miRNAs play important roles in gene regulation, and their dysregulation is associated with many diseases, including epithelial ovarian cancer (EOC). In this study, we determined the expression and ...function of miR-590-3p in EOC. miR-590-3p levels were higher in high-grade carcinoma when compared with low-grade or tumors with low malignant potential. Interestingly, plasma levels of miR-590-3p were significantly higher in patients with EOC than in subjects with benign gynecologic disorders. Transient transfection of miR-590-3p mimics or stable transfection of mir-590 increased cell proliferation, migration, and invasion.
studies revealed that mir-590 accelerated tumor growth and metastasis. Using a cDNA microarray, we identified forkhead box A2 (FOXA2) and versican (VCAN) as top downregulated and upregulated genes by mir-590, respectively. miR-590-3p targeted FOXA2 3' UTR to suppress its expression. In addition, knockdown or knockout of FOXA2 enhanced cell proliferation, migration, and invasion. Overexpression of FOXA2 decreased, whereas knockout of FOXA2 increased VCAN mRNA and protein levels, which was due to direct binding and regulation of the VCAN gene by FOXA2. Interrogation of the TCGA ovarian cancer database revealed a negative relationship between FOXA2 and VCAN mRNA levels in EOC tumors, and high FOXA2/low VCAN mRNA levels in tumors positively correlated with patient survival. Finally, overexpression of FOXA2 or silencing of VCAN reversed the effects of mir-590. These findings demonstrate that miR-590-3p promotes EOC development via a novel FOXA2-VCAN pathway.
Low FOXA2/high VCAN levels mediate the tumor-promoting effects of miR-590-3p and negatively correlate with ovarian cancer survival.
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The aim was to study the incidence and survival of patients with uterine sarcoma diagnosed in the period from 2000 to 2012 based on Surveillance, Epidemiology, and End Results (SEER) database.
All 18 ...registries of the SEER database were used to select cases. We included women aged 30 years or older diagnosed with uterine sarcoma. Histological subtypes were defined as leiomyosarcoma, carcinosarcoma, stromal sarcoma, adenosarcoma, and sarcoma not otherwise specified according to the 2003 World Health Organization classification. Using SEER*Stat software version 8.1.2. We calculated the age-adjusted incidence rates, extent of disease at time of diagnosis, and survival rates with different treatment modalities for white, black, and other races. Univariate and multivariate Cox proportional hazards analysis were done to examine factors affecting survival.
We identified 13,089 patients diagnosed with uterine sarcoma in the period from 2000 to 2012. The age-adjusted incidence rate for patients aged 50 years or older was more than that of younger patients (6.4/10 vs 1.5/10, P < 0.0001). Also, the age-adjusted incidence rate for black women was twice that of white women (7.3/10 vs 3.5/10, P < 0.0001). Carcinosarcoma was the most commonly diagnosed subtype followed by leiomyosarcoma. Women aged 50 years or older had worse survival than those younger than 50 years (hazard ratio, 1.78; 95% confidence interval, 1.64-1.92; P < 0.001). The overall survival of patients who had surgery with radiation was better than those who had surgery alone (hazard ratio, 0.89; 95% confidence interval, 0.83-0.95; P < 0.001). In women with localized disease, surgery was associated with better survival than surgery with radiation (66.4% vs 74.4%, P < 0.00001).
Uterine sarcoma is an aggressive tumor that occurs more in old age and among women of black race. Poor survival was associated with old age, black race, and advanced disease stage. Radiotherapy in patients with localized stage does not improve the survival.
Ovarian cancer is a challenging disease to diagnose and treat effectively with five-year survival rates below 50%. Previous patient experience research in high-income countries highlighted common ...challenges and opportunities to improve survival and quality of life for women affected by ovarian cancer. However, no comparable data exist for low-and middle-income countries, where 70% of women with the disease live. This study aims to address this evidence gap.
This is an observational multi-country study set in low- and middle-income countries. We aim to recruit over 2000 women diagnosed with ovarian cancer across multiple hospitals in 24 countries in Asia, Africa and South America. Country sample sizes have been calculated (n = 70-96 participants /country), taking account of varying national five-year disease prevalence rates. Women within five years of their diagnosis, who are in contact with participating hospitals, are invited to take part in the study. A questionnaire has been adapted from a tool previously used in high-income countries. It comprises 57 multiple choice and two open-ended questions designed to collect information on demographics, women's knowledge of ovarian cancer, route to diagnosis, access to treatments, surgery and genetic testing, support needs, the impact of the disease on women and their families, and their priorities for action. The questionnaire has been designed in English, translated into local languages and tested according to local ethics requirements. Questionnaires will be administered by a trained member of the clinical team.
