1
|
Papalois KB, Fotopoulou C. Infrastructural and public health awareness gaps for the diagnosis and treatment of ovarian cancer: A literature review. Arch Gynecol Obstet 2024; 309:1807-1813. [PMID: 38413425 DOI: 10.1007/s00404-024-07371-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 01/02/2024] [Indexed: 02/29/2024]
Abstract
Ovarian cancer (OC) is the sixth most common cancer in women. This literature review and thematic analysis presents gaps in Health Literacy including public knowledge on symptoms, risk, and screening for OC. We have identified a strong variation in national and international Healthcare Infrastructure, and access to specialized care, and treatment guidelines; all inequalities that have a direct impact on patient prognosis and survival. Promoting health behaviors such as self-efficacy, signposting, and regular surveying have the potential to improve health literacy and patient outcomes. Furthermore, increased funding, access to high-volume centers, and homogenization of treatment guidelines may reduce inequalities and improve prognosis.
Collapse
Affiliation(s)
| | - Christina Fotopoulou
- Department of Gynaecologic Oncology, Imperial College London Faculty of Medicine, London, UK
| |
Collapse
|
2
|
Brezis MR, Shachar E, Peleg Hasson S, Laskov I, Michaan N, Levy B, Wolf I, Safra T. Effectiveness and safety of standard chemotherapy in older patients with ovarian cancer: a retrospective analysis by age group and treatment regimen. Front Oncol 2023; 13:1289379. [PMID: 38152363 PMCID: PMC10751294 DOI: 10.3389/fonc.2023.1289379] [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: 09/05/2023] [Accepted: 11/29/2023] [Indexed: 12/29/2023] Open
Abstract
Objective To evaluate the effectiveness and safety of standard chemotherapy administered to patients >70 years with advanced ovarian cancer (OC). Methods Medical records of 956 advanced-stage patients with OC treated between 2002-2020 with standard surgery and paclitaxel-carboplatin chemotherapy in a three-weekly (PC-3W) or weekly (PC-1W) regimen were reviewed. Treatment response and tolerability were compared between patients ≤70 years (N=723) and >70 years (N=233) with stratification to septuagenarians (>70-80 years) and octogenarians (>80 years). Results Median overall survival (mOS) in patients >70 was 41.26 months (95% confidence interval [Cl], 37.22-45.14) and median progression-free survival (mPFS) was 11.04 months (95% Cl, 8.97-15.74). No statistically significant differences in mPFS and mOS were observed between septuagenarians and octogenarians. Patients >70 treated with PC-1W versus PC-3W had significantly longer mOS (57.17 versus 30.00 months) and mPFS (19.09 versus 8.15 months). Toxicity rates were mostly similar between younger and older patients. Among patients >70 treated with PC-1W, the rate of neutropenia (75.7% versus 51.8%, p=0.0005), thrombocytopenia (41.0% versus 22.2%, p=0.0042) and anemia (78.1% versus 51.9%, p<0.0001) were significantly higher and the rate of grade 2 alopecia was statistically significantly lower compared with those >70 treated with PC-3W. Significantly more patients treated with PC-1W completed ≥6 chemotherapy cycles, suggesting better tolerability of this regimen. Conclusions Older patients with OC may benefit from improved OS with reasonable toxicity if treated with standard chemotherapy. Older patients treated with PC-1W are more likely to complete the full chemotherapy course and survive longer compared with those treated with conventional PC-3W.
Collapse
Affiliation(s)
- Miriam R. Brezis
- Division of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Eliya Shachar
- Division of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shira Peleg Hasson
- Division of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ido Laskov
- Division of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nadav Michaan
- Division of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Bar Levy
- Division of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ido Wolf
- Division of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tamar Safra
- Division of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
3
|
Algera MD, Morton R, Sundar SS, Farrell R, van Driel WJ, Brennan D, Rijken MJ, Sfeir S, Allen L, Eiken M, Coleman RL. Exploring international differences in ovarian cancer care: a survey report on global patterns of care, current practices, and barriers. Int J Gynecol Cancer 2023; 33:1612-1620. [PMID: 37591611 PMCID: PMC10579489 DOI: 10.1136/ijgc-2023-004563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/24/2023] [Indexed: 08/19/2023] Open
Abstract
OBJECTIVE Although global disparities in survival rates for patients with ovarian cancer have been described, variation in care has not been assessed globally. This study aimed to evaluate global ovarian cancer care and barriers to care. METHODS A survey was developed by international ovarian cancer specialists and was distributed through networks and organizational partners of the International Gynecologic Cancer Society, the Society of Gynecologic Oncology, and the European Society of Gynecological Oncology. Respondents received questions about care organization. Outcomes were stratified by World Bank Income category and analyzed using descriptive statistics and logistic regressions. RESULTS A total of 1059 responses were received from 115 countries. Respondents were gynecological cancer surgeons (83%, n=887), obstetricians/gynecologists (8%, n=80), and other specialists (9%, n=92). Income category breakdown was as follows: high-income countries (46%), upper-middle-income countries (29%), and lower-middle/low-income countries (25%). Variation in care organization was observed across income categories. Respondents from lower-middle/low-income countries reported significantly less frequently that extensive resections were routinely performed during cytoreductive surgery. Furthermore, these countries had significantly fewer regional networks, cancer registries, quality registries, and patient advocacy groups. However, there is also scope for improvement in these components in upper-middle/high-income countries. The main barriers to optimal care for the entire group were patient co-morbidities, advanced presentation, and social factors (travel distance, support systems). High-income respondents stated that the main barriers were lack of surgical time/staff and patient preferences. Middle/low-income respondents additionally experienced treatment costs and lack of access to radiology/pathology/genetic services as main barriers. Lack of access to systemic agents was reported by one-third of lower-middle/low-income respondents. CONCLUSIONS The current survey report highlights global disparities in the organization of ovarian cancer care. The main barriers to optimal care are experienced across all income categories, while additional barriers are specific to income levels. Taking action is crucial to improve global care and strive towards diminishing survival disparities and closing the care gap.
Collapse
Affiliation(s)
- Marc Daniël Algera
- Gynecology Oncology, Maastricht UMC+, Maastricht, The Netherlands
- Scientific Bureau, Dutch Institute for Clinical Auditing, Leiden, The Netherlands
- GROW- School for Oncology and Reproduction, Maastricht, The Netherlands
| | - Rhett Morton
- Obstetrics and Gynaecology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Sudha S Sundar
- Department of Gynaecology Oncology, University of Birmingham, West Midlands, UK
| | - Rhonda Farrell
- Gynaecology, Royal Hospital for Women, Sydney, New South Wales, Australia
| | - Willemien J van Driel
- Gynecologic Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Donal Brennan
- Gynaecology Oncology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Marcus J Rijken
- Gynecologic Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Selina Sfeir
- Department of Gynaecology Oncology, University of Birmingham, Birmingham, UK
| | - Lucy Allen
- Department of Gynaecology Oncology, University of Birmingham, Birmingham, UK
| | - Mary Eiken
- International Gynecologic Cancer Society, Austin, Texas, USA
| | | |
Collapse
|
4
|
Osredkar J, Jagarlamudi KK, Cviič D, Škof E, Cvjetićanin B, Zore A, Lukanović D, Eriksson S, Meglič L. Clinical Significance of the TK1-Specific Activity in the Early Detection of Ovarian Cancer. Oncology 2023; 102:17-29. [PMID: 37673047 DOI: 10.1159/000533428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 07/07/2023] [Indexed: 09/08/2023]
Abstract
INTRODUCTION Ovarian cancer is the eighth most common cause of cancer death in women. One of the major concerns is almost two-thirds of cases are typically diagnosed in the late stage as the symptoms are unspecific in the early stage of ovarian cancer. It is known that the combination of TK1 protein with CA 125 or HE4 showed better performance than either of them alone. That is why, the aim of the study was to investigate whether the TK1-specific activity (TK1 SA) could function as a complement marker for early-stage diagnosis of ovarian cancer. METHODS The study included a set of 198 sera consisting of 134 patients with ovarian tumors (72 benign and 62 malignant) and 64 healthy age-matched controls. The TK1 SA was determined using TK1 activity by TK-Liaison and TK1 protein by AroCell TK 210 ELISA. Further, CA 125, HE4, as well as risk of ovarian malignancy algorithm index were also determined in the same set of clinical samples. RESULTS The TK1 SA was significantly different between healthy compared to ovarian cancer patients (p < 0.0001). Strikingly, TK1 SA has higher sensitivity (55%) compared to other biomarkers in the detection of benign ovarian tumors. Further, the highest sensitivity was achieved by the combination of TK1 SA with CA 125 and HE4 for the detection of benign tumors as well as malignant ovarian tumors (72.2% and 88.7%). In addition, TK1 SA could significantly differentiate FIGO stage I/II from stage III/IV malignancies (p = 0.026). Follow-up of patients after surgery and chemotherapy showed a significant difference compared to TK1 SA at the time of diagnosis. CONCLUSIONS These results indicate that TK1 SA is a promising blood-based biomarker that could complement CA 125 and HE4 for the detection of early stages of ovarian cancer.
Collapse
Affiliation(s)
- Joško Osredkar
- Institute of Clinical Chemistry and Biochemistry, University Medical Centre Ljubljana, Ljubljana, Slovenia
- University of Ljubljana, Faculty of Pharmacy, Ljubljana, Slovenia
| | - Kiran Kumar Jagarlamudi
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Science, Uppsala, Sweden
- Research and Development Division, AroCell AB, Stockholm, Sweden
| | - Diana Cviič
- Institute of Clinical Chemistry and Biochemistry, University Medical Centre Ljubljana, Ljubljana, Slovenia
- University of Ljubljana, Faculty of Pharmacy, Ljubljana, Slovenia
| | - Erik Škof
- Institute of Oncology, Ljubljana, Slovenia
- University Ljubljana, Medical Faculty, Ljubljana, Slovenia
| | - Branko Cvjetićanin
- Division of Gynecology, Department of Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Andrej Zore
- Division of Gynecology, Department of Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - David Lukanović
- Division of Gynecology, Department of Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Staffan Eriksson
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Science, Uppsala, Sweden
- Research and Development Division, AroCell AB, Stockholm, Sweden
| | - Leon Meglič
- University Ljubljana, Medical Faculty, Ljubljana, Slovenia
- Division of Gynecology, Department of Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| |
Collapse
|
5
|
Maleki Z, Vali M, Nikbakht HA, Hassanipour S, Kouhi A, Sedighi S, Farokhi R, Ghaem H. Survival rate of ovarian cancer in Asian countries: a systematic review and meta-analysis. BMC Cancer 2023; 23:558. [PMID: 37328812 DOI: 10.1186/s12885-023-11041-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 06/05/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Ovarian cancer is amongst one of the most commonly occurring cancers affecting women, and the leading cause of gynecologic related cancer death. Its poor prognosis and high mortality rates can be attributed to the absence of specific signs and symptoms until advance stages, which frequently leads to late diagnosis. Survival rate of patients diagnosed with ovarian cancer can be used in order to better assess current standard of care; the aim of this study is to evaluate the survival rate of ovarian cancer patients in Asia. METHODS Systematic review was performed on articles that were published by the end of August 2021 in five international databases, including Medline / PubMed, ProQuest, Scopus, Web of Knowledge, and Google Scholar. The Newcastle-Ottawa quality evaluation form was used for cohort studies to evaluate the quality of the articles. The Cochran-Q and I2 tests were used to calculate the heterogeneity of the studies. The Meta-regression analysis was also done according to when the study was published. RESULTS A total of 667 articles were reviewed, from which 108 were included in this study because they passed the criteria. Based on a randomized model, the survival rates of ovarian cancer after 1, 3 and 5 years were respectively 73.65% (95% CI, 68.66-78.64), 61.31% (95% CI, 55.39-67.23) and 59.60% (95% CI, 56.06-63.13). Additionally, based on meta-regression analysis, there was no relationship between the year of study and survival rate. CONCLUSIONS The 1-year survival rate was higher than that of 3- and 5-year for ovarian cancer. This study provides invaluable information that can not only help establish better standard of care for treatment of ovarian cancer, but also assist in development of superior health interventions for prevention and treatment of the disease.
Collapse
Affiliation(s)
- Zahra Maleki
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohebat Vali
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein-Ali Nikbakht
- Social Determinants of Health Research Center, Health Research Institute, Department of Biostatistics & Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran
| | - Soheil Hassanipour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Aida Kouhi
- Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Saman Sedighi
- Department of Neurosurgery, Keck school of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Roya Farokhi
- Department of Health, Health Systems Research, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Haleh Ghaem
- Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
- Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
| |
Collapse
|
6
|
Bing X, Lei H, Zhao X, Cheng Y, Wang L, Yang J, Xu M, Yu C, Chen T. Use of Period Analysis to Timely Assess Five-Year Relative Survival for Patients with Ovarian Cancer from Taizhou, Eastern China. J Clin Med 2023; 12:jcm12103480. [PMID: 37240586 DOI: 10.3390/jcm12103480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/02/2023] [Accepted: 03/31/2023] [Indexed: 05/28/2023] Open
Abstract
OBJECTIVE Ovarian cancer is a deadly gynecologic malignancy with a poor prognosis. It is essential to evaluate the early detection and screening programs of ovarian cancer via timely assessment of long-time survival, particularly in China where those data are incredibly limited. Here, we aimed to provide timely and accurately assessment of long-term survival estimate of ovarian cancer patients from eastern China. METHODS Data of 770 ovarian cancer patients diagnosed between 2004-2018 were obtained from four cancer registries in Taizhou, eastern China, were included. We used period analysis to calculate five-year relative survival (RS) of aforementioned ovarian cancer patients for overall and the stratification by age at diagnosis and region. RESULTS Our findings demonstrated that the overall five-year RS for ovarian cancer patients in Taizhou between 2014 and 2018 was 69.2%, while urban areas were higher compared to rural areas (77.6% vs. 64.9%). We also observed a significant age gradient with the five-year RS decreasing from 79.6% for age group < 55 years to 66.9% for age group > 74 years. Furthermore, we identified a clear upward trend of five-year RS over the study period, both overall and stratified by region and age at diagnosis. CONCLUSION This is the first study in China using period analysis to provide the most up-to-date five-year RS for ovarian cancer patients from Taizhou, eastern China, which reaches 69.2% during 2014-2018. Our results provide valuable information for timely assessment of early detection and screening programs for ovarian cancer in eastern China.
Collapse
Affiliation(s)
- Xin Bing
- Department of Cancer Prevention, Zhejiang Cancer Hospital, Hangzhou 310022, China
- School of Public Health, Hangzhou Normal University, Hangzhou 311121, China
| | - Huijun Lei
- Department of Cancer Prevention, Zhejiang Cancer Hospital, Hangzhou 310022, China
- Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou 310022, China
| | - Xiaojiao Zhao
- Department of Cancer Prevention, Zhejiang Cancer Hospital, Hangzhou 310022, China
- School of Public Health, Hangzhou Normal University, Hangzhou 311121, China
| | - Yongran Cheng
- School of Public Health, Hangzhou Medical College, Hangzhou 310013, China
| | - Liangyou Wang
- Department of Non-Communicable Chronic Disease Control and Prevention, Taizhou Center for Disease Control and Prevention, Taizhou 318000, China
| | - Jun Yang
- School of Public Health, Hangzhou Normal University, Hangzhou 311121, China
| | - Mingzhi Xu
- Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou 310022, China
- Department of General Medicine, Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - Chenhuan Yu
- Department of Cancer Prevention, Zhejiang Cancer Hospital, Hangzhou 310022, China
- Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou 310022, China
| | - Tianhui Chen
- Department of Cancer Prevention, Zhejiang Cancer Hospital, Hangzhou 310022, China
- Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou 310022, China
- Department of Preventive Medicine, School of Medicine, Ningbo University, Ningbo 315211, China
| |
Collapse
|
7
|
So KA, Shim SH, Lee SJ, Kim TJ. Surgical Treatment Outcomes of Gynecologic Cancer in Older Patients: A Retrospective Study. J Clin Med 2023; 12:jcm12072518. [PMID: 37048601 PMCID: PMC10094859 DOI: 10.3390/jcm12072518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/15/2023] [Accepted: 03/26/2023] [Indexed: 03/29/2023] Open
Abstract
This study aimed to evaluate oncologic characteristics and surgical outcomes in older patients with gynecologic cancers. This retrospective study included patients aged ≥65 years who were diagnosed with gynecologic cancers and underwent surgical treatment between 2005 and 2020. We reviewed the medical records for age at diagnosis, body mass index, American Society of Anesthesiologists score, comorbidities, postoperative complications, cancer stage, histologic type, surgical treatment, postoperative outcome, and survival rate. Data were compared between groups according to the age at the time of diagnosis: <75 years (young-old) and ≥75 years (old-old). In total, 131 patients were identified: 53 (40.5%) with ovarian or primary peritoneal cancer (OC), 44 (33.6%) with endometrial cancer (EC), 30 (22.9%) with cervical cancer, and 4 (3.1%) with leiomyosarcoma. The patients’ mean age was 70 (range, 65–83) years; 106 (80.9%) were young-old and 25 (19.1%) were old-old. Postoperative complications occurred in 19 (14.5%) patients. Four patients died within six months after surgery, and three died because of disease progression. There was no difference in the survival rates between the two groups among those with OC and EC. Older patients with gynecologic cancers showed good surgical outcomes and tolerable postoperative complications. Therefore, we can safely offer surgical treatment to older patients.
