Cancer Research and Treatment

Original Articles

Efficacy of Chemotherapy Following Prior PARP-Inhibitor Treatment in Patients with Ovarian Cancer: Jung Chul Kim, Junsik Park, Yong Jae Lee, Eun Ji Nam, Sang Wun Kim, Sung-Hoon Kim, Young Tae Kim, Se Ik Kim, Jae-Weon Kim, Byoung-Gie Kim, Jung-Yun Lee; Received December 23, 2024 Accepted March 16, 2025 Published online March 19, 2025; DOI: https://doi.org/10.4143/crt.2024.1202 [Accepted]

Abstract PDF: Purpose
Considering the current lack of consensus on post-poly (adenosine diphosphate-ribose) polymerase inhibitor (PARPi) treatment strategies, this study aimed to evaluate the efficacy of subsequent therapy and compare the outcomes of regimes in patients with recurrent ovarian cancer after PARPi treatment.
Materials and Methods
This multi-center retrospective cohort study analyzed data on patients diagnosed with ovarian cancer between January 2012 and June 2023 who had previously used PARPi after first- to fourth-line platinum-based chemotherapy. The primary endpoint was progression-free survival (PFS), which was the interval between recurrence after using PARPi and subsequent recurrence in the case of recurrence.
Results
Of 318 patients, 147/318 (46.2%) recurred after the PARPi maintenance. Patients were categorized into groups based on subsequent therapy except non-treated (11/147, 7.5%): platinum-based chemotherapy (89/147, 60.5%), non-platinum-based chemotherapy (21/147, 14.3%), other treatments (26/147, 17.7%), and the median PFS (mPFS) for each group were 7.3, 4.8 and 11.4 months, respectively. Among the platinum-based chemotherapy group, the gemcitabine + carboplatin regimen demonstrated a longer mPFS (10.1 months) than the other regimens (6.6 months, p=0.0194). In non-platinum-based chemotherapy, no statistically significant differences were observed among the regimens. And, in the other therapy group, where the proportion of patients with oligometastasis was as high as 88.5%, no significant differences were observed among the therapies, including other modalities.
Conclusion
In the subsequent chemotherapy of recurrent ovarian cancer after platinum-based chemotherapy and PARPi, the gemcitabine + carboplatin regimen demonstrated a potential to delay recurrence more effectively compared to other therapies.

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Gynecologic cancer

Effect of Waiting Time from Pathological Diagnosis to Definitive Concurrent Chemoradiation for Cervical Cancer on Overall Survival: Kyoung Won Noh, Bomi Kim, Chel Hun Choi, Tae-Joong Kim, Jeong-Won Lee, Byoung-Gie Kim, Duk-Soo Bae, Won Kyung Cho, Won Park, Yoo-Young Lee; Cancer Res Treat. 2022;54(1):245-252. Published online April 15, 2021; DOI: https://doi.org/10.4143/crt.2021.023

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to evaluate the effect of waiting time, from diagnosis to initiation of definitive concurrent chemoradiation (CCRT), on overall survival in cervical cancer patients.
Materials and Methods
Patients with cervical cancer who were treated with definitive CCRT between 2000 and 2017 were retrospectively reviewed. Time from initial pathological diagnosis to definitive CCRT was analyzed both as a continuous variable (per day) and as a categorical variable in two groups (group 1 ≤ median, group 2 > median). Patients with a waiting time of more than 60 days were excluded.
Results
The median waiting time was 14 days (0-60). There were differences between group 1 and group 2 in age and chemotherapy regimens. However, no significant difference was found in the International Federation of Gynecology and Obstetrics stage, cell type, or the number of cycles of chemotherapy received during CCRT. A longer waiting time was associated with poorer overall survival on the Kaplan-Meier curve (group 1 vs. group 2, p=0.042). On multivariate analysis, intervals as either a continuous variable (hazard ratio [HR], 1.023; 95% confidence interval [CI], 1.006 to 1.040; p=0.007) or a categorical variable (HR, 1.513; 95% CI, 1.073 to 2.134; p=0.018), FIGO stage, cell type, and the number of cycles of chemotherapy received during CCRT were significant independent prognostic factors for overall survival.
Conclusion
A shorter waiting time from pathological diagnosis to definitive CCRT showed benefit on overall survival. Our findings suggest that an effort to minimize waiting times should be recommended in cervical cancer patients who are candidates for CCRT.

Citations

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Effect of waiting time for radiotherapy after last induction chemotherapy on prognosis of locally advanced nasopharyngeal carcinoma
Kui‐Xuan Zhu, Ting Ding, Yi‐Min E, Hong‐Wei Yang, Rui‐Ping Wu, Run‐Jia Liu, Ling‐Li Zhou, Wen‐Jie Fu, Mei‐Ping Jiang, Xiao‐Li Wang
Head & Neck.2024; 46(5): 1189. CrossRef
An Innovative Thermal Imaging Prototype for Precise Breast Cancer Detection: Integrating Compression Techniques and Classification Methods
Khaled S. Ahmed, Fayroz F. Sherif, Mohamed S. Abdallah, Young-Im Cho, Shereen M. ElMetwally
Bioengineering.2024; 11(8): 764. CrossRef
Prognostic impact of waiting time between diagnosis and treatment in patients with cervical cancer: A nationwide population-based study
Amy P. Hack, Ronald P. Zweemer, Trudy N. Jonges, Femke van der Leij, Cornelis G. Gerestein, Max Peters, Ina M. Jürgenliemk-Schulz, Peter S.N. van Rossum
Gynecologic Oncology.2022; 165(2): 339. CrossRef
The Role of Conization before Radical Hysterectomy in Cervical Cancer including High Risk Factors of Recurrence: Propensity Score Matching
Chi-Son Chang, Ji Song Min, Ki Hyeon Song, Chel Hun Choi, Tae-Joong Kim, Jeong-Won Lee, Byoung-Gie Kim, Yoo-Young Lee
Cancers.2022; 14(16): 3863. CrossRef
Survival outcomes following treatment delays among patients with early-stage female cancers: a nationwide study
Yu Min, Zheran Liu, Rendong Huang, Ruidan Li, Jing Jin, Zhigong Wei, Ling He, Yiyan Pei, Ning Li, Yongllin Su, Xiaolin Hu, Xingchen Peng
Journal of Translational Medicine.2022;[Epub] CrossRef

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Gynecologic Cancer

Early Metabolic Response Assessed Using ¹⁸F-FDG-PET/CT for Image-Guided Intracavitary Brachytherapy Can Better Predict Treatment Outcomes in Patients with Cervical Cancer: Nalee Kim, Won Park, Won Kyung Cho, Duk-Soo Bae, Byoung-Gie Kim, Jeong-Won Lee, Tae-Joong Kim, Chel Hun Choi, Yoo-Young Lee, Young Seok Cho; Cancer Res Treat. 2021;53(3):803-812. Published online December 9, 2020; DOI: https://doi.org/10.4143/crt.2020.1251

