Ovarian Cancer, Version 1.2016, NCCN Clinical Practice Guidelines in Oncology

Morgan, Robert J.; Armstrong, Deborah K.; Alvarez, Ronald D.; Bakkum-Gamez, Jamie N.; Behbakht, Kian; Chen, Lee May; Copeland, Larry J.; Crispens, Marta A.; Rosa, Mattia De; Dorigo, Oliver; Gershenson, David M.; Gray, Heidi J.; Hakam, Ardeshir; Havrilesky, Laura J.; Johnston, Carolyn; Lele, Shashikant; Martin, Lainie P.; Matulonis, Ursula A.; O’Malley, David M.; Penson, Richard T.; Percac‐Lima, Sanja; Pineda, Mario Javier; Plaxe, Steven C.; Powell, Matthew A.; Ratner, Elena; Remmenga, Steven W.; Rose, Peter G.; Sabbatini, Paul; Santoso, Joseph T.; Werner, Theresa L.; Burns, Jennifer L.; Hughes, Miranda

doi:10.6004/jnccn.2016.0122

Cited by 307 publications

(263 citation statements)

References 197 publications

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“…Finally, the effect of discrepancy on the completeness of the primary surgery was evaluated. Concerning the staging procedure, principles of surgery suggested in the National Comprehensive Cancer Network Guidelines on Ovarian Cancer were used as standard 8. For newly diagnosed apparently early-stage ovarian malignancy, staging laparotomy including bilateral salpingo-oophorectomy, hysterectomy, omentectomy, pelvic, and para-aortic lymphadenectomy should be performed.…”

Section: Methodsmentioning

confidence: 99%

Intraoperative frozen section analysis of ovarian tumors: a 11-year review of accuracy with clinicopathological correlation in a Hong Kong Regional hospital

Kung¹,

Tsang²,

Yu³

2019

Int J Gynecol Cancer

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ObjectiveIntra-operative frozen section (IFS) can provide an instinct guide for treatment of ovarian tumors intra-operatively, though limitations exist. This study intended to evaluate the diagnostic performance of IFS and possible clinicopathological factors influencing the diagnostic accuracy of IFS.MethodsA retrospective review of IFS of ovarian lesions from 2006 to 2016 was done. The diagnostic performance of benign, borderline, and malignant IFS diagnosis was evaluated. Logistic regression analysis was used to assess the influence of clinicopathological parameters on the likelihood of underdiagnosis.ResultsThere were 1143 consecutive cases during the study period. The overall accuracy was 93.7%. For benign diagnoses, the IFS diagnostic accuracy, sensitivity, and specificity were 97.20%, 100%, and 92.51%, respectively. If borderline and malignant diagnoses were considered as a single group, the IFS diagnostic accuracy was 97.20%, with 92.51% sensitivity and 100% specificity. At univariate regression analysis, intact capsules at time of delivery (ORunadj = 1.9), stage I lesions (ORunadj = 3.76) and ultrasound (USG) score 0 (ORunadj = 2.52) were positively associated with underdiagnosis. Further multivariate analysis showed that only stage I lesions (OR = 3.62) and USG score 0 (OR = 2.32) were positively associated with underdiagnosis. For the cases with underdiagnosed IFS, 54% (34/63) received incomplete primary staging surgery.ConclusionsThe study demonstrated that IFS provided excellent specificity to differentiate borderline or malignant tumors from benign lesions. IFS in early-stage ovarian cancers needs to be interpreted with caution, though IFS is most important for this group of lesions. A reliable IFS diagnosis often requires efficient communication between surgeons and pathologists.

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Section: Methodsmentioning

confidence: 99%

Intraoperative frozen section analysis of ovarian tumors: a 11-year review of accuracy with clinicopathological correlation in a Hong Kong Regional hospital

Kung¹,

Tsang²,

Yu³

2019

Int J Gynecol Cancer

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“…However, despite aggressive frontline treatment, ∼70% of patients will relapse in the first 3 years. Among the accepted options for patients with relapsed disease are pegylated liposomal doxorubicin (PLD) and other drugs [4–8] with response rates from 10% to 25%. With a dose schedule and toxicity profile somewhat more favorable, PLD has become a common first option for patients who relapse after platinum-based treatment [9, 10].…”

