Cancer Research and Treatment

Original Articles

Gynecologic cancer

Image-Guided Versus Conventional Brachytherapy for Locally Advanced Cervical Cancer: Experience of Single Institution with the Same Practitioner and Time Period: Tae Hoon Lee, Kyung Su Kim, Hak Jae Kim, Chang Heon Choi, Seonghee Kang, Keun-Yong Eom, Chan Woo Wee, Yong Sang Song, Noh Hyun Park, Jae-Weon Kim, Hyun Hoon Chung, Hee Seung Kim, Maria Lee, Hyun-Cheol Kang; Cancer Res Treat. 2023;55(1):258-269. Published online August 10, 2022; DOI: https://doi.org/10.4143/crt.2022.418

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to compare treatment outcomes and toxicity profile between imaged-guided brachytherapy (IGBT) versus conventional brachytherapy (CBT) performed by the same practitioner during the same time period.
Materials and Methods
Medical records of 104 eligible patients who underwent brachytherapy for locally advanced cervical cancer were retrospectively reviewed. Fifty patients (48.1%) underwent IGBT, and 54 (51.9%) patients underwent CBT. All patients underwent concurrent chemoradiation with cisplatin. High-dose-rate intracavitary brachytherapy with dose prescription of 25-30 Gy in 4-6 fractions was performed for all patients. Late lower gastrointestinal (GI) and urinary toxicities occurred more than 3 months after the end of brachytherapy were included for comparative and dosimetric analyses.
Results
The median follow-up period was 18.33 months (range, 3.25 to 38.43 months). There were no differences in oncologic outcomes between the two groups. The IGBT group had lower rate of actuarial grade ≥ 3 toxicity than the CBT group (2-year, 4.5% vs. 25.7%; p=0.030). Cumulative equieffective D2cc of sigmoid colon was significantly correlated with grade ≥ 2 lower GI toxicity (p=0.033), while equieffective D2cc of rectum (p=0.055) and bladder (p=0.069) showed marginal significance with corresponding grade ≥ 2 toxicities in the IGBT group. Half of grade ≥ 3 lower GI toxicities impacted GI tract above the rectum. Optimal thresholds of cumulative D2cc of sigmoid colon and rectum were 69.7 Gy and 70.8 Gy, respectively, for grade ≥ 2 lower GI toxicity.
Conclusion
IGBT showed superior toxicity profile to CBT. Evaluating the dose to the GI tract above rectum by IGBT might prevent some toxicities.

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Cisplatin

Reactions Weekly.2023; 1947(1): 125. CrossRef
A Mixed Methods Study to Implement the Synergy Tool and Evaluate Its Impact on Long-Term Care Residents
Farinaz Havaei, Francis Kobekyaa, Andy Ma, Maura MacPhee, Wei Zhang, Megan Kaulius, Bahar Ahmadi, Sheila Boamah, Adam Easterbrook, Amy Salmon
Healthcare.2023; 11(15): 2187. CrossRef

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Effect of BRCA1/2 Mutational Status on Survival Outcomes According to Secondary Cytoreductive Surgery and Maintenance Therapy in Platinum-Sensitive Relapsed Ovarian Cancer: A Real-World Evidence Study: Se Ik Kim, Hyunji Lim, Hee Seung Kim, Hyun Hoon Chung, Jae-Weon Kim, Noh Hyun Park, Yong-Sang Song, Maria Lee; Cancer Res Treat. 2023;55(1):245-257. Published online July 19, 2022; DOI: https://doi.org/10.4143/crt.2022.232

Abstract PDF Supplementary Material PubReader ePub: Purpose
This study aimed to investigate the impact of BRCA1/2 mutational status on survival outcomes in patients with platinum-sensitive relapsed (PSR) epithelial ovarian cancer (EOC).
Materials and Methods
We retrospectively identified patients who received secondary treatment for PSR EOC at our institution between January 2007 and June 2021 and who underwent BRCA1/2 gene testing by either germline or somatic methods. The association between BRCA1/2 mutational status and survival outcomes was evaluated. Both secondary cytoreductive surgery (CRS) and maintenance therapy were stratified considering real-world clinical practice.
Results
Of 262 patients, 91 (34.7%) and 171 (65.3%) were assigned to BRCA1/2 mutation and wild-type groups, respectively. The two groups had similar proportions of patients undergoing secondary CRS (26.4% vs. 32.7%, p=0.286) and maintenance therapy (54.9% vs. 46.2%, p=0.178). Overall, no differences in progression-free survival (PFS; median, 19.7 vs. 15.1 months, p=0.120) and overall survival (OS; p=0.400) were observed between the two groups. In multivariate analyses, BRCA1/2 mutational status was not associated with PFS (adjusted hazard ratio, 0.816; 95% confidence interval, 0.596 to 1.119; p=0.207). BRCA1/2 mutational status did not affect PFS among patients who underwent secondary CRS (n=80) and among those who did not (n=182) (p=0.074 and p=0.222, respectively). PFS did not differ in the BRCA1/2 mutational status among the patients who received bevacizumab maintenance (n=90, p=0.992).
Conclusion
In this real-world evidence study, BRCA1/2 mutational status itself was not associated with PFS and OS in PSR EOC, which was consistent with whether secondary CRS or not and with bevacizumab maintenance.

