1
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Köbel M, Kang EY, Lee S, Terzic T, Karnezis AN, Ghatage P, Woo L, Lee CH, Meagher NS, Ramus SJ, Gorringe KL. Infiltrative pattern of invasion is independently associated with shorter survival and desmoplastic stroma markers FAP and THBS2 in mucinous ovarian carcinoma. Histopathology 2024; 84:1095-1110. [PMID: 38155475 DOI: 10.1111/his.15128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/07/2023] [Accepted: 12/11/2023] [Indexed: 12/30/2023]
Abstract
AIMS Mucinous ovarian carcinoma (MOC) is a rare ovarian cancer histotype with generally good prognosis when diagnosed at an early stage. However, MOC with the infiltrative pattern of invasion has a worse prognosis, although to date studies have not been large enough to control for covariables. Data on reproducibility of classifying the invasion pattern are limited, as are molecular correlates for infiltrative invasion. We hypothesized that the invasion pattern would be associated with an aberrant tumour microenvironment. METHODS AND RESULTS Four subspecialty pathologists assessed interobserver reproducibility of the pattern of invasion in 134 MOC. Immunohistochemistry on fibroblast activation protein (FAP) and THBS2 was performed on 98 cases. Association with survival was tested using Cox regression. The average interobserver agreement for the infiltrative pattern was moderate (kappa 0.60, agreement 86.3%). After reproducibility review, 24/134 MOC (18%) were determined to have the infiltrative pattern and this was associated with a higher risk of death, independent of FIGO stage, grade, and patient age in a time-dependent manner (hazard ratio [HR] = 10.2, 95% confidence interval [CI] 3.0-34.5). High stromal expression of FAP and THBS2 was more common in infiltrative MOC (FAP: 60%, THBS2: 58%, both P < 0.001) and associated with survival (multivariate HR for FAP: 1.5 [95% CI 1.1-2.1] and THBS2: 1.91 [95% CI 1.1-3.2]). CONCLUSIONS The pattern of invasion should be included in reporting for MOC due to the strong prognostic implications. We highlight the histological features that should be considered to improve reproducibility. FAP and THBS2 are associated with infiltrative invasion in MOC.
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Affiliation(s)
- Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Centre, Calgary, AB, Canada
| | - Eun-Young Kang
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Centre, Calgary, AB, Canada
| | - Sandra Lee
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Centre, Calgary, AB, Canada
| | - Tatjana Terzic
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Centre, Calgary, AB, Canada
| | - Antony N Karnezis
- Department of Pathology and Laboratory Medicine, University of California Davis, Sacramento, CA, USA
| | - Prafull Ghatage
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Lawrence Woo
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Cheng-Han Lee
- Department of Pathology and Laboratory Medicine, University of Alberta, Edmonton, AB, Canada
| | - Nicola S Meagher
- School of Clinical Medicine, Faculty of Medicine and Health, University of NSW Sydney, Sydney, NSW, Australia
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, NSW, Australia
| | - Susan J Ramus
- School of Clinical Medicine, Faculty of Medicine and Health, University of NSW Sydney, Sydney, NSW, Australia
- Adult Cancer Program, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, NSW, Australia
| | - Kylie L Gorringe
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Vic., Australia
- Peter MacCallum Cancer Centre, Melbourne, Vic., Australia
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2
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Zheng H, Chen J, Huang J, Yi H, Zhang S, Zheng X. A novel clinical nomogram for predicting cancer-specific survival in patients with non-serous epithelial ovarian cancer: A real-world analysis based on the Surveillance, Epidemiology, and End Results database and external validation in a tertiary center. Transl Oncol 2024; 42:101898. [PMID: 38308920 PMCID: PMC10847761 DOI: 10.1016/j.tranon.2024.101898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 12/24/2023] [Accepted: 01/28/2024] [Indexed: 02/05/2024] Open
Abstract
BACKGROUND Currently, there is a lack of prognostic evaluation methods for non-serous epithelial ovarian cancer (EOC). METHOD We collected patients with non-serous EOC diagnosed between 2010 and 2017 from the Surveillance, Epidemiology, and End Results (SEER) database into a training cohort (n = 2078) and an internal validation cohort (n = 891). Meanwhile, patients meeting the criteria were screened from the Fujian Provincial Maternal and Child Health Hospital from 2013 to 2022 as an external validation cohort (n = 56). Univariate and multivariable logistic regression were used to determine the independent prognostic factors of cancer-specific survival (CSS) to construct the nomogram. The nomogram was validated by the concordance index (C-index), receiver operating characteristics (ROC) curve and calibration curves. RESULT Age, laterality, preoperative CA125 status, histologic type, tumor grade, AJCC stage, surgery lesion, number of lymph nodes examined, residual lesion size, and bone metastasis were identified as independent prognostic factors to construct the nomogram. The nomogram showed better predictive ability than FIGO stage through internal and external cohorts validation. The C-index of the nomogram in the training cohort, validation cohort, and external validation cohort were 0.831, 0.835 and 0.944 higher than those of the Federation International of Gynecology and Obstetric (FIGO) stage, P<0.05. The Area Under Curve (AUC) values results indicated great clinical usefulness of the nomogram. The calibration curve indicated good agreement between the nomogram prediction and actual survival. CONCLUSION We developed a nomogram with high predictive accuracy to predict survival in patients with non-serous EOC.
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Affiliation(s)
- Hui Zheng
- National Key Gynecology Clinical Specialty Construction Institution of China, Fujian Province Key Clinical Specialty for Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350000, China
| | - Jingjing Chen
- Department of Obstetrics and Gynecology, Fuding General Hospital, Fuding, 355200, China
| | - Jimiao Huang
- National Key Gynecology Clinical Specialty Construction Institution of China, Fujian Province Key Clinical Specialty for Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350000, China
| | - Huan Yi
- National Key Gynecology Clinical Specialty Construction Institution of China, Fujian Province Key Clinical Specialty for Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350000, China
| | - Shaoyu Zhang
- Department of Obstetrics and Gynecology, Fuding General Hospital, Fuding, 355200, China
| | - Xiangqin Zheng
- National Key Gynecology Clinical Specialty Construction Institution of China, Fujian Province Key Clinical Specialty for Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350000, China.
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3
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Wang Y, Liu L, Yu Y. Mucins and mucinous ovarian carcinoma: Development, differential diagnosis, and treatment. Heliyon 2023; 9:e19221. [PMID: 37664708 PMCID: PMC10468386 DOI: 10.1016/j.heliyon.2023.e19221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/11/2023] [Accepted: 08/16/2023] [Indexed: 09/05/2023] Open
Abstract
Mucinous ovarian carcinoma (MOC) is a rare histological type of epithelial ovarian cancer. It has poor response to conventional platinum-based chemotherapy regimens and PARPi-based maintenance treatment, resulting in short survival and poor prognosis in advanced-disease patients. MOC is characterized by mucus that is mainly composed of mucin in the cystic cavity. Our review discusses in detail the role of mucins in MOC. Mucins are correlated with MOC development. Furthermore, they are valuable in the differential diagnosis of primary and secondary ovarian mucinous tumors. Some types of mucins have been studied in the context of chemoresistance and targeted therapy for ovarian cancer. This review may provide a new direction for the diagnosis and treatment of advanced MOC.
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Affiliation(s)
- Yicong Wang
- Department of Obstetrics and Gynecology, Dalian Municipal Central Hospital, Dalian, China
| | - Lifeng Liu
- Department of Obstetrics and Gynecology, Dalian Municipal Central Hospital, Dalian, China
| | - Yongai Yu
- Department of Obstetrics and Gynecology, Dalian Municipal Central Hospital, Dalian, China
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4
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Grabowska-Derlatka L, Derlatka P, Hałaburda-Rola M. Characterization of Primary Mucinous Ovarian Cancer by Diffusion-Weighted and Dynamic Contrast Enhancement MRI in Comparison with Serous Ovarian Cancer. Cancers (Basel) 2023; 15:cancers15051453. [PMID: 36900244 PMCID: PMC10000545 DOI: 10.3390/cancers15051453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/17/2023] [Accepted: 02/23/2023] [Indexed: 03/02/2023] Open
Abstract
(1) Background. The purpose of this study is to evaluate the diagnostic accuracy of a quantitative analysis of diffusion-weighted imaging (DWI) and dynamic contrast enhanced (DCE) MRI of mucinous ovarian cancer (MOC). It also aims to differentiate between low grade serous carcinoma (LGSC), high-grade serous carcinoma (HGSC) and MOC in primary tumors. (2) Materials and Methods. Sixty-six patients with histologically confirmed primary epithelial ovarian cancer (EOC) were included in the study. Patients were divided into three groups: MOC, LGSC and HGSC. In the preoperative DWI and DCE MRI, selected parameters were measured: apparent diffusion coefficients (ADC), time to peak (TTP), and perfusion maximum enhancement (Perf. Max. En.). ROI comprised a small circle placed in the solid part of the primary tumor. The Shapiro-Wilk test was used to test whether the variable had a normal distribution. The Kruskal-Wallis ANOVA test was used to determine the p-value needed to compare the median values of interval variables. (3) Results. The highest median ADC values were found in MOC, followed by LGSC, and the lowest in HGSC. All differences were statistically significant (p < 0.000001). This was also confirmed by the ROC curve analysis for MOC and HGSC, showing that ADC had excellent diagnostic accuracy in differentiating between MOC and HGSC (p < 0.001). In the type I EOCs, i.e., MOC and LGSC, ADC has less differential value (p = 0.032), and TTP can be considered the most valuable parameter for diagnostic accuracy (p < 0.001). (4) Conclusions. DWI and DCE appear to be very good diagnostic tools in differentiating between serous carcinomas (LGSC, HGSC) and MOC. Significant differences in median ADC values between MOC and LGSC compared with those between MOC and HGSC indicate the usefulness of DWI in differentiating between less and more aggressive types of EOC, not only among the most common serous carcinomas. ROC curve analysis showed that ADC had excellent diagnostic accuracy in differentiating between MOC and HGSC. In contrast, TTP showed the greatest value for differentiating between LGSC and MOC.
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Affiliation(s)
- Laretta Grabowska-Derlatka
- Second Department of Clinical Radiology, Medical University of Warsaw, Banacha 1a St., 02-097 Warsaw, Poland
| | - Pawel Derlatka
- Second Department Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2 St., 00-315 Warsaw, Poland
- Correspondence: ; Tel.: +48-22-5966-512
| | - Marta Hałaburda-Rola
- Second Department of Clinical Radiology, Medical University of Warsaw, Banacha 1a St., 02-097 Warsaw, Poland
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5
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Devlin MJ, Miller RE. Disparity in the era of personalized medicine for epithelial ovarian cancer. Ther Adv Med Oncol 2023; 15:17588359221148024. [PMID: 36643655 PMCID: PMC9837277 DOI: 10.1177/17588359221148024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 12/12/2022] [Indexed: 01/13/2023] Open
Abstract
The treatment of high-grade serous ovarian cancer and high-grade endometrioid ovarian cancer has seen significant improvements in recent years, with BRCA1/2 and homologous recombination status guiding a personalized approach which has resulted in improved patient outcomes. However, for other epithelial ovarian cancer subtypes, first-line treatment remains unchanged from the platinum-paclitaxel trials of the early 2000s. In this review, we explore novel therapeutic approaches being adopted in the treatment of clear cell, mucinous, carcinosarcoma and low-grade serous ovarian cancer and the biological rational behind them. We discuss why such disparities exist, the challenges faced in conducting dedicated trials in these rarer histologies and look towards new approaches being adopted to overcome them.
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Affiliation(s)
| | - Rowan E. Miller
- Department of Medical Oncology, St Bartholomew’s Hospital, London, UK,Department of Medical Oncology, University College London Hospital, London, UK
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6
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Meagher NS, Gorringe KL, Wakefield M, Bolithon A, Pang CNI, Chiu DS, Anglesio MS, Mallitt KA, Doherty JA, Harris HR, Schildkraut JM, Berchuck A, Cushing-Haugen KL, Chezar K, Chou A, Tan A, Alsop J, Barlow E, Beckmann MW, Boros J, Bowtell DD, Brand AH, Brenton JD, Campbell I, Cheasley D, Cohen J, Cybulski C, Elishaev E, Erber R, Farrell R, Fischer A, Fu Z, Gilks B, Gill AJ, Gourley C, Grube M, Harnett PR, Hartmann A, Hettiaratchi A, Høgdall CK, Huzarski T, Jakubowska A, Jimenez-Linan M, Kennedy CJ, Kim BG, Kim JW, Kim JH, Klett K, Koziak JM, Lai T, Laslavic A, Lester J, Leung Y, Li N, Liauw W, Lim BW, Linder A, Lubiński J, Mahale S, Mateoiu C, McInerny S, Menkiszak J, Minoo P, Mittelstadt S, Morris D, Orsulic S, Park SY, Pearce CL, Pearson JV, Pike MC, Quinn CM, Mohan GR, Rao J, Riggan MJ, Ruebner M, Salfinger S, Scott CL, Shah M, Steed H, Stewart CJ, Subramanian D, Sung S, Tang K, Timpson P, Ward RL, Wiedenhoefer R, Thorne H, Cohen PA, Crowe P, Fasching PA, Gronwald J, Hawkins NJ, Høgdall E, Huntsman DG, James PA, Karlan BY, Kelemen LE, Kommoss S, Konecny GE, Modugno F, Park SK, Staebler A, Sundfeldt K, Wu AH, Talhouk A, Pharoah PD, Anderson L, DeFazio A, Köbel M, Friedlander ML, Ramus SJ. Gene-Expression Profiling of Mucinous Ovarian Tumors and Comparison with Upper and Lower Gastrointestinal Tumors Identifies Markers Associated with Adverse Outcomes. Clin Cancer Res 2022; 28:5383-5395. [PMID: 36222710 PMCID: PMC9751776 DOI: 10.1158/1078-0432.ccr-22-1206] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/22/2022] [Accepted: 10/05/2022] [Indexed: 01/24/2023]
Abstract
PURPOSE Advanced-stage mucinous ovarian carcinoma (MOC) has poor chemotherapy response and prognosis and lacks biomarkers to aid stage I adjuvant treatment. Differentiating primary MOC from gastrointestinal (GI) metastases to the ovary is also challenging due to phenotypic similarities. Clinicopathologic and gene-expression data were analyzed to identify prognostic and diagnostic features. EXPERIMENTAL DESIGN Discovery analyses selected 19 genes with prognostic/diagnostic potential. Validation was performed through the Ovarian Tumor Tissue Analysis consortium and GI cancer biobanks comprising 604 patients with MOC (n = 333), mucinous borderline ovarian tumors (MBOT, n = 151), and upper GI (n = 65) and lower GI tumors (n = 55). RESULTS Infiltrative pattern of invasion was associated with decreased overall survival (OS) within 2 years from diagnosis, compared with expansile pattern in stage I MOC [hazard ratio (HR), 2.77; 95% confidence interval (CI), 1.04-7.41, P = 0.042]. Increased expression of THBS2 and TAGLN was associated with shorter OS in MOC patients (HR, 1.25; 95% CI, 1.04-1.51, P = 0.016) and (HR, 1.21; 95% CI, 1.01-1.45, P = 0.043), respectively. ERBB2 (HER2) amplification or high mRNA expression was evident in 64 of 243 (26%) of MOCs, but only 8 of 243 (3%) were also infiltrative (4/39, 10%) or stage III/IV (4/31, 13%). CONCLUSIONS An infiltrative growth pattern infers poor prognosis within 2 years from diagnosis and may help select stage I patients for adjuvant therapy. High expression of THBS2 and TAGLN in MOC confers an adverse prognosis and is upregulated in the infiltrative subtype, which warrants further investigation. Anti-HER2 therapy should be investigated in a subset of patients. MOC samples clustered with upper GI, yet markers to differentiate these entities remain elusive, suggesting similar underlying biology and shared treatment strategies.
