Microsatellite Instability Is an Independent Indicator of Recurrence in Sporadic Stage I-II Endometrial Adenocarcinoma

2001 ◽  
Vol 19 (4) ◽  
pp. 1008-1014 ◽  
Author(s):  
Silvia Fiumicino ◽  
Alfredo Ercoli ◽  
Gabriella Ferrandina ◽  
Patricia Hess ◽  
Giuseppina Raspaglio ◽  
...  
Keyword(s):  
Microsatellite Instability ◽  
Treatment Options ◽  
Endometrial Adenocarcinoma ◽  
Disease Free Survival ◽  
Myometrial Invasion ◽  
Stage I ◽  
Mononucleotide Repeat ◽  
Dinucleotide Repeats ◽  
Clinicopathologic Characteristics

PURPOSE: The aim of this study was to define the prognostic role of microsatellite status in 65 stage I-II primary sporadic endometrioid endometrial adenocarcinoma (EEA) patients. PATIENTS AND METHODS: Familiarity for neoplasia was ascertained in all patients on the basis of a questionnaire. Microsatellite status was assessed by matching normal and tumoral DNA probed for five dinucleotide repeats and one mononucleotide repeat marker. Microsatellite status was analyzed in relation to clinicopathologic characteristics of the patients and length of disease-free survival (DFS). RESULTS: Eleven tumors (17%) of 65 had instability at two or more loci and were considered as unstable or microsatellite instability (MI). Tumors with no instability or instability at one locus were classified as microsatellite stable (MS). The percentage of MI was significantly higher in poorly than in well to moderately differentiated tumors (50% v 9%; P = .003). The 5-year DFS rate of MI patients was 63% (95% confidence interval [CI], 35% to 91%) versus 96% (95% CI, 91% to 101%) of MS patients (P = .0004). In multivariate analysis, only the presence of MI, stage II of disease, and depth of myometrial invasion greater than 50% retained independent prognostic roles. CONCLUSION: The assessment of microsatellite status may provide useful information for preoperative prognostic characterization of stage I-II primary sporadic EEA patients in which more individualized treatment options can be attempted.

Tailored surgical staging and radiation therapy in clinical stage I endometrioid endometrial adenocarcinoma (EEA)

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e16511-e16511
Author(s):  
K. M. Bermudez Wagner ◽  
M. B. Thomas ◽  
C. Miyamoto ◽  
B. Micaily ◽  
E. Hernandez
Keyword(s):  
Adjuvant Therapy ◽  
Proportional Hazards ◽  
Clinical Stage ◽  
Endometrial Adenocarcinoma ◽  
Myometrial Invasion ◽  
Retrospective Chart Review ◽  
Progression Free Survival ◽  
Cox Proportional Hazards ◽  
Stage I ◽  
Outcome Analysis

e16511 Background: Pelvic lymph node dissection (LND) requirement to adequately stage endometrial cancer has been subject of debate. We conducted an outcome analysis of clinical stage I endometrioid endometrial adenocarcinoma (EEA) patients who underwent surgery with tailored LND and adjuvant therapy (radiation (RT) or chemotherapy) between 1997 and 2008. Methods: Retrospective chart review was performed at our institution. All patients underwent exploratory laparotomy, cytology, total abdominal hysterectomy and bilateral salpingoophorectomy. Pelvic and para-aortic LND was perforned in high-risk patients when technically possible. Cox proportional hazards and the Kaplan Meier method were used for data analysis. Results: 119 patients (stage I 92, II 11, III 15, and IV 1) were identified. Median BMI was 34 and 81% had significant co-morbidities. 50% underwent para-aortic LND (median 4 nodes) and 25% underwent pelvic LND (median 15 nodes), of whom 8% and 10% were positive, respectively. Postoperative complications occurred in 22%. 26% received RT. With a mean follow-up of 20 months, 5-year progression-free survival (PFS) and overall survival (OS) was 71% and 84%. The OS for stage I and IIIC was 88% and 83%, respectively. OS for patients with or without LND was not statistically different ( 73% vs.82%). 12 (10%) recurrences were noted, 8 of which were hematological (HF) with a 5-year HF probability of 21%. On multivariate analysis only myometrial invasion > 50% was independent risk factor for HF. Patients receiving RT showed a trend toward decreased in local recurrences ( 0% vs.30% p = 0.1) but no improvement in OS. Conclusions: In patients with EEA, a tailored approach to LND and adjuvant therapy results in good outcome, but many still have therapy-associated adverse events. Although no difference was found in OS between patients who underwent LND and those who did not, similar survival for patients with stages I and IIIC suggests that therapy directed by the knowledge of nodal status may have an impact on survival. No significant financial relationships to disclose.

