Evaluation of the incidence and clinical significance of WT-1 expression in uterine serous carcinoma

McEachron, Jennifer; Baqir, Agha Wajdan; Zhou, Nancy; Jabbar, Absia; Gupta, Raavi; Levitan, Daniel; Lee, Yi-Chun

doi:10.1016/j.gore.2021.100918

Cited by 6 publications

(6 citation statements)

References 24 publications

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“…This marker is therefore considered to be of some value in distinguishing ESC from tubo-ovarian HGSC, particularly if the pattern of expression (negative/focal and weak vs diffuse and strong) is taken into account rather than the presence of any expression. WT1 expression has been shown to have adverse prognostic significance in gynecological cancers overall as it is a marker of tubo-ovarian HGSC, among the most aggressive of all gynecological malignancies 44,45 . Among tubo-ovarian HGSC and ESC, however, expression of WT1 indicates favorable prognosis and improved response to chemotherapy, respectively 43 .…”

Section: Case Presentationmentioning

confidence: 99%

“…WT1 expression has been shown to have adverse prognostic significance in gynecological cancers overall as it is a marker of tubo-ovarian HGSC, among the most aggressive of all gynecological malignancies. 44,45 Among tubo-ovarian HGSC and ESC, however, expression of WT1 indicates favorable prognosis and improved response to chemotherapy, respectively. 43 This marker is also emerging as a potential antigen target for cancer immunotherapy.…”

Section: High-grade Serous Carcinoma With Concurrent Involvement Of T...mentioning

confidence: 99%

“…43 This marker is also emerging as a potential antigen target for cancer immunotherapy. 44 In addition to showing overlap in expression between tuboovarian HGSC and ESC, with no established cutoff points for distinction, WT1 expression is affected by technical aspects, including staining protocols and fixation, as well as previous exposure to chemotherapy. 43,45 For all of these reasons, the expression of WT1 must be interpreted alongside other clinicopathological factors, as its discriminatory value in an individual case has not been established, especially in widely disseminated carcinoma or postchemotherapy.…”

Section: High-grade Serous Carcinoma With Concurrent Involvement Of T...mentioning

confidence: 99%

“…Among tubo-ovarian HGSC and ESC, however, expression of WT1 indicates favorable prognosis and improved response to chemotherapy, respectively 43 . This marker is also emerging as a potential antigen target for cancer immunotherapy 44 …”

Section: Case Presentationmentioning

confidence: 99%

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Carcinomas With Concurrent Involvement of the Endometrium and Uterine Adnexa—Implications for Pathological Diagnosis and Clinical Management in Current Practice

Singh

Tinker

Gilks

2022

AJSP: Reviews and Reports

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A proportion of endometrial and adnexal carcinomas have concurrent involvement of the other site. In the case of high-grade serous carcinomas involving the tubal epithelium as well as endometrium, distinction of tubo-ovarian high-grade serous from endometrial serous carcinoma can have implications for surgical as well as nonsurgical treatment approaches, including targeted therapies and referral to clinical genetics services. The other situation is involvement of the endometrium and ovary by low-grade endometrioid carcinoma; here separation of high-stage endometrial carcinoma from 2 low-stage, low-grade tumors determines adjuvant treatment decisions. These challenging scenarios are illustrated with case presentations and criteria for pathological reporting while acknowledging uncertainty where this is warranted. It is accepted that these are areas in transition, and any criteria offered are likely to change in the light of new information.

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Section: Case Presentationmentioning

confidence: 99%

Section: High-grade Serous Carcinoma With Concurrent Involvement Of T...mentioning

confidence: 99%

Section: High-grade Serous Carcinoma With Concurrent Involvement Of T...mentioning

confidence: 99%

Section: Case Presentationmentioning

confidence: 99%

See 2 more Smart Citations

Carcinomas With Concurrent Involvement of the Endometrium and Uterine Adnexa—Implications for Pathological Diagnosis and Clinical Management in Current Practice

Singh

Tinker

Gilks

2022

AJSP: Reviews and Reports

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“…Endometrial serous carcinoma is usually negative or only focally positive for WT-1, while adnexal/ extra-uterine HGSC generally demonstrate strong and diffuse WT-1 nuclear staining (Fig. 8) (although it has been reported that up to 20% of extra-uterine HGSC can be negative for WT-1) [32,33]. In these cases, clinical and radiologic correlation can be recommended in the diagnostic comment.…”

Section: Ovarian Epithelial Neoplasmsmentioning

confidence: 99%

Practical Approach to the Evaluation of Malignant Peritoneal Fluids in the Setting of Gynecologic Neoplasms

