Second Opinion Expert Pathology in Endometrial Cancer: Potential Clinical Implications

2017 ◽  
Vol 27 (2) ◽  
pp. 289-296 ◽  
Author(s):  
Friederike Grevenkamp ◽  
Felix Kommoss ◽  
Friedrich Kommoss ◽  
Sigurd Lax ◽  
Falko Fend ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Carcinoma ◽  
Clinical Relevance ◽  
Second Opinion ◽  
World Health ◽  
Clinical Implications ◽  
Pathology Report ◽  
Low Grade ◽  
Tumor Type ◽  
Case Review

ObjectiveIn cancer patients, the pathology report serves as an important basis for treatment. Therefore, a correct cancer diagnosis is crucial, and diagnostic discrepancies may be of clinical relevance. It was the aim of this study to perform a specialized histopathology review and to investigate potential clinical implications of expert second opinion pathology in endometrial cancer.MethodsPatients treated for endometrial carcinoma at the Tübingen University Women's hospital between 2003 and 2013 were identified. Original pathology reports were reviewed, and contributing pathologists were asked to submit original slides and paraffin blocks. Case review was subsequently performed by 3 pathologists specialized in gynecological pathology who were blinded for clinical information. For histological typing, the World Health Organization 2014 classification was used, grading and staging were performed according to International Federation of Gynecology and Obstetrics 2009. Risk assignment was performed based on the 2013 European Society for Medical Oncology clinical practice guidelines.ResultsIn 565 of 745 cases, which had originally been diagnosed as endometrial carcinoma, archival histological slides and blocks were available. In 55 (9.7%) of 565 cases, a major diagnostic discrepancy of potential clinical relevance was found after expert review. In 38 of these 55 cases, the diagnostic discrepancy was related to tumor type (n = 24), grade (n = 10) or myoinvasion (n = 4). In 17 cases, the diagnosis of endometrial carcinoma could not be confirmed (atypical hyperplasia, n = 10; endometrial carcinosarcoma, n = 4; neuroendocrine carcinoma, n = 1; leiomyosarcoma, n = 1; atypical polypoid adenomyoma, n = 1). Minor discrepancies not changing risk classification were also noted in 214 (37.9%) of 565, most frequently for grade within the low-grade (G1/G2) category (n = 184).ConclusionsA retrospective gynecopathological case review was shown to reveal limited but significant discrepancies in histological diagnoses as well as typing and grading of endometrial carcinomas, some directly impacting clinical management. Second opinion pathology therefore not only helps to improve the quality of translational research study cohorts but might also help to optimize patient care in difficult cases.

Clinical Relevance of Alternative Lengthening of Telomeres in Cancer

2020 ◽  
Vol 20 (6) ◽  
pp. 485-497
Author(s):  
Guilherme G. da Silva ◽  
Karollyne S. Morais ◽  
Daniel S. Arcanjo ◽  
Diêgo M. de Oliveira
Keyword(s):  
Clinical Relevance ◽  
New Drugs ◽  
Cellular Structures ◽  
Clinical Implications ◽  
Tumor Type ◽  
Alternative Lengthening ◽  
Cell Immortalization ◽  
New Generation ◽  
Related Proteins ◽  
Druggable Targets

The alternative lengthening of telomere (ALT) is a pathway responsible for cell immortalization in some kinds of tumors. Since the first description of ALT is relatively recent in the oncology field, its mechanism remains elusive, but recent works address ALT-related proteins or cellular structures as potential druggable targets for more specific and efficient antitumor therapies. Moreover, some new generation compounds for antitelomerase therapy in cancer were able to provoke acquisition of ALT phenotype in treated tumors, enhancing the importance of studies on this alternative lengthening of the telomere. However, ALT has been implicated in different – sometimes opposite – outcomes, according to the tumor type studied. Then, in order to design and develop new drugs for ALT+ cancer in an effective way, it is crucial to understand its clinical implications. In this review, we gathered works published in the last two decades to highlight the clinical relevance of ALT on oncology.

scholarly journals Management of Early Stage, High-Risk Endometrial Carcinoma: Preoperative and Surgical Considerations

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Sareena Singh ◽  
Shandhini Raidoo ◽  
Gaetan Pettigrew ◽  
Robert DeBernardo
Keyword(s):  
Endometrial Cancer ◽  
High Risk ◽  
Endometrial Carcinoma ◽  
Early Stage ◽  
Staging System ◽  
Current Data ◽  
Low Grade ◽  
Gynecologic Malignancy ◽  
High Risk Disease ◽  
Developed World