Collapse
|
8
|
A Dual Biomarker TK1 Protein and CA125 or HE4-Based Algorithm as a Better Diagnostic Tool than ROMA Index in Early Detection of Ovarian Cancer. Cancers (Basel) 2023; 15:cancers15051593. [PMID: 36900385 PMCID: PMC10000714 DOI: 10.3390/cancers15051593] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/20/2023] [Accepted: 02/26/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND The early detection of ovarian cancer is presently not effective, and it is crucial to establish biomarkers for the early diagnosis of ovarian cancer to improve the survival of patients. MATERIALS AND METHODS The aim of this study was to investigate the role of thymidine kinase 1 (TK1) in combination with CA 125 or HE4 to serve as a potential diagnostic biomarkers for ovarian cancer. In this study, a set of 198 serum samples consisting of 134 ovarian tumor patients and 64 healthy age-matched controls were analyzed. The TK1 protein levels in serum samples were determined using the AroCell TK 210 ELISA. RESULTS A combination of TK1 protein with CA 125 or HE4 showed better performance than either of them alone in the differentiation of early stage ovarian cancer from the healthy control group, but also a significantly better performance than the ROMA index. However, this was not observed using a TK1 activity test in combination with the other markers. Furthermore, the combination of TK1 protein and CA 125 or HE4 could differentiate early stage disease (stage I, II) more efficiently from advanced-stage (stage III, IV) disease (p < 0.0001). CONCLUSIONS The combination of TK1 protein with CA 125 or HE4 increased the potential of detecting ovarian cancer at early stages.
Collapse
|
9
|
Armbrust R, Ledwon P, Von Rüsten A, Schneider C, Sehouli J. Primary Treatment Results in Patients with Ovarian, Fallopian or Peritoneal Cancer-Results of a Clinical Cancer Registry Database Analysis in Germany. Cancers (Basel) 2022; 14:cancers14194638. [PMID: 36230561 PMCID: PMC9559681 DOI: 10.3390/cancers14194638] [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: 07/11/2022] [Revised: 09/14/2022] [Accepted: 09/22/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The current therapy of ovarian cancer is based on the so-called “Three-Pillar-Model”, consisting of surgery, chemotherapy and maintenance therapy. This study represents the first major analysis of a federal cancer database of OC patients from the states Berlin/Brandenburg in Germany. The primary objective was to evaluate the prevailing established quality indicators surgical outcome, adjuvant chemotherapy and integrity of surgical staging in early stages. Methods: Data from the Clinical Cancer Registry for Brandenburg and Berlin of the years 2009−2019 were analyzed. Objectives were defined by a working group of selected physicians. Descriptive statistics were performed, as well as survival analysis. Results: A total of 2771 primary OC cases were included. Results regarding histological subtype met the suspected allocation with predominantly high-grade serous OC in advanced stage. The rate of complete surgical staging in FIGO stages I−IIA was 57%, and the rate of macroscopic complete resection in >FIGO III was 53%. Five-year survival rate varied from 79% (FIGO I) to 40% (FIGO III). Rate of adjuvant chemotherapy was above 50%. Conclusion: The results elucidate quality measurements and treatment results and show good treatment outcomes in patients with primary diagnosis. However, they also indicate deficits and can help to establish new quality indicators to further improve the treatment.
Collapse
Affiliation(s)
- Robert Armbrust
- Department of Gynecology with Center for Oncological Surgery, Virchow Campus Clinic, Charité Medical University, 10117 Berlin, Germany
- Correspondence: ; Tel.: +49-30-450-664-356
| | - Peter Ledwon
- Gynecolocigal Tumor Center Berlin, 13353 Berlin, Germany
| | - Anne Von Rüsten
- Clinical Cancer Registry for Brandenburg and Berlin, 03044 Cottbus, Germany
| | | | - Jalid Sehouli
- Department of Gynecology with Center for Oncological Surgery, Virchow Campus Clinic, Charité Medical University, 10117 Berlin, Germany
| |
Collapse
|
10
|
Zhang S, Cheng C, Lin Z, Xiao L, Su X, Zheng L, Mu Y, Liao M, Ouyang R, Li W, Ma J, Cai J, Liu L, Wang D, Zeng F, Liu J. The global burden and associated factors of ovarian cancer in 1990-2019: findings from the Global Burden of Disease Study 2019. BMC Public Health 2022; 22:1455. [PMID: 35907822 PMCID: PMC9339194 DOI: 10.1186/s12889-022-13861-y] [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: 05/15/2022] [Accepted: 07/22/2022] [Indexed: 11/10/2022] Open
Abstract
Background Ovarian cancer (OC) is a major cause of cancer-related deaths among women. The aim of this study was to estimate and report data on the current burden of ovarian cancer worldwide over the past 30 years. Method Based on the data provided by GBD 2019, we collected and interpreted the disease data of ovarian cancer by incidence, mortality, disability-adjusted life-years (DALYs), and used corresponding age-standardized rates as indicators. Also, we categorized the data by attributed risk factors and captured deaths due to high fasting plasma glucose, occupational exposure to asbestos and high body-mass index, respectively. All outcomes in the study were reported using mean values and corresponding 95% uncertainty intervals (95% UI). Results Globally, there were 294422 (260649 to 329727) incident cases in 2019, and the number of deaths and DALYs were 198412 (175357 to 217665) and 5.36 million (4.69 to 5.95). The overall burden was on the rise, with a percentage change of 107.8% (76.1 to 135.7%) for new cases, 103.8% (75.7 to 126.4%) for deaths and 96.1% (65.0 to 120.5%) for DALYs. Whereas the age-standardized rates kept stable during 1990–2019. The burden of ovarian cancer increased with age. and showed a totally different trends among SDI regions. Although high SDI region had the declining rates, the burden of ovarian cancer remained stable in high-middle and low SDI regions, and the middle and low-middle SDI areas showed increasing trends. High fasting plasma glucose was estimated to be the most important attributable risk factor for ovarian cancer deaths globally, with a percentage change of deaths of 7.9% (1.6 to 18.3%), followed by occupational exposure to asbestos and high body mass index. Conclusions Although the age-standardized rates of ovarian cancer didn’t significantly change at the global level, the burden still increased, especially in areas on the lower end of the SDI range. Also, the disease burden due to different attributable risk factors showed heterogeneous, and it became more severe with age. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13861-y.
Collapse
Affiliation(s)
- Shiwen Zhang
- Department of Public Health and Preventive , of Medicine, Jinan University, Guangzhou, China
| | - Chen Cheng
- Department of Public Health and Preventive , of Medicine, Jinan University, Guangzhou, China
| | - Zejian Lin
- Department of Public Health and Preventive , of Medicine, Jinan University, Guangzhou, China
| | - Linzi Xiao
- Department of Public Health and Preventive , of Medicine, Jinan University, Guangzhou, China
| | - Xin Su
- Department of Public Health and Preventive , of Medicine, Jinan University, Guangzhou, China
| | - Lu Zheng
- Department of Public Health and Preventive , of Medicine, Jinan University, Guangzhou, China
| | - Yingjun Mu
- Department of Public Health and Preventive , of Medicine, Jinan University, Guangzhou, China
| | - Minqi Liao
- Department of Public Health and Preventive , of Medicine, Jinan University, Guangzhou, China
| | - Ruiqing Ouyang
- Department of Public Health and Preventive , of Medicine, Jinan University, Guangzhou, China
| | - Wanlin Li
- Department of Public Health and Preventive , of Medicine, Jinan University, Guangzhou, China
| | - Junrong Ma
- Department of Public Health and Preventive , of Medicine, Jinan University, Guangzhou, China
| | - Jun Cai
- Department of Public Health and Preventive , of Medicine, Jinan University, Guangzhou, China
| | - Lu Liu
- Department of Preventive Medicine Laboratory, School of Public Health, Zunyi Medical University, Zunyi, China
| | - Donghong Wang
- Department of Gynaecology and Obstetrics, Affiliated Hospital of Zunyi Medical University, Guizhou, China
| | - Fangfang Zeng
- Department of Public Health and Preventive , of Medicine, Jinan University, Guangzhou, China.
| | - Jun Liu
- Department of Preventive Medicine Laboratory, School of Public Health, Zunyi Medical University, Zunyi, China.
| |
Collapse
|
11
|
Liu Q, Zhang H, Yang X, Liu X, Yin F, Guo P, Yin Y, Zheng K, Yang Z, Han Y. Systemic characterization of alternative splicing related to prognosis, immune infiltration, and drug sensitivity analysis in ovarian cancer. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:126. [PMID: 35282039 PMCID: PMC8848412 DOI: 10.21037/atm-21-6422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 12/15/2021] [Indexed: 11/24/2022]
Abstract
Background Alternative splicing (AS) plays an essential role in tumorigenesis and progression. This study intended to construct an innovative prognostic model based on AS events to gain more precise survival prediction and search for potential therapeutic targets in ovarian cancer. Methods Seven types of AS events in ovarian serous cystadenocarcinoma (OV) patients with RNA-seq were obtained using The Cancer Genome Atlas (TCGA) SpliceSeq tool and database. Cox and Kaplan-Meier curve analyses were employed to establish the prognostic models. Relying on drug sensitivity data from the CellMiner database, Genomics of Drug Sensitivity (GDS) was adopted to estimate the platinum-sensitive analysis. Furthermore, a prognostic splicing factor (SF)-AS network was constructed using Cytoscape. Finally, in order to explore the influence of the tumor microenvironment on the prognosis of OV patients, we first combined a similar network fusion and consensus clustering (SNF-CC) algorithm to identify three OV subtypes based on survival-related AS events and then utilized single-sample Gene Set Enrichment Analysis (ssGSEA) method to perform immune cell infiltration analysis. Results A total of 48,049 AS events and 21,841 related genes were selected from 318 OV samples, and 2,206 AS events associated with disease-free survival (DFS) were identified. Multivariate Cox and Kaplan-Meier curve analyses were then employed to establish the prognostic models. Receiver operating characteristic (ROC) analysis from 0.59 to 0.75 showed that these models were highly efficient in distinguishing patient survival. GDS was adopted with the CellMiner database to provide some insights for platinum-sensitive analysis of OV. Furthermore, a prognostic SF-AS network, which discovered a significant connection between SFs and prognostic AS genes, was constructed using Cytoscape. The combined SNF-CC algorithm revealed three distinct OV subtypes based on the prognostic AS events, and the associations between this novel molecular classification and immune cell infiltration were further explored. Conclusions We developed a powerful prognostic AS signature for OV and provided a deeper understanding of SF-AS network regulatory mechanisms, as well as platinum-sensitive and cancer immune microenvironments. These results revealed various candidate biomarkers and potential targets for OV treatment strategies.
Collapse
Affiliation(s)
- Qingyang Liu
- School of Life and Pharmaceutical Science, Dalian University of Technology, Dalian, China
| | - Hao Zhang
- School of Life and Pharmaceutical Science, Dalian University of Technology, Dalian, China
| | - Xiaocheng Yang
- School of Life and Pharmaceutical Science, Dalian University of Technology, Dalian, China
| | - Xuesong Liu
- School of Health Professions, Yingkou Vocational and Technical College, Yingkou, China
| | - Fanxing Yin
- School of Life and Pharmaceutical Science, Dalian University of Technology, Dalian, China
| | - Panpan Guo
- School of Life and Pharmaceutical Science, Dalian University of Technology, Dalian, China
| | - Yuhan Yin
- School of Life and Pharmaceutical Science, Dalian University of Technology, Dalian, China
| | - Kaijiang Zheng
- School of Life and Pharmaceutical Science, Dalian University of Technology, Dalian, China
| | - Zhuo Yang
- Department of Gynecology, Cancer Hospital of Dalian University of Technology (Liaoning Cancer Hospital & Institute), Shenyang, China
| | - Yanshuo Han
- School of Life and Pharmaceutical Science, Dalian University of Technology, Dalian, China
| |
Collapse
|
12
|
Deuster E, Hysenaj I, Kahaly M, Schmoeckel E, Mayr D, Beyer S, Kolben T, Hester A, Kraus F, Chelariu-Raicu A, Burges A, Mahner S, Jeschke U, Trillsch F, Czogalla B. The Platelet-Activating Factor Receptor's Association with the Outcome of Ovarian Cancer Patients and Its Experimental Inhibition by Rupatadine. Cells 2021; 10:cells10092337. [PMID: 34571986 PMCID: PMC8466210 DOI: 10.3390/cells10092337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/17/2021] [Accepted: 08/26/2021] [Indexed: 12/20/2022] Open
Abstract
The platelet-activating factor receptor (PAFR) and its ligand (PAF) are important inflammatory mediators that are overexpressed in ovarian cancer. The receptor is an important player in ovarian cancer development. In this study, we aimed to evaluate the prognostic value of PAFR in epithelial ovarian cancer (EOC) and the potential use of its antagonist, rupatadine, as an experimental treatment. Tissue microarrays of ovarian cancer patients, most markedly those with a non-mucinous subtype, immunohistochemically overexpressed PAFR. Elevated cytoplasmic PAFR expression was found to significantly and independently impair patients' overall and recurrence-free survival (OS: median 83.48 vs. 155.03 months; p = 0.022; RFS: median 164.46 vs. 78.03 months; p = 0.015). In vitro, the serous ovarian cancer subtypes especially displayed an elevated PAFR gene and protein expression. siRNA knockdown of PAFR decreased cell proliferation significantly, thus confirming the receptor's protumorigenic effect on ovarian cancer cells. The clinically approved PAFR antagonist rupatadine effectively inhibited in vitro cell proliferation and migration of ovarian cancer cells. PAFR is a prognostic marker in ovarian cancer patients and its inhibition through rupatadine may have important therapeutic implications in the therapy of ovarian cancer patients.