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to identify the prognostic value of early metabolic response assessed using ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) during radiation therapy (RT) for cervical cancer.
Materials and Methods
We identified 116 patients treated with definitive RT, including FDG-PET/CT–guided intracavitary brachytherapy, between 2009 and 2018. We calculated parameters including maximum (SUV_max) and mean standardized uptake values (SUV_mean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) for baseline FDG-PET/CT (PET_base) and image-guided brachytherapy planning FDG-PET/CT (PET_IGBT). Multivariable analyses of disease-free survival (DFS) and overall survival (OS) were performed.
Results
We observed a time-dependent decrease in PET parameters between PET_base and PET_IGBT; ΔSUV_max, ΔSUV_mean, ΔMTV, and ΔTLG were 65%, 61%, 78%, and 93%, respectively. With a median follow-up of 59.5 months, the 5-year DFS and OS rates were 66% and 79%, respectively. Multivariable analysis demonstrated that ΔSUV_max ≥ 50% was associated with favorable DFS (hazard ratio [HR], 2.56; 95% confidence interval [CI], 1.14 to 5.77) and OS (HR, 5.14; 95% CI, 1.55 to 17.01). Patients with ΔSUV_max ≥ 50% (n=87) showed better DFS and OS than those with ΔSUV_max < 50% (n=29) (DFS, 76% vs. 35%, p < 0.001; OS, 90% vs. 41%, p < 0.001, respectively). Adenocarcinoma was frequently observed in ΔSUV_max < 50% compared to ΔSUV_max ≥ 50% (27.6% vs. 10.3%, p=0.003). In addition, models incorporating metabolic parameters showed improved accuracy for predicting DFS (p=0.012) and OS (p=0.004) than models with clinicopathologic factors.
Conclusion
Changes in metabolic parameters, especially those in SUV_max by > 50%, can help improve survival outcome predictions for patients with cervical cancer treated with definitive RT.

Citations

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Personalized strategies for brachytherapy of cervix cancer
Guillaume Camprodon, Alexandra Gabro, Zineb El Ayachi, Supriya Chopra, Remi Nout, Philippe Maingon, Cyrus Chargari
Cancer/Radiothérapie.2024; 28(6-7): 610. CrossRef
Brachytherapy for cervical cancer: from intracavitary to interstitial technique
Xiaojing Yang, Hanru Ren, Zhen Li, Jie Fu
Frontiers in Oncology.2024;[Epub] CrossRef
Application of three-dimensional multi-imaging combination in brachytherapy of cervical cancer
Zhaoming Zhang, Ning Zhang, Guanghui Cheng
La radiologia medica.2023; 128(5): 588. CrossRef
MRI- and PET-Based Assessment of Radiological and Clinical Factors Associated With Cervical Cancer Response to External Beam Radiation Therapy
Arun G Paul, Steven Miller, Lance K Heilbrun, Daryn W Smith
Cureus.2022;[Epub] CrossRef

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Pretreatment Lymph Node Metastasis as a Prognostic Significance in Cervical Cancer: Comparison between Disease Status: Soo Young Jeong, Hyea Park, Myeong Seon Kim, Jun Hyeok Kang, E Sun Paik, Yoo-Young Lee, Tae Joong Kim, Jeong Won Lee, Byoung-Gie Kim, Duk Soo Bae, Chel Hun Choi; Cancer Res Treat. 2020;52(2):516-523. Published online October 29, 2019; DOI: https://doi.org/10.4143/crt.2019.328

Abstract PDF Supplementary Material PubReader ePub

Purpose
Lymph node metastasis (LNM) is the most significant prognostic factor in cervical cancer that was recently incorporated into the International Federation of Gynecology and Obstetrics (FIGO) staging system. This study was performed to evaluate whether the prognostic significance of LNM differs according to disease status.
Materials and Methods
Patients with FIGO stage IB or higher cervical cancer who had pretreatment computed tomography and/or magnetic resonance imaging studies as well as long-term follow-up were enrolled in this retrospective study. The hazard ratio (HR) of Cox regression was used to determine the prognostic significance of LNM. The HRs were compared between the different tumor groups (based on stage, histology, tumor size, primary treatment, age, parametrium involvement, and lymphovascular space invasion).
Results
A total of 970 patients treated between January 1999 and December 2007 were included. The pretreatment LNM had prognostic significance in patients with stage IB1/IIA (HR for progression-free survival 2.10, p=0.001; HR for overall survival 1.99, p=0.005). However, the significance gradually decreased or disappeared with advancing stages. Similarly, the prognostic significance of the pretreatment LNM decreased with advancing disease status, including old age, parametrial involvement or lymphovascular space involvement. In contrast, the tumor size was associated with the prognostic significance of LNM with advancing status. The significance of the clinical LNM did not reflect the significance of the clinical stage. In contrast, the tumor size, parametrial involvement, and significance of the pathologic LNM reflected the clinical stage.
Conclusion
In patients with cervical cancer, pretreatment LNM on imaging has different clinical significance depending on the tumor status.