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Affiliation(s)
- Nicola S. Meagher
- School of Clinical Medicine, Faculty of Medicine and Health, University of NSW Sydney, Sydney, New South Wales, Australia
- Adult Cancer Program, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, New South Wales, Australia
| | - Kylie L. Gorringe
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Medical Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Matthew Wakefield
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- Department of Medical Biology, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Adelyn Bolithon
- School of Clinical Medicine, Faculty of Medicine and Health, University of NSW Sydney, Sydney, New South Wales, Australia
- Adult Cancer Program, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, New South Wales, Australia
| | - Chi Nam Ignatius Pang
- School of Biotechnology and Biomolecular Sciences, The University of New South Wales, Sydney, New South Wales, Australia
- Bioinformatics Unit, Children's Medical Research Institute, Westmead, Sydney, Australia
| | - Derek S. Chiu
- British Columbia's Gynecological Cancer Research Team (OVCARE), University of British Columbia, BC Cancer, and Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Michael S. Anglesio
- British Columbia's Gynecological Cancer Research Team (OVCARE), University of British Columbia, BC Cancer, and Vancouver General Hospital, Vancouver, British Columbia, Canada
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kylie-Ann Mallitt
- School of Clinical Medicine, Faculty of Medicine and Health, University of NSW Sydney, Sydney, New South Wales, Australia
- Centre for Big Data Research in Health, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Jennifer A. Doherty
- Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Holly R. Harris
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington
- Department of Epidemiology, University of Washington, Seattle, Washington
| | - Joellen M. Schildkraut
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Andrew Berchuck
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Duke University Medical Center, Durham, North Carolina
| | - Kara L. Cushing-Haugen
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Ksenia Chezar
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, Alberta, Canada
| | - Angela Chou
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- Department of Anatomical Pathology, Royal North Shore Hospital, Sydney, New South Wales, Australia
- The University of Sydney, Sydney, New South Wales, Australia
| | - Adeline Tan
- Division of Obstetrics and Gynaecology, Medical School, University of Western Australia, Crawley, Western Australia, Australia
- Western Women's Pathology, Western Diagnostic Pathology, Wembley, Western Australia, Australia
| | - Jennifer Alsop
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Ellen Barlow
- Gynaecological Cancer Centre, Royal Hospital for Women, Sydney, New South Wales, Australia
| | - Matthias W. Beckmann
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Jessica Boros
- The University of Sydney, Sydney, New South Wales, Australia
- Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - David D.L. Bowtell
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Medical Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | | | - Alison H. Brand
- The University of Sydney, Sydney, New South Wales, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - James D. Brenton
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
| | - Ian Campbell
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Medical Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Dane Cheasley
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Medical Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Joshua Cohen
- David Geffen School of Medicine, Department of Obstetrics and Gynecology, University of California at Los Angeles, Los Angeles, California
| | - Cezary Cybulski
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - Esther Elishaev
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Ramona Erber
- Institute of Pathology, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander Universität Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, Germany
| | - Rhonda Farrell
- The University of Sydney, Sydney, New South Wales, Australia
- Prince of Wales Private Hospital, Randwick, New South Wales, Australia
| | - Anna Fischer
- Institute of Pathology and Neuropathology, Tübingen University Hospital, Tübingen, Germany
| | - Zhuxuan Fu
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania
| | - Blake Gilks
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Anthony J. Gill
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- Department of Anatomical Pathology, Royal North Shore Hospital, Sydney, New South Wales, Australia
- The University of Sydney, Sydney, New South Wales, Australia
| | | | - Charlie Gourley
- Nicola Murray Centre for Ovarian Cancer Research, Cancer Research UK Scotland Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Marcel Grube
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - Paul R. Harnett
- The University of Sydney, Sydney, New South Wales, Australia
- Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales, Australia
| | - Arndt Hartmann
- Institute of Pathology and Neuropathology, Tübingen University Hospital, Tübingen, Germany
| | - Anusha Hettiaratchi
- The Health Precincts Biobank (formerly the Health Science Alliance Biobank), UNSW Biospecimen Services, Mark Wainwright Analytical Centre, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Claus K. Høgdall
- Department of Gynaecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Tomasz Huzarski
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
- Department of Genetics and Pathology, University of Zielona Góra, Zielona Góra, Poland
| | - Anna Jakubowska
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
- Independent Laboratory of Molecular Biology and Genetic Diagnostics, Pomeranian Medical University, Szczecin, Poland
| | | | - Catherine J. Kennedy
- The University of Sydney, Sydney, New South Wales, Australia
- Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Byoung-Gie Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae-Weon Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Jae-Hoon Kim
- Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kayla Klett
- Women's Cancer Research Center, Magee-Womens Research Institute and Hillman Cancer Center, Pittsburgh, Pennsylvania
| | | | - Tiffany Lai
- David Geffen School of Medicine, Department of Obstetrics and Gynecology, University of California at Los Angeles, Los Angeles, California
| | - Angela Laslavic
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Jenny Lester
- David Geffen School of Medicine, Department of Obstetrics and Gynecology, University of California at Los Angeles, Los Angeles, California
| | - Yee Leung
- Division of Obstetrics and Gynaecology, Medical School, University of Western Australia, Crawley, Western Australia, Australia
- Department of Gynaecological Oncology, King Edward Memorial Hospital, Subiaco, Western Australia, Australia
- Australia New Zealand Gynaecological Oncology Group, Camperdown, New South Wales, Australia
| | - Na Li
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Parkville Familial Cancer Centre, The Royal Melbourne Hospital and Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Winston Liauw
- School of Clinical Medicine, Faculty of Medicine and Health, University of NSW Sydney, Sydney, New South Wales, Australia
- Cancer Care Centre, St George Hospital, Sydney, New South Wales, Australia
| | - Belle W.X. Lim
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Anna Linder
- Department of Obstetrics and Gynecology, Inst of Clinical Science, Sahlgrenska Center for Cancer Research, University of Gothenburg, Gothenburg, Sweden
| | - Jan Lubiński
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - Sakshi Mahale
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Constantina Mateoiu
- Department of Pathology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Simone McInerny
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Parkville Familial Cancer Centre, The Royal Melbourne Hospital and Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Janusz Menkiszak
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Parham Minoo
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, Alberta, Canada
| | - Suzana Mittelstadt
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - David Morris
- St George and Sutherland Clinical School, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Sandra Orsulic
- David Geffen School of Medicine, Department of Obstetrics and Gynecology, University of California at Los Angeles, Los Angeles, California
| | - Sang-Yoon Park
- Center for Gynecologic Cancer, National Cancer Center Institute for Cancer Control, Goyang, Republic of Korea
| | - Celeste Leigh Pearce
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California
| | - John V. Pearson
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Malcolm C. Pike
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Carmel M. Quinn
- The Health Precincts Biobank (formerly the Health Science Alliance Biobank), UNSW Biospecimen Services, Mark Wainwright Analytical Centre, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Ganendra Raj Mohan
- Department of Gynaecological Oncology, King Edward Memorial Hospital, Subiaco, Western Australia, Australia
- Department of Gynaecological Oncology, St John of God Subiaco Hospital, Subiaco, Western Australia, Australia
- School of Medicine, University of Notre Dame, Fremantle, Western Australia, Australia
| | - Jianyu Rao
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Marjorie J. Riggan
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Duke University Medical Center, Durham, North Carolina
| | - Matthias Ruebner
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Stuart Salfinger
- Department of Gynaecological Oncology, St John of God Subiaco Hospital, Subiaco, Western Australia, Australia
| | - Clare L. Scott
- Sir Peter MacCallum Department of Medical Oncology, The University of Melbourne, Parkville, Victoria, Australia
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- Department of Medical Biology, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Mitul Shah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Helen Steed
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Alberta, Edmonton, Alberta, Canada
- Section of Gynecologic Oncology Surgery, North Zone, Alberta Health Services, Edmonton, Alberta, Canada
| | - Colin J.R. Stewart
- School for Women's and Infants' Health, University of Western Australia, Perth, Western Australia, Australia
| | | | - Soseul Sung
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Katrina Tang
- Department of Anatomical Pathology, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Paul Timpson
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Robyn L. Ward
- The University of Sydney, Sydney, New South Wales, Australia
| | - Rebekka Wiedenhoefer
- Institute of Pathology and Neuropathology, Tübingen University Hospital, Tübingen, Germany
| | - Heather Thorne
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | | | - Paul A. Cohen
- Division of Obstetrics and Gynaecology, Medical School, University of Western Australia, Crawley, Western Australia, Australia
- Department of Gynaecological Oncology, St John of God Subiaco Hospital, Subiaco, Western Australia, Australia
| | - Philip Crowe
- School of Clinical Medicine, Faculty of Medicine and Health, University of NSW Sydney, Sydney, New South Wales, Australia
- Department of Surgery, Prince of Wales Private Hospital, Randwick, New South Wales, Australia
| | - Peter A. Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Jacek Gronwald
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - Nicholas J. Hawkins
- School of Clinical Medicine, Faculty of Medicine and Health, University of NSW Sydney, Sydney, New South Wales, Australia
| | - Estrid Høgdall
- Department of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - David G. Huntsman
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Molecular Oncology, BC Cancer Research Centre, Vancouver, British Columbia, Canada
| | - Paul A. James
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Parkville Familial Cancer Centre, The Royal Melbourne Hospital and Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Beth Y. Karlan
- David Geffen School of Medicine, Department of Obstetrics and Gynecology, University of California at Los Angeles, Los Angeles, California
| | - Linda E. Kelemen
- Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina
| | - Stefan Kommoss
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - Gottfried E. Konecny
- David Geffen School of Medicine, Department of Obstetrics and Gynecology, University of California at Los Angeles, Los Angeles, California
| | - Francesmary Modugno
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania
- Women's Cancer Research Center, Magee-Womens Research Institute and Hillman Cancer Center, Pittsburgh, Pennsylvania
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Sue K. Park
- Cancer Research Institute, Seoul National University, Seoul, Korea
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Integrated Major in Innovative Medical Science, Seoul National University College of Medicine, Seoul, South Korea
| | - Annette Staebler
- Institute of Pathology and Neuropathology, Tübingen University Hospital, Tübingen, Germany
| | - Karin Sundfeldt
- Department of Obstetrics and Gynecology, Inst of Clinical Science, Sahlgrenska Center for Cancer Research, University of Gothenburg, Gothenburg, Sweden
| | - Anna H. Wu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California
| | - Aline Talhouk
- British Columbia's Gynecological Cancer Research Team (OVCARE), University of British Columbia, BC Cancer, and Vancouver General Hospital, Vancouver, British Columbia, Canada
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Paul D.P. Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, United Kingdom
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Lyndal Anderson
- The University of Sydney, Sydney, New South Wales, Australia
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, New South Wales, Australia
| | - Anna DeFazio
- The University of Sydney, Sydney, New South Wales, Australia
- Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
- The Daffodil Centre, a joint venture with Cancer Council NSW, The University of Sydney, Sydney, New South Wales, Australia
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, Alberta, Canada
| | - Michael L. Friedlander
- School of Clinical Medicine, Faculty of Medicine and Health, University of NSW Sydney, Sydney, New South Wales, Australia
- Gynaecological Cancer Centre, Royal Hospital for Women, Sydney, New South Wales, Australia
- Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Susan J. Ramus
- School of Clinical Medicine, Faculty of Medicine and Health, University of NSW Sydney, Sydney, New South Wales, Australia
- Adult Cancer Program, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, New South Wales, Australia
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Long X, Li R, Tang Y, Yang L, Zou D. The effect of chemotherapy in patients with stage I mucinous ovarian cancer undergoing fertility-sparing surgery. Front Oncol 2022; 12:1028842. [DOI: 10.3389/fonc.2022.1028842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/24/2022] [Indexed: 11/11/2022] Open
Abstract
ObjectiveTo determine the effect of adjuvant chemotherapy in patients with stage I mucinous ovarian cancer (MOC) undergoing fertility-preserving surgery.Patients and methodsThe clinicopathological characteristics and survival information of young women with stage I MOC from SEER databases between 2004 and 2019 were collected. The relationship between chemotherapy and the characteristics was examined by univariate and multivariate logistic regression analyses. Univariable and multivariate Cox proportional hazards survival analysis were employed for cancer-specific survival. Cox analysis was performed to build a nomogram model.ResultsAll 901 eligible patients with stage I MOC were screened from the SEER database. There were 321(35.6%) patients aged 9-30 years, 580(64.4%) aged 31-45 years, 645 (71.6%) patients with stage IA/IB, 256 (28.4%) with stage IC disease, 411(45.6%) who underwent fertility-sparing surgery, and276(30.6%) who received postoperative adjuvant chemotherapy. Multivariate logistic regression analyses showed that postoperative chemotherapy was often used in patients aged 31-45 relative to aged 9-30 (HR: 2.215, 95%CI 1.443-3.401, P < 0.001) or with grade 3 compared to grade 1 tumors (HR: 7.382, 95%CI 4.054-13.443, P < 0.001) or with stage IC compared to stage IA/IB (HR: 6.436, 95%CI 4.515-9.175, P < 0.001) or with non-fertility sparing surgery relative to fertility-sparing (HR:2.226, 95%CI 1.490-3.327, P < 0.001). Multivariate analysis for the special population with fertility preservation indicated that patients with chemotherapy (HR: 2.905, 95% CI: 0.938-6.030, P=0.068) or with grade 3 (HR: 4.750, 95% CI: 1.419-15.896, P=0.011) had a greater risk of mortality. Significant CSS differences were observed between the non-chemotherapy and chemotherapy groups in MOC when patients were stage IA/IB-grade 2 (P=0.004) (10-year CSS rates of chemotherapy=84%, non-chemotherapy = 100%), but not when they were stage IA/IB-grade 1, stage IA/IB-grade 3 or stage IC (both P>0.05). A prognostic prediction nomogram model was built for stage I MOC patient who underwent fertility-sparing and the C-index was 0.709.DiscussionThe patients aged 31-45 years, with grade 3, stage IC, and non-fertility-sparing surgery were more likely to receive adjuvant chemotherapy in the real world. For stage I MOC patient who underwent fertility-sparing surgery, the choice of chemotherapy may increase the risk of death, and it should be carefully selected in clinical practice.
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Huang J, Zhang Y, Zhou J, Fang M, Wu X, Luo Y, Huang Q, Ouyang Y, Xiao S. Development and validation of a prognostic nomogram for patients with stage II colon mucinous adenocarcinoma. Int J Colorectal Dis 2022; 37:2173-2184. [PMID: 36149446 DOI: 10.1007/s00384-022-04251-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/14/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE Mucinous histology is generally considered as a risk factor of prognosis in stage II colon cancer, but there is no appropriate model for prognostic evaluation and treatment decision in patients with stage II colon mucinous adenocarcinoma (C-MAC) Thus, it is urgent to develop a comprehensive, individualized evaluation tool to reflect the heterogeneity of stage II C-MAC. METHODS Patients with stage II C-MAC who underwent surgical treatment in the Surveillance, Epidemiology, and End Results Program were enrolled and randomly divided into training cohort (70%) and internal validation cohort (30%). Prognostic predictors which were determined by univariate and multivariate analysis in the training cohort were included in the nomogram. The calibration curves, decision curve analysis, X-tile analysis, and Kaplan-Meier curve of the nomogram were validated in the internal validation cohort. RESULTS Three thousand seven hundred sixty-two patients of stage II C-MAC were enrolled. The age, pathological T (pT) stage, tumor number, serum carcinoembryonic antigen (CEA), and perineural invasion (PNI) were independent predictors of overall survival (OS), which were used to establish a nomogram. Calibration curves of the nomogram indicated good consistency between nomogram prediction and actual survival for 1-, 3- and 5-year OS. Besides, patients with stage II C-MAC could be divided into high-, middle-, and low-risk subgroups by the nomogram. Further subgroup analysis indicated that patients in the high-risk group could have a survival benefit from chemotherapy after surgical treatment. CONCLUSIONS We established the first nomogram to accurately predict the survival of stage II C-MAC patients who underwent surgical treatment. In addition, the nomogram identified low-, middle-, and high-risk subgroups of patients and found chemotherapy might improve survival in the high-risk subgroup of stage II C-MAC patients.
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Affiliation(s)
- Jia Huang
- The First Affiliated Hospital, Cancer Research Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, People's Republic of China.,The First Affiliated Hospital, Department of Ultrasound Medicine, Hengyang Medical School, University of South China Hengyang, Hunan, People's Republic of China
| | - Yiwei Zhang
- The First Affiliated Hospital, Cancer Research Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, People's Republic of China
| | - Jia Zhou
- The First Affiliated Hospital, Cancer Research Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, People's Republic of China.,The First Affiliated Hospital, Department of Ultrasound Medicine, Hengyang Medical School, University of South China Hengyang, Hunan, People's Republic of China
| | - Min Fang
- The First Affiliated Hospital, Department of Gastrointestinal Surgery, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, People's Republic of China
| | - Xiaofeng Wu
- The First Affiliated Hospital, Cancer Research Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, People's Republic of China.,The First Affiliated Hospital, Department of Gastrointestinal Surgery, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, People's Republic of China
| | - Yuhang Luo
- The First Affiliated Hospital, Cancer Research Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, People's Republic of China
| | - Qiulin Huang
- The First Affiliated Hospital, Department of Gastrointestinal Surgery, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, People's Republic of China.
| | - Yujuan Ouyang
- Nuclear Industrial Hygiene School, University of South China, Hengyang, Hunan, 421001, People's Republic of China.
| | - Shuai Xiao
- The First Affiliated Hospital, Cancer Research Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, People's Republic of China. .,The First Affiliated Hospital, Department of Gastrointestinal Surgery, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, People's Republic of China.
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Poudel D, Acharya K, Poudel N, Adhikari A, Khaniya B, Maskey S. Bilateral ovarian mucinous carcinoma (stage III) with omental involvement and incidental hydronephrosis: A rare case report. Int J Surg Case Rep 2022; 97:107415. [PMID: 35863287 PMCID: PMC9403200 DOI: 10.1016/j.ijscr.2022.107415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/11/2022] [Accepted: 07/11/2022] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Though ovarian malignancies are common, mucinous ovarian carcinomas of high grade are rare. They usually occur in a young female under 40 years of age. Here, we present a case of mucinous ovarian carcinoma (stage III), with omental involvement and incidental hydronephrosis in a 67-year-old female patient. CASE PRESENTATION A 67-year-old female patient presented to us with a history of lower abdominal pain for 2 months and per-vaginal discharge for the last 6 days. On deep palpation of the abdomen, a nodular mass occupying the suprapubic region was found. Bimanual palpation revealed a mass on the right and left adnexa. After visualization of septate cystic mass bilaterally on CECT, she was planned for staging laparotomy with bilateral salpingo-oophorectomy (BSO) with infra-colic omentectomy with peritoneal cytology. Incidentally, a horseshoe-shaped kidney with right mild hydronephrosis was found. After surgery and histopathologic examination, mucinous ovarian carcinoma (stage III), with omental involvement was confirmed. DISCUSSION Mucinous ovarian carcinomas are rare malignancies, with different natural history, molecular profile, and prognosis as compared to other epithelial tumors of the ovary. These carcinomas can be either primary or secondary (those metastasized to the ovary from elsewhere), and this differentiation is essential. The therapeutic approach to the patients depends upon the stage at which these carcinomas are diagnosed. CONCLUSION Mucinous ovarian carcinomas are rare and have unique features among the epithelial ovarian carcinomas. Appreciation of these features will surely make a positive impact in improving the management and thus the prognosis of these carcinomas.
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Affiliation(s)
- Diptee Poudel
- Maharajgunj Medical Campus, Tribhuvan University Institute of Medicine, Kathmandu, Nepal
| | - Kshitiz Acharya
- Maharajgunj Medical Campus, Tribhuvan University Institute of Medicine, Kathmandu, Nepal.
| | - Navin Poudel
- Maharajgunj Medical Campus, Tribhuvan University Institute of Medicine, Kathmandu, Nepal.
| | - Ashmita Adhikari
- Department of Obstetrics and Gynecology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Bishal Khaniya
- Department of Obstetrics and Gynecology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Suvana Maskey
- Department of Obstetrics and Gynecology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
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10
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Zhang K, Feng S, Ge Y, Ding B, Shen Y. A Nomogram Based on SEER Database for Predicting Prognosis in Patients with Mucinous Ovarian Cancer: A Real-World Study. Int J Womens Health 2022; 14:931-943. [PMID: 35924098 PMCID: PMC9341457 DOI: 10.2147/ijwh.s372328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/19/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose Mucinous ovarian cancer (MOC) is a rare histological type of EOC. In order to guide the clinical diagnosis and management of MOC patients, we constructed and verified a nomogram for the estimation of overall survival in patients with MOC. Patients and Methods We collected 494 patients with MOC diagnosed from 2010 to 2015 in SEER database, and the following main inclusion criteria were used: (1) patients whose MOC was confirmed by pathology; (2) patients without a history of primary other cancer. Subsequently, we performed randomized grouping (6:4) and Cox hazard regression analysis in the training group. Subsequently, the nomogram was established. A variety of indicators were used to validate the prognosis value of nomogram, including the C-index, area under the receiver operating characteristic curve, calibration curve, and decision curve analysis (DCA). Moreover, Kaplan–Meier analysis was used to compare the survival results among different risk subgroups. Results Cox hazard regression analysis revealed that age, grade, FIGO stage and log odds of positive lymph nodes stage were independent risk factors for patients with MOC. In the training group, the C-index of the nomogram was 0.827 (95% CI: 0.791–0.863) and the areas under the curve (AUC) predicting the 1-, 3- and 5-year survival rate were 0.853 (95% CI: 0.791–0.915), 0.886 (95% CI: 0.852–0.920) and 0.815 (95% CI: 0.766–0.864), respectively. The calibration curve revealed that the nomogram of the 1-, 3- and 5-year survival rate was consistent with the actual fact. Patients with high risk had a poorer prognosis than those with low risk (P < 0.001). DCA revealed that the nomogram had the best clinical value than other classical prognostic markers. Similarly, nomogram had excellent prognostic ability in the testing group. Conclusion The nomogram was constructed to predict overall survival in patients with MOC, which had the significance for clinical evaluation.
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Affiliation(s)
- Ke Zhang
- Department of Obstetrics and Gynaecology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, People’s Republic of China
| | - Songwei Feng
- Department of Obstetrics and Gynaecology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, People’s Republic of China
| | - Yu Ge
- Department of Obstetrics and Gynaecology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, People’s Republic of China
| | - Bo Ding
- Department of Obstetrics and Gynaecology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, People’s Republic of China
| | - Yang Shen
- Department of Obstetrics and Gynaecology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, People’s Republic of China
- Correspondence: Yang Shen, Department of Obstetrics and Gynaecology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, People’s Republic of China, Email
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11
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Che H, Jatsenko T, Lenaerts L, Dehaspe L, Vancoillie L, Brison N, Parijs I, Van Den Bogaert K, Fischerova D, Heremans R, Landolfo C, Testa AC, Vanderstichele A, Liekens L, Pomella V, Wozniak A, Dooms C, Wauters E, Hatse S, Punie K, Neven P, Wildiers H, Tejpar S, Lambrechts D, Coosemans A, Timmerman D, Vandenberghe P, Amant F, Vermeesch JR. Pan-Cancer Detection and Typing by Mining Patterns in Large Genome-Wide Cell-Free DNA Sequencing Datasets. Clin Chem 2022; 68:1164-1176. [PMID: 35769009 DOI: 10.1093/clinchem/hvac095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 04/25/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Cell-free DNA (cfDNA) analysis holds great promise for non-invasive cancer screening, diagnosis, and monitoring. We hypothesized that mining the patterns of cfDNA shallow whole-genome sequencing datasets from patients with cancer could improve cancer detection. METHODS By applying unsupervised clustering and supervised machine learning on large cfDNA shallow whole-genome sequencing datasets from healthy individuals (n = 367) and patients with different hematological (n = 238) and solid malignancies (n = 320), we identified cfDNA signatures that enabled cancer detection and typing. RESULTS Unsupervised clustering revealed cancer type-specific sub-grouping. Classification using a supervised machine learning model yielded accuracies of 96% and 65% in discriminating hematological and solid malignancies from healthy controls, respectively. The accuracy of disease type prediction was 85% and 70% for the hematological and solid cancers, respectively. The potential utility of managing a specific cancer was demonstrated by classifying benign from invasive and borderline adnexal masses with an area under the curve of 0.87 and 0.74, respectively. CONCLUSIONS This approach provides a generic analytical strategy for non-invasive pan-cancer detection and cancer type prediction.
