Recurrence of low risk (LR), early stage endometrial carcinoma (EC), a clinicopathologic analysis

2015 ◽  
Vol 139 (3) ◽  
pp. 599
Author(s):  
Tinera Buckley ◽  
Mary Belniak ◽  
Amy Brown ◽  
Srinivas Mandavilli ◽  
X. Clare Zhou
Keyword(s):  
Endometrial Carcinoma ◽  
Early Stage ◽  
Low Risk

Is Complete Surgical Staging Necessary in Clinically Early-Stage Endometrial Carcinoma?

2009 ◽  
Vol 19 (6) ◽  
pp. 1057-1061 ◽  
Author(s):  
Nakarin Sirisabya ◽  
Tarinee Manchana ◽  
Pongkasem Worasethsin ◽  
Nipon Khemapech ◽  
Ruangsak Lertkhachonsuk ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Early Stage ◽  
Clinical Stage ◽  
Myometrial Invasion ◽  
Low Risk ◽  
Histologic Grade ◽  
Surgical Staging ◽  
Pelvic Node ◽  
Node Metastasis ◽  
Deep Myometrial Invasion

The purpose of this study was to evaluate the incidence of pelvic/para-aortic node metastases and the other pathological characteristics from medical records of patients with endometrial carcinoma treated at King Chulalongkorn Memorial Hospital, Bangkok, Thailand, between1996 and 2005. The records of 213 patients with endometrial carcinoma who had complete surgical staging were reviewed. A particular focus was on clinically early-stage disease. Clinical staging could be determined in 206 patients. Of the 206 patients, 182 (88.3%) presented with clinical stage I disease. However, only 142 (78%) of these patients were confirmed as surgical stage I and 22% were upstaged. Preoperative histologic grade was diagnosed inaccurately in 15.9% of patients and 7.7% were upgraded. Of patients with preoperative histologic grade 1, 33% had deep myometrial invasion, 8.2% had pelvic node metastasis, and 3.3% had para-aortic node metastasis. Even in clinical stage IaG1, pelvic node metastasis occurred in 5.6% and para-aortic node metastasis in 1.3%. It has been suggested that complete surgical staging may not be necessary in patients with low-risk endometrial carcinoma who have disease limited to the uterus without grade 3 or deep myometrial invasion. However, proper selection of such low-risk patients remains problematic. In situations where there is limited preoperative and intraoperative assessment of high-risk factors, particularly radiographic imaging and frozen section assessment, the role of complete surgical staging is beneficial.

scholarly journals CanAssist Breast Impacting Clinical Treatment Decisions in Early-Stage HR+ Breast Cancer Patients: Indian Scenario

2019 ◽  
Author(s):  
Satish Sankaran ◽  
Jyoti Bajpai Dikshit ◽  
Chandra Prakash SV ◽  
SE Mallikarjuna ◽  
SP Somashekhar ◽  
...  
Keyword(s):  
High Risk ◽  
Early Stage ◽  
Risk Groups ◽  
Treatment Decisions ◽  
Low Risk ◽  
Not Given ◽  
Breast Cancer Patients ◽  
Number Of Patients ◽  
Risk Of Cancer ◽  
The Impact

AbstractCanAssist Breast (CAB) has thus far been validated on a retrospective cohort of 1123 patients who are mostly Indians. Distant metastasis–free survival (DMFS) of more than 95% was observed with significant separation (P < 0.0001) between low-risk and high-risk groups. In this study, we demonstrate the usefulness of CAB in guiding physicians to assess risk of cancer recurrence and to make informed treatment decisions for patients. Of more than 500 patients who have undergone CAB test, detailed analysis of 455 patients who were treated based on CAB-based risk predictions by more than 140 doctors across India is presented here. Majority of patients tested had node negative, T2, and grade 2 disease. Age and luminal subtypes did not affect the performance of CAB. On comparison with Adjuvant! Online (AOL), CAB categorized twice the number of patients into low risk indicating potential of overtreatment by AOL-based risk categorization. We assessed the impact of CAB testing on treatment decisions for 254 patients and observed that 92% low-risk patients were not given chemotherapy. Overall, we observed that 88% patients were either given or not given chemotherapy based on whether they were stratified as high risk or low risk for distant recurrence respectively. Based on these results, we conclude that CAB has been accepted by physicians to make treatment planning and provides a cost-effective alternative to other similar multigene prognostic tests currently available.

scholarly journals Effect of a pulmonary nodule fact sheet on patient anxiety and knowledge: a quality improvement initiative

2018 ◽  
Vol 7 (3) ◽  
pp. e000437 ◽  
Author(s):  
Matthew T Koroscil ◽  
Mitchell H Bowman ◽  
Michael J Morris ◽  
Andrew J Skabelund ◽  
Andrew M Hersh
Keyword(s):  
Lung Cancer ◽  
Quality Improvement ◽  
Pulmonary Nodule ◽  
Early Stage ◽  
Pulmonary Nodules ◽  
Low Risk ◽  
Quality Improvement Initiative ◽  
Patient Anxiety ◽  
Patient Understanding ◽  
Fact Sheet