Citations

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Predicting the risk of lymph node metastasis in colon cancer: development and validation of an online dynamic nomogram based on multiple preoperative data
Longlian Deng, Lemuge Che, Haibin Sun, Riletu En, Bowen Ha, Tao Liu, Tengqi Wang, Qiang Xu
BMC Gastroenterology.2025;[Epub] CrossRef
Complete remission of a high-risk, locally advanced cervical cancer with para-aortic lymph node metastases treated with first-line tislelizumab plus bevacizumab combined with chemotherapy followed by radiotherapy with maintenance therapy: a case report
Juan Lang, Qianqian Liu, Rong Ji, Miao Qiu, Siben Wang, Qingmeng Liu, Dapeng Li, Ping Chen, Zhongkui Xiong
Frontiers in Immunology.2025;[Epub] CrossRef
Application of CT in predicting lymph node metastasis in cervical cancer and construction of a preoperative nomogram
Xiao Meng, Siyu Song, Ke Li, Yajie Duan, Jiayuan Zhong, Jiawei Wang, Shichao Han
Scientific Reports.2025;[Epub] CrossRef
Development of cervical intraepithelial neoplasia and invasive cervical cancer due to oxidative stress
Amir Asotić, Memić Asotić, Muhamed Memić, Kerim Asotić, Amra Asotić
Sanamed.2024; 19(1): 39. CrossRef
Investigating and Analyzing Prognostic Factors and Their Impact on Recurrent Cervical Cancers
Ashish Uke, Shweta B Dahake, Anurag Luharia, Monika Luharia, Gaurav V Mishra, Chanrashekhar Mahakalkar
Cureus.2024;[Epub] CrossRef
Based on 3D-PDU and clinical characteristics nomogram for prediction of lymph node metastasis and lymph-vascular space invasion of early cervical cancer preoperatively
Shuang Dong, Yan-Qing Peng, Ya-Nan Feng, Xiao-Ying Li, Li-Ping Gong, Shuang Zhang, Xiao-Shan Du, Li-Tao Sun
BMC Women's Health.2024;[Epub] CrossRef
Recent Advances in Cervical Cancer Management: A Review on Novel Prognostic Factors in Primary and Recurrent Tumors
Angela Santoro, Frediano Inzani, Giuseppe Angelico, Damiano Arciuolo, Emma Bragantini, Antonio Travaglino, Michele Valente, Nicoletta D’Alessandris, Giulia Scaglione, Stefania Sfregola, Alessia Piermattei, Federica Cianfrini, Paola Roberti, Gian Franco Za
Cancers.2023; 15(4): 1137. CrossRef
Identification of lymph node metastasis in pre‐operation cervical cancer patients by weakly supervised deep learning from histopathological whole‐slide biopsy images
Qingqing Liu, Nan Jiang, Yiping Hao, Chunyan Hao, Wei Wang, Tingting Bian, Xiaohong Wang, Hua Li, Yan zhang, Yanjun Kang, Fengxiang Xie, Yawen Li, XuJi Jiang, Yuan Feng, Zhonghao Mao, Qi Wang, Qun Gao, Wenjing Zhang, Baoxia Cui, Taotao Dong
Cancer Medicine.2023; 12(17): 17952. CrossRef
Roles of DWI and T2-weighted MRI volumetry in the evaluation of lymph node metastasis and lymphovascular invasion of stage IB–IIA cervical cancer
Y. Wang, X. Chen, H. Pu, Y. Yuan, S. Li, G. Chen, Y. Liu, H. Li
Clinical Radiology.2022; 77(3): 224. CrossRef
Risk Factor Assessment of Lymph Node Metastasis in Patients With FIGO Stage IB1 Cervical Cancer
Mu Xu, Xiaoyan Xie, Liangzhi Cai, Yongjin Xie, Qiao Gao, Pengming Sun
Frontiers in Oncology.2022;[Epub] CrossRef
Intravoxel Incoherent Motion (IVIM) MR Quantification in Locally Advanced Cervical Cancer (LACC): Preliminary Study on Assessment of Tumor Aggressiveness and Response to Neoadjuvant Chemotherapy
Miriam Dolciami, Silvia Capuani, Veronica Celli, Alessandra Maiuro, Angelina Pernazza, Innocenza Palaia, Violante Di Donato, Giusi Santangelo, Stefania Maria Rita Rizzo, Paolo Ricci, Carlo Della Rocca, Carlo Catalano, Lucia Manganaro
Journal of Personalized Medicine.2022; 12(4): 638. CrossRef
The prognostic significance of pretreatment squamous cell carcinoma antigen levels in cervical cancer patients treated by concurrent chemoradiation therapy and a comparison of dosimetric outcomes and clinical toxicities between tomotherapy and volumetric
Yuan-Kai Cheng, Shih-Hsun Kuo, Heng-Hsuan Yen, Jing-Hu Wu, Yu-Chieh Chen, Ming-Yii Huang
Radiation Oncology.2022;[Epub] CrossRef
What MRI-based tumor size measurement is best for predicting long-term survival in uterine cervical cancer?
Njål Lura, Kari S. Wagner-Larsen, David Forsse, Jone Trovik, Mari K. Halle, Bjørn I. Bertelsen, Øyvind Salvesen, Kathrine Woie, Camilla Krakstad, Ingfrid S. Haldorsen
Insights into Imaging.2022;[Epub] CrossRef
Clinical value of MRI, serum SCCA, and CA125 levels in the diagnosis of lymph node metastasis and para-uterine infiltration in cervical cancer
Chao Ran, Jian Sun, Yunhui Qu, Na Long
World Journal of Surgical Oncology.2021;[Epub] CrossRef
A Novel Four-Gene Prognostic Signature as a Risk Biomarker in Cervical Cancer
Jun Wang, Hua Zheng, Yatian Han, Geng Wang, Yanbin Li, Cuida Meng
International Journal of Genomics.2020; 2020: 1. CrossRef

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Molecular Signature for Lymphatic Invasion Associated with Survival of Epithelial Ovarian Cancer: E Sun Paik, Hyun Jin Choi, Tae-Joong Kim, Jeong-Won Lee, Byoung-Gie Kim, Duk-Soo Bae, Chel Hun Choi; Cancer Res Treat. 2018;50(2):461-473. Published online May 22, 2017; DOI: https://doi.org/10.4143/crt.2017.104

Abstract PDF Supplementary Material PubReader ePub

Purpose
We aimed to develop molecular classifier that can predict lymphatic invasion and their clinical significance in epithelial ovarian cancer (EOC) patients.
Materials and Methods
We analyzed gene expression (mRNA, methylated DNA) in data from The Cancer Genome Atlas. To identify molecular signatures for lymphatic invasion, we found differentially expressed genes. The performance of classifier was validated by receiver operating characteristics analysis, logistic regression, linear discriminant analysis (LDA), and support vector machine (SVM). We assessed prognostic role of classifier using random survival forest (RSF) model and pathway deregulation score (PDS). For external validation,we analyzed microarray data from 26 EOC samples of Samsung Medical Center and curatedOvarianData database.
Results
We identified 21 mRNAs, and seven methylated DNAs from primary EOC tissues that predicted lymphatic invasion and created prognostic models. The classifier predicted lymphatic invasion well, which was validated by logistic regression, LDA, and SVM algorithm (C-index of 0.90, 0.71, and 0.74 for mRNA and C-index of 0.64, 0.68, and 0.69 for DNA methylation). Using RSF model, incorporating molecular data with clinical variables improved prediction of progression-free survival compared with using only clinical variables (p < 0.001 and p=0.008). Similarly, PDS enabled us to classify patients into high-risk and low-risk group, which resulted in survival difference in mRNA profiles (log-rank p-value=0.011). In external validation, gene signature was well correlated with prediction of lymphatic invasion and patients’ survival.
Conclusion
Molecular signature model predicting lymphatic invasion was well performed and also associated with survival of EOC patients.