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Identification of Patients with Recurrent Epithelial Ovarian Cancer Who Will Benefit from More Than Three Lines of Chemotherapy: Aeran Seol, Ga Won Yim, Joo Yeon Chung, Se Ik Kim, Maria Lee, Hee Seung Kim, Hyun Hoon Chung, Jae-Weon Kim, Noh Hyun Park, Yong Sang Song; Cancer Res Treat. 2022;54(4):1219-1229. Published online November 17, 2021; DOI: https://doi.org/10.4143/crt.2021.1010

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to identify patients who would benefit from third and subsequent lines of chemotherapy in recurrent epithelial ovarian cancer (EOC).
Materials and Methods
Recurrent EOC patients who received third, fourth, or fifth-line palliative chemotherapy were retrospectively analyzed. Patients’ survival outcomes were assessed according to chemotherapy lines. Based on the best objective response, patients were divided into good-response (stable disease or better) and poor response (progressive disease or those who died before response assessment) groups. Survival outcomes were compared between the two groups, and factors associated with chemotherapy responses were investigated.
Results
A total of 189 patients were evaluated. Ninety-four and 95 patients were identified as good and poor response group respectively, during the study period of 2008 to 2021. The poor response group showed significantly worse progression-free survival (median, 2.1 months vs. 9.7 months; p < 0.001) and overall survival (median, 5.0 months vs. 22.9 months; p < 0.001) compared with the good response group. In multivariate analysis adjusting for clinicopathologic factors, short treatment-free interval (TFI) (hazard ratio [HR], 5.557; 95% confidence interval [CI], 2.403 to 12.850), platinum-resistant EOC (HR, 2.367; 95% CI, 1.017 to 5.510), and non-serous/endometrioid histologic type (HR, 5.045; 95% CI, 1.152 to 22.088) were identified as independent risk factors for poor response. There was no difference in serious adverse events between good and poor response groups (p=0.167).
Conclusion
Third and subsequent lines of chemotherapy could be carefully considered for palliative purposes in recurrent EOC patients with serous or endometrioid histology, initial platinum sensitivity, and long TFIs from the previous chemotherapy regimen.

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CircSETDB1 contributes to paclitaxel resistance of ovarian cancer cells by sponging miR-508-3p and regulating ABCC1 expression
Chunyan Huang, Li Qin, Sailan Chen, Qin Huang
Anti-Cancer Drugs.2022;[Epub] CrossRef

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Germline and Somatic BRCA1/2 Gene Mutational Status and Clinical Outcomes in Epithelial Peritoneal, Ovarian, and Fallopian Tube Cancer: Over a Decade of Experience in a Single Institution in Korea: Se Ik Kim, Maria Lee, Hee Seung Kim, Hyun Hoon Chung, Jae-Weon Kim, Noh Hyun Park, Yong-Sang Song; Cancer Res Treat. 2020;52(4):1229-1241. Published online July 27, 2020; DOI: https://doi.org/10.4143/crt.2020.557

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to present a single institutional experience with BRCA1/2 gene tests and the effects of pathogenic mutations in epithelial peritoneal, ovarian, and fallopian tube cancer (POFTC) on survival outcomes.
Materials and Methods
We identified patients with epithelial POFTCs who underwent BRCA1/2 gene testing by either germline or somatic methods between March 2007 and March 2020. Based on the BRCA1/2 test results, patients were divided into BRCA mutation and wild-type groups, followed by comparisons of clinicopathologic characteristics and survival outcomes after primary treatment.
Results
The annual number of POFTC patients who received BRCA1/2 gene tests increased gradually. In total, 511 patients were included and BRCA1/2 mutations were observed in 143 (28.0%). Among 57 patients who received both germline and somatic tests, three (5.3%) showed discordant results from the two tests. Overall, no differences in progression-free survival (PFS; p=0.467) and overall survival (p=0.641) were observed between the BRCA mutation and wild-type groups; however, multivariate analyses identified BRCA1/2 mutation as an independent favorable prognostic factor for PFS (adjusted hazard ratio [aHR], 0.765; 95% confidence interval [CI], 0.593 to 0.987; p=0.040). In 389 patients with International Federation of Gynecology and Obstetrics stage III-IV, different results were shown depending on primary treatment strategy: while BRCA1/2 mutation significantly improved PFS in the subgroup of neoadjuvant chemotherapy (aHR, 0.619; 95% CI, 0.385 to 0.995; p=0.048), it did not affect patient PFS in the subgroup of primary debulking surgery (aHR, 0.759; 95% CI, 0.530 to 1.089; p=0.135).
Conclusion
BRCA1/2 mutations are frequently observed in patients with epithelial POFTCs, and such patients showed better PFS than did those harboring wild-type BRCA1/2.

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Overview of Molecular Diagnostics in Irish Clinical Oncology
Tyler Medina, Seán O. Hynes, Maeve Lowery, Paddy Gillespie, Walter Kolch, Cathal Seoighe
HRB Open Research.2024; 7: 16. CrossRef
Trends in the Incidence and Survival Rates of Primary Ovarian Clear Cell Carcinoma Compared to Ovarian Serous Carcinoma in Korea
Se Ik Kim, Hyeong In Ha, Kyung Jin Eoh, Jiwon Lim, Young-Joo Won, Myong Cheol Lim
Frontiers in Oncology.2022;[Epub] CrossRef
Characteristics of homologous recombination repair pathway genes mutation in ovarian cancers
Zongbi Yi, Min Chen, Shaoxing Sun, Chunxu Yang, Zijie Mei, Hui Yang, Qingming Xiang, Hui Qiu
Cancer Innovation.2022; 1(3): 220. CrossRef

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An Alternative Triage Strategy Based on Preoperative MRI for Avoiding Trimodality Therapy in Stage IB Cervical Cancer: Jung-Yun Lee, Jina Youm, Jae Weon Kim, Kidong Kim, Hak Jae Kim, Jeong Yeon Cho, Min A Kim, Noh Hyun Park, Yong-Sang Song; Cancer Res Treat. 2016;48(1):259-265. Published online March 20, 2015; DOI: https://doi.org/10.4143/crt.2014.370