Endometrial cancer is the most common gynecologic malignancy in the developed world. Most cases are diagnosed at an early stage and have low-grade histology, portending an overall excellent prognosis. There exists a subgroup of patients with early, high-risk disease, whose management remains controversial, as current data is clouded by inclusion of early stage tumors with different high-risk features for recurrence, unstandardized protocols for surgical staging, and an evolving staging system by which we are grouping these patients. Here, we present preoperative and intraoperative considerations that should be taken into account when planning surgical management for this population of patients.

scholarly journals Endometrial Carcinoma staging Issues Laparotomy versus Laparoscopic Approach which is More Feasible and Safer?

2019 ◽  
Vol 4 (2) ◽  
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Carcinoma ◽  
Uterine Cancer ◽  
Surgical Staging ◽  
Peritoneal Cytology ◽  
Tumor Type ◽  
Statistical Significant Difference ◽  
Conversion Rates ◽  
Hospitalization Period ◽  
Significant Difference

Background: Surgical staging of endometrial cancer is considered one of the main pathways for managing those categories of cases. Uterine cancers are considered a challenging surgical scenario in many situations due to anatomical changes in tissue planes and metastatic disease besides the presence of obesity in many cases requiring management. Aim: To compare laparoscopy versus laparotomy for complete uterine cancer surgical staging. Methodology: Cases having clinical stage I to IIA endometrial carcinoma have been randomly allocated to laparoscopy or open laparotomy including hysterectomy, salpingo - oophorectomy, pelvic cytology, pelvic and para-aortic lymphadenectomy. The chief research study outcomes were the 6-week morbidity, mortality issues, hospitalization period and conversion rates from laparoscopy to laparotomy. Results: There was no statistical significant difference as regards the Surgical stage, tumor type, types and numbers of nodes of the studied research groups in which there was no statistical significant difference as regards surgical staging, tumor type observed, peritoneal cytology, type of nodes, no nodes, Para aortic nodes only, pelvic nodes only, both pelvic and para - aortic nodes, any pelvic node, no. of nodes median (IQR) values = 0.996, 0.998, 0.929, 0.607, 0.928, 0.669, 0.541, 0.562, 0.680, 0.934 consecutively. Conclusions and recommendations: The current research elucidates the privilege of laparoscopic surgical staging for early stage endometrial cancer, however future research studies are required to be performed in multi centric fashion and to put in consideration variability’s in BMI, coexisting medical morbidities e.g. DM, hypertension besides the racial and ethnic differences

CD44 expression in papillary serous endometrial carcinoma

2003 ◽  
Vol 13 (4) ◽  
pp. 480-484 ◽  
Author(s):  
S. Hosford ◽  
J. Elliott ◽  
Z.-W. Ma ◽  
R. Majeste ◽  
B. Dubeshter
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Carcinoma ◽  
Myometrial Invasion ◽  
Cervical Cytology ◽  
Tumor Type ◽  
Nodal Metastases ◽  
Malignant Cells ◽  
Clinicopathologic Features ◽  
Tumor Spread ◽  
Cd44 Expression

The objective of this paper is to evaluate the relationship between CD44 expression and the clinicopathologic features of papillary serous endometrial cancer. CD44 expression was assessed in 32 cases of papillary serous endometrial carcinoma by standard immunohistochemical staining techniques. Clinicopathologic features including myometrial invasion, nodal metastases, tumor spread, stage, and the shedding of malignant cells on cervical cytology were reviewed. The Chi-square test was used for statistical analysis.CD44 was not expressed in 81% of patients with papillary serous endometrial carcinoma. Malignant cells were seen on cervical cytology in 68% of all cases with significantly more in the CD44-negative group (78% vs. 33%, P 0.05). CD44 expression was not related to stage, myometrial invasion, nodal involvement, or intraperitoneal spread. We conclude that the cell adhesion molecule CD44 is expressed infrequently in papillary serous endometrial carcinoma. Shedding of malignant cells on cervical cytology is common in papillary serous endometrial cancer and occurs more frequently in CD44-negative cases. CD44 expression doesn't appear to be related to known prognostic features such as nodal metastases or stage. The biologic aggressiveness of this tumor type may, in part, be related to its lack of CD44 expression.