Section: Introductionmentioning

confidence: 99%

A phase 2, randomized, double-blind, placebo- controlled study of chemo-immunotherapy combination using motolimod with pegylated liposomal doxorubicin in recurrent or persistent ovarian cancer: a Gynecologic Oncology Group partners study

et al. 2017

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BackgroundA phase 2, randomized, placebo-controlled trial was conducted in women with recurrent epithelial ovarian carcinoma to evaluate the efficacy and safety of motolimod—a Toll-like receptor 8 (TLR8) agonist that stimulates robust innate immune responses—combined with pegylated liposomal doxorubicin (PLD), a chemotherapeutic that induces immunogenic cell death.Patients and methodsWomen with ovarian, fallopian tube, or primary peritoneal carcinoma were randomized 1 : 1 to receive PLD in combination with blinded motolimod or placebo. Randomization was stratified by platinum-free interval (≤6 versus >6–12 months) and Gynecologic Oncology Group (GOG) performance status (0 versus 1). Treatment cycles were repeated every 28 days until disease progression.ResultsThe addition of motolimod to PLD did not significantly improve overall survival (OS; log rank one-sided P = 0.923, HR = 1.22) or progression-free survival (PFS; log rank one-sided P = 0.943, HR = 1.21). The combination was well tolerated, with no synergistic or unexpected serious toxicity. Most patients experienced adverse events of fatigue, anemia, nausea, decreased white blood cells, and constipation. In pre-specified subgroup analyses, motolimod-treated patients who experienced injection site reactions (ISR) had a lower risk of death compared with those who did not experience ISR. Additionally, pre-treatment in vitro responses of immune biomarkers to TLR8 stimulation predicted OS outcomes in patients receiving motolimod on study. Immune score (tumor infiltrating lymphocytes; TIL), TLR8 single-nucleotide polymorphisms, mutational status in BRCA and other DNA repair genes, and autoantibody biomarkers did not correlate with OS or PFS.ConclusionsThe addition of motolimod to PLD did not improve clinical outcomes compared with placebo. However, subset analyses identified statistically significant differences in the OS of motolimod-treated patients on the basis of ISR and in vitro immune responses. Collectively, these data may provide important clues for identifying patients for treatment with immunomodulatory agents in novel combinations and/or delivery approaches.Trial registrationClinicaltrials.gov, NCT 01666444.

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“…According to the most recent National Comprehensive Cancer Network (NCCN) guidelines, epithelial ovarian cancer is grouped into type I ovarian cancer (mostly originating from the ovary) and type II ovarian cancer (mostly originating from the oviduct) [31]. We compared E2F1 expression levels in 59 cases of type I tumors and 17 normal ovarian tissues, and E2F1 expression was significantly elevated in the ovarian carcinoma tissues and was positively associated with FIGO stage I–II and III–IV disease.…”

Section: Discussionmentioning

confidence: 99%

E2F-1 targets miR-519d to regulate the expression of the ras homolog gene family member C

et al. 2017

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E2F1 (E2F transcription factor 1) can act as a tumor suppressor or oncogene. We report the molecular mechanism of E2F1 in ovarian carcinoma tumorigenesis and progression. E2F1 expression levels in ovarian carcinoma tissue were examined by immunohistochemistry. After E2F1 plasmid transfection and E2F1-microRNA-519d (miR-519d)/si-RhoC (Ras homolog gene family member C) co-transfection, ovarian cancer cell phenotypes and the related molecules were examined in vitro and in vivo. E2F1 was overexpressed in type I and type II ovarian carcinoma as compared to normal ovary tissues and normal fallopian tube tissues, respectively. E2F1 overexpression promoted cell proliferation, G1–S progression, survival, migration, and invasion in vitro; miR-519d or siRhoC co-transfection reversed E2F1 oncogenic effects. E2F1 overexpression promoted tumor growth in vivo; miR-519d overexpression inhibited it. E2F1 overexpression increased RhoC, Bcl-2, cyclin D1, survivin, MMP2 (matrix metalloproteinase 2), MMP9, STAT3 (signal transducer and activator of transcription 3), and HuR (ELAV-like RNA-binding protein 1) expression; miR-519d overexpression decreased their expression. E2F1 downregulated miR-519d directly and miR-519d downregulated RhoC directly. Conversely, miR-519d directly downregulated E2F1, There is a direct repressive regulatory loop between E2F1 and miR-519d. We provide evidence that E2F1/miR-519d/RhoC is a promising signaling pathway for diagnosing and treating ovarian carcinoma.

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Ovarian Cancer, Version 1.2016, NCCN Clinical Practice Guidelines in Oncology

Cited by 307 publications

References 197 publications

Intraoperative frozen section analysis of ovarian tumors: a 11-year review of accuracy with clinicopathological correlation in a Hong Kong Regional hospital

Intraoperative frozen section analysis of ovarian tumors: a 11-year review of accuracy with clinicopathological correlation in a Hong Kong Regional hospital

A phase 2, randomized, double-blind, placebo- controlled study of chemo-immunotherapy combination using motolimod with pegylated liposomal doxorubicin in recurrent or persistent ovarian cancer: a Gynecologic Oncology Group partners study

E2F-1 targets miR-519d to regulate the expression of the ras homolog gene family member C

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