Collapse
Affiliation(s)
- Eileen Deuster
- Department of Obstetrics and Gynecology, University Hospital, Ludwig Maximilians University (LMU) Munich, 81377 Munich, Germany; (E.D.); (I.H.); (M.K.); (S.B.); (T.K.); (A.H.); (F.K.); (A.C.-R.); (A.B.); (S.M.); (U.J.); (F.T.)
| | - Ivi Hysenaj
- Department of Obstetrics and Gynecology, University Hospital, Ludwig Maximilians University (LMU) Munich, 81377 Munich, Germany; (E.D.); (I.H.); (M.K.); (S.B.); (T.K.); (A.H.); (F.K.); (A.C.-R.); (A.B.); (S.M.); (U.J.); (F.T.)
| | - Maja Kahaly
- Department of Obstetrics and Gynecology, University Hospital, Ludwig Maximilians University (LMU) Munich, 81377 Munich, Germany; (E.D.); (I.H.); (M.K.); (S.B.); (T.K.); (A.H.); (F.K.); (A.C.-R.); (A.B.); (S.M.); (U.J.); (F.T.)
| | - Elisa Schmoeckel
- Institute of Pathology, Faculty of Medicine, Ludwig Maximilians University (LMU) Munich, 81377 Munich, Germany; (E.S.); (D.M.)
| | - Doris Mayr
- Institute of Pathology, Faculty of Medicine, Ludwig Maximilians University (LMU) Munich, 81377 Munich, Germany; (E.S.); (D.M.)
| | - Susanne Beyer
- Department of Obstetrics and Gynecology, University Hospital, Ludwig Maximilians University (LMU) Munich, 81377 Munich, Germany; (E.D.); (I.H.); (M.K.); (S.B.); (T.K.); (A.H.); (F.K.); (A.C.-R.); (A.B.); (S.M.); (U.J.); (F.T.)
| | - Thomas Kolben
- Department of Obstetrics and Gynecology, University Hospital, Ludwig Maximilians University (LMU) Munich, 81377 Munich, Germany; (E.D.); (I.H.); (M.K.); (S.B.); (T.K.); (A.H.); (F.K.); (A.C.-R.); (A.B.); (S.M.); (U.J.); (F.T.)
| | - Anna Hester
- Department of Obstetrics and Gynecology, University Hospital, Ludwig Maximilians University (LMU) Munich, 81377 Munich, Germany; (E.D.); (I.H.); (M.K.); (S.B.); (T.K.); (A.H.); (F.K.); (A.C.-R.); (A.B.); (S.M.); (U.J.); (F.T.)
| | - Fabian Kraus
- Department of Obstetrics and Gynecology, University Hospital, Ludwig Maximilians University (LMU) Munich, 81377 Munich, Germany; (E.D.); (I.H.); (M.K.); (S.B.); (T.K.); (A.H.); (F.K.); (A.C.-R.); (A.B.); (S.M.); (U.J.); (F.T.)
| | - Anca Chelariu-Raicu
- Department of Obstetrics and Gynecology, University Hospital, Ludwig Maximilians University (LMU) Munich, 81377 Munich, Germany; (E.D.); (I.H.); (M.K.); (S.B.); (T.K.); (A.H.); (F.K.); (A.C.-R.); (A.B.); (S.M.); (U.J.); (F.T.)
| | - Alexander Burges
- Department of Obstetrics and Gynecology, University Hospital, Ludwig Maximilians University (LMU) Munich, 81377 Munich, Germany; (E.D.); (I.H.); (M.K.); (S.B.); (T.K.); (A.H.); (F.K.); (A.C.-R.); (A.B.); (S.M.); (U.J.); (F.T.)
| | - Sven Mahner
- Department of Obstetrics and Gynecology, University Hospital, Ludwig Maximilians University (LMU) Munich, 81377 Munich, Germany; (E.D.); (I.H.); (M.K.); (S.B.); (T.K.); (A.H.); (F.K.); (A.C.-R.); (A.B.); (S.M.); (U.J.); (F.T.)
| | - Udo Jeschke
- Department of Obstetrics and Gynecology, University Hospital, Ludwig Maximilians University (LMU) Munich, 81377 Munich, Germany; (E.D.); (I.H.); (M.K.); (S.B.); (T.K.); (A.H.); (F.K.); (A.C.-R.); (A.B.); (S.M.); (U.J.); (F.T.)
- Department of Obstetrics and Gynecology, University Hospital Augsburg, 86156 Augsburg, Germany
| | - Fabian Trillsch
- Department of Obstetrics and Gynecology, University Hospital, Ludwig Maximilians University (LMU) Munich, 81377 Munich, Germany; (E.D.); (I.H.); (M.K.); (S.B.); (T.K.); (A.H.); (F.K.); (A.C.-R.); (A.B.); (S.M.); (U.J.); (F.T.)
| | - Bastian Czogalla
- Department of Obstetrics and Gynecology, University Hospital, Ludwig Maximilians University (LMU) Munich, 81377 Munich, Germany; (E.D.); (I.H.); (M.K.); (S.B.); (T.K.); (A.H.); (F.K.); (A.C.-R.); (A.B.); (S.M.); (U.J.); (F.T.)
- Correspondence:
| |
Collapse
|
13
|
Baczewska M, Knapp P, Dobroch J, Bernaczyk P, Guzik P, Sitnik P, Bortnik W. Two Concurrent Cancers in a 19-Year-Old Patient: Yolk Sac Ovarian Tumor and Metastatic Gastrointestinal Tract Malignancy-Case Report. J Pediatr Adolesc Gynecol 2021; 34:561-565. [PMID: 33689915 DOI: 10.1016/j.jpag.2021.02.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 01/31/2021] [Accepted: 02/22/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Two concurrent malignancies present in a young person is an extremely rare condition. Diagnoses of gastric cancer primarily concern older patients. There are very few reports of concomitant Krukenberg tumor and germ-cell ovarian malignancy. CASE A 19-year-old girl was admitted to the gynecologic oncology department with symptoms of advanced malignancy. Radiological imaging revealed disseminated neoplastic disease with bulky adnexal tumors. Cytoreductive surgery was performed, achieving no visible disease (T = 0 cm). The final pathology report confirmed metastatic mixed adenoneuroendocrine carcinoma (MANEC) in both ovaries, originating from the gastrointestinal tract. Moreover, the primary germ cell yolk sac tumor was found in the left ovary. CONCLUSION In cases of concomitant gastric and ovarian tumors, metastatic disease (Krukenberg tumor) should be considered in the differential diagnosis. This concerns even adolescent patients. In particular cases, including tumors with germ cell components, primary debulking surgery is crucial for prognosis.
Collapse
Affiliation(s)
- Marta Baczewska
- Department of Gynecology and Gynecologic Oncology, Medical University of Bialystok, Poland.
| | - Pawel Knapp
- Department of Gynecology and Gynecologic Oncology, University Oncology Center, Medical University of Bialystok, Poland
| | - Jakub Dobroch
- Department of Gynecology and Gynecologic Oncology, Medical University of Bialystok, Poland
| | - Piotr Bernaczyk
- Department of Medical Pathomorphology, Medical University of Bialystok, Poland
| | - Paweł Guzik
- Clinical Department of Gynecology and Obstetrics, City Hospital, Rycerska 4 Str. 35-241 Rzeszów, Poland
| | - Piotr Sitnik
- Department of Gynecology and Gynecologic Oncology, University Oncology Center, Department of Gynecological Endocrinology and Adolescent Gynecology, Medical University of Bialystok, Poland
| | - Wiktor Bortnik
- Department of Gynecological Endocrinology and Adolescent Gynecology, Department of Gynecology and Gynecologic Oncology, University Oncology Center, Medical University of Bialystok, Poland
| |
Collapse
|
14
|
Hakamy S, Assidi M, Jafri MA, Nedjadi T, Alkhatabi H, Al-Qahtani A, Al-Maghrabi J, Sait K, Al-Qahtani M, Buhmeida A, Chaudhary A. Assessment of prognostic value of tissue inhibitors of metalloproteinase 3 (TIMP3) protein in ovarian cancer. Libyan J Med 2021; 16:1937866. [PMID: 34240668 PMCID: PMC8274532 DOI: 10.1080/19932820.2021.1937866] [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] [Indexed: 01/04/2023] Open
Abstract
Background: TIMP3 is a multifunctional proteolytic enzyme belonging to TIMPs family and acts as a potent inhibitor of matrix metalloproteinases (MMPs). TIMP3 possesses a tumor suppresive function by directly promoting tumor cell apoptosis, preventing angiogenesis and extracellular matrix remodelling. The lower expression of TIMP3 was associated with poor prognosis and overall survival in various cancer types. The aim of this study was to evaluate the association of TIMP3 protein expression with ovarian cancer (OC) clinicopathological features and survival outcomes.Patients and Methods:
One hundred forty four of OC FFPE samples were collected from King Abdulaziz University Hospital, Saudi Arabia and constructed in tissue microarray (TMA) slides. Automated Ventana immunostainer platform was used to evaluate TIMP3 protein expression patterns.Results:
The study showed that TIMP3 exhibits cytoplasmic localisation. This TIMP3 protein expression was not associated with age, tumor size and the involvement of lymph nodes (p > 0.05). However, it was significantly correlated with tumor stage (p < 0.05) and borderline significant with endpoint status (p = 0.07). Interestingly, the Kaplan-Meier analysis of disease specific survival (DSS) outcomes showed a significant association (p = 0.02, log rank) between OC patients with higher TIMP3 expression compared to those with lower expression. In fact, OC patients with high TIMP3 expression had longer survivals. Multivariate Cox’s regression analysis suggests that low TIMP3 protein expression pattern is an independent poor survival marker (p = 0.025).Conclusion: Cytoplasmic TIMP3 protein expression could be used as a good prognosticator to stratify poorly prognostic OC patients in order to personlaize their disease management.
Collapse
Affiliation(s)
- Sahar Hakamy
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia.,Medical Technology Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mourad Assidi
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia.,Medical Technology Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammad A Jafri
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia.,Medical Technology Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Taoufik Nedjadi
- King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences. Ministry of National Guard-Health Affairs, Jeddah, Saudi Arabia
| | - Heba Alkhatabi
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia.,Medical Technology Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abrar Al-Qahtani
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Jaudah Al-Maghrabi
- Department of Pathology, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Khalid Sait
- Department of Obstetrics and Gynecology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed Al-Qahtani
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdelbaset Buhmeida
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Adeel Chaudhary
- Medical Technology Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.,Center of Innovation in Personalized Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| |
Collapse
|
15
|
Platelet-Activating Factor Acetylhydrolase Expression in BRCA1 Mutant Ovarian Cancer as a Protective Factor and Potential Negative Regulator of the Wnt Signaling Pathway. Biomedicines 2021; 9:biomedicines9070706. [PMID: 34206491 PMCID: PMC8301368 DOI: 10.3390/biomedicines9070706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/12/2021] [Accepted: 06/17/2021] [Indexed: 11/17/2022] Open
Abstract
Aberrantly activated Wnt/β-catenin signaling pathway, as well as platelet-activating factor (PAF), contribute to cancer progression and metastasis of many cancer entities. Nonetheless, the role of the degradation enzyme named platelet-activating factor acetylhydrolase (PLA2G7/PAF-AH) in ovarian cancer etiology is still unclear. This study investigated the functional impact of platelet-activating factor acetylhydrolase on BRCA1 mutant ovarian cancer biology and its crosstalk with the Wnt signaling pathway. PAF-AH, pGSK3β, and β-catenin expressions were analyzed in 156 ovarian cancer specimens by immunohistochemistry. PAF-AH expression was investigated in ovarian cancer tissue, serum of BRCA1-mutated patients, and in vitro in four ovarian cancer cell lines. Functional assays were performed after PLA2G7 silencing. The association of PAF-AH and β-catenin was examined by immunocytochemistry. In an established ovarian carcinoma collective, we identified PAF-AH as an independent positive prognostic factor for overall survival (median 59.9 vs. 27.4 months; p = 0.016). PAF-AH correlated strongly with the Wnt signaling proteins pGSK3β (Y216; nuclear: cc = 0.494, p < 0.001; cytoplasmic: cc = 0.488, p < 0.001) and β-catenin (nuclear: cc = 0.267, p = 0.001; cytoplasmic: cc = 0.291, p < 0.001). In particular, high levels of PAF-AH were found in tumor tissue and in the serum of BRCA1 mutation carriers. By in vitro expression analysis, a relevant gene and protein expression of PLA2G7/PAF-AH was detected exclusively in the BRCA1-negative ovarian cancer cell line UWB1.289 (p < 0.05). Functional assays showed enhanced viability, proliferation, and motility of UWB1.289 cells when PLA2G7/PAF-AH was downregulated, which underlines its protective character. Interestingly, by siRNA knockdown of PLA2G7/PAF-AH, the immunocytochemistry staining pattern of β-catenin changed from a predominantly membranous expression to a nuclear one, suggesting a negative regulatory role of PAF-AH on the Wnt/β-catenin pathway. Our data provide evidence that PAF-AH is a positive prognostic factor with functional impact, which seems particularly relevant in BRCA1 mutant ovarian cancer. For the first time, we show that its protective character may be mediated by a negative regulation of the Wnt/β-catenin pathway. Further studies need to specify this effect. Potential use of PAF-AH as a biomarker for predicting the disease risk of BRCA1 mutation carriers and for the prognosis of patients with BRCA1-negative ovarian cancer should be explored.
Collapse
|
16
|
Romero I, López-Guerrero JA, Pignata S. Real-world experience with trabectedin for the treatment of recurrent ovarian cancer. Expert Rev Anticancer Ther 2021; 21:1089-1095. [PMID: 34128757 DOI: 10.1080/14737140.2021.1941890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction: The efficacy and safety of trabectedin/pegylated liposomal doxorubicin (trabectedin/PLD) in patients with recurrent ovarian cancer have been demonstrated in randomized clinical studies. Real-world evidence is a subsequent necessary step for completing information from clinical practice. In the case of trabectedin/PLD, this evidence derives from prospective studies, retrospective analyses, and case series.Areas covered: The present narrative review provides the most relevant data about efficacy and safety of trabectedin/PLD in real-world studies, and the interpretation of the experience with trabectedin/PLD in clinical practice for patients with recurrent ovarian cancer.Expert opinion: Trabectedin/PLD has a proven antitumor activity that is maintained when administered in advanced lines. Trabectedin/PLD in patients who have relapsed between 6 and 12 months have showed comparable survival outcomes than platinum-based regimens. Moreover, the administration of trabectedin/PLD was associated with a positive survival trend after two previous platinum lines and a significantly superior PFS after subsequent platinum-based therapy. Additionally, the activity of trabectedin seems to be increased in patients with BRCA-mutated ovarian cancer. Overall, real-word evidence has confirmed that trabectedin/PLD is an effective and safe non-platinum combination for advanced lines of chemotherapy in patients with platinum-sensitive recurrent ovarian cancer.
Collapse
Affiliation(s)
- Ignacio Romero
- outpatient services, Fundación Instituto Valenciano De Oncología, Valencia, Spain
| | | | - Sandro Pignata
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Napoli, Italy
| |
Collapse
|
17
|
Shin DW, Bae J, Ha J, Jung KW. Conditional Relative Survival of Ovarian Cancer: A Korean National Cancer Registry Study. Front Oncol 2021; 11:639839. [PMID: 33996553 PMCID: PMC8113866 DOI: 10.3389/fonc.2021.639839] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/30/2021] [Indexed: 12/24/2022] Open
Abstract
Objective Conditional relative survival (CRS) rates, which take into account changes in prognosis over time, are useful estimates for survivors and their clinicians as they make medical and personal decisions. We aimed to present the 5-year relative conditional survival probabilities of patients diagnosed with ovarian cancer from 1997–2016. Methods This nationwide retrospective cohort study used data from the Korean Central Cancer Registry. Patients diagnosed with ovarian cancer between 1997 and 2016 were included. CRS rates were calculated stratified by age at diagnosis, cancer stage, histology, treatment received, year of diagnosis, and social deprivation index. Results The 5-year relative survival rate at the time of diagnosis was 61.1% for all cases. The probability of surviving an additional 5 years, conditioned on having already survived 1, 2, 3, 4, and 5 years after diagnosis was 65.0, 69.5, 74.6, 79.3, and 83.9%, respectively. Patients with poorer initial survival estimates (older, distant stage, serous histology) generally showed the largest increases in CRS over time. The probability of death was highest in the first year after diagnosis (11.8%), and the conditional probability of death in the 2nd, 3rd, 4th, and 5th years declined to 9.4%, 7.9%, 6.1%, and 5.2%, respectively. Conclusion CRS rates for patients with ovarian cancer increased with each year they survived, but this did not reach the level of ‘no excess mortality’ even 5 years after diagnosis. The largest improvements in CRS were observed in patients with poorer initial prognoses. Our findings provide updated prognosis to ovarian cancer survivors and clinicians.
