Malignant Melanoma of the Vulva FIGO Stage I: Evaluation of Prognostic Factors in 43 Patients with Emphasis on DNA Ploidy and Surgical Treatment

ObjectivesTo assess the effects on relative survival of established and new prognostic factors in stage I–III grade 1–3 endometrioid endometrial carcinoma and in the subgroup of stage I grade 1–2.MethodsThis was a population-based, retrospective study including all women (n=1113) in the western Swedish healthcare region diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage I–III grade 1–3 endometrioid endometrial carcinoma in 2006–2011. Histology, grade, stage, and age were prospectively reported to the regional clinical and national cancer registers. DNA ploidy and S-phase fraction were analyzed by flow cytometer. S-phase fraction cut-off was set at ≥8%. Tumor biopsies were classified as diploid if there was one G0/G1 peak or the DNA index was 1.0±0.04. Overexpression of p53 as determined by immunohistochemistry was positive if strong nuclear staining was found in >30% of the neoplastic cells.ResultsBased on univariable statistical analyses we found that 5-year relative survival was significantly associated with S-phase fraction, DNA ploidy, p53, stage, grade, and age. Excess mortality for S-phase fraction ≥8%, aneuploidy, and p53 overexpression was 8, 14, and 8 and times higher, respectively. However, in a multivariable regression model, adjusted for stage, grade, and age, S-phase fraction, DNA ploidy, and p53 were not statistically independent prognostic factors (p=0.413, p=0.107, p=0.208, respectively) for 5-year relative survival in stage I–III grade 1–3 endometrioid endometrial carcinoma. In a subgroup analysis of stage I grade 1–2, aneuploidy identified a subgroup with impaired 5-year relative survival.ConclusionWe can conclude that S-phase fraction, DNA ploidy, and p53 overexpression did not improve identification of high-risk patients by stage, grade, and age in stage I–III endometrioid endometrial carcinoma. In stage I, aneuploidy and grade 2 predicted lower relative survival rates than other variables.

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Surgical Treatment in FIGO Stage I Cervical Cancer: Evolution of Concepts

Current Women s Health Reviews ◽

10.2174/1573404810703020129 ◽

2007 ◽

Vol 3 (2) ◽

pp. 129-137

Author(s):

Francesco Raspagliesi ◽

Antonino Ditto ◽

Francesco Hanozet ◽

Fabio Martinelli ◽

Eugenio Solima ◽

...

Keyword(s):

Cervical Cancer ◽

Surgical Treatment ◽

Figo Stage ◽

Stage I ◽

Cancer Evolution

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Exploration of interactions between prognostic factors of stage I malignant melanoma

Melanoma Research ◽

10.1097/00008390-199608000-00007 ◽

1996 ◽

Vol 6 (4) ◽

pp. 319-324 ◽

Cited By ~ 1

Author(s):

U. Helfenstein ◽

G. Schiiler ◽

M. Bopp ◽

S. Morf ◽

D. Schüler

Keyword(s):

Prognostic Factors ◽

Malignant Melanoma ◽

Stage I

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Prognostic Factors in Early-Stage Leiomyosarcoma of the Uterus

International Journal of Gynecological Cancer ◽

10.1111/igc.0b013e3181a1bfbc ◽

2009 ◽

Vol 19 (3) ◽

pp. 385-390 ◽

Cited By ~ 40

Author(s):

Manuela Pelmus ◽

Frédérique Penault-Llorca ◽

Louis Guillou ◽

Françoise Collin ◽

Gérard Bertrand ◽

...

Keyword(s):

Prognostic Factors ◽

Prognostic Factor ◽

Vascular Invasion ◽

Early Stage ◽

Prognostic Significance ◽

Figo Stage ◽

Stage I ◽

Free Interval ◽

Important Prognostic Factor ◽

Pathologic Features

Uterine leiomyosarcomas (LMSs) are rare cancers representing less than 1% of all uterine malignancies. Clinical International Federation of Gynecology and Obstetrics (FIGO) stage is the most important prognostic factor. Other significant prognostic factors, especially for early stages, are difficult to establish because most of the published studies have included localized and extra-pelvian sarcomas. The aim of our study was to search for significant prognostic factors in clinical stage I and II uterine LMS. The pathologic features of 108 uterine LMS including 72 stage I and II lesions were reviewed using standardized criteria. The prognostic significance of different pathologic features was assessed. The median follow-up in the whole group was 64 months (range, 6-223 months). The 5-year overall survival (OS) and metastasis-free interval and local relapse-free interval rates in the whole group and early-stage group (FIGO stages I and II) were 40% and 57%, 42% and 50%, 56% and 62%, respectively. Clinical FIGO stage was the most important prognostic factor for OS in the whole group (P = 4 × 10−15). In the stage I and II group, macroscopic circumscription was the most significant factor predicting OS (P = 0.001). In the same group, mitotic score and vascular invasion were associated with metastasis-free interval (P = 0.03 and P = 0.04, respectively). Uterine LMSs diagnosed using standardized criteria have a poor prognosis, and clinical FIGO stage is an ominous prognostic factor. In early-stage LMS, pathologic features such as mitotic score, vascular invasion, and tumor circumscription significantly impact patient outcome.

