Assessing the risk of clinical and pathologic factors for relapse of borderline ovarian tumours

The objective of this study was to identify clinical and pathologic factors that are significant to relapse in borderline ovarian tumours (BOT). All patients with BOTs from 1997 to 2012 in our institute were identified. 115 patients were included in the study. The Cox proportional hazards model was used to identify significant factors. The median age was 42 years (range 14-85 years). The majority of the patients were at FIGO stage I (88.7%), and most of the patients had mucinous histology (66.1%), reflecting the predominant distribution of mucinous BOTs in East Asia. The median follow-up was 3.3 years (range 0-4.1 years). Twelve patients (10.4%) relapsed and two died consequently. Advanced stage, invasive implants and restaging surgery were significant factors of recurrence. Serous tumours had slightly higher risk than mucinous tumours, but the difference was not significant. As the study was performed in an area where mucinous BOTs are predominant, the results may complement current literature on BOT management.

Differentiating between borderline and invasive malignancies in ovarian tumors using a multivariate logistic regression model

OBJECTIVE

The objective of this study was to build a model to differentiate between borderline and invasive ovarian tumors.

MATERIALS AND METHODS

We performed a retrospective study involving 148 patients with borderline or invasive ovarian tumors in our institute between 1997 and 2012. Clinical and pathologic data were collected. Logistic regression was used to build the model.

RESULTS

The model was created based on the following variables (p < 0.05): menopausal status; preoperative serum level of cancer antigen 125; the greatest diameter of the tumor; and the presence of solid parts on ultrasound imaging. The sensitivity and specificity of the model were 94.6% [95% confidence interval (CI), 0.887-1] and 78.3% (95% CI, 0.614-0.952) for patients aged ≥ 50 years, and 76.0% (95% CI, 0.622-0.903) and 60.0% (95% CI, 0.438-0.762) for those aged < 50 years, respectively. The performance of the model was tested using cross-validation.

CONCLUSION

Differentiation between borderline and invasive ovarian tumors can be achieved using a model based on the following criteria: menopausal status; cancer antigen 125 level; and ultrasound parameters. The model is helpful to oncologists and patients in the initial evaluation phase of ovarian tumors.

A longitudinal analysis with CA-125 to predict overall survival in patients with ovarian cancer

Objective

The objective of this study was to explore the association of longitudinal CA-125 measurements with overall survival (OS) time by developing a flexible model for patient-specific CA-125 profiles, and to provide a simple and reliable prediction of OS.

Methods

A retrospective study was performed on 275 patients with ovarian cancer who underwent at least one cycle of primary chemotherapy in our institute. Serial measurements of patients' CA-125 levels were performed at different frequencies according to their clinical plans. A statistical model coupling the Cox proportional hazards and the mixed-effects models was applied to determine the association of OS with patient-specific longitudinal CA-125 values. Stage and residual tumor size were additional variables included in the analysis.

Results

A total of 1,601 values of CA-125 were included. Longitudinal CA-125 levels, stage, and the residual tumor size were all significantly associated with OS. A patient-specific survival probability could be calculated. Validation showed that, in average, 85.4% patients were correctly predicted to have a high or low risk of death at a given time point. Comparison with a traditional model using CA-125 half-life and time to reach CA-125 nadir showed that the longitudinal CA-125 model had an improved predicative value.

Conclusion

Longitudinal CA-125 values, measured from the diagnosis of ovarian cancer to the completion of primary chemotherapy, could be used to reliably predict OS after adjusting for the stage and residual tumor disease. This model could be potentially useful in clinical counseling of patients with ovarian cancer.

Three-dimensional laser scanning two-photon fluorescence confocal microscopy of polymer materials using a new, efficient upconverting fluorophore

Three-dimensional confocal imaging of polymer samples was achieved by the use of two-photon excited fluorescence in both positive and negative contrast modes. The fluorophore was a new and highly efficient two-photon induced upconverter, resulting in improved signal strength at low pumping power. Because of the relatively long wavelength of the excitation source (798 nm from a mode-locked Ti:Sapphire laser), this technique shows a larger penetration depth into the samples than provided by conventional single-photon fluorescence confocal microscopy. Single-photon and two-photon images of the same area of each sample show significant differences. The results suggest the possibility of using two-photon confocal microscopy, in conjunction with highly efficient fluorophores, as a tool to study the surface, interface, and fracture in material science applications.