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Identifying Stage II Colorectal Cancer Recurrence Associated Genes by Microarray Meta-Analysis and Building Predictive Models with Machine Learning Algorithms
Wei Lu, Xiang Pan, Siqi Dai, Dongliang Fu, Maxwell Hwang, Yingshuang Zhu, Lina Zhang, Jingsun Wei, Xiangxing Kong, Jun Li, Qian Xiao, Kefeng Ding, Quan Cheng
Journal of Oncology.2021; 2021: 1. CrossRef

10,314 View
249 Download
5 Web of Science
1 Crossref

An Open-Label, Randomized, Parallel, Phase II Trial to Evaluate the Efficacy and Safety of a Cremophor-Free Polymeric Micelle Formulation of Paclitaxel as First-Line Treatment for Ovarian Cancer: A Korean Gynecologic Oncology Group Study (KGOG-3021): Shin-Wha Lee, Yong-Man Kim, Chi Heum Cho, Young Tae Kim, Seok Mo Kim, Soo Young Hur, Jae-Hoon Kim, Byoung-Gie Kim, Seung-Cheol Kim, Hee-Sug Ryu, Soon Beom Kang; Cancer Res Treat. 2018;50(1):195-203. Published online March 21, 2017; DOI: https://doi.org/10.4143/crt.2016.376

Abstract PDF PubReader ePub

Purpose
Genexol-PM is a biodegradable cremophor EL–free polymeric micelle formulation of paclitaxel. Here,we compared efficacy and safety of Genexol-PM plus carboplatin versus Genexol plus carboplatin for ovarian cancer treatment.
Materials and Methods
In this multicenter, randomized, phase II study, patients with International Federation of Gynecology and Obstetrics IC-IV epithelial ovarian cancer were randomly assigned (1:1) to receive Genexol-PM 260 mg/m² or Genexol 175 mg/m² with 5 area under the curve carboplatin every 3weeks (6 cycles). The primary endpointwas the carbohydrate antigen 125 and Response Evaluation Criteria In Solid Tumor composite overall response rate (ORR).
Results
Of 131 enrolled patients, 98 were included in intention-to-treat analysis. Mean dosages were 260.00±0.00 mg/m² Genexol-PM or 174.24±3.81 mg/m² Genexol. Median followup was 18.0 months (range, 6.1 to 33.8 months). ORR was 88.0% (95% confidence interval [CI], 80.4 to 95.6) with Genexol-PM, and 77.1% (95% CI, 67.1 to 87.1) with Genexol (noninferiority threshold, 16.3%). Median time to progression was 14.8 months (95% CI, 11.3 to 20.2) with Genexol-PM and 15.4 months (95% CI, 13.2 to 29.6) with Genexol (p=0.550). Overall, six patients died. Neutropenia was the most common toxicity (incidences of 86.0% vs. 77.1%, p=0.120). Peripheral neuropathy incidences were 84.0% versus 64.6% (p= 0.148). Peripheral neuropathy of ≥ grade 3 occurred in one patient receiving Genexol. All toxicities were manageable.
Conclusion
Genexol-PM plus carboplatin as first-line treatment in patients with epithelial ovarian cancer demonstrated non-inferior efficacy and well-tolerated toxicities compared with the standard paclitaxel regimen. Further studies are warranted to optimize the dose and schedule, and to investigate long-term outcomes.

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Patient-Derived Xenograft Models of Epithelial Ovarian Cancer for Preclinical Studies: Eun Jin Heo, Young Jae Cho, William Chi Cho, Ji Eun Hong, Hye-Kyung Jeon, Doo-Yi Oh, Yoon-La Choi, Sang Yong Song, Jung-Joo Choi, Duk-Soo Bae, Yoo-Young Lee, Chel Hun Choi, Tae-Joong Kim, Woong-Yang Park, Byoung-Gie Kim, Jeong-Won Lee; Cancer Res Treat. 2017;49(4):915-926. Published online January 4, 2017; DOI: https://doi.org/10.4143/crt.2016.322

Abstract PDF Supplementary Material PubReader ePub

Purpose
Patient-derived tumor xenografts (PDXs) can provide more reliable information about tumor biology than cell line models. We developed PDXs for epithelial ovarian cancer (EOC) that have histopathologic and genetic similarities to the primary patient tissues and evaluated their potential for use as a platform for translational EOC research.
Materials and Methods
We successfully established PDXs by subrenal capsule implantation of primary EOC tissues into female BALB/C-nude mice. The rate of successful PDX engraftment was 48.8% (22/45 cases). Hematoxylin and eosin staining and short tandem repeat analysis showed histopathological and genetic similarity between the PDX and primary patient tissues.
Results
Patients whose tumors were successfully engrafted in mice had significantly inferior overall survival when compared with those whose tumors failed to engraft (p=0.040). In preclinical tests of this model, we found that paclitaxel-carboplatin combination chemotherapy significantly deceased tumor weight in PDXs compared with the control treatment (p=0.013). Moreover, erlotinib treatment significantly decreased tumor weight in epidermal growth factor receptor–overexpressing PDX with clear cell histology (p=0.023).
Conclusion
PDXs for EOC with histopathological and genetic stability can be efficiently developed by subrenal capsule implantation and have the potential to provide a promising platform for future translational research and precision medicine for EOC.

Citations

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Nomograms Predicting Platinum Sensitivity, Progression-Free Survival, and Overall Survival Using Pretreatment Complete Blood Cell Counts in Epithelial Ovarian Cancer: E Sun Paik, Insuk Sohn, Sun-Young Baek, Minhee Shim, Hyun Jin Choi, Tae-Joong Kim, Chel Hun Choi, Jeong-Won Lee, Byoung-Gie Kim, Yoo-Young Lee, Duk-Soo Bae; Cancer Res Treat. 2017;49(3):635-642. Published online September 27, 2016; DOI: https://doi.org/10.4143/crt.2016.282

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study was conducted to evaluate the prognostic significance of pre-treatment complete blood cell count (CBC), including white blood cell (WBC) differential, in epithelial ovarian cancer (EOC) patients with primary debulking surgery (PDS) and to develop nomograms for platinum sensitivity, progression-free survival (PFS), and overall survival (OS).
Materials and Methods
We retrospectively reviewed the records of 757 patients with EOC whose primary treatment consisted of surgical debulking and chemotherapy at Samsung Medical Center from 2002 to 2012. We subsequently created nomograms for platinum sensitivity, 3-year PFS, and 5-year OS as prediction models for prognostic variables including age, stage, grade, cancer antigen 125 level, residual disease after PDS, and pre-treatment WBC differential counts. The models were then validated by 10-fold cross-validation (CV).
Results
In addition to stage and residual disease after PDS, which are known predictors, lymphocyte and monocyte count were found to be significant prognostic factors for platinum-sensitivity, platelet count for PFS, and neutrophil count for OS on multivariate analysis. The area under the curves of platinum sensitivity, 3-year PFS, and 5-year OS calculated by the 10-fold CV procedure were 0.7405, 0.8159, and 0.815, respectively.
Conclusion
Prognostic factors including pre-treatment CBC were used to develop nomograms for platinum sensitivity, 3-year PFS, and 5-year OS of patients with EOC. These nomograms can be used to better estimate individual outcomes.

