOXM1 isoforms in OC through the use of human tissue samples.
Material & Methods: Fresh ovarian primary tumors, ascites and peritoneal metastases from patients suffering advanced serous OC were collected from surgery room and processed for microarray analysis to detect FOXM1 expression levels. FOXM1 isoforms were analysed at mRNA expression level by using RTqPCR in a set of new frozen tissue samples.
Results: We found that FOXM1 overexpression is increased in OC peritoneal metastases. Now, we are characterizing the isoforms of FOXM1 in primary, ascites and metastatic tumors. Nevertheless, more samples need to be analysed in order to have conclusive results.
Conclusions: The present study highlights the role of FOXM1 isoforms in OC dissemination and pursues the idea to elucidate the biologic role of FOXM1 in OC tumorigenesis.
Citation Format: Tatiana Altadill, Marina Rigau, Blanca Majem, Lucia Lanau, Josep Castellví, Ángel García, Assumpció Pérez-Benavente, José Luis Sánchez, Silvia Cabrera, Jordi Xercavins, Josep Maria del Campo, Antonio Gil-Moreno, Marta Llauradó, Jaume Reventós. Analyses of FOXM1 isoforms in ovarian cancer. [abstract]. In: Proceedings of the AACR Special Conference on Advances in Ovarian Cancer Research: From Concept to Clinic; Sep 18-21, 2013; Miami, FL. Philadelphia (PA): AACR; Clin Cancer Res 2013;19(19 Suppl):Abstract nr A28.
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Affiliation(s)
- Tatiana Altadill
- 1Research Unit in Biomedicine and Translational Oncology, Research Institute Vall d'Hebron University, Barcelona, Spain,
| | - Marina Rigau
- 1Research Unit in Biomedicine and Translational Oncology, Research Institute Vall d'Hebron University, Barcelona, Spain,
| | - Blanca Majem
- 1Research Unit in Biomedicine and Translational Oncology, Research Institute Vall d'Hebron University, Barcelona, Spain,
| | - Lucia Lanau
- 1Research Unit in Biomedicine and Translational Oncology, Research Institute Vall d'Hebron University, Barcelona, Spain,
| | - Josep Castellví
- 2Department of Pathology, Vall d'Hebron University Hospital, Barcelona, Spain,
| | - Ángel García
- 2Department of Pathology, Vall d'Hebron University Hospital, Barcelona, Spain,
| | | | - José Luis Sánchez
- 3Department of Gynecological Oncology, Vall d'Hebron University Hospital, Barcelona, Spain,
| | - Silvia Cabrera
- 3Department of Gynecological Oncology, Vall d'Hebron University Hospital, Barcelona, Spain,
| | - Jordi Xercavins
- 3Department of Gynecological Oncology, Vall d'Hebron University Hospital, Barcelona, Spain,
| | - Josep Maria del Campo
- 4Department of Medical Oncology, Gynecological and Head and Neck Tumors, Vall d'Hebron Institute of O, Barcelona, Spain,
| | - Antonio Gil-Moreno
- 3Department of Gynecological Oncology, Vall d'Hebron University Hospital, Barcelona, Spain,
| | - Marta Llauradó
- 5Medical University, University of British Columbia, Vancouver, Canada
| | - Jaume Reventós
- 1Research Unit in Biomedicine and Translational Oncology, Research Institute Vall d'Hebron University, Barcelona, Spain,
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Rigau M, Majem B, Altadill T, Lanau L, Sánchez-Iglesias JL, Castellví J, Pérez-Benavente A, Cabrera S, García A, Xercavins J, Alameda F, Matias-Guiu X, Gil-Moreno A, Campo JMD, Llauradó M, Reventós J. Abstract A56: Identification of a micro RNA profile to predict response to therapy and improve patient survival in ovarian cancer. Clin Cancer Res 2013. [DOI: 10.1158/1078-0432.ovca13-a56] [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
Introduction & Objectives: Ovarian cancer (OC) is the leading cause of death among gynecological malignancies in developed countries. The standard treatment is surgery plus platinum-paclitaxel (CP/TX) chemotherapy. Nevertheless, 70% of these patients are diagnosed in advanced stages, and, among those, 75% will recur, become resistant to therapies and die. We believe that an improvement in OC survival might be related with an early identification of those patients, since long survival (SV) is related to chemosensitivity. Our aim is to identify an expression profile of micro RNAs (miRNAs) associated with SV of patients with advanced OC.
