Therapeutic Modalities in Early-Stage Uterine Papillary Serous Carcinomas, Carcinosarcomas, Clear-Cell and Mixed Histology Carcinomas: Treatment of Choice Is Combined Chemotherapy and Radiation

ObjectiveThe aim of the study was to examine the patterns of care and the impact of chemotherapy and radiation on survival in women diagnosed with uterine clear cell carcinoma (UCCC). The primary outcomes of this analysis were receipt of treatment within 6 months of diagnosis and overall survival.Methods and MaterialsWomen diagnosed with UCCC from 2003 to 2011 were identified through the National Cancer Data Base. Standard univariate and multivariable analyses with logistic regression were performed. Kaplan-Meier survival analysis was used to generate overall survival data. Factors predictive of outcome were evaluated using the log-rank test and Cox proportional hazards model.ResultsA total of 3212 patients were identified. Chemotherapy, radiation, and combination chemotherapy and radiation were administered in 23.3%, 19.7%, and 11.1% of women, respectively. After adjusting for age, race, socioeconomic status, facility type, stage, surgery, lymph node dissection, comorbidity index, period of diagnosis, and registry location, there was an association between combined chemotherapy and radiation (hazard ratio, 0.74; 95% confidence interval, 0.61–0.90) with improved survival. Adjuvant therapy was not associated with improved survival among patients with early-stage disease (stages I and II). Both chemotherapy and combined chemotherapy and radiation were associated with significantly improved survival among patients with advanced-stage disease (stages III and IV).ConclusionsIn patients with early-stage UCCC, adjuvant therapy was not associated with significantly improved survival. Chemotherapy and combination of chemotherapy and radiation were associated with improved survival in patients with advanced-stage UCCC.

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FS-C4BP (fully-sialylated alpha-chain of complement 4-binding protein) is a novel biomarker that can detect early stage epithelial ovarian cancer, especially clear cell carcinoma

10.26226/morressier.5770e29dd462b80290b4c232 ◽

2016 ◽

Author(s):

Masae Ikeda

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Cell Carcinoma ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Early Stage ◽

Binding Protein ◽

Alpha Chain ◽

Complement 4

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Adjuvant brachytherapy for FIGO stage I serous or clear cell endometrial cancer

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2020-002217 ◽

2021 ◽

pp. ijgc-2020-002217

Author(s):

Elizabeth B Jeans ◽

William G Breen ◽

Trey C Mullikin ◽

Brittany A Looker ◽

Andrea Mariani ◽

...

Keyword(s):

Endometrial Cancer ◽

Clear Cell ◽

Early Stage ◽

Figo Stage ◽

Stage I ◽

High Dose ◽

Vaginal Cuff ◽

Locoregional Failure ◽

Platinum Based Chemotherapy ◽

Increased Risk

ObjectivesOptimal adjuvant treatment for early-stage clear cell and serous endometrial cancer remains unclear. We report outcomes for women with surgically staged International Federation of Gynecology and Obstetrics (FIGO) stage I clear cell, serous, and mixed endometrial cancers following adjuvant vaginal cuff brachytherapy with or without chemotherapy.MethodsFrom April 1998 to January 2020, women with FIGO stage IA–IB clear cell, serous, and mixed endometrial cancer underwent surgery and adjuvant vaginal cuff brachytherapy. Seventy-six patients received chemotherapy. High-dose rate vaginal cuff brachytherapy was planned to a total dose of 21 gray in three fractions using a multichannel vaginal cylinder. The primary objective was to determine the effectiveness of adjuvant vaginal cuff brachytherapy and to identify surgicopathological risk factors that could portend towards worse oncological outcomes.ResultsA total of 182 patients were included in the analysis. Median follow-up was 5.3 years (2.3–12.2). Ten-year survival was 73.3%. Five-year cumulative incidence (CI) of vaginal, pelvic, and para-aortic relapse was 1.4%, 2.1%, and 0.9%, respectively. Five-year locoregional failure, any recurrence, peritoneal relapse, and other distant recurrence was 4.4%, 11.6%, 5.3%, and 6.7%, respectively. On univariate analysis, locoregional failure was worse for larger tumors (per 1 cm) (HR 1.9, 95% CI 1.2 to 3.0, p≤0.01). Any recurrence was worse for tumors of at least 3.5 cm (HR 3.8, 95% CI 1.3 to 11.7, p=0.02) and patients with positive/suspicious cytology (HR 4.4, 95% CI 1.5 to 12.4, p≤0.01). Ten-year survival for tumors of at least 3.5 cm was 56.9% versus 86.6% for those with smaller tumors (HR 2.9, 95% CI 1.4 to 5.8, p≤0.01). Ten-year survival for positive/suspicious cytology was 50.9% versus 77.4% (HR 2.2, 95% CI 0.9 to 5.4, p=0.09). Multivariate modeling demonstrated worse locoregional failure, any recurrence, and survival with larger tumors, as well as any recurrence with positive/suspicious cytology. Subgroup analysis demonstrated improved outcomes with the use of adjuvant chemotherapy in patients with large tumors or positive/suspicious cytology.ConclusionAdjuvant vaginal cuff brachytherapy alone without chemotherapy is an appropriate treatment for women with negative peritoneal cytology and small, early-stage clear cell, serous, and mixed endometrial cancer. Larger tumors or positive/suspicious cytology are at increased risk for relapse and worse survival, and should be considered for additional upfront adjuvant treatments, such as platinum-based chemotherapy.