scholarly journals Endometrial cancer and microsatellite instability status

Open Medicine ◽  
2014 ◽  
Vol 10 (1) ◽  
Author(s):  
Daiva Kanopiene ◽  
Jolanta Vidugiriene ◽  
Konstantinas Povilas Valuckas ◽  
Giedre Smailyte ◽  
Saule Uleckiene ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Microsatellite Instability ◽  
Myometrial Invasion ◽  
Repair System ◽  
High Status ◽  
Clinicopathologic Characteristics ◽  
Dna Mismatch ◽  
Dna Mismatch Repair System ◽  
Clinicopathologic Parameters ◽  
Analysis System

AbstractMicrosatellite instability (MSI) is an important factor in the development of various cancers as an identifier of a defective DNA mismatch repair system. The objective of our study was to define the association between microsatellite instability status and traditional clinicopathologic characteristics of endometrioid type adenocarcinoma. Material and methods: MSI status of endometrial cancer was examined by employing the Promega MSI Analysis System. This system uses 5 mononucleotide markers to identify MSI in tumour and normal tissue DNA (BAT-25, BAT-26, NR-21, NR-24, and MONO-27), and 2 pentanucleotide markers (Penta C and Penta D) for specimen identification. In this study, we investigated MSI status in 109 endometrial carcinomas. Results and conclusions: One hundred (92%) of 109 endometrial cancers showed endometrioid type histology and only 9 (8%) non-endometrioid type. MSI-high was found in 17% (17/100) of endometrioid type adenocarcinomas, in 0% (0/9) of non-endometrioid carcinomas. Selected clinicopathologic parameters for endometrioid type adenocarcinomas were compared to the MSI status which was separated into two groups – MSI-high and MSI stable. The results showed that MSI-high status was related to clinicopathologic parameters such as deep myometrial invasion and higher histologic grade in endometrioid type adenocarcinomas.

scholarly journals Survival after Curative Resection for Stage I Colorectal Mucinous Adenocarcinoma

2020 ◽  
Author(s):  
Liang Huang ◽  
Shuangling Luo ◽  
Sicong Lai ◽  
Yonghua Cai ◽  
Zhanzhen Liu ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Mucinous Adenocarcinoma ◽  
Disease Free Survival ◽  
Stage I ◽  
Prognostic Impact ◽  
Clinicopathologic Characteristics ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Free Survival ◽  
Disease Free

Abstract Background : The prognostic value of the mucinous adenocarcinoma histotype on the early stages especially for stage I colorectal cancer (CRC) is still unclear. This study determined the clinicopathologic characteristics and long-term outcome of stage I colorectal mucinous adenocarcinomas (MAC).Methods : Among the total of 503 patients with stage I CRC (56 having MAC and 447 having non-MAC) who underwent radical resection, the correlation between clinicopathological factors and MAC was analyzed. Multivariate analysis was performed to determine whether mucinous histotype itself was an independent prognostic impact in stage I patients.Results : MACs were observed more frequently located in the colon than rectum ( p =0.046), more frequently displayed the microsatellite instability (MSI) phenotype ( p =0.023) and had a greater frequency of T2 stage ( p =0.001). The rate of recurrence was 13.5% and the cancer-specific mortality was 4.3% among all stage I CRC patients. There was no difference in disease-free survival and overall survival between MACs and non-MACs. On multivariate analysis, older age ( p =0.030), rectal cancer ( p =0.025), lymphovascular invasion (LVI) ( p <0.001), and microsatellite stability (MSS) phenotypes ( p =0.023) were independently associated to poor survival of stage I CRC. A high carcinoembryonic antigen (CEA) level ( p =0.031), LVI ( p =0.002) and MSS phenotypes ( p =0.012) were independently related to short disease-free survival of stage I CRC.Conclusions : Compared with non-MAC, MAC patients had more T2 patients and more MSI phenotypes in stage I CRC at presentation, but the mucinous histology is not a significant predictor of recurrence and prognosis in stage I CRC.