Collapse
Affiliation(s)
- Dong Wook Shin
- Supportive Care Center/Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea
| | - Jaeman Bae
- Department of Obstetric and Gynecology, Hanyang University, Seoul, South Korea
| | - Johyun Ha
- The Korea Central Cancer Registry, National Cancer Center, Goyang, South Korea.,Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, South Korea
| | - Kyu-Won Jung
- The Korea Central Cancer Registry, National Cancer Center, Goyang, South Korea.,Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, South Korea
| |
Collapse
|
18
|
FU J, SHANG Y, QIAN Z, HOU J, YAN F, LIU G, DEHUA L, TIAN X. Chimeric Antigen receptor-T (CAR-T) cells targeting Epithelial cell adhesion molecule (EpCAM) can inhibit tumor growth in ovarian cancer mouse model. J Vet Med Sci 2021; 83:241-247. [PMID: 33328392 PMCID: PMC7972873 DOI: 10.1292/jvms.20-0455] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 12/05/2020] [Indexed: 12/27/2022] Open
Abstract
Ovarian cancer (OC) is one of the most lethal solid tumors with poor prognosis. In 2017, two chimeric antigen receptor-T (CAR-T) cell drugs were approved by the U.S. Food and Drug Administration (FDA), and continuously optimized CAR-T cells therapy might be the novel hope for OC patient. EpCAM are known to be over-expressed in OC cells and could be targeted by CAR-T cells. However, the feasibility of using EpCAM-CAR-T cells to treat OC still needs to be verified. We engineered the 3rd-generation EpCAM-CAR containing a single-chain variable fragment (scFv) EpCAM-scFv that targeting EpCAM, a CD8 transmembrane domain, the costimulatory domains from both CD28 and 4-1BB, and activating domain CD3ζ and then transduced the CAR into T-cells via lentivirus. In addition, the cytotoxicity and cytokine releasing ability of the EpCAM-CAR-T cells against OC cell SKOV3 were verified in vitro. The in vivo data also showed that EpCAM-CAR-T cells significantly reduced the tumor size in OC xenograft mouse models. The anti-tumor activity of EpCAM-CAR-T cells against OC in vitro and in vivo indicated that the CAR-T might provide a promising therapeutic approach to OC.
Collapse
Affiliation(s)
- Juan FU
- Department of Obstetrics and Gynecology, the First
Affiliated Hospital of Dalian Medical University, Dalian, 116000, China
| | - Yuhong SHANG
- Department of Obstetrics and Gynecology, the First
Affiliated Hospital of Dalian Medical University, Dalian, 116000, China
| | - Zhang QIAN
- Shanghai Yihao Biological Technology Co., Ltd., Shanghai,
200231, China
| | - Jinping HOU
- Department of Pathology, the First Affiliated Hospital of
Dalian Medical University, Dalian, 116000, China
| | - Feng YAN
- Department of Pathology, the First Affiliated Hospital of
Dalian Medical University, Dalian, 116000, China
| | - Guodi LIU
- Shanghai Yihao Biological Technology Co., Ltd., Shanghai,
200231, China
| | - Li DEHUA
- Shanghai Yihao Biological Technology Co., Ltd., Shanghai,
200231, China
| | - Xiaoli TIAN
- Shanghai Yihao Biological Technology Co., Ltd., Shanghai,
200231, China
| |
Collapse
|
19
|
Dumas L, Bowen R, Butler J, Banerjee S. Under-Treatment of Older Patients with Newly Diagnosed Epithelial Ovarian Cancer Remains an Issue. Cancers (Basel) 2021; 13:cancers13050952. [PMID: 33668809 PMCID: PMC7956315 DOI: 10.3390/cancers13050952] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 02/16/2021] [Accepted: 02/18/2021] [Indexed: 01/28/2023] Open
Abstract
Older women with ovarian cancer have disproportionately poorer survival outcomes than their younger counterparts and receive less treatment. In order to understand where the gaps lie in the treatment of older patients, studies incorporating more detailed assessment of baseline characteristics and treatment delivery beyond the scope of most cancer registries are required. We aimed to assess the proportion of women over the age of 65 who are offered and receive standard of care for first-line ovarian cancer at two UK NHS Cancer Centres over a 5-year period (December 2009 to August 2015). Standard of care treatment was defined as a combination of cytoreductive surgery and if indicated platinum-based chemotherapy (combination or single-agent). Sixty-five percent of patients aged 65 and above received standard of care treatment. Increasing age was associated with lower rates of receiving standard of care (35% > 80 years old versus 78% of 65-69-year-olds, p = 0.000). Older women were less likely to complete the planned chemotherapy course (p = 0.034). The oldest women continue to receive lower rates of standard care compared to younger women. Once adjusted for Federation of Gynaecology and Obstetrics (FIGO) stage, Eastern Cooperative Oncology Group (ECOG) performance status and first-line treatment received, age was no longer an independent risk factor for poorer overall survival. Optimisation of vulnerable patients utilising a comprehensive geriatric assessment and directed interventions to facilitate the delivery of standard of care treatment could help narrow the survival discrepancy between the oldest patients and their younger counterparts.
Collapse
Affiliation(s)
- Lucy Dumas
- Gynaecology Unit, Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (L.D.); (J.B.)
- Institute of Cancer Research, 15 Cotswold Road, Sutton, London SM2 5NG, UK
| | - Rebecca Bowen
- Department of Oncology, Royal United Hospitals Bath NHS Foundation Trust, Bath BA1 3NG, UK;
| | - John Butler
- Gynaecology Unit, Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (L.D.); (J.B.)
| | - Susana Banerjee
- Gynaecology Unit, Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (L.D.); (J.B.)
- Institute of Cancer Research, 15 Cotswold Road, Sutton, London SM2 5NG, UK
- Correspondence:
| |
Collapse
|
20
|
Zhang Q, Liu G, Liu J, Yang M, Fu J, Liu G, Li D, Gu Z, Zhang L, Pan Y, Cui X, Wang L, Zhang L, Tian X. The antitumor capacity of mesothelin-CAR-T cells in targeting solid tumors in mice. MOLECULAR THERAPY-ONCOLYTICS 2021; 20:556-568. [PMID: 33738341 PMCID: PMC7943972 DOI: 10.1016/j.omto.2021.02.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 02/18/2021] [Indexed: 12/24/2022]
Abstract
Since the approval of chimeric antigen receptor (CAR) T cell therapy targeting CD19 by the FDA, CAR-T cell therapy has received increasing attention as a new method for targeting tumors. Although CAR-T cell therapy has a good effect against hematological malignancies, it has been less effective against solid tumors. In the present study, we selected mesothelin (MSLN/MESO) as a target for CAR-T cells because it is highly expressed by solid tumors but only expressed at low levels by normal tissues. We engineered a third generation MSLN-CAR comprising a single-chain variable fragment (scFv) targeting MSLN (MSLN-scFv), a CD8 transmembrane domain, the costimulatory domains from CD28 and 4-1BB, and the activating domain CD3ζ. In vitro, MSLN-CAR-T cells killed various solid tumor cell lines, demonstrating that it could specifically kill MSLN-positive cells and release cytokines. In vivo, we investigated the effects of MSLN-CAR-T cell therapy against ovarian, breast, and colorectal cancer cell-line-derived xenografts (CDX) and MSLN-positive colorectal and gastric cancer patient-derived xenografts (PDX). MSLN-CAR decreased the growth of MSLN-positive tumors concomitant with significantly increased T cells and cytokine levels compared to the control group. These results indicated that modified MSLN-CAR-T cells could be a promising therapeutic approach for solid tumors.
Collapse
Affiliation(s)
- Qian Zhang
- Shanghai Yihao Biological Technology, Co., Ltd., Shanghai 200231, China
| | - Guoping Liu
- Department of General Surgery, Changhai Hospital, Shanghai 200433, China
| | - Jibin Liu
- Institute of Tumor of Nantong Tumor Hospital, No. 30, North Tongyang Road, Pingchao Town, Tongzhou District, Nantong City, Jiangsu Province 226361, China
| | - Mu Yang
- Department of Pathology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200080, China
| | - Juan Fu
- Department of Obstetrics and Gynecology, the First Affiliated Hospital of Dalian Medical University, Dalian 116000, China
| | - Guodi Liu
- Shanghai Yihao Biological Technology, Co., Ltd., Shanghai 200231, China
| | - Dehua Li
- Shanghai Yihao Biological Technology, Co., Ltd., Shanghai 200231, China
| | - Zhangjie Gu
- Shanghai Yihao Biological Technology, Co., Ltd., Shanghai 200231, China
| | - Linsong Zhang
- Shanghai Yihao Biological Technology, Co., Ltd., Shanghai 200231, China
| | - Yingjiao Pan
- Shanghai Yihao Biological Technology, Co., Ltd., Shanghai 200231, China
| | - Xingbing Cui
- Shanghai Yihao Biological Technology, Co., Ltd., Shanghai 200231, China
| | - Lu Wang
- Shanghai Yihao Biological Technology, Co., Ltd., Shanghai 200231, China
| | - Lixin Zhang
- State Key Laboratory of Bioreactor Engineering, East China University of Science and Technology, Room 18-201, 130 Meilong Road, Shanghai 200237, China
| | - Xiaoli Tian
- Shanghai Yihao Biological Technology, Co., Ltd., Shanghai 200231, China
| |
Collapse
|
21
|
Michels J, Genestie C, Dunant A, Caron O, Lanoy E, Colomba E, Pommeret F, Rey A, Gouy S, Duvillard P, Teuff GL, Larue C, Savoye AM, Lhommé C, Leary A, Morice P, Pautier P. Impact of young age on platinum response in women with epithelial ovarian cancer: Results of a large single-institution registry. Gynecol Oncol 2020; 160:77-82. [PMID: 33059915 DOI: 10.1016/j.ygyno.2020.09.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/28/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVE In young women, EOC is a rare disease with an uncertain genetic and biological substrate. METHODS We report a long follow-up of EOC patients treated at Gustave Roussy between 1990 and 2009. We matched young patients aged ≤30 years to randomly selected older patients aged ≥40 years according to known prognostic factors (i.e. FIGO stage, histology and surgical residual disease) and the date of diagnosis with a threshold at the year 2000 to balance the treatment procedures. RESULTS EOC was diagnosed in 68 patients aged ≤30 years matched with 111 patients aged ≥40 years. Low-grade (LG) (i.e. serous and endometrioid) (52%, n = 35) and mucinous (i.e. 23%, n = 16 infiltrative and 12% n = 8 expansile) tumors are prevalent. High-grade (HG) tumors are rare (7%, n = 5). Early stage diseases (53%, n = 36 FIGO I/II) are predominant. Response to platinum based chemotherapy is observed to be inferior in young patients as compared to matched older patients (ORR, 29 vs 84% p = 0.0002). For HG tumors the PFS is of 0% at 5 and 10 years in younger as compared to 30% in older patients. No difference in PFS (median 4.9 vs 9.8 ms, p = 0.58) and OS (not reached vs 15.3 ms, p = 0.47) is found overall among younger and older patients respectively. The median follow-up was 72 months (range, 11-288 months). No genetic abnormalities were found. CONCLUSIONS Young EOC patients are most often diagnosed at an early FIGO stage with LG serous or mucinous histology. Tumors are significantly more resistant to platinum-based chemotherapy in younger patients.
Collapse
Affiliation(s)
- Judith Michels
- Department of Medical Oncology, Gustave-Roussy, Villejuif, France.
| | | | - Ariane Dunant
- Biostatistics and Epidemiology Unit, Gustave-Roussy, Villejuif, France
| | | | - Emilie Lanoy
- Biostatistics and Epidemiology Unit, Gustave-Roussy, Villejuif, France; Paris-Saclay University, Paris-Sud Univ., UVSQ, CESP, INSERM, Villejuif, France
| | - Emeline Colomba
- Department of Medical Oncology, Gustave-Roussy, Villejuif, France
| | - Fanny Pommeret
- Department of Medical Oncology, Gustave-Roussy, Villejuif, France
| | - Annie Rey
- Biostatistics and Epidemiology Unit, Gustave-Roussy, Villejuif, France
| | | | | | - Gwenael Le Teuff
- Biostatistics and Epidemiology Unit, Gustave-Roussy, Villejuif, France; Paris-Saclay University, Paris-Sud Univ., UVSQ, CESP, INSERM, Villejuif, France
| | - Christine Larue
- Biostatistics and Epidemiology Unit, Gustave-Roussy, Villejuif, France
| | | | - Catherine Lhommé
- Department of Medical Oncology, Gustave-Roussy, Villejuif, France
| | - Alexandra Leary
- Department of Medical Oncology, Gustave-Roussy, Villejuif, France
| | | | - Patricia Pautier
- Department of Medical Oncology, Gustave-Roussy, Villejuif, France
| |
Collapse
|
22
|
N-Glycome changes reflecting resistance to platinum-based chemotherapy in ovarian cancer. J Proteomics 2020; 230:103964. [PMID: 32898699 DOI: 10.1016/j.jprot.2020.103964] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 08/14/2020] [Accepted: 08/31/2020] [Indexed: 12/12/2022]
Abstract
A number of studies have reported aberrant glycosylation in connection with malignancy. Our investigation further expands on this topic through the examination of N-glycans, which could be associated with the resistance of advanced stage, high-grade non-mucinous ovarian cancer to platinum/taxane based chemotherapy. We used tissue samples of 83 ovarian cancer patients, randomly divided into two independent cohorts (basic and validation). Both groups involved either cases with/without postoperative tumor residue or the cases determined either resistant or sensitive to this chemotherapy. In the validation cohort, preoperative serum samples were also available. N-glycans released from tumors and sera were permethylated and analyzed by matrix-assisted laser desorption/ionization mass spectrometry (MALDI-MS). The MS analysis yielded a consecutive detection of 68 (tissue) and 63 (serum) N-glycan spectral signals. Eight of these were found to be differentially abundant in tissues of both independent cohorts including the cases with a postoperative cancer residue. One of these glycans was detected as differentially abundant in sera of the validation cohort. No statistically significant differences in intensities due to the same N-glycans were found in the cases without postoperative macroscopic residues in either the basic or validation cohort. From the biochemical point of view, the statistically significant N-glycans correspond to the structures carrying bisecting (terminal) GlcNAc residue and tetra-antennary structures with sialic acid and/or fucose residues. Among them, six tissue N-glycans could be considered potential markers connected with a resistance to chemotherapy in ovarian cancer patients. The prediction of primary resistance to standard chemotherapy may identify the group of patients suitable for alternative treatment strategies. SIGNIFICANCE: Drug resistance has become a major impediment to a successful treatment of patients with advanced ovarian cancer. The glycomic measurements related to cancer are becoming increasingly popular in identification of the key molecules as potential diagnostic and prognostic indicators. Our report deals with identification of differences in N-glycosylation of proteins in tissue and serum samples from the individuals showing sensitivity or resistance to platinum/taxane-based chemotherapy. The detection sensitivity to chemotherapy is vitally important for these patients.
