Therapeutic significance of full lymphadenectomy in early-stage ovarian clear cell carcinoma

Yamazaki, Hiroyuki; Todo, Yukiharu; Shimada, Chisa; Takeshita, Sho; Minobe, Shinichiro; Okamoto, Kazuhira; Yamashiro, Katsushige; Kato, Hidenori

doi:10.3802/jgo.2018.29.e19

Cited by 25 publications

(25 citation statements)

References 23 publications

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“…A lack of lymph node sampling in ovarian cancer patients may play a role as well. In patients with gross intra-abdominal disease, and macroscopically normal lymph nodes, standard lymphadenectomy does not contribute to prolonged overall nor progression-free survival in these patients [ 26 27 ]. This might influence the correlation between affected lymph nodes and the risk on PM.…”

Section: Discussionmentioning

confidence: 99%

Incidence and predictors of peritoneal metastases of gynecological origin: a population-based study in the Netherlands

Burg

Timmermans

et al. 2020

J Gynecol Oncol

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Objective: Peritoneal metastases (PM) are a challenge in gynecological cancers, but its appearance has never been described in a population-based study. Therefore, we describe the incidence of PM and identify predictors that increase the probability of peritoneal spread. Methods: All ovarian, endometrial and cervical cancer patients diagnosed in the Netherlands between 1989 and 2015 were identified from the Netherlands Cancer Registry and stratified for PM. Crude and age-adjusted incidence over time was calculated. Independent predictors for PM were identified using uni-and multivariable analyses. Results: The 94,981 patients were diagnosed with ovarian, endometrial or cervical cancer and respectively 61%, 2% and 1% presented with PM. Predictors for PM in ovarian cancer were: age between 50 and 74 years (odds ratio [OR]=1.19; 95% confidence interval [CI]=1.08-1.32), other distant metastases (OR=1.25; 95% CI=1.10-1.41), poor differentiation grade (OR=2.00; 95% CI=1.73-2.32) and serous histology. Predictors in endometrial cancer were lymph node metastases (OR=2.32; 95% CI=1.65-3.26), other distant metastases (OR=1.38; 95% CI=1.08-1.77), high-grade tumors (OR=1.95; 95% CI=1.38-2.76) and clear cell (OR=1.49; 95% CI=1.04-2.13) or serous histology (OR=2.71; 95% CI=2.15-3.42). In cervical cancer, the risk is higher in adenocarcinoma than in squamous cell carcinoma (OR=4.92; 95% CI=3.11-7.79). Conclusion: PM are frequently seen in patients with ovarian cancer. In endometrial and cervical cancer PM are rare. Histological subtype was the strongest predictive factor for PM in all 3 cancers. Better understanding of predictive factors for PM and thus the biological behavior is of paramount importance.

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Section: Discussionmentioning

confidence: 99%

Incidence and predictors of peritoneal metastases of gynecological origin: a population-based study in the Netherlands

Burg

Timmermans

et al. 2020

J Gynecol Oncol

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“…A 10-lymph node cutoff was defined as adequate lymphadenectomy according to the Gynecologic Oncology Group criteria. Several retrospective studies have demonstrated favorable survival outcomes of systematic lymphadenectomy on patients with early-stage OCCC [ 13 – 15 ]. In a combined exploratory analysis of three prospectively randomized phase III multicenter trials, Magazzino et al reported that lymphadenectomy offered benefit to patients with advanced OC who received complete intraperitoneal debulking [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Development and validation of Nomograms for predicting overall survival and Cancer-specific survival in patients with ovarian clear cell carcinoma