Mendoza¹,

Lastra²

2022

Acta Cytologica

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Background: Evaluation of peritoneal fluid cytology, either from ascitic fluids or as result of peritoneal washings, is a fundamental aspect in the evaluation of women presenting with clinically concerning or histologically confirmed gynecologic neoplasms. Summary: Ascitic fluid samples are often the initial and only source of diagnostic material in women presenting with gynecologic malignancies, and important therapeutic decisions will result from the information provided in the cytology report. On the other hand, cytologic evaluation of peritoneal washing specimens obtained during surgical excision of a presumed gynecologic neoplasm provides crucial information to the clinical team regarding tumor staging, often with significant therapeutic implications. While recognition of high-grade tumors in either of these samples is generally straightforward, low-grade tumors and unusual neoplasms can prove to be more difficult to recognize, differentiate from benign mimics, and correctly diagnose, particularly in low-cellularity specimens. Even with high grade tumors, a mere diagnosis of “Positive for malignancy” in diagnostic ascitic fluid specimens might not suffice to guide clinical management, and the use of ancillary techniques to further and more definitively characterize the lesional cells is required. Key Messages: This review will focus on the clinically relevant issues surrounding interpretation of peritoneal fluid cytology specimens in the setting of gynecologic neoplasms, making emphasis on the salient cytomorphologic and immunocytochemical features of the various neoplastic processes, in an attempt to provide a practical yet effective guide on how to best evaluate, diagnose, and report these samples.

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High-grade serous carcinoma occurring after risk-reducing salpingo-oophorectomy in BRCA1/2 germline pathogenic variant carriers

Stroot,

Bart,

Hollema

et al. 2024

JNCI: Journal of the National Cancer Institute

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Background Risk-reducing salpingo-oophorectomy (RRSO) effectively prevents high-grade serous carcinoma (HGSC) in BRCA1/2 germline pathogenic variant (GPV) carriers. Still, some women develop HGSC after RRSO without pathologic findings. This study assessed long-term incidence and risk factors for developing HGSC after RRSO without pathologic findings. Methods BRCA1/2 GPV carriers were selected from Hereditary Breast and Ovarian cancer in the Netherlands (HEBON) cohort. Follow-up data for HGSC after RRSO were obtained from the Dutch Nationwide Pathology Databank (PALGA) and confirmed by histopathological review. Cumulative incidence rates of HGSC were calculated using Kaplan-Meier analyses. Cox proportional hazards model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for factors associated with an increased risk of HGSC following RRSO without pathologic findings. Results A total of 2519 women were included, with a median follow-up of 13.4 years (range: 0.0-27.6). The 20-years cumulative incidence rate of HGSC was 1.5% (95% CI: 0.0-2.1) for BRCA1 and 0.2% (95% CI: 0.0-1.4) for BRCA2 GPV carriers. All women who developed HGSC underwent RRSO after the recommended age. Incomplete embedding of the RRSO specimen (HR: 4.2, 95% CI: 1.4-12.6), higher age at RRSO (HR per year: 1.1, 95% CI: 1.0-1.1), and carrying a BRCA1 GPV (HR: 12.1, 95% CI: 1.6-91.2) were associated with increased risk of HGSC. Conclusions In BRCA1/2 GPV carriers, long-term incidence of HGSC after RRSO without pathologic findings was low. Strict adherence to guidelines regarding timely RRSO followed by complete specimen embedding can further reduce the risk of HGSC in the years following RRSO.

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Evaluation of the incidence and clinical significance of WT-1 expression in uterine serous carcinoma

Abstract: Highlights Approximately one-fifth of uterine serous carcinomas (USC) will express WT-1. WT-1 expression is associated with a significant improvement in platinum sensitivity. Improved platinum sensitivity among WT-1 positive tumors contributes to a superior PFS vs. WT-1 negative tumors.

Cited by 6 publications

References 24 publications

Carcinomas With Concurrent Involvement of the Endometrium and Uterine Adnexa—Implications for Pathological Diagnosis and Clinical Management in Current Practice

Carcinomas With Concurrent Involvement of the Endometrium and Uterine Adnexa—Implications for Pathological Diagnosis and Clinical Management in Current Practice

Practical Approach to the Evaluation of Malignant Peritoneal Fluids in the Setting of Gynecologic Neoplasms

High-grade serous carcinoma occurring after risk-reducing salpingo-oophorectomy in BRCA1/2 germline pathogenic variant carriers

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