Citations

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Pertinence des marqueurs tumoraux, scores (cliniques et biologiques) et algorithmes à visée diagnostique et pronostique devant une masse ovarienne suspecte d’un cancer épithélial. Article rédigé sur la base de la recommandation nationale de bonnes pratiqu
S. Bendifallah, G. Body, E. Daraï, L. Ouldamer
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Proton Pump Inhibition Enhances the Cytotoxicity of Paclitaxel in Cervical Cancer: Taejong Song, Hye-Kyung Jeon, Ji Eun Hong, Jung-Joo Choi, Tae-Joong Kim, Chel Hun Choi, Duk-Soo Bae, Byoung-Gie Kim, Jeong-Won Lee; Cancer Res Treat. 2017;49(3):595-606. Published online September 27, 2016; DOI: https://doi.org/10.4143/crt.2016.034

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study was conducted to investigate whether a proton pump inhibitor (PPI) could enhance chemosensitivity via the inhibition of vacuolar-type H+ ATPase (V-ATPase) in cervical cancer.
Materials and Methods
The expression of V-ATPase was evaluated in 351 formalin-fixed, paraffin-embedded human cervical cancer tissues using immunohistochemistry and compared with clinicopathologic risk factors for disease prognosis. The influence of cell proliferation and apoptosis following V-ATPase siRNA transfection or esomeprazole pretreatment was assessed in cervical cancer cell lines using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide and enzyme-linked immunosorbent assay, respectively.
Results
Immunohistochemical analysis revealed that V-ATPase was expressed in about 60% of cervical cancer tissue samples (211/351), and the expression was predominantly found in adenocarcinoma histology (p=0.016). Among patients with initially bulky cervical cancer (n=89), those with V-ATPase expression had shorter disease-free survival (p=0.005) and overall survival (p=0.023). Co-treatment with V-ATPase siRNA or esomeprazole with paclitaxel significantly decreased the cell proliferation of cervical cancer cell lines, including HeLa and INT407, compared to cell lines treated with paclitaxel alone (p < 0.01). Moreover, V-ATPase siRNA or esomeprazole followed by paclitaxel significantly increased the expression of active caspase-3 in these cells compared to cells treated with paclitaxel alone (both, p < 0.05).
Conclusion
V-ATPase was predominantly expressed in cervical adenocarcinoma, and the expression of V-ATPases was associated with poor prognosis. The inhibition of V-ATPase via siRNA or PPI (esomeprazole) might enhance the chemosensitivity of paclitaxel in cervical cancer cells.

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Nutrition and Cancer.2023; 75(1): 265. CrossRef
Esomeprazole Alleviates Cisplatin Resistance by Inhibiting the AKT/mTOR Pathway in Ovarian Cancer Cells
Jingya Duan, Zisen Zhang, Jinfeng Du, Jihua Zhang, Minmin Li, Canyu Li
OncoTargets and Therapy.2023; Volume 16: 425. CrossRef
Proton pump inhibitors may enhance the risk of digestive diseases by regulating intestinal microbiota
Liang Tian, Chongfei Huang, Wenkang Fu, Long Gao, Ningning Mi, Mingzhen Bai, Haidong Ma, Chao Zhang, Yawen Lu, Jinyu Zhao, Xianzhuo Zhang, Ningzu Jiang, Yanyan Lin, Ping Yue, Jinqiu Yuan, Wenbo Meng
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Cátia Santos‐Pereira, Lígia R. Rodrigues, Manuela Côrte‐Real
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Prognostic Value of Different Patterns of Squamous Cell Carcinoma Antigen Level for the Recurrent Cervical Cancer: Bae Kwon Jeong, Seung Jae Huh, Doo Ho Choi, Won Park, Duk Soo Bae, Byoung-Gie Kim; Cancer Res Treat. 2013;45(1):48-54. Published online March 31, 2013; DOI: https://doi.org/10.4143/crt.2013.45.1.48

Abstract PDF PubReader ePub

PURPOSE
In some unusual cases, in patients with cervical cancer, an elevation of squamous cell carcinoma antigen (SCC-Ag) was not observed at diagnosis but was observed on recurrence, or vice versa. The objective of this study was to identify patient-, disease-, and treatment-related factors associated with this unusual level of SCC-Ag, and to determine whether SCC-Ag is a useful tumor marker in such patients.
MATERIALS AND METHODS
Among 129 patients with recurrence, 14 who showed a normal SCC-Ag level at diagnosis but an elevated level at recurrence were classified as group I; 22 patients with an elevated SCC-Ag level at diagnosis but not at recurrence were classified as group II; and 76 patients with an elevated SCC-Ag level at both diagnosis and recurrence were classified as group III.
RESULTS
In univariate analysis, unusual SCC-Ag showed statistically significant relationships with pathology and biochemical response to treatment. However, in the multivariate analysis, none of the clinicopathologic factors showed a statistical relationship with unusual levels of SCC-Ag. The 5-year disease-free survival rates for groups I, II, and III were 7.1%, 9.1%, and 0% (p=0.418), and the 5-year overall survival rates were 34.3%, 58.4%, and 33.3% (p=0.142), respectively.
CONCLUSION
The value of SCC-Ag has been confirmed in all patients; thus, check of SCC-Ag level at follow-up should be considered. Although no statistically significant differences were observed among the groups, we conclude that patients with a high initial SCC-Ag and elevated SCC-Ag at relapse have poor prognosis due to high SCC-Ag level.

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Predictors of distant metastasis or local recurrent after radiotherapy in patients with cervical cancer
Chufan Wu, Xiaojuan Lv, Fangfang Wang, Qing Xu, Hanmei Lou, Xiaojing Zhang
BMC Cancer.2025;[Epub] CrossRef
Utility of vaginal vault cytology in the local recurrence of cervical cancer
Kazuto Nakamura, Soichi Yamashita, Keiko Kigure, Toshio Nishimura, Ikuro Ito, Anri Azuma, Kohshiro Nakao, Ken Ando, Tatsuya Kanuma
BMC Women's Health.2023;[Epub] CrossRef
Study on the preoperative value of serum SCC-Ag in predicting the stromal invasion of cervical squamous cell carcinoma
Lin Qin
Journal of Cancer Research and Clinical Oncology.2023; 149(11): 9167. CrossRef
Prognostic Effect of Primary Recurrence Patterns in Squamous Cervical Carcinoma After Radical Surgery
Zongkai Zhang, Long Jiang, Rui Bi, Xiaohua Wu, Guihao Ke, Jun Zhu
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Can serial evaluation of serum SCC-Ag-level predict tumor recurrence and patient survival in squamous-cell carcinoma of uterine cervix treated with definitive chemoradiotherapy? A multi-institutional analysis
Kyu Hye Choi, Mina Yu, Songmi Jeong, Jong Hoon Lee
International Journal of Clinical Oncology.2020; 25(7): 1405. CrossRef
Preoperative SCC-Ag as a predictive marker for the use of adjuvant chemotherapy in cervical squamous cell carcinoma with intermediate-risk factors
Hong-tao Guo, Xue-han Bi, Ting Lei, Xiao Lv, Guang Yao, Yao Chen, Chang Liu
BMC Cancer.2020;[Epub] CrossRef
Significance of elevated SCC-Ag level on tumor recurrence and patient survival in patients with squamous-cell carcinoma of uterine cervix following definitive chemoradiotherapy: a multi-institutional analysis
Kyu Hye Choi, Sea-Won Lee, Mina Yu, Songmi Jeong, Jeong Won Lee, Jong Hoon Lee
Journal of Gynecologic Oncology.2019;[Epub] CrossRef
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Peng Chen, Liang Jiao, Dan-Bo Wang
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Weijing Zhang, Jianping Ou, Fangyong Lei, Teng Hou, Shu Wu, Chunhao Niu, Liqun Xu, Yanna Zhang
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The assessment of the prognostic value of tumor markers and cytokines as SCCAg, CYFRA 21.1, IL-6, VEGF and sTNF receptors in patients with squamous cell cervical cancer, particularly with early stage of the disease
Beata Kotowicz, Malgorzata Fuksiewicz, Joanna Jonska-Gmyrek, Mariusz Bidzinski, Maria Kowalska
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Guoxing Zhou, Xiao Chen, Fei Tang, Jie Zhou, Yibin Wang, Zhongqiu Wang
International Journal of Gynecological Cancer.2016; 26(2): 361. CrossRef
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Case Reports

