A new prognostic model for FIGO stage 1 epithelial ovarian cancer

Background: Adjuvant platinum-based chemotherapy improves survival in women with early-stage epithelial ovarian cancer (EOC). Yet, there is a wide variety in clinical practice. Methods: All patients diagnosed with FIGO I and IIa EOC (2006-2010) in the south of the Netherlands were analyzed. The percentage of patients that received adjuvant chemotherapy was determined as well as the comprehensiveness of staging and outcome. Results: Forty percent (54/135) of the patients with early-stage EOC received adjuvant chemotherapy. Treatment with adjuvant chemotherapy was associated with FIGO stage, clear-cell histology and nonoptimal staging. Optimal staging was achieved in 50%, and nonoptimal staging was associated with advanced age, comorbidity and treatment in a non-referral hospital. Overall, there was no difference in outcome between patients with and without adjuvant chemotherapy. Yet, in grade 3 tumors, adjuvant chemotherapy seems beneficial. Conclusions: Selective treatment of patients with early-stage EOC might reduce adjuvant chemotherapy without compromising outcome.

Download Full-text

The FIGO Stage IVA Versus IVB of Ovarian Cancer: Prognostic Value and Predictive Value for Neoadjuvant Chemotherapy

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000001186 ◽

2018 ◽

Vol 28 (3) ◽

pp. 453-458 ◽

Cited By ~ 5

Author(s):

Parvin Tajik ◽

Roelien van de Vrie ◽

Mohammad H. Zafarmand ◽

Corneel Coens ◽

Marrije R. Buist ◽

...

Keyword(s):

Ovarian Cancer ◽

Overall Survival ◽

Neoadjuvant Chemotherapy ◽

Epithelial Ovarian Cancer ◽

Prognostic Value ◽

Median Overall Survival ◽

Stage Iv ◽

Figo Stage ◽

Figo Staging ◽

Stage Ivb

ObjectiveThe revised version of the International Federation of Gynaecology and Obstetrics (FIGO) staging system (2014) for epithelial ovarian cancer includes a number of changes. One of these is the division of stage IV into 2 subgroups. Data on the prognostic and predictive significance of this classification are scarce. The effect of neoadjuvant chemotherapy (NACT) versus primary debulking surgery (PDS) in relation to the subclassification of FIGO stage IV is also unknown.MethodsWe used data of the EORTC 55971 trial, in which 670 patients with previous stage IIIC or IV epithelial ovarian cancer were randomly assigned to PDS or NACT; 160 patients had previous stage IV. Information on previous FIGO staging and presence of pleural effusion with positive cytology were used to classify tumors as either stage IVA or IVB. We tested the association between stage IVA/IVB and survival to evaluate the prognostic value and interactions between stage, treatment, and survival to evaluate the predictive performance.ResultsAmong the 160 participants with previous stage IV disease, 103 (64%) were categorized as stage IVA and 57 (36%) as stage IVB tumors. Median overall survival was 24 months in FIGO stage IVA and 31 months in stage IVB patients (P = 0.044). Stage IVB patients treated with NACT had 9 months longer median overall survival compared with IVB patients undergoing PDS (P = 0.025), whereas in IVA patients, no significant difference was observed (24 vs 26 months, P = 0.48).ConclusionsThe reclassification of FIGO stage IV into stage IVA or IVB was not prognostic as expected. Compared with stage IVA patients, stage IVB patients have a better overall survival and may benefit more from NACT.

Download Full-text

Laboratory cross-comparison of homologous recombination repair mutation analysis in tumor in a multicenter epithelial ovarian cancer series: The BORNEO GEICO 60-0 study.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e17550 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e17550-e17550

Author(s):

Ignacio Romero ◽

Ana Oaknin ◽

Zaida Garcia-Casado ◽

Raul Marquez ◽

Alfonso Yubero Esteban ◽

...

Keyword(s):

