Clinical characteristics and prognostic inflection points among long‐term survivors of advanced epithelial ovarian cancer

Son, Joo-Hyuk; Kong, Tae-Wook; Paek, Jiheum; Song, Kwan-Heup; Chang, Suk-Joon; Ryu, Hee Sug

doi:10.1002/ijgo.12315

Cited by 12 publications

(10 citation statements)

References 22 publications

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“…Even though there is a high initial response rate to first-line platinum or taxane chemotherapy, most patients with ovarian cancer suffer from recurrences. Commonly diagnosed at an advanced stage, aggressively progressive characteristics have been identified as a major obstacle to the long-term remission of ovarian cancer, and an effective strategy is required for overcoming cancer progression, including migration and invasion [27]. In this study, we focused on E2F8 as a potential target for the inhibition of ovarian cancer progression.…”

Section: Disussionmentioning

confidence: 99%

E2F8 Induces Cell Proliferation and Invasion through the Epithelial–Mesenchymal Transition and Notch Signaling Pathways in Ovarian Cancer

Eoh

Kim

Lee

et al. 2020

IJMS

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Background: Despite the recent research implicating E2F8 (E2F Transcription Factor 8) in cancer, the role of E2F8 in the progression of ovarian cancer has remained unclear. Hence, we explored the bio-functional effects of E2F8 knockdown on ovarian cancer cell lines in vitro and in vivo. Methods: The expression of E2F8 was compared between ovarian cancer and noncancer tissues, and its association with the progression-free survival of ovarian cancer patients was analyzed. To demonstrate the function of E2F8 in cell proliferation, migration, and invasion, we employed RNA interference to suppress E2F8 expression in ovarian cancer cell lines. Finally, the effect of E2F8 knockdown was investigated in a xenograft mouse model of ovarian cancer. Results: Ovarian cancer tissue exhibited significantly higher E2F8 expression compared to that of normal ovarian tissue. Clinical data showed that E2F8 was a significant predictor of progression-free survival. Moreover, the prognosis of the ovarian cancer patients with high E2F8 expression was poorer than that of the patients with low E2F8 expression. In vitro experiments using E2F8-knockdown ovarian cancer cell lines demonstrated that E2F8 knockdown inhibited cell proliferation, migration, and tumor invasion. Additionally, E2F8 was a potent inducer and modulator of the expression of epithelial–mesenchymal transition and Notch signaling pathway-related markers. We confirmed the function of E2F8 in vivo, signifying that E2F8 knockdown was significantly correlated with reduced tumor size and weight. Conclusions: Our findings indicate that E2F8 is highly correlated with ovarian cancer progression. Hence, E2F8 can be utilized as a prognostic marker and therapeutic target against ovarian malignancy.

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Section: Disussionmentioning

confidence: 99%

E2F8 Induces Cell Proliferation and Invasion through the Epithelial–Mesenchymal Transition and Notch Signaling Pathways in Ovarian Cancer

Eoh

Kim

Lee

et al. 2020

IJMS

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“…Approximately 1,900 stage III aggressive EOC patients were included into a study conducted by Winter and colleagues; they identified the independent predictors of poor prognosis in stage III EOC patients, including mucinous or clear-cell histology, increasing age, impaired performance status, and gross residual disease (RD), which have been widely recognized so far ( 7 ). Additionally, recent extensive studies have focused on identifying the clinicopathological factors that LTS possessed in advanced EOC ( 4 , 8 - 11 ). While there is a deficiency of information in the literature on the early recognition of short-term survivor (STS) of advanced EOC to date, some prognostic factors of ovarian cancer were well-known, but we have hardly found any research on tumor size and omental metastasis that affected the overall survival (OS) in advanced EOC patients.…”

Section: Introductionmentioning

confidence: 99%

Clinicopathologic factors associated with short-term survival in advanced epithelial ovarian cancer

Zhou¹,

Liu

Yin³

et al. 2019

Transl. Cancer Res.