Metastatic Skin Lesions on Lower Extremities in a Patient with Recurrent Serous Papillary Ovarian Carcinoma: A Case Report and Literature Review: Moon-Kyung Kim, Seo-Hee Kim, Yoo-Young Lee, Chel Hun Choi, Tae-Joong Kim, Jeoung-Won Lee, Je-Ho Lee, Duk-Soo Bae, Byoung-Gie Kim; Cancer Res Treat. 2012;44(2):142-145. Published online June 30, 2012; DOI: https://doi.org/10.4143/crt.2012.44.2.142

Abstract PDF PubReader ePub

Clinical observation of skin metastasis in ovarian cancer cases is relatively uncommon. And distant metastatic skin lesions including the extremities are much rarer still as most metastatic skin lesions are located in the skin in the abdominal wall adjacent to where the primary ovarian tumors exist. We report the case of a 60-year-old woman who presented skin lesions on both lower extremities as a consequence of the metastasis of serous papillary adenocarcinoma of the ovary. She presented with erythematous and painful cutaneous nodules on both upper legs and in the inguinal area 42 months after initial diagnosis of ovarian cancer. Skin biopsy revealed metastasis of adenocarcinoma in the dermis. She was treated with surgical excision and systemic chemotherapy. Literature review has suggested that a combined modality approach including surgical excision and chemotherapy may be useful in the management of skin metastases due to ovarian cancer.

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Cutaneous Metastases—Histological Particularities of Multifaceted Entities
Andreea Cătălina Tinca, Bianca Andreea Lazar, Andreea Raluca Cozac-Szőke, Georgian Nicolae Radu, Simina Petra Simion, Diana Maria Chiorean, Irina Bianca Kosovski, Adrian Horațiu Sabău, Raluca Niculescu, Iuliu Gabriel Cocuz, Raluca-Diana Hagău, Emoke Andre
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Skin metastasis from ovarian cancer with somatic BRCA1 mutation: A case report and literature review
Jingheng Zhang, Wenfeng He, Zhenhua Zhang, Hui Dong, Xiangyu Deng, Qinglian Wen, Dan Li
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Metastasis of ovarian cancer to nasal skin and skin on the trunk: a rare case report
Chen Chen, Ouyang Yingyao, Xiang Yan, He Qianru, Wang Hong, Chen Chen, Yang Lei
Frontiers in Oncology.2023;[Epub] CrossRef
A Rare and Sinister Presentation of Cutaneous Metastasis over Right Lower Limb in a Case of Ovarian Carcinoma
Preema Sinha, Parul Kamboj, Anamika Sinha, Juhi Sharma
Journal of Marine Medical Society.2022; 24(2): 211. CrossRef
Clinicopathologic features of cutaneous metastases from internal malignancies
Hyeong Mok Kwon, Gyu Yeong Kim, Dong Hoon Shin, Young Kyung Bae
Journal of Pathology and Translational Medicine.2021; 55(4): 289. CrossRef
Rare Sites Metastasis in Ovarian Carcinoma: a Compilation of 3 Case Reports
Megha Nandwani, Debabrata Barmon, Dimpy Begum, Amal C. Kataki
Indian Journal of Surgical Oncology.2020; 11(1): 150. CrossRef
Cutaneous metastasis of PD-L1 positive ovarian carcinoma
Victoria Hastings, Jennifer McEachron, Marguax J. Kanis
Gynecologic Oncology Reports.2020; 33: 100607. CrossRef
PET/CT for Evaluation of Ovarian Cancer
Jukka Kemppainen, Johanna Hynninen, Johanna Virtanen, Marko Seppänen
Seminars in Nuclear Medicine.2019; 49(6): 484. CrossRef
Cutaneous Metastases in Ovarian Cancer
Isao Otsuka
Cancers.2019; 11(9): 1292. CrossRef
Skin metastases in ovarian clear cell adenocarcinoma: a case report and a review of the literature
Gina Nam, Young-mee Lim, Min Sun Cho, Junghye Lee, Yun Hwan Kim
Obstetrics & Gynecology Science.2017; 60(6): 593. CrossRef
Two independent incidences of skin metastases in the umbilicus and abdominal wall in ovarian serous adenocarcinoma
Hongyan Cheng, Chunmei Gao, Runtong Zhang, Zhaojie Yang, Guiyu Zhang
Medicine.2017; 96(49): e9118. CrossRef
Cutaneous metastases from adenocarcinoma of the ovary
Heidi H. McDonald, Milton R. Moore, Jeffrey J. Meffert
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Ovarian carcinoma presenting as cutaneous nasal metastasis
Ana Marta António, João Vitor Alves, João Goulão, Elvira Bártolo
Anais Brasileiros de Dermatologia.2016; 91(5 suppl 1): 101. CrossRef

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Benign Metastasizing Leiomyoma with Multiple Lymph Node Metastasis: A Case Report: Gun Yoon, Tae-Joong Kim, Chang-Ohk Sung, Chel Hun Choi, Jeong-Won Lee, Je-Ho Lee, Duk-Soo Bae, Byoung-Gie Kim; Cancer Res Treat. 2011;43(2):131-133. Published online June 30, 2011; DOI: https://doi.org/10.4143/crt.2011.43.2.131

Abstract PDF PubReader ePub

This is a case report about benign metastasizing leiomyoma with multiple lymph node metastasis. A 34-year-old woman received an abdominal myomectomy for a suspicious leiomyoma. On the pathology report, atypical leiomyoma was suspected. Due to the suspicion of multiple lymph node metastasis on pelvis computed tomography (CT) 1 year after the operation, she was transferred to the Samsung Medical Center on October, 2009 for further work up. According to original slide review, it was determined to be a benign leiomyoma with a mitotic count <5/10 high-power fields, little cytological atypia and no tumor cell necrosis. Additional immunostaining was done. Multiple lymph node metastasis and a small lung nodule were identified on positron emission tomogarphy-CT and chest CT. Extensive debulking surgery and diagnostic video-assisted thoracoscopic surgery (VATS) wedge resection were subsequently done. Metastatic lesions were reported to have a histology similar to that of the original mass. VATS right upper lobectomy with mediastinal lymph node dissection was performed because of the pathology result of VATS (adenocarcinoma). She started taking an aromatase inhibitor (Letrozole(R)) and there was no evidence of recurrence of disease on an imaging study and no post-operative complications until recently.

