741P Immune features of high-grade ovarian cancer associated with exceptional disease free survival (DFS): An analysis from VIVROVAIRE, a GINECO/GINEGEPS study

ObjectiveRecently it has been demonstrated that constitutively activated signal transducer and activator of transcription 1 (STAT1) gene expression may act as a biomarker of ovarian cancer chemotherapy response. In this study, our objective was to validate the use of STAT1 immunohistochemistry as a prognostic biomarker for disease outcome using a cohort derived from Latin America.MethodsWe evaluated a cohort of Brazilian high-grade serous ovarian cancer, comprising 65 patients with outcome data covering more than 5 years to determine the prognostic and predictive value of STAT1 expression levels. High-grade serous ovarian cancer tumors were used to construct a tissue microarray. Exploratory analyses were conducted on clinical, histopathological, and STAT1 expression data that included descriptive statistics and Pearson correlative analyses. Survival curves for disease-free survival and overall survival were obtained by the Kaplan-Meier method, and the significance of homogeneity between the classes was assessed by log-rank statistics (Mantel-Cox).ResultsHigh expression of STAT1 in tumors was significantly associated with improved disease-free survival (P = 0.0256) and overall survival (P = 0.0193). Proportional hazards regression analysis showed STAT1 expression had an independent effect on both disease-free survival (P = 0.0358) and overall survival (P = 0.0469).ConclusionsThese findings from a Brazilian cohort of patients with ovarian cancer reinforce the association of high STAT1 expression with better response to chemotherapy, providing additional validation of this protein as both a prognostic and predictive biomarker. Collectively, these results together with other recently published studies increase the feasibility of using the STAT1 pathway for the development of novel immunomodulator drugs that could enhance response to treatment.

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Validation of a clinicopathological score for the prediction of post-surgical evolution of pituitary adenoma: retrospective analysis on 566 patients from a tertiary care centre

Acta Endocrinologica ◽

10.1530/eje-18-0749 ◽

2019 ◽

Vol 180 (2) ◽

pp. 127-134 ◽

Cited By ~ 19

Author(s):

S Asioli ◽

A Righi ◽

M Iommi ◽

C Baldovini ◽

F Ambrosi ◽

...

Keyword(s):

Pituitary Adenomas ◽

Proliferative Activity ◽

Disease Free Survival ◽

Low Grade ◽

High Grade ◽

Tumour Type ◽

Disease Evolution ◽

Free Survival ◽

Disease Free

Objective and design A clinicopathological score has been proposed by Trouillas et al. to predict the evolution of pituitary adenomas. Aim of our study was to perform an independent external validation of this score and identify other potential predictor of post-surgical outcome. Methods The study sample included 566 patients with pituitary adenomas, specifically 253 FSH/LH-secreting, 147 GH-secreting, 85 PRL-secreting, 72 ACTH-secreting and 9 TSH-secreting tumours with at least 3-year post-surgical follow-up. Results In 437 cases, pituitary adenomas were non-invasive, with low (grade 1a: 378 cases) or high (grade 1b: 59 cases) proliferative activity. In 129 cases, tumours were invasive, with low (grade 2a: 87 cases) or high (grade 2b: 42 cases) proliferative activity. During the follow-up (mean: 5.8 years), 60 patients developed disease recurrence or progression, with a total of 130 patients with pituitary disease at last follow-up. Univariate analysis demonstrated a significantly higher risk of disease persistence and recurrence/progression in patients with PRL-, ACTH- and FSH/LH-secreting tumours as compared to those with somatotroph tumours, and in those with high proliferative activity (grade 1b and 2b) or >1 cm diameter. Multivariate analysis confirmed tumour type and grade to be independent predictors of disease-free-survival. Tumour invasion, Ki-67 and tumour type were the only independent prognostic factors of disease-free survival. Conclusions Our data confirmed the validity of Trouillas’ score, being tumour type and grade independent predictors of disease evolution. Therefore, we recommend to always consider both features, together with tumour histological subtype, in the clinical setting to early identify patients at higher risk of recurrence.

