Oncologic outcome and adverse events after para-aortic lymphadenectomy for FIGO stage IIIC endometrioid adenocarcinoma of the uterine body

15062 Background: Patients (pts) with newly diagnosed AOC generally receive platinum plus taxane therapy. G represents a new active agent to improve the standard regimen. To investigate the safety of two schedules of induction treatments both followed by triplet PCG we have drafted a phase II study. Methods: 14 pts, suboptimally debulked (FIGO stage IIIc) entered the study. HDC ( AUC 7,5) was administered for 2 courses every 21 days ( arm A) and P ( 80 mg/sqm, d 1,8,15,22) + G ( 2500 mg/sqm, d 1,15) (arm B). Both regimens have been followed by standard triplet P ( 175 mg/sqm, d1) + C ( AUC 5, d1) + G ( 800 mg/sqm, d1,8) every 21 days for a total of 6 courses. Antiemetics, corticoids, antihistaminics and ranitidine have been added. Results: The median age was 57 y (39–68). Histology was serous in 64.3%, mixed 14.3% and other 21.4%. All pts had Grade 3 tumor but one. Seven pts received arm A schedule and 7 arm B both followed by PCG regimen. Worst haematological toxicities ( in term of nadir) observed in all courses for all pts were neutropenia G4 ( 42.8% arm A vs 71.4% arm B), anemia G2 (71.4% arm A vs 57.1% arm B), thrombocytopenia G2 ( 57.1% arm A vs 42.8% arm B). Most common non haematological toxicities were alopecia and mild nausea/vomiting. Mild paresthesias in both regimens were observed. No sepsis or neutropenic fever nor unespected toxicity or treatment-related deaths were observed. 71.4% of pts completed foreseen schedules of treatments. 78.5% of pts received erytropoietin and 28.5% G-CSF support. Conclusions: HDC and weekly PG followed by triplet PCG are feasible and safety regimens in AOC pts ( residual disease > 1 cm). Further phase II-III setting study using these schedules will be conducted. No significant financial relationships to disclose.

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A feasibility study of intravenous (IV) paclitaxel, intraperitoneal (IP) carboplatin, and IP paclitaxel in patients with epithelial ovarian carcinoma, fallopian tube carcinoma, or peritoneal carcinoma

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.e16549 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. e16549-e16549

Author(s):

S. Nagao ◽

R. Oishi ◽

N. Iwasa ◽

M. Shimizu ◽

K. Hasegawa ◽

...

Keyword(s):

Ovarian Carcinoma ◽

Fallopian Tube ◽

Feasibility Study ◽

Epithelial Ovarian Carcinoma ◽

Clear Cell Adenocarcinoma ◽

Endometrioid Adenocarcinoma ◽

Fallopian Tube Carcinoma ◽

Peritoneal Carcinoma ◽

Stage Iiic ◽

Grade 3

e16549 Background: This is a feasibility study for a future trial to assess the feasibility of intravenous (IV) paclitaxel, intraperitoneal (IP) carboplatin and IP paclitaxel (TCipTip therapy) in patients with epithelial ovarian carcinoma, fallopian tube carcinoma or peritoneal carcinoma. Methods: The patients eligible for this study had histologically confirmed, stage IC-IV epithelial ovarian carcinoma, fallopian tube carcinoma or peritoneal carcinoma. IV paclitaxel was administered at 135 mg/m2 followed by IP carboplatin administration based on the area under the curve =6 on day1, and IP paclitaxel was administered at 60 mg/m2 on day 8. To ensure the safety, the three initial patients received 45 mg/m2 of IP paclitaxel on day 8. The toxicity grade was determined by CTCAE version 3. This study has been approved by the institutional review committee. Results: During November 2007 and December 2008, 10 patients were entered in this study. The patients included 7 epithelial ovarian carcinoma (stage IC, 2; stage IIIC, 5), 2 stage IIIC primary peritoneal carcinoma, and 1 stage IIA fallopian tube carcinoma. There were 7 serous adenocarcinoma, 2 endometrioid adenocarcinoma, 1 clear cell adenocarcinoma. The incidences of grade 3/4 hematological toxicities were 48% for neutropenia, 28% for thrombocytopenia, and 48% for anemia. Grade 3/4 neurotoxicity, abdominal pain nor IP catheter related toxicity was not observed. IP paclitaxel at 2nd or 3rd cycle was skipped in 4 patients by grade 3/4 neutropenia (grade 3, 3; grade 4, 1 ). Conclusions: TCipTip therapy is feasible for patients with epithelial ovarian carcinoma, fallopian tube carcinoma or peritoneal carcinoma. No significant financial relationships to disclose.