IntroductionThe utilisation of chest CT for the evaluation of pulmonary disorders, including low-dose CT for lung cancer screening, is increasing in the USA. As a result, the discovery of both screening-detected and incidental pulmonary nodules has become more frequent. Despite an overall low risk of malignancy, pulmonary nodules are a common cause of emotional distress among adult patients.MethodsWe conducted a multi-institutional quality improvement (QI) initiative involving 101 participants to determine the effect of a pulmonary nodule fact sheet on patient knowledge and anxiety. Males and females aged 35 years or older, who had a history of either screening-detected or incidental solid pulmonary nodule(s) sized 3–8 mm, were included. Prior to an internal medicine or pulmonary medicine clinic visit, participants were given a packet containing a pre-fact sheet survey, a pulmonary nodule fact sheet and a post-fact sheet survey.ResultsOf 101 patients, 61 (60.4%) worried about their pulmonary nodule at least once per month with 18 (17.8%) worrying daily. The majority 67/101 (66.3%) selected chemotherapy, chemotherapy and radiation, or radiation as the best method to cure early-stage lung cancer. Despite ongoing radiographic surveillance, 16/101 (15.8%) stated they would not be interested in an intervention if lung cancer was diagnosed. Following review of the pulmonary nodule fact sheet, 84/101 (83.2%) reported improved anxiety and 96/101 (95.0%) reported an improved understanding of their health situation. Patient understanding significantly improved from 4.2/10.0 to 8.1/10.0 (p<0.01).ConclusionThe incorporation of a standardised fact sheet for subcentimeter solid pulmonary nodules improves patient understanding and alleviates anxiety. We plan to implement pulmonary nodule fact sheets into the care of our patients with low-risk subcentimeter pulmonary nodules.

Comparison of the Prognoses of FIGO Stage I to Stage II Adenosquamous Carcinoma and Adenocarcinoma of the Uterine Cervix Treated With Radical Hysterectomy

2012 ◽  
Vol 22 (8) ◽  
pp. 1389-1397 ◽  
Author(s):  
Seiji Mabuchi ◽  
Mika Okazawa ◽  
Yasuto Kinose ◽  
Koji Matsuo ◽  
Masateru Fujiwara ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
High Risk ◽  
Uterine Cervix ◽  
Radical Hysterectomy ◽  
Adenosquamous Carcinoma ◽  
Early Stage ◽  
Univariate Analysis ◽  
Low Risk ◽  
Histological Subtype

ObjectivesTo evaluate the significance of adenosquamous carcinoma (ASC) compared with adenocarcinoma (AC) in the survival of surgically treated early-stage cervical cancer.MethodsWe retrospectively reviewed the medical records of 163 patients with International Federation of Gynecology and Obstetrics stage IA2 to stage IIB cervical cancer who had been treated with radical hysterectomy with or without adjuvant radiotherapy between January 1998 and December 2008. The patients were classified according to the following: (1) histological subtype (ASC group or AC group) and (2) pathological risk factors (low-risk or intermediate/high-risk group). Survival was evaluated using the Kaplan-Meier method and compared using the log-rank test. Multivariate analysis of progression-free survival (PFS) was performed using the Cox proportional hazards regression model to investigate the prognostic significance of histological subtype.ResultsClinicopathological characteristics were similar between the ASC and AC histology groups. Patients with the ASC histology displayed a PFS rate similar to that of the patients with the AC histology in both the low-risk and intermediate/high-risk groups. Neither the recurrence rate nor the pattern of recurrence differed between the ASC group and the AC group. Univariate analysis revealed that patients with pelvic lymph node metastasis and parametrial invasion achieved significantly shorter PFS than those without these risk factors.ConclusionsCharacteristics of the patients and the tumors as well as survival outcomes of ASC were comparable to adenocarcinoma of early-stage uterine cervix treated with radical hysterectomy. Our results in part support that the management of ASC could be the same as the one of AC of the uterine cervix.

Defining low-risk lesions in early-stage esophageal adenocarcinoma

2020 ◽  
Author(s):  
Smita Sihag ◽  
Sergio De La Torre ◽  
Meier Hsu ◽  
Tamar Nobel ◽  
Kay See Tan ◽  
...  
Keyword(s):  
Esophageal Adenocarcinoma ◽  
Early Stage ◽  
Low Risk

Prognosis-associated methylation subtypes in endometrial carcinoma patients and the role of magnetic nanoparticles in gene extraction

2021 ◽  
Vol 11 (8) ◽  
pp. 1288-1298
Author(s):  
Liang Wang ◽  
Fengxia Xue
Keyword(s):  
Endometrial Cancer ◽  
Magnetic Nanoparticles ◽  
Endometrial Carcinoma ◽  
High Throughput Sequencing ◽  
Risk Groups ◽  
Vital Role ◽  
Low Risk ◽  
The Cancer Genome Atlas ◽  
Consensus Clustering ◽  
Tumor Subtypes

Endometrial cancer is one of the most common gynecological malignancies, and DNA methylation plays a vital role in its occurrence and development. In this study, we collected the relevant data on endometrial cancer from the Cancer Genome Atlas database and UCSC website. By screening and processing the data, we obtained 410 samples and 16,381 methylation sites. Endometrial carcinoma can be divided into seven molecular subtypes using consensus clustering method. Based on the analysis of the differences among subtypes, the methylation degree of different sites was obtained, and the prognosis model of methylation sites was established. Based on the median value of the train group, the train and test groups were divided into high and low-risk groups. The survival between the high and low-risk groups was different. It also showed that this model can predict the survival of patients, with better accuracy. In conclusion, the tumor subtypes based on methylation sites can provide a better guidance for treatment, relapse, and prognosis of endometrial cancer. In this study, magnetic nanoparticles can be used to extract genomic DNA and total RNA due to their paramagnetism and biocompatibility, then transcriptome high-throughput sequencing was performed. It may serve as potential cancer immune biomarker targets for developing future oncological treatments.

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