Ovarian Preservation in Stage I Low-Grade Endometrial Stromal Sarcomas

Aims and Background The orbit is an uncommon primary site for non-Hodgkin's lymphomas (NHL), and it accounts for less than 1% of all sites of primary presentations. We report the experience of the Department of Radiation Oncology at Ankara University Faculty of Medicine with radiation therapy in treatment of patients with stage I primary orbital NHL. Methods From February 1978 through August 1993, 14 patients with stage I primary orbital NHL were treated with radiation therapy. According to the Working Formulation classification, 8 patients had low-grade and 6 had intermediate-grade lymphomas. The most commonly used radiation therapy technique was a single anterior field with a Cobalt-60 unit, delivering 40 Gy in 2 Gy daily fractions. Two patients with intermediate-grade lymphomas received the CHOP regimen following radiation therapy. Results Follow-up ranged from 0.8 to 18.3 years (median, 10.3 years). Local control was achieved in all patients. Two patients with low-grade lymphomas relapsed locally and were successfully salvaged with radiation therapy. Three patients with intermediate-grade lymphomas failed systemically. Salvage therapy consisted of combination chemotherapy for 2 of them but was unsuccessful. Overall survival probabilities at 2, 5 and 10 years were 78.6%, 61.1% and 52.4%, respectively, for the entire group of 14 patients. Overall, cause-specific and disease-free survival probabilities were higher for patients with low-grade lymphomas than for those with intermediate-grade lymphomas (P = 0.03, P = 0.03 and P = 0.06, respectively). Cataracts were observed in 9 and lacrimal disorders in 4 patients. Conclusions The study suggests that among stage I primary orbital NHL, low-grade lymphomas could be treated with radiation therapy alone, whereas combination chemotherapy could accompany radiation therapy for intermediate-grade lymphomas.

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Ovarian preservation in low-grade endometrial cancer and endometrial intraepithelial neoplasia: outcomes and long-term health sequelae

Gynecologic Oncology ◽

10.1016/s0090-8258(21)01079-9 ◽

2021 ◽

Vol 162 ◽

pp. S225

Author(s):

Jennifer Hagen ◽

Annika Deitermann ◽

Annelise Wilhite ◽

Britt Erickson

Keyword(s):

Endometrial Cancer ◽

Intraepithelial Neoplasia ◽

Low Grade ◽

Ovarian Preservation ◽

Endometrial Intraepithelial Neoplasia

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Redefining Stage I Endometrial Cancer: Incorporating Histology, a Binary Grading System, Myometrial Invasion, and Lymph Node Assessment

International Journal of Gynecological Cancer ◽

10.1097/igc.0b013e3182a5055e ◽

2013 ◽

Vol 23 (9) ◽

pp. 1620-1628 ◽

Cited By ~ 14

Author(s):

Joyce N. Barlin ◽

Robert A. Soslow ◽

Megan Lutz ◽

Qin C. Zhou ◽

Caryn M. St. Clair ◽

...

Keyword(s):

Endometrial Cancer ◽

Myometrial Invasion ◽

Staging System ◽

Stage I ◽

Low Grade ◽

List Type ◽

High Grade ◽

High Grade Carcinoma ◽

Concordance Probability ◽

Grade 3

ObjectiveWe propose a new staging system for stage I endometrial cancer and compare its performance to the 1988 and 2009 International Federation of Gynecology and Obstetrics (FIGO) systems.MethodsWe analyzed patients with 1988 FIGO stage I endometrial cancer from January 1993 to August 2011. Low-grade carcinoma consisted of endometrioid grade 1 to grade 2 lesions. High-grade carcinoma consisted of endometrioid grade 3 or nonendometrioid carcinomas (serous, clear cell, and carcinosarcoma). The proposed system is as follows:IA. Low-grade carcinoma with less than half myometrial invasionIA1: Negative nodesIA2: No nodes removedIB. High-grade carcinoma with no myometrial invasionIB1: Negative nodesIB2: No nodes removedIC. Low-grade carcinoma with half or greater myometrial invasionIC1: Negative nodesIC2: No nodes removedID. High-grade carcinoma with any myometrial invasionID1: Negative nodesID2: No nodes removedResultsData from 1843 patients were analyzed. When patients were restaged with our proposed system, the 5-year overall survival significantly differed (P < 0.001): IA1, 96.7%; IA2, 92.2%; IB1, 92.2%; IB2, 76.4%; IC1, 83.9%; IC2, 78.6%; ID1, 81.1%; and ID2, 68.8%. The bootstrap-corrected concordance probability estimate for the proposed system was 0.627 (95% confidence interval, 0.590–0.664) and was superior to the concordance probability estimate of 0.530 (95% confidence interval, 0.516–0.544) for the 2009 FIGO system.ConclusionsBy incorporating histological subtype, grade, myometrial invasion, and whether lymph nodes were removed, our proposed system for stage I endometrial cancer has a superior predictive ability over the 2009 FIGO staging system and provides a novel binary grading system (low-grade including endometrioid grade 1–2 lesions; high-grade carcinoma consisting of endometrioid grade 3 carcinomas and nonendometrioid carcinomas).

