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Plasma circulating P‐selectin glycoprotein ligand‐1 (PSGL‐1) levels and its clinical correlation in patients with epithelial ovarian cancer (EOC) are unknown. The study determined plasma PSGL‐1 levels in EOC patients and investigated its relationship with clinicopathological factors and prognosis. Plasma PSGL‐1 levels were measured using ELISA in 69 patients with EOC, 34 patients with benign ovarian cystadenoma, and 36 healthy controls. Subsequently, the relationship between PSGL‐1 levels and clinicopathological characteristics of patients, as well as the prognosis of EOC patients, was examined. Additionally, the specificity and sensitivity of plasma PSGL‐1 were assessed through ROC curve analysis. Plasma PSGL‐1 was upregulated in EOC patients compared with healthy subjects and/or patients with benign ovarian cystadenoma (p < 0.01). Elevated levels of PSGL‐1 in the plasma were positively associated with advanced FIGO stage (p < 0.001), tumor size (p = 0.001), tumor metastasis (p = 0.036), and tumor recurrence (p = 0.013), while was negatively correlated with residual tumor size (p < 0.001). Kaplan–Meier survival analysis showed that high plasma PSGL‐1 levels were associated with progression‐free survival (p = 0.0345). In univariate and multivariate Cox regression analyses, PSGL‐1 (HR = 1.456, p = 0.009) was an independent prognostic marker. Plasma PSGL‐1 levels distinguished EOC patients and healthy individuals (AUC = 0.905), patients at late and early FIGO stages (AUC = 0.886), and metastatic and non‐metastatic EOC (AUC = 0.722). The expression of plasma PSGL‐1 is significantly increased in patients with EOC, serving as a reliable biomarker to differentiate between healthy individuals and those with EOC. Furthermore, PSGL‐1 in patients is correlated with prognostic indicators, such as advanced FIGO stage, tumor lymph node metastasis, and progression‐free survival. [ABSTRACT FROM AUTHOR]

This study aims to compare the diagnostic efficacy of DWI (Diffusion Weighted Imaging) and DCE-MRI (Dynamic Contrast Enhancement-Magnetic Resonance Imaging) in the depth of myometrial invasion, cervical invasion and FIGO (Federation International of Gynecology and Obstetrics) staging in patients with endometrial cancer. 128 patients were selected for preoperative diagnosis with DWI and DCE-MRI techniques. The diagnostic efficacy of the two diagnostic methods on the depth of myometrial invasion, cervical invasion and FIGO staging was compared. Receiver operating characteristic curves were plotted for the two diagnostic methods to further compare the differences between the two diagnostic methods. The accuracy, sensitivity, positive predictive value and negative predictive value of DWI were conspicuously higher than that of DCE-MRI in the diagnosis of depth of myometrial invasion and cervical invasion (p < 0.05). ROC (Receiver Operating Characteristic Curve) analysis demonstrated that the diagnostic effect of DWI was better than that of DCE-MRI in the diagnosis of depth of myometrial invasion and cervical invasion, and the difference in the area under the curve between the two diagnostic methods was statistically significant (p < 0.05). In terms of FIGO staging diagnosis, the accuracy of DWI was 86.72%, which was higher than 65.63% of DCE-MRI (χ² = 15.689, p < 0.001). For patients with endometrial cancer, preoperative depth of myometrial invasion, cervical invasion and FIGO staging have critical guiding significance for clinical diagnosis and treatment. Compared with DCE-MRI, DWI has better diagnostic efficacy for depth of myometrial invasion, cervical invasion and FIGO staging, which is worthy of clinical application. [ABSTRACT FROM AUTHOR]