Ovarian Cancer ◽

Homologous Recombination ◽

Epithelial Ovarian Cancer ◽

Mutational Analysis ◽

Figo Stage ◽

Parp Inhibitors ◽

Homologous Recombination Repair ◽

Recombination Repair ◽

Class 1 ◽

Uncertain Significance

e17550 Background: In epithelial ovarian cancer (EOC), the identification of mutations in homologous recombination repair (HRR) genes on tumor is prognostic, predictive of response to PARP inhibitors, and a tool to identify individuals at genetic cancer risk. The aim of this study is to compare the concordance between two laboratories in identifying and classifying genetic variants in HRR genes. Methods: In a multicentre ambispective series of unselected, non mucinous EOC of all stages formalin-fixed and paraffin embedded tumors were collected. These samples underwent the same mutational analysis of 15 HRR genes ( ATM, BARD1, BRCA1, BRCA2, BRIP1, CDK12, CHEK1, CHEK2, FANCL, PALB2, PPP2R2A, RAD51B, RAD51C, RAD51D, RAD54L) in two different Laboratories (Lab1, Lab2) that used their own validated multi-gene NGS panels. Variant allele frequency (VAF) threshold was 5% for single nucleotide polymorphism and 10% for indels. Large rearrangements were not analyzed. Variants were classified into three categories based on ACMG criteria: non-mutated (class 1-2), Variants of Uncertain Significance (VUS: class 3) and likely pathogenic/pathogenic (class 4-5). Results: A total of 81 cases were sent for the analysis. One had low DNA quality and therefore 80 cases were finally studied (85% high grade serous and 74% FIGO stage III-IV). Results reported by Lab1 and Lab2 (lab1/Lab2) were the following: 21/19 (26%/24%) cases had BRCA1/2 mutations, 7/8 (8.7%/10%) mutations on other HRR genes including two in ATM and RAD51D, one in CHEK1, CHEK2, and FANCL and one RAD51C reported in Lab2 only while the rest were either VUS 23/27 (29%/34%) or non-mutated 29/26 (36%/33%). Concordance between laboratories in classifying patients was 93.75% (kappa coefficient 0.86). Discrepancies (DC) on variants were classified into arbitrary categories, namely 0= complete concordance, category 1 meaning DC in detection assumed to be due to tumor heterogeneity (VAF nearby the threshold) or technique (1A), or caused by laboratories performance and avoidable (1B) and the category 2 identified DC in interpretation without clinical relevance (2A) or clinically relevant (2B), the results of total number of variants are shown in table. Overall, regarding clinically relevant DC in HRR genes, 9 DC in variants were observed including six 2B, two 1A and one 1B and they affect 5 (6.3%) patients since some were overlapping. Conclusions: In our EOC series the concordance of two Laboratories in the identification of clinically relevant HRR mutations on tumor is high but discrepancies in interpretation remain a challenge that needs further harmonization.[Table: see text]

Download Full-text

Risk stratification of abdominopelvic failure for FIGO stage III epithelial ovarian cancer patients: implications for adjuvant radiotherapy

Journal of Gynecologic Oncology ◽

10.3802/jgo.2013.24.2.146 ◽

2013 ◽

Vol 24 (2) ◽

pp. 146 ◽

Cited By ~ 4

Author(s):

Jee Suk Chang ◽

Woong Sub Koom ◽

Sang Wun Kim ◽

Sunghoon Kim ◽

Yong Bae Kim ◽

...

Keyword(s):

Ovarian Cancer ◽

Risk Stratification ◽

Epithelial Ovarian Cancer ◽

Cancer Patients ◽

Adjuvant Radiotherapy ◽

Figo Stage ◽

Stage Iii

Download Full-text

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.

Download Full-text

Hypodontia phenotype in patients with epithelial ovarian cancer

Radiology and Oncology ◽

10.2478/raon-2014-0034 ◽

2015 ◽

Vol 49 (1) ◽

pp. 65-70 ◽

Cited By ~ 2

Author(s):

Anita Fekonja ◽

Andrej Cretnik ◽

Danijel Zerdoner ◽

Iztok Takac

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Figo Stage ◽

Clinicopathological Characteristics ◽

Control Group ◽

Malignant Tumours ◽

Cancer Group ◽

Significant Difference ◽

The University ◽

And Control

Abstract Background. Ovarian cancer is usually diagnosed in an advanced stage and the present clinical and diagnostic molecular markers for early OC screening are insufficient. The aim of this study was to identify potential relationship between the hypodontia and epithelial ovarian cancer (EOC). Patients and methods. A retrospective study was conducted on 120 patients with EOC treated at the Department of Gynaecologic and Breast Oncology at the University Clinical Centre and 120 gynaecological healthy women (control group) of the same mean age. Women in both groups were reviewed for the presence of hypodontia and the patients with EOC also for clinicopathological characteristics of EOC according to hypodontia phenotype. Results. Hypodontia was diagnosed in 23 (19.2%) of patients with EOC and 8 (6.7%) controls (p = 0.004; odds ratio [OR] = 3.32; confidence interval [CI], 1.42-7.76). There was no statistically significant difference in patients with EOC with or without hypodontia regarding histological subtype (p = 0.220); they differed in regard to FIGO stage (p = 0.014; OR =3.26; CI, 1.23-8.64) and tumour differentiation grade (p = 0.042; OR = 3.1; CI, 1.01-9.53). Also, bilateral occurrence of EOC was more common than unilateral occurrence in women with hypodontia (p = 0.021; OR = 2.9; CI, 1.15-7.36). We also found statistically significant difference between the ovarian cancer group and control group in presence of other malignant tumours in subjects (p < 0.001). Conclusions. The results of the study suggest a statistical association between EOC and hypodontia phenotype. Hypodontia might serve as a risk factor for EOC detection.