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Affiliation(s)
- Huiwen Che
- Department of Human Genetics, Laboratory for Cytogenetics and Genome Research, KU Leuven, Leuven, Belgium
| | - Tatjana Jatsenko
- Department of Human Genetics, Laboratory for Cytogenetics and Genome Research, KU Leuven, Leuven, Belgium
| | - Liesbeth Lenaerts
- Department of Oncology, Laboratory of Gynecological Oncology, KU Leuven, Leuven, Belgium
| | - Luc Dehaspe
- Centre for Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | - Leen Vancoillie
- Centre for Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | - Nathalie Brison
- Centre for Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | - Ilse Parijs
- Centre for Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | | | - Daniela Fischerova
- Department of Obstetrics and Gynaecology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Ruben Heremans
- Department of Development and Regeneration, Woman and Child, KU Leuven, Leuven, Belgium
| | - Chiara Landolfo
- Department of Gynecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium
| | - Antonia Carla Testa
- Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore Roma, Rome, Italy
| | | | - Lore Liekens
- Department of Oncology, Molecular Digestive Oncology, KU Leuven, Leuven, Belgium
| | - Valentina Pomella
- Department of Oncology, Molecular Digestive Oncology, KU Leuven, Leuven, Belgium
| | - Agnieszka Wozniak
- Department of Oncology, Laboratory of Experimental Oncology, KU Leuven, Leuven, Belgium
| | - Christophe Dooms
- Department of Chronic Diseases and Metabolism, Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium.,Department of Pneumology, University Hospitals Leuven, Leuven, Belgium
| | - Els Wauters
- Department of Chronic Diseases and Metabolism, Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium.,Department of Pneumology, University Hospitals Leuven, Leuven, Belgium
| | - Sigrid Hatse
- Department of Oncology, Laboratory of Experimental Oncology, KU Leuven, Leuven, Belgium.,Multidisciplinary Breast Centre, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - Kevin Punie
- Multidisciplinary Breast Centre, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium.,Department of General Medical Oncology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - Patrick Neven
- Department of Gynecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium.,Multidisciplinary Breast Centre, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - Hans Wildiers
- Multidisciplinary Breast Centre, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium.,Department of General Medical Oncology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - Sabine Tejpar
- Department of Oncology, Molecular Digestive Oncology, KU Leuven, Leuven, Belgium
| | - Diether Lambrechts
- Department of Human Genetics, Laboratory of Translational Genetics, VIB-KU Leuven, Leuven, Belgium
| | - An Coosemans
- Department of Oncology, Laboratory of Tumor Immunology and Immunotherapy, Leuven Cancer Institute, KU Leuven, Leuven, Belgium
| | - Dirk Timmerman
- Department of Development and Regeneration, Woman and Child, KU Leuven, Leuven, Belgium.,Department of Gynecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium
| | - Peter Vandenberghe
- Department of Human Genetics, Laboratory of Genetics of Malignant Diseases, KU Leuven, Leuven, Belgium.,Department of Hematology, University Hospitals Leuven, Leuven, Belgium
| | - Frédéric Amant
- Department of Oncology, Laboratory of Gynecological Oncology, KU Leuven, Leuven, Belgium.,Department of Gynecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium.,Department of Surgery, Center for Gynecological Oncology Amsterdam, Academic Medical Centre Amsterdam-University of Amsterdam and the Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Joris Robert Vermeesch
- Department of Human Genetics, Laboratory for Cytogenetics and Genome Research, KU Leuven, Leuven, Belgium.,Centre for Human Genetics, University Hospitals Leuven, Leuven, Belgium
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12
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Patient-derived tumor models are attractive tools to repurpose drugs for ovarian cancer treatment: Pre-clinical updates. Oncotarget 2022; 13:553-575. [PMID: 35359749 PMCID: PMC8959092 DOI: 10.18632/oncotarget.28220] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 03/08/2022] [Indexed: 11/29/2022] Open
Abstract
Despite advances in understanding of ovarian cancer biology, the progress in translation of research findings into new therapies is still slow. It is associated in part with limitations of commonly used cancer models such as cell lines and genetically engineered mouse models that lack proper representation of diversity and complexity of actual human tumors. In addition, the development of de novo anticancer drugs is a lengthy and expensive process. A promising alternative to new drug development is repurposing existing FDA-approved drugs without primary oncological purpose. These approved agents have known pharmacokinetics, pharmacodynamics, and toxicology and could be approved as anticancer drugs quicker and at lower cost. To successfully translate repurposed drugs to clinical application, an intermediate step of pre-clinical animal studies is required. To address challenges associated with reliability of tumor models for pre-clinical studies, there has been an increase in development of patient-derived xenografts (PDXs), which retain key characteristics of the original patient’s tumor, including histologic, biologic, and genetic features. The expansion and utilization of clinically and molecularly annotated PDX models derived from different ovarian cancer subtypes could substantially aid development of new therapies or rapid approval of repurposed drugs to improve treatment options for ovarian cancer patients.
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Chelariu-Raicu A, Holley E, Mayr D, Klauschen F, Wehweck F, Rottmann M, Kessler M, Kaltofen T, Czogalla B, Trillsch F, Mahner S, Schmoeckel E. A combination of immunohistochemical markers, MUC1, MUC5AC, PAX8 and growth pattern for characterization of mucinous neoplasm of the ovary. Int J Gynecol Cancer 2022; 32:662-668. [PMID: 35185017 DOI: 10.1136/ijgc-2021-003104] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Because mucinous carcinomas are rare tumors that affect several organ sites and are known to originate from different tissues, leading to frequent misdiagnoses, the objective was to characterize the differences between primary mucinous tumors of the ovary and metastatic mucinous cancer to the ovary by studying the expression pattern of several candidate biomarkers. METHODS Tissue samples of mucinous histology were obtained between 1985 and 2015. Individual ovary and colon tissue samples were analyzed, including standard (PAX8, CK20, CK7, CDX2, SATB2, estrogen/progesterone) and new (MUC1, MUC5AC) biomarkers, which were then scored for immunoreactivity semi-quantitatively. RESULTS The study cohort included 98 mucinous tumor samples, including benign mucinous cystadenoma (n=24), mucinous borderline tumors (n=24), mucinous carcinomas (n=40), and metastatic mucinous ovarian carcinomas (n=10). A strong positive correlation was found between PAX8 scoring (p=0.003), CK7 scoring (p=0.0001), and MUC1 scoring (p=0.001) in primary mucinous ovarian cancer. Tumors of increasing invasiveness were analyzed and a significant decrease in the scoring of MUC5AC (p=0.001) was observed, with a stronger expression in adenomas (87%) and borderline tumors (75%), and a lower expression in mucinous cancers (42%). Patients survived significantly longer when their tumors expressed high PAX8 and showed an expansile invasion pattern (p=0.005 and p=0.015, respectively) compared with patients with PAX8-negative tumors and destructive invasion pattern. CONCLUSION The study data support the diagnostic value of MUC1 as a new biomarker to differentiate between primary and metastatic mucinous ovarian cancer. In addition, the tumor growth pattern along with the PAX8 immunophenotype might represent potential prognostic biomarkers for primary mucinous ovarian carcinomas.
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Affiliation(s)
- Anca Chelariu-Raicu
- Department of Obstetrics and Gynecology, University Hospital, Ludwig Maximilians University Munich, Munich, Bayern, Germany
| | | | | | | | | | - Miriam Rottmann
- Institute for Medical Information Processing, Biometry and Epidemiology, Munich, Germany
| | - Mirjana Kessler
- Department of Obstetrics and Gynecology, University Hospital, Ludwig Maximilians University Munich, Munich, Bayern, Germany
| | - Till Kaltofen
- Department of Obstetrics and Gynecology, University Hospital, Ludwig Maximilians University Munich, Munich, Bayern, Germany
| | - Bastian Czogalla
- Department of Obstetrics and Gynecology, University Hospital, Ludwig Maximilians University Munich, Munich, Bayern, Germany
| | - Fabian Trillsch
- Department of Obstetrics and Gynecology, University Hospital, Ludwig Maximilians University Munich, Munich, Bayern, Germany
| | - Sven Mahner
- Department of Obstetrics and Gynecology, University Hospital, Ludwig Maximilians University Munich, Munich, Bayern, Germany
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14
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Ahn T, Kim K, Kim H, Kim S, Park S, Lee K. A transcriptome-Based Deep Neural Network Classifier for Identifying the Site of Origin in Mucinous Cancer. Cancer Inform 2022; 21:11769351221135141. [DOI: 10.1177/11769351221135141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 09/30/2022] [Indexed: 11/16/2022] Open
Abstract
Purpose: There is a lack of tools for identifying the site of origin in mucinous cancer. This study aimed to evaluate the performance of a transcriptome-based classifier for identifying the site of origin in mucinous cancer. Materials And Methods: Transcriptomic data of 1878 non-mucinous and 82 mucinous cancer specimens, with 7 sites of origin, namely, the uterine cervix (CESC), colon (COAD), pancreas (PAAD), stomach (STAD), uterine endometrium (UCEC), uterine carcinosarcoma (UCS), and ovary (OV), obtained from The Cancer Genome Atlas, were used as the training and validation sets, respectively. Transcriptomic data of 14 mucinous cancer specimens from a tissue archive were used as the test set. For identifying the site of origin, a set of 100 differentially expressed genes for each site of origin was selected. After removing multiple iterations of the same gene, 427 genes were chosen, and their RNA expression profiles, at each site of origin, were used to train the deep neural network classifier. The performance of the classifier was estimated using the training, validation, and test sets. Results: The accuracy of the model in the training set was 0.998, while that in the validation set was 0.939 (77/82). In the test set which is newly sequenced from a tissue archive, the model showed an accuracy of 0.857 (12/14). t-SNE analysis revealed that samples in the test set were part of the clusters obtained for the training set. Conclusion: Although limited by small sample size, we showed that a transcriptome-based classifier could correctly identify the site of origin of mucinous cancer.
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Affiliation(s)
- Taejin Ahn
- Department of Life Science, Handong Global University, Pohang, Republic of Korea
| | - Kidong Kim
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hyojin Kim
- Department of Pathology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Sarah Kim
- Department of Life Science, Handong Global University, Pohang, Republic of Korea
| | - Sangick Park
- Department of Life Science, Handong Global University, Pohang, Republic of Korea
| | - Kyoungbun Lee
- Department of Pathology, Seoul National University Hospital, Seoul, Republic of Korea
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15
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Gu JH, Gong TT, Wu QJ, Liu FH, Wen ZY, Gao C, Wei YF, Yang Z. Association Between Pre-diagnostic Dietary Supplements Intake and Ovarian Cancer Survival: Findings From a Prospective Cohort Study in Chinese Women. Front Nutr 2022; 8:758178. [PMID: 34970575 PMCID: PMC8712326 DOI: 10.3389/fnut.2021.758178] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 11/11/2021] [Indexed: 12/11/2022] Open
Abstract
Background: As a result of a limited number of studies and inconsistent findings, there remains uncertainty in whether pre-diagnostic dietary supplements intake affects survival after ovarian cancer (OC) diagnosis. Methods: The association between pre-diagnostic dietary supplements intake and all-cause OC mortality was examined in the OC follow-up study, which included a hospital-based cohort (n = 703) of Chinese women diagnosed with OC between 2015 and 2020. Pre-diagnostic dietary supplements information was collected using self-administered questionnaires. Deaths were ascertained up to March 31, 2021, via death registry linkage. Cox proportional hazards were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the aforementioned association. Results: A total of 130 women died during the median follow-up of 37.2 months (interquartile: 24.7–50.2 months). We found no evidence that any pre-diagnostic dietary supplements intake compared with never is associated with OC survival (HR = 0.75, 95%CI: 0.47–1.18). Furthermore, our study suggested no association for ever supplements intakes of vitamin A (HR = 0.48, 95%CI: 0.07–3.46), vitamin C (HR = 0.64, 95%CI: 0.27–1.54), vitamin D (HR = 1.19, 95%CI: 0.28–5.03), vitamin E (HR = 0.47, 95%CI: 0.06–3.87), multivitamin (HR = 0.49, 95%CI: 0.14–1.67), calcium (HR = 0.96, 95%CI: 0.53–1.72), and fish oil/DHA (HR = 0.31, 95%CI: 0.04–2.37) with OC survival. Interestingly, we only found a detrimental effect of vitamin B supplementation intake (HR = 3.78, 95%CI: 1.33–0.69) on OC survival. Conclusions: We found no evidence that any pre-diagnostic dietary supplements intake is associated with OC survival. Considering lower exposure of dietary supplements before OC diagnosis in the present study, further studies are warranted to confirm these findings.
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Affiliation(s)
- Jia-Hui Gu
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ting-Ting Gong
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Fang-Hua Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhao-Yan Wen
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Chang Gao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yi-Fan Wei
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhuo Yang
- Department of Gynecology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China
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16
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Lee SW, Sung JA, Jung M, Kim H, Lee C. Prognosis in primary mucinous ovarian carcinoma: focusing on the five pathological findings indicating metastatic mucinous carcinoma to the ovary. J Gynecol Oncol 2021; 33:e18. [PMID: 34910399 PMCID: PMC8899875 DOI: 10.3802/jgo.2022.33.e18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 11/21/2021] [Accepted: 11/21/2021] [Indexed: 11/30/2022] Open
Abstract
Objective Pathological features indicating metastatic mucinous carcinoma to the ovary (MMCO) have been rarely reported in primary mucinous ovarian carcinoma (PMOC). However, little is known about how often they are observed in PMOC and how they relate to patient prognosis. In this study, we investigated the pathological features indicating MMCO in a large cohort of PMOCs and analyzed their association with patient prognosis. Methods We reviewed surgically treated PMOC patients diagnosed at the Seoul National University Hospital from 1995 to 2019, according to the updated WHO classification, and investigated the presence of pathological features indicating MMCO. Results A total of 144 patients with PMOCs were included. The 5 pathological findings indicating MMCO, including an infiltrative invasive pattern, the absence of benign or borderline components, a smaller tumor size, the presence of signet ring cells and the presence of extracellular mucin were observed in PMOC (21.6%, 43.1%, 20.8%, 4.3% and 12.9%, respectively), and were significantly correlated with poor overall and progression-free survival rates in PMOC. The patient’s prognosis worsened as the extent of the infiltrative invasive pattern increased (p<0.001). In addition, the prognostic power was stronger when the 5 pathological factors were analyzed together (new grouping system) than when analyzed individually (p<0.001) and the new grouping system was identified as an independent prognostic factor regardless of FIGO stage. Conclusion Five pathological findings indicating MMCO in PMOC were significantly associated with poor prognosis in PMOC patients. Also, the new grouping system combining these findings was identified as an independent prognostic factor. Pathologic features indicating metastatic mucinous carcinoma to the ovary (MMCO) have been rarely reported in primary mucinous ovarian carcinomas (PMOCs). We found the 5 pathological findings indicating MMCO in PMOC were significantly associated with poor prognosis in PMOC patients.
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Affiliation(s)
- Sang Won Lee
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Jung-A Sung
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Minsun Jung
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Haeryoung Kim
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Cheol Lee
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.
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17
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Shoji T, Tatsuki S, Abe M, Tomabechi H, Takatori E, Kaido Y, Nagasawa T, Kagabu M, Baba T, Itamochi H. Novel Therapeutic Strategies for Refractory Ovarian Cancers: Clear Cell and Mucinous Carcinomas. Cancers (Basel) 2021; 13:6120. [PMID: 34885229 PMCID: PMC8656608 DOI: 10.3390/cancers13236120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/24/2021] [Accepted: 11/30/2021] [Indexed: 12/13/2022] Open
Abstract
Ovarian cancer has the worst prognosis among gynecological cancers. In particular, clear cell and mucinous carcinomas are less sensitive to chemotherapy. The establishment of new therapies is necessary to improve the treatment outcomes for these carcinomas. In previous clinical studies, chemotherapy with cytotoxic anticancer drugs has failed to demonstrate better treatment outcomes than paclitaxel + carboplatin therapy. In recent years, attention has been focused on treatment with molecular target drugs and immune checkpoint inhibitors that target newly identified biomarkers. The issues that need to be addressed include the most appropriate combination of therapies, identifying patients who may benefit from each therapy, and how results should be incorporated into the standard of care for ovarian clear cell and mucinous carcinomas. In this article, we have reviewed the most promising therapies for ovarian clear cell and mucinous carcinomas, which are regarded as intractable, with an emphasis on therapies currently being investigated in clinical studies.
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Affiliation(s)
- Tadahiro Shoji
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Shunsuke Tatsuki
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Marina Abe
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Hidetoshi Tomabechi
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Eriko Takatori
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Yoshitaka Kaido
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Takayuki Nagasawa
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Masahiro Kagabu
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Tsukasa Baba
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Hiroaki Itamochi
- Department of Clinical Oncology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan;
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18
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Yan C, Yang H, Chen L, Liu R, Shang W, Yuan W, Yang F, Sun Q, Xia L. Clinical significance of mucinous component in colorectal adenocarcinoma: a propensity score-matched study. BMC Cancer 2021; 21:1286. [PMID: 34852768 PMCID: PMC8638428 DOI: 10.1186/s12885-021-09031-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 11/15/2021] [Indexed: 01/12/2023] Open
Abstract
Background This study aims to investigate the clinical significance and prognostic value of mucinous component (MC) in colorectal adenocarcinoma (AC). Methods Patients with colorectal AC and AC with MC (ACMC) (1–100%) underwent surgical resection between January 2007 and February 2018 were retrospectively reviewed. Propensity score matching (PSM) was performed according to a 1:1 ratio. Receiver-operating characteristic (ROC) curve was used to identify the optimal cut-off value of MC ratio for prognostic prediction. The clinicopathological features and 3-year overall survival (OS) of AC patients, mucinous adenocarcinoma (MAC) (MC > 50%) patients, and ACMC (1–50%) patients were compared before and after matching. Multivariable analysis was used for analyzing independent risk factors related to prognosis. Results A total of 532 patients were enrolled in this study. Patients with AC, MAC, and ACMC (1–50%) exhibited different clinicopathological features. However, their 3-year OS rates were similar (82.00% vs. 74.11% vs. 81.48%, P = 0.38). After matching, ROC curve determined 70% as the optimal cut-off value. And patients with ACMC > 70% had a much poorer 3-year OS compared with ACMC (1–70%) patients and AC patients (47.37% vs. 86.15% vs. 79.76%, P < 0.001). In addition, ACMC > 70% was revealed as a risk factor for poor survival in univariate analysis (HR = 1.643, 95%CI = 1.025–2.635, P = 0.039), though not an independent risk factor in multivariable analysis (HR = 1.550, 95%CI = 0.958–2.507, P = 0.074). Conclusions MAC is usually diagnosed at an advanced stage. MAC has a similar survival with AC and ACMC (1–50%) patients before and after matching. Patients with ACMC > 70% exhibited a much poorer OS, and should be given more clinical attention.
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Affiliation(s)
- Chuanwang Yan
- Department of General Surgery, Shandong Provincial Qianfoshan Hospital, Weifang Medical University, Key Laboratory of Metabolism and Gastrointestinal Tumor, the First Affiliated Hospital of Shandong First Medical University, Key Laboratory of Laparoscopic Technology, the First Affiliated Hospital of Shandong First Medical University, Shandong Medicine and Health Key Laboratory of General Surgery, Weifang, 261000, Shandong, China
| | - Hui Yang
- Department of General Surgery, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Key Laboratory of Metabolism and Gastrointestinal Tumor, the First Affiliated Hospital of Shandong First Medical University, Key Laboratory of Laparoscopic Technology, the First Affiliated Hospital of Shandong First Medical University, Shandong Medicine and Health Key Laboratory of General Surgery, Jinan, 250000, Shandong, China
| | - Lili Chen
- Department of Pathology, Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan, 250000, Shandong, China
| | - Ran Liu
- Department of General Surgery, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Key Laboratory of Metabolism and Gastrointestinal Tumor, the First Affiliated Hospital of Shandong First Medical University, Key Laboratory of Laparoscopic Technology, the First Affiliated Hospital of Shandong First Medical University, Shandong Medicine and Health Key Laboratory of General Surgery, Jinan, 250000, Shandong, China
| | - Wei Shang
- Department of General Surgery, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Key Laboratory of Metabolism and Gastrointestinal Tumor, the First Affiliated Hospital of Shandong First Medical University, Key Laboratory of Laparoscopic Technology, the First Affiliated Hospital of Shandong First Medical University, Shandong Medicine and Health Key Laboratory of General Surgery, Jinan, 250000, Shandong, China
| | - Wenguang Yuan
- Department of General Surgery, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Key Laboratory of Metabolism and Gastrointestinal Tumor, the First Affiliated Hospital of Shandong First Medical University, Key Laboratory of Laparoscopic Technology, the First Affiliated Hospital of Shandong First Medical University, Shandong Medicine and Health Key Laboratory of General Surgery, Jinan, 250000, Shandong, China
| | - Fei Yang
- Department of Pathology, Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan, 250000, Shandong, China.
| | - Qing Sun
- Department of Pathology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Clinical Pathology, Shandong Lung Cancer Institute, Shandong Institute of Nephrology, Jinan, China.
| | - Lijian Xia
- Department of Pathology, Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan, 250000, Shandong, China.
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19
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El Bairi K, Al Jarroudi O, Le Page C, Afqir S. Does the "Devil" originate from the fallopian tubes? Semin Cancer Biol 2021; 77:56-66. [PMID: 33766647 DOI: 10.1016/j.semcancer.2021.03.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 03/14/2021] [Accepted: 03/20/2021] [Indexed: 02/08/2023]
Abstract
Epithelial ovarian cancer (OC) is a heterogeneous disease and continues to be mostly diagnosed in advanced stages. The high lethality, the high rate of platinum-resistance, and the poor survival outcomes are the principal factors for categorizing OC among the most aggressive gynecological cancers. Only recently, a substantial progress has been made in our latest understanding of the origins of OC, particularly of high-grade serous histology. For a long time, the accumulation of genetic alterations in epithelial single layer cells of ovarian cysts caused by cyclic ovulations was considered as the most important driver and the long-standing dogma of ovarian tumorigenesis. Besides, the unique biological features and high histological heterogeneity of OC did not support this hypothesis. Indeed, various extra-ovarian cells of origin and multiple sites to each histotype were proposed, supported by cogent evidence from clinical cohorts and animal studies. In light of this enigma, this review was conducted to discuss the recent evidence supporting the revised origins of ovarian carcinoma histotypes with a particular focus on high-grade serous OC which may impact diagnostic and preventive approaches.