Abstract PDF PubReader ePub

Purpose
Adjuvant chemoradiation following primary surgery is frequently indicated in patients with stage IB cervical cancer. The aim of this study is to evaluate the role of a magnetic resonance imaging (MRI)-based strategy in avoiding trimodality therapy.
Materials and Methods
We retrospectively reviewed all patients with stage IB cervical cancer treated initially with primary surgery at Seoul National University Hospital. We suggest an alternative triage strategy in which the primary treatment modality is determined based on preoperative MRI findings. Using this strategy, primary surgery is only indicated when there is no evidence of parametrial involvement (PMI) and lymph node metastasis (LNM) in the MRI results; when there is evidence of either or both of these factors, primary chemoradiation is selected. Assuming that this strategy is applied to our cohort, we evaluate how the rate of trimodality therapy is affected.
Results
Of the 254 patients in our sample, 77 (30.3%) had at least one category 1 risk factor (PMI, LNM, positive resection margin) upon pathologic examination. If the MRI-based strategy had been applied to our cohort, 168 patients would have undergone primary surgery and 86 would have undergone primary chemoradiation. Only 25 patients (9.8%) would have required trimodality therapy based on an indication of at least one category 1 pathologic risk factor following radical hysterectomy.
Conclusion
The inclusion of MRI in the decision-making process for primary treatment modality could have reduced the number of patients requiring trimodality therapy based on the indication of a category 1 risk factor from 30.3% to 9.8% in our cohort.

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Deep-learning-based radiomics of intratumoral and peritumoral MRI images to predict the pathological features of adjuvant radiotherapy in early-stage cervical squamous cell carcinoma
Xue-Fang Zhang, Hong-yuan Wu, Xu-Wei Liang, Jia-Luo Chen, Jianpeng Li, Shihao Zhang, Zhigang Liu
BMC Women's Health.2024;[Epub] CrossRef
Definitive Chemoradiotherapy versus Radical Hysterectomy Followed by Tailored Adjuvant Therapy in Women with Early-Stage Cervical Cancer Presenting with Pelvic Lymph Node Metastasis on Pretreatment Evaluation: A Propensity Score Matching Analysis
Jongmoo Park, Yeon-Joo Kim, Mi-Kyung Song, Joo-Hyun Nam, Sang-Yoon Park, Young-Seok Kim, Joo-Young Kim
Cancers.2021; 13(15): 3703. CrossRef
Quality of life among survivors of early-stage cervical cancer in Taiwan: an exploration of treatment modality differences
Chia-Chun Li, Ting-Chang Chang, Yun-Fang Tsai, Lynn Chen
Quality of Life Research.2017; 26(10): 2773. CrossRef
Parametrial Involvement on Magnetic Resonance Imaging Has No Effect on the Survival of Early-Stage Cervical Cancer Patients
Kyungmi Yang, Won Park, Seung Jae Huh, Byung Kwan Park, Chan Kyo Kim, Byoung-Gie Kim, Duk-Soo Bae, Jeong-Won Lee
International Journal of Gynecological Cancer.2017; 27(3): 507. CrossRef
Treatment strategies for stage IB cervical cancer: A cost-effectiveness analysis from Korean, Canadian and US perspectives
Jung-Yun Lee, Janice S. Kwon, David E. Cohn, Younhee Kim, Blair Smith, Tae-Jin Lee, Jae-Weon Kim
Gynecologic Oncology.2016; 140(1): 83. CrossRef

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Safety of Fertility-Sparing Surgery in Primary Mucinous Carcinoma of the Ovary: Jung-Yun Lee, Yu Ri Jo, Tae Hun Kim, Hee Seung Kim, Min A Kim, Jae Weon Kim, Noh Hyun Park, Yong-Sang Song; Cancer Res Treat. 2015;47(2):290-305. Published online August 29, 2014; DOI: https://doi.org/10.4143/crt.2014.004

Abstract PDF PubReader ePub

Purpose
The aim of this study is to evaluate the safety of fertility-sparing surgery as the treatment for patients with primary mucinous epithelial ovarian cancer.
Materials and Methods
A retrospective study of patients with mucinous ovarian cancer between 1991 and 2010 was performed. The demographics and survival outcomes were compared between patients who underwent fertility-sparing surgery and those who underwent radical surgery.
Results
A total of 110 patients underwent primary surgery. At the time of surgery, tumors appeared to be grossly confined to the ovaries in 90 patients, and evidence of metastasis was definite in 20 patients. Of the 90 patients with tumors that appeared to be grossly confined to the ovaries at surgical exploration, 35 (38.9%) underwent fertility-sparing surgery. The Kaplan- Meier curve and the log rank test showed no difference in either recurrence-free survival (p=0.792) or disease-specific survival (p=0.706) between the two groups. Furthermore, there was no significant difference in recurrence-free survival (p=0.126) or disease-specific survival (p=0.377) between the two groups, even when the analysis was limited to women below the age of 40. In a multivariate Cox model, fertility-sparing surgery had no effect on either recurrence-free survival (recurrence hazard ratio [HR], 1.20; 95% confidence interval [CI], 0.25 to 5.71) or disease-specific survival (death HR, 0.88; 95% CI, 0.17 to 4.60).
Conclusion
Fertility-sparing surgery in primary mucinous cancer grossly confined to the ovaries may be a safe option and one not associated with an increase in recurrence or mortality.