Material & Methods: Formalin-fixed paraffin-embedded (FFPE) primary tumor tissues from late stage (III/IV) OC patients were collected at the time of surgery for the study. All patients were treated with optimal surgery and standard chemotherapy (CP/TX; after surgery). Samples were divided into two groups; (a) patients with “long SV” (SV>10 years after diagnosis) and (b) patients with “short SV”. The identification of miRNAs associated with each profile of SV was performed using TaqMan Array MicroRNA microfluidic cards in 30 patients.
Results: The identification phase has shown that the majority of the miRNAs appeared to be down-regulated in the group of “short SV” versus the “long SV”. A validation phase in a new group of tumor tissue samples is ready to validate the promising miRNA candidates that seem to be associated with the resistant (short SV) and the sensitive (long SV) profiles.
Conclusions: The ability to identify markers associated with “long SV” in patients with advanced OC could allow transforming the impact of the disease through the reduction of chemotherapy treatments and the reduction of unnecessary health care costs. Moreover, it could permit the generation of knowledge applicable to the future development of new therapies for the “short SV” since they are supposed to be resistant to the therapy.
Citation Format: Marina Rigau, Blanca Majem, Tatiana Altadill, Lucia Lanau, José-Luis Sánchez-Iglesias, Josep Castellví, Assumpció Pérez-Benavente, Silvia Cabrera, Angel García, Jordi Xercavins, Francesc Alameda, Xavier Matias-Guiu, Antonio Gil-Moreno, Josep-Maria Del Campo, Marta Llauradó, Jaume Reventós. Identification of a micro RNA profile to predict response to therapy and improve patient survival in ovarian cancer. [abstract]. In: Proceedings of the AACR Special Conference on Advances in Ovarian Cancer Research: From Concept to Clinic; Sep 18-21, 2013; Miami, FL. Philadelphia (PA): AACR; Clin Cancer Res 2013;19(19 Suppl):Abstract nr A56.
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Affiliation(s)
- Marina Rigau
- 1Research Unit in Biomedicine and Translational Oncology, Research Institute Vall d'Hebron University, Barcelona, Barcelona, Spain,
| | - Blanca Majem
- 1Research Unit in Biomedicine and Translational Oncology, Research Institute Vall d'Hebron University, Barcelona, Barcelona, Spain,
| | - Tatiana Altadill
- 1Research Unit in Biomedicine and Translational Oncology, Research Institute Vall d'Hebron University, Barcelona, Barcelona, Spain,
| | - Lucia Lanau
- 1Research Unit in Biomedicine and Translational Oncology, Research Institute Vall d'Hebron University, Barcelona, Barcelona, Spain,
| | | | - Josep Castellví
- 3Department of Pathology, Vall d'Hebron University Hospital, Barcelona, Barcelona, Spain,
| | - Assumpció Pérez-Benavente
- 2Department of Gynecological Oncology, Vall d'Hebron University Hospital, Barcelona, Barcelona, Spain,
| | - Silvia Cabrera
- 2Department of Gynecological Oncology, Vall d'Hebron University Hospital, Barcelona, Barcelona, Spain,
| | - Angel García
- 3Department of Pathology, Vall d'Hebron University Hospital, Barcelona, Barcelona, Spain,
| | - Jordi Xercavins
- 2Department of Gynecological Oncology, Vall d'Hebron University Hospital, Barcelona, Barcelona, Spain,
| | - Francesc Alameda
- 4Pathology Department, Hospital del Mar, Barcelona, Barcelona, Spain,
| | - Xavier Matias-Guiu
- 5Pathology Department, Hospital Arnau de Vilanova, Lleida, Lleida, Spain,
| | - Antonio Gil-Moreno
- 2Department of Gynecological Oncology, Vall d'Hebron University Hospital, Barcelona, Barcelona, Spain,