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Affiliation(s)
- Khalid El Bairi
- Department of Medical Oncology, Mohammed VI University Hospital, Oujda, Morocco; Faculty of Medicine and Pharmacy, Mohammed I(st) University, Oujda, Morocco.
| | - Ouissam Al Jarroudi
- Department of Medical Oncology, Mohammed VI University Hospital, Oujda, Morocco; Faculty of Medicine and Pharmacy, Mohammed I(st) University, Oujda, Morocco
| | - Cécile Le Page
- Research Institute of McGill University Health Center (RI-MUHC), Montréal, QC, Canada
| | - Said Afqir
- Department of Medical Oncology, Mohammed VI University Hospital, Oujda, Morocco; Faculty of Medicine and Pharmacy, Mohammed I(st) University, Oujda, Morocco
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20
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Abstract
OPINION STATEMENT Complete surgical resection is the gold-standard treatment for all mucinous ovarian carcinoma (MOC) cases. Advanced-stage disease is often additionally treated with adjuvant platinum-based chemotherapy; however, these were developed largely against the more common high-grade serous ovarian carcinoma and have low efficacy in treating MOC. More effective therapeutics are needed to treat late-stage and platinum-resistant tumors; however, traditional drug development and clinical trial paradigms are a major challenge for such a rare disease. New approaches to support evidence-based treatment decisions are required, such as registry trials. Recently, a number of targeted therapies have emerged as viable treatment options in other cancer types, and for some of these, the actionable tumor mutations are also seen in MOC. Thus, a promising alternative approach to provide benefit to current MOC patients involves DNA sequencing to identify a tumor's unique mutational profile and allow matching to available targeted agents. Such a pipeline can involve special approval to administer a drug already approved for clinical use in other cancer types to a given MOC patient, or their inclusion in existing ongoing clinical trials, such as basket trials encompassing patients with tumors from a range of anatomical sites. Implementation of such personalized medicine can be boosted using improved pre-clinical models, where through a clinical research collaboration a patient's own tumor cells can be used to a test a range of putative therapies prior to administration in the clinic, enabling selection of the available pharmaceutical/s that give any given patient the best possible chance of cancer remission.
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21
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Xiao S, Huang J, Zhang Y, Tang R, Xu Y, He R, Huang Q, Ouyang J, Zu X, Peng X, Fu K. Endoscopy biopsy is not efficiency enough for diagnosis of mucinous colorectal adenocarcinoma. Discov Oncol 2021; 12:44. [PMID: 35201497 PMCID: PMC8777509 DOI: 10.1007/s12672-021-00443-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 10/21/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Endoscopy biopsy (EB) is the standard diagnostic method for colorectal cancer (CRC), whereas its accuracy and efficiency in mucinous adenocarcinoma (MAC) initial diagnosis is unclear. METHODS The initial EB and postoperative specimen (PS) pathological diagnosis of MAC from two centers were retrospectively collected and analyzed. The accuracy and efficiency of initial EB compared with PS pathological diagnosis were analyzed. The potential factors which would affect the initial EB diagnosis of MAC were analyzed. RESULTS 280 and 78 eligible cases were enrolled in this study from two centers respectively. The initial EB diagnosis accuracy for MAC were 84.62% and 83.33%. However, among the cases of PS diagnosis with MAC, the diagnostic efficiency of initial EB was only 36.49% and 32.50% respectively. Lower tumor differentiation and more EB number were associated with an increased probability for the EB diagnosis of MAC, but only tumor differentiation was an independent diagnositic factor for EB in the two cohorts. CONCLUSIONS The accuracy of initial EB with MAC is high, but the diagnostic efficiency was extremely low. Tumor differentiation and EB number were associated with the diagnosis efficiency of MAC before surgery.
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Affiliation(s)
- Shuai Xiao
- The First Affiliated Hospital, Institute of Oncology, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China.
- The First Affiliated Hospital, Department of Gastrointestinal Surgery, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China.
| | - Jia Huang
- The First Affiliated Hospital, Institute of Oncology, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China
| | - Yiwei Zhang
- The First Affiliated Hospital, Institute of Oncology, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China
| | - Rong Tang
- The First Affiliated Hospital, Department of Gastrointestinal Surgery, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China
| | - Yunhua Xu
- The First Affiliated Hospital, Institute of Oncology, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China
| | - Rongfang He
- The First Affiliated Hospital, Department of Pathology, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China
| | - Qiulin Huang
- The First Affiliated Hospital, Department of Gastrointestinal Surgery, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China
| | - Jun Ouyang
- The First Affiliated Hospital, Department of Gastrointestinal Surgery, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China
| | - Xuyu Zu
- The First Affiliated Hospital, Institute of Oncology, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China
| | - Xiuda Peng
- The Second Affiliated Hospital, Department of Surgery, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China
| | - Kai Fu
- Institute of Molecular Precision Medicine and Hunan Key Laboratory of Molecular Precision Medicine, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
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22
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D'Alessandro G, Frigerio M, Barra F, Costantini S, Gustavino C, Ferrero S. Systematic review and meta-analysis on the impact of the levonorgestrel-releasing intrauterine system in reducing risk of ovarian cancer. Int J Gynaecol Obstet 2021; 156:418-424. [PMID: 33969485 PMCID: PMC9290617 DOI: 10.1002/ijgo.13737] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/07/2021] [Accepted: 05/07/2021] [Indexed: 11/12/2022]
Abstract
Background Ovarian carcinoma (OC) is one of the most widespread tumors in the world and is characterized by low survival rates. Objective To determine whether the levonorgestrel‐releasing intrauterine system (LNG‐IUS) can prevent OC. Search strategy The literature until December 2020 were systematically reviewed according to the PRISMA Statement for Reporting Systematic Reviews (PROSPERO: CRD42019137957). Selection criteria Studies assessing the impact of LNG‐IUS on the risk of OC were included. Data collection and analysis Data were extracted independently by two authors to ensure accuracy and consistency. Main results A total of 34 323 records were obtained, of which three satisfied the inclusion criteria. In total, 1687 events of OC in a population of 20 461 311 person‐years were considered. Data pooling revealed that the use of LNG‐IUS did not confer a lower risk of OC relative to the never‐use of LNG‐IUS, with an estimated odds ratio of 0.66 (95% confidence interval 0.41–1.08; I2 = 84%; P = 0.002). Conclusion The meta‐analysis did not demonstrate a preventive role of LNG‐IUS on OC. However, it was carried out on a few papers, and a definitive conclusion on the topic still cannot be drawn. Further studies are indicated in the future to define the impact of LNG‐IUS on OC. The meta‐analysis carried out on three papers did not demonstrate a preventive role of the levonorgestrel‐releasing intrauterine device on ovarian cancer.
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Affiliation(s)
- Gloria D'Alessandro
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genova, Genova, Italy
| | | | - Fabio Barra
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genova, Genova, Italy
| | - Sergio Costantini
- Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Claudio Gustavino
- Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Simone Ferrero
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genova, Genova, Italy
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23
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Zhou YW, Long YX, Chen Y, Liu JY, Pu D, Huang JY, Bi F, Li Q, Gou HF, Qiu M. First-line therapy of bevacizumab plus chemotherapy versus cetuximab plus chemotherapy for metastatic colorectal cancer patients with mucinous adenocarcinoma or mucinous component. Cancer Med 2021; 10:3388-3402. [PMID: 33939281 PMCID: PMC8124114 DOI: 10.1002/cam4.3876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 03/09/2021] [Accepted: 03/13/2021] [Indexed: 02/05/2023] Open
Abstract
Background To compare the efficacy of first‐line bevacizumab plus chemotherapy with cetuximab plus chemotherapy based on the stratification of metastatic colorectal cancer (mCRC) patients with mucinous adenocarcinoma (MA) or mucinous component (MC). Methods A retrospective study involving all mCRC patients receiving first‐line bevacizumab‐based or cetuximab‐based chemotherapy at our hospital from September 2013 to January 2020 was conducted. Overall survival (OS), progression‐free survival (PFS), and objective response rate (ORR) were compared between the cetuximab‐chemotherapy group and the bevacizumab‐chemotherapy group on the basis of the conventional pathological classification of MA or MC. Results A total of 620 patients with mCRC were included in our study, consisting of 141 (22.7%) patients with MA/MC and 479 (77.3%) patients with non‐mucinous adenocarcinoma (NMA). In the MA/MC cohort, patients who were treated with bevacizumab‐based chemotherapy were associated with significantly better OS than those treated with cetuximab‐base chemotherapy (30.0 vs. 26.3 months, p = 0.002), irrespective of tumor sites. The efficacy of bevacizumab‐based chemotherapy was higher in nearly all subgroups as shown in the subgroup analysis. In the NMA cohort, median OS was better in the cetuximab plus chemotherapy group than that in the bevacizumab plus chemotherapy group (32.2 vs. 27.0 months, p = 0.005) for left‐side mCRC patients, whereas OS was significantly longer in the bevacizumab plus chemotherapy group for right‐side mCRC patients (26.0 vs. 20.9 months, p = 0.013). Conclusion Conventional pathological classification (e.g. MA/MC) should be considered when tailoring the individualized optimal treatment for mCRC. Bevacizumab plus chemotherapy as first‐line therapy may be the optimal option for patients with MA/MC.
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Affiliation(s)
- Yu-Wen Zhou
- Department of Biotherapy, Cancer Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yi-Xiu Long
- Department of Biotherapy, Cancer Center, West China Hospital of Sichuan University, Chengdu, China
| | - Ye Chen
- Department of Abdominal Oncology, Cancer Center, West China Hospital of Sichuan University, Chengdu, China
| | - Ji-Yan Liu
- Department of Biotherapy, Cancer Center, West China Hospital of Sichuan University, Chengdu, China
| | - Dan Pu
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jia-Yan Huang
- Department of Radiology and Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, China
| | - Feng Bi
- Department of Abdominal Oncology, Cancer Center, West China Hospital of Sichuan University, Chengdu, China
| | - Qiu Li
- Department of Abdominal Oncology, Cancer Center, West China Hospital of Sichuan University, Chengdu, China
| | - Hong-Feng Gou
- Department of Abdominal Oncology, Cancer Center, West China Hospital of Sichuan University, Chengdu, China
| | - Meng Qiu
- Department of Abdominal Oncology, Cancer Center, West China Hospital of Sichuan University, Chengdu, China
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Huang J, Huang Q, Tang R, Chen G, Zhang Y, He R, Zu X, Fu K, Peng X, Xiao S. Hemicolectomy Does Not Provide Survival Benefit for Right-Sided Mucinous Colon Adenocarcinoma. Front Oncol 2021; 10:608836. [PMID: 33598431 PMCID: PMC7882730 DOI: 10.3389/fonc.2020.608836] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 12/11/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The extent of bowel resection is widely debated in colon cancer surgery. Right hemicolectomy (RHC) and partial colectomy (PC) are the most common operation options for right-sided colon cancer (RCC). However, there are still no treatment guidelines or published studies to guide surgical options for mucinous adenocarcinoma (MAC) of RCC. METHODS Patients with MAC and non-specific adenocarcinoma (AC) of RCC who underwent RHC and PC from 2010 to 2015 in the Surveillance, Epidemiology, and End Results (SEER) database were retrieved. The general characteristics and survival were compared and analyzed. RESULTS A total of 27,910 RCC patients were enrolled in this study, among them 3,413 were MAC. The results showed that race, carcinoembryonic antigen (CEA) level, perineural invasion (PNI), tumor size, tumor location, TNM stage, liver metastasis, chemotherapy were significantly different between MAC and AC groups. The MAC group had similar dissected lymph nodes, but more positive lymph nodes than the AC group. The overall survival (OS) of the MAC group was poorer than that of the AC group, but cancer-specific survival (CSS) was similar between the two groups. The RHC subgroup of the MAC group had more patients of age ≤60 years, larger tumor size, cecum/ascending colon location and dissected lymph nodes than the PC subgroup, but similar positive lymph nodes, perioperative mortality, OS and CSS as the PC subgroup. Moreover, the univariate and multivariable analyses for the survival of RCC patients with MAC showed that RHC might not be a superior predictor for OS and CSS compared with PC. CONCLUSIONS RHC could not dissect more positive lymph nodes or provide long-term survival benefits for RCC patients with MAC compared with PC. This study could provide some evidence for surgery treatment selection for MAC of RCC, which has important clinical value in individual management of colon cancer patients.
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Affiliation(s)
- Jia Huang
- Institute of Clinical Medicine, the First Affiliated Hospital, University of South China, Hengyang, China
- Hengyang Medical College, University of South China, Hengyang, China
| | - Qiulin Huang
- Department of Gastrointestinal Surgery, the First Affiliated Hospital, University of South China, Hengyang, China
| | - Rong Tang
- Department of Gastrointestinal Surgery, the First Affiliated Hospital, University of South China, Hengyang, China
| | - Guodong Chen
- Department of Surgery, the First Affiliated Hospital, University of South China, Hengyang, China
| | - Yiwei Zhang
- Department of Surgery, the First Affiliated Hospital, University of South China, Hengyang, China
| | - Rongfang He
- Department of Pathology, the First Affiliated Hospital, Hengyang, China
| | - Xuyu Zu
- Institute of Clinical Medicine, the First Affiliated Hospital, University of South China, Hengyang, China
- Hengyang Medical College, University of South China, Hengyang, China
| | - Kai Fu
- Institute of Molecular Precision Medicine and Hunan Key Laboratory of Molecular Precision Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Xiuda Peng
- Department of Surgery, the Second Affiliated Hospital, University of South China, Hengyang, China
| | - Shuai Xiao
- Institute of Clinical Medicine, the First Affiliated Hospital, University of South China, Hengyang, China
- Department of Gastrointestinal Surgery, the First Affiliated Hospital, University of South China, Hengyang, China
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25
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Santandrea G, Piana S, Valli R, Zanelli M, Gasparini E, De Leo A, Mandato VD, Palicelli A. Immunohistochemical Biomarkers as a Surrogate of Molecular Analysis in Ovarian Carcinomas: A Review of the Literature. Diagnostics (Basel) 2021; 11:199. [PMID: 33572888 PMCID: PMC7911119 DOI: 10.3390/diagnostics11020199] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 12/27/2022] Open
Abstract
The term "ovarian carcinoma" encompasses at least five different malignant neoplasms: high-grade serous carcinoma, low-grade serous carcinoma, endometrioid carcinoma, mucinous carcinoma, and clear cell carcinoma. These five histotypes demonstrated distinctive histological, molecular, and clinical features. The rise of novel target therapies and of a tailored oncological approach has demanded an integrated multidisciplinary approach in the setting of ovarian carcinoma. The need to implement a molecular-based classification in the worldwide diagnostic and therapeutic setting of ovarian cancer demanded a search for easy-to-use and cost-effective molecular-surrogate biomarkers, relying particularly on immunohistochemical analysis. The present review focuses on the role of immunohistochemistry as a surrogate of molecular analysis in the everyday diagnostic approach to ovarian carcinomas.
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Affiliation(s)
- Giacomo Santandrea
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41121 Modena, Italy
- Pathology Unit, AUSL-IRCCS Reggio Emilia, 42123 Reggio Emilia, Italy; (S.P.); (R.V.); (M.Z.); (A.P.)
| | - Simonetta Piana
- Pathology Unit, AUSL-IRCCS Reggio Emilia, 42123 Reggio Emilia, Italy; (S.P.); (R.V.); (M.Z.); (A.P.)
| | - Riccardo Valli
- Pathology Unit, AUSL-IRCCS Reggio Emilia, 42123 Reggio Emilia, Italy; (S.P.); (R.V.); (M.Z.); (A.P.)
| | - Magda Zanelli
- Pathology Unit, AUSL-IRCCS Reggio Emilia, 42123 Reggio Emilia, Italy; (S.P.); (R.V.); (M.Z.); (A.P.)
| | - Elisa Gasparini
- Oncology Unit, AUSL-IRCCS Reggio Emilia, 42123 Reggio Emilia, Italy;
| | - Antonio De Leo
- Molecular Diagnostic Unit, AUSL Bologna, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy;
| | - Vincenzo Dario Mandato
- Unit of Obstetrics and Gynaecology, AUSL-IRCCS Reggio Emilia, 42123 Reggio Emilia, Italy;
| | - Andrea Palicelli
- Pathology Unit, AUSL-IRCCS Reggio Emilia, 42123 Reggio Emilia, Italy; (S.P.); (R.V.); (M.Z.); (A.P.)
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26
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C K R, Thomas V, Thomas DS, Daniel S, Sebastian A, Thomas A, Chandy RG, Peedicayil A. Metastatic Tumors to the Ovary-a Surgeon's Dilemma. Indian J Surg Oncol 2021; 12:152-157. [PMID: 33814846 DOI: 10.1007/s13193-020-01267-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 11/24/2020] [Indexed: 10/22/2022] Open
Abstract
The ovary is a common site of metastasis. Differential diagnosis of ovarian carcinomas, including secondary tumors, remains a challenging task. Clinical decision-making depends on an accurate diagnosis of the type of ovarian cancer. This study was done to evaluate the pattern of metastatic tumors to the ovary and clinical details and to analyze the survival outcomes over a period of 5 years. Patients who had metastatic tumors to the ovary are identified from the electronic database from 1 January 2015 to 30 September 2019. Clinical details are collected from the electronic charts. Survival data is collected over the phone. The total number of ovarian cancers treated during the time period was 720, of which primary high-grade mucinous tumors contributed 9 (1.2%), and metastatic tumors to ovary 70 (10%). The highest levels of CEA were seen in carcinoma rectum, colon, and cholangiocarcinoma. CA 19-9 was very high in carcinoma gall bladder, pancreas, and cholangiocarcinoma. Common primaries were stomach (23%), gall bladder (13%), and colon (13%). Adenocarcinoma with signet ring cells was found in 29% of the patients. The median follow-up was 7 months (range 1 to 40 months). The median overall survival was 10 months after diagnosis (95% CI,7.9-12.0). There was no statistically significant difference in survival between patients who had peritoneal carcinomatosis with enlarged ovaries and those who had metastasis confined to ovaries (p value 0.360). A diagnosis of metastatic tumors to the ovary is associated with a very poor prognosis and the focus of treatment should be to improve the quality of life. Supplementary Information The online version contains supplementary material available at 10.1007/s13193-020-01267-4.