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Comparison of Results with CO2 Laser and Traditional Surgical Treatment of Stage I Malignant Melanoma

Tumori Journal ◽

10.1177/030089168707300207 ◽

1987 ◽

Vol 73 (2) ◽

pp. 127-130 ◽

Cited By ~ 4

Author(s):

Umberto Maria Reali ◽

Eleonora Donati ◽

Roberto Quercetani ◽

Carlo Ciardi ◽

Cristina Chiarugi

Keyword(s):

Surgical Treatment ◽

Malignant Melanoma ◽

Co2 Laser ◽

Laser Surgery ◽

Treated Group ◽

Healing Time ◽

Stage I ◽

Surgical Methods ◽

Negative Effect

The follow-up data on 39 cases of stage I malignant melanoma treated with CO2 laser are compared to those of an analogous group of cases treated by traditional surgical methods and selected for their clinical and pathologic similarities with the laser-treated group. The findings were expressed in terms of tumor-free time and were evaluated by variance analysis. The data showed that traditional methods gave better results. CO2 laser surgery requires longer healing time, which may have a negative effect on the course of the disease.

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Prophylactic lymph node dissection in clinical stage I cutaneous malignant melanoma: Results of surgical treatment in 1319 patients

British Journal of Surgery ◽

10.1002/bjs.1800690217 ◽

1982 ◽

Vol 69 (2) ◽

pp. 108-111 ◽

Cited By ~ 134

Author(s):

G. W. Milton ◽

H. M. Shaw ◽

W. H. McCarthy ◽

L. Pearson ◽

C. M. Balch ◽

...

Keyword(s):

Lymph Node ◽

Surgical Treatment ◽

Malignant Melanoma ◽

Lymph Node Dissection ◽

Clinical Stage ◽

Cutaneous Malignant Melanoma ◽

Stage I ◽

Node Dissection ◽

Prophylactic Lymph Node Dissection

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Significance of morphometric, DNA cytometric features, and other prognostic markers on survival of endometrial cancer patients in northern Norway

International Journal of Gynecological Cancer ◽

10.1136/ijgc-00009577-200201000-00008 ◽

2002 ◽

Vol 12 (1) ◽

pp. 49-56 ◽

Cited By ~ 1

Author(s):

A Ørbo ◽

M Rydningen ◽

B Straume ◽

S Lysne

Keyword(s):

Endometrial Cancer ◽

Cancer Patients ◽

Vascular Invasion ◽

Prognostic Markers ◽

Dna Ploidy ◽

Prognostic Significance ◽

Figo Stage ◽

Stage I ◽

Northern Norway

Abstract.Ørbo A, Rydningen M, Straume B, Lysne S. Significance of morphometric, DNA cytometric features, and other prognostic markers on survival of endometrial cancer patients in northern Norway.The objective of this study was to evaluate the prognostic value of nuclear morphometric features and DNA ploidy by flow cytometry next to depth of myometrial invasion and vascular invasion in endometrial cancer of all FIGO stages.A total of 123 women (103 FIGO stage I, eight stage II, and 12 stage III and IV) from northern Norway were studied. The follow-up period was between 7 and 19 years. The median age of patients was 62 years. The primary surgery was performed in the University Hospital of Tromsø or in the seven different reference hospitals in the northern part of Norway after an endometrial cancer diagnosis. The histologic, morphometric, flowcytometric and immunohistochemical investigations were based on archival paraffin-embedded material. The information regarding the follow-up data and clinical information were obtained from the medical records.Thirteen (10.6%) patients from the entire group (all stages) but only three (2.7%) of the FIGO stage I and II patients died from locally recurrent or metastatic disease. FIGO substage (P = 0.0006; odds ratio [OR] = 16.44, 95% confidence interval [CI] = 3.36–80.45), vascular invasion (P = 0.01, OR = 6.42, CI = 1.57–26.34) and nuclear size (P = 0.025, 0 R = 1.3, CI = 1.05–1.61) were independently correlated with recurrence in a multivariate analysis but histologic grade and DNA ploidy were not. Vascular invasion was poorly reproducible both between and within the same observer, however.In this retrospective study of all stages of endometrial carcinoma with long follow-up periods the primary tumor characteristics nuclear perimeter and FIGO stage were of prognostic significance in addition to the poorly reproducible vessel invasion.

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