scholarly journals Role of preoperative CA-125 levels in predicting the DFS and OS in epithelial ovarian cancer

2017 ◽  
Vol 7 (1) ◽  
pp. 69
Author(s):  
Shashidhar V. Karpurmathrmath ◽  
Velukuru Sai Vivek ◽  
Manjunath I. Nandennavar ◽  
Veerandra Angadi ◽  
Annalakshmi Sekar
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Stage Iv ◽  
Significant Rise ◽  
Stage I ◽  
Ca 125 ◽  
Screening Methods

Background: Ovarian cancer has the highest mortality rate among all the other gynaecologic malignancies. Stage I cancer treated with surgery and adjuvant chemotherapy report a 5-year overall survival of 95% while this value significantly drops to 25% in stage IIIC and IV patients. Unfortunately, effective screening methods to detect the early cancer are yet to be identified.Methods: All the patients diagnosed to have epithelial ovarian carcinoma from January 2012 to December 2014 at our center with pre-treatment CA-125 levels were included in this retrospective study. Disease free survival and overall survival were tabulated either by telephonic conversation or on a regular follow up visit to the hospital.Results: Among the 69 patients enrolled 38% of the patients were in the age group of 50-60 years. 58% of patients had stage 3 disease up front. mean CA-125 levels were lowest in patients with stage I disease and the highest in stage IV disease with a statistically significant rise in CA-125 levels with the stage of disease. Only 52% of the patients completed the treatment as per protocol. There was a significant negative co relation between the CA-125 levels and survival rates in both the sub groups of patients who received complete and incomplete treatment respectively.Conclusions: In the present study we would like to conclude that pre-operative CA-125, which has already been included in the screening algorithms like ROCA, has a greater potential to become a prognostic marker. Present study is limited by the small number of patient’s and thus larger multi centric studies with better randomization could establish the role of CA-125 as a prognostication marker.

Stage I-II endometrial adenocarcinoma evolution of therapeutic paradigms: the role of surgery and adjuvant radiation

2002 ◽  
Vol 12 (3) ◽  
pp. 237-249 ◽  
Author(s):  
K Look
Keyword(s):  
Overall Survival ◽  
Radiation Therapy ◽  
Adjuvant Radiotherapy ◽  
Survival Benefit ◽  
Older Patients ◽  
Endometrial Adenocarcinoma ◽  
Stage I ◽  
Surgical Staging ◽  
Adjuvant Radiation

Abstract.Look K. Stage I-II endometrial adenocarcinoma evolution of therapeutic paradigms: the role of surgery and adjuvant radiation.The objective was to review the English-language literature regarding the utility of adjuvant radiation therapy following surgery for endometrial adenocarcinoma. An OVID software (Ovid Technologies, Inc., New York, NY) search of Medline articles from 1975 to 2001 was conducted using the keywords “endometrial neoplasm,”“surgery,” and “radiation therapy.” The papers were assessed with regard to (a) extent of surgical staging (b) type of adjuvant radiotherapy utilized: external vs. brachytherapy vs. combination therapy; and (c) whether the patients were treated as part of prospective trial or reported as a descriptive series reflecting an institution's practice pattern. Survival rates are excellent for patients with early stage disease treated in either paradigm of extended-surgical staging with more restricted use of the adjuvant therapy or simple hysterectomy bilateral salpingoophorectomy with more frequent use of adjvuant radiotherapy. All three prospecctive-randomized trials (PRCT) have shown an improvement in local control but no overall survival benefit for the entire accrued group. All three PRCTs have shown a higher risk of disease recurrence in older patients or those with grade 3 histology or deep invasion. Each suggests there may be a survival benefit for the subset of patients with such high-risk features, but at present there is no prospective data that demonstrates adjuvant radiotherapy will improve the overall survival for the highest-risk subset of older patients with high-grade deeply invasive disease.