Purpose: To construct a new clinical staging system including the number of lymph node metastases to supplement the International Federation of Gynecology and Obstetrics (FIGO) staging for the prognosis of endometrial carcinoma patients.Methods: This cohort study retrieved the data of 28,824 patients confirmed as endometrial carcinoma between 2010 and 2015 in the surveillance, epidemiology, and end results (SEER) database. COX risk proportional model was established to evaluate the association between FIGO staging with the all-cause mortality of endometrial carcinoma. The diagnostic value of FIGO staging and the new staging for the mortality of patients were evaluated by receiver operator characteristic curve (ROC). Hazard ratio (HR) and 95% confidence interval (CI) were effect size.Results: The 5-year survival rate of all participants was 77.21%. The median follow-up time was 60.00 (60.00,60.00) months. Patients at FIGO staging IB (HR=1.75, 95% CI: 1.62– 1.90), FIGO staging II (HR=2.22, 95% CI: 2.00– 2.47), FIGO staging IIIA (HR=2.74, 95% CI: 2.43– 3.09), FIGO staging IIIB (HR=4.07, 95% CI: 3.48– 4.76), FIGO staging IIIC1 (HR=3.84, 95% CI: 3.52– 4.20), FIGO staging IIIC2 (HR=4.52, 95% CI: 4.09– 4.99), FIGO staging IVA (HR=5.56, 95% CI: 4.58– 6.74), and FIGO staging IVB (HR=7.62, 95% CI: 6.94– 8.36) were associated with increased risk of all-cause mortality of endometrial carcinoma patients. After adding positive lymph nodes as another covariate in Model 3, the effect on of FIGO staging survival was reduced when the FIGO staging was higher than stage III/IV. The C-index of the new staging 0.781 (95% CI: 0.774– 0.787) was higher than FIGO staging 0.776 (95% CI: 0.770– 0.783).Conclusion: Our new staging using the number of positive lymph nodes supplement to the FIGO staging was superior than the FIGO staging for predicting the prognosis of endometrial cancer patients, which might help more accurately identify endometrial carcinoma patients who were at high risk of mortality and offer timely treatments in these patients. [ABSTRACT FROM AUTHOR]

Introduction: Cervical cancer is among the most frequent types of neoplasia worldwide and remains the fourth leading cause of cancer death in women, a fact that raises the necessity for further development of therapeutic strategies. NCCN guidelines recommend radiation therapy with or without chemotherapy as the gold standard for locally advanced cervical cancer. Also, some studies claim that performing surgery after chemo-radiation therapy does not necessarily improve the therapeutic outcome. This study aims to determine the impact of the risk factors, various characteristics, and surgical treatment for patients in different stages of the disease on survival rate. Material and methods: Our study started as a retrospective, observational, unicentric one, carried out on a cohort of 96 patients diagnosed with cervical cancer from the surgical department of the Bucharest Oncological Institute, followed from 1 January 2019 for a period of 3 years. After the registration of the initial parameters, however, the study became prospective, as the patients were closely monitored through periodical check-ups. The end-point of the study is either the death of the participants or reaching the end of the follow-up period, and, therefore, we divided the cohort into two subgroups: the ones who survived after three years and the ones who did not. All 96 patients, with disease stages ranging from IA2 to IIIB, underwent radio-chemotherapy followed by adjuvant surgery. Results: Among the 96 patients, 45 (46%) presented residual tumor after radio-chemotherapy. Five patients (5%) presented positive resection margins at the post-operative histopathological examination. The presence of residual tumor, the FIGO stage post-radiotherapy, positive resection margins, and lympho-vascular and stromal invasions differed significantly between the subgroups, being more represented in the subgroup that reached the end-point. Variables correlated with the worst survival in Kaplan–Meier were the pelvic lymph node involvement—50% at three years (p—0.015)—and the positive resection margins—only 20% at three years (p < 0.001). The univariate Cox model identified as mortality-associated risk factors the same parameters as above, but also the intraoperative stage III FIGO (p < 0.001; HR 9.412; CI: 2.713 to 32.648) and the presence of post-radiotherapy adenopathy (p—0.031; HR: 3.915; CI: 1.136 to 13.487) identified through imagistic methods. The independent predictors of the overall survival rate identified were the positive resection margins (p—0.002; HR: 6.646; CI 2.0 to 22.084) and the post-radiotherapy stage III FIGO (p—0.003; HR: 13.886; CI: 2.456 to 78.506). Conclusions: The most important predictor factors of survival rate are the positive resection margins and the FIGO stage after radiotherapy. According to the NCCN guidelines in stages considered advanced (beyond stages IB3, IIA2), the standard treatment is neoadjuvant chemoradiotherapy. In our study, with radical surgery after neoadjuvant therapy, 46% of patients presented residual tumor at the intraoperative histopathological examination, a fact that makes the surgical intervention an important step in completing the treatment of these patients. In addition, based on the patient's features/comorbidities and the clinical response to chemotherapy/radiotherapy, surgeons could carefully tailor the extent of radical surgery, thus resulting in a personalized surgical approach for each patient. However, a potential limitation can be represented by the relatively small number of patients (96) and the unicentric nature of our study. [ABSTRACT FROM AUTHOR]