| | - Josep-Maria Del Campo
- 6Department of Medical Oncology, Vall d'Hebron Institute of Oncology, Barcelona, Barcelona, Spain
| | - Marta Llauradó
- 1Research Unit in Biomedicine and Translational Oncology, Research Institute Vall d'Hebron University, Barcelona, Barcelona, Spain,
| | - Jaume Reventós
- 1Research Unit in Biomedicine and Translational Oncology, Research Institute Vall d'Hebron University, Barcelona, Barcelona, Spain,
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Gil-Moreno A, Magrina JF, Pérez-Benavente A, Díaz-Feijoo B, Sánchez-Iglesias JL, García A, Cabrera-Díaz S, Puig O, Martínez-Gómez X, Xercavins J. Location of aortic node metastases in locally advanced cervical cancer. Gynecol Oncol 2012; 125:312-4. [PMID: 22333995 DOI: 10.1016/j.ygyno.2012.02.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2012] [Revised: 02/02/2012] [Accepted: 02/04/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND To assess the location of aortic node metastasis in patients with locally advanced cervical cancer undergoing extraperitoneal aortic lymphadenectomy to define the extent of the aortic lymphadenectomy. MATERIAL AND METHODS Between August 2001 and December 2010, 100 consecutive patients with primary locally advanced cervical cancer underwent extraperitoneal laparoscopic aortic and common iliac lymphadenectomy. The location of aortic node metastases, inframesenteric or infrarenal was noted. RESULTS The mean number±standard deviation (SD) of aortic nodes removed was 15.9 ± 7.8 (range 4-62). The mean number ± SD of inframesenteric (including common iliac) nodes removed was 8.8 ± 4.5 (range 2-41) and the mean number ± SD of infrarenal nodes removed was 7.8 ± 4.1 (range 2-21). Positive aortic nodes were observed in 16 patients, and in 5 (31.2%) of them the infrarenal nodes were the only nodes involved, with negative inframesenteric nodes. CONCLUSION Inframesenteric aortic nodes are negative in the presence of positive infrarenal nodes in about one third of patients with locally advanced cervical cancer and aortic metastases.
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Affiliation(s)
- A Gil-Moreno
- Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Materno-Infantil Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
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Salicrú S, Gil-Moreno A, Montero A, Roure M, Pérez-Benavente A, Xercavins J. Laparoscopic Radical Hysterectomy with Pelvic Lymphadenectomy in Early Invasive Cervical Cancer. J Minim Invasive Gynecol 2011; 18:555-68. [DOI: 10.1016/j.jmig.2011.05.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Revised: 04/30/2011] [Accepted: 05/16/2011] [Indexed: 10/18/2022]
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Gil-Moreno A, Franco-Camps S, Cabrera S, Pérez-Benavente A, Martínez-Gómez X, Garcia A, Xercavins J. Pretherapeutic Extraperitoneal Laparoscopic Staging of Bulky or Locally Advanced Cervical Cancer. Ann Surg Oncol 2010; 18:482-9. [DOI: 10.1245/s10434-010-1320-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2010] [Indexed: 11/18/2022]
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Franco-Camps S, Cabrera S, Pérez-Benavente A, Díaz-Feijoo B, Bradbury M, Xercavins J, Gil-Moreno A. Extraperitoneal Laparoscopic Approach for Diagnosis and Treatment of Aortic Lymph Node Recurrence in Gynecologic Malignancy. J Minim Invasive Gynecol 2010; 17:570-5. [DOI: 10.1016/j.jmig.2010.03.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2009] [Revised: 03/16/2010] [Accepted: 03/18/2010] [Indexed: 10/19/2022]
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