Role of lymphadenectomy and pelvic radiotherapy in patients with clinical FIGO stage I endometrial adenocarcinoma: an analysis of 208 patients

2006 ◽  
Vol 16 (5) ◽  
pp. 1885-1893 ◽  
Author(s):  
I. KALOGIANNIDIS ◽  
S. LAMBRECHTS ◽  
F. AMANT ◽  
P. NEVEN ◽  
E. VAN LIMBERGEN ◽  
...  
Keyword(s):  
Endometrial Adenocarcinoma ◽  
Figo Stage ◽  
Stage I ◽  
Pelvic Radiotherapy

scholarly journals Improved Survival after Breast-Conserving Therapy Compared with Mastectomy in Stage I-IIA Breast Cancer

Cancers ◽  
2021 ◽  
Vol 13 (16) ◽  
pp. 4044
Author(s):  
Ivica Ratosa ◽  
Gaber Plavc ◽  
Nina Pislar ◽  
Tina Zagar ◽  
Andraz Perhavec ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Stage ◽  
Local Treatment ◽  
Disease Free Survival ◽  
Breast Conserving Therapy ◽  
Stage I ◽  
Study Cohort ◽  
Postoperative Radiation Therapy ◽  
Distant Relapse

In the current study, we sought to compare survival outcomes after breast-conserving therapy (BCT) or mastectomy alone in patients with stage I-IIA breast cancer, whose tumors are typically suitable for both locoregional treatments. The study cohort consisted of 1360 patients with stage I-IIA (T1–2N0 or T0–1N1) breast cancer diagnosed between 2001 and 2013 and treated with either BCT (n = 1021, 75.1%) or mastectomy alone (n = 339, 24.9%). Median follow-ups for disease-free survival (DFS) and overall survival (OS) were 6.9 years (range, 0.3–15.9) and 7.5 years (range, 0.2–25.9), respectively. Fifteen (1.1%), 14 (1.0%) and 48 (3.5%) patients experienced local, regional, and distant relapse, respectively. For the whole cohort of patients, the estimated 5-year DFS and OS were 96% and 97%, respectively. After stratification based on the type of local treatment, the estimated 5-year DFS for BCT was 97%, while it was 91% (p < 0.001) for mastectomy-only treatment. Inverse probability of treatment weighting matching based on confounding confirmed that mastectomy was associated with worse DFS (HR 2.839, 95% CI 1.760–4.579, p < 0.0001), but not with OS (HR 1.455, 95% CI 0.844–2.511, p = 0.177). In our study, BCT was shown to have improved disease-specific outcomes compared to mastectomy alone, emphasizing the important role of adjuvant treatments, including postoperative radiation therapy, in patients with early-stage breast cancer at diagnosis.

scholarly journals Clinicopathological Role of Serum-Derived Hyaluronan-Associated Protein (SHAP)-Hyaluronan Complex in Endometrial Cancer

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Hiromitsu Yabushita ◽  
Keita Iwasaki ◽  
Kouhei Kanyama ◽  
Yukihiko Obayashi ◽  
Lisheng Zhuo ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Cancer Patients ◽  
Histological Grade ◽  
Disease Free Survival ◽  
Myometrial Invasion ◽  
Serum Levels ◽  
Free Survival ◽  
Vascular Space ◽  
Disease Free

The role of hyaluronan (HA), serum-derived HA-associated protein (SHAP)-HA complex and hyaluronan synthase (HAS) in endometrial carcinomas was investigated. The relationship of metalloproteinase (MMP) and its inhibitor (TIMP) with HA and the SHAP-HA complex was also examined. The expression of HAS1 was related to the depth of myometrial invasion and lymph-vascular space involvement. The serum levels of HA, SHAP-HA complex, MMP-9, and TIMP-1 were increased in related with the depth of myometrial invasion, histological grade and lymph-vascular space involvement. They were also higher in the HAS1-positive group compared to -negative group. The serum concentrations of HA and SHAP-HA complex had a significant correlation with the MMP-9 and TIMP-1. The patients with elevated SHAP-HA complex had the shorter disease-free survival. The multivariate analysis revealed that the SHAP-HA complex was the independent variable for disease-free survival of endometrial cancer patients. In conclusion, the elevation of serum SHAP-HA complex depended on the HAS1 expression and the SHAP-HA complex is a useful marker to predict disease recurrence in endometrial cancer patients. The SHAP-HA complex may promote the lymph-vascular space involvement and the synthesis and activation of MMP-9 and TIMP-1 in the progression of endometrial cancer.

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