Collapse
|
23
|
Ghaddab I, Briki R, Bouguizene S, Khairi H. [Clinical, therapeutic and prognostic aspects of malignant germ cell tumors of the ovary: experience of 21 years old Tunisian]. Pan Afr Med J 2020; 36:178. [PMID: 32952822 PMCID: PMC7467897 DOI: 10.11604/pamj.2020.36.178.23916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 06/19/2020] [Indexed: 11/30/2022] Open
Abstract
Introduction les tumeurs germinales malignes de l´ovaire (TGMO) sont des tumeurs ovariennes rares. Chaque type histologique peut avoir des particularités cliniques et thérapeutiques qu´il est important de connaître. L´objectif était de rapporter et analyser les particularités des données épidémiologiques, diagnostiques, anatomopathologiques, thérapeutiques et pronostiques des TGMO dans notre contexte tunisien. Méthodes notre étude est une enquête rétrospective descriptive et analytique réalisée aux services de Gynécologie-obstétrique du CHU FARHAT HACHED de Sousse sur une période de 21 ans colligeant tous les cas des patientes ayant été traitées pour TGMO. Résultats un nombre total de 30 dossiers a été éligible pour notre étude. L´âge moyen de nos patientes était de 22ans. La majorité des patientes étaient en période d´activité génitale. Le motif de consultation était représenté essentiellement par les douleurs abdomino-pelviennes suivie d´une augmentation du volume abdominal. L´échographie abdominopelvienne a été pratiquée chez 80% de nos patientes montrant un aspect suspect de malignité chez 100% d´entre elles. Pour nos patientes, 70% ont été abordées par laparotomie médiane vu le volume tumoral et 30% seulement par cœlioscopie. 76,7% ont eu un traitement conservateur. On a noté la prédominance de stade I alors qu´on n´a pas eu de cas en stade IV. La survie globale tout stade confondu était de 96,7% à 2ans et de 85,7% à 5ans et 75,8% à 10ans. Les facteurs pronostiques des TGMO isolés de notre série étaient le délai de consultation supérieur à 6mois, l´âge supérieur à 30ans, la taille tumorale supérieure à 20cm et le stade tumoral. Conclusion il serait plus intéressant de rassembler les autres cas de TGMO diagnostiqués au niveau des autres registres du cancer du pays afin d´établir un registre national des tumeurs rares de l´ovaire.
Collapse
Affiliation(s)
- Imen Ghaddab
- Service de Gynécologie et d´Obstétrique, Hôpital Universitaire Farhat Hached, Sousse, Tunisie
| | - Raja Briki
- Service de Gynécologie et d´Obstétrique, Hôpital Universitaire Farhat Hached, Sousse, Tunisie
| | - Sassi Bouguizene
- Service de Gynécologie et d´Obstétrique, Hôpital Universitaire Farhat Hached, Sousse, Tunisie
| | - Hedi Khairi
- Service de Gynécologie et d´Obstétrique, Hôpital Universitaire Farhat Hached, Sousse, Tunisie
| |
Collapse
|
24
|
Jiao Z, Huang L, Sun J, Xie J, Wang T, Yin X, Zhang H, Chen J. Six-transmembrane epithelial antigen of the prostate 1 expression promotes ovarian cancer metastasis by aiding progression of epithelial-to-mesenchymal transition. Histochem Cell Biol 2020; 154:215-230. [PMID: 32382787 DOI: 10.1007/s00418-020-01877-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2020] [Indexed: 12/18/2022]
Abstract
Ovarian cancer is a severe malignant tumour of the female genital organs. Six-transmembrane epithelial antigen of the prostate 1 (STEAP1) expression is correlated with the occurrence and progression of multiple cancers. Here, we assessed STEAP1 expression in ovarian cancer and explored the relationship between STEAP1 and ovarian cancer progression. We used immunohistochemistry and public databases to test STEAP1 expression in normal human ovarian tissues, benign ovarian tumours, and ovarian cancer. The expression of STEAP1 and epithelial-to-mesenchymal transition (EMT)-related genes was analysed using immunocytochemistry, quantitative reverse transcription polymerase chain reaction, and western blotting in ovarian cancer cell lines. Lentivirus was used to knockdown and overexpress STEAP1. Invasion, migration, growth, clonogenicity, and apoptosis were assessed using transwell assay, growth curve, plate clone formation assay, and flow cytometry. We used a tumour xenograft to verify the relationship between STEAP1 and in vivo ovarian cancer cell growth. Matrix metalloproteinase-2 (MMP2) and matrix metalloproteinase-9 (MMP9) activities were examined using Matrix metalloproteinase zymography assay. STEAP1 was highly expressed in the human ovarian cancer tissues and a highly invasive ovarian cancer cell line. Overexpression of STEAP1 was related to poor prognosis in ovarian cancer patients. Down-regulation of STEAP1 suppressed the invasion, migration, proliferation, clonogenicity, EMT progression in human ovarian cancer cells and xenograft tumour growth in vivo, but it enhanced apoptosis. In human ovarian cancer, the STEAP1 gene is highly expressed, and its function is correlated with human ovarian cancer cell metastasis and growth. STEAP1 may be a possible target for suppressing ovarian cancer metastasis.
Collapse
Affiliation(s)
- Zhi Jiao
- Department of Maternal and Child Health, School of Public Health, Shandong University, Jinan, 250012, China
| | - Lei Huang
- Department of Pediatrics, Maternal and Child Health Care Hospital of Shandong Province, Jinan, 250014, China
| | - Jiali Sun
- Department of Vascular Anomalies and Interventional Radiology, Qilu Children's Hospital of Shandong University, Jinan, 250022, China
| | - Jie Xie
- Child Healthcare Department, Qingdao Women and Children's Hospital, Qingdao, 266034, China
| | - Tiantian Wang
- Shibei District Disease Prevention and Control Center, Qingdao, 266012, China
| | - Xiu Yin
- Department of Scientific Research, Jining No. 1 People's Hospital, Jining, 272000, China
| | - Haozheng Zhang
- Research Institute of Pediatrics, Qilu Children's Hospital of Shandong University, Jinan, 250022, China
| | - Jie Chen
- Department of Maternal and Child Health, School of Public Health, Shandong University, Jinan, 250012, China.
| |
Collapse
|
25
|
Glajzer J, Grabowski JP, Sehouli J, Pfisterer J. Recurrent Treatment in Ovarian Cancer Patients: What Are the Best Regimens and the Order They Should Be Given? Curr Treat Options Oncol 2020; 21:49. [PMID: 32350695 DOI: 10.1007/s11864-020-00747-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OPINION STATEMENT The choice of the right treatment regimen for recurrent ovarian cancer (rOC) remains a case-by-case decision. It is based on multiple factors that involve patient characteristics and biological factors at the same time. The prioritization of factors is still subject to changes with a trend towards a more personalized medicine. Therefore, participation and engagement in clinical studies constitutes a substantial need for the future development of the treatment algorithm of rOC.
Collapse
Affiliation(s)
- Joanna Glajzer
- Department of Gynecology and Center of Oncological Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
| | - Jacek P Grabowski
- Department of Gynecology and Center of Oncological Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Jalid Sehouli
- Department of Gynecology and Center of Oncological Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | | |
Collapse
|
26
|
Lord R, Rauniyar J, Morris T, Condon O, Jones R, Miller R, Hall M, Lofts F, Glasspool RM, Hudson E. Real world outcomes in platinum sensitive relapsed ovarian, fallopian tube, or peritoneal cancer treated in routine clinical practice in the United Kingdom prior to poly-ADP ribose polymerase inhibitors. Int J Gynecol Cancer 2020; 30:1026-1033. [DOI: 10.1136/ijgc-2019-000973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 12/23/2019] [Accepted: 01/22/2020] [Indexed: 11/04/2022] Open
Abstract
IntroductionThe introduction of poly-ADP ribose polymerase inhibitors in ovarian cancer has demonstrated significantly improved progression free survival in four randomized controlled clinical trials in patients with platinum sensitive relapsed ovarian cancer. While overall survival data remain immature, this real world evidence study sets a baseline for future evaluation of poly-ADP ribose polymerase inhibitors.MethodsA retrospective chart review was undertaken to investigate real world survival outcomes across 13 National Health Service Trusts in England, Wales, and Scotland. Patients were included if they had platinum sensitive relapsed high grade serous ovarian cancer and had responded to secondline platinum based chemotherapy. Clinical data were collected retrospectively from electronic prescribing records and chart notes. The index date for overall survival analysis was defined as the later of (1) day 1 of the final secondline platinum based treatment or (2) date of response to secondline treatment. The primary objective was overall survival from the index date. Secondary objectives included progression free survival and overall survival by subsequent line of treatment. BRCA mutation status was collected where available. Quality of life questionnaires were not assessed within this study.Results233 patients were identified who met the study inclusion criteria. Patient characteristics were consistent with other published data, with a median age of 61 years (range 35–85). Sensitivity analysis of the primary objective demonstrated that the earliest point poly-ADP ribose polymerase inhibitors may be initiated (following completion of secondline chemotherapy) is associated with a median overall survival of 19.8 months. Secondline median overall survival and progression free survival from the index date were 19.3±2.4 months and 7.3±1.2 months, respectively. 144 patients were treated with thirdline chemotherapy with median overall survival and progression free survival from the index date (either date of last cycle of thirdline treatment or date of response to thirdline treatment) of 8.3±2.6 and 4.4±1.8 months, respectively.ConclusionOverall survival was shown to be shorter in this real world study compared with randomized clinical trials, and underlines the differences in clinical outcomes of patients in a real life setting. This baseline real world study has demonstrated poor survival outcomes in this patient group prior to availability of poly-ADP ribose polymerase inhibitors.
Collapse
|
27
|
Bennetsen AKK, Baandrup L, Aalborg GL, Kjaer SK. Non-epithelial ovarian cancer in Denmark - Incidence and survival over nearly 40 years. Gynecol Oncol 2020; 157:693-699. [PMID: 32223987 DOI: 10.1016/j.ygyno.2020.03.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 03/16/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To examine trends in incidence and survival of non-epithelial ovarian cancer in Denmark over nearly 40 years, using nationwide, population-based cancer registry data. METHODS From 1978 to 2016, we identified the non-epithelial ovarian cancer cases among all ovarian malignancies in the Danish Cancer Registry. Age-specific incidence rates, age-standardized incidence rates, and average annual percentage change (AAPC) were estimated with 95% confidence intervals (CIs). Overall and 5-year relative survival analyses were conducted and supplemented with Cox regression to explore the effect of different characteristics on overall mortality. RESULTS A total of 720 non-epithelial ovarian cancers were identified, corresponding to 3.4% of all ovarian malignancies. The majority of non-epithelial ovarian cancers were germ cell tumors (49.9%) and sex cord-stromal tumors (38.6%). The age-standardized incidence rate of germ cell tumors was stable over the study period, ranging between 0.33 and 0.39 per 100,000 woman-years. In contrast, the age-standardized incidence rate of sex cord-stromal tumors declined from 0.30 (1978-1987) to 0.09 (2008-2016) per 100,000 woman-years (AAPC = -5.15%; 95% CI: -7.29, -2.96). The 5-year relative survival of germ cell tumors and sex cord-stromal tumors was 94% and 79%, respectively, in the most recent period (2008-2011). Cox regression showed that overall mortality was associated with calendar year, age, and stage. CONCLUSIONS The incidence of germ cell tumors was stable over calendar time, whereas the incidence of sex cord-stromal tumors decreased significantly. Non-epithelial ovarian cancer overall mortality has decreased during the study period and this could not be explained by taking stage and age at diagnosis into account.
Collapse
Affiliation(s)
- A K K Bennetsen
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, 2100 Copenhagen, Denmark.
| | - L Baandrup
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, 2100 Copenhagen, Denmark.
| | - G L Aalborg
- Statistics and Pharmacoepidemiology, Danish Cancer Society Research Center, 2100 Copenhagen, Denmark.
| | - S K Kjaer
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, 2100 Copenhagen, Denmark; Department of Gynecology, Rigshospitalet, University of Copenhagen, 2100 Copenhagen, Denmark.
| |
Collapse
|
28
|
Zijlstra M, Timmermans M, Fransen H, van der Aa M, Reyners A, Raijmakers N, van de Poll-Franse L. Treatment patterns and associated factors in patients with advanced epithelial ovarian cancer: a population-based study. Int J Gynecol Cancer 2020; 29:1032-1037. [PMID: 31263022 DOI: 10.1136/ijgc-2019-000489] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 05/02/2019] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES A significant proportion of women with advanced-stage ovarian cancer receive no cancer-directed treatment and limited research has been devoted to this group. This population-based study aimed to gain insight into treatment patterns and trends in patients with advanced epithelial ovarian cancer in the Netherlands and the main reasons for deciding for no cancer-directed treatment. METHODS All patients diagnosed with advanced epithelial ovarian cancer, International Federation of Gynecology and Obstetrics (FIGO) classification IIB-IV, between 2008 and 2016 were identified from the Netherlands Cancer Registry. Trends in the number of patients receiving cancer-directed treatment were analyzed. Multivariable logistic regression analysis was used to identify factors associated with no cancer-directed treatment. The main reasons for no cancer-directed treatment were analyzed. RESULTS A total of 9303 patients were included, of whom 14% (n=1270) received no cancer-directed treatment while 67% (n=6218) received a combination of cytoreductive surgery and chemotherapy. Some 15% (n=1399) received chemotherapy only, and 4.5% (n=416) surgical resection or hormonal therapy only. The proportion of patients receiving no cancer-directed treatment was higher in 2014-2016 (16%, n=496/3175) compared with 2008-2010 (11%, n=349/3057, p<0.001). Associated factors with no cancer-directed treatment were higher age, FIGO stage IV, lower socioeconomic status, co-morbidity, and more recent years of diagnosis (p<0.001). Main reasons for no cancer-directed treatment were patient's choice (40%) and poor condition of the patient (29%). CONCLUSIONS The proportion of patients with advanced epithelial ovarian cancer not receiving cancer-directed treatment has increased in the last decade in the Netherlands. Patient's choice was the main reason for the decision to undergo no cancer-directed treatment, which indicates patient involvement in the decision-making process. The second most common reason for no cancer-directed treatment was poor condition of the patient, which might indicate careful selection of patients for treatment. Decision-making regarding treatment is well-considered, but more insight is needed, especially from the patient's perspective.
Collapse
Affiliation(s)
- Myrte Zijlstra
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Department of Medical Oncology, Maxima Medical Centre, Eindhoven, The Netherlands.,Netherlands Association for Palliative Care (PZNL), Utrecht, The Netherlands
| | - Maite Timmermans
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Department of Gynaecology, Haga Hospital, The Hague, The Netherlands
| | - Heidi Fransen
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Netherlands Association for Palliative Care (PZNL), Utrecht, The Netherlands
| | - Maaike van der Aa
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - An Reyners
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Natasja Raijmakers
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Netherlands Association for Palliative Care (PZNL), Utrecht, The Netherlands
| | - Lonneke van de Poll-Franse
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,CoRPS- Center of Research on Psychology in Somatic diseases, Department of Medicaland Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| |
Collapse
|
29
|
Dou Y, Jiang X, Xie H, He J, Xiao S. The Jun N-terminal kinases signaling pathway plays a "seesaw" role in ovarian carcinoma: a molecular aspect. J Ovarian Res 2019; 12:99. [PMID: 31639019 PMCID: PMC6802331 DOI: 10.1186/s13048-019-0573-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 09/21/2019] [Indexed: 12/16/2022] Open
Abstract
Ovarian cancer is the most common gynecological malignancy that causes cancer-related deaths in women today; this being the case, developing an understanding of ovarian cancer has become one of the major driving forces behind cancer research overall. Moreover, such research over the last 20 years has shown that the Jun N-terminal kinase (JNK) signaling pathway plays an important role in regulating cell death, survival, growth and proliferation in the mitogen-activated protein kinases (MAPK) signaling pathway, an important pathway in the formation of cancer. Furthermore, the JNK signaling pathway is often regulated by an abnormal activation in human tumors and is frequently reported in the literature for its effect on the progression of ovarian cancer. Although the FDA has approved some JNK inhibitors for melanoma, the agency has not approved JNK inhibitors for ovarian cancer. However, there are some experimental data on inhibitors and activators of the JNK signaling pathway in ovarian cancer, but related clinical trials need to be further improved. Although the Jun N-terminal kinase (JNK) signaling pathway is implicated in the formation of cancer in general, research has also indicated that it has a role in suppressing cancer as well. Here, we summarize this seemingly contradictory role of the JNK signaling pathway in ovarian cancer, that ‘seesaws’ between promoting and suppressing cancer, as well as summarizing the application of several JNK pathway inhibitors in cancer in general, and ovarian cancer in particular.