This study will inform further research, advocacy, and action in low- and middle-income countries based on tailored approaches to the national, regional and global challenges and opportunities. In addition, participating countries can choose to repeat the study to track progress and the protocol can be adapted for other countries and other diseases.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Ovarian cancer (OC) is a common reason for mortality among women. Deep learning has recently proven better performance in predicting OC stages and subtypes. However, most of the state-of-the-art deep ...learning models employ single modality data, which may afford low-level performance due to insufficient representation of important OC characteristics. Furthermore, these deep learning models still lack to the optimization of the model construction, which requires high computational cost to train and deploy them. In this work, a hybrid evolutionary deep learning model, using multi-modal data, is proposed. The established multi-modal fusion framework amalgamates gene modality alongside with histopathological image modality. Based on the different states and forms of each modality, we set up deep feature extraction network, respectively. This includes a predictive antlion-optimized long-short-term-memory model to process gene longitudinal data. Another predictive antlion-optimized convolutional neural network model is included to process histopathology images. The topology of each customized feature network is automatically set by the antlion optimization algorithm to make it realize better performance. After that the output from the two improved networks is fused based upon weighted linear aggregation. The deep fused features are finally used to predict OC stage. A number of assessment indicators was used to compare the proposed model to other nine multi-modal fusion models constructed using distinct evolutionary algorithms. This was conducted using a benchmark for OC and two benchmarks for breast and lung cancers. The results reveal that the proposed model is more precise and accurate in diagnosing OC and the other cancers.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Obesity has long been associated with endometrial cancer. However, there is a paucity of studies addressing the impact of morbid obesity in type II endometrial cancer on oncologic and surgical ...outcomes. In this study, the author retrospectively compared morbid to non-morbid obese in clinico-epidemiologic, surgical, and oncologic outcomes. Both groups were comparable as regards all clinico-epidemiologic parameters. Vaginal involvement, survival, and recurrence were also comparable between the 2 groups. Para-aortic adenopathy and treatment with preoperative therapy were the only significant predictors of DFS. Surgery is feasible with equivalent complications and oncologic outcomes in morbidly obese patients with type II endometrial cancer.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Background
In this retrospective study, we discuss our experience as a large tertiary referral center in Egypt in the management and follow-up of borderline tumors
Patients and methods
This is a ...retrospective cohort study where all patients diagnosed with a borderline ovarian tumor at Oncology Center Mansoura University from November 2014 to June 2020 were included. Demographics, preoperative, operative, postoperative, pathologic, and oncologic follow-up data were retrieved from a prospectively maintained electronic database. The included patients were followed until April 2022.
Results
We included 27 patients with borderline ovarian tumors. The mean age of the study patients was 47.67 ± 16.39 years. The median CA 125 was 33 (6–304 U/ml). Frozen section examination was utilized in 13 patients (48.14%), where a diagnosis of borderline ovarian tumors was revealed in 8 patients. Recurrence was reported in one patient with serous type after approximately 26 months. The most common pathological type in our cohort was the mucinous borderline type reported in 14 patients (51.9%), followed by the serous type reported in 11 patients (40.7%), and the seromucinous type in 1 patient only. Patients with mucinous borderline type were significantly younger (40.083 ± 18.47 vs. 53.73 ± 11.91 years,
p
= 0.028). Interestingly, Cancer Antigen 125 levels were significantly higher in mucinous than serous and seromucinous types 67(16–304) vs. 20(6–294.6) U/ml,
p
= 0.027. On the other hand, the radiological tumor size of serous and seromucinous types was larger than that of the mucinous type 23(19–31) cm vs. 8(5–20) cm,
p
= 0.001. Over a median follow-up period of 58.66 (54.16–63.16) months, only one postoperative mortality was reported, while only one recurrence was reported.
Conclusion
Borderline ovarian tumors still represent a dilemma either in diagnosis or management. A frozen section examination could help to reach a preliminary diagnosis. Total abdominal hysterectomy and bilateral salpingo-oophorectomy are the cornerstone of surgical management; however, fertility-sparing surgery could be a valid option for women desiring fertility.
