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Sama S, Rosqvist S, Savage T, Lomo L, Sibbald K, Straubhar A, Werner TL. Durable response to BRAF inhibitor monotherapy in recurrent metastatic low grade serous ovarian cancer. Gynecol Oncol Rep 2024; 53:101412. [PMID: 38779189 PMCID: PMC11109349 DOI: 10.1016/j.gore.2024.101412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 05/05/2024] [Accepted: 05/06/2024] [Indexed: 05/25/2024] Open
Abstract
Low grade serous ovarian cancers (LGSOC) in an advanced setting have limited systemic treatment options. In this paper we report a case of metastatic LGSOC harboring a BRAF mutation, treated with dabrafenib. We discuss the clinical, pathologic and molecular characteristics as well as surgical considerations and ongoing investigations in LGSOC.
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Affiliation(s)
- Shashank Sama
- Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, USA
| | | | - Talicia Savage
- Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, USA
| | - Lesley Lomo
- Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, USA
| | | | | | - Theresa L. Werner
- Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, USA
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Zhang T, Liu Q, Zhu Y, Huang Y, Qin J, Wu X, Zhang S. Lymphocyte and macrophage infiltration in omental metastases indicates poor prognosis in advance stage epithelial ovarian cancer. J Int Med Res 2021; 49:3000605211066245. [PMID: 34939862 PMCID: PMC8721736 DOI: 10.1177/03000605211066245] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective To investigate the prognostic value of immune cells within omental metastases originating from advanced epithelial ovarian cancer (EOC). Methods We performed immunohistochemical analysis to determine the levels of CD4+/CD8+ tumor-infiltrating lymphocytes (TILs) and CD68+ tumor-associated microphages (TAMs) in omental specimens from 100 patients with advanced EOC. Significant prognostic factors, including immune cells and clinical parameters, were assessed by Kaplan–Meier survival analysis and Cox models. Results Cox regression analysis showed that elevated levels of CD68+ TAMs and intra-islet CD4+ TILs in omental metastases were the main risk factors associated with worse survival outcomes for advanced EOC. Moreover, the survival analysis of relationships between omental immune cells and favorable clinical predictors revealed additional prognostic stratification information. Conclusion Omental immune cells (TAMs and TILs) provide alternative prognostic factors in advanced EOC. In contrast to markers of the EOC tumor microenvironment at the primary site, elevated CD68+ TAMs and intra-islet CD4+ TILs in omental metastases serve as negative prognostic markers in advanced EOC and imply an unfavorable outcome.
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Affiliation(s)
- Tao Zhang
- Department of Oncology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Qin Liu
- Department of Pathology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yingfan Zhu
- Department of Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yizhou Huang
- Department of Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jiale Qin
- Department of Oncology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaodong Wu
- Department of Oncology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Songfa Zhang
- Department of Oncology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Feng C, Xu Y, Liu Y, Zhu L, Wang L, Cui X, Lu J, Zhang Y, Zhou L, Chen M, Zhang Z, Li P. Gene Expression Subtyping Reveals Immune alterations:TCGA Database for Prognosis in Ovarian Serous Cystadenocarcinoma. Front Mol Biosci 2021; 8:619027. [PMID: 34631788 PMCID: PMC8497788 DOI: 10.3389/fmolb.2021.619027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 09/06/2021] [Indexed: 12/24/2022] Open
Abstract
Serous ovarian cancer is the most common and primary death type in ovarian cancer. In recent studies, tumor microenvironment and tumor immune infiltration significantly affect the prognosis of ovarian cancer. This study analyzed the four gene expression types of ovarian cancer in TCGA database to extract differentially expressed genes and verify the prognostic significance. Meanwhile, functional enrichment and protein interaction network analysis exposed that these genes were related to immune response and immune infiltration. Subsequently, we proved these prognostic genes in an independent data set from the GEO database. Finally, multivariate cox regression analysis revealed the prognostic significance of TAP1 and CXCL13. The genetic alteration and interaction network of these two genes were shown. Then, we established a nomogram model related to the two genes and clinical risk factors. This model performed well in Calibration plot and Decision Curve Analysis. In conclusion, we have obtained a list of genes related to the immune microenvironment with a better prognosis for serous ovarian cancer, and based on this, we have tried to establish a clinical prognosis model.