scholarly journals Racial Differences in Oncogene Mutations Detected in Early-Stage Low-Grade Endometrial Cancers

2012 ◽  
Vol 22 (8) ◽  
pp. 1367-1372 ◽  
Author(s):  
Michele L. Cote ◽  
Govindaraja Atikukke ◽  
Julie J. Ruterbusch ◽  
Sara H. Olson ◽  
Shawnita Sealy-Jefferson ◽  
...  
Keyword(s):  
African American ◽  
Endometrial Cancer ◽  
Endometrial Carcinoma ◽  
African American Women ◽  
Racial Differences ◽  
Early Stage ◽  
Fisher Exact Test ◽  
Low Grade ◽  
Urban Hospital ◽  
American Women

ObjectiveTo describe the pattern and frequency of oncogene mutations in white and African American women with endometrial cancer and to determine if racial differences in oncogene mutations exist among women with pathologically similar tumors.MethodsPatients with endometrial cancer from a large urban hospital were identified through medical records, and representative formalin-fixed paraffin-embedded tumor blocks were retrieved. The study sample included 150 patients (84 African Americans) who underwent total abdominal hysterectomy for endometrial cancer. The Sequenom MassARRAY system and the OncoCarta Assay version 1.0 (Sequenom) were used to test for 238 mutations in 19 common oncogenes. The χ2test and the Fisher exact test were used to assess differences in distribution of variables by race and oncogene mutation status.ResultsThere were 20 mutations identified in 2 oncogenes (PIK3CAandKRAS) in tumors from 19 women (12.7%). Most of the mutations were found inPIK3CA(16/20). Thirteen percent of endometrioid tumors harbored mutations (11PIK3CAand 2KRAS) as did 29% of the malignant mixed Mullerian tumors (3PIK3CAand 1KRAS). There were no observed mutations in serous, clear cell, or mucinous tumor types. Among low-grade endometrioid cancers, tumors from African American patients were significantly associated with harboring either aKRASorPIK3CAmutation (P= 0.04), with 7PIK3CAmutations and all 4KRASmutations identified in African American women.ConclusionsThis study provides preliminary evidence that oncogene mutation frequency of some subtypes of histologically similar endometrial carcinoma differ by race. Additional studies are needed to further explore this phenomenon in patients with endometrial carcinoma.

scholarly journals ASSOCIATION OF STEROID RECEPTOR EXPRESSION WITH THE CLINICAL AND HISTOLOGICAL FINDINGS IN PATIENTS WITH ENDOMETRIAL CANCER

2021 ◽  
Vol 71 (5) ◽  
pp. 1875-79
Author(s):  
Aisha Shahid ◽  
Ghulam Haider ◽  
Paras Memon ◽  
Shumyla Beg ◽  
Mehwish Shahzadi ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Progesterone Receptor ◽  
Endometrial Carcinoma ◽  
Menopausal Status ◽  
Stage Iv ◽  
Receptor Expression ◽  
Low Grade ◽  
Endometrioid Adenocarcinoma ◽  
Histological Findings ◽  
Estrogen And Progesterone Receptor

Objective: To determine the association of estrogen and progesterone receptor expression with the clinical and histological findings of endometrial cancer. Study Design: Prospective observational study. Place and Duration of Study: Jinnah Postgraduate Medical Centre, Karachi between Sep 2017 to Oct 2019. Methodology: A total of 130 patients were diagnosed with endometrial carcinoma. Data from patient files were collected regarding tumour histology, grade, stage, tumour receptor expression, and the clinical characteristics: parity, menopausal status. The receptor expression profile was documented for each patient. Data were analyzed using SPSS version 25. The association between ER/PR expression categories and clinical/histological features were explored using the chi-square test. Results: The estrogen and progesterone receptor expressions were significantly associated with low-grade (Grade I and II) tumours and with Stage I and Stage II endometrial carcinoma with p<0.001. About 34 (34.7%) cases of endometrioid histology were negative for both estrogen and progesterone receptors. The ER and PR negativity was strongly associated with Grade III endometrial cancer (p=0.003). The majority of the stage IV cancers were negative for both the ER and PR receptors with a p<0.001. Conclusion: Estrogen and progesterone positivity was associated with endometrioid adenocarcinoma, well-differentiated, and less advanced stage of endometrial cancer at the time of diagnosis.