Citations

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A Complex Case: Solid Unilateral Ovarian Mucinous Carcinoma Masquerading as Leiomyosarcoma in Postmenopausal Women
Naina Kumar, Immanuel Pradeep, Mishu Mangla, Annapurna Srirambhatla
Current Womens Health Reviews.2025;[Epub] CrossRef
Safety of fertility-sparing surgery in young women with stage I endometrioid epithelial and mucinous ovarian cancer: A population-based analysis
Jing Li, Huimin Qiao, Yunyun Liu, Chunxian Huang, Aoshuang Cheng, Zhongqiu Lin, Lijuan Wang, Huaiwu Lu
European Journal of Surgical Oncology.2024; 50(1): 107276. CrossRef
Mucinous ovarian carcinoma: A survey of practice in Australia and New Zealand
Niveditha Rajadevan, Ariane Flinkier, Hugo Saunders, Yeh Chen Lee, Clare Scott, Pearly Khaw, Prue Allan, Claire Davies, John Andrews, Michelle Wilson, Janine M Lombard, Michelle Harrison, Heshani Nesfield, Anna DeFazio, Tarek Meniawy, Kylie L Gorringe
Australian and New Zealand Journal of Obstetrics and Gynaecology.2024; 64(4): 319. CrossRef
Evaluation of Outcomes of Mucinous Ovarian Cancer Treated at a Tertiary Care Cancer Hospital in Pakistan
Syed Abdul Mannan Hamdani, Musa Azhar, Abdul Wahab, Tahira Yasmeen, Neelam Siddiqui
South Asian Journal of Cancer.2023; 12(01): 081. CrossRef
Update on Prognostic and Predictive Markers in Mucinous Ovarian Cancer
Fulvio Borella, Marco Mitidieri, Stefano Cosma, Chiara Benedetto, Luca Bertero, Stefano Fucina, Isabelle Ray-Coquard, Annalisa Carapezzi, Domenico Ferraioli
Cancers.2023; 15(4): 1172. CrossRef
Safety of fertility sparing management in invasive mucinous ovarian carcinoma
Soyoun Rachel Kim, Ainhoa Madariaga, Liat Hogen, Danielle Vicus, Allan Covens, Carlos Parra-Herran, Stephanie Lheureux, Lilian T. Gien
Gynecologic Oncology.2023; 174: 129. CrossRef
Rare Epithelial Ovarian Cancers: Low Grade Serous and Mucinous Carcinomas
Olivia Craig, Abhimanyu Nigam, Genevieve V. Dall, Kylie Gorringe
Cold Spring Harbor Perspectives in Medicine.2023; 13(9): a038190. CrossRef
Oncological and Reproductive Outcomes After Fertility-Sparing Surgery for Stage I Mucinous Ovarian Carcinoma
Wei Lin, Dongyan Cao, Xiaohua Shi, Yan You, Jiaxin Yang, Keng Shen
Frontiers in Oncology.2022;[Epub] CrossRef
Surgical treatment for clinical early-stage expansile and infiltrative mucinous ovarian cancer: can staging surgeries safely be omitted?
Marc D. Algera, Willemien J. van Driel, Koen K. van de Vijver, Roy F.P.M. Kruitwagen, Christianne A.R. Lok
Current Opinion in Oncology.2022; 34(5): 497. CrossRef
Primary mucinous ovarian cancer: options for surgery and chemotherapy
Katherine C Kurnit, Michael Frumovitz
International Journal of Gynecologic Cancer.2022; 32(11): 1455. CrossRef
Outcomes after Fertility-sparing Surgery for Women with Ovarian Cancer: A Systematic Review of the Literature
Alexandra Bercow, Roni Nitecki, Paula C. Brady, J.Alejandro Rauh-Hain
Journal of Minimally Invasive Gynecology.2021; 28(3): 527. CrossRef
Fertility preserving surgery in carcinoma ovary: a single institution experience
T. Subramanyeshwar Rao, KVVN Raju, Vikas Gupta, R. Rajagopalan Iyer
Indian Journal of Gynecologic Oncology.2021;[Epub] CrossRef
Fertility-Sparing Surgery in Gynecologic Cancer: A Systematic Review
Teska Schuurman, Sanne Zilver, Sanne Samuels, Winnie Schats, Frédéric Amant, Nienke van Trommel, Christianne Lok
Cancers.2021; 13(5): 1008. CrossRef
Fertility preservation in rare ovarian tumors
Anca Chelariu-Raicu, Lauren P Cobb, David M Gershenson
International Journal of Gynecologic Cancer.2021; 31(3): 432. CrossRef
Oncologic outcomes of uterine preservation for pre-menopausal patients with stage II epithelial ovarian carcinoma
Dimitrios Nasioudis, Lakeisha Mulugeta-Gordon, Erin McMinn, Maureen Byrne, Emily M Ko, Lori Cory, Ashley F Haggerty, Nawar A Latif
International Journal of Gynecologic Cancer.2021; 31(3): 480. CrossRef
Fertility-Sparing Surgery for Ovarian Cancer
Geoffroy Canlorbe, Nathalie Chabbert-Buffet, Catherine Uzan
Journal of Clinical Medicine.2021; 10(18): 4235. CrossRef
Emerging molecular alterations leading to histology-specific targeted therapies in ovarian cancer beyond PARP inhibitors
M. Bartoletti, L. Musacchio, G. Giannone, V. Tuninetti, A. Bergamini, G. Scambia, D. Lorusso, G. Valabrega, G. Mangili, F. Puglisi, S. Pignata
Cancer Treatment Reviews.2021; 101: 102298. CrossRef
Options for the Treatment of Mucinous Ovarian Carcinoma
Olivia Craig, Carolina Salazar, Kylie L. Gorringe
Current Treatment Options in Oncology.2021;[Epub] CrossRef
Fertility sparing surgery vs radical surgery for epithelial ovarian cancer: a meta-analysis of overall survival and disease-free survival
Denghua Liu, Jing Cai, Aiwei Gao, Zehua Wang, Liqiong Cai
BMC Cancer.2020;[Epub] CrossRef
Fertility‐sparing treatment for early‐stage epithelial ovarian cancer: Contemporary oncologic, reproductive and endocrinologic perspectives
Rachel S. Mandelbaum, Maximilian Klar, Tsuyoshi Takiuchi, Liat Bainvoll, Shinya Matsuzaki, Richard J. Paulson, Koji Matsuo
Journal of Obstetrics and Gynaecology Research.2020; 46(8): 1263. CrossRef
Impact of uterus‐preserving surgery on Stage I primary mucinous epithelial ovarian carcinoma: A multi‐institutional study with propensity score‐weighted analysis
Masato Yoshihara, Hiroaki Kajiyama, Satoshi Tamauchi, Shohei Iyoshi, Akira Yokoi, Shiro Suzuki, Michiyasu Kawai, Tetsuro Nagasaka, Kunihiko Takahashi, Shigeyuki Matsui, Fumitaka Kikkawa
International Journal of Gynecology & Obstetrics.2020; 150(2): 177. CrossRef
Tumeurs épithéliales de l’ovaire : préservation de la fertilité. Article rédigé sur la base de la recommandation nationale de bonnes pratiques cliniques en cancérologie intitulée « Conduites à tenir initiales devant des patientes atteintes d’un cancer épi
C. Uzan, B. Courbiere, N. Chabbert-Buffet
Gynécologie Obstétrique Fertilité & Sénologie .2019; 47(2): 180. CrossRef
Mucinous Ovarian Carcinoma
Dan L. Longo, Philippe Morice, Sebastien Gouy, Alexandra Leary
New England Journal of Medicine.2019; 380(13): 1256. CrossRef
Early stage mucinous ovarian cancer: A review
Erin K. Crane, Jubilee Brown
Gynecologic Oncology.2018; 149(3): 598. CrossRef
Results of Fertility-Sparing Surgery for Expansile and Infiltrative Mucinous Ovarian Cancers
Sebastien Gouy, Marine Saidani, Amandine Maulard, Slim Bach-Hamba, Enrica Bentivegna, Alexandra Leary, Patricia Pautier, Mojgan Devouassoux-Shisheboran, Catherine Genestie, Philippe Morice
The Oncologist.2018; 23(3): 324. CrossRef
Assisted reproductive techniques after fertility-sparing treatments in gynaecological cancers
Ignacio Zapardiel, Maria Cruz, Maria D. Diestro, Antonio Requena, Juan A. Garcia-Velasco
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Fertility-Sparing Surgery in Epithelial Ovarian Cancer
Enrica Bentivegna, Philippe Morice, Catherine Uzan, Sebastien Gouy
Future Oncology.2016; 12(3): 389. CrossRef
Mucinous ovarian cancer: A therapeutic review
Wen Xu, Jack Rush, Kirsty Rickett, Jermaine I.G. Coward
Critical Reviews in Oncology/Hematology.2016; 102: 26. CrossRef
Long-term results of fertility-sparing treatment compared with standard radical surgery for early-stage epithelial ovarian cancer
Robert Fruscio, Lorenzo Ceppi, Silvia Corso, Francesca Galli, Tiziana Dell'Anna, Federica Dell'Orto, Daniela Giuliani, Annalisa Garbi, Stefania Chiari, Costantino Mangioni, Rodolfo Milani, Irene Floriani, Nicoletta Colombo, Cristina Maria Bonazzi
British Journal of Cancer.2016; 115(6): 641. CrossRef
Fertility-sparing surgery in epithelial ovarian cancer: a systematic review of oncological issues
E. Bentivegna, S. Gouy, A. Maulard, P. Pautier, A. Leary, N. Colombo, P. Morice
Annals of Oncology.2016; 27(11): 1994. CrossRef

