Intraoperative Rupture of the Ovarian Capsule in Early-Stage Ovarian Cancer

Dioun, Shayan; Wu, Jy S.; Chen, Ling; Kaplan, Samantha; Huang, Yongmei; Melamed, Alexander; Gockley, Allison; Clair, Caryn M. St.; Hou, June Y.; Tergas, Ana I.; Khoury‐Collado, Fady; Machida, Hiroko; Mikami, Mikio; Matsuo, Koji; Hershman, Dawn L.; Wright, Jason D.

doi:10.1097/aog.0000000000004455

Cited by 8 publications

(7 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous studies31 32 have reported controversial prognosis impact of surgical spill, which could vary across different populations and histological types 33. Recent systematic review and meta-analysis of high-quality observational studies shows similar results to our findings 34. Nevertheless, although surgical spill occurs in up to half of stage I cases, guidelines recommend no specific post-operative treatment to stage IC1 disease 18…”

Section: Discussionsupporting

confidence: 87%

Impact of substage and histologic type in stage I ovarian carcinoma survival: a multicenter retrospective observational study

Imterat

Bizzarri

Fruscio

et al. 2022

Int J Gynecol Cancer

View full text Add to dashboard Cite

ObjectiveThis international study aimed to investigate the impact of substage, histological type and other prognostic factors on long-term survival for stage I ovarian carcinoma.MethodsOur study was a retrospective multicenter cohort study that included patients with the International Federation of Gynecology and Obstetrics (FIGO) stage I (IA-IC3) ovarian carcinoma treated at four European referral centers in Germany and Italy. Using Kaplan-Meier survival curves we compared overall and disease-free survival between the different stage I groups.ResultsA total of 1115 patients were included. Of these, 48.4% (n=540) were in stage IA, 6.6% (n=73) stage IB, and 45% (n=502) stage IC, of the latter substage IC1, 54% (n=271), substage IC2, 31.5% (n=158), and substage IC3, 14.5% (n=73). Five-year overall and disease-free survival rates for the entire cohort were 94% and 86%, respectively, with no difference between stage IA and IB. However, there was a significantly better overall and disease-free survival for stage IA as compared with stage IC (p=0.007 and p<0.001, respectively). Multivariate analysis revealed incomplete/fertility-sparing staging (HR 1.95; 95% CI 1.27 to 2.99, and HR 3.54; 95% CI 1.83 to 6.86, respectively), and stage IC (HR 2.47; 95% CI 1.63 to 3.75) as independent risk factors for inferior disease-free survival, while low-grade endometrioid (HR 0.42; 95% CI 0.25 to 0.72) and low-grade mucinous (HR 0.17; 95% CI 0.06 to 0.44) histology had superior disease-free survival. Considering overall survival, stage IC (HR 2.41; 95% CI 1.45 to 4.01) and older age (HR 2.41; 95% CI 1.46 to 3.95) were independent risk factors.ConclusionAlthough stage I ovarian carcinoma exhibited excellent outcomes, the prognosis of patients with stage IA differs significantly compared with stage IC. Sub-optimal staging as an indicator for quality of care, and tumor biology defined by histology (low-grade endometrioid/mucinous) independently impact disease-free survival.

show abstract

Section: Discussionsupporting

confidence: 87%

Impact of substage and histologic type in stage I ovarian carcinoma survival: a multicenter retrospective observational study

Imterat

Bizzarri

Fruscio

et al. 2022

Int J Gynecol Cancer

View full text Add to dashboard Cite

show abstract

“…We also analysed independent risk factors related to OCCC outcomes, including IDO1, IDO2, TDO2 and IL4I1 expression and clinical features. According to previous studies, advanced stage, metastasis, bilateral tumours and tumour rupture were risk factors related to poor prognosis in ovarian cancers 7,44–47 . In conclusion, positive IDO1, TDO2 and IL4I1 expression was considered as unfavourable factor of OCCC.…”

Section: Discussionmentioning

confidence: 74%

“…According to previous studies, advanced stage, metastasis, bilateral tumours and tumour rupture were risk factors related to poor prognosis in ovarian cancers. 7,[44][45][46][47] In conclusion, positive IDO1, TDO2 and IL4I1 expression was considered as unfavourable factor of OCCC. Unfortunately, in our prognostic analysis, IDO1, IDO2, TDO2 and IL4I1 expression was not significantly associated with the OCCC survival rate, as shown in Table 4.…”

Section: T a B L E 3 Relations Between Expression Of Trp Catabolising...mentioning

confidence: 92%

Tryptophan metabolism enzymes are potential targets in ovarian clear cell carcinoma