Download Full-text

Development and internal validation of a prognostic model for survival after debulking surgery for epithelial ovarian cancer

Gynecologic Oncology ◽

10.1016/j.ygyno.2014.07.099 ◽

2014 ◽

Vol 135 (1) ◽

pp. 13-18 ◽

Cited By ~ 8

Author(s):

M.J. Rutten ◽

J.H.L. Boldingh ◽

E. Schuit ◽

H. Trum ◽

W. van Driel ◽

...

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Prognostic Model ◽

Debulking Surgery ◽

Internal Validation

Download Full-text

MicroRNA characteristics in epithelial ovarian cancer

PLoS ONE ◽

10.1371/journal.pone.0252401 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0252401

Author(s):

Kira Philipsen Prahm ◽

Claus Kim Høgdall ◽

Mona Aarenstrup Karlsen ◽

Ib Jarle Christensen ◽

Guy Wayne Novotny ◽

...

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Expression Profiles ◽

Pelvic Mass ◽

Figo Stage ◽

Clinicopathological Characteristics ◽

Type I ◽

Histologic Subtype ◽

Mirna Expression Profiles ◽

Using Data

The purpose of the current study was to clarify differences in microRNA expression according to clinicopathological characteristics, and to investigate if miRNA profiles could predict cytoreductive outcome in patients with FIGO stage IIIC and IV ovarian cancer. Patients enrolled in the Pelvic Mass study between 2004 and 2010, diagnosed and surgically treated for epithelial ovarian cancer, were used for investigation. MicroRNA was profiled from tumour tissue with global microRNA microarray analysis. Differences in miRNA expression profiles were analysed according to histologic subtype, FIGO stage, tumour grade, type I or II tumours and result of primary cytoreductive surgery. One microRNA, miR-130a, which was found to be associated with serous histology and advanced FIGO stage, was also validated using data from external cohorts. Another seven microRNAs (miR-34a, miR-455-3p, miR-595, miR-1301, miR-146-5p, 193a-5p, miR-939) were found to be significantly associated with the clinicopathological characteristics (p ≤ 0.001), in our data, but mere not similarly significant when tested against external cohorts. Further validation in comparable cohorts, with microRNA profiled using newest and similar methods are warranted.

Download Full-text

EPDR1, Which Is Negatively Regulated by miR-429, Suppresses Epithelial Ovarian Cancer Progression via PI3K/AKT Signaling Pathway

Frontiers in Oncology ◽

10.3389/fonc.2021.751567 ◽

2021 ◽

Vol 11 ◽

Author(s):

Zhendan Zhao ◽

Zhiling Wang ◽

Pengling Wang ◽

Shujie Liu ◽

Yingwei Li ◽

...

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Signaling Pathway ◽

Cancer Progression ◽

Figo Stage ◽

Luciferase Reporter ◽

Migration And Invasion ◽

Gynecology And Obstetrics

Epithelial ovarian cancer (EOC) is the main pathological type of ovarian cancer. In this study, we found that ependymin-related 1 (EPDR1) was remarkably downregulated in EOC tissues, and low EPDR1 expression was associated with International Federation of Gynecology and Obstetrics (FIGO) stage, metastasis, and poor prognosis. We confirmed that EPDR1 overexpression dramatically suppressed EOC cell proliferation, migration, and invasion in vitro and in vivo. Mechanistically, EPDR1 inhibited EOC tumorigenesis and progression, at least in part, through the repression of the PI3K (Phosphoinositide 3-kinase)/AKT (AKT Serine/Threonine Kinase 1) signaling pathway. Furthermore, the expression and function of EPDR1 were regulated by miR-429, as demonstrated by luciferase reporter assays and rescue experiments. In conclusion, our study validated that EPDR1, negatively regulated by miR-429, played an important role as a tumor-suppressor gene in EOC development via inhibition of the PI3K/AKT pathway. The miR-429/EPDR1 axis might provide novel therapeutic targets for individualized treatment of EOC patients in the future.

Download Full-text