2020

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Background Ovarian clear cell carcinoma (OCCC) is a rare histologic type of ovarian cancer. There is a lack of an efficient prognostic predictive tool for OCCC in clinical work. This study aimed to construct and validate nomograms for predicting the overall survival (OS) and cancer-specific survival (CSS) in patients with OCCC. Methods Data of patients with primary diagnosed OCCC in the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2016 was extracted. Prognostic factors were evaluated with LASSO Cox regression and multivariate Cox regression analysis, which were applied to construct nomograms. The performance of the nomogram models was assessed by the concordance index (C-index), calibration plots, decision curve analysis (DCA) and risk subgroup classification. The Kaplan-Meier curves were plotted to compare survival outcomes between subgroups. Results A total of 1541 patients from SEER registries were randomly divided into a training cohort (n = 1079) and a validation cohort (n = 462). Age, laterality, stage, lymph node (LN) dissected, organ metastasis and chemotherapy were independently and significantly associated with OS, while laterality, stage, LN dissected, organ metastasis and chemotherapy were independent risk factors for CSS. Nomograms were developed for the prediction of 3- and 5-year OS and CSS. The C-indexes for OS and CSS were 0.802[95% confidence interval (CI) 0.773–0.831] and 0.802 (0.769–0.835), respectively, in the training cohort, while 0.746 (0.691–0.801) and 0.770 (0.721–0.819), respectively, in the validation cohort. Calibration plots illustrated favorable consistency between the nomogram predicted and actual survival. C-index and DCA curves also indicated better performance of nomogram than the AJCC staging system. Significant differences were observed in the survival curves of different risk subgroups. Conclusions We have constructed predictive nomograms and a risk classification system to evaluate the OS and CSS of OCCC patients. They were validated to be of satisfactory predictive value, and could aid in future clinical practice.

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“…OCCC is of the epithelial subtype, occurring in 1-25% of epithelial ovarian cancers, and 4-10% of those presenting with lymph node metastasis. 16,17 The typical US features hematogenous metastases from extramammary malignancies to breast include oval shaped, circumscribed hypoechoic masses without calcifications or architectural distortion. 18 In this review, only 17 patients had undergone breast US examination, and the lesions presented as solid (accounting for 70.00% and 50.00% of breast lesions metastasized from all cancer types and OSCs, respectively), hypoechoic (accounting for 57.14% and 62.50% of breast lesions metastasized from all cancer types and OSCs), oval/spiculated and circumscribed/indistinct lesions without calcification (accounting for 94.11% and 90.00% of breast lesions metastasized from all cancer types and OSCs), which were summarized in Table 2.…”

Section: Discussionmentioning

confidence: 99%

<p>Metastasis of Ovarian Cancer to Breast: A Case Report and Review of Imaging Manifestations</p>

Wang

2020

CMAR

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Metastasis of ovarian cancer to breast (MOCB) is rare, and the diagnosis is difficult due to the varied imaging manifestations. The objective of this paper is to report a special case of MOCB, review the imaging manifestations of MOCB and attempt to determine the characteristic imaging features that might be helpful in making the diagnosis and providing appropriate systemic therapy. A 40-year-old woman presented with a breast lesion six years after a diagnosis of ovarian serous cystadenocarcinoma. Ultrasound (US) and magnetic resonance imaging (MRI) examinations were performed; the final diagnosis was metastasis of ovarian serous cystadenocarcinoma to breast according to the histological examination and immunohistochemical examination after lumpectomy. Herein, we reviewed 41 cases diagnosed with MOCB, which include imaging of the metastatic breast lesion or a detailed description without imaging. In this review, we summarized that MOCB could present with calcifications (especially microcalcifications) on mammography (MM). MOCB presenting as inflammatory breast cancer usually shows swelling and skin thickening on MM and US, and increased fludeoxyglucose (FDG) uptake on positron emission tomography/computed tomography (PET/CT). These manifestations could be helpful in differentiating malignant tumors from benign ones, but it may still be difficult to distinguish between primary and metastatic tumors. The correct diagnosis of MOCB requires a combination of the clinical history of the primary tumor, careful clinical examination, radiology and anatomic pathological evaluation.

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Therapeutic significance of full lymphadenectomy in early-stage ovarian clear cell carcinoma

Cited by 25 publications

References 23 publications

Incidence and predictors of peritoneal metastases of gynecological origin: a population-based study in the Netherlands

Incidence and predictors of peritoneal metastases of gynecological origin: a population-based study in the Netherlands

Development and validation of Nomograms for predicting overall survival and Cancer-specific survival in patients with ovarian clear cell carcinoma

<p>Metastasis of Ovarian Cancer to Breast: A Case Report and Review of Imaging Manifestations</p>

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