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Impact of Chemoradiation on Prognosis in Stage IVB Cervical Cancer with Distant Lymphatic Metastasis: Hee Seung Kim, Taehun Kim, Eung Seok Lee, Hak Jae Kim, Hyun Hoon Chung, Jae Weon Kim, Yong Sang Song, Noh Hyun Park; Cancer Res Treat. 2013;45(3):193-201. Published online September 30, 2013; DOI: https://doi.org/10.4143/crt.2013.45.3.193

Abstract PDF PubReader ePub

PURPOSE
The purpose of this study was to determine whether chemoradiation (CCR) is efficient for improving prognosis, compared with systemic chemotherapy (SC), in patients with stage IVB cervical cancer who have distant lymphatic metastasis.
MATERIALS AND METHODS
Among 2,322 patients with cervical cancer between January 2000 and March 2010, 43 patients (1.9%) had stage IVB disease. After exclusion of 19 patients due to insufficient data and hematogenous metastasis, 24 patients (1%) who received CCR (n=10) or SC (n=14) were enrolled. We compared tumor response, progression-free survival (PFS) and overall survival (OS), and disease recurrence between CCR and SC.
RESULTS
Complete response rates were 60% and 0% after CCR and SC (p<0.01). Grade 3 or 4 leukopenia was more common in patients treated with CCR (24.4% vs. 9.1%, p=0.03), whereas grade 3 or 4 neuropenia was more frequent in those treated with SC (28.4% vs. 11.1%, p=0.03). Development of grade 3 proctitis occurred as a late radiotherapy (RT)-related toxicity in only one patient (10%) treated with CCR. In addition, squamous cell carcinoma and CCR were favorable prognostic factors for improvement of PFS (adjusted hazard ratios [HRs], 0.17 and 0.12; 95% confidence intervals [CIs], 0.04 to 0.80 and 0.03 to 0.61), and only CCR was significant for improvement of OS (adjusted HR, 0.15; 95% CI, 0.02 to 0.90). However, no differences in the rate and pattern of disease recurrence were observed between CCR and SC.
CONCLUSION
CCR may be more effective than SC for improving survival, and can be regarded as a feasible method with some caution regarding late RT-related toxicity for treatment of stage IVB cervical cancer with distant lymphatic metastasis.