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Affiliation(s)
- Ramesan C K
- Department of Gynaecologic Oncology, Christian Medical College, Vellore, Vellore, Tamil Nadu 632004 India
| | - Vinotha Thomas
- Department of Gynaecologic Oncology, Christian Medical College, Vellore, Vellore, Tamil Nadu 632004 India
| | - Dhanya Susan Thomas
- Department of Gynaecologic Oncology, Christian Medical College, Vellore, Vellore, Tamil Nadu 632004 India
| | - Sherin Daniel
- Department of General Pathology, Christian Medical College, Vellore, Vellore, Tamil Nadu India
| | - Ajit Sebastian
- Department of Gynaecologic Oncology, Christian Medical College, Vellore, Vellore, Tamil Nadu 632004 India
| | - Anitha Thomas
- Department of Gynaecologic Oncology, Christian Medical College, Vellore, Vellore, Tamil Nadu 632004 India
| | - Rachel George Chandy
- Department of Gynaecologic Oncology, Christian Medical College, Vellore, Vellore, Tamil Nadu 632004 India
| | - Abraham Peedicayil
- Department of Gynaecologic Oncology, Christian Medical College, Vellore, Vellore, Tamil Nadu 632004 India
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27
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Kang EY, Cheasley D, LePage C, Wakefield MJ, da Cunha Torres M, Rowley S, Salazar C, Xing Z, Allan P, Bowtell DDL, Mes-Masson AM, Provencher DM, Rahimi K, Kelemen LE, Fasching PA, Doherty JA, Goodman MT, Goode EL, Deen S, Pharoah PDP, Brenton JD, Sieh W, Mateoiu C, Sundfeldt K, Cook LS, Le ND, Anglesio MS, Gilks CB, Huntsman DG, Kennedy CJ, Traficante N, DeFazio A, Kaufmann S, Churchman M, Gourley C, Stephens AN, Meagher NS, Ramus SJ, Antill YC, Campbell I, Scott CL, Köbel M, Gorringe KL. Refined cut-off for TP53 immunohistochemistry improves prediction of TP53 mutation status in ovarian mucinous tumors: implications for outcome analyses. Mod Pathol 2021; 34:194-206. [PMID: 32724153 PMCID: PMC9704519 DOI: 10.1038/s41379-020-0618-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/15/2020] [Accepted: 06/19/2020] [Indexed: 11/09/2022]
Abstract
TP53 mutations are implicated in the progression of mucinous borderline tumors (MBOT) to mucinous ovarian carcinomas (MOC). Optimized immunohistochemistry (IHC) for TP53 has been established as a proxy for the TP53 mutation status in other ovarian tumor types. We aimed to confirm the ability of TP53 IHC to predict TP53 mutation status in ovarian mucinous tumors and to evaluate the association of TP53 mutation status with survival among patients with MBOT and MOC. Tumor tissue from an initial cohort of 113 women with MBOT/MOC was stained with optimized IHC for TP53 using tissue microarrays (75.2%) or full sections (24.8%) and interpreted using established criteria as normal or abnormal (overexpression, complete absence, or cytoplasmic). Cases were considered concordant if abnormal IHC staining predicted deleterious TP53 mutations. Discordant tissue microarray cases were re-evaluated on full sections and interpretational criteria were refined. The initial cohort was expanded to a total of 165 MBOT and 424 MOC for the examination of the association of survival with TP53 mutation status, assessed either by TP53 IHC and/or sequencing. Initially, 82/113 (72.6%) cases were concordant using the established criteria. Refined criteria for overexpression to account for intratumoral heterogeneity and terminal differentiation improved concordance to 93.8% (106/113). In the expanded cohort, 19.4% (32/165) of MBOT showed evidence for TP53 mutation and this was associated with a higher risk of recurrence, disease-specific death, and all-cause mortality (overall survival: HR = 4.6, 95% CI 1.5-14.3, p = 0.0087). Within MOC, 61.1% (259/424) harbored a TP53 mutation, but this was not associated with survival (overall survival, p = 0.77). TP53 IHC is an accurate proxy for TP53 mutation status with refined interpretation criteria accounting for intratumoral heterogeneity and terminal differentiation in ovarian mucinous tumors. TP53 mutation status is an important biomarker to identify MBOT with a higher risk of mortality.
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MESH Headings
- Adult
- Australia
- Biomarkers, Tumor/genetics
- DNA Mutational Analysis
- Female
- Humans
- Immunohistochemistry
- Middle Aged
- Mutation
- Neoplasms, Cystic, Mucinous, and Serous/genetics
- Neoplasms, Cystic, Mucinous, and Serous/mortality
- Neoplasms, Cystic, Mucinous, and Serous/pathology
- Neoplasms, Cystic, Mucinous, and Serous/therapy
- North America
- Observer Variation
- Ovarian Neoplasms/genetics
- Ovarian Neoplasms/mortality
- Ovarian Neoplasms/pathology
- Ovarian Neoplasms/therapy
- Predictive Value of Tests
- Prognosis
- Reproducibility of Results
- Risk Assessment
- Risk Factors
- Tissue Array Analysis
- Tumor Suppressor Protein p53/genetics
- United Kingdom
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Affiliation(s)
- Eun Young Kang
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada
| | - Dane Cheasley
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia
| | - Cecile LePage
- Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
- Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Matthew J Wakefield
- Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
| | - Michelle da Cunha Torres
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia
| | - Simone Rowley
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Carolina Salazar
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia
| | - Zhongyue Xing
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia
| | - Prue Allan
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - David D L Bowtell
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia
| | - Anne-Marie Mes-Masson
- Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
- Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Diane M Provencher
- Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
- Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Kurosh Rahimi
- Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
- Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Linda E Kelemen
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center ER-EMN, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Jennifer A Doherty
- Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Marc T Goodman
- Samuel Oschin Comprehensive Cancer Institute, Cancer Prevention and Genetics Program, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Ellen L Goode
- Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Suha Deen
- Department of Histopathology, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Paul D P Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - James D Brenton
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Weiva Sieh
- Department of Genetics and Genomic Sciences, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Constantina Mateoiu
- Department of Pathology and Cytology, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Karin Sundfeldt
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Sahlgrenska Cancer Center, University of Gothenburg, Gothenburg, Sweden
| | - Linda S Cook
- University of New Mexico Health Sciences Center, University of New Mexico, Albuquerque, NM, USA
| | - Nhu D Le
- Cancer Control Research, BC Cancer Research Centre, Vancouver, BC, Canada
| | - Michael S Anglesio
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
| | - C Blake Gilks
- Cancer Control Research, BC Cancer Research Centre, Vancouver, BC, Canada
- British Columbia's Ovarian Cancer Research (OVCARE) Program, Vancouver General Hospital, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - David G Huntsman
- Cancer Control Research, BC Cancer Research Centre, Vancouver, BC, Canada
- British Columbia's Ovarian Cancer Research (OVCARE) Program, Vancouver General Hospital, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Catherine J Kennedy
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Westmead, NSW, Australia
| | - Nadia Traficante
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia
| | - Anna DeFazio
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Westmead, NSW, Australia
| | - Scott Kaufmann
- Division of Oncology Research, Mayo Clinic, Rochester, MN, USA
| | - Michael Churchman
- Nicola Murray Centre for Ovarian Cancer Research, Cancer Research UK Edinburgh Centre, MRC IGMM, University of Edinburgh, Edinburgh, UK
| | - Charlie Gourley
- Nicola Murray Centre for Ovarian Cancer Research, Cancer Research UK Edinburgh Centre, MRC IGMM, University of Edinburgh, Edinburgh, UK
| | | | - Nicola S Meagher
- School of Women's and Children's Health, Faculty of Medicine, University of NSW Sydney, Sydney, NSW, Australia
- Adult Cancer Program, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, NSW, Australia
| | - Susan J Ramus
- School of Women's and Children's Health, Faculty of Medicine, University of NSW Sydney, Sydney, NSW, Australia
- Adult Cancer Program, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, NSW, Australia
| | - Yoland C Antill
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia
- Cabrini Health, Malvern, VIC, Australia
- Frankston Hospital, Frankston, VIC, Australia
| | - Ian Campbell
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia
| | - Clare L Scott
- Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
- The Royal Women's Hospital, Parkville, VIC, Australia
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada.
| | - Kylie L Gorringe
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia
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Abstract
Epithelial ovarian cancer (EOC) is a heterogeneous group of diseases with distinct biological and clinical behaviour. Despite the differences between them, the capability of tumour cells to continuously proliferate and avoid death is maintained among histotypes. This ability is the result of alterations at different levels, causing the deregulation of cell cycle and proliferative-related pathways. Even if the leading role is played by RB and TP53, changes in other molecular pathways are involved in the development of EOC. This ability can be exploited to generate in vitro and in vivo models resembling the conditions of tumour development in a patient. In vivo models, such as patient-derived xenografts (PDX) or genetically engineered mouse models (GEMM), represent a fundamental tool in the study of the molecular mechanisms implicated in each EOC biotype for testing new therapeutic approaches. Herein we describe the major proliferation-related pathways and its disruption found in EOC and how these features can be used to establish in vivo models for translational research. Epithelial ovarian cancer (EOC) molecular biotypes are defined by distinct biology and clinical behaviour. Sustained proliferation and resistance to cell death mechanisms characterised tumour cells. RB and TP53 tumour-suppressor genes are highly implicated in EOC pathogenesis. In vitro and in vivo models have a key role in the study of molecular mechanisms involved in EOC pathogenesis. Development of animal models that mimic disease features constitute essential tools for new drugs testing.
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29
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Huang J, Chen G, Liu H, Zhang Y, Tang R, Huang Q, Fu K, Peng X, Xiao S. Surgery improves the prognosis of colon mucinous adenocarcinoma with liver metastases: a SEER-based study. BMC Cancer 2020; 20:908. [PMID: 32967651 PMCID: PMC7510088 DOI: 10.1186/s12885-020-07400-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 09/13/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Mucinous adenocarcinoma (MC) is the second most common pathological type of colon carcinoma (CC). Colon cancer liver metastases (CLMs) are common and lethal, and complete resection of the primary tumour and metastases for CLM patients would be beneficial. However, there is still no consensus on the role of surgery for MC with liver metastases (M-CLM). METHODS Patients diagnosed with M-CLM or classical adenocarcinoma with CLM (A-CLM) from 2010 to 2013 in the Surveillance, Epidemiology, and End Results (SEER) database were retrieved. The clinicopathological features and overall survival (OS) and cancer-specific survival (CSS) data were compared and analysed. RESULTS The results showed that the M-CLM group had a larger tumour size, more right colon localizations, higher pT and pN stages, more female patients, and more retrieved and positive lymph nodes and accounted for a higher proportion of surgeries than the A-CLM group. The OS and CSS of M-CLM patients who underwent any type of surgery were significantly better than those of patients who did not undergo any surgery, but poorer than those of A-CLM patients who underwent surgery. Meanwhile, the OS and CSS of M-CLM and A-CLM patients who did not undergo any surgery were comparable. Compared with hemicolectomy, partial colectomy led to similar or better OS and CSS for M-CLM, and surgery was an independent protective factor for long-term survival in M-CLM. CONCLUSIONS M-CLM had distinct clinicopathological characteristics from A-CLM, and surgery could improve the survival and is an independent favourable prognostic factor for M-CLM. In addition, partial colectomy might be a non-inferiority choice as hemicolectomy for M-CLM according to the results from this study.
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Affiliation(s)
- Jia Huang
- Institute of Clinical Medicine of the First Affiliated Hospital, University of South China, Hengyang, Hunan, 421001, People's Republic of China.,Hengyang Medical College, University of South China, Hengyang, Hunan, 421001, People's Republic of China
| | - Guodong Chen
- Department of Surgery of the First Affiliated Hospital, University of South China, Hengyang, Hunan, 421001, People's Republic of China
| | - Huan Liu
- Department of Surgery of the First Affiliated Hospital, University of South China, Hengyang, Hunan, 421001, People's Republic of China
| | - Yiwei Zhang
- Department of Surgery of the First Affiliated Hospital, University of South China, Hengyang, Hunan, 421001, People's Republic of China
| | - Rong Tang
- Department of Gastrointestinal Surgery of the First Affiliated Hospital, University of South China, Hengyang, Hunan, 421001, People's Republic of China
| | - Qiulin Huang
- Department of Gastrointestinal Surgery of the First Affiliated Hospital, University of South China, Hengyang, Hunan, 421001, People's Republic of China
| | - Kai Fu
- Institute of Molecular Precision Medicine and Hunan Key Laboratory of Molecular Precision Medicine, and Department of General Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People's Republic of China.
| | - Xiuda Peng
- Department of Surgery of the Second Affiliated Hospital, University of South China, Hengyang, Hunan, 421001, People's Republic of China.
| | - Shuai Xiao
- Institute of Clinical Medicine of the First Affiliated Hospital, University of South China, Hengyang, Hunan, 421001, People's Republic of China. .,Department of Gastrointestinal Surgery of the First Affiliated Hospital, University of South China, Hengyang, Hunan, 421001, People's Republic of China.
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Altered Organelle Calcium Transport in Ovarian Physiology and Cancer. Cancers (Basel) 2020; 12:cancers12082232. [PMID: 32785177 PMCID: PMC7464720 DOI: 10.3390/cancers12082232] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 07/31/2020] [Accepted: 08/06/2020] [Indexed: 12/14/2022] Open
Abstract
Calcium levels have a huge impact on the physiology of the female reproductive system, in particular, of the ovaries. Cytosolic calcium levels are influenced by regulatory proteins (i.e., ion channels and pumps) localized in the plasmalemma and/or in the endomembranes of membrane-bound organelles. Imbalances between plasma membrane and organelle-based mechanisms for calcium regulation in different ovarian cell subtypes are contributing to ovarian pathologies, including ovarian cancer. In this review, we focused our attention on altered calcium transport and its role as a contributor to tumor progression in ovarian cancer. The most important proteins described as contributing to ovarian cancer progression are inositol trisphosphate receptors, ryanodine receptors, transient receptor potential channels, calcium ATPases, hormone receptors, G-protein-coupled receptors, and/or mitochondrial calcium uniporters. The involvement of mitochondrial and/or endoplasmic reticulum calcium imbalance in the development of resistance to chemotherapeutic drugs in ovarian cancer is also discussed, since Ca2+ channels and/or pumps are nowadays regarded as potential therapeutic targets and are even correlated with prognosis.
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31
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Modeling the Diversity of Epithelial Ovarian Cancer through Ten Novel Well Characterized Cell Lines Covering Multiple Subtypes of the Disease. Cancers (Basel) 2020; 12:cancers12082222. [PMID: 32784519 PMCID: PMC7465288 DOI: 10.3390/cancers12082222] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 08/04/2020] [Accepted: 08/05/2020] [Indexed: 12/30/2022] Open
Abstract
Cancer cell lines are amongst the most important pre-clinical models. In the context of epithelial ovarian cancer, a highly heterogeneous disease with diverse subtypes, it is paramount to study a wide panel of models in order to draw a representative picture of the disease. As this lethal gynaecological malignancy has seen little improvement in overall survival in the last decade, it is all the more pressing to support future research with robust and diverse study models. Here, we describe ten novel spontaneously immortalized patient-derived ovarian cancer cell lines, detailing their respective mutational profiles and gene/biomarker expression patterns, as well as their in vitro and in vivo growth characteristics. Eight of the cell lines were classified as high-grade serous, while two were determined to be of the rarer mucinous and clear cell subtypes, respectively. Each of the ten cell lines presents a panel of characteristics reflective of diverse clinically relevant phenomena, including chemotherapeutic resistance, metastatic potential, and subtype-associated mutations and gene/protein expression profiles. Importantly, four cell lines formed subcutaneous tumors in mice, a key characteristic for pre-clinical drug testing. Our work thus contributes significantly to the available models for the study of ovarian cancer, supplying additional tools to better understand this complex disease.
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32
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Lee AW, Wu AH, Wiensch A, Mukherjee B, Terry KL, Harris HR, Carney ME, Jensen A, Cramer DW, Berchuck A, Doherty JA, Modugno F, Goodman MT, Alimujiang A, Rossing MA, Cushing-Haugen KL, Bandera EV, Thompson PJ, Kjaer SK, Hogdall E, Webb PM, Huntsman DG, Moysich KB, Lurie G, Ness RB, Stram DO, Roman L, Pike MC, Pearce CL. Estrogen Plus Progestin Hormone Therapy and Ovarian Cancer: A Complicated Relationship Explored. Epidemiology 2020; 31:402-408. [PMID: 32028322 PMCID: PMC7584395 DOI: 10.1097/ede.0000000000001175] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Menopausal estrogen-alone therapy is a risk factor for endometrial and ovarian cancers. When a progestin is included with the estrogen daily (continuous estrogen-progestin combined therapy), there is no increased risk of endometrial cancer. However, the effect of continuous estrogen-progestin combined therapy on risk of ovarian cancer is less clear. METHODS We pooled primary data from five population-based case-control studies in the Ovarian Cancer Association Consortium, including 1509 postmenopausal ovarian cancer cases and 2295 postmenopausal controls. Information on previous menopausal hormonal therapy use, as well as ovarian cancer risk factors, was collected using in-person interviews. Logistic regression was used to assess the association between use of continuous estrogen-progestin combined therapy and risk of ovarian cancer by duration and recency of use and disease histotype. RESULTS Ever postmenopausal use of continuous estrogen-progestin combined therapy was not associated with increased risk of ovarian cancer overall (OR = 0.85, 95% CI = 0.72, 1.0). A decreased risk was observed for mucinous ovarian cancer (OR = 0.40, 95% CI = 0.18, 0.91). The other main ovarian cancer histotypes did not show an association (endometrioid: OR = 0.86, 95% CI = 0.57, 1.3, clear cell: OR = 0.68, 95% CI = 0.40, 1.2; serous: OR = 0.98, 95% CI = 0.80, 1.2). CONCLUSIONS Given that estrogen-alone therapy has been shown to be associated with increased risk of ovarian cancer, these findings are consistent with the hypothesis that adding a progestin each day ameliorates the carcinogenic effects of estrogen on the cells of origin for all histotypes of ovarian cancer.
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Affiliation(s)
- Alice W. Lee
- Department of Public Health, California State University, Fullerton, Fullerton, CA, USA
| | - Anna H. Wu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Ashley Wiensch
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Bhramar Mukherjee
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Kathryn L. Terry
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Holly R. Harris
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Michael E. Carney
- Department of Obstetrics and Gynecology, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Allan Jensen
- Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Daniel W. Cramer
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Andrew Berchuck
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC, USA
| | - Jennifer Anne Doherty
- Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Francesmary Modugno
- Ovarian Cancer Center of Excellence, Womens Cancer Research Program, Magee-Womens Research Institute and Hillman Cancer Center, Pittsburgh, PA, USA
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Marc T. Goodman
- Cancer Prevention and Control, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Community and Population Health Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Aliya Alimujiang
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Mary Anne Rossing
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Kara L. Cushing-Haugen
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Elisa V. Bandera
- Cancer Prevention and Control Program, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Pamela J. Thompson
- Cancer Prevention and Control, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Susanne K. Kjaer
- Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Gynaecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Estrid Hogdall
- Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
- Molecular Unit, Department of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Penelope M. Webb
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - David G. Huntsman
- Department of Molecular Oncology, BC Cancer Research Centre, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- OVCARE, Vancouver Coastal Health Research Centre, Vancouver General Hospital and University of British Columbia, Vancouver, BC, Canada
- Department of Obstetrics and Gyencology, University of British Columbia, Vancouver, BC, Canada
| | - Kirstin B. Moysich
- Division of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Galina Lurie
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Roberta B. Ness
- University of Texas School of Public Health, Houston, TX, USA
| | - Daniel O. Stram
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lynda Roman
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Malcolm C. Pike
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Celeste Leigh Pearce
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
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Ovarian Endometrioid Carcinoma Misdiagnosed as Mucinous Carcinoma: An Underrecognized Problem. Int J Gynecol Pathol 2020; 38:568-575. [PMID: 30480647 DOI: 10.1097/pgp.0000000000000564] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Primary mucinous carcinoma of the ovary is uncommon, and while numerous studies have focused on improving our ability to distinguish these tumors from gastrointestinal metastases, recent data suggest that up to one fifth are still misdiagnosed with a previously underrecognized culprit: endometrioid carcinoma. Using an index case of an ovarian endometrioid carcinoma with mucinous differentiation masquerading as a mucinous carcinoma, we sought to identify the most efficient biomarker combination that could distinguish these 2 histotypes. Eight immunohistochemical markers were assessed on tissue microarrays from 183 endometrioid carcinomas, 77 mucinous carcinomas, and 72 mucinous borderline tumors. Recursive partitioning revealed a simple 2-marker panel consisting of PR and vimentin. The combination of PR absence and vimentin absence could predict mucinous tumors with a sensitivity of 95.1%, a specificity of 96.7%, and an overall accuracy of 96.0%. Additional marker combinations did not improve accuracy. The 5-yr ovarian cancer-specific survival for mucinous carcinoma was significantly worse than endometrioid carcinoma (70% vs. 86%, respectively, P=0.02). Our proposed 2-marker algorithm allows diagnostic distinction between mucinous and endometrioid ovarian carcinomas when morphology is not straightforward. Given key differences in the underlying biology and clinical behavior of these 2 histotypes, improved diagnostic precision is essential for guiding appropriate management and treatment.
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34
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Babaier A, Ghatage P. Mucinous Cancer of the Ovary: Overview and Current Status. Diagnostics (Basel) 2020; 10:E52. [PMID: 31963927 PMCID: PMC7168201 DOI: 10.3390/diagnostics10010052] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 01/13/2020] [Accepted: 01/15/2020] [Indexed: 02/06/2023] Open
Abstract
Mucinous ovarian cancer (MOC) is a rare subtype of epithelial ovarian carcinoma (EOC). Whereas all EOC subtypes are addressed in the same way, MOC is a distinct entity. Appreciating the pathological features and genomic profile of MOC may result in the improvement in management and, hence, the prognosis. Distinguishing primary MOC from metastatic mucinous carcinoma can be challenging but is essential. Early-stage MOC carries an excellent prognosis, with advanced disease having a poor outcome. Surgical management plays an essential role in the early stage and in metastatic disease. Chemotherapy is usually administered for stage II MOC and beyond. The standard gynecology protocol is frequently used, but gastrointestinal regimens have also been administered. As MOC is associated with multiple molecular alterations, targeted therapy could be the answer to treat this disease.