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Increased circulating tumor DNA as a noninvasive biomarker of early treatment response in patients with metastatic ovarian carcinoma: A pilot study

Tumor Biology ◽

10.1177/1010428320919198 ◽

2020 ◽

Vol 42 (5) ◽

pp. 101042832091919 ◽

Cited By ~ 1

Author(s):

Mariana Cartaxo Alves ◽

Fernando Luiz Affonso Fonseca ◽

Alayne Magalhães Trindade Domingues Yamada ◽

Lílian Arruda do Rego Barros ◽

André Lopes ◽

...

Keyword(s):

Ovarian Cancer ◽

Ovarian Carcinoma ◽

Systemic Treatment ◽

Disease Free Survival ◽

Advanced Ovarian Cancer ◽

Early Response ◽

Circulating Tumor Dna ◽

Free Survival ◽

Disease Free ◽

Tumor Dna

Detection of circulating tumor DNA is a new noninvasive technique with potential roles in diagnostic, follow-up, and prognostic evaluation of patients with many types of solid tumors. We aimed to evaluate the role of circulating tumor DNA in the setting of metastatic ovarian carcinoma. A prospective cohort of patients with metastatic ovarian cancer who were referred to systemic therapy was enrolled. Blood samples were collected before the start of treatment and monthly thereafter for 6 months. Circulating tumor DNA was quantified by real-time quantitative reverse transcription polymerase chain reaction of different lengths of Arthrobacter luteus elements as described by Umetani et al. A total of 11 patients were included, 2 for primary disease and 9 for recurrent disease. After the first cycle of chemotherapy, patients whose circulating tumor DNA levels increased from baseline were more likely to respond to chemotherapy than those whose circulating tumor DNA levels did not increase (p = 0.035). Furthermore, patients whose circulating tumor DNA levels rose after the first cycle of chemotherapy also had improved disease-free survival compared to those whose circulating tumor DNA levels did not increase (p = 0.0074). We conclude that the increase in circulating tumor DNA values collected in peripheral blood after the first cycle of systemic treatment in patients with advanced ovarian cancer is associated with an early response to systemic treatment and correlates with superior disease-free survival in this population. Circulating tumor DNA might be a specific, noninvasive, and cost-effective new biomarker of early response to systemic treatment in these patients.

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49. 1-, 5- and 10-year high-grade disease-free survival after laser ablation of biopsy proven AIN2/3: outcomes from a single centre prospective cohort

Sexual Health ◽

10.1071/shv10n6ab49 ◽

2013 ◽

Vol 10 (6) ◽

pp. 594

Author(s):

Sanjaya Wijeyekoon ◽

John Thornhill ◽

Mayura Nathan

Keyword(s):

Laser Ablation ◽

Laser Treatment ◽

Prospective Cohort ◽

Disease Free Survival ◽

Study Entry ◽

High Grade ◽

Free Survival ◽

Sex With Men ◽

One Year ◽

Disease Free

Objective To describe the characteristics and overall high-grade disease-free survival of 153 consecutive patients treated by laser ablation of biopsy proven high-grade anal neoplasia over an 18.5-year period. Design: Prospective cohort study. Study entry was at the first laser treatment for biopsy proven AIN 2/3. Outcome measures: The principal outcome was high-grade disease-free survival time. High-grade disease-free survival was defined as the time from entry into the cohort to the date of next laser treatment for biopsy-proven high-grade disease. Patients who did not have recurrent high-grade disease at their most recent clinic assessment were censored. Results: Data were evaluated for 153 consecutive patients who were treated by laser ablation of anal high-grade (AIN 2/3) disease between January 1996 and July 2013. These constituted 240 separate treatment episodes over 18.5 years. The majority of subjects were men (91.5%), 44.1% were smokers and 86.3% were classified as men who have sex with men (MSM). At the study entry 64.7% were HIV positive. The median high-grade disease-free survival was 716.5 days (range 11–4730). One year overall high-grade disease-free survival was 77.7% (95% CI 71.7–82.5). Five-year overall high-grade disease-free survival was 51.4% (43.6–58.5). The 10-year overall high-grade disease-free survival was 49.1% (40.5–57.1). There was no difference in high-grade disease-free survival when stratified by HIV positivity status (P = 0.394–log rank). Conclusions: Following laser ablation, recurrence of high-grade disease was low at 1, 5 and 10 years. There was no difference in disease-free survival based on HIV status.