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Intensity-Modulated Radiation Therapy for Uterine Cervical Cancer to Reduce Toxicity and Enhance Efficacy – an Option or a Must?: A Narrative Review
Sea-Won Lee, Aeran Kim, Sung Jong Lee, Sung Hwan Kim, Jong Hoon Lee
Cancer Research and Treatment.2024; 56(1): 1. CrossRef
Outcomes associated with treatment to all sites of disease in patients with stage IVB cancer of the cervix
Shira Peleg Hasson, Shira Felder, Limor Helpman, Alexandra Taylor, Mihal Shalamov, Sireen Abuakar, Smadar Bauer, Ronnie Shapira-Frommer, Inbal Greenhouse, Jacob Korach, Tatiana Rabin, Jeffrey Goldstein, Akram Saad
International Journal of Gynecologic Cancer.2023; 33(5): 683. CrossRef
Definitive pelvic radiotherapy for patients with newly diagnosed stage IVB cervical cancer: a systematic review
David Viveros-Carreño, Santiago Vieira-Serna, Carlos Fernando Grillo - Ardila, Juliana Rodriguez, Nathalia Mora-Soto, Anuja Jhingran, Pedro T Ramirez, Rene Pareja
International Journal of Gynecologic Cancer.2023; 33(7): 1057. CrossRef
Definitive vs palliative pelvic radiation for patients with newly diagnosed stage IVB cervical cancer treated with bevacizumab – An exploratory study
Rachel L. Wiley, Ioana L. Bondre, Randa Jalloul, Ann H. Klopp, Jolyn S. Taylor, Lois M. Ramondetta
Gynecologic Oncology Reports.2022; 40: 100963. CrossRef
Survival, treatment pattern, and treatment outcome in patients with cervical cancer metastatic to distant lymph nodes
Haoliang Lin, Dongyan Wang, Hui Li, Chuling Wu, Fengqian Zhang, Zhongqiu Lin, Tingting Yao
Frontiers in Oncology.2022;[Epub] CrossRef
Dynamic Nomogram Based on the Metastatic Number and Sites and Therapy Strategies Predicting the Prognosis of Patients with Metastatic Cervical Cancer
Yuan Ma, Jing Li, Xinyue Tan, Mengjiao Cai, Xiaozhi Zhang, Jinlu Ma
International Journal of Women's Health.2022; Volume 14: 1807. CrossRef
Significance of Concurrent Chemoradiotherapy as Primary Treatment in Patients with Metastatic Cervical Cancer
Satomi Hattori, Nobuhisa Yoshikawa, Kazumasa Mogi, Kosuke Yoshida, Masato Yoshihara, Satoshi Tamauchi, Yoshiki Ikeda, Akira Yokoi, Kimihiro Nishino, Kaoru Niimi, Shiro Suzuki, Hiroaki Kajiyama
Current Oncology.2021; 28(3): 1663. CrossRef
A Nomogram-Based Risk Classification System Predicting the Overall Survival of Patients With Newly Diagnosed Stage IVB Cervix Uteri Carcinoma
Wenke Yu, Lu Huang, Zixing Zhong, Tao Song, Hong'en Xu, Yongshi Jia, Jinming Hu, Huafeng Shou
Frontiers in Medicine.2021;[Epub] CrossRef
Surgery of primary sites for stage IVB cervical cancer patients receiving chemoradiotherapy: a population-based study
Haoran Li, Yangyang Pang, Xi Cheng
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Feasibility of Oxaliplatin, Leucovorin, and 5-Fluorouracil (FOLFOX-4) Chemotherapy in Heavily Pretreated Patients with Recurrent Epithelial Ovarian Cancer: Hee Jun Lee, Hee Seung Kim, Noh Hyun Park, Hyun Hoon Chung, Jae Weon Kim, Yong Sang Song; Cancer Res Treat. 2013;45(1):40-47. Published online March 31, 2013; DOI: https://doi.org/10.4143/crt.2013.45.1.40

Abstract PDF PubReader ePub

PURPOSE
The purpose of this study is to evaluate the efficacy and toxicity of oxaliplatin, leucovorin, and 5-fluorouracil (FOLFOX-4) chemotherapy in heavily pretreated patients with recurrent epithelial ovarian cancer (EOC).
MATERIALS AND METHODS
Clinical data were reviewed in 28 patients who received FOLFOX-4 as more than the second-line chemotherapy, consisting of 85 mg/m2 of oxaliplatin as a 2-hour infusion, 200 mg/m2 of leucovorin as a 2-hour infusion, and bolus 400 mg/m2 on day 1, followed by a 22-hour infusion of 600 mg/m2 of 5-fluorouracil for two consecutive days every three weeks. In addition, its efficacy and toxicity were compared with those reported in in three previous relevant studies.
RESULTS
A total of 128 cycles of FOLFOX-4 were administered with the median number of five cycles (range, 1 to 10 cycles). In nine patients with measurable disease, complete response (CR) and partial response (PR) were observed in 0 (0%) and two (22.2%) patients, whereas in 19 patients with non-measurable disease, CR and PR were observed in 0 (0%) and five (26.3%) patients. Among all patients, grade 3 anemia, neutropenia, and thrombocytopenia were observed in two (7.1%), three (10.7%), and one (3.6%) patient, and grade 3 fatigue, nausea and vomiting, and peripheral neuropathy were observed in one (3.6%), two (7.1%), and three (10.7%) patients. In addition, median values of time to progressive disease and chemotherapy-specific survival were three months (range, 0 to 10 months) and nine months (range, 4 to 24 months).
CONCLUSION
FOLFOX-4 is feasible as salvage chemotherapy with acceptable toxicity for heavily pretreated patients with recurrent EOC.