Ovarian conservation for young women with early-stage low-grade endometrial cancer: A proposal for a two-step approach

2021 ◽  
Author(s):  
Koji Matsuo ◽  
Rachel S. Mandelbaum ◽  
Shinya Matsuzaki ◽  
Maximilian Klar ◽  
Lynda D. Roman ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Young Women ◽  
Early Stage ◽  
Low Grade ◽  
Ovarian Conservation

scholarly journals QOL-36. USE OF CANNABINOIDS IN THE PEDIATRIC CENTRAL NERVOUS SYSTEM TUMOR POPULATION

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii438-iii438
Author(s):  
Kathleen Dorris ◽  
Jessica Channell ◽  
Ashley Mettetal ◽  
Molly Hemenway ◽  
Natalie Briones ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Central Nervous System ◽  
Nervous System ◽  
Cell Activity ◽  
Cns Tumors ◽  
Low Grade ◽  
Tumor Type ◽  
Central Nervous System Tumor ◽  
The Impact

Abstract BACKGROUND Cannabinoids, including cannabidiol (CBD) and tetrahydrocannabinol (THC), are a class of compounds found in marijuana. Numerous studies in adults have examined cannabinoid use in management of cancer-related symptoms such as nausea, anorexia, and pain. Less is known about the use in the pediatric oncology population. METHODS A prospective observational study has been ongoing since 2016 at Children’s Hospital Colorado to evaluate cannabinoids’ impact using PedsQL™ modules on quality of life of pediatric patients with central nervous system (CNS) tumors who are 2–18 years old. Laboratory assessments of T-cell activity and pharmacokinetics of CBD, THC and associated metabolites are in process. Diaries with exploratory information on cannabinoid use patterns are being collected. RESULTS Thirty-three patients (14:19; male:female) have been enrolled with a median age of 6.4 years (range, 2.9–17.7 years). The most common tumor type in enrolled patients is embryonal tumors (13/33; 39%). Nine (27%) patients have low-grade glial/glioneuronal tumors, and eight (24%) had high-grade/diffuse midline gliomas. The remaining patients had ependymoma or craniopharyngioma. The median time on cannabinoids is 9 months. Most (n=20) patients have used oral products with CBD and THC. One patient continues on cannabinoid therapy in follow up. Preliminary immune function analyses identified impaired neutrophil superoxide anion production and chemotaxis in patients taking cannabinoids at early time points on therapy. CONCLUSIONS Families of children with various CNS tumors are pursuing cannabinoid therapy for both antitumor and supportive care purposes. Analysis of the impact of cannabinoids on patients’ quality of life is ongoing.

scholarly journals CD133 Expression in the Nucleus Is Associated with Endometrial Carcinoma Staging and Tumor Angioinvasion

2021 ◽  
Vol 10 (10) ◽  
pp. 2144
Author(s):  
Milosz Pietrus ◽  
Kazimierz Pitynski ◽  
Marcin Waligora ◽  
Katarzyna Milian-Ciesielska ◽  
Monika Bialon ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Plasma Membrane ◽  
Tumor Progression ◽  
Endometrial Carcinoma ◽  
Molecular Level ◽  
Risk Group ◽  
High Risk Group ◽  
Cd133 Expression ◽  
Transmembrane Glycoprotein ◽  
The Impact

Background: (1) Endometrial cancer is one of the most common cancers affecting women, with a growing incidence. To better understand the different behaviors associated with endometrial cancer, it is necessary to understand the changes that occur at a molecular level. CD133 is one of the factors that regulate tumor progression, which is primarily known as the transmembrane glycoprotein associated with tumor progression or cancer stem cells. The aim of our study was to assess the impact of subcellular CD133 expression on the clinical course of endometrial cancer. (2) Methods: CD133 expression in the plasma membrane, nucleus, and cytoplasm was assessed by immunohistochemical staining in a group of 64 patients with endometrial cancer representing FIGO I-IV stages, grades 1–3 and accounting for tumor angioinvasion. (3) Results: Nuclear localization of CD133 expression was increased in FIGO IB-IV stages compared to FIGO IA. Furthermore, CD133 expression in the nucleus and plasma membrane is positively and negatively associated with a higher grade of endometrial cancer and angioinvasion, respectively. (4) Conclusions: Our findings suggest that positive nuclear CD133 expression in the tumor may be related to a less favorable prognosis of endometrial carcinoma patients and has emerged as a useful biomarker of a high-risk group.

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