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Background Epithelial ovarian cancer (EOC) is the most lethal gynaecological malignancy, and there is a deficiency of information in the literature on the early recognition of short-term survivor (STS). This study aimed to identify the clinicopathological factors associated with STS in late-stage EOC and to establish a predictive model to identify STS. Methods Selected patients with International Federation of Gynecology and Obstetrics (FIGO) stage III or IV EOC were included in the study, and a retrospective analysis was performed. The characteristics of the patients who survived not more than 2 years (STS) were compared to those who survived at least 2 years (defined as long-term survivors, LTS). Binary logistic regression and receiver operating characteristic curve (ROC) were used to identify the independent prognostic factors associated with EOC and assess the predictive accuracy for STS. Results We identified 254 patients with advanced EOC including 57 STS and 197 LTS. A univariate analysis revealed that STS had a tendency to have omental metastasis and larger tumor size, to be platinum resistant, to have non-serous histology, to undergo suboptimal cytoreduction, to have comorbidity, and to undergo primary chemotherapy less than 6 courses. Binary regression analysis revealed that tumor size (P=0.033), platinum resistance (P<0.001), non-serous histology (P=0.048) and number of primary chemotherapy (P=0.028) were significant independent predictors of STS. A developed predictive model using these predictors had an AUC =0.831; platinum resistance alone had an AUC =0.732. Conclusions Tumor size, omental metastasis, platinum resistance, non-serous histology, and number of primary chemotherapy are predictors associated with STS when controlling other confounding factors. Tumor size and omental metastasis may be considered novel, important prognostic factors for advanced EOC patients. Platinum resistance was the most important prognosticator for STS; hence, more work is needed for the early identification and treatment of these EOC patients.

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“…The prognostic role of histological subtypes on the survival outcome among long-term survivors of advanced EOC has been explored by limited studies. A previous study by Son et al [ 27 ] reported that 91% of deaths occurred within 8 years, and that survival for 8 years may represent the prognostic inﬂection point for long-term survival in advanced EOC. However, only 11 patients survived for >8 years in the Son et al’s [ 27 ] study.…”

Section: Discussionmentioning

confidence: 99%

“…A previous study by Son et al [ 27 ] reported that 91% of deaths occurred within 8 years, and that survival for 8 years may represent the prognostic inﬂection point for long-term survival in advanced EOC. However, only 11 patients survived for >8 years in the Son et al’s [ 27 ] study. In our study, approximately 80% of ovarian cancer–related deaths occurred in <5 years.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Survival Among Histological Subtypes in Advanced Epithelial Ovarian Cancer: Population-Based Study Using the Surveillance, Epidemiology, and End Results Database

Yang¹,

Su²,

Wang³

et al. 2021

JMIR Public Health Surveill

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Background Actual long-term survival rates for advanced epithelial ovarian cancer (EOC) are rarely reported. Objective This study aimed to assess the role of histological subtypes in predicting the prognosis among long-term survivors (≥5 years) of advanced EOC. Methods We performed a retrospective analysis of data among patients with stage III-IV EOC diagnosed from 2000 to 2014 using the Surveillance, Epidemiology, and End Results cancer data of the United States. We used the chi-square test, Kaplan–Meier analysis, and multivariate Cox proportional hazards model for the analyses. Results We included 8050 patients in this study, including 6929 (86.1%), 743 (9.2%), 237 (2.9%), and 141 (1.8%) patients with serous, endometrioid, clear cell, and mucinous tumors, respectively. With a median follow-up of 91 months, the most common cause of death was primary ovarian cancer (80.3%), followed by other cancers (8.1%), other causes of death (7.3%), cardiac-related death (3.2%), and nonmalignant pulmonary disease (3.2%). Patients with the serous subtype were more likely to die from primary ovarian cancer, and patients with the mucinous subtype were more likely to die from other cancers and cardiac-related disease. Multivariate Cox analysis showed that patients with endometrioid (hazard ratio [HR] 0.534, P<.001), mucinous (HR 0.454, P<.001), and clear cell (HR 0.563, P<.001) subtypes showed better ovarian cancer-specific survival than those with the serous subtype. Similar results were found regarding overall survival. However, ovarian cancer–specific survival and overall survival were comparable among those with endometrioid, clear cell, and mucinous tumors. Conclusions Ovarian cancer remains the primary cause of death in long-term ovarian cancer survivors. Moreover, the probability of death was significantly different among those with different histological subtypes. It is important for clinicians to individualize the surveillance program for long-term ovarian cancer survivors.

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Clinical characteristics and prognostic inflection points among long‐term survivors of advanced epithelial ovarian cancer

Abstract: Survival for 8 years might represent a prognostic inflection point for long-term survival in advanced EOC.

Cited by 12 publications

References 22 publications

E2F8 Induces Cell Proliferation and Invasion through the Epithelial–Mesenchymal Transition and Notch Signaling Pathways in Ovarian Cancer

E2F8 Induces Cell Proliferation and Invasion through the Epithelial–Mesenchymal Transition and Notch Signaling Pathways in Ovarian Cancer

Clinicopathologic factors associated with short-term survival in advanced epithelial ovarian cancer

Long-Term Survival Among Histological Subtypes in Advanced Epithelial Ovarian Cancer: Population-Based Study Using the Surveillance, Epidemiology, and End Results Database

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