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Efficacy and long-term safety with bevacizumab included in neoadjuvant and adjuvant therapies in patients with advanced ovarian cancer: Results of the ANTHALYA trial.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.5538 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. 5538-5538 ◽

Cited By ~ 1

Author(s):

Florence Joly ◽

Paul H. Cottu ◽

Sebastien Gouy ◽

Eric Lambaudie ◽

Frédéric Selle ◽

...

Keyword(s):

Objective Response ◽

Advanced Ovarian Cancer ◽

Response Rates ◽

Figo Stage ◽

Circulating Tumor Cell ◽

Complete Resection ◽

Ca 125 ◽

Stage Iiic ◽

Cell Counts

5538 Background: ANTHALYA showed that neoadjuvant Bevacizumab (B) added to Carboplatin and Paclitaxel (CP) was well tolerated and achieved encouraging complete resection rates at IDS (58.6%) in unresectable FIGO stage IIIC/IV ovarian, tubal or peritoneal adenocarcinoma (EJC 2017;70:133–42). We report response rates, PFS and long-term safety. Methods: Patients (pts) in ANTHALYA were randomized 2:1 to 4 cycles (c) of neoadjuvant CP ±3 c of B (15 mg/kg), IDS for eligible patients, then 1 c of CP + 3 c CPB + 21 c of B. Response and progression were evaluated by RECIST 1.1 using CT scan and CA-125. Circulating tumor cell counts (CTC) were evaluated at baseline, c2 and IDS. Results: 95 pts were treated in CP (n=37) or BCP (n=58) groups (mean study duration were 16.1 months [mo] and 16.9 mo, respectively). 80 pts (CP: 81% / BCP: 88%) had a CA-125 response (50% reduction in CA-125 level) before IDS. Objective response rates were 65% (62% CP / 67% BCP) before IDS (28 days after c4), 46% at c8 (46% CP/ 47% BCP) and 19% at c26 (19% CP/ 19% BCP). 24 (64.9%) CP pts and 26 (44.8%) BCP pts progressed during follow up (median PFS 21.2 mo [95%CI: 14.5, 26.7] and 23.5 mo [18.5, 30.6], respectively). Median PFS was respectively: 25.8 mo (21.0, 30.0) and 17.1 mo (13.5, 22.2) for pts with/without complete resection at IDS; 21.0 mo (15.0, 25.4) and 25.8 mo (18.5, 27.2) for pts with/without baseline CTCs (n=29 / 59); 21.8 mo (17.5, 27.1) and 22.2 mo (15.3, 38.0) for pts with FIGO IIIC and IV tumors. 36 pts did not receive adjuvant therapy within the study (21 were unresectable for IDS), 59 pts (57% CP / 66% BCP) received it. Of those, 34 pts (52% CP / 61% BCP) had Grade ≥3 adverse events including neutropenia (29% CP / 34% BCP), HBP (10% CP / 8% BCP), proteinuria (10% CP / 0% BCP), deep venous thrombosis (5% CP / 3% BCP), pulmonary embolism (0% CP / 8% BCP). Conclusions: Neoadjuvant BCP followed by IDS and adjuvant BCP achieves high response rates and extended PFS with an acceptable toxicity in this specific population of pts with FIGO stage IIIC/IV ovarian, tubal or peritoneal adenocarcinoma not eligible for primary debulking surgery. IDS outcome and CTC counts should be further explored as long term prognostic factors. Clinical trial information: NCT01739218.

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Figo stage IIIC endometrial cancer patients undergoing surgery and adjuvant radiation therapy

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/s0360-3016(00)80042-5 ◽

2000 ◽

Vol 48 (3) ◽

pp. 123 ◽

Cited By ~ 2

Author(s):

K Murphy ◽

P.P Connell ◽

R.B McBride ◽

A.J Mundt

Keyword(s):

Radiation Therapy ◽

Endometrial Cancer ◽

Cancer Patients ◽

Figo Stage ◽

Adjuvant Radiation ◽

Stage Iiic ◽

Adjuvant Radiation Therapy

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Post-radiation Changes in the Tumor Microenvironment of Endometrioid Adenocarcinoma of the Uterine Body

Health and Ecology Issues ◽

10.51523/2708-6011.2019-16-3-12 ◽

2019 ◽

pp. 66-70

Author(s):

D. A. Zinovkin

Keyword(s):

Tumor Microenvironment ◽

Endometrioid Adenocarcinoma ◽

Post Radiation ◽

Uterine Body

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FIGO stage IIIC endometrial carcinoma: Resection of macroscopic nodal disease and other determinants of survival

International Journal of Gynecological Cancer ◽

10.1136/ijgc-00009577-200309000-00015 ◽

2003 ◽

Vol 13 (5) ◽

pp. 664-672 ◽

Cited By ~ 11

Author(s):

R. E. Bristow ◽

M. L. Zahurak ◽

C. J. Alexander ◽

R. C. Zellars ◽

F. J. Montz

Keyword(s):