Collapse
Affiliation(s)
- Yingyu Dou
- Department of Gynecology and Obstetrics, the third Xiangya Hospital, the Central South University, Changsha, 410013, Hunan, China
| | - Xiaoyan Jiang
- Department of Gynecology and Obstetrics, the third Xiangya Hospital, the Central South University, Changsha, 410013, Hunan, China
| | - Hui Xie
- Department of Gynecology and Obstetrics, the third Xiangya Hospital, the Central South University, Changsha, 410013, Hunan, China
| | - Junyu He
- Cancer Research Institute, the Central South University, Changsha, 410011, Hunan, China
| | - Songshu Xiao
- Department of Gynecology and Obstetrics, the third Xiangya Hospital, the Central South University, Changsha, 410013, Hunan, China.
| |
Collapse
|
30
|
Garrido MP, Torres I, Vega M, Romero C. Angiogenesis in Gynecological Cancers: Role of Neurotrophins. Front Oncol 2019; 9:913. [PMID: 31608227 PMCID: PMC6761325 DOI: 10.3389/fonc.2019.00913] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 09/02/2019] [Indexed: 12/13/2022] Open
Abstract
Angiogenesis, or generation of new blood vessels from other pre-existing, is a key process to maintain the supply of nutrients and oxygen in tissues. Unfortunately, this process is exacerbated in pathologies such as retinopathies and cancers with high angiogenesis as ovarian cancer. Angiogenesis is regulated by multiple systems including growth factors and neurotrophins. One of the most studied angiogenic growth factors is the vascular endothelial growth factor (VEGF), which is overexpressed in several cancers. It has been recently described that neurotrophins could regulate angiogenesis through direct and indirect mechanisms. Neurotrophins are a family of proteins that include nerve growth factor (NGF), brain-derived growth factor (BDNF), and neurotrophins 3 and 4/5 (NT 3, NT 4/5). These molecules and their high affinity receptors (TRKs) regulate the development, maintenance, and plasticity of the nervous system. Furthermore, it was recently described that they display essential functions in non-neuronal tissues, such as reproductive organs among others. Studies have shown that several types of cancer overexpress neurotrophins such as NGF and BDNF, which might contribute to tumor progression and angiogenesis. Besides, in recent years the FDA has approved the use of pharmacologic inhibitors of pan-TRK receptors in patients with TRKs fusion-positive cancers. In this review, we discuss the mechanisms by which neurotrophins stimulate tumor progression and angiogenesis, with emphasis on gynecological cancers.
Collapse
Affiliation(s)
- Maritza P Garrido
- Laboratory of Endocrinology and Reproductive Biology, Hospital Clínico Universidad de Chile, Santiago, Chile.,Departamento de Obstetricia y Ginecología, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Ignacio Torres
- Laboratory of Endocrinology and Reproductive Biology, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Margarita Vega
- Laboratory of Endocrinology and Reproductive Biology, Hospital Clínico Universidad de Chile, Santiago, Chile.,Departamento de Obstetricia y Ginecología, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Carmen Romero
- Laboratory of Endocrinology and Reproductive Biology, Hospital Clínico Universidad de Chile, Santiago, Chile.,Departamento de Obstetricia y Ginecología, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| |
Collapse
|
31
|
Chan Wah Hak C, Coyle C, Kocache A, Short D, Sarwar N, Seckl MJ, Gonzalez MA. Emergency Etoposide-Cisplatin (Em-EP) for patients with germ cell tumours (GCT) and trophoblastic neoplasia (TN). BMC Cancer 2019; 19:770. [PMID: 31382912 PMCID: PMC6683367 DOI: 10.1186/s12885-019-5968-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 07/22/2019] [Indexed: 11/10/2022] Open
Abstract
Background Etoposide (E) at 100 mg/m2 combined with Cisplatin (P) at 20 mg/m2 represents an induction 2-day regimen embedded in our clinical practice for patients with advanced GCT or TN at high risk of early death. We evaluated 24/7 Em-EP administration to a combined GCT-TN cohort at our Emergency Cancer Treatment Centre (ECTC) to determine its efficacy within the acute setting. Methods Patients who received Em-EP during a five-year interval were identified from electronic databases at Imperial College Healthcare NHS Trust. Data collected included demographics, treatment details and clinical outcome. Results Em-EP was administered in the emergency setting to 104 patients, predominantly young adults (median age 35, range 17–71). Half the cases were GCT (n = 52): 22 male (6 seminomas, 13 non-seminomas); 30 female (2 dysgerminomas, 28 non-dysgerminomas). The other 50% were treated for TN (n = 52): 45 gestational (GTN) and 7 non-gestational. Most patients received Em-EP for a new cancer diagnosis (n = 100, 96%), within 24 h (n = 93, 89%) and out-of-hours (n = 74, 70%). Indications for Em-EP included symptomatic disease (n = 66, 63%), high-burden disease, (n = 51, 49%) and organ failure requiring Intensive Care Unit support (n = 9, 9%). Neutropenic sepsis was observed in 5%. Four-week overall survival after Em-EP administration was 98%. Conclusions Despite the potentially fatal complications encountered in the acute setting, early mortality with Em-EP is low at our ECTC. Specialist units that treat unwell patients with advanced GCT or TN should consider making Em-EP available 24/7 for emergency administration. Its efficacy within a prospective cohort and in other platinum-sensitive malignancies requires evaluation. Electronic supplementary material The online version of this article (10.1186/s12885-019-5968-7) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Charleen Chan Wah Hak
- Department of Medical Oncology, Imperial College Healthcare National Health Service Trust, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK.
| | - Christopher Coyle
- Department of Medical Oncology, Imperial College Healthcare National Health Service Trust, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
| | - Arwa Kocache
- Department of Medical Oncology, Imperial College Healthcare National Health Service Trust, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
| | - Dee Short
- Department of Medical Oncology, Imperial College Healthcare National Health Service Trust, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
| | - Naveed Sarwar
- Department of Medical Oncology, Imperial College Healthcare National Health Service Trust, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
| | - Michael J Seckl
- Department of Medical Oncology, Imperial College Healthcare National Health Service Trust, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
| | - Michael A Gonzalez
- Department of Medical Oncology, Imperial College Healthcare National Health Service Trust, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
| |
Collapse
|
32
|
Shen X, Zhu W. Long non-coding RNA LINC01627 is a prognostic risk factor for epithelial ovarian cancer. Oncol Lett 2019; 18:2861-2868. [PMID: 31452765 PMCID: PMC6704277 DOI: 10.3892/ol.2019.10661] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Accepted: 05/30/2019] [Indexed: 12/17/2022] Open
Abstract
Ovarian malignancies are commonly diagnosed cancers of the female reproductive system. Recent studies have revealed that long non-coding RNAs (lncRNAs) can regulate a variety of oncological processes. In the present study, ovarian cancer expression datasets were searched in the GEO database using the GPL570 platform. Differential lncRNA expression between normal ovarian tissues and ovarian tumors were analyzed using the R package 'limma', and patient prognosis was accessed using the package 'survival'. Four databases, GSE14001, GSE18520, GSE38666 and GSE40595, were used for the analysis. A total of 64 lncRNAs were highly expressed and 4 were downregulated within these four databases. Prognostic analysis of the 68 lncRNAs in the four databases was performed, and revealed that the expression of long intergenic non-protein coding RNA 1627 (LINC01627) was negatively associated with patient prognosis in GSE19829 and GSE62193; there was no association between LINC01627 expression and patient's prognosis in GSE18520 or GSE63885. To investigate the proposed association between LINC01627 and patient prognosis, meta-analysis revealed that the total hazard ratio was 1.38 and the 95% confidence interval was between 1.04 and 1.83. Subgroup analysis revealed that LINC01627 may predict patient prognosis in high-grade, advanced and serous epithelial ovarian cancer, which was a risk factor for prognosis. Further assessment was performed in clinical samples and ovarian cancer cells, where the knockdown of LINC01627 inhibited the proliferative and migratory capacities of HO8910 and HEY cells. Collectively, the present results suggested that lncRNA LINC01627 may serve an oncogenic role in the development of epithelial ovarian tumors.
Collapse
Affiliation(s)
- Xiaoqing Shen
- Department of Gynecology and Obstetrics, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215004, P.R. China
| | - Weipei Zhu
- Department of Gynecology and Obstetrics, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215004, P.R. China
| |
Collapse
|
33
|
The Role of Epithelial-to-Mesenchymal Plasticity in Ovarian Cancer Progression and Therapy Resistance. Cancers (Basel) 2019; 11:cancers11060838. [PMID: 31213009 PMCID: PMC6628067 DOI: 10.3390/cancers11060838] [Citation(s) in RCA: 149] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 06/03/2019] [Accepted: 06/12/2019] [Indexed: 12/12/2022] Open
Abstract
Ovarian cancer is the most lethal of all gynecologic malignancies and the eighth leading cause of cancer-related deaths among women worldwide. The main reasons for this poor prognosis are late diagnosis; when the disease is already in an advanced stage, and the frequent development of resistance to current chemotherapeutic regimens. Growing evidence demonstrates that apart from its role in ovarian cancer progression, epithelial-to-mesenchymal transition (EMT) can promote chemotherapy resistance. In this review, we will highlight the contribution of EMT to the distinct steps of ovarian cancer progression. In addition, we will review the different types of ovarian cancer resistance to therapy with particular attention to EMT-mediated mechanisms such as cell fate transitions, enhancement of cancer cell survival, and upregulation of genes related to drug resistance. Preclinical studies of anti-EMT therapies have yielded promising results. However, before anti-EMT therapies can be effectively implemented in clinical trials, more research is needed to elucidate the mechanisms leading to EMT-induced therapy resistance.
Collapse
|
34
|
Deuster E, Mayr D, Hester A, Kolben T, Zeder-Göß C, Burges A, Mahner S, Jeschke U, Trillsch F, Czogalla B. Correlation of the Aryl Hydrocarbon Receptor with FSHR in Ovarian Cancer Patients. Int J Mol Sci 2019; 20:ijms20122862. [PMID: 31212758 PMCID: PMC6628023 DOI: 10.3390/ijms20122862] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 06/04/2019] [Accepted: 06/06/2019] [Indexed: 11/16/2022] Open
Abstract
Expression of the aryl hydrocarbon receptor (AhR) has been described in various tumor entities from different organs. However, its role in ovarian cancer has not been thoroughly investigated. We aimed to elucidate the prognostic impact of AhR, its correlation with the follicle-stimulating hormone receptor (FSHR), and their functional role in ovarian cancer. By immunohistochemistry, AhR staining was analyzed in a subset of 156 samples of ovarian cancer patients. AhR staining was assessed in the nucleus and the cytoplasm using the semi-quantitative immunoreactive score (IRS), and the scores were grouped into high- and low-level expression. AhR expression was detected in all histological subtypes, with clear cell ovarian cancer displaying the highest staining intensity. Low cytoplasmic expression of AhR was associated with longer overall survival (median 183.46 vs. 85.07 months; p = 0.021). We found a positive correlation between AhR and FSHR (p = 0.005). Ovarian cancer patients with high cytoplasmic AhR and concurrent FSHR expression had the worst outcome (median 69.72 vs. 43.32 months; p = 0.043). Consequently, low cytoplasmic AhR expression seems to be associated with improved survival in ovarian cancer patients. Our data suggest that AhR and FSHR levels correlate with each other, and their concurrent expression was observed in ovarian cancer patients with the worst outcome. Further investigation of the interaction of both receptors and their functional role might better predict the impact of endocrine therapy in ovarian cancer.
Collapse
Affiliation(s)
- Eileen Deuster
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany.
| | - Doris Mayr
- Institute of Pathology, Faculty of Medicine, LMU Munich, 81377 Munich, Germany.
| | - Anna Hester
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany.
| | - Thomas Kolben
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany.
| | - Christine Zeder-Göß
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany.
| | - Alexander Burges
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany.
| | - Sven Mahner
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany.
| | - Udo Jeschke
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany.
| | - Fabian Trillsch
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany.
| | - Bastian Czogalla
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany.
| |
Collapse
|
35
|
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.
Collapse
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
| | | | | |
Collapse
|
36
|
van Walree IC, van Soolingen NJ, Hamaker ME, Smorenburg CH, Louwers JA, van Huis-Tanja LH. Treatment decision-making in elderly women with ovarian cancer: an age-based comparison. Int J Gynecol Cancer 2019; 29:158-165. [DOI: 10.1136/ijgc-2018-000026] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 08/13/2018] [Accepted: 09/06/2018] [Indexed: 12/27/2022] Open
Abstract
ObjectiveTo investigate treatment choices and outcomes in women with ovarian cancer, comparing elderly (≥75 years) and younger patients (<75 years).MethodsA single-center retrospective analysis of patients diagnosed with ovarian cancer between 2010 and 2015. The initial treatment plan and course of treatment were extracted from medical files.ResultsOf 128 included patients, 34% were aged ≥75 years. The initial treatment plan consisted of the combination of cytoreductive surgery and platinum-based doublet chemotherapy (ie, standard treatment) in only 10% of the elderly patients with an indication for this treatment. 5% of these patients completed this treatment without adaptations (compared with 85% and 48%, respectively, in younger patients). 38% of the elderly patients with an indication for cytoreductive surgery and chemotherapy received best supportive care only. Patient preference was an important reason to withhold standard treatment. Surgery- and chemotherapy-related complications and hospital admissions did not differ between groups. Median survival was lower in the elderly (p=0.002) and in patients receiving best supportive care (p<0.001).ConclusionsElderly patients were less frequently treated in accordance with the treatment guideline. To select those older patients who may benefit from (adapted) treatment is challenging. Future studies should evaluate determinants associated with treatment completion to improve outcomes in this vulnerable population.
Collapse
|
37
|
Vitale SG, Capriglione S, Zito G, Lopez S, Gulino FA, Di Guardo F, Vitagliano A, Noventa M, La Rosa VL, Sapia F, Valenti G, Rapisarda AMC, Peterlunger I, Rossetti D, Laganà AS. Management of endometrial, ovarian and cervical cancer in the elderly: current approach to a challenging condition. Arch Gynecol Obstet 2018; 299:299-315. [PMID: 30542793 DOI: 10.1007/s00404-018-5006-z] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 12/05/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE Gynaecological cancer management in older people represents a current challenge. Therefore, in the present paper, we aimed to gather all the evidence reported in the literature concerning gynecological cancers in the elderly, illustrating the state of art and the future perspectives. METHODS We searched MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials, IBECS, BIOSIS, Web of Science, SCOPUS and Grey literature (Google Scholar; British Library) from January 1952 to May 2017, using the terms "ovarian cancer", "endometrial cancer", "cervical cancer", "gynecological cancers" combined with 'elderly', 'cancer', 'clinical trial' and 'geriatric assessment'. RESULTS The search identified 81 citations, of which 65 were potentially relevant after initial evaluation and met the criteria for inclusion and were analyzed. We divided all included studies into three different issue: "Endometrial cancer", "Ovarian cancer" and "Cervical cancer". CONCLUSIONS The present literature review shows that, in spite of the higher burden of comorbidities, elderly patients can also benefit from standard treatment to manage their gynecological cancers. It is important to overcome the common habit of undertreating the elderly patients because they are more fragile and with a lower life expectancy than their younger counterpart. Further trials with elderly women are warranted.