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Comparison of outcomes in early-stage uterine clear cell carcinoma and serous carcinoma

Brachytherapy ◽

10.1016/j.brachy.2018.08.015 ◽

2019 ◽

Vol 18 (1) ◽

pp. 38-43 ◽

Cited By ~ 3

Author(s):

Minsi Zhang ◽

T. Jonathan Yang ◽

Neil B. Desai ◽

Deborah DeLair ◽

Marisa A. Kollmeier ◽

...

Keyword(s):

Cell Carcinoma ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Early Stage ◽

Serous Carcinoma ◽

Uterine Clear Cell Carcinoma

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Descriptive analysis of 192 cases of breast cancer occurring before age 40 in Yaounde, Cameroon

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20172898 ◽

2017 ◽

Vol 6 (7) ◽

pp. 2704 ◽

Cited By ~ 1

Author(s):

Félix Essiben ◽

Pascal Foumane ◽

Esther JNU Meka ◽

Michèle Tchakounté ◽

Julius Sama Dohbit ◽

...

Keyword(s):

Breast Cancer ◽

Ductal Carcinoma ◽

Early Stage ◽

Descriptive Analysis ◽

Survival Rates ◽

The United States ◽

Therapeutic Modalities ◽

History Of ◽

Case Files ◽

Common Histological Type

Background: Breast cancer is today a global health problem. With 1,671,149 new cases diagnosed in 2012, it is the most common female cancer in the world and accounts for 11.9% of all cancers and it affects more people than prostate cancer. In 2008, The United States statistics showed that, for all cancer that affect women before 40 years, more than 40% of them concerned the breast. The aim of this study was to describe the clinical, histopathological and therapeutic aspects of breast cancer in women under 40 years of age in Yaoundé.Methods: This was a retrospective study with data collected from 192 medical case files of women treated over a period of 12 years, from January 2004 to December 2015 at the Yaounde General Hospital and the Yaounde Gyneco-Obstetric and Pediatric Hospital. Microsoft Epi Info version 3.4.5 and SPSS version 20.0 softwares were used for data analysis.Results: From 2004 to 2015, 1489 cases of breast cancer were treated in both hospitals. Of these, 462 women were less than 40 years old, representing a proportion of 31.0%. The mean age at diagnosis was 33.5±5.0 years and 17.7% of women had a family history of breast cancer. The average time before an initial consultation was 6.7±6.6 months. Most cases were classified as T4 (46.1%). The most common histological type was ductal carcinoma (87.4%). Grades SBR II and SBR III were predominant (76.4%). Axillary dissection (64.4%) and neoadjuvant chemotherapy (43.9%) were the main therapeutic modalities. The overall survival rate at 5 years was 51.2%. Five-year survival rates with no local recurrence and no metastatic occurrence were 35.8% and 43.2% respectively.Conclusions: Breast cancer largely affects women under the age of 40 and is often discovered late, at an advanced stage. The prognosis appears poor. Only screening could facilitate diagnosis at an early stage of the disease for better outcomes.

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Ion Channels: New Actors Playing in Chemotherapeutic Resistance

Cancers ◽

10.3390/cancers11030376 ◽

2019 ◽

Vol 11 (3) ◽

pp. 376 ◽

Cited By ~ 13

Author(s):

Philippe Kischel ◽

Alban Girault ◽

Lise Rodat-Despoix ◽

Mohamed Chamlali ◽

Silviya Radoslavova ◽

...

Keyword(s):

Ion Channels ◽

Molecular Mechanisms ◽

Early Stage ◽

Breast Cancers ◽

Altered Expression ◽

Acquired Drug Resistance ◽

Therapeutic Modalities ◽

Channel Expression ◽

Systemic Agents ◽

Resistance To Chemotherapy

In the battle against cancer cells, therapeutic modalities are drastically limited by intrinsic or acquired drug resistance. Resistance to therapy is not only common, but expected: if systemic agents used for cancer treatment are usually active at the beginning of therapy (i.e., 90% of primary breast cancers and 50% of metastases), about 30% of patients with early-stage breast cancer will have recurrent disease. Altered expression of ion channels is now considered as one of the hallmarks of cancer, and several ion channels have been linked to cancer cell resistance. While ion channels have been associated with cell death, apoptosis and even chemoresistance since the late 80s, the molecular mechanisms linking ion channel expression and/or function with chemotherapy have mostly emerged in the last ten years. In this review, we will highlight the relationships between ion channels and resistance to chemotherapy, with a special emphasis on the underlying molecular mechanisms.

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