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Affiliation(s)
- Chunxia Feng
- Department of Radiotherapy and Oncology, The Second Affiliated Hospital of Soochow University, Suzhou, China.,Department of Radiotherapy and Oncology, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, China
| | - Yan Xu
- Department of Radiotherapy and Oncology, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, China.,Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yuanyuan Liu
- Clinical Research and Lab Center, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, China
| | - Lixia Zhu
- Department of Gynecology, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, China
| | - Le Wang
- Department of Radiotherapy and Oncology, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, China
| | - Xixi Cui
- Department of Radiotherapy and Oncology, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, China
| | - Jingjing Lu
- Department of Radiotherapy and Oncology, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, China
| | - Yan Zhang
- Department of Radiotherapy and Oncology, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, China
| | - Lina Zhou
- Department of Radiotherapy and Oncology, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, China
| | - Minbin Chen
- Department of Radiotherapy and Oncology, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, China
| | - Zhiqin Zhang
- Department of Biobank, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, China
| | - Ping Li
- Department of Radiotherapy and Oncology, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, China
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Kang JH, Lai YL, Cheng WF, Kim HS, Kuo KT, Chen YL, Lee YY. Clinical factors associated with prognosis in low-grade serous ovarian carcinoma: experiences at two large academic institutions in Korea and Taiwan. Sci Rep 2020; 10:20012. [PMID: 33203969 PMCID: PMC7672053 DOI: 10.1038/s41598-020-77075-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 11/02/2020] [Indexed: 01/22/2023] Open
Abstract
Low-grade ovarian serous carcinoma (LGSOC) has clinical features different from high-grade serous ovarian carcinoma (HGSOC) accounting for the majority of epithelial ovarian cancer. Because of its rarity, previous studies have only focused on the high-grade disease without considering the differences between the two subtypes. This study aimed to evaluate the effect of the clinical prognostic factors known for HGSOC on survival in patients with LGSOC. Based on the Federation of Gynecology and Obstetrics (FIGO) stage, progression-free survival (PFS) was markedly decreased in advanced disease compared with early disease. For stage I, patients with stage IC had poorer survival than those with stage IA and IB regardless of the number of cycles of adjuvant chemotherapy. For advanced disease, no gross residual disease after primary cytoreductive surgery was significantly associated with longer PFS when compared with gross residual disease. In multivariate analysis for PFS and overall survival (OS), age, preoperative CA-125, time interval from surgery to chemotherapy, and the number of cycles of adjuvant chemotherapy were not associated with prognosis. Complete cytoreduction was the only independent prognostic factor for PFS (HR 2.45, p = 0.045). Our study revealed that the known prognostic factors in HGSOC did not show any effect on the survival in LGSOC except for FIGO stage and complete cytoreduction.
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Affiliation(s)
- Jun-Hyeok Kang
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, Seoul, Republic of Korea
| | - Yen-Ling Lai
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Wen-Fang Cheng
- Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, 100, Taiwan
| | - Hyun-Soo Kim
- Department of Pathology and Translation Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kuan-Ting Kuo
- Department of Pathology and Graduate Institute of Pathology, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Pathology and Laboratory Medicine, National Taiwan University Hospital, Hsin-Chu Biomedical Park Branch, Hsin-Chu, Taiwan
| | - Yu-Li Chen
- Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, 100, Taiwan.
| | - Yoo-Young Lee
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, Seoul, Republic of Korea.
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Huang S, Han S, Zhang J, Zhong Z, Wang J. Semaphorin-4C is upregulated in epithelial ovarian cancer. Oncol Lett 2020; 19:3333-3338. [PMID: 32256827 DOI: 10.3892/ol.2020.11444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 11/01/2019] [Indexed: 11/06/2022] Open
Abstract
The present retrospective study aimed to investigate the expression of semaphorin-4C (Sema4C) in epithelial ovarian cancer (EOC), and to determine the association between Sema4C expression and patient clinicopathological characteristics. Sema4C mRNA expression was detected by reverse transcription-quantitative polymerase chain reaction in the tissues of 74 cases of EOC, 20 cases of ovarian epithelial benign tumor, 20 cases of ovarian borderline epithelial tumor and 15 cases of normal ovarian tissue. Immunohistochemistry was used to detect the expression and localization of Sema4C. The association between Sema4C expression level and patients clinicopathological characteristics was determined by χ2 test. The results demonstrated that Sema4C expression level in ovarian epithelial carcinoma tissues was significantly higher compared with that in benign tumors, borderline epithelial tumors and normal ovarian tissues (P<0.05). In addition, Sema4C expression in ovarian cancer tissues was significantly associated with the clinical and pathological stages of tumors (P<0.05). In conclusion, the present study demonstrated that Sema4C expression was upregulated in EOC.