Radiation Therapy ◽

Adjuvant Chemotherapy ◽

Lymph Nodes ◽

Endometrial Carcinoma ◽

Figo Stage ◽

Cox Proportional Hazards ◽

Rank Test ◽

Nodal Disease ◽

Stage Iiic

The objective of this study was to evaluate the potential survival benefit of debulking macroscopic adenopathy and other clinical prognostic factors among patients with node-positive endometrial carcinoma. Demographic, operative, pathologic, & follow-up data were abstracted retrospectively for 41 eligible patients with FIGO stage IIIC endometrial cancer. Survival curves were generated using the Kaplan-Meier method and statistical comparisons were performed using the log rank test, logistic regression analysis, and the Cox proportional hazards regression model. All patients had positive pelvic lymph nodes and 20 patients (48.8%) had positive para-aortic lymph nodes. Postoperatively, all patients received whole pelvic radiation therapy, 17 received extended-field radiation therapy, and 15 patients received chemotherapy. The median disease-specific survival (DSS) time for all patients was 30.6 months (median follow-up 34. 0 months). Patients with completely resected macroscopic lymphadenopathy had a significantly longer median DSS time (37.5 months), compared to patients left with gross residual nodal disease (8.8 months, P = 0.006). On multivariate analysis, independent predictors of DSS were gross residual nodal disease (HR 7.96, 95% CI 2.54–24.97, P < 0. 001), age ≥ 65 years (HR 6.22, 95% CI 2.05–18.87, P = 0.001), and the administration of adjuvant chemotherapy (HR 0.22, 95% CI 0.07–0.76, P = 0.016). We conclude that in patients with stage IIIC endometrial carcinoma, complete resection of macroscopic nodal disease and the administration of adjuvant chemotherapy, in addition to directed radiation therapy, are associated with improved survival.

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CLINICAL SIGNIFICANCE OF CLASSIFICATION BETWEEN G1 AND G2, IN UTERINE BODY ENDOMETRIOID ADENOCARCINOMA

10.26226/morressier.599bdc78d462b80296ca1070 ◽

2017 ◽

Author(s):

Seigi Furukawa

Keyword(s):

Clinical Significance ◽

Endometrioid Adenocarcinoma ◽

Uterine Body

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Expression of claudin-3 and claudin-4 in normal, hyperplastic, and malignant endometrial tissue

International Journal of Gynecological Cancer ◽

10.1111/j.1525-1438.2006.00748.x ◽

2007 ◽

Vol 17 (1) ◽

pp. 233-241 ◽

Cited By ~ 46

Author(s):

X. Y. Pan ◽

B. Wang ◽

Y. C. Che ◽

Z. P. Weng ◽

H. Y. Dai ◽

...

Keyword(s):

Myometrial Invasion ◽

Figo Stage ◽

Endometrial Tissue ◽

Endometrioid Adenocarcinoma ◽

Mrna Levels ◽

Membrane Expression ◽

Normal Endometrium ◽

Transmission Electron Microscopy Analysis ◽

Intense Staining ◽

Electron Microscopy Analysis

To clarify the roles of claudins in endometrial tumorigenesis, we determined levels of protein and messengerRNA (mRNA) expression of claudin-3 and claudin-4 in human endometrial tissue (proliferative phase [PE, n= 25]; secretory phase [SE, n= 25]; simple hyperplasia [SH, n= 20]; complex hyperplasia [CH, n= 12]; atypical hyperplasia [AH, n= 15]; endometrioid adenocarcinoma [EEC, n= 30]) using immunohistochemistry, western blotting, and real-time polymerase chain reaction, respectively. Morphologic changes of tight junctions (TJs) were also observed in normal, hyperplastic, and malignant endometrial tissue. Absence or weak staining for claudin-3 and claudin-4 was observed in PE, SE, SH, and CH, while medium to intense staining was detected in AH and EEC. Staining of claudin-3 and claudin-4 was predominantly localized to the glandular epithelial cell membrane. Expression of claudin-3 and claudin-4 was significantly increased in the groups of AH and EEC in comparison with the groups of CH, SH, and normal cyclic endometrium at both protein and mRNA levels. The highest expression was observed in EEC. Although no relevance was found with regard to FIGO stage and histologic grade, overexpression of claudin-3 and claudin-4, especially claudin-4, significantly correlated with myometrial invasion. Transmission electron microscopy analysis indicated morphologic disruptions of TJs may lag behind the increase of claudins expression. These results demonstrate that claudin-3 and claudin-4 are strongly expressed in AH and EEC, but less frequently in normal endometrium. The upregulation of claudins expression during endometrial carcinogenesis suggests their potential utility as diagnostic and prognostic biomarkers.

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