Lymphovascular space invasion and Ki67 as predictors of lymph node metastasis in primary low grade serous ovarian cancer

The positive threshold of the immunohistochemical parameter Ki67 for predicting the recurrence of cervical cancer

OBJECTIVE

To find the optimal threshold of Ki67 and evaluate its significance in predicting recurrence of stage I-II cervical cancer.

METHODS

A total of 1130 patients were included after screening. Univariate and multivariate Cox regression analysis were used to select factors associated with recurrence of cervical cancer. The receiver operating characteristic (ROC) curve was used to assess the optimal threshold of Ki67. The differences of clinicopathological parameters and the survival analysis between the two groups divided based on the optimal threshold of Ki67 were compared.

RESULTS

Multivariate Cox regression analysis showed that Ki67 (p < 0.001) was significant prognostic predictor for recurrence of cervical cancer. The optimal threshold of Ki67 was 42%. The recurrence-free survival (RFS) and the overall survival (OS) of cervical cancer patients in the high-Ki67 group (Ki67≥42%) were much lower than those in the low-Ki67 group (Ki67<42%) (p < 0.001, p < 0.001). Among the 380 patients with low-risk cervical cancer, the RFS and OS of patients in the high-Ki67 group were also lower than those in the low-Ki67 group (p < 0.001, p < 0.001).

CONCLUSION

The Ki67 was a useful prognostic factor in patients with stage I-II cervical cancer, and the Ki67 labeling index 42.0% was optimal threshold for predicting recurrence.

Impact of cytoreductive surgery on survival of patients with low-grade serous ovarian carcinoma: A multicentric study of Turkish Society of Gynecologic Oncology (TRSGO-OvCa-001)

BACKGROUND AND OBJECTIVES

The aim of this study was to analyze the factors affecting recurrence-free (RFS) and overall survival (OS) rates of women diagnosed with low-grade serous ovarian cancer (LGSOC).

METHODS

Databases from 13 participating centers in Turkey were searched retrospectively for women who had been treated for stage I-IV LGSOC between 1997 and 2018.

RESULTS

Overall 191 eligible women were included. The median age at diagnosis was 49 years (range, 21-84 years). One hundred seventy-five (92%) patients underwent primary cytoreductive surgery. Complete and optimal cytoreduction was achieved in 148 (77.5%) and 33 (17.3%) patients, respectively. The median follow-up period was 44 months (range, 2-208 months). Multivariate analysis showed the presence of endometriosis (p = .012), lymphovascular space invasion (LVSI) (p = .022), any residual disease (p = .023), and the International Federation of Gynecology and Obstetrics (FIGO) stage II-IV disease (p = .045) were negatively correlated with RFS while the only presence of residual disease (p = .002) and FIGO stage II-IV disease (p = .003) significantly decreased OS.

CONCLUSIONS

The maximal surgical effort is warranted for complete cytoreduction as achieving no residual disease is the single most important variable affecting the survival of patients with LGSOC. The prognostic role of LVSI and endometriosis should be evaluated by further studies as both of these parameters significantly affected RFS.