Collapse
Affiliation(s)
- Salvatore Giovanni Vitale
- Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Via Consolare Valeria 1, 98125, Messina, Italy
| | - Stella Capriglione
- Department of Obstetrics and Gynecology, Istituto per la Sicurezza Sociale, 47893, Cailungo-Borgo Maggiore, Republic of San Marino.
| | - Gabriella Zito
- Department of Obstetrics and Gynecology, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Via dell'Istria 65/1, 34137, Trieste, Italy
| | - Salvatore Lopez
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, 06520, USA.,Department of Experimental and Clinical Medicine, Magna Graecia University, 88100, Catanzaro, Italy
| | | | - Federica Di Guardo
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Via Tindaro 2, 95124, Catania, Italy
| | - Amerigo Vitagliano
- Department of Woman and Child Health, University of Padua, Via Giustiniani 3, 35128, Padua, Italy
| | - Marco Noventa
- Department of Woman and Child Health, University of Padua, Via Giustiniani 3, 35128, Padua, Italy
| | - Valentina Lucia La Rosa
- Unit of Psychodiagnostics and Clinical Psychology, University of Catania, Via Santa Sofia 78, 95124, Catania, Italy
| | - Fabrizio Sapia
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Via Santa Sofia 78, 95124, Catania, Italy
| | - Gaetano Valenti
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Via Santa Sofia 78, 95124, Catania, Italy
| | - Agnese Maria Chiara Rapisarda
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Via Santa Sofia 78, 95124, Catania, Italy
| | - Isabel Peterlunger
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Ospedale di Cattinara, Strada di Fiume 447, 34149, Trieste, Italy
| | - Diego Rossetti
- Unit of Gynecology and Obstetrics, Desenzano del Garda Hospital, Section of Gavardo, Via A. Gosa 74, 25085, Gavardo, Brescia, Italy
| | - Antonio Simone Laganà
- Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Via Consolare Valeria 1, 98125, Messina, Italy
| |
Collapse
|
38
|
O'Neill D, Pounds R, Vella J, Singh K, Yap J. The diagnostic conundrum of chronic ectopic pregnancy: A case report. Case Rep Womens Health 2018; 20:e00086. [PMID: 30505696 PMCID: PMC6251942 DOI: 10.1016/j.crwh.2018.e00086] [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: 10/02/2018] [Revised: 10/24/2018] [Accepted: 10/26/2018] [Indexed: 12/22/2022] Open
Abstract
Chronic ectopic pregnancy (CEP) is a rare condition caused by implantation of trophoblastic tissue in the fallopian tube, which causes protracted tissue destruction at the site of attachment. The process of minor rupture and bleeding results in chronic inflammation, giving rise to a haematocele which often resembles a pelvic mass. Unlike ectopic pregnancy, the level of serum human chorionic gonadotropin (hCG) in patients with CEP is usually low or undetectable as chorionic villi are generally sparse. Therefore, CEP often poses a specific diagnostic challenge for clinicians, as both biochemical markers and imaging modalities are unreliable in its diagnosis. Nevertheless, in cases where serum bhCG is significantly elevated in the presence of a large pelvic mass, the possibility of a malignant ovarian germ cell tumour (MOGCT) must be considered and investigated appropriately. Here, we present a rare case of a young woman who was referred to a gynaecological cancer centre with an acute abdomen for the treatment of MOGCT but was subsequently diagnosed with CEP following laparotomy. In our case report, we highlight the diagnostic conundrum of CEP and MOGCT and discuss the surgical challenges both these conditions pose, especially as many of these women are young and desire fertility preservation. Chronic ectopic pregnancy is a differential diagnosis in women with a complex adnexal mass. It may present with low or raised hCG. Differentiation between it and germ cell tumour can be challenging. Management involves surgical excision following radiological imaging. Follow up is required until normalisation of hCG.
Collapse
Affiliation(s)
- Danielle O'Neill
- Birmingham Cancer Research UK Cancer Centre, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Rachel Pounds
- Birmingham Cancer Research UK Cancer Centre, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Josefa Vella
- Department of Histopathology, Birmingham Women's NHS Foundation Trust, Mindelsohn Way, Edgbaston, Birmingham B15 2TG, UK
| | - Kavita Singh
- Pan Birmingham Gynaecological Cancer Centre, City Hospital, Dudley Road, B18 7QH, UK
| | - Jason Yap
- Birmingham Cancer Research UK Cancer Centre, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, B15 2TT, UK.,Pan Birmingham Gynaecological Cancer Centre, City Hospital, Dudley Road, B18 7QH, UK
| |
Collapse
|
39
|
Cioffi R, Bergamini A, Rabaiotti E, Petrone M, Pella F, Ferrari D, Mangili G, Candiani M. Neoadjuvant chemotherapy in high-risk ovarian cancer patients: Role of age. TUMORI JOURNAL 2018; 105:168-173. [PMID: 30157707 DOI: 10.1177/0300891618792468] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To review a single-center clinical experience with neoadjuvant chemotherapy (NACT) in a population of frail epithelial ovarian cancer (EOC) patients and investigate the prognostic role of advanced age. METHODS We retrospectively reviewed clinical data from 102 advanced EOC patients treated with NACT and presenting high perioperative risk. Patients were divided into 2 groups: group A, including patients aged 70 years or older; and group B, including patients below 70 years old. Univariate and multivariate analyses were performed to compare survival and prognostic factors for survival between the two groups. RESULTS Forty-two patients (41.2%) were older than 70 years. Elderly patients were more likely to present comorbidities ( p = 0.0001), poor performance status ( p = 0.04), and multiple indications for NACT ( p = 0.03). They showed a reduced response to NACT, since only 64% of elderly patients underwent surgical debulking (98.3% vs 64.3%, p = 0.001) and, among these, half of them were optimally debulked (79.3% vs 50%, p = 0.01). Median progression-free survival (PFS) and overall survival (OS) were significantly lower in group A (respectively, 9 vs 13 months, p = 0.005, and 21 vs 29 months, p = 0.01). Advanced age, IV stage, presence of ascites, and residual disease >1 cm were significantly associated with a lower PFS. However, when analyzing factors associated with OS, the only significant ones were higher American Society of Anesthesiologists score and residual disease >1 cm. CONCLUSIONS Age was not found to be a prognostic factor for survival. This highlights the necessity of validated geriatric assessment tools predicting functional age and treatment tolerability to avoid undertreatment of elderly patients.
Collapse
Affiliation(s)
- Raffaella Cioffi
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alice Bergamini
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Emanuela Rabaiotti
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Micaela Petrone
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesca Pella
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Davide Ferrari
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giorgia Mangili
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Candiani
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| |
Collapse
|
40
|
Li Z, Sun Q, Huang X, Zhang J, Hao J, Li Y, Zhang S. The Efficacy of Radiofrequency Hyperthermia Combined with Chemotherapy in the Treatment of Advanced Ovarian Cancer. Open Med (Wars) 2018; 13:83-89. [PMID: 29876524 PMCID: PMC5984478 DOI: 10.1515/med-2018-0013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 02/07/2018] [Indexed: 02/05/2023] Open
Abstract
This study investigated the effect of radiofrequency hyperthermia combined with chemotherapy in the treatment of advanced ovarian cancer. METHODS Seventy-five patients with advanced ovarian cancer were grouped into observation (n = 36) and control (n = 37) groups according to different treatment methods. The age of the patients in the control and the experimental groups were (55 + 11) and (53 + 12) years old, respectively. The control group was received chemotherapy alone (paclitaxel + cisplatin chemotherapy), and on the basis of systemic chemotherapy, the observation group was administered therapy in conjunction with abdominal pelvic radiofrequency hyperthermia. RESULTS The tumor remission rate, ascites, serum CA125 levels, pain control, quality of life enhancement, III+IV bone marrow suppression and improvement of gastrointestinal reaction in the observation group were better than those of the control group (all P< 0.05). CONCLUSION Radiofrequency hyperthermia combined with chemotherapy in the treatment of advanced ovarian cancer has significantly improved the tumor remission rate, ascite control and CA125 levels, and substantially reduced the gastrointestinal reaction and bone marrow suppression rate, which is worthy of intensive clinical application.
Collapse
Affiliation(s)
- Zhihui Li
- Department of Obstetrics and Gynecology Affiliated Hospital of Beihua University, Jilin, 132000, China
| | - Qinge Sun
- Department of Gynecology Weihai Municipal Hospital, Shandong, 264200, China
| | - Xiaoyan Huang
- Department of Gynecology Weihai Municipal Hospital, Shandong, 264200, China
| | - Jianzhong Zhang
- Department of Gynecology Weihai Municipal Hospital, Shandong, 264200, China
| | - Jing Hao
- Department of Gynecology Weihai Municipal Hospital, Shandong, 264200, China
| | - Yue Li
- Department of Gynecology Weihai Municipal Hospital, Shandong, 264200, China
| | - Shihong Zhang
- Department of Obstetrics and Gynecology Affiliated Hospital of Beihua University, Jilin, 132000, China
| |
Collapse
|
41
|
Chen F, Shen J, Wang J, Cai P, Huang Y. Clinical analysis of four serum tumor markers in 458 patients with ovarian tumors: diagnostic value of the combined use of HE4, CA125, CA19-9, and CEA in ovarian tumors. Cancer Manag Res 2018; 10:1313-1318. [PMID: 29861641 PMCID: PMC5968799 DOI: 10.2147/cmar.s155693] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Purpose To investigate the diagnostic values of human epididymis protein 4 (HE4), carbohydrate antigen 125 (CA125), carbohydrate antigen 19-9 (CA19-9), and carcinoembryonic antigen (CEA) for ovarian tumors. Methods The participants were divided into three groups: 386 healthy women (control group), 262 patients with benign ovarian tumors (the benign group), and 196 patients with malignant pelvic tumors (the malignant group). The serum levels of HE4, CA125, CA19-9, and CEA were analyzed by electrochemiluminescent immunoassay. Results It showed that serum levels of HE4, CA125, CA19-9, and CEA of patients with malignant ovarian tumors were significantly higher than those in the control group and benign group (P<0.01). HE4 had a high specificity (96.56%) in malignant ovarian tumors. The tumor markers HE4, CA125, CA19-9, and CEA had a sensitivity of 63.78%, 62.75%, 35.71%, and 38.78%, respectively. The combined use of two or more tumor markers (parallel test) had a higher diagnostic sensitivity but lower specificity than a single tumor marker. The combined efficiency of HE4 and CA125 was the highest, with a sensitivity and specificity of 80.10% and 69.08%, respectively. HE4 and CA125 combined with the Risk of Ovarian Malignancy Algorithm provided an efficient means of screening and diagnosis of ovarian malignancies. The diagnostic sensitivity increased to 88.52% when three or four tumor markers were used but showed no significant difference compared with the combination of HE4 and CA125 (P>0.05). Conclusion The combination of three or four tumor markers did not improve the diagnostic efficacy when compared with the combination of HE4 and CA125.
Collapse
Affiliation(s)
- Fawen Chen
- Department of Clinical Laboratory, Fujian Provincial Hospital South Branch.,Department of Blood Transfusion
| | - Jing Shen
- Department of Clinical Laboratory, Fujian Provincial Hospital, Provincial Clinical College of Fujian Medical University, Fuzhou, People's Republic of China
| | - Jianwei Wang
- Department of Clinical Laboratory, Fujian Provincial Hospital South Branch
| | - Pengwei Cai
- Department of Clinical Laboratory, Fujian Provincial Hospital South Branch
| | - Yi Huang
- Department of Clinical Laboratory, Fujian Provincial Hospital, Provincial Clinical College of Fujian Medical University, Fuzhou, People's Republic of China
| |
Collapse
|
42
|
Trends in net survival from ovarian cancer in six European Latin countries: results from the SUDCAN population-based study. Eur J Cancer Prev 2018; 26 Trends in cancer net survival in six European Latin Countries: the SUDCAN study:S107-S113. [PMID: 28005613 DOI: 10.1097/cej.0000000000000302] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
European Latin countries have some similarities in their health systems. It is thus interesting to look at their differences in cancer survival (here, ovarian cancer) through monitoring of specific indicators of quality care. The aim of this SUDCAN collaborative study was to compare the trends in 1 and 5-year net survival from ovarian cancer and the trends in the excess mortality rates between six European Latin countries (Belgium, France, Italy, Portugal, Spain and Switzerland). The data were extracted from the EUROCARE-5 database. First, the net survival was studied over the 2000-2004 period using the Pohar-Perme estimator. For trend analyses, the study period was specific to each country. The results are reported from 1992 to 2004 in France, Italy, Spain and Switzerland, and from 2000 to 2004 in Belgium and Portugal. The analyses were carried out using a flexible excess rate modelling. Over the period 2000-2004, there were slight differences in the 5-year age-standardized net survivals from ovarian cancer; they ranged from 36% in Spain to 42% in Belgium. Net survival was much higher in young than in old age groups, but this difference was more marked in Spain and less marked in France. Between 1992 and 2004, the net survival increased in all countries, mainly in young and middle-aged women. However, the differences in 5-year net survival between these countries were larger in 2004 than in 1992. Slight differences were observed in survival from ovarian cancer between the six European Latin countries. A considerable improvement in survival was observed in all countries, especially in young and middle-aged women. This study highlights the need for further monitoring of ovarian cancer outcomes.
Collapse
|
43
|
Timmermans M, Sonke GS, Van de Vijver KK, van der Aa MA, Kruitwagen RFPM. No improvement in long-term survival for epithelial ovarian cancer patients: A population-based study between 1989 and 2014 in the Netherlands. Eur J Cancer 2017; 88:31-37. [PMID: 29179135 DOI: 10.1016/j.ejca.2017.10.030] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 10/20/2017] [Accepted: 10/28/2017] [Indexed: 12/30/2022]
Abstract
AIM This study investigates changes in therapy and long-term survival for patients with epithelial ovarian cancer (EOC) in the Netherlands. METHODS All patients with EOC, including peritoneal and fallopian tube carcinoma, diagnosed in the Netherlands between 1989 and 2014 were selected from the Netherlands Cancer Registry. Changes in therapy were studied and related to overall survival (OS) using multivariable Cox regression models. RESULTS A total of 32,540 patients were diagnosed with EOC of whom 22,047 (68%) had advanced stage disease. In early stage, lymph node dissection as part of surgical staging procedures increased over time from 4% in 1989-1993 to 62% in 2009-2014 (P < 0.001). In advanced stage, the number of patients receiving optimal treatment with surgery and chemotherapy increased from 55% in 1989-1993 to 67% in 2009-2014 (P < 0.001). Five-year survival rates improved in both early stage (74% versus 79%) and advanced stage (16% versus 24%) as well as in all patients combined (31% versus 34%). Ten-year survival rates, however, slightly improved in early stage (62% versus 67%) and advanced stage (10% versus 13%) but remained essentially unchanged at 24% for all patients combined. CONCLUSION Despite intensified treatment and staging procedures, long-term survival for women with EOC has not improved in the last 25 years. The observed improvements in 5-year OS reflect a more prolonged disease control rather than better chances for cure. Furthermore, the apparent better long-term outcome, when early and advanced stage patients are analysed separately, is largely due to improved staging procedures and the ensuing stage migration. These effects disappear in a combined analysis of all patients.
Collapse
Affiliation(s)
- M Timmermans
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands; GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.
| | - G S Sonke
- Division of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - K K Van de Vijver
- Divisions of Diagnostic Oncology and Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - M A van der Aa
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - R F P M Kruitwagen
- GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands; Department of Obstetrics and Gynaecology, Maastricht University Medical Centre, Maastricht, The Netherlands
| |
Collapse
|
44
|
Vermeulen CKM, Tadesse W, Timmermans M, Kruitwagen RFPM, Walsh T. Only complete tumour resection after neoadjuvant chemotherapy offers benefit over suboptimal debulking in advanced ovarian cancer. Eur J Obstet Gynecol Reprod Biol 2017; 219:100-105. [PMID: 29078115 DOI: 10.1016/j.ejogrb.2017.10.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 10/14/2017] [Accepted: 10/17/2017] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The aim of this study was to compare surgical results and survival outcome of advanced ovarian cancer patients who were treated with primary versus interval debulking surgery. STUDY DESIGN In this retrospective study stage III and IV ovarian cancer patients who received debulking surgery from 2006 to 2015 were included. Surgical results were described as complete, optimal or suboptimal debulking and chi-square test was used to assess significant differences. Overall survival was measured using Kaplan-Meier curves, the log-rank test and uni- and multivariable Cox regression analyses. RESULTS Of 146 patients included in the study, 55 patients were treated with primary debulking surgery (PDS) followed by adjuvant chemotherapy and 91 patients received neoadjuvant chemotherapy (NAC) followed by interval debulking surgery (IDS). Complete or optimal debulking (0-10mm of residual disease) was achieved in 76.4% (n=42) of the PDS group and in 79.1% (n=72) of the IDS group. Overall median survival was 38 months for PDS and 31 months for IDS, which was not significantly different (p=0.181). In the IDS group, a significant difference was found in OS between complete and optimal resection (p=0.013). Besides that, no difference in survival outcome was found in the IDS group between patients with optimal or suboptimal debulking (median survival were 20 and 19 months respectively). CONCLUSION Complete debulking surgery is of utmost importance, both in case of PDS and IDS. Achieving optimal interval debulking of 1-10mm residual disease did not show any survival benefit over suboptimal interval debulking.