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Affiliation(s)
- Shaoyan Huang
- Department of Oncology, Yantaishan Hospital, Yantai, Shandong 264000, P.R. China
| | - Shan Han
- Department of Oncology, Dongying People's Hospital, Dongying, Shandong 257091, P.R. China
| | - Jianzhong Zhang
- Department of Anesthesia, Yantaishan Hospital, Yantai, Shandong 264000, P.R. China
| | - Zhaokun Zhong
- Department of Oncology, Yantaishan Hospital, Yantai, Shandong 264000, P.R. China
| | - Jianrong Wang
- Department of Obstetrics and Gynecology, Dongying People's Hospital, Dongying, Shandong 257091, P.R. China
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Monk BJ, Herzog TJ, Tewari KS. Evolution of Chemosensitivity and Resistance Assays as Predictors of Clinical Outcomes in Epithelial Ovarian Cancer Patients. Curr Pharm Des 2017; 22:4717-4728. [PMID: 27145761 DOI: 10.2174/1381612822666160505114326] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 05/04/2016] [Indexed: 02/06/2023]
Abstract
Epithelial ovarian cancer (EOC) is responsible for more cancer-related deaths than any other malignancy of the female reproductive system. The standard of care for advanced EOC involves a combination of cytoreductive surgery and platinum-based chemotherapy. Although a majority of patients respond to a platinum-containing regimen, many fail to respond to first-line treatment (platinum-refractory disease) or experience disease progression within 6 months of completing treatment (platinum-resistant disease). Even in patients who initially respond to platinum-based therapy, secondary development of platinum resistance is common. Many chemotherapeutic regimens with comparable efficacy and toxicities are available, leaving the determination of optimal therapy to the physician's discretion. There have been many efforts over the years to develop accurate predictors of outcomes in patients treated with chemotherapy to help inform treatment decisions. Predictive treatment markers are particularly relevant in a disease such as EOC, where a large number of similarly efficacious chemotherapy regimens are available. Chemosensitivity and resistance assays (CSRAs) are attractive approaches to interrogate the efficacy and complex biology of EOC. Some early predictive cellular tests, such as the early clonogenic assays, were limited by technical and logistical issues. Over time, changes in these assays have improved their prognostic and predictive value, but there is still a lack of widespread adoption due to methodological difficulties or limited clinical validation. Herein, we provide an overview of the evolution of CSRAs used to predict outcomes in patients treated with chemotherapy that have been evaluated for use in EOC, with a focus on the latest generation chemoresponse assay.
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Affiliation(s)
- Bradley J Monk
- Dignity Health St. Joseph's Hospital and Medical Center, 500 W. Thomas Road, Suite 600, Phoenix, AZ 85013.
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Davidson BA, Foote J, Brower SL, Tian C, Havrilesky LJ, Secord AA. Analysis of in vitro chemoresponse assays in endometrioid endometrial adenocarcinoma: an observational ancillary analysis. GYNECOLOGIC ONCOLOGY RESEARCH AND PRACTICE 2016; 3:13. [PMID: 27980799 PMCID: PMC5134103 DOI: 10.1186/s40661-016-0032-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 11/15/2016] [Indexed: 11/20/2022]
Abstract
Background Chemotherapy plays a role in the treatment of endometrioid endometrial cancer (EEC); however, tumor grade may affect response. Our objective was to evaluate associations between tumor grade and in vitro chemoresponse. Methods We conducted an analysis of primary tumor samples from women with EEC undergoing in vitro chemoresponse testing. Results were classified as sensitive (S), intermediate (I), or resistant (R) to each drug tested. Correlations between tumor grade and response were examined. Results Data was collected from 159 patients: 28 with grade 1 (18%), 52 with grade 2 (32%), and 79 (50%) with grade 3 tumors. Median age of patients was 62 (range 31–92). Most patients were Caucasian (83%) with advanced disease (Stage III: 50.9%; Stage IV: 13.2%). Overall chemoresponse was similar across all grades. Fifty percent, 56 and 51% for grade 1, 2, and 3 tumors, respectively, demonstrated S results to at least 1 agent. There was no association between grade and in vitro response to chemotherapy agents (p > 0.05) except a marginal association between grade and doxorubicin response (p = 0.08). Grade 1 and 2 cancers were more likely to demonstrate R results for doxorubicin compared to grade 3 cancers (G1: 19% vs G2: 25% vs G3: 8%; p = 0.08). In a subset tested for all 7 agents, only one patient tumor was pan-R and 4 were pan-S. Conclusions Based on our data, grades 1–3 EEC have similar in vitro chemoresponse. These findings suggest that chemotherapy may be useful in advanced low grade EECs, but further clinical correlation is needed.
