Spectrum of Ovarian Incidentalomas: Diagnosis and Management

Income and education inequalities in ovarian cancer mortality in Canada: 1990-2019

Ovarian cancer ranks as the fifth leading cause of cancer deaths among Canadian women. This study aims to investigate trends in socioeconomic inequalities in ovarian cancer mortality over the past three decades, from 1990 to 2019. A dataset was construed at Census Division (n = 280) level in Canada using information from the Canadian Vital Statistics Death Database, the Canadian Census of Population and the National Household Survey. Socioeconomic inequalities in ovarian cancer mortality were assessed using the age-standardized Concentration Index (C), based on average/median equivalized household income, and educational attainment (bachelor's degree or higher). The average crude mortality rate for ovarian cancer in Canada was 9.7 per 100,000, with the highest rates in British Columbia and the Atlantic region. The negative values of age-standardized C based on average income and educational attainment - indicating higher ovarian cancer mortality rates among low socioeconomic groups - reached statistical significance in certain years, particularly in the more recent period. Trend analysis revealed a notable pattern of increasing income inequality in ovarian cancer mortality over time based on average income. The observed socioeconomic inequalities in ovarian cancer mortality warrant further investigation to identify the underlying factors contributing to this pattern in Canada.

Do Laparoscopic Approaches Ensure Oncological Safety and Prognosis for Serosa-Exposed Colon Cancer? A Comparative Study against the Open Approach

The adoption of laparoscopic surgery in the management of serosa-exposed colorectal cancer has raised concerns. This study aimed to investigate whether laparoscopic surgery is associated with an increased risk of postoperative recurrence in patients undergoing resection for serosa-exposed colon cancer. A retrospective analysis was conducted on a cohort of 315 patients who underwent curative resection for pathologically confirmed T4a colon cancer without distant metastases at the Asan Medical Center between 2006 and 2015. Patients were categorized according to the surgical approach method: laparoscopic surgery (MIS group) versus open surgery (Open group). Multivariate analysis was employed to identify risk factors associated with overall survival (OS) and disease-free survival (DFS). The MIS group included 148 patients and the Open group had 167 patients. Of the total cohort, 106 patients (33.7%) experienced recurrence during the follow-up period. Rates, patterns, and time to recurrence were not different between groups. The MIS group (55.8%) showed more peritoneal metastasis compared to the Open group (44.4%) among recurrence sites, but it was not significant (p = 0.85). There was no significant difference in the five-year OS (73.5% vs. 78.4% p = 0.374) or DFS (62.0% vs. 64.6%; p = 0.61) between the Open and MIS groups. Age and the pathologic N stage were independently associated with OS, and the pathologic N stage was the only associated risk factor for DFS. The laparoscopic approach for serosa-exposed colon cancer did not compromise the DFS and OS. This study provides evidence that laparoscopic surgery does not compromise oncologic outcomes of patients with T4a colon cancer although peritoneal seeding is the most common type of disease failure of serosa-exposed colon cancer.