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Interval Debulking Surgery After Neodjuvant Chemotherapy Vs Primary Debulking Surgery For Stage Iii Epithelial Ovarian Carcinoma

Tumori Journal ◽

10.1177/0300891620914135 ◽

2020 ◽

Vol 106 (1_suppl) ◽

pp. 15-15

Author(s):

BM Ahmed ◽

AT Amin ◽

MK Khallaf ◽

A Ahmed Refaat ◽

SA Sileem

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Disease Free Survival ◽

Figo Stage ◽

Stage Iii ◽

Debulking Surgery ◽

Free Survival ◽

Primary Debulking Surgery ◽

Interval Debulking Surgery ◽

Disease Free

Introduction: Ovarian cancer is the most lethal gynecologic malignancy and is the fifth most common cause of cancer-related death among women. Approach to FIGO stage III epithelial ovarian cancer remains challengeable. This study aims to evaluate the outcome of interval debulking surgery (IDS) vs. primary debulking surgery (PDS) for FIGO stage III epithelial ovarian cancer. Materials and Methods: During a period of six years (January 2014 to December 2019), we analyzed the patients for eligibility criteria, which were: (1) FIGO stage III epithelial ovarian cancer. (2) The age of 18 years or more (3) Patients underwent either PDS or IDS and received chemotherapy at South Egypt Cancer Institute. We divided them into two groups: (1) Those received three cycles of neoadjuvant chemotherapy and then underwent IDS plus three additional cycles of adjuvant chemotherapy and (2) Those who have PDS followed by six cycles of chemotherapy. Results: This study includes 380 eligible patients. The first group included 226 patients (59.47%) underwent PDS then 6 cycles of chemotherapy, while the group of IDS included 154 patients (40.53%). The treatment modality was not significant for overall survival (OS); however disease-free survival (DFS) was significantly reduced after IDS when compared to PDS (median DFS: 33 months; 95% CI 30.23-35.77 vs. 45 months; 95% CI 41.25-48.75 respectively; p= .000). Moreover, in subgroup analysis, OS and DFS were significantly dropped after IDS in elderly patients, patients with bad performance status, sub-optimal cytoreduction as well as high grade and undifferentiated tumors when compared to those who underwent PDS. Conclusion: Although treatment modality may not impact overall survival (OS), however, PDS results in a better disease-free survival than IDS. Moreover, IDS results in a significant drop in OS and DFS in special patients subgroups when compared to PDS. Therefore patients selection should be considered.

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Evaluating high-grade prostatic intraepithelial neoplasia as a predictor of outcome following radical prostatectomy

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.4612 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 4612-4612

Author(s):

P. M. Pierorazio ◽

S. M. Lambert ◽

T. R. McCann ◽

A. E. Katz ◽

C. A. Olsson ◽

...

Keyword(s):