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Affiliation(s)
- Brittany A Davidson
- Division of Gynecologic Oncology, Duke University Medical Center, Duke University, DUMC Box 3079, Durham, NC 27710 USA
| | - Jonathan Foote
- Division of Gynecologic Oncology, Duke University Medical Center, Duke University, DUMC Box 3079, Durham, NC 27710 USA
| | - Stacey L Brower
- Product Development, Helomics Corporation, Pittsburgh, PA USA
| | - Chunqiao Tian
- Product Development, Helomics Corporation, Pittsburgh, PA USA
| | - Laura J Havrilesky
- Division of Gynecologic Oncology, Duke University Medical Center, Duke University, DUMC Box 3079, Durham, NC 27710 USA
| | - Angeles Alvarez Secord
- Division of Gynecologic Oncology, Duke University Medical Center, Duke University, DUMC Box 3079, Durham, NC 27710 USA
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Kaldawy A, Segev Y, Lavie O, Auslender R, Sopik V, Narod SA. Low-grade serous ovarian cancer: A review. Gynecol Oncol 2016; 143:433-438. [PMID: 27581327 DOI: 10.1016/j.ygyno.2016.08.320] [Citation(s) in RCA: 107] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Revised: 08/16/2016] [Accepted: 08/17/2016] [Indexed: 01/01/2023]
Abstract
Epithelial ovarian cancers can be divided into the more common, aggressive type II cancers and the less common, slow-growing type I cancers. Under this model, serous ovarian carcinomas can be subdivided into high-grade (type II) and low-grade (type I) tumours. The two-tier system for grading serous ovarian carcinomas is superior to more detailed grading systems in terms of predicting survival. Low-grade serous carcinomas typically present in young women and have a relatively good prognosis, despite being resistant to chemotherapy. Low-grade serous cancers have a high prevalence of KRAS and BRAF mutations, but a low prevalence of TP53 mutations (which are characteristic of high-grade serous cancers). Among women with low-grade serous ovarian cancer, the presence of a KRAS/BRAF mutation is a favorable prognostic factor. Studies of the mitogen-activated protein kinase (MAPK) inhibitor in low-grade serous ovarian cancer suggest that identifying MAPK mutations might eventually be useful in guiding treatment.
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Affiliation(s)
- Anis Kaldawy
- Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel; The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Yakir Segev
- Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel; The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Ofer Lavie
- Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel; The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Ron Auslender
- Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel; The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Victoria Sopik
- Women's College Research Institute, Familial Breast Cancer Research Unit, Toronto, Canada
| | - Steven A Narod
- Women's College Research Institute, Familial Breast Cancer Research Unit, Toronto, Canada.
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Tatar B, Boyraz G, Selçuk İ, Doğan AK, Usubütün A, Tuncer ZS. In vitro chemosensitivity in ovarian carcinoma: Comparison of three leading assays. J Turk Ger Gynecol Assoc 2016; 17:35-40. [PMID: 27026777 DOI: 10.5152/jtgga.2016.16017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 01/22/2016] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE An alternative approach to the current therapy of ovarian carcinoma is the individualization of treatment by determining the sensitivity of tumoral tissue to chemotherapeutic agents before the initiation of chemotherapy. The objectives of the study are to determine the efficacy of in vitro chemosensitivity assays in ovarian carcinoma and to measure the correlation of three leading assays. MATERIAL AND METHODS Fresh tumoral tissue samples of 26 newly diagnosed primary ovarian cancer patients were studied with 3-(4,5-dimeth-ylthiazol-2-yl)-2,5-diphenyltetrazolyum bromide (MTT) assay, adenosine triphosphate-tumor chemosensitivity assay (ATP-TCA) and differential staining cytotoxicity (DISC) assays. Chemosensitivity of tumors were studied for paclitaxel, carboplatin, docetaxel, topotecan, gemcitabine, and doxorubicin with each of the three assays. Subgroup analysis was performed for stage, grade, and histologic type. RESULTS The in vitro chemosensitivity results of MTT, ATP, and DISC assays were found to be similar. The subgroups in which in vitro assays would be more useful were encountered for patients with advanced stage and serous histology ovarian carcinoma. CONCLUSIONS In vitro chemosensitivity can be determined in ovarian carcinoma with ATP, MTT, or DISC assays before the initiation of chemotherapy. These three assays correlate well with each other and are particularly useful for serous and advanced cancers. Large prospective studies comparing standard versus assay-directed therapy with an endpoint of overall survival are required before routine clinical utilization of these assays.
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Affiliation(s)
- Burak Tatar
- Department of Gynecologic Oncology, Süleyman Demirel University School of Medicine, Isparta, Turkey
| | - Gökhan Boyraz
- Department of Gynecologic Oncology, Hacettepe University School of Medicine, Ankara, Turkey
| | - İlker Selçuk
- Department of Gynecologic Oncology, Zekai Tahir Burak Maternity and Teaching Hospital, Ankara, Turkey
| | - Alper K Doğan
- Onkosel Biotechnology, Hacettepe University Technopolis, Ankara, Turkey
| | - Alp Usubütün
- Department of Pathology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Zafer Selçuk Tuncer
- Department of Gynecologic Oncology, Hacettepe University School of Medicine, Ankara, Turkey
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