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Original Articles

Uterine Leiomyosarcoma : 14-year Two-center Experience of 31 Cases: Woo Young Kim, Suk-Joon Chang, Ki-Hong Chang, Jong-Hyuck Yoon, Jang Hee Kim, Byoung-Gie Kim, Duk-Soo Bae, Hee-Sug Ryu; Cancer Res Treat. 2009;41(1):24-28. Published online March 31, 2009; DOI: https://doi.org/10.4143/crt.2009.41.1.24

Abstract PDF PubReader ePub

Purpose

The aim of this study was to evaluate the clinicopathological characteristics of uterine leiomyosarcoma (LMS) and possible prognostic factors.

Materials and Methods

This study included 31 patients with histologically proven LMS at Samsung Medical Center and Ajou University Hospital between 1994 and 2007. The medical records and available histological slides were reviewed retrospectively.

Results

The median age was 46 years (range, 32~63). The most common symptom was vaginal bleeding (11 patients, 35.5%). There were 23 patients with stage I, one patient with stage III, seven patients with stage IV disease. The median follow up time was 29 months (range, 1~94). The most common recurrence site was lung (5 case), followed by pelvis and upper abdomen (2 case). Nine patients died of disease with a 5-year overall survival rate of 63%. Early tumor stage and mitotic count were the prognostic factor in univariate analysis (p<0.0001 and p=0.0031, respectively), but early tumor stage only was associated with prognosis in multivariate analysis (p=0.010 vs p=0.143). Adjuvant treatment for early stage disease did not decrease the recurrence rate (p=0.1075), but high mitotic count (15>10HPF) had a trend for disease recurrence in early stage LMS (p=0.0859).

Conclusion

Mitotic count less than 15/HPF in early stage may be related with longer progression-free interval, but we could not reach the conclusion that adjuvant therapy in early stage LMS be effective.

Citations

Citations to this article as recorded by

2‑D08 mediates notable anticancer effects through multiple cellular pathways in uterine leiomyosarcoma cells
Hosouk Joung, Hyunju Liu
Oncology Reports.2024;[Epub] CrossRef
Anticancer Activity of the Combination of Cabozantinib and Temozolomide in Uterine Sarcoma
Joseph J. Noh, Young-Jae Cho, Ji-Yoon Ryu, Jung-Joo Choi, Jae Ryoung Hwang, Ju-Yeon Choi, Jeong-Won Lee
Clinical Cancer Research.2022; 28(17): 3850. CrossRef
Epigenetic Features in Uterine Leiomyosarcoma and Endometrial Stromal Sarcomas: An Overview of the Literature
Bruna Cristine de Almeida, Laura Gonzalez dos Anjos, Andrey Senos Dobroff, Edmund Chada Baracat, Qiwei Yang, Ayman Al-Hendy, Katia Candido Carvalho
Biomedicines.2022; 10(10): 2567. CrossRef
Impact of Chemotherapy in the Adjuvant Setting of Early Stage Uterine Leiomyosarcoma: A Systematic Review and Updated Meta-Analysis
Alessandro Rizzo, Margherita Nannini, Annalisa Astolfi, Valentina Indio, Pierandrea De Iaco, Anna Myriam Perrone, Antonio De Leo, Lorena Incorvaia, Valerio Di Scioscio, Maria Abbondanza Pantaleo
Cancers.2020; 12(7): 1899. CrossRef
Adjuvant Chemotherapy in Uterine Leiomyosarcoma: Trends and Factors Impacting Usage
Dhara Patel, Elizabeth Handorf, Margaret von Mehren, Lainie Martin, Sujana Movva
Sarcoma.2019; 2019: 1. CrossRef
Prognostic factors for recurrence and survival in uterine leiomyosarcoma: Korean single center experience with 50 cases
E Sun Paik, Jae Hong Kang, Jihye Kim, Yeon-Joo Lee, Chel Hun Choi, Tae-Joong Kim, Byoung-Gie Kim, Duk-Soo Bae, Jeong-Won Lee
Obstetrics & Gynecology Science.2019; 62(2): 103. CrossRef
Effect of adjuvant therapy on the risk of recurrence in early-stage leiomyosarcoma: A meta-analysis
Su Hyun Chae, Seung-Hyuk Shim, Misoo Chang, Ah Young Choi, Gun Gu Kang, Sun Joo Lee, Soo-Nyung Kim
Gynecologic Oncology.2019; 154(3): 638. CrossRef
Clinicopathological Correlation of Uterine Corpus Tumors: A Study of 433 Cases
Divya Shekhar Shetty, Alka Vikas Gosavi, Prashant Shankarrao Murarkar, Kalpana Ranjitsingh Sulhyan
Indian Journal of Gynecologic Oncology.2019;[Epub] CrossRef
Efficacy of adjuvant chemotherapy in early stage uterine leiomyosarcoma: A systematic review and meta-analysis
Giorgio Bogani, Giovanni Fucà, Giuseppa Maltese, Antonino Ditto, Fabio Martinelli, Mauro Signorelli, Valentina Chiappa, Cono Scaffa, Ilaria sabatucci, Francesca Lecce, Francesco Raspagliesi, Domenica Lorusso
Gynecologic Oncology.2016; 143(2): 443. CrossRef
Uterine sarcomas and parasitic myomas after laparoscopic hysterectomy with power morcellation
Jasmine Tan-Kim, Katherine A. Hartzell, Caryl S. Reinsch, Cristina H. O’Day, John S. Kennedy, Shawn A. Menefee, Terry A. Harrison
American Journal of Obstetrics and Gynecology.2015; 212(5): 594.e1. CrossRef
Successful removal of uterine leiomyosarcoma tumour thrombus propagating to the right atrium
Yu Hui Lim, Lui Shiong Lee, Chong Hee Lim, Ghee Kheng Chew
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Lung Metastasis after an Eighteen-Years-Long Disease-Free Period since Uterine Leiomyosarcoma Diagnosis
M. Guazzaroni, D. Tosti, M. Rascioni, M. Mataloni, D. Citraro, G. Simonetti
Case Reports in Oncological Medicine.2014; 2014: 1. CrossRef
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Ga Won Yim, Eun Ji Nam, Sang Wun Kim, Young Tae Kim
Yonsei Medical Journal.2014; 55(3): 563. CrossRef
Postoperative radiotherapy improves local control and survival in patients with uterine leiomyosarcoma
Philip Wong, Kathy Han, Jenna Sykes, Charles Catton, Stephane Laframboise, Anthony Fyles, Lee Manchul, Wilfred Levin, Michael Milosevic
Radiation Oncology.2013;[Epub] CrossRef
Uterine Sarcomas: Then and Now
Shaan H. Shah, Jyothi P. Jagannathan, Katherine Krajewski, Kevin N. O???Regan, Suzanne George, Nikhil H. Ramaiya
American Journal of Roentgenology.2012; 199(1): 213. CrossRef
Prognostic Factors and Outcomes in 28 Cases of Uterine Leiomyosarcoma
V. Loizzi, G. Cormio, D. Nestola, M. Falagario, A. Surgo, A. Camporeale, G. Putignano, L. Selvaggi
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Surgical treatment of uterine sarcoma
Joo-Hyun Nam
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The impact of tumor morcellation during surgery on the prognosis of patients with apparently early uterine leiomyosarcoma
Jeong-Yeol Park, Sun-Kyung Park, Dae-Yeon Kim, Jong-Hyeok Kim, Yong-Man Kim, Young-Tak Kim, Joo-Hyun Nam
Gynecologic Oncology.2011; 122(2): 255. CrossRef
Co-existence of three rare gynecological tumors in a 79-year-old woman
Hongkai Zhang, Melinda Lerwill
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10,762 View
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19 Crossref