Simple Summary: Magnetic resonance imaging (MRI) has a pivotal role in accurately staging cervical cancer and has been formally incorporated into the 2018 FIGO staging system. MRI can accurately assess tumour size and local and distant invasion as well as lymph node involvement, which is essential for triaging patients into surgical or chemotherapeutic management. In this review, we highlight key MRI findings and pitfalls pertaining to the updated FIGO stages and their implications for treatment selection into surgery or chemoradiation. Cervical cancer is the fourth most common cancer in women worldwide and the most common gynaecological malignancy. The FIGO staging system is the most commonly utilised classification system for cervical cancer worldwide. Prior to the most recent update in the FIGO staging in 2018, the staging was dependent upon clinical assessment alone. Concordance between the surgical and clinical FIGO staging decreases rapidly as the tumour becomes more advanced. MRI now plays a central role in patients diagnosed with cervical cancer and enables accurate staging, which is essential to determining the most appropriate treatment. MRI is the best imaging option for the assessment of tumour size, location, and parametrial and sidewall invasion. Notably, the presence of parametrial invasion precludes surgical options, and the patient will be triaged to chemoradiotherapy. As imaging is intrinsic to the new 2018 FIGO staging system, nodal metastases have been included within the classification as stage IIIC disease. The presence of lymph node metastases within the pelvis or abdomen is associated with a poorer prognosis, which previously could not be included in the staging classification as these could not be reliably detected on clinical examination. MRI findings corresponding to the 2018 revised FIGO staging of cervical cancers and their impact on treatment selection will be described. [ABSTRACT FROM AUTHOR]

Simple Summary: In this commentary, I delve into the complexities and potential of the recently proposed 2023 FIGO staging system for endometrial cancer, with a focus on the incorporation of molecular classifications. I aim to evaluate the predictive capacity of histology and molecular testing, emphasizing the challenge of utilizing the POLE mutation test in determining prognosis. By addressing challenges like discerning synchronous independent tumors from metastatic ones when both endometrium and ovary are involved, and considering new elements such as lymph node metastasis size, this work may inform future treatment approaches, reinforcing the indispensable role of pathologists in this evolving landscape. This commentary explores the complexities of the FIGO 2023 staging system and the inclusion of The Cancer Genome Atlas's (TCGA) molecular classification in the management of endometrial cancer. It highlights the importance of histology as a prognostic tool, while scrutinizing the merits and demerits of its application to aggressive endometrial cancers. The commentary review sheds light on the recent introductions of lymphovascular space invasion (LVSI) and lymph node metastasis size in cancer staging. It outlines the difficulties in differentiating between synchronous and metastatic endometrial and ovarian cancers, underlining their implications on treatment strategies. Furthermore, the commentary discusses the integration of molecular classifications within the FIGO 2023 framework, emphasizing the pivotal yet challenging implementation of the pathogenic POLE mutation test. The commentary concludes by reaffirming the vital role of pathologists in executing the FIGO 2023 staging system. [ABSTRACT FROM AUTHOR]

Copyright of Progress in Modern Biomedicine is the property of Publishing House of Progress in Modern Biomedicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

OBJECTIVE The objective of this study was to compare Federation of Gynecology and Obstetrics (FIGO) 2009 and 2018 staging systems in patients with uterine cervical cancer. METHODS Medical records of 571 patients who were treated with adjuvant radiotherapy or radiochemotherapy between 2001 and 2018 were retrospectively reviewed. Differences in overall survival (OS) and progression-free survival (PFS) rates according to FIGO 2009 and FIGO 2018 staging systems were compared using the log-rank test. Cox regression model was used to identify independent prognostic factors for survival. RESULTS The median follow-up was 59 months. Five-year OS and PFS rates were 81.1% and 77.7%, respectively. Stage migration was recorded in 401 patients (70.2%) and the most remarkable stage migration was detected in stage I patients (60%). A total of 157 (27.5%) patients upstaged to stage IIIC disease. According to FIGO 2009, 5-year OS rates were 87.3%, 80.5% (p=0.076), and PFS rates were 82.8%, 77.5% (p=0.036) for stage IB1 and IB2, respectively. According to FIGO 2018, the 5-year OS rates for stage IB1, IB2, and IB3 were 89.8%, 87.1%, and 81.4% (p=0.310), and PFS rates were 90.2%, 80.5%, and 80.1% (p=0.189), respectively. Patients with =2 pelvic lymph node (LN) metastases had worse 5-year OS and PFS rates than patients with one metastasis (p=0.015 and p=0.006). Number of para-aortic LN metastasis and metastatic LN ratio (MLNR) were also correlated with 5-year OS and PFS. CONCLUSION Current FIGO staging system better discriminates patients with cervical cancer. However, integration of metastatic LN number and/or MLNR to the upcoming FIGO staging system may improve the prognostic value of the staging. [ABSTRACT FROM AUTHOR]