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Separation of Low- Versus High-grade Crohn’s Disease-associated Small Bowel Carcinomas is Improved by Invasive Front Prognostic Marker Analysis

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz140 ◽

2019 ◽

Vol 14 (3) ◽

pp. 295-302 ◽

Cited By ~ 6

Author(s):

Giovanni Arpa ◽

Federica Grillo ◽

Paolo Giuffrida ◽

Gabriella Nesi ◽

Catherine Klersy ◽

...

Keyword(s):

Crohn’S Disease ◽

Small Bowel ◽

Crohn's Disease ◽

Stage I ◽

Low Grade ◽

Invasive Front ◽

Poorly Differentiated Clusters ◽

Small Bowel Carcinoma ◽

Poorly Differentiated ◽

Tumour Budding

Abstract Background and Aims Crohn’s disease-associated small bowel carcinoma is a rare event, usually reported to have a severe prognosis. However, in previous investigations we have found a minority of cases displaying a relatively favourable behaviour, thus outlining the need to improve the histopathological prediction of Crohn’s disease-associated small bowel carcinoma prognosis. Methods As in recent studies on colorectal cancer, a substantial improvement in prognostic evaluations has been provided by the histological analysis of the tumour invasive front; we therefore systematically analysed the tumour budding and poorly differentiated clusters in the invasive front of 47 Crohn’s disease-associated small bowel carcinomas collected through the Small Bowel Cancer Italian Consortium. Results Both tumour budding and poorly differentiated cluster analyses proved highly effective in prognostic evaluation of Crohn’s disease-associated small bowel carcinomas. In addition, they retained prognostic value when combined with two other parameters, i.e. glandular histology and stage I/II, both known to predict a relatively favourable small bowel carcinoma behaviour. In particular, association of tumour budding and poorly differentiated clusters in a combined invasive front score allowed identification of a minor subset of cancers [12/47, 25%] characterised by combined invasive front low grade coupled with a glandular histology and a low stage [I or II] and showing no cancer-related death during a median follow-up of 73.5 months. Conclusions The improved distinction of lower- from higher-grade Crohn’s disease-associated small bowel carcinomas provided by invasive front analysis should be of potential help in choosing appropriate therapy for these rare and frequently ominous neoplasms.

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Transcriptional Characterization of Stage I Epithelial Ovarian Cancer: A Multicentric Study

Cells ◽

10.3390/cells8121554 ◽

2019 ◽

Vol 8 (12) ◽

pp. 1554

Author(s):

Enrica Calura ◽

Matteo Ciciani ◽

Andrea Sambugaro ◽

Lara Paracchini ◽

Giuseppe Benvenuto ◽

...

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Stage I ◽

Molecular Heterogeneity ◽

Low Grade ◽

Multicentric Study ◽

Molecular Alterations ◽

Molecular Features ◽

Signaling Axis ◽

Tumor Biopsies

Stage I epithelial ovarian cancer (EOC) represents about 10% of all EOCs. It is characterized by a complex histopathological and molecular heterogeneity, and it is composed of five main histological subtypes (mucinous, endometrioid, clear cell and high, and low grade serous), which have peculiar genetic, molecular, and clinical characteristics. As it occurs less frequently than advanced-stage EOC, its molecular features have not been thoroughly investigated. In this study, using in silico approaches and gene expression data, on a multicentric cohort composed of 208 snap-frozen tumor biopsies, we explored the subtype-specific molecular alterations that regulate tumor aggressiveness in stage I EOC. We found that single genes rather than pathways are responsible for histotype specificities and that a cAMP-PKA-CREB1 signaling axis seems to play a central role in histotype differentiation. Moreover, our results indicate that immune response seems to be, at least in part, involved in histotype differences, as a higher immune-reactive behavior of serous and mucinous samples was observed with respect to other histotypes.