MR Imaging in Endometrial Carcinoma as a Diagnostic Tool for the Prediction of Myometrial Invasion and Lymph Node Metastasis: Ui Nam Ryoo, Chel Hun Choi, Ji Yeong Yoon, Soo Kyung Noh, Heeseok Kang, Woo Young Kim, Boh Hyun Kim, Tae-Joong Kim, Jeong-Won Lee, Je-Ho Lee, Byoung-Gie Kim, Duk-Soo Bae; Cancer Res Treat. 2007;39(4):165-170. Published online December 31, 2007; DOI: https://doi.org/10.4143/crt.2007.39.4.165

Abstract PDF PubReader ePub

Purpose

The purpose of this study was to evaluate the factors that are associated with the accuracy of magnetic resonance (MR) imaging for predicting myometrial invasion and lymph node metastasis in women with endometrial carcinoma.

Materials and Methods

We retrospectively reviewed the medical records and preoperative MR imaging reports of 128 women who had pathologically proven endometrial carcinoma. We compared the MR imaging and the histopathology findings.

Results

The sensitivity, specificity and accuracy for identifing any myometrial invasion (superficial or deep) were 0.81, 0.61 and 0.74, respectively; these values for deep myometrial invasion were 0.60, 0.94 and 0.86, respectively. The sensitivity, specificity and accuracy of MR imaging for detecting lymph node metastasis were 50.0%, 96.6% and 93.0%, respectively. The patients who were older, had more deliveries and a larger tumor size more frequently had incorrect prediction of deep myometrial invasion (p=0.034, p=0.044, p=0.061, respectively). A higher tumor grade, a histology other than the endometrioid type, myometrial invasion on MR findings and a larger tumor size were associated with a more frequent false-negative prediction of lymph node metastasis (p=0.018, p=0.017, p=0.002, p=0.047, respectively). A larger tumor size was also associated with more frequent false-positive results (p=0.009).

Conclusions

There are several factors that make accurate assessment of myometrial invasion or lymph node metastasis difficult with using MRI; therefore, the patients with these factors should have their MR findings cautiously interpreted.

Citations

Citations to this article as recorded by

Magnetic resonance imaging pitfalls in determining myometrial invasion in stage I endometrial cancer: A case report and literature review
Hariyono Winarto, Muhammad Habiburrahman, Trifonia Pingkan Siregar, Kartiwa Hadi Nuryanto
Radiology Case Reports.2022; 17(8): 2680. CrossRef
Diagnostic Accuracy of Clinical Biomarkers for Preoperative Prediction of Lymph Node Metastasis in Endometrial Carcinoma: A Systematic Review and Meta-Analysis
Casper Reijnen, Joanna IntHout, Leon F.A.G. Massuger, Fleur Strobbe, Heidi V.N. Küsters-Vandevelde, Ingfrid S. Haldorsen, Marc P.L.M. Snijders, Johanna M.A. Pijnenborg
The Oncologist.2019; 24(9): e880. CrossRef
Feasibility of a reduced field‐of‐view diffusion‐weighted (rFOV) sequence in assessment of myometrial invasion in patients with clinical FIGO stage I endometrial cancer
Priya Bhosale, Jingfei Ma, Revathy Iyer, Preetha Ramalingam, Wei Wei, Pamela Soliman, Michael Frumovitz, Vikas Kundra
Journal of Magnetic Resonance Imaging.2016; 43(2): 316. CrossRef
Contrast‐enhanced MRI in preoperative assessment of myometrial and cervical invasion, and lymph node metastasis: diagnostic value and error analysis in endometrial carcinoma
Fei Teng, Yan‐Fang Zhang, Ying‐Mei Wang, Jing Yu, Xu Lang, Wen‐Yan Tian, Chang‐Xin Jiang, Feng‐Xia Xue
Acta Obstetricia et Gynecologica Scandinavica.2015; 94(3): 266. CrossRef
Magnetic Resonance Imaging in the Assessment of High-Risk Features of Endometrial Carcinoma A Meta-Analysis
Anna Luomaranta, Arto Leminen, Mikko Loukovaara
International Journal of Gynecological Cancer.2015; 25(5): 837. CrossRef
Predictive value of serum human epididymis protein 4 and cancer antigen 125 concentrations in endometrial carcinoma
Sami K. Saarelainen, Nina Peltonen, Terho Lehtimäki, Antti Perheentupa, Maarit H. Vuento, Johanna U. Mäenpää
American Journal of Obstetrics and Gynecology.2013; 209(2): 142.e1. CrossRef
Preoperative assessment of endometrial carcinoma by three‐dimensional power Doppler angiography
S. K. Saarelainen, M. H. Vuento, P. Kirkinen, J. U. Mäenpää
Ultrasound in Obstetrics & Gynecology.2012; 39(4): 466. CrossRef
Pre-operative systemic inflammatory response markers in predicting lymph node metastasis in endometrioid endometrial adenocarcinoma
Dong Hoon Suh, Hee Seung Kim, Hyun Hoon Chung, Jae Weon Kim, Noh Hyun Park, Yong Sang Song, Soon-Beom Kang
European Journal of Obstetrics & Gynecology and Reproductive Biology.2012; 162(2): 206. CrossRef
The preoperative assessment of deep myometrial invasion by three‐dimensional ultrasound versus MRI in endometrial carcinoma
SAMI K. SAARELAINEN, LEA KÖÖBI, RITVA JÄRVENPÄÄ, MARITA LAURILA, JOHANNA U. MÄENPÄÄ
Acta Obstetricia et Gynecologica Scandinavica.2012; 91(8): 983. CrossRef

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