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Alejandro Schcolnik-Cabrera, Mandy Juárez, Bernardo Oldak, Mayra Cruz-Rivera, Ana Flisser, Alfonso Dueñas-González, Vinnitsa Buzoianu-Anguiano, Sandra Orozco-Suarez, Fela Mendlovic
Archives of Medical Research.2020; 51(1): 65. CrossRef
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Abdulaziz Babaier, Prafull Ghatage
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p53 Codon 72 Polymorphism and Cervical Adenocarcinoma Risk in Korean Women: Jeong Hwa Kim, Ju Won Roh, Kyung Sun Kim, Hyeon Jung Jung, Jae Weon Kim, Noh Hyun Park, Yong Sang Song, Soon Beom Kang, Hyo Pyo Lee; Cancer Res Treat. 2001;33(3):243-249. Published online June 30, 2001; DOI: https://doi.org/10.4143/crt.2001.33.3.243

Abstract PDF: PURPOSE
This study was undertaken to analyze whether the p53 codon 72 single nucleotide polymorphism might be correlated with the risk and/or the prognosis of cervical cancer in Korean women.
MATERIALS AND METHODS
Peripheral blood samples derived from patients with cervical squamous cell carcinoma (SCC) (n=68), cervical adenocarcinoma (n=37), cervical intraepithelial neoplasia (CIN) III (n=98) and normal controls (n=98) were examined. Germline genomic DNA was extracted from peripheral blood leukocytes and examined by PCR amplification of the specific alleles assay described by Storey et al.5 Statistical analysis was performed using the Chi-Square test or the Kaplan-Meier survival analysis, logistic regression analysis.
RESULTS
The proportions of individuals who were homozygous for the proline allele, and heterozygous for the two allele, homozygous for arginine allele in each group were 15%, 47%, 38% in the SCC group; 6%, 7%, 24% in the adenocarcinoma group; 7%, 33%, 60% in the CIN III group; and 11%, 38%, 51% in the control group. No significant difference was found between the three groups (p>0.05). However there was a significant difference in the adenocarcinoma group (p<0.05). Arg/Arg homozygote reduced the risk of adenocarcinoma. No significant difference existed in 5-year survival rates in the three groups (p=0.22 in SCC, p=0.91 in adenocarcinoma).
CONCLUSION
These findings suggest that Arg/Arg homozygocity of the p53 codon 72 would be a protective factor against the development of cervical adenocarcinoma.

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p21WAF1/CIP1 Codon 31 Polymorphism in Korean Women: Association with Cervical Cancer Susceptibility and Prognosis: Ju Won Roh, Kyung Sun Kim, Jae Weon Kim, Moon Hong Kim, Hyun Hoon Chung, Noh Hyun Park, Yong Sang Song, Soon Beom Kang, Hyo Pyo Lee; J Korean Cancer Assoc. 2000;32(6):1050-1058.

Abstract PDF: PURPOSE
The aim of this study was to determine whether certain genotype of p21WAF1/Cip1 might be associated with risk of cervical cancer in Korean women.
MATERIALS AND METHODS
We used the specimens derived from cervical cancer (n=111) composed of two histologic groups; SCCA (n=67) and adenocarcinoma (n=44), CIN III (n=101) and controls (n=98). For the determination of p21WAF1/Cip1 polymorphism, DNA was examined by PCR-RFLP using BsmAI. We compared the distribution of p21WAF1/Cip1 genotype of Korean women with that of other ethnic groups and analyzed the distribution of invasive cancer, CIN III and controls.
RESULTS
The genotype frequency of controls was different from that of Caucasian and Chinese (p<0.001) but similar to that of Japanese (p=0.21). There was no difference in the genotype frequency of p21WAF1/Cip1 among SCCA, CIN III and controls (p>0.05). A significant increase of Ser/Ser genotype was found in adenocarcinoma patients with high-risk HPV compared with the controls (p=0.009). The OR was 3.59, 95% CI=1.55~8.31, when comparing that group with controls. However, we could not find differences of prognosis.
CONCLUSION
We found that codon 31 Ser/Ser homozygote of the p21WAF1/Cip1 would be a risk factor for the adenocarcinoma of cervix associated with high-risk HPV in Korean women.

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Polymorphisms in E6 Gene of Human Papillomavirus Type 16 Found in Cervical Tissues from Korean Women: Jae Weon Kim, Ju Won Roh, Moon Hong Kim, Noh Hyun Park, Yong Sang Song, Soon Beom Kang, Hyo Pyo Lee; J Korean Cancer Assoc. 2000;32(5):875-883.

Abstract PDF: PURPOSE
To examine the distribution of HPV 16 E6 polymorphisms and analyse the possible association between the polymorphisms and cervical cancer development in Korean women.
MATERIALS AND METHODS
Fifty-four cases of uterine cervical tissues containing HPV 16 DNA confirmed by polymerase chain reaction (PCR) from Korean women were subjected to investigate the E6 gene mutations. PCR-amplified products were sequenced by the fluorescent dideoxy ter mination method and the results obtained from sequencing were analysed. And newly designed PASA method was tried to develop rapid test for identification of the most commonly detected variation.
RESULTS
Among the 27 cervical cancer cases, only two (7.4%) was found as a prototype. Among 11 kind of variants identified in total, 4 variants (5 nucleotide sites) which were never reported before has been found, registered firstly to GenBank. The most frequently found variation was D25E, absolutely different from the previous reports from the western country. There was no statistically significant trend for the D25E variation to be more frequently detected in cancerous lesions than in noncancerous lesions. All of the DNA sequencing results observed could be confirmed by PASA method.
CONCLUSION
These results suggest that Korean-specific genetic factors might operate during the cervical carcinogenesis.