Radical Prostatectomy ◽

Perineural Invasion ◽

Disease Free Survival ◽

Intraepithelial Neoplasia ◽

High Grade ◽

Free Survival ◽

Pathologic Stage ◽

Significant Difference ◽

The Relationship ◽

Disease Free

4612 Background: The presence of high-grade prostatic intraepithelial neoplasia (HGPIN) has been associated with future development of prostate cancer. High-grade intraepithelial neoplasia in other malignancies is associated with adverse outcome. This study examines the relationship between the presence of HGPIN in prostatectomy specimens, biochemical disease free survival (bDFS) and other cancer specific outcomes following radical retropubic prostatectomy (RRP). Methods: The Columbia University Urologic Oncology Database was reviewed and 2,522 were identified who had undergone radical prostatectomy from 1988 to 2005; 2,133 patients with or without HGPIN were included. Two-sample proportion analysis of means with 95% confidence intervals and ANOVA techniques were used to evaluate the relationship between HGPIN and pathologic stage, Gleason sum, perineural invasion, multifocality, extracapsular extension (ECE), margin status, and nodal status. Kaplan-Meier analysis with log-rank test and a multivariate Cox proportional hazard model controlling for preoperative PSA, Gleason sum and pathologic stage were used to assess differences in bDFS. Results: 1,885 of 2,133 (88.4%) patients demonstrated HGPIN. There was no significant difference in the distribution of pathologic stage or Gleason sum between the patients with and without HGPIN. The HGPIN-positive group had higher rates of perineural invasion (69.9 vs. 57.5%; p = 0.003), multifocality (63.0 vs. 38.4%; p = 0.000) and ECE (56.4% vs. 48.4%; p = 0.059). There was no statistically significant difference observed in nodal status or margin status between the two groups. Patients without HGPIN had an increased bDFS demonstrated by a predicted disease free survival of 73.6% versus 67.0% at 9 years (p = 0.045) with a median follow-up of 50 months. In the multivariate Cox hazard model HGPIN, PSA, Gleason sum and pathologic stage were validated as independent predictors of failure (p < 0.001). The risk of failure was 1.9 × greater in the HGPIN-positive group than the HGPIN-negative group (p=0.006). Conclusions: The presence of HGPIN in the radical prostatectomy specimen denotes a significantly higher rate of tumor multifocality, perineural invasion, ECE, and ultimately biochemical recurrence. No significant financial relationships to disclose.

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Outcome in Advanced Ovarian Cancer following an Appropriate and Comprehensive Effort at Upfront Cytoreduction: A Twenty-Year Experience in a Single Cancer Institute

International Journal of Surgical Oncology ◽

10.1155/2010/214919 ◽

2010 ◽

Vol 2010 ◽

pp. 1-8 ◽

Cited By ~ 2

Author(s):

Anne Marszalek ◽

Séverine Alran ◽

Suzy Scholl ◽

Virginie Fourchotte ◽

Corinne Plancher ◽

...

Keyword(s):

Ovarian Cancer ◽

Overall Survival ◽

Prognostic Factor ◽

Surgical Procedure ◽

Menopausal Status ◽

Disease Free Survival ◽

Tumor Type ◽

Free Survival ◽

The Impact ◽

Disease Free

Objectives. The purpose of this retrospective evaluation of advanced-stage ovarian cancer patients was to compare outcome with published findings from other centers and to discuss future options for the management of advanced ovarian carcinoma patients.Methods. A retrospective series of 340 patients with a mean age of 58 years (range: 17–88) treated for FIGO stage III and IV ovarian cancer between January 1985 and January 2005 was reviewed. All patients had primary cytoreductive surgery, without extensive bowel, peritoneal, or systematic lymph node resection, thereby allowing initiation of chemotherapy without delay. Chemotherapy consisted of cisplatin-based chemotherapy in combination with alkylating agents before 2000, whereas carboplatin and paclitaxel regimes were generally used after 1999-2000. Overall survival and disease-free survival were analyzed by the Kaplan-Meier method and the log-rank test.Results. With a mean followup of 101 months (range: 5 to 203), 280 events (recurrence or death) were observed and 245 patients (72%) had died. The mortality and morbidity related to surgery were low. The main prognostic factor for overall survival was postoperative residual disease (P<.0002), while the main prognostic factor for disease-free survival was histological tumor type (P<.0007). Multivariate analysis identified three significant risk factors: optimal surgery (RR=2.2for suboptimal surgery), menopausal status (RR=1.47for postmenopausal women), and presence of a taxane in the chemotherapy combination (RR=0.72).Conclusion. These results confirm that optimal surgery defined by an appropriate and comprehensive effort at upfront cytoreduction limits morbidity related to the surgical procedure and allows initiation of chemotherapy without any negative impact on survival. The impact of neoadjuvant chemotherapy to improve resectability while lowering the morbidity of the surgical procedure is discussed.

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