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Affiliation(s)
- Abdulaziz Babaier
- Department of Gynecologic Oncology, King Fahad Specialist Hospital, Dammam 32253, Saudi Arabia
| | - Prafull Ghatage
- Department of Gynecologic Oncology, Tom Baker Cancer Centre, Calgary, AB T2N4N2, Canada;
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35
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Meagher NS, Wang L, Rambau PF, Intermaggio MP, Huntsman DG, Wilkens LR, El-Bahrawy MA, Ness RB, Odunsi K, Steed H, Herpel E, Anglesio MS, Zhang B, Lambie N, Swerdlow AJ, Lubiński J, Vierkant RA, Goode EL, Menon U, Toloczko-Grabarek A, Oszurek O, Bilic S, Talhouk A, García-Closas M, Wang Q, Tan A, Farrell R, Kennedy CJ, Jimenez-Linan M, Sundfeldt K, Etter JL, Menkiszak J, Goodman MT, Klonowski P, Leung Y, Winham SJ, Moysich KB, Behrens S, Kluz T, Edwards RP, Gronwald J, Modugno F, Hernandez BY, Chow C, Kelemen LE, Keeney GL, Carney ME, Natanzon Y, Robertson G, Sharma R, Gayther SA, Alsop J, Luk H, Karpinskyj C, Campbell I, Sinn P, Gentry-Maharaj A, Coulson P, Chang-Claude J, Shah M, Widschwendter M, Tang K, Schoemaker MJ, Koziak JM, Cook LS, Brenton JD, Daley F, Kristjansdottir B, Mateoiu C, Larson MC, Harnett PR, Jung A, deFazio A, Gorringe KL, Pharoah PDP, Minoo P, Stewart C, Bathe OF, Gui X, Cohen P, Ramus SJ, Köbel M. A combination of the immunohistochemical markers CK7 and SATB2 is highly sensitive and specific for distinguishing primary ovarian mucinous tumors from colorectal and appendiceal metastases. Mod Pathol 2019; 32:1834-1846. [PMID: 31239549 PMCID: PMC8207534 DOI: 10.1038/s41379-019-0302-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 05/17/2019] [Accepted: 05/18/2019] [Indexed: 11/08/2022]
Abstract
Primary ovarian mucinous tumors can be difficult to distinguish from metastatic gastrointestinal neoplasms by histology alone. The expected immunoprofile of a suspected metastatic lower gastrointestinal tumor is CK7-/CK20+/CDX2+/PAX8-. This study assesses the addition of a novel marker SATB2, to improve the diagnostic algorithm. A test cohort included 155 ovarian mucinous tumors (105 carcinomas and 50 borderline tumors) and 230 primary lower gastrointestinal neoplasms (123 colorectal adenocarcinomas and 107 appendiceal neoplasms). All cases were assessed for SATB2, PAX8 CK7, CK20, and CDX2 expression on tissue microarrays. Expression was scored in a 3-tier system as absent, focal (1-50% of tumor cells) and diffuse ( >50% of tumor cells) and then categorized into either absent/present or nondiffuse/diffuse. SATB2 and PAX8 expression was further evaluated in ovarian tumors from an international cohort of 2876 patients (expansion cohort, including 159 mucinous carcinomas and 46 borderline mucinous tumors). The highest accuracy of an individual marker in distinguishing lower gastrointestinal from ovarian mucinous tumors was CK7 (91.7%, nondiffuse/diffuse cut-off) followed by SATB2 (88.8%, present/absent cut-off). The most effective combination was CK7 and SATB2 with accuracy of 95.3% using the 3-tier interpretation, absent/focal/diffuse. This combination outperformed the standard clinical set of CK7, CK20 and CDX2 (87.5%). Re-evaluation of outlier cases confirmed ovarian origin for all but one case. The accuracy of SATB2 was confirmed in the expansion cohort (91.5%). SATB2 expression was also detected in 15% of ovarian endometrioid carcinoma but less than 5% of other ovarian histotypes. A simple two marker combination of CK7 and SATB2 can distinguish lower gastrointestinal from ovarian primary mucinous tumors with greater than 95% accuracy. PAX8 and CDX2 have value as second-line markers. The utility of CK20 in this setting is low and this warrants replacement of this marker with SATB2 in clinical practice.
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Affiliation(s)
- Nicola S Meagher
- School of Women's and Children's Health, Faculty of Medicine, University of NSW Sydney, Sydney, NSW, Australia
- Prince of Wales Clinical School. UNSW Sydney, Sydney, NSW, Australia
- Adult Cancer Program. Lowy Cancer Research Centre, Sydney, Australia
| | - Linyuan Wang
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, AB, Canada
| | - Peter F Rambau
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, AB, Canada
- Pathology Department, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania
| | - Maria P Intermaggio
- School of Women's and Children's Health, Faculty of Medicine, University of NSW Sydney, Sydney, NSW, Australia
- Adult Cancer Program. Lowy Cancer Research Centre, Sydney, Australia
| | - David G Huntsman
- British Columbia's Ovarian Cancer Research (OVCARE) Program, Vancouver General Hospital, BC Cancer Agency and University of British Columbia, Vancouver, BC, Canada
- Department of Molecular Oncology, BC Cancer Agency Research Centre, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Lynne R Wilkens
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Mona A El-Bahrawy
- Department of Histopathology, Imperial College London, Hammersmith Hospital, London, UK
| | - Roberta B Ness
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Kunle Odunsi
- Department of Gynecologic Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Helen Steed
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology. Royal Alexandra Hospital, Edmonton, AB, Canada
| | - Esther Herpel
- Tissue Bank of the National Center for Tumor Diseases, University of Heidelberg, Heidelberg, Germany
- Department of Pathology, Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Michael S Anglesio
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Bonnie Zhang
- Bendat Family Comprehensive Cancer Centre, St John of God Subiaco Hospital, Subiaco, Western Australia, Australia
| | - Neil Lambie
- NSW Health Pathology. Prince of Wales Hospital, Sydney, NSW, Australia
| | - Anthony J Swerdlow
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
- Division of Breast Cancer Research, The Institute of Cancer Research, London, UK
| | - Jan Lubiński
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Robert A Vierkant
- Department of Health Science Research, Division of Biomedical Statistics and Informatics. Mayo Clinic, Rochester, MN, USA
| | - Ellen L Goode
- Department of Health Science Research, Division of Epidemiology. Mayo Clinic, Rochester, MN, USA
| | - Usha Menon
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, University College London, London, UK
| | | | - Oleg Oszurek
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Sanela Bilic
- Bendat Family Comprehensive Cancer Centre, St John of God Subiaco Hospital, Subiaco, Western Australia, Australia
| | - Aline Talhouk
- British Columbia's Ovarian Cancer Research (OVCARE) Program, Vancouver General Hospital, BC Cancer Agency and University of British Columbia, Vancouver, BC, Canada
| | - Montserrat García-Closas
- Division of Cancer Epidemiology and Genetics. National Cancer Institute, Bethesda, MD, USA
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - Qin Wang
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Adeline Tan
- Division of Obstetrics and Gynaecology, Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Western Australia, Australia
- Western Women's Pathology, Western Diagnostic Pathology, Wembley, Western Australia, Australia
| | - Rhonda Farrell
- Prince of Wales Private Hospital, Randwick, NSW, Australia
| | - Catherine J Kennedy
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, NSW, Australia
| | | | - Karin Sundfeldt
- Department of Obstetrics and Gynecology, Sahlgrenska Cancer Center, Inst Clinical Scienses, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Department of Gynecology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - John L Etter
- Division of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Janusz Menkiszak
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Marc T Goodman
- Cancer Prevention and Control, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Community and Population Health Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Paul Klonowski
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, AB, Canada
| | - Yee Leung
- Histopathology Department, King Edward Memorial Hospital, Perth, Western Australia, Australia
| | - Stacey J Winham
- Department of Health Science Research, Division of Biomedical Statistics and Informatics. Mayo Clinic, Rochester, MN, USA
| | - Kirsten B Moysich
- Division of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Sabine Behrens
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Tomasz Kluz
- Department of Obstetrics and Gynecology, Fryderyk Chopin University Hospital No 1, Faculty of Medicine, Rzeszów University, Rzeszów, Poland
| | - Robert P Edwards
- Ovarian Cancer Center of Excellence, Womens Cancer Research Program, Magee-Womens Research Institute and University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jacek Gronwald
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Francesmary Modugno
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Womens Cancer Research Center, Magee-Womens Research Institute and Hillman Cancer Center, Pittsburgh, PA, USA
| | | | - Christine Chow
- Genetic Pathology Evaluation Centre, Vancouver General Hospital and University of British Columbia, Vancouver, BC, Canada
| | - Linda E Kelemen
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Gary L Keeney
- Department of Laboratory Medicine and Pathology, Division of Anatomic Pathology. Mayo Clinic, Rochester, MN, USA
| | - Michael E Carney
- Department of Obstetrics and Gynecology, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Yanina Natanzon
- Department of Health Science Research, Division of Epidemiology. Mayo Clinic, Rochester, MN, USA
| | - Gregory Robertson
- School of Women's and Children's Health, Faculty of Medicine, University of NSW Sydney, Sydney, NSW, Australia
- St George Private Hospital, Kogarah, NSW, Australia
| | - Raghwa Sharma
- Pathology West ICPMR Westmead, Westmead Hospital, The University of Sydney, Sydney, NSW, Australia
- University of Western Sydney at Westmead Hospital, Westmead, NSW, Australia
| | - Simon A Gayther
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Center for Cancer Prevention and Translational Genomics, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jennifer Alsop
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Hugh Luk
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Chloe Karpinskyj
- Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London, London, UK
| | - Ian Campbell
- Peter MacCallum Cancer Center, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Peter Sinn
- Department of Pathology, Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Aleksandra Gentry-Maharaj
- Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London, London, UK
| | - Penny Coulson
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH). University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mitul Shah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Martin Widschwendter
- Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London, London, UK
| | - Katrina Tang
- NSW Health Pathology. Prince of Wales Hospital, Sydney, NSW, Australia
| | - Minouk J Schoemaker
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | | | - Linda S Cook
- University of New Mexico Health Sciences Center. University of New Mexico, Albuquerque, NM, USA
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, AB, Canada
| | - James D Brenton
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Frances Daley
- Division of Breast Cancer Research. Institute of Cancer Research, London, UK
- Division of Bioscience, Brunel University, London, UK
| | - Björg Kristjansdottir
- Department of Obstetrics and Gynecology, Sahlgrenska Cancer Center, Inst Clinical Scienses, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Department of Gynecology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Constantina Mateoiu
- Department of Pathology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Melissa C Larson
- Department of Health Science Research, Division of Biomedical Statistics and Informatics. Mayo Clinic, Rochester, MN, USA
| | - Paul R Harnett
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia
- The Crown Princess Mary Cancer Centre Westmead, Sydney-West Cancer Network. Westmead Hospital, Sydney, NSW, Australia
| | - Audrey Jung
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Anna deFazio
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, NSW, Australia
| | | | - Paul D P Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Parham Minoo
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, AB, Canada
| | - Colin Stewart
- Histopathology Department, King Edward Memorial Hospital, Perth, Western Australia, Australia
| | - Oliver F Bathe
- Departments of Surgery and Oncology, Tom Baker Cancer Centre, Calgary, AB, Canada
| | - Xianyong Gui
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, AB, Canada
| | - Paul Cohen
- Bendat Family Comprehensive Cancer Centre, St John of God Subiaco Hospital, Subiaco, Western Australia, Australia
- Division of Obstetrics and Gynaecology, Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Western Australia, Australia
| | - Susan J Ramus
- School of Women's and Children's Health, Faculty of Medicine, University of NSW Sydney, Sydney, NSW, Australia
- Adult Cancer Program. Lowy Cancer Research Centre, Sydney, Australia
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Sydney, NSW, Australia
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, AB, Canada.
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Gershenson DM, Okamoto A, Ray-Coquard I. Management of Rare Ovarian Cancer Histologies. J Clin Oncol 2019; 37:2406-2415. [DOI: 10.1200/jco.18.02419] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
| | - Aikou Okamoto
- The Jikei University School of Medicine, Tokyo, Japan
| | - Isabelle Ray-Coquard
- Centre Leon Bèrard, Université Claude Bernard Lyon, Groupe d’Investigateurs Nationaux pour l’Étude des Cancers de l’Ovaire (GINECO), Lyon, France
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Cheasley D, Wakefield MJ, Ryland GL, Allan PE, Alsop K, Amarasinghe KC, Ananda S, Anglesio MS, Au-Yeung G, Böhm M, Bowtell DDL, Brand A, Chenevix-Trench G, Christie M, Chiew YE, Churchman M, DeFazio A, Demeo R, Dudley R, Fairweather N, Fedele CG, Fereday S, Fox SB, Gilks CB, Gourley C, Hacker NF, Hadley AM, Hendley J, Ho GY, Hughes S, Hunstman DG, Hunter SM, Jobling TW, Kalli KR, Kaufmann SH, Kennedy CJ, Köbel M, Le Page C, Li J, Lupat R, McNally OM, McAlpine JN, Mes-Masson AM, Mileshkin L, Provencher DM, Pyman J, Rahimi K, Rowley SM, Salazar C, Samimi G, Saunders H, Semple T, Sharma R, Sharpe AJ, Stephens AN, Thio N, Torres MC, Traficante N, Xing Z, Zethoven M, Antill YC, Scott CL, Campbell IG, Gorringe KL. The molecular origin and taxonomy of mucinous ovarian carcinoma. Nat Commun 2019; 10:3935. [PMID: 31477716 PMCID: PMC6718426 DOI: 10.1038/s41467-019-11862-x] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 08/07/2019] [Indexed: 02/03/2023] Open
Abstract
Mucinous ovarian carcinoma (MOC) is a unique subtype of ovarian cancer with an uncertain etiology, including whether it genuinely arises at the ovary or is metastatic disease from other organs. In addition, the molecular drivers of invasive progression, high-grade and metastatic disease are poorly defined. We perform genetic analysis of MOC across all histological grades, including benign and borderline mucinous ovarian tumors, and compare these to tumors from other potential extra-ovarian sites of origin. Here we show that MOC is distinct from tumors from other sites and supports a progressive model of evolution from borderline precursors to high-grade invasive MOC. Key drivers of progression identified are TP53 mutation and copy number aberrations, including a notable amplicon on 9p13. High copy number aberration burden is associated with worse prognosis in MOC. Our data conclusively demonstrate that MOC arise from benign and borderline precursors at the ovary and are not extra-ovarian metastases.
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Affiliation(s)
| | - Matthew J Wakefield
- Walter and Eliza Hall Institute, Parkville, Australia
- The University of Melbourne, Melbourne, Australia
| | | | - Prue E Allan
- Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Kathryn Alsop
- Peter MacCallum Cancer Centre, Melbourne, Australia
- The University of Melbourne, Melbourne, Australia
| | | | - Sumitra Ananda
- Peter MacCallum Cancer Centre, Melbourne, Australia
- Western Health, St. Albans, Australia
| | | | - George Au-Yeung
- Peter MacCallum Cancer Centre, Melbourne, Australia
- The University of Melbourne, Melbourne, Australia
| | - Maret Böhm
- Kinghorn Cancer Centre and Garvan Institute of Medical Research, Darlinghurst, Australia
| | - David D L Bowtell
- Peter MacCallum Cancer Centre, Melbourne, Australia
- The University of Melbourne, Melbourne, Australia
| | - Alison Brand
- Westmead Hospital, University of Sydney, Sydney, Australia
| | | | - Michael Christie
- The University of Melbourne, Melbourne, Australia
- Royal Melbourne Hospital, Parkville, Australia
| | - Yoke-Eng Chiew
- Westmead Hospital, University of Sydney, Sydney, Australia
| | - Michael Churchman
- Nicola Murray Centre for Ovarian Cancer Research, Cancer Research UK Edinburgh Centre, University of Edinburgh, Edinburgh, UK
| | - Anna DeFazio
- Westmead Hospital, University of Sydney, Sydney, Australia
| | - Renee Demeo
- Peter MacCallum Cancer Centre, Melbourne, Australia
| | | | | | - Clare G Fedele
- Peter MacCallum Cancer Centre, Melbourne, Australia
- The University of Melbourne, Melbourne, Australia
| | - Sian Fereday
- Peter MacCallum Cancer Centre, Melbourne, Australia
- The University of Melbourne, Melbourne, Australia
| | - Stephen B Fox
- Peter MacCallum Cancer Centre, Melbourne, Australia
- The University of Melbourne, Melbourne, Australia
| | | | - Charlie Gourley
- Nicola Murray Centre for Ovarian Cancer Research, Cancer Research UK Edinburgh Centre, University of Edinburgh, Edinburgh, UK
| | | | | | - Joy Hendley
- Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Gwo-Yaw Ho
- Walter and Eliza Hall Institute, Parkville, Australia
| | | | | | | | | | | | | | | | | | | | - Jason Li
- Peter MacCallum Cancer Centre, Melbourne, Australia
| | | | - Orla M McNally
- The University of Melbourne, Melbourne, Australia
- Royal Womens Hospital, Parkville, Australia
| | | | | | | | - Diane M Provencher
- CRCHUM, Montreal, Canada
- Centre Hospitalier de L'Université de Montreal, Montreal, Canada
| | - Jan Pyman
- Royal Womens Hospital, Parkville, Australia
- Royal Children's Hospital, Flemington, Australia
| | - Kurosh Rahimi
- CRCHUM, Montreal, Canada
- Centre Hospitalier de L'Université de Montreal, Montreal, Canada
| | | | | | - Goli Samimi
- Kinghorn Cancer Centre and Garvan Institute of Medical Research, Darlinghurst, Australia
| | | | | | - Ragwha Sharma
- Westmead Hospital, University of Sydney, Sydney, Australia
- NSW Health Pathology, Sydney, Australia
| | | | | | - Niko Thio
- Peter MacCallum Cancer Centre, Melbourne, Australia
| | | | - Nadia Traficante
- Peter MacCallum Cancer Centre, Melbourne, Australia
- The University of Melbourne, Melbourne, Australia
| | | | | | - Yoland C Antill
- Cabrini Health, Malvern, Australia
- Frankston Hospital, Frankston, Australia
| | - Clare L Scott
- Peter MacCallum Cancer Centre, Melbourne, Australia
- Walter and Eliza Hall Institute, Parkville, Australia
- The University of Melbourne, Melbourne, Australia
- Royal Melbourne Hospital, Parkville, Australia
| | - Ian G Campbell
- Peter MacCallum Cancer Centre, Melbourne, Australia
- The University of Melbourne, Melbourne, Australia
| | - Kylie L Gorringe
- Peter MacCallum Cancer Centre, Melbourne, Australia.
- The University of Melbourne, Melbourne, Australia.
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Gore M, Hackshaw A, Brady WE, Penson RT, Zaino R, McCluggage WG, Ganesan R, Wilkinson N, Perren T, Montes A, Summers J, Lord R, Dark G, Rustin G, Mackean M, Reed N, Kehoe S, Frumovitz M, Christensen H, Feeney A, Ledermann J, Gershenson DM. An international, phase III randomized trial in patients with mucinous epithelial ovarian cancer (mEOC/GOG 0241) with long-term follow-up: and experience of conducting a clinical trial in a rare gynecological tumor. Gynecol Oncol 2019; 153:541-548. [PMID: 31005287 PMCID: PMC6559214 DOI: 10.1016/j.ygyno.2019.03.256] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 03/26/2019] [Indexed: 12/18/2022]
Abstract
Objectives We evaluated four different treatment regimens for advanced-stage mucinous epithelial ovarian cancer. Methods We conducted a multicenter randomized factorial trial (UK and US). Patients were diagnosed with primary mEOC: FIGO stage II–IV or recurrence after stage I disease. Treatment arms were paclitaxel-carboplatin, oxaliplatin-capecitabine, paclitaxel-carboplatin-bevacizumab, or oxaliplatin-capecitabine-bevacizumab. Chemotherapy was given 3-weekly for 6 cycles, and bevacizumab (3-weekly) was continued as maintenance (for 12 cycles). Endpoints included overall-survival (OS), progression-free survival (PFS), toxicity and quality of life (QoL). Results The trial stopped after 50 patients were recruited due to slow accrual. Median follow-up was 59 months. OS hazard ratios (HR) for the two main comparisons were: 0.78 (p = 0.48) for Oxal-Cape vs. Pac-Carbo (each with/without bevacizumab), and 1.04 (p = 0.92) for bevacizumab vs. no bevacizumab. Corresponding PFS HRs were: 0.84 and 0.80. Retrospective central pathology review revealed only 45% (18/40) cases with available material had confirmed primary mEOC. Among these, OS HR for Oxal-Cape vs. Pac-Carbo was 0.36 (p = 0.14); PFS HR = 0.62 (p = 0.40). Grade 3–4 toxicity was seen in 61% Pac-Carbo, 61% Oxal-Cape, 54% Pac-Carbo-Bev, and 85% Oxal-Cape-Bev. QoL was similar between the four arms. Conclusion mEOC/GOG0241 represents an example of a randomized rare tumor trial. Logistical challenges led to early termination, including difficulties in local histopathological diagnosis and accessing drugs outside their labelled indication. There was misalignment between central funders who support clinical trials in rare cancers and the deprioritisation of such work by those managing and funding research at a local level. Rare cancer trials should include centralised pathology review before treatment. Clinical trial registry number: ISRCTN83438782. mEOC/GOG-0241 is one of the first international rare tumor trials. Oxaliplatin/capecitabine might be worth further study. Long-term follow-up is feasible in rare tumors. Challenges were lack of local resources and funding for experimental licenced therapies.