The current role of lymphadenectomy in early-stage high-risk endometrioid endometrial cancer is to guide further adjuvant treatment according to lymph node status. Whether the procedure has any ...therapeutic role remains controversial. In this study we aimed to investigate the outcome of current practices by performing a population-based retrospective cohort analysis using the US population-derived freely accessible public Surveillance, Epidemiology and End Results program (SEER) database. SEER data from patients with endometrial cancer treated between 2004 and 2012 were accessed online on March 1, 2016. Kaplan-Meier estimators were used to describe the survival distribution and the log-rank (Mantel-Cox) test was used to perform overall and pairwise comparisons of the survival distributions. The cohort included 47,463 patients, 10,288 of whom fulfilled high-risk criteria. A higher lymph node yield count was associated with better overall survival, although the removal of more than 40 lymph nodes did not confer any further survival benefit. The application of pelvic irradiation without lymph node status confirmation did not provide a survival benefit. From this analysis, no evidence of a survival benefit associated with lymphadenectomy was found. However, the current role lymphadenectomy as a staging and guiding tool for further adjuvant treatment was supported. Well-designed prospective randomized trials are required to conclusively determine the prognostic and therapeutic value of lymphadenectomy in patients with high-risk endometrioid endometrial cancers.
For women achieving clinical remission after the completion of initial treatment for epithelial ovarian cancer, 80% with advanced-stage disease will develop recurrence. However, the standard ...treatment of women with recurrent platinum-sensitive diseases remains poorly defined. Secondary (SCS), tertiary (TCS) or quaternary (QCS) cytoreduction surgery for recurrence has been suggested to be associated with increased overall survival (OS). We searched five databases for studies reporting death rate, OS, cytoreduction rates, post-operative morbidity/mortality and diagnostic models predicting complete cytoreduction in a platinum-sensitive disease recurrence setting. Death rates calculated from raw data were pooled based on a random-effects model. Meta-regression/linear regression was performed to explore the role of complete or optimal cytoreduction as a moderator. Pooled death rates were 45%, 51%, 66% for SCS, TCS and QCS, respectively. Median OS for optimal cytoreduction ranged from 16–91, 24–99 and 39–135 months for SCS, TCS and QCS, respectively. Every 10% increase in complete cytoreduction rates at SCS corresponds to a 7% increase in median OS. Complete cytoreduction rates ranged from 9–100%, 35–90% and 33–100% for SCS, TCS and QCS, respectively. Major post-operative thirty-day morbidity was reported to range from 0–47%, 13–33% and 15–29% for SCS, TCS and QCS, respectively. Thirty-day post-operative mortality was 0–6%, 0–3% and 0–2% for SCS, TCS and QCS, respectively. There were two externally validated diagnostic models predicting complete cytoreduction at SCS, but none for TCS and QCS. In conclusion, our data confirm that maximal effort higher order cytoreductive surgery resulting in complete cytoreduction can improve survival.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Background: Obesity is a well-known risk factor for many health problems including endometrial cancer. In addition, it may act as an obstacle to achieving optimal treatment of endometrial cancer and ...may be associated with disease recurrence.
Aim: To explore the impact of obesity on the operative procedure, recurrence of disease and survival in patients with endometrial cancer.
Methods: A retrospective study of 267 patients with endometrial carcinoma who underwent surgery at the Oncology Center-Mansoura University from January 2011 to December 2017. Patients were divided according to their body mass index (BMI) into two groups, Group 1 with a BMI Results: Group 1 included 46 patients and Group 2 included 221. The mean operative time was longer in Group 2 without statistically significant difference. Twenty-two (47.8%) patients in Group 1 and 71 (32.1%) in Group 2 underwent lymphadenectomy (p = 0.062). The estimated blood loss was significantly higher in Group 2 (p < 0.05). No statistically significant difference was found between the two groups regarding the intra or post-operative complications, despite the high incidence of complications in Group 2. The median disease-free survival (DFS) was 74 months in Group 1 vs. 66 months in Group 2. Obesity did not have a statistically significant impact on DFS among the studied cases (p=0.24).
Conclusion: In the current study, obesity did not significantly impact the operative procedure, surgical complications or DFS in patient with endometrial cancer.
Background
Desmoplastic small-round-cell tumor (DSRCT) is an extremely rare and highly aggressive malignancy. It is of yet unclear origin, but it is assumed to be of a mesothelial origin based on its ...tendency for widespread metastasis in serosal linings.
Case presentation
In this report, we describe a young female who presented with bilateral ovarian masses that mimicked the classic clinical picture of ovarian cancer. The patient had a cytoreductive surgery done in the form of total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, pelvic peritonectomy, low para-aortic and bilateral iliac lymphadenectomy. Postoperative course was smooth with no adverse events. The final pathology report revealed desmoplastic small-round-cell tumor. Afterwards, the patient was referred to medical oncologist to receive her adjuvant therapy.
Conclusions
DSRCT is still an unknown disease to us given the limited number of cases and poor survival. Given the lack of clear guidelines, treatment is offered based on the best available evidence and the collaborative effort of a multi-disciplinary team.
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