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The Inefficiency of Routine Performance of a Batch of Tests in the Clinical Staging Work-up of Cervical Carcinoma: Soon Sup Shim, Jae Weon Kim, Yong Beom Kim, Ju Won Rho, Chul Min Lee, Noh Hyun Park, Yong Sang Song, Soon Beom Kang, Hyo Pyo Lee; J Korean Cancer Assoc. 2000;32(4):705-713.

Abstract PDF: PURPOSE
This study was to evaluate the efficiency of routine performance of a batch of tests in the clinical staging work-up of cervical carcinoma.
MATERIALS AND METHODS
The medical records were reviewed for 1,393 consecutive cervical carcinoma patients who underwent pretreatment staging work-up in Seoul National University Hospital from January 1988 to December 1997. The impression stage -which is designated ten tatively by the findings of pelvic examination and biopsy-, the results of staging work-up, and the finally allotted FIGO clinical stage were reviewed. The annual trend of stage distribution and the positive yields of tests were evaluated.
RESULTS
Annual trend shows that Ia is increasing. The positive yield of chest x-ray was 0.22% (3/1, 379; Ib: 1, IIa: 1, IIb: 1), intravenous pyelography (IVP) 2.50% (31/1, 242; Ib: 2, IIa: 4, IIb: 17, IIIb: 8), cystoscopy 0.55% (6/1, 093; IIb: 4, IIIb: 2), and proctosigmoidoscopy 0.086% (1/1, 157; Ib: 1). After completing the staging work-up, 29 patients (2.08%) were upstaged. The routine performance of IVP in impression stage Ia and cystoscopy in impression stage IIa or less was considered inefficient. The routine performance of proctosigmoidoscopy was considered inefficient because of its very low yield.
CONCLUSION
The selective performance of tests according to the impression stage during staging work-up is recommended to minimize the unnecessary treatment delay, cost, and patients' discomfort.

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p53 and bcl-2 Gene Expression in Gastational Trophoblastic Disease: Noh Hyun Park, Ju Won Roh, Jae Weom Kim, Yong Sang Song, In Ae Park, Soon Beom Kang, Hyo Pyo Lee; J Korean Cancer Assoc. 1999;31(3):582-589.

Abstract PDF: PURPOSE
p53 and bcl-2 expressions are known as important cell survival factors and their levels of expression are related with patients prognosis in various human malignancies. But there are few data about p53 and bcl-2 expression and their role in the genesis of gestational trophoblastic disease (GTD). The aims of this study are to describe p53 and bcl-2 expression in normal trophoblast and hydatidifonn mole (HM), and to identify the role of p53 and bcl-2 in the genesis of gestational trophoblastic tumor (GlTI from HM.
MATERIALS AND METHODS
Paraffin-embedded tissue sections from 32 cases of HM and 9 cases of normal early pregnancy placentas were obtained. Of 32 HM patients, 15 cases were cured after molar evacuation (group A), and 17 cases progressed to GT1' (group B). p53 and bcl-2 immunohistochemical stainings were done and their reactivity were graded. The positive rates of p53 and bcl-2 overexpression among normal placenta, group A, and group B were compared and analyzed.
RESULTS
p53 mutant gene overexpression was more frequently detected in HM (68%) than in normal placentas (22%)(p<0.05). bcl-2 was overexpressed in 31% of HM and 11% of normal placenta, but the difference was statistically insignificant (P > 0.05). The difference in bcl-2 and p53 expression between group A and group B was not observed (P>0.05). There was no inverse relationship between p53 and bcl-2 expression in group A, and group B (P>0.05).
CONCLUSIONS
p53 gene mutation may play a mle in the process of HM development, but p53 and bcl-2 were not associated with the genesis of GTI' from H-mole. More studies are needed to identify the molecular process in the progression of the GTD.

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Analysis of 38 Cases of Metastatic Cancer of Ovary: Jae Ho Yum, Jae Weon Kim, Yong Beom Kim, Chul Min Lee, Noh Hyun Park, Yong Sang Song, Soon Beom Kang, Hyo Pyo Lee; J Korean Cancer Assoc. 1999;31(3):575-581.

Abstract PDF: PURPOSE
The relative ftequency of ovarian metastases from various organs reported in literature varies with geographic distribution. To our knowledge, there has been no comprehensive report on the subject of metastatic cancer to the ovary in Korea, so we tried to evaluate the clinical characteristics of them.
MATERIALS AND METHODS
We reviewed the files of the Department of Pathology from January 1988 to December 1997 in Seoul National University Hospital and obtained 38 cases diagnosed as metastatic cancer to ovary. We retrospectively reviewed the patients' records and evaluated the clinical characteristics, treatment modalities and clinical outcome.
RESULTS
The mean age of patients was 43.7 years (range: 19-63) and the most common symptom was pelvic pain (21.1%). The origins of primary cancer were as follows in the order of frequency: stomach (65.8%), colon (13.2%), unknown (10.5%), hematologic malignancy (7.9%) and lung (2.6%). The most common pathologic findings were metastatic adenocarcinoma in 34 cases (89.5%), among which 14 cases (36.8%, 14/38) were Krukenberg tumor. The origins of primary cancer were diagnosed preoperatively in only 18 cases (47.4%). Eleven patients (28.9%) received surgery only, while 27 patients (71.1%) received both surgery and adjuvant chemotheiapy. For all patients, the median survival was 17 (range: 11-23) months and the overall 3-year survival rate (3YSR) was 28.6%. There were no significant differences in 3YSR according to primary tumor sites, status of ovarian involvement, pathologic finding, diagnostic time and treatment modalities.
CONCLUSION
Although the overall survival rate and clinical factors which might affect survival were similar to previous reports from Westem countries, the most common origin of primary cancer was different.

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