Combined score of pretreatment platelet count and CA125 level (PLT-CA125) stratified prognosis in patients with FIGO stage IV epithelial ovarian cancer

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.

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A Practical Nomogram to Predict Early Death in Advanced Epithelial Ovarian Cancer

Frontiers in Oncology ◽

10.3389/fonc.2021.655826 ◽

2021 ◽

Vol 11 ◽

Author(s):

Zixuan Song ◽

Yangzi Zhou ◽

Xue Bai ◽

Dandan Zhang

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Stage Iv ◽

Early Death ◽

Premature Death ◽

Figo Stage ◽

Stage Iii ◽

Internal Validation ◽

Gynecological Malignancy ◽

Clinical Pragmatism

Background: Ovarian cancer is a common gynecological malignancy, most of which is epithelial ovarian cancer (EOC). Advanced EOC is linked with a higher incidence of premature death. To date, no effective prognostic tools are available to evaluate the possibility of early death in patients with advanced EOC.Methods: Advanced (FIGO stage III and IV) EOC patients who were enrolled in the Surveillance, Epidemiology, and End Results database between 2004 and 2015 were regarded as subjects and studied. We aimed to construct a nomogram that can deliver early death prognosis in patients with advanced EOC by identifying crucial independent factors using univariate and multivariate logistic regression analyses to help deliver accurate prognoses.Results: In total, 13,403 patients with advanced EOC were included in this study. Three hundred ninety-seven out of a total of 9,379 FIGO stage III patients died early. There were 4,024 patients with FIGO stage IV, 414 of whom died early. Nomograms based on independent prognostic factors have the satisfactory predictive capability and clinical pragmatism. The internal validation feature of the nomogram demonstrated a high level of accuracy of the predicted death.Conclusions: By analyzing data from a large cohort, a clinically convenient nomogram was established to predict premature death in advanced EOC. This tool can aid clinicians in screening patients who are at higher risk for tailoring treatment plans.

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Neutrophil-to-Lymphocyte Ratio and Platelet Count Predict Long-Term Outcome of Stage IIIC Epithelial Ovarian Cancer

Cellular Physiology and Biochemistry ◽

10.1159/000488420 ◽

2018 ◽

Vol 46 (1) ◽

pp. 178-186 ◽

Cited By ~ 5

Author(s):

Mingyi Zhou ◽

Liankun Li ◽

Xiaobin Wang ◽

Chunyan Wang ◽

Danbo Wang

Keyword(s):

Ovarian Cancer ◽

Platelet Count ◽

Epithelial Ovarian Cancer ◽

Group Versus ◽

Figo Stage ◽

Stage Iiic ◽

Term Outcome ◽

Long Term Outcome ◽

Lymphocyte Ratio

Background/Aims: Prognostic value of neutrophil-to-lymphocyte ratio (NLR) and platelet count (PC) in patients with International Federation of Gynecology and Obstetrics (FIGO) stage IIIC epithelial ovarian cancer (EOC) is controversial. Methods: A total of 370 stage IIIC EOC patients who underwent primary debulking surgery (PDS) at the Department of Gynecology of Liaoning Cancer Hospital and Institute between January 2003 and August 2016 and had full information were involved. Patients were stratified into a high NLR (H-NLR) group versus a low NLR (L-NLR) group and a high PC (H-PC) group versus a low PC (L-PC) group according to cutoff values calculated through receiver operating characteristic (ROC) curves. Prognostic values of NLR and PC for progression-free survival (PFS) and overall survival (OS) were assessed. Results: We identified the optimal cut-off value of 3.08 for NLR and 289.5*109/L for PC. The median PFS and OS of the patients with H-NLR were shorter than L-NLR (PFS: 16.9 months vs. 19.5 months, hazard ratio [HR] 1.3, 95% confidence interval [CI] 1.03–1.63, P = 0.022; OS: 33.5 months vs. 46.8 months, HR 1.3, 95% CI 1.01–1.66, P = 0.001). The median PFS and OS of the patients with H-PC were shorter than L-PC (PFS: 15.3 months vs. 21.6 months, HR 1.3, 95% CI 1.04–1.63, P < 0.001; OS: 37.3 months vs. 46.1 months, HR 1.14, 95% CI 0.89–1.46, P = 0.306). Conclusions: H-NLR and H-PC could predict poor long-term outcome of patients with FIGO stage III EOC.

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Prognostic impact of debulking surgery and residual tumor in patients with epithelial ovarian cancer FIGO stage IV

Gynecologic Oncology ◽

10.1016/j.ygyno.2015.12.007 ◽

2016 ◽

Vol 140 (2) ◽

pp. 215-220 ◽

Cited By ~ 31

Author(s):

Beyhan Ataseven ◽

Christoph Grimm ◽

Philipp Harter ◽

Florian Heitz ◽

Alexander Traut ◽

...

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Stage Iv ◽

Residual Tumor ◽

Figo Stage ◽

Prognostic Impact ◽

Debulking Surgery

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The revised 2014 FIGO staging system for epithelial ovarian cancer: is a subclassification of FIGO stage IV justified?

Geburtshilfe und Frauenheilkunde ◽

10.1055/s-0036-1592990 ◽

2016 ◽

Vol 76 (10) ◽

Cited By ~ 1

Author(s):

B Ataseven ◽

P Harter ◽

F Heitz ◽

S Heikaus ◽

C Grimm ◽

...

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Stage Iv ◽

Staging System ◽

Figo Stage ◽

Figo Staging

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Survival Impact of Surgical Cytoreduction in Stage IV Epithelial Ovarian Cancer

Gynecologic Oncology ◽

10.1006/gyno.1998.5145 ◽

1999 ◽

Vol 72 (3) ◽

pp. 278-287 ◽

Cited By ~ 220

Author(s):

Robert E. Bristow ◽

Fredrick J. Montz ◽

Leo D. Lagasse ◽

Ronald S. Leuchter ◽

Beth Y. Karlan

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Stage Iv

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Clinical Practice of Adjuvant Chemotherapy in Patients with Early-Stage Epithelial Ovarian Cancer

Chemotherapy ◽

10.1159/000445024 ◽

2016 ◽

Vol 61 (6) ◽

pp. 287-294

Author(s):

Lindy M.J. Frielink ◽

Brenda M. Pijlman ◽

Nicole P.M. Ezendam ◽

Johanna M.A. Pijnenborg

Keyword(s):

Ovarian Cancer ◽

Clinical Practice ◽

Adjuvant Chemotherapy ◽

Epithelial Ovarian Cancer ◽

Early Stage ◽

Figo Stage ◽

Selective Treatment ◽

Platinum Based Chemotherapy ◽

Grade 3 ◽

Practice Methods

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.

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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]

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