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Affiliation(s)
- Martin Gore
- Royal Marsden NHS Foundation Trust, London, UK
| | - Allan Hackshaw
- Cancer Research UK & UCL Cancer Trials Centre, London, UK.
| | | | | | - Richard Zaino
- Penn State Health Milton S. Hershey Medical Centre, PA, USA
| | | | | | - Nafisa Wilkinson
- University College London Hospitals NHS Foundation Trust, London, UK
| | | | - Ana Montes
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Jeffrey Summers
- Maidstone and Tunbridge Wells NHS Foundation Trust, Kent, UK
| | - Rosemary Lord
- Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK
| | - Graham Dark
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | | | | | | | - Sean Kehoe
- Institute of Cancer and Genomics, University of Birmingham, Birmingham, UK
| | | | | | - Amanda Feeney
- Cancer Research UK & UCL Cancer Trials Centre, London, UK
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Affiliation(s)
- Philippe Morice
- From the Departments of Gynecological Surgery and Medical Oncology (P.M., S.G., A.L.), INSERM Unit 981 (A.L.), and INSERM Unit 10-30 (P.M.), Gustave Roussy Cancer Campus, Villejuif, and University Paris-Sud (Paris XI), Le Kremlin Bicêtre (P.M.) - both in France
| | - Sebastien Gouy
- From the Departments of Gynecological Surgery and Medical Oncology (P.M., S.G., A.L.), INSERM Unit 981 (A.L.), and INSERM Unit 10-30 (P.M.), Gustave Roussy Cancer Campus, Villejuif, and University Paris-Sud (Paris XI), Le Kremlin Bicêtre (P.M.) - both in France
| | - Alexandra Leary
- From the Departments of Gynecological Surgery and Medical Oncology (P.M., S.G., A.L.), INSERM Unit 981 (A.L.), and INSERM Unit 10-30 (P.M.), Gustave Roussy Cancer Campus, Villejuif, and University Paris-Sud (Paris XI), Le Kremlin Bicêtre (P.M.) - both in France
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40
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Kajiyama H, Suzuki S, Yoshikawa N, Kawai M, Nagasaka T, Kikkawa F. Survival impact of capsule status in stage I ovarian mucinous carcinoma-A mulicentric retrospective study. Eur J Obstet Gynecol Reprod Biol 2019; 234:131-136. [PMID: 30685661 DOI: 10.1016/j.ejogrb.2019.01.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 12/31/2018] [Accepted: 01/05/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND The influence of capsule rupture on patients' oncologic outcome has been controversial in early-stage ovarian carcinoma. The aim of this study was to investigate the significance of the capsule status in early-stage patients with mucinous epithelial ovarian carcinoma (mEOC). PATIENTS AND METHODS During the period of 1990-2015, 351 patients with stage I-IV mEOC were identified in the multicentric database. Of these, a total of 194 mEOC patients with a stage I tumor were in the study. RESULTS The median follow-up of the surviving patients was 67.6 (2.0-248.1) months. The FIGO stage distribution was IA in 85 (43.8%), IB in 2 (1.0%), IC1 in 58 (29.9%), IC2 in 18 (9.3%), and IC3 in 31 (16.0%). The 5-year overall survival (OS) rates in patients with stage IA-B, IC1, and IC2-3 tumors were 95.8, 82.5, and 82.9%, respectively {IA-B vs. IC1: P = 0.0031, IA vs. IC2-3: P = 0.0042}. Similarly, the 5-year recurrence-free survival rates in patients with stage IA-B, IC1, and IC2-3 tumors were 93.5, 73.0, and 79.2%, respectively (Log-rank: P = 0.0034). Among all patients, 104 received adjuvant chemotherapy and 90 did not. There was no significant difference in each substage group between the non-chemotherapy and chemotherapy groups in the 5-year overall survival rate {chemotherapy (yes vs. no): 87.0 vs. 90.3%: P = 0.5389}. Multivariate analysis demonstrated that the capsule status was a significant prognostic factor for OS {IA-B (referent) vs. IC1: HR (95% CI): 3.527 (1.125-12.568), P = 0.0300)}. CONCLUSION mEOC patients staged greater than IC1 show a marked risk of mortality even after postoperative chemotherapy.
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Affiliation(s)
- Hiroaki Kajiyama
- From Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Japan.
| | - Shiro Suzuki
- From Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Japan
| | - Nobuhisa Yoshikawa
- From Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Japan
| | - Michiyasu Kawai
- Department of Obstetrics and Gynecology, Toyohashi Municipal Hospital, Japan
| | - Tetsuro Nagasaka
- Division of Medical Laboratory Sciences, School of Health Science, Nagoya University, Japan
| | - Fumitaka Kikkawa
- From Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Japan
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Elsherif SB, Faria SC, Lall C, Iyer R, Bhosale PR. Ovarian Cancer Genetics and Implications for Imaging and Therapy. J Comput Assist Tomogr 2019; 43:835-845. [DOI: 10.1097/rct.0000000000000932] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Freimund AE, Beach JA, Christie EL, Bowtell DD. Mechanisms of Drug Resistance in High-Grade Serous Ovarian Cancer. Hematol Oncol Clin North Am 2018; 32:983-996. [DOI: 10.1016/j.hoc.2018.07.007] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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43
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Akinwunmi B, Vitonis AF, Titus L, Terry KL, Cramer DW. Statin therapy and association with ovarian cancer risk in the New England Case Control (NEC) study. Int J Cancer 2018; 144:991-1000. [PMID: 30006925 DOI: 10.1002/ijc.31758] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 06/25/2018] [Accepted: 07/04/2018] [Indexed: 12/17/2022]
Abstract
Statins are widely used to lower blood cholesterol and reduce risk for cardiovascular diseases, but attention has recently focused on a role in cancer prevention or therapy. Here we present data from a large case-control study addressing whether statin use can lower the risk for epithelial ovarian cancer (EOC). Between 1992 and 2008, data including medications used for at least 6 months were collected from 2,040 cases with EOC and 2,100 frequency-matched controls without the disease who participated in the New England Case Control study. We used unconditional logistic regression controlling for matching factors and potential confounders to examine the association between statin use and the risk for EOC. Overall, women who used statins had 32% lower risk of ovarian cancer compared to non-users (Odds ratio (OR) 0.68, 95% Confidence Interval (CI): 0.54-0.85), adjusting for the matching factors and other covariates. The reduced risk was most apparent in women taking a lipophilic statin who began use after age 49, and who had used them 2-4.9 years. Statin use was associated with lower risks for both serous and non-serous histologic subtypes with the strongest effect seen for mucinous and mixed epithelial subtypes. The association became apparent about a decade after the introduction of statins and did not appear to be confounded by indications for use of statins or medications used concomitantly. In this case-control study, statins were found to lower the risk for both serous and non-serous EOC and especially mucinous EOC.
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Affiliation(s)
- Babatunde Akinwunmi
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, MA.,Department of Global Education, Harvard Medical School, Boston, MA
| | - Allison F Vitonis
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, MA
| | - Linda Titus
- Departments of Epidemiology and Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH
| | - Kathryn L Terry
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, MA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA
| | - Daniel W Cramer
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, MA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA
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Li Y, Feng Y, Dai W, Li Q, Cai S, Peng J. Prognostic Effect of Tumor Sidedness in Colorectal Cancer: A SEER-Based Analysis. Clin Colorectal Cancer 2018; 18:e104-e116. [PMID: 30448100 DOI: 10.1016/j.clcc.2018.10.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 10/21/2018] [Accepted: 10/22/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND The prognostic value of tumor sidedness in metastatic colorectal cancer (CRC) has been established, but its impact on nonmetastatic disease remains unclear. Our study aimed to explore the prognostic effect of tumor sidedness by subgroup survival analyses, according to histology and tumor grade in stage I-IV CRCs. METHODS A retrospective population-based study was conducted based on Surveillance, Epidemiology and End Results (SEER) data. Population data in the SEER 9 registry (1975-2014) were used to determine survival trends of CRCs, and associated population data in the SEER 18 registry (2000 to 2014) were used to assess the prognostic impact of tumor sidedness on CRCs. RESULTS The 5-year cause-specific survival for all subgroups of CRCs improved from 1975 to 2014. Of 238,826 patients, 44.2% had right-sided cancer. Patients with right-sided cancer were more likely to be older, to be women, to have disease of mucinous or signet-ring cell histology, to have more poorly differentiated tumors, and to be diagnosed with a more advanced disease stage. Multivariate Cox regression showed stage I-II right-sided cancers had better cause-specific survival than the left-sided cancers (left colon: hazard ratio [HR] = 1.091, 95% confidence interval [CI], 1.052-1.132; rectum: HR = 1.363; 95% CI, 1.304-1.425; P < .001), while stage III and IV right-sided cancers had worse cause-specific survival. In subgroup analyses by histology and tumor grade within stage III CRCs, right-sided poorly differentiated mucinous adenocarcinoma showed significantly better survival (left colon: HR = 1.352; 95% CI, 1.145-1.596; rectum: HR = 1.125; 95% CI, 0.916-1.381; P = .002). CONCLUSION The relationship between sidedness and prognosis in CRCs depends on stage and histopathologic characteristics, especially for stage III disease.
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Affiliation(s)
- Yaqi Li
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yang Feng
- Department of Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Weixing Dai
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Qingguo Li
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Sanjun Cai
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Junjie Peng
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
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Meagher NS, Schuster K, Voss A, Budden T, Pang CNI, deFazio A, Ramus SJ, Friedlander ML. Does the primary site really matter? Profiling mucinous ovarian cancers of uncertain primary origin (MO-CUP) to personalise treatment and inform the design of clinical trials. Gynecol Oncol 2018; 150:527-533. [DOI: 10.1016/j.ygyno.2018.07.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 07/09/2018] [Accepted: 07/16/2018] [Indexed: 01/09/2023]
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Kelemen LE, Earp M, Fridley BL, Chenevix-Trench G, Fasching PA, Beckmann MW, Ekici AB, Hein A, Lambrechts D, Lambrechts S, Van Nieuwenhuysen E, Vergote I, Rossing MA, Doherty JA, Chang-Claude J, Behrens S, Moysich KB, Cannioto R, Lele S, Odunsi K, Goodman MT, Shvetsov YB, Thompson PJ, Wilkens LR, Dörk T, Antonenkova N, Bogdanova N, Hillemanns P, Runnebaum IB, du Bois A, Harter P, Heitz F, Schwaab I, Butzow R, Pelttari LM, Nevanlinna H, Modugno F, Edwards RP, Kelley JL, Ness RB, Karlan BY, Lester J, Orsulic S, Walsh C, Kjaer SK, Jensen A, Cunningham JM, Vierkant RA, Giles GG, Bruinsma F, Southey MC, Hildebrandt MA, Liang D, Lu K, Wu X, Sellers TA, Levine DA, Schildkraut JM, Iversen ES, Terry KL, Cramer DW, Tworoger SS, Poole EM, Bandera EV, Olson SH, Orlow I, Vestrheim Thomsen LC, Bjorge L, Krakstad C, Tangen IL, Kiemeney LA, Aben KK, Massuger LF, van Altena AM, Pejovic T, Bean Y, Kellar M, Cook LS, Le ND, Brooks-Wilson A, Gronwald J, Cybulski C, Jakubowska A, Lubiński J, Wentzensen N, Brinton LA, Lissowska J, Hogdall E, Engelholm SA, Hogdall C, Lundvall L, Nedergaard L, Pharoah PD, Dicks E, Song H, Tyrer JP, McNeish I, Siddiqui N, Carty K, Glasspool R, Paul J, Campbell IG, Eccles D, Whittemore AS, McGuire V, Rothstein JH, Sieh W, Narod SA, Phelan CM, McLaughlin JR, Risch HA, Anton-Culver H, Ziogas A, Menon U, Gayther SA, Gentry-Maharaj A, Ramus SJ, Wu AH, Pearce CL, Lee AW, Pike MC, Kupryjanczyk J, Podgorska A, Plisiecka-Halasa J, Sawicki W, Goode EL, Berchuck A. rs495139 in the TYMS-ENOSF1 Region and Risk of Ovarian Carcinoma of Mucinous Histology. Int J Mol Sci 2018; 19:E2473. [PMID: 30134598 PMCID: PMC6163881 DOI: 10.3390/ijms19092473] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 08/05/2018] [Accepted: 08/09/2018] [Indexed: 12/20/2022] Open
Abstract
Thymidylate synthase (TYMS) is a crucial enzyme for DNA synthesis. TYMS expression is regulated by its antisense mRNA, ENOSF1. Disrupted regulation may promote uncontrolled DNA synthesis and tumor growth. We sought to replicate our previously reported association between rs495139 in the TYMS-ENOSF1 3' gene region and increased risk of mucinous ovarian carcinoma (MOC) in an independent sample. Genotypes from 24,351 controls to 15,000 women with invasive OC, including 665 MOC, were available. We estimated per-allele odds ratios (OR) and 95% confidence intervals (CI) using unconditional logistic regression, and meta-analysis when combining these data with our previous report. The association between rs495139 and MOC was not significant in the independent sample (OR = 1.09; 95% CI = 0.97⁻1.22; p = 0.15; N = 665 cases). Meta-analysis suggested a weak association (OR = 1.13; 95% CI = 1.03⁻1.24; p = 0.01; N = 1019 cases). No significant association with risk of other OC histologic types was observed (p = 0.05 for tumor heterogeneity). In expression quantitative trait locus (eQTL) analysis, the rs495139 allele was positively associated with ENOSF1 mRNA expression in normal tissues of the gastrointestinal system, particularly esophageal mucosa (r = 0.51, p = 1.7 × 10-28), and nonsignificantly in five MOC tumors. The association results, along with inconclusive tumor eQTL findings, suggest that a true effect of rs495139 might be small.
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Affiliation(s)
- Linda E. Kelemen
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC 29425, USA
- Department of Public Health Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Madalene Earp
- Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic, Rochester, MN 55905, USA; (M.E.); (E.L.G.)
| | - Brooke L. Fridley
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612 USA;
| | - Georgia Chenevix-Trench
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD 4006, Australia;
| | | | - Peter A. Fasching
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Comprehensive Cancer Center, 91054 Erlangen, Germany; (P.A.F.); (M.W.B.); (A.H.)
- Department of Medicine, Division of Hematology and Oncology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, USA
| | - Matthias W. Beckmann
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Comprehensive Cancer Center, 91054 Erlangen, Germany; (P.A.F.); (M.W.B.); (A.H.)
| | - Arif B. Ekici
- Institute of Human Genetics, Friedrich-Alexander-University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen Nuremberg, Erlangen 91054, Germany;
| | - Alexander Hein
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Comprehensive Cancer Center, 91054 Erlangen, Germany; (P.A.F.); (M.W.B.); (A.H.)
| | - Diether Lambrechts
- Vesalius Research Center, University of Leuven, Leuven 3001, Belgium;
- Laboratory for Translational Genetics, Department of Oncology, University of Leuven, Leuven 3000, Belgium
| | - Sandrina Lambrechts
- Division of Gynecologic Oncology, Department of Obstetrics and Gynaecology and Leuven Cancer Institute, University Hospitals Leuven, Leuven 3000, Belgium; (S.L.); (E.V.N.); (I.V.)
| | - Els Van Nieuwenhuysen
- Division of Gynecologic Oncology, Department of Obstetrics and Gynaecology and Leuven Cancer Institute, University Hospitals Leuven, Leuven 3000, Belgium; (S.L.); (E.V.N.); (I.V.)
| | - Ignace Vergote
- Division of Gynecologic Oncology, Department of Obstetrics and Gynaecology and Leuven Cancer Institute, University Hospitals Leuven, Leuven 3000, Belgium; (S.L.); (E.V.N.); (I.V.)
| | - Mary Anne Rossing
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA;
- Department of Epidemiology, University of Washington, Seattle, WA 98402, USA
| | - Jennifer A. Doherty
- Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT 84112, USA;
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany; (J.C.-C.); (S.B.)
- University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Sabine Behrens
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany; (J.C.-C.); (S.B.)
| | - Kirsten B. Moysich
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY 14263, USA; (K.B.M.); (R.C.)
| | - Rikki Cannioto
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY 14263, USA; (K.B.M.); (R.C.)
| | - Shashikant Lele
- Department of Gynecological Oncology, Roswell Park Cancer Institute, Buffalo, NY 14263, USA; (S.L.); (K.O.)
| | - Kunle Odunsi
- Department of Gynecological Oncology, Roswell Park Cancer Institute, Buffalo, NY 14263, USA; (S.L.); (K.O.)
| | - Marc T. Goodman
- Department of Cancer Prevention and Control, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; (M.T.G.); (P.J.T.)
- Community and Population Health Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Yurii B. Shvetsov
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI 96813, USA; (Y.B.S.); (L.R.W.)
| | - Pamela J. Thompson
- Department of Cancer Prevention and Control, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; (M.T.G.); (P.J.T.)
- Community and Population Health Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Lynne R. Wilkens
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI 96813, USA; (Y.B.S.); (L.R.W.)
| | - Thilo Dörk
- Gynaecology Research Unit, Hannover Medical School, Hannover 30625, Germany; (T.D.); (N.B.)
| | - Natalia Antonenkova
- Byelorussian Institute for Oncology and Medical Radiology Aleksandrov N.N., Minsk 223040, Belarus;
| | - Natalia Bogdanova
- Gynaecology Research Unit, Hannover Medical School, Hannover 30625, Germany; (T.D.); (N.B.)
| | - Peter Hillemanns
- Clinics of Obstetrics and Gynaecology, Hannover Medical School, Hannover 30625, Germany;
| | - Ingo B. Runnebaum
- Department of Gynecology, Jena University Hospital-Friedrich Schiller University, Jena 07743, Germany;
| | - Andreas du Bois
- Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte (KEM), Essen 45136, Germany; (A.d.B.); (P.H.); (F.H.)
- Department of Gynecology and Gynecologic Oncology, Dr. Horst Schmidt Kliniken Wiesbaden, Wiesbaden 65199, Germany
| | - Philipp Harter
- Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte (KEM), Essen 45136, Germany; (A.d.B.); (P.H.); (F.H.)
- Department of Gynecology and Gynecologic Oncology, Dr. Horst Schmidt Kliniken Wiesbaden, Wiesbaden 65199, Germany
| | - Florian Heitz
- Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte (KEM), Essen 45136, Germany; (A.d.B.); (P.H.); (F.H.)
- Department of Gynecology and Gynecologic Oncology, Dr. Horst Schmidt Kliniken Wiesbaden, Wiesbaden 65199, Germany
| | - Ira Schwaab
- Praxis für Humangenetik, Wiesbaden 65187, Germany;
| | - Ralf Butzow
- Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki 00290, Finland;
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki 00290, Finland; (L.M.P.); (H.N.)
| | - Liisa M. Pelttari
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki 00290, Finland; (L.M.P.); (H.N.)
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki 00290, Finland; (L.M.P.); (H.N.)
| | - Francesmary Modugno
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; (F.M.); (R.P.E.); (J.L.K.)
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15213, USA
- Women’s Cancer Research Program, Magee-Women's Research Institute and Hillman Cancer Center, Pittsburgh, PA 15213, USA
| | - Robert P. Edwards
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; (F.M.); (R.P.E.); (J.L.K.)
| | - Joseph L. Kelley
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; (F.M.); (R.P.E.); (J.L.K.)
| | - Roberta B. Ness
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX 77030, USA;
| | - Beth Y. Karlan
- Women’s Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; (B.Y.K.); (J.L.); (S.O.); (C.W.)
| | - Jenny Lester
- Women’s Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; (B.Y.K.); (J.L.); (S.O.); (C.W.)
| | - Sandra Orsulic
- Women’s Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; (B.Y.K.); (J.L.); (S.O.); (C.W.)
| | - Christine Walsh
- Women’s Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; (B.Y.K.); (J.L.); (S.O.); (C.W.)
| | - Susanne K. Kjaer
- Department of Gynaecology, Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark; (S.K.K.); (C.H.); (L.L.)
- Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Centre, DK-2100 Copenhagen, Denmark; (A.J.); (E.H.)
| | - Allan Jensen
- Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Centre, DK-2100 Copenhagen, Denmark; (A.J.); (E.H.)
| | - Julie M. Cunningham
- Department of Laboratory Medicine and Pathology, Division of Experimental Pathology, Mayo Clinic, Rochester, MN 55905, USA;
| | - Robert A. Vierkant
- Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN 55905, USA;
| | - Graham G. Giles
- Centre for Epidemiology and Biostatistics, University of Melbourne, VIC 3010, Australia;
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC 3004, Australia;
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia
| | - Fiona Bruinsma
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC 3004, Australia;
| | - Melissa C. Southey
- Department of Pathology, University of Melbourne, Melbourne, VIC 3010, Australia; (M.C.S.); (I.G.C.)
| | - Michelle A.T. Hildebrandt
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (M.A.T.H.); (X.W.)
| | - Dong Liang
- College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX 77004, USA;
| | - Karen Lu
- Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Xifeng Wu
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (M.A.T.H.); (X.W.)
| | - Thomas A. Sellers
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA; (T.A.S.); (S.S.T.); (C.M.P.)
| | - Douglas A. Levine
- Laura and Isaac Perlmutter Cancer Center, New York University Langone Health, New York, NY 10016, USA;
| | - Joellen M. Schildkraut
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA 22908, USA;
| | - Edwin S. Iversen
- Department of Statistical Science, Duke University, Durham, NC 27708, USA;
| | - Kathryn L. Terry
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (K.L.T.); (D.W.C.)
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Daniel W. Cramer
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (K.L.T.); (D.W.C.)
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Shelley S. Tworoger
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA; (T.A.S.); (S.S.T.); (C.M.P.)
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (K.L.T.); (D.W.C.)
| | - Elizabeth M. Poole
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA;
| | - Elisa V. Bandera
- Cancer Prevention and Control Program, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08903, USA;
| | - Sara H. Olson
- Memorial Sloan Kettering Cancer Center, Department of Epidemiology and Biostatistics, New York, NY 10065, USA; (S.H.O.); (I.O.); (M.C.P.)
| | - Irene Orlow
- Memorial Sloan Kettering Cancer Center, Department of Epidemiology and Biostatistics, New York, NY 10065, USA; (S.H.O.); (I.O.); (M.C.P.)
| | - Liv Cecilie Vestrheim Thomsen
- Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen 5021, Norway; (L.C.V.T.); (L.B.); (C.K.); (I.L.T.)
- Centre for Cancer Biomarkers CCBIO, Department of Clinical Science, University of Bergen, Bergen 5020, Norway
| | - Line Bjorge
- Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen 5021, Norway; (L.C.V.T.); (L.B.); (C.K.); (I.L.T.)
- Centre for Cancer Biomarkers CCBIO, Department of Clinical Science, University of Bergen, Bergen 5020, Norway
| | - Camilla Krakstad
- Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen 5021, Norway; (L.C.V.T.); (L.B.); (C.K.); (I.L.T.)
- Centre for Cancer Biomarkers CCBIO, Department of Clinical Science, University of Bergen, Bergen 5020, Norway
| | - Ingvild L. Tangen
- Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen 5021, Norway; (L.C.V.T.); (L.B.); (C.K.); (I.L.T.)
- Centre for Cancer Biomarkers CCBIO, Department of Clinical Science, University of Bergen, Bergen 5020, Norway
| | - Lambertus A. Kiemeney
- Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen 6525 EZ, The Netherlands; (L.A.K.); (K.K.H.A.)
| | - Katja K.H. Aben
- Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen 6525 EZ, The Netherlands; (L.A.K.); (K.K.H.A.)
- Netherlands Comprehensive Cancer Organisation, Utrecht 3511 DT, The Netherlands
| | - Leon F.A.G. Massuger
- Radboud University Medical Centre, Department of Obstetrics and Gynecology, Nijmegen 6525 GA, The Netherlands; (L.F.A.G.M.); (A.M.v.A.)
| | - Anne M. van Altena
- Radboud University Medical Centre, Department of Obstetrics and Gynecology, Nijmegen 6525 GA, The Netherlands; (L.F.A.G.M.); (A.M.v.A.)
| | - Tanja Pejovic
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR 97239, USA; (T.P.); (Y.B.); (M.K.)
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR 97239, USA
| | - Yukie Bean
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR 97239, USA; (T.P.); (Y.B.); (M.K.)
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR 97239, USA
| | - Melissa Kellar
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR 97239, USA; (T.P.); (Y.B.); (M.K.)
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR 97239, USA
| | - Linda S. Cook
- Division of Epidemiology, Biostatistics and Preventive Medicine, Department of Internal Medicine, University of New Mexico, Albuquerque, NM 87131, USA;
| | - Nhu D. Le
- Cancer Control Research, British Columbia Cancer Agency, Vancouver, BC V5Z 1L3, Canada;
| | - Angela Brooks-Wilson
- Canada’s Michael Smith Genome Sciences Centre, British Columbia Cancer Agency, Vancouver, BC V5Z 1L3, Canada;
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
| | - Jacek Gronwald
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin 71-252, Poland; (J.G.); (C.C.); (A.J.); (J.L.)
| | - Cezary Cybulski
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin 71-252, Poland; (J.G.); (C.C.); (A.J.); (J.L.)
| | - Anna Jakubowska
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin 71-252, Poland; (J.G.); (C.C.); (A.J.); (J.L.)
- Independent Laboratory of Molecular Biology and Genetic Diagnostics, Pomeranian Medical University, Szczecin 70-111, Poland
| | - Jan Lubiński
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin 71-252, Poland; (J.G.); (C.C.); (A.J.); (J.L.)
| | - Nicolas Wentzensen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA; (N.W.); (L.A.B.)
| | - Louise A. Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA; (N.W.); (L.A.B.)
| | - Jolanta Lissowska
- Department of Cancer Epidemiology and Prevention, M. Sklodowska-Curie Institute-Oncology Center, Warsaw 02-034, Poland;
| | - Estrid Hogdall
- Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Centre, DK-2100 Copenhagen, Denmark; (A.J.); (E.H.)
- Department of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen DK-2100, Denmark
| | - Svend Aage Engelholm
- Department of Radiation Oncology, Rigshospitalet, University of Copenhagen, Copenhagen DK-2100, Denmark;
| | - Claus Hogdall
- Department of Gynaecology, Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark; (S.K.K.); (C.H.); (L.L.)
| | - Lene Lundvall
- Department of Gynaecology, Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark; (S.K.K.); (C.H.); (L.L.)
| | - Lotte Nedergaard
- Department of Pathology, Rigshospitalet, University of Copenhagen, Copenhagen DK-2100, Denmark;
| | - Paul D.P. Pharoah
- The Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK;
- The Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge CB1 8RN, UK; (E.D.); (H.S.); (J.P.T.)
| | - Ed Dicks
- The Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge CB1 8RN, UK; (E.D.); (H.S.); (J.P.T.)
| | - Honglin Song
- The Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge CB1 8RN, UK; (E.D.); (H.S.); (J.P.T.)
| | - Jonathan P. Tyrer
- The Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge CB1 8RN, UK; (E.D.); (H.S.); (J.P.T.)
| | - Iain McNeish
- Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London, London W12 0NN, UK;
| | - Nadeem Siddiqui
- Department of Gynaecological Oncology, Glasgow Royal Infirmary, Glasgow G4 0SF, UK;
| | - Karen Carty
- Cancer Research UK Clinical Trials Unit, The Beatson West of Scotland Cancer Centre, Glasgow G12 0YN, UK; (K.C.); (R.G.); (J.P.)
| | - Rosalind Glasspool
- Cancer Research UK Clinical Trials Unit, The Beatson West of Scotland Cancer Centre, Glasgow G12 0YN, UK; (K.C.); (R.G.); (J.P.)
| | - James Paul
- Cancer Research UK Clinical Trials Unit, The Beatson West of Scotland Cancer Centre, Glasgow G12 0YN, UK; (K.C.); (R.G.); (J.P.)
| | - Ian G. Campbell
- Department of Pathology, University of Melbourne, Melbourne, VIC 3010, Australia; (M.C.S.); (I.G.C.)
- Cancer Genetics Laboratory, Research Division, Peter MacCallum Cancer Centre, St Andrews Place, East Melbourne, VIC 3000, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC 3000, Australia
| | - Diana Eccles
- Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK;
| | - Alice S. Whittemore
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA 94305, USA; (A.S.W.); (V.M.)
| | - Valerie McGuire
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA 94305, USA; (A.S.W.); (V.M.)
| | - Joseph H. Rothstein
- Department of Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (J.H.R.); (W.S.)
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (J.H.R.); (W.S.)
| | - Weiva Sieh
- Department of Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (J.H.R.); (W.S.)
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (J.H.R.); (W.S.)
| | - Steven A. Narod
- Women’s College Research Institute, University of Toronto, Toronto, ON M5S 1A8, Canada;
| | - Catherine M. Phelan
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA; (T.A.S.); (S.S.T.); (C.M.P.)
| | - John R. McLaughlin
- Public Health Ontario, Samuel Lunenfeld Research Institute, Toronto, ON M5T 3L9, Canada;
| | - Harvey A. Risch
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT 06510, USA;
| | - Hoda Anton-Culver
- Department of Epidemiology, Genetic Epidemiology Research Institute, School of Medicine, University of California Irvine, Irvine, CA 92617, USA; (H.A-C.); (A.Z.)
| | - Argyrios Ziogas
- Department of Epidemiology, Genetic Epidemiology Research Institute, School of Medicine, University of California Irvine, Irvine, CA 92617, USA; (H.A-C.); (A.Z.)
| | - Usha Menon
- MRC Clinical Trials at UCL, Institute of Clinical Trials & Methodology, Population Health Sciences, University College London, London, WC1V 6LJ, UK; (U.M.); (A.G.-M.)
| | - Simon A. Gayther
- Department of Biomedical Sciences and Center for Cancer Prevention and Translational Genomics, Samuel Oschin Comprensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA;
| | - Aleksandra Gentry-Maharaj
- MRC Clinical Trials at UCL, Institute of Clinical Trials & Methodology, Population Health Sciences, University College London, London, WC1V 6LJ, UK; (U.M.); (A.G.-M.)
| | - Susan J. Ramus
- School of Women’s and Children’s Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia;
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, NSW 2010, Australia
| | - Anna H. Wu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA 90033, USA; (A.H.W.); (C.L.P.)
| | - Celeste Leigh Pearce
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA 90033, USA; (A.H.W.); (C.L.P.)
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Alice W. Lee
- Department of Public Health, California State University, Fullerton, CA 92831, USA;
| | - Malcolm C. Pike
- Memorial Sloan Kettering Cancer Center, Department of Epidemiology and Biostatistics, New York, NY 10065, USA; (S.H.O.); (I.O.); (M.C.P.)
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA 90033, USA; (A.H.W.); (C.L.P.)
| | - Jolanta Kupryjanczyk
- Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie Institute-Oncology Center, Warsaw 02-034, Poland; (J.K.); (A.P.); (J.P.-H.)
| | - Agnieszka Podgorska
- Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie Institute-Oncology Center, Warsaw 02-034, Poland; (J.K.); (A.P.); (J.P.-H.)
| | - Joanna Plisiecka-Halasa
- Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie Institute-Oncology Center, Warsaw 02-034, Poland; (J.K.); (A.P.); (J.P.-H.)
| | - Wlodzimierz Sawicki
- Department of Obstetrics, Gynecology and Oncology, Second Faculty of Medicine, Medical University of Warsaw, Mazovian Bródno Hospital, Warsaw 03-242, Poland;
| | - Ellen L. Goode
- Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic, Rochester, MN 55905, USA; (M.E.); (E.L.G.)
| | - Andrew Berchuck
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27710, USA;
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Ricci F, Affatato R, Carrassa L, Damia G. Recent Insights into Mucinous Ovarian Carcinoma. Int J Mol Sci 2018; 19:ijms19061569. [PMID: 29795040 PMCID: PMC6032258 DOI: 10.3390/ijms19061569] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 05/11/2018] [Accepted: 05/18/2018] [Indexed: 12/31/2022] Open
Abstract
Ovarian mucinous tumors represent a group of rare neoplasms with a still undefined cell of origin but with an apparent progression from benign to borderline to carcinoma. Even though these tumors are different from the other histological subtypes of epithelial ovarian neoplasms, they are still treated with a similar chemotherapeutic approach. Here, we review its pathogenesis, molecular alterations, (differential) diagnosis, clinical presentation and current treatment, and how recent molecular and biological information on this tumor might lead to better and more specific clinical management of patients with mucinous ovarian carcinoma.
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Affiliation(s)
- Francesca Ricci
- IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Laboratory of Molecular Pharmacology, Via Giuseppe La Masa 19, 20156 Milan, Italy.
| | - Roberta Affatato
- IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Laboratory of Molecular Pharmacology, Via Giuseppe La Masa 19, 20156 Milan, Italy.
| | - Laura Carrassa
- IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Laboratory of Molecular Pharmacology, Via Giuseppe La Masa 19, 20156 Milan, Italy.
| | - Giovanna Damia
- IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Laboratory of Molecular Pharmacology, Via Giuseppe La Masa 19, 20156 Milan, Italy.
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48
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Massively parallel sequencing analysis of mucinous ovarian carcinomas: genomic profiling and differential diagnoses. Gynecol Oncol 2018; 150:127-135. [PMID: 29793804 DOI: 10.1016/j.ygyno.2018.05.008] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 04/30/2018] [Accepted: 05/07/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Mucinous ovarian cancer (MOC) is a rare type of epithelial ovarian cancer resistant to standard chemotherapy regimens. We sought to characterize the repertoire of somatic mutations in MOCs and to define the contribution of massively parallel sequencing to the classification of tumors diagnosed as primary MOCs. METHODS Following gynecologic pathology and chart review, DNA samples obtained from primary MOCs and matched normal tissues/blood were subjected to whole-exome (n = 9) or massively parallel sequencing targeting 341 cancer genes (n = 15). Immunohistochemical analysis of estrogen receptor, progesterone receptor, PTEN, ARID1A/BAF250a, and the DNA mismatch (MMR) proteins MSH6 and PMS2 was performed for all cases. Mutational frequencies of MOCs were compared to those of high-grade serous ovarian cancers (HGSOCs) and mucinous tumors from other sites. RESULTS MOCs were heterogeneous at the genetic level, frequently harboring TP53 (75%) mutations, KRAS (71%) mutations and/or CDKN2A/B homozygous deletions/mutations (33%). Although established criteria for diagnosis were employed, four cases harbored mutational and immunohistochemical profiles similar to those of endometrioid carcinomas, and one case for colorectal or endometrioid carcinoma. Significant differences in the frequencies of KRAS, TP53, CDKN2A, FBXW7, PIK3CA and/or APC mutations between the confirmed primary MOCs (n = 19) and HGSOCs, mucinous gastric and/or mucinous colorectal carcinomas were found, whereas no differences in the 341 genes studied between MOCs and mucinous pancreatic carcinomas were identified. CONCLUSIONS Our findings suggest that the assessment of mutations affecting TP53, KRAS, PIK3CA, ARID1A and POLE, and DNA MMR protein expression may be used to further aid the diagnosis and treatment decision-making of primary MOC.
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49
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Wei W, Giulia F, Luffer S, Kumar R, Wu B, Tavallai M, Bekele RT, Birrer MJ. How can molecular abnormalities influence our clinical approach. Ann Oncol 2018; 28:viii16-viii24. [PMID: 29232470 DOI: 10.1093/annonc/mdx447] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background Despite improvements in diagnostics and treatment, the clinical outcome of epithelial ovarian cancer remains poor over the last three decades. Recent high-throughput genomic studies have demonstrated ovarian cancer as a highly heterogeneous entity with distinctive molecular signatures among different or even within the same histotype. In this article, we review the molecular genetics of epithelial ovarian cancer and how they have been translated into modern clinical trials, as well as their implications in patient stratification for more targeted and personalized approaches. Patients and methods Multiple genomic studies were collected to summarize the major advances in understanding ovarian cancer-associated molecular abnormalities with emphasis on their potential clinical applicability to rationalize the design of recent clinical trials. Results The clinical management of ovarian cancer can significantly benefit from comprehensive molecular profiling studies, which have uncovered the distinctiveness of ovarian cancer subsets bearing characteristic genomic aberrance and consequentially dysregulated genes and pathways underlying the tumor progression and chemoresistance. Genomics studies have demonstrated a powerful tool to delineate the molecular basis responsible for diverse clinical behaviors associated with tumor histology and grade. In addition, molecular signatures obtained by integrated 'omics' analyses have promised opportunities for novel therapeutic or stratification biomarkers to tailor current clinical management as well as novel predictive tools of clinical end points including patient prognosis and therapeutic efficacy. Conclusions Recent progress in understanding the molecular landscape of ovarian cancer has profoundly shifted the design of clinical trials from empirical, unitary paradigms to more rationalized and personalized regimes. Correspondingly, a promising prospective has emerged for ovarian cancer patients to have considerably improved outcome upon careful alignment of patient characteristics, therapeutic biomarkers and targeting approaches. Nevertheless, extensive validation and inference of potential biomarkers are pressing demands on both bioinformatic and biological levels to warrant sufficient clinical relevance for potential translation, so that the performance of related clinical trial can be well predicted and achieved.
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Affiliation(s)
- W Wei
- Center for Cancer Research, The Gillette Center for Gynecologic Oncology, Massachusetts General Hospital, Boston, USA
| | - F Giulia
- Center for Cancer Research, The Gillette Center for Gynecologic Oncology, Massachusetts General Hospital, Boston, USA
| | - S Luffer
- Center for Cancer Research, The Gillette Center for Gynecologic Oncology, Massachusetts General Hospital, Boston, USA
| | - R Kumar
- Center for Cancer Research, The Gillette Center for Gynecologic Oncology, Massachusetts General Hospital, Boston, USA
| | - B Wu
- Center for Cancer Research, The Gillette Center for Gynecologic Oncology, Massachusetts General Hospital, Boston, USA
| | - M Tavallai
- Center for Cancer Research, The Gillette Center for Gynecologic Oncology, Massachusetts General Hospital, Boston, USA
| | - R T Bekele
- Center for Cancer Research, The Gillette Center for Gynecologic Oncology, Massachusetts General Hospital, Boston, USA
| | - M J Birrer
- Center for Cancer Research, The Gillette Center for Gynecologic Oncology, Massachusetts General Hospital, Boston, USA
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50
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Liew PL, Huang RL, Weng YC, Fang CL, Hui-Ming Huang T, Lai HC. Distinct methylation profile of mucinous ovarian carcinoma reveals susceptibility to proteasome inhibitors. Int J Cancer 2018; 143:355-367. [PMID: 29451304 PMCID: PMC6001480 DOI: 10.1002/ijc.31324] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 01/14/2018] [Accepted: 02/05/2018] [Indexed: 12/23/2022]
Abstract
Mucinous type of epithelial ovarian cancer (MuOC) is a unique subtype with a poor survival outcome in recurrent and advanced stages. The role of type-specific epigenomics and its clinical significance remains uncertain. We analyzed the methylomic profiles of 6 benign mucinous adenomas, 24 MuOCs, 103 serous type of epithelial ovarian cancers (SeOCs) and 337 nonepithelial ovarian cancers. MuOC and SeOC exhibited distinct DNA methylation profiles comprising 101 genes, 81 of which exhibited low methylation in MuOC and were associated with the response to glucocorticoid, ATP hydrolysis-coupled proton transport, proteolysis involved in the cellular protein catabolic process and ion transmembrane transport. Hierarchical clustering analysis showed that the profiles of MuOC were similar to colorectal adenocarcinoma and stomach adenocarcinoma. Genetic interaction network analysis of differentially methylated genes in MuOC showed a dominant network module is the proteasome subunit beta (PSMB) family. Combined functional module and methylation analysis identified PSMB8 as a candidate marker for MuOC. Immunohistochemical staining of PSMB8 used to validate in 94 samples of ovarian tumors (mucinous adenoma, MuOC or SeOC) and 62 samples of gastrointestinal cancer. PSMB8 was commonly expressed in MuOC and gastrointestinal cancer samples, predominantly as strong cytoplasmic and occasionally weak nuclei staining, but was not expressed in SeOC samples. Carfilzomib, a second-generation proteasome inhibitor, suppressed MuOC cell growth in vitro. This study unveiled a mucinous-type-specific methylation profile and suggests the potential use of a proteasome inhibitor to treat MuOC.
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Affiliation(s)
- Phui-Ly Liew
- Department of Pathology, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan.,Department of Pathology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Rui-Lan Huang
- Department of Obstetrics and Gynecology, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan.,Translational epigenetic center, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan
| | - Yu-Chun Weng
- Translational epigenetic center, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan
| | - Chia-Lang Fang
- Department of Pathology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Pathology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Tim Hui-Ming Huang
- Department of Molecular Medicine/Institute of Biotechnology, University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Hung-Cheng Lai
- Department of Obstetrics and Gynecology, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan.,Translational epigenetic center, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan.,Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, 410008, People's Republic of China.,Hunan Key Laboratory of Pharmacogenetics, Institute of Clinical Pharmacology, Central South University, Changsha, 410078, People's Republic of China
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