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Incidence and Survival Among Young Women With Stage I–III Breast Cancer: SEER 2000–2015

JNCI Cancer Spectrum ◽

10.1093/jncics/pkz040 ◽

2019 ◽

Vol 3 (3) ◽

Cited By ~ 7

Author(s):

Alexandra Thomas ◽

Anthony Rhoads ◽

Elizabeth Pinkerton ◽

Mary C Schroeder ◽

Kristin M Conway ◽

...

Keyword(s):

Breast Cancer ◽

Survival Data ◽

De Novo ◽

Stage Iv ◽

Premenopausal Women ◽

The United States ◽

Stage I ◽

Low Grade ◽

High Grade ◽

Stage Iv Breast Cancer

Abstract Background Although recent findings suggest that de novo stage IV breast cancer is increasing in premenopausal women in the United States, contemporary incidence and survival data are lacking for stage I–III cancer. Methods Women aged 20–29 (n = 3826), 30–39 (n = 34 585), and 40–49 (n = 126 552) years who were diagnosed with stage I–III breast cancer from 2000 to 2015 were identified from the Surveillance, Epidemiology, and End Results 18 registries database. Age-adjusted, average annual percentage changes in incidence and 5- and 10-year Kaplan-Meier survival curves were estimated by race and ethnicity, stage, and hormone receptor (HR) status and grade (low to well and moderately differentiated; high to poorly and undifferentiated) for each age decade. Results The average annual percentage change in incidence was positive for each age decade and was highest among women aged 20–29 years. Increased incidence was driven largely by HR+ cancer, particularly HR+ low-grade cancer in women aged 20–29 and 40–49 years. By 2015, incidence of HR+ low- and high-grade cancer each independently exceeded incidence of HR− cancer in each age decade. Survival for HR+ low- and high-grade cancer decreased with decreasing age; survival for HR− cancer was similar across age decades. Among all women aged 20–29 years, 10-year survival for HR+ high-grade cancer was lower than that for HR+ low-grade or HR− cancer. Among women aged 20–29 years with stage I cancer, 10-year survival was lowest for HR+ high-grade cancer. Conclusions HR+ breast cancer is increasing in incidence among premenopausal women, and HR+ high-grade cancer was associated with reduced survival among women aged 20–29 years. Our findings can help guide further evaluation of preventive, diagnostic, and therapeutic strategies for breast cancer among premenopausal women.

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Low-grade endometrial stromal sarcoma: a single center's experience with 22 cases

International Journal of Gynecological Cancer ◽

10.1111/j.1525-1438.2007.01159.x ◽

2008 ◽

Vol 18 (5) ◽

pp. 1084-1089 ◽

Cited By ~ 40

Author(s):

W. Y. Kim ◽

J.-W. Lee ◽

C. H. Choi ◽

H. Kang ◽

T.-J. Kim ◽

...

Keyword(s):

Disease Free Survival ◽

Endometrial Stromal Sarcoma ◽

Disease Recurrence ◽

Primary Treatment ◽

Stage I ◽

Low Grade ◽

Stromal Sarcoma ◽

Case Surgery ◽

Abnormal Vaginal Bleeding ◽

Disease Free

The aim of this retrospective study was to evaluate the clinical behavior and management outcome of low-grade endometrial stromal sarcoma (LGESS). From September 1994, to March 2007, 22 patients with histologically proven stage I LGESS were included in this study. Clinicopathologic variables, recurrence, and management outcomes were reviewed retrospectively. The median age of the 22 patients was 43 years. The most common presenting symptom was abnormal vaginal bleeding. All patients underwent a hysterectomy and had stage I disease. Six patients had adjuvant therapy after the hysterectomy. The median follow-up period was 77 months (range 12–202 months). Ten patients had disease recurrence. The median disease-free survival period was 111 months (range 6–182 months). The pelvis (eight cases) was the most common site of recurrence followed by the lung (four cases) and the liver (one case). Recurrent disease was treated with surgery (one case), surgery plus chemotherapy (five cases), chemotherapy (two cases), and surgery plus radiotherapy (two cases). Two patients died after 25 and 54 months after disease recurrence. Treatment with a bilateral salpingo-oophorectomy or adjuvant chemoradiation did not affect the disease-free interval. LGESS is usually a slow-growing neoplasm with an indolent clinical course. Surgery is the primary treatment for recurrent endometrial stromal sarcoma when feasible. Adjuvant treatment (radiotherapy, chemotherapy, or both) had no effect on the prognosis of patients with stage I disease

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