Zhang,

Gao,

Wang

et al. 2023

Cancer Medicine

View full text Add to dashboard Cite

AimAs the second most prevalent subtype of epithelial ovarian cancers, ovarian clear cell carcinoma (OCCC) is known for its chemoresistance to conventional platinum‐based therapy. In this work, we examined the tryptophan (Trp) metabolism enzymes' differential expression in patients with OCCC to assess the potential for personalised treatment.MethodsA total of 127 OCCC tissues were used to construct tissue microarrays, and immunohistochemistry (IHC) staining of the Trp enzymes IDO1, IDO2, TDO2 and IL4I1 was performed. The correlations between Trp enzyme expression and clinical characteristics were analysed.ResultsPositive IDO1, IDO2, TDO2 and IL4I1 staining was identified in 26.8%, 94.5%, 75.6% and 82.7% of OCCC respectively. IDO1‐positive samples were more common in the chemoresistant group than in the platinum‐sensitive group (46.7% vs. 19.8%). Moreover, positive expression of IDO1, TDO2 and IL4I1 was related to advanced stage, metastasis, bilateral tumours, endometriosis and tumour rupture (p < 0.05) respectively. Univariate analysis revealed a significant association between bilateral tumours, lymph node metastasis, advanced stage, distant metastasis and aberrant cytology with a poor prognosis for OCCC, while the absence of residual tumour was correlated with a favourable outcome (p < 0.05). However, only bilateral tumours and lymph node metastases were related to a poor prognosis after multivariate analysis.ConclusionThis is the first study to investigate the expression of the Trp enzymes IDO1, IDO2, TDO2 and IL4I1 in OCCC tissues. IDO2, TDO2 and IL4I1 were detected in the majority of OCCC. Clinical traits were correlated with IDO1, IDO2, TDO2 and IL4I1 expression. IDO1 may be used as a therapeutic target given the large percentage of chemoresistant cases with IDO1 expression. These results will aid the development of personalised therapies for OCCC.

show abstract

“…A recent meta-analysis based on 17 retrospective cohort studies et al highlighted the negative impact of intraoperative ovarian capsule rupture on progression-free survival and overall survival of women with early-stage disease [ 3 ]. Specifically, the authors reported a nearly double risk of experiencing a recurrence (HR 1.92, 95% CI 1.34, 2.76) and a 50% increase in the risk of dying (HR 1.48, 95% CI 1.15, 1.91).…”

Section: Discussionmentioning

confidence: 99%

“…However, in the presence of intraoperative rupture of the ovarian capsule both progression-free (PFS) as well as overall survival (OS) rates are expected to fall. In a recent meta-analysis that was based on 17 studies, researchers observed that cyst rupture was associated with a nearly double risk of recurrence (hazards ratio 1.92, 95% CI 1.34–2.76) and a 48% increased chance of death (hazards ratio 1.48, 95% CI 1.15–1.91) compared to women that had intact cyst removal [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Is There a Survival Benefit of Adjuvant Chemotherapy in Stage IC1 Epithelial Ovarian Cancer Patients? A Meta-Analysis

et al. 2022

View full text Add to dashboard Cite

The purpose of the present systematic review is to clarify whether adjuvant chemotherapy improves survival rates in women with stage IC1 ovarian cancer. We searched Medline, Scopus, Clinicaltrials.gov, EMBASE, Cochrane Central Register of Controlled Trials CENTRAL and Google Scholar. We considered comparative observational studies and randomized trials that investigated survival outcomes (progression-free (PFS) and overall survival (OS)) among women with intraoperative rupture of early-stage epithelial ovarian cancer who received adjuvant chemotherapy and those that did not. Eleven studies, which recruited 7556 patients, were included. The risk of bias was defined as moderate after assessment with the Risk of Bias in non-Randomized Trials tool. Meta-analysis was performed with RStudio. Seven studies investigated the impact of adjuvant chemotherapy on recurrence-free survival of patients experiencing intraoperative cyst rupture for otherwise stage I ovarian cancer. The outcome was not affected by the use of adjuvant chemotherapy as the effect estimate was not significant (HR 1.24, 95% CI 0.74, 2.04). The analysis of data from 5 studies similarly revealed that overall survival rates were comparable among the two groups (HR 0.75, 95% CI 0.54, 1.05). This meta-analysis did not detect any benefit from adjuvant chemotherapy for stage IC ovarian cancer patients with cyst rupture. However, conclusions from this investigation are limited by a study population which included multiple histologic subtypes, high and low grade tumors and incompletely staged patients.

show abstract

Intraoperative Rupture of the Ovarian Capsule in Early-Stage Ovarian Cancer

Cited by 8 publications

References 57 publications

Impact of substage and histologic type in stage I ovarian carcinoma survival: a multicenter retrospective observational study

Impact of substage and histologic type in stage I ovarian carcinoma survival: a multicenter retrospective observational study

Tryptophan metabolism enzymes are potential targets in ovarian clear cell carcinoma

Is There a Survival Benefit of Adjuvant Chemotherapy in Stage IC1 Epithelial Ovarian Cancer Patients? A Meta-Analysis

Contact Info

Product

Resources

About