Collapse
Affiliation(s)
- Carolien K M Vermeulen
- Department of Gynaecologic Oncology, Mater Misericordiae University Hospital, Dublin, Ireland; Department of Obstetrics and Gynaecology, Maastricht University Medical Centre, Maastricht, The Netherlands, The Netherlands.
| | - Workineh Tadesse
- Department of Gynaecologic Oncology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Maite Timmermans
- Department of Obstetrics and Gynaecology, Maastricht University Medical Centre, Maastricht, The Netherlands, The Netherlands; GROW, School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands; Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Roy F P M Kruitwagen
- Department of Obstetrics and Gynaecology, Maastricht University Medical Centre, Maastricht, The Netherlands, The Netherlands; GROW, School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Tom Walsh
- Department of Gynaecologic Oncology, Mater Misericordiae University Hospital, Dublin, Ireland
| |
Collapse
|
45
|
Bartakova A, Michalova K, Presl J, Vlasak P, Kostun J, Bouda J. CD44 as a cancer stem cell marker and its prognostic value in patients with ovarian carcinoma. J OBSTET GYNAECOL 2017; 38:110-114. [PMID: 28816557 DOI: 10.1080/01443615.2017.1336753] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The aim of our study was to clarify whether the CD44 adhesion molecule as a cancer stem cell marker could also serve as a prognostic factor in patients with epithelial ovarian cancer (EOC). A retrospective study was performed on 87 patients with histologically verified EOC. Specimens of both primary tumour and implantation metastases were tested from 48 of them. CD44 expression was detected by immunohistochemistry. We looked for the cut-off levels of CD44 expression using the Cox regression model. We confirmed statistically significant prognostic factors for overall survival (OS) and disease-free interval (DFI) to be: stage of the disease, postoperative residual tumour and papillary serous histological type. We demonstrated a statistically significant correlation between low CD44 expression and serous papillary carcinoma histotype, tumour recurrence and chemoresistance at a value below 2%. CD44 was neither a prognostic factor of OS nor of DFI. IMPACT STATEMENT What is already known about this subject: Epithelial ovarian cancer is the second most common gynaecological cancer in developed countries. Despite great efforts devoted to ovarian cancer research during past decades, levels of patient mortality have changed very little. Cancer stem cells (CSCs) are subpopulations of cells with typical characteristics of stem cells - i.e. the ability to self-renew and differentiate in a variety of cell types. The main surface marker typical for CSCs is CD44. The aim of our study was to clarify whether the CD44 as a CSCs marker could serve as a prognostic factor in patients with epithelial ovarian cancer. Previous studies published on this topic revealed controversial results. The novelty of our study lies in looking for the cut-off using the Cox regression model. WHAT THIS STUDY ADDS We demonstrated a statistically significant correlation between low CD44 expression and serous papillary carcinoma histotype, tumour recurrence and chemoresistance at a value below 2%, however, CD44 was neither a prognostic factor of overall survival nor of disease-free interval. We propose to investigate other markers including other CSCs as a prognostic factors or potential aims for targeted therapy in ovarian cancer.
Collapse
Affiliation(s)
- Alena Bartakova
- a Department of Gynaecology and Obstetrics , University Hospital Pilsen, Charles University , Prague , Czech Republic
| | - Kveta Michalova
- b Sikl's Department of Pathology , University Hospital Pilsen, Charles University , Prague , Czech Republic
| | - Jiri Presl
- a Department of Gynaecology and Obstetrics , University Hospital Pilsen, Charles University , Prague , Czech Republic
| | - Pavel Vlasak
- a Department of Gynaecology and Obstetrics , University Hospital Pilsen, Charles University , Prague , Czech Republic
| | - Jan Kostun
- a Department of Gynaecology and Obstetrics , University Hospital Pilsen, Charles University , Prague , Czech Republic
| | - Jiri Bouda
- a Department of Gynaecology and Obstetrics , University Hospital Pilsen, Charles University , Prague , Czech Republic
| |
Collapse
|
46
|
Alsina-Sanchís E, Figueras A, Lahiguera A, Gil-Martín M, Pardo B, Piulats JM, Martí L, Ponce J, Matias-Guiu X, Vidal A, Villanueva A, Viñals F. TGFβ Controls Ovarian Cancer Cell Proliferation. Int J Mol Sci 2017; 18:ijms18081658. [PMID: 28758950 PMCID: PMC5578048 DOI: 10.3390/ijms18081658] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 07/17/2017] [Accepted: 07/24/2017] [Indexed: 12/15/2022] Open
Abstract
There have been no major improvements in the overall survival of ovarian cancer patients in recent decades. Even though more accurate surgery and more effective treatments are available, the mortality rate remains high. Given the differences in origin and the heterogeneity of these tumors, research to elucidate the signaling pathways involved is required. The Transforming Growth Factor (TGFβ) family controls different cellular responses in development and cell homeostasis. Disruption of TGFβ signaling has been implicated in many cancers, including ovarian cancer. This article considers the involvement of TGFβ in ovarian cancer progression, and reviews the various mechanisms that enable the TGFβ signaling pathway to control ovarian cancer cell proliferation. These mechanistic explanations support the therapeutic use of TGFβ inhibitors in ovarian cancer, which are currently in the early phases of development.
Collapse
Affiliation(s)
- Elisenda Alsina-Sanchís
- Program Against Cancer Therapeutic Resistance (ProCURE), Institut Català d'Oncologia, Hospital Duran i Reynals, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
| | - Agnès Figueras
- Program Against Cancer Therapeutic Resistance (ProCURE), Institut Català d'Oncologia, Hospital Duran i Reynals, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
| | - Alvaro Lahiguera
- Program Against Cancer Therapeutic Resistance (ProCURE), Institut Català d'Oncologia, Hospital Duran i Reynals, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
| | - Marta Gil-Martín
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
- Medical Oncology Department, Institut Català d'Oncologia, Hospital Duran i Reynals, IDIBELL, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
| | - Beatriz Pardo
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
- Medical Oncology Department, Institut Català d'Oncologia, Hospital Duran i Reynals, IDIBELL, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
| | - Josep M Piulats
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
- Medical Oncology Department, Institut Català d'Oncologia, Hospital Duran i Reynals, IDIBELL, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
| | - Lola Martí
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
- Gynaecologic Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
| | - Jordi Ponce
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
- Gynaecologic Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
| | - Xavier Matias-Guiu
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
- Servei d'Anatomia Patològica, Hospital Universitari de Bellvitge, CIBERONC, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
| | - August Vidal
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
- Servei d'Anatomia Patològica, Hospital Universitari de Bellvitge, CIBERONC, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
- Xenopat, Carrer de la Feixa Llarga S/N, L'Hospitalet de Llobregat, 08907 Barcelona, Spain.
- Departament de Patologia i Terapèutica Experimental, Universitat de Barcelona, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
| | - Alberto Villanueva
- Program Against Cancer Therapeutic Resistance (ProCURE), Institut Català d'Oncologia, Hospital Duran i Reynals, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
- Xenopat, Carrer de la Feixa Llarga S/N, L'Hospitalet de Llobregat, 08907 Barcelona, Spain.
| | - Francesc Viñals
- Program Against Cancer Therapeutic Resistance (ProCURE), Institut Català d'Oncologia, Hospital Duran i Reynals, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
- Departament de Ciències Fisiològiques, Universitat de Barcelona, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
| |
Collapse
|
47
|
Aloesin Suppresses Cell Growth and Metastasis in Ovarian Cancer SKOV3 Cells through the Inhibition of the MAPK Signaling Pathway. Anal Cell Pathol (Amst) 2017; 2017:8158254. [PMID: 28702312 PMCID: PMC5494088 DOI: 10.1155/2017/8158254] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 04/18/2017] [Indexed: 12/30/2022] Open
Abstract
Aloesin is an active constituent of the herb aloe vera and plays a crucial role in anti-inflammatory activity, ultraviolet protection, and antibacterium. We investigated the role and possible mechanisms of aloesin in the cell growth and metastasis of ovarian cancer. It was found that aloesin inhibited cell viability and cell clonality in a dose-dependent manner. It arrests the cell cycle at the S-phase and induced apoptosis in SKOV3 cells. In an in vivo experiment, it was observed that aloesin inhibited tumor growth. Moreover, it inhibited migration and invasion of cancer in SKOV3 cells. Interestingly, members from the mitogen-activated protein kinase (MAPK) signaling family became less phosphorylated as the aloesin dose increased. This suggests that aloesin exerts its anticancer effect through the MAPK signaling pathway. Our data also highlights the possibility of using aloesin as a novel therapeutic drug for ovarian cancer treatment.
Collapse
|
48
|
Matz M, Coleman MP, Sant M, Chirlaque MD, Visser O, Gore M, Allemani C. The histology of ovarian cancer: worldwide distribution and implications for international survival comparisons (CONCORD-2). Gynecol Oncol 2017; 144:405-413. [PMID: 27931752 PMCID: PMC6195192 DOI: 10.1016/j.ygyno.2016.10.019] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 10/12/2016] [Accepted: 10/14/2016] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Ovarian cancers comprise several histologically distinct tumour groups with widely different prognosis. We aimed to describe the worldwide distribution of ovarian cancer histology and to understand what role this may play in international variation in survival. METHODS The CONCORD programme is the largest population-based study of global trends in cancer survival. Data on 681,759 women diagnosed during 1995-2009 with cancer of the ovary, fallopian tube, peritoneum and retroperitonum in 51 countries were included. We categorised ovarian tumours into six histological groups, and explored the worldwide distribution of histology. RESULTS During 2005-2009, type II epithelial tumours were the most common. The proportion was much higher in Oceania (73.1%), North America (73.0%) and Europe (72.6%) than in Central and South America (65.7%) and Asia (56.1%). By contrast, type I epithelial tumours were more common in Asia (32.5%), compared with only 19.4% in North America. From 1995 to 2009, the proportion of type II epithelial tumours increased from 68.6% to 71.1%, while the proportion of type I epithelial tumours fell from 23.8% to 21.2%. The proportions of germ cell tumours, sex cord-stromal tumours, other specific non-epithelial tumours and tumours of non-specific morphology all remained stable over time. CONCLUSIONS The distribution of ovarian cancer histology varies widely worldwide. Type I epithelial, germ cell and sex cord-stromal tumours are generally associated with higher survival than type II tumours, so the proportion of these tumours may influence survival estimates for all ovarian cancers combined. The distribution of histological groups should be considered when comparing survival between countries and regions.
Collapse
Affiliation(s)
- Melissa Matz
- Cancer Survival Group, London School of Hygiene & Tropical Medicine, London, UK.
| | - Michel P Coleman
- Cancer Survival Group, London School of Hygiene & Tropical Medicine, London, UK
| | - Milena Sant
- Department of Preventive and Predictive Medicine, Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Maria Dolores Chirlaque
- Department of Epidemiology, Regional Health Council, IMIB, Arrixaca, Murcia, Spain, CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain, Department of Health and Social Sciences, Murcia University, Murcia, Spain
| | - Otto Visser
- Department of Registration, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | - Martin Gore
- The Royal Marsden NHS Foundation Trust, London, UK
| | - Claudia Allemani
- Cancer Survival Group, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
49
|
Matz M, Coleman MP, Carreira H, Salmerón D, Chirlaque MD, Allemani C. Worldwide comparison of ovarian cancer survival: Histological group and stage at diagnosis (CONCORD-2). Gynecol Oncol 2017; 144:396-404. [PMID: 27919574 PMCID: PMC6195190 DOI: 10.1016/j.ygyno.2016.11.019] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 10/21/2016] [Accepted: 11/12/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Ovarian cancer comprises several histological groups with widely differing levels of survival. We aimed to explore international variation in survival for each group to help interpret international differences in survival from all ovarian cancers combined. We also examined differences in stage-specific survival. METHODS The CONCORD programme is the largest population-based study of global trends in cancer survival, including data from 60 countries for 695,932 women (aged 15-99years) diagnosed with ovarian cancer during 1995-2009. We defined six histological groups: type I epithelial, type II epithelial, germ cell, sex cord-stromal, other specific non-epithelial and non-specific morphology, and estimated age-standardised 5-year net survival for each country by histological group. We also analysed data from 67 cancer registries for 233,659 women diagnosed from 2001 to 2009, for whom information on stage at diagnosis was available. We estimated age-standardised 5-year net survival by stage at diagnosis (localised or advanced). RESULTS Survival from type I epithelial ovarian tumours for women diagnosed during 2005-09 ranged from 40 to 70%. Survival from type II epithelial tumours was much lower (20-45%). Survival from germ cell tumours was higher than that of type II epithelial tumours, but also varied widely between countries. Survival for sex-cord stromal tumours was higher than for the five other groups. Survival from localised tumours was much higher than for advanced disease (80% vs. 30%). CONCLUSIONS There is wide variation in survival between histological groups, and stage at diagnosis remains an important factor in ovarian cancer survival. International comparisons of ovarian cancer survival should incorporate histology.
Collapse
Affiliation(s)
- Melissa Matz
- Cancer Survival Group, London School of Hygiene & Tropical Medicine, London, UK.
| | - Michel P Coleman
- Cancer Survival Group, London School of Hygiene & Tropical Medicine, London, UK
| | - Helena Carreira
- Cancer Survival Group, London School of Hygiene & Tropical Medicine, London, UK
| | - Diego Salmerón
- Department of Epidemiology, Regional Health Council, IMIB, Arrixaca, Murcia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Health and Social Sciences, Murcia University, Murcia, Spain
| | - Maria Dolores Chirlaque
- Department of Epidemiology, Regional Health Council, IMIB, Arrixaca, Murcia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Health and Social Sciences, Murcia University, Murcia, Spain
| | - Claudia Allemani
- Cancer Survival Group, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
50
|
Long Noncoding RNA MIR4697HG Promotes Cell Growth and Metastasis in Human Ovarian Cancer. Anal Cell Pathol (Amst) 2017; 2017:8267863. [PMID: 28168162 PMCID: PMC5259593 DOI: 10.1155/2017/8267863] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Accepted: 10/26/2016] [Indexed: 12/19/2022] Open
Abstract
Ovarian cancer is one of the three most common gynecological malignant tumors worldwide. The prognosis of patients suffering from this malignancy remains poor because of limited therapeutic strategies. Herein, we investigated the role of a long noncoding RNA named MIR4697 host gene (MIR4697HG) in the cell growth and metastasis of ovarian cancer. Results showed that the transcriptional level of MIR4697HG in cancerous tissues increased twofold compared with that in adjacent noncancerous tissues. MIR4697HG was differentially expressed in ovarian cancer cell lines, with the highest levels in OVCAR3 and SKOV3 cells. MIR4697HG knockdown by specific shRNA significantly inhibited cell proliferation and colony formation in both OVCAR3 and SKOC3 cells. Consistently, in a xenograft model of ovarian cancer, MIR4697HG depletion also significantly restricted tumor volumes and weights. Furthermore, MIR4697HG knockdown inhibited cell migration and invasion capacities. Invasion ability was inhibited by 58% in SKOV3 cells and 40% in OVCAR3 cells, and migration ability was inhibited by 73% in SKOV3 cells and 62% in OVCAR3 cells after MIR4697HG knockdown. MIR4697HG knockdown also caused a decrease in matrix metalloprotease-9, phosphorylated ERK, and phosphorylated AKT. These data suggested that MIR4697HG promoted ovarian cancer growth and metastasis. The aggressive role of MIR4697HG in ovarian cancer may be related to the ERK and AKT signaling pathways.
Collapse
|