Copyright of Imaging Science & Photochemistry is the property of Imaging Science & Photochemistry Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Worldwide 85% of cervical cancer (CC) related deaths occur in low- and middle-income countries. Sub-Saharan Africa is burdend by an overlapping high incidence of CC as well as HIV infection, a risk factor for HPV associated disease progression. Recent upscaling of CC screening activities increased the number of CC diagnoses in a previous unscreened population. The aim of the 2H study was to follow up on women with CC in the context of available health care services in Tanzania in relation to their HIV infection status.Methods: This longitudinal observational cohort study included women with histological confirmed CC from Mbeya, Tanzania, between 2013-2019. All women were referred for CC staging and cancer-directed therapies (CDT), including surgery and/or radio-chemotherapy, or palliative care. Annual follow-up focused on successful linkage to CDT, interventions and survival. We assessed factors on compliance, used Kaplan-Meier-Survivor functions to evaluate survival time and poisson regression models to calculate incidence rate ratios on mortality (IRR) two years after diagnosis.Results: Overall, 270 women with CC (123 HIV infected) were included. Staging information, available in 185 cases, showed 84.9% presented with advanced stage disease (FIGO ≥ IIB), no difference was seen in respect to HIV status. HIV-infected women were 12 years younger at the time of cancer diagnosis (median age 44.8 versus 56.4 years, p < 0.001). Median follow up period was 11.9 months (range 0.2-67.2). Survival information, available in 231 cases, demonstrated for women diagnosed in early-stage disease a median survival time of 38.3 months, in advanced-stage 16.0 months and late-stage disease 6.5 months after diagnosis. Of all women, 42% received CDT or palliative support. HIV co-infection and education were associated with higher health care compliance. CDT was significantly associated with lower 2-year mortality rates (IRR 0.62, p = 0.004). HIV coinfection did not impact mortality rates after diagnosis.Conclusion: High numbers of advanced and late staged CC were diagnosed, compliance to CDT was low. A beneficial impact of CDT on CC mortality could be demonstrated for local health care services. This study indicates challenges for successful linkage and supports an effective scale up of cancer care and treatment facilities. [ABSTRACT FROM AUTHOR]

Simple Summary: Primary vulvar malignancy is a rare gynecological neoplasm constituting 5–8% of cases. Considering the prognostic capability of staging, FIGO has introduced the revised 2021 staging for vulvar cancer. We review the etiopathogenesis revised 2021 International Federation of Gynecology and Obstetrics (FIGO) classification and emphasize imaging in the staging of vulvar cancer. Vulvar cancer is a rare gynecological malignancy. It constitutes 5–8% of all gynecologic neoplasms, and squamous cell carcinoma is the most common variant. This article aims to review the etiopathogenesis revised 2021 International Federation of Gynecology and Obstetrics (FIGO) classification and emphasize imaging in the staging of vulvar cancer. The staging has been regulated by FIGO since 1969 and is subjected to multiple revisions. Previous 2009 FIGO classification is limited by the prognostic capability, which prompted the 2021 revisions and issue of a new FIGO classification. Although vulvar cancer can be visualized clinically, imaging plays a crucial role in the staging of the tumor, assessing the tumor extent, and planning the management. In addition, sentinel lymph node biopsy facilitates the histopathological staging of the draining lymph node, thus enabling early detection of tumor metastases and better survival rates. [ABSTRACT FROM AUTHOR]

Endometrial carcinoma is the most common gynaecological cancer in developed countries. Most cases are low-volume/low-grade tumour at presentation; however, high-grade subtypes may present with locally advanced disease with higher propensity for spread outside of the pelvis. MRI has a role in local staging of the tumour and helping the clinicians in treatment decision making. This pictorial essay gives examples of endometrial carcinoma at different stages with histological correlation. It also explores the potential limitations and pitfalls of imaging in this context. [ABSTRACT FROM AUTHOR]

The purpose of this article is to review the current molecular classification of endometrial cancer, the imaging findings in early and advanced disease, and the current management strategies, focusing on the new systemic therapies for advanced EC. In recent years, the management of endometrial cancer has significantly changed. The molecular characterization of endometrial cancer has shed new light into the biologic behavior of this disease, the International Federation of Gynecology and Obstetrics staging system was recently revised, and imaging was formally incorporated in the management of endometrial cancer. Recent genomic analysis of endometrial cancer led to the approval of new molecular-targeted therapies and immune checkpoint inhibitors. Imaging allows assessment of myometrial invasion, cervical stromal extension, lymph node involvement and distant metastases, and has a crucial role for treatment planning. Treatment strategies, which include surgery, radiation and systemic therapies are based on accurate staging and risk stratification. [ABSTRACT FROM AUTHOR]

The purpose of the study was to compare FIGO 2009 and 2018 uterine cervical carcinoma staging systems in terms of patient distribution and efficacy in predicting treatment outcome in patients treated with surgery and adjuvant radiotherapy (RT)+/-concomitant chemotherapy (CT). METHODS The records of 184 uterine cervical cancer patients treated with post-operative RT/RCT from 2007 to 2017 were retrospectively reviewed. Surgical procedure was in the form of Wertheim surgery in 96 patients (52%) and pelvic lymph node dissection was performed in 32 patients (17.5%). One hundred and sixty-six patients (87.5%) received both external RT and intracavitary brachytherapy, and 23 (12.5%) patients were treated only with external RT. RESULTS The median follow-up time was 61.5 months (range, 8-132 moths). One hundred and fifty-one (82%) patients were alive, and 144 (94%) of these were free of disease at the time of this analysis. The median time for locoregional failure and distant metastasis were 25 months (range, 8-88 months) and 38 months (range, 12-118 months). Stage migration was recorded in 130 patients (70.7%) in our series when the International Federation of Gynecology and Obstetrics (FIGO) 2018 staging system was used. The most remarkable stage migration was detected for Stage I patients. A total of 119 (64.6%) patients with Stage I showed stage migration. Five-year locoregional control, disease-free survival, disease-specific survival, and overall survival rates were 91%, 88%, 91%, and 83%, respectively. CONCLUSION The updated FIGO staging system for invasive cervical cancer incorporates imaging and pathological findings. Our results suggest us that the major improvement of 2018 staging system for uterine cervical carcinoma is that it produced better discrimination in terms of survival outcome in patients with lymph node metastases both pelvic and para-aortic. [ABSTRACT FROM AUTHOR]

The International Federation of Gynecology and Obstetrics (FIGO) staging system of carcinoma cervix saw a radical change in 2018 with the inclusion of cross-sectional imaging tools for the assessment of disease extent and staging. One of the major revisions is the inclusion of lymph node status, detected either on imaging or pathological evaluation, in the staging system. The changes were based on long-term patient follow-up and survival rates reported in literature. Thus, it becomes imperative for a radiologist to be well versed with the recent staging system, its limitations, and implications on the patient management. [ABSTRACT FROM AUTHOR]

Background: Cervical cancer continues to be one of the leading causes of cancer deaths among females in low and middle-income countries. In this study, we aimed to assess the independent prognostic value of clinical and potential prognostic factors in progression-free survival (PFS) in cervical cancer.Methods: We conducted a retrospective study on 92 cervical cancer patients treated from 2017 to 2019 at the Zhuhai Hospital of Traditional Chinese and Western Medicine. Tumor characteristics, treatment options, progression-free survival and follow-up information were collected. Kaplan-Meier method was used to assess the PFS.Results: Results showed that the number of retrieved lymph nodes had a statistically significant effect on PFS of cervical cancer patients (P = 0.002). Kaplan-Meier survival curve analysis showed that cervical cancer patients with initial symptoms age 25-39 had worse survival prognoses (P = 0.020). And the using of uterine manipulator in laparoscopic treatment showed a better prognosis (P < 0.001). A novel discovery of our study was to verify the prognostic values of retrieved lymph nodes count combining with FIGO staging system, which had never been investigated in cervical cancer before. According to the Kaplan-Meier survival curve analysis and receiver operating characteristic (ROC) curve analysis, significant improvements were found after the combination of retrieved lymph nodes count and FIGO stage in predicting PFS for cervical cancer patients (P < 0.001, AUC = 0.826, 95% CI: 0.689-0.962).Conclusion: Number of retrieved lymph nodes, initial symptoms age, uterine manipulator, and retrieved lymph nodes count combining with FIGO staging system could be potential prognostic factors for cervical cancer patients. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the clinical and pathological characteristics, and the recurrence and prognostic factors of borderline ovarian tumors (BOTs).Methods: The data of 286 patients admitted to hospital and followed up for more than ten months were analyzed retrospectively to study the clinicopathological characteristics and related factors of recurrence.Results: The median age of the patients was 42.06 ± 14.97 years, and the duration of the follow-up ranged from 10-109 months. During the follow-up period, 40 patients had a recurrence. Of these patients, 36 were ≤ 40 years, and patients with premenopausal recurrence accounted for 20.5% (36/176). In patients undergoing conservative treatment or radical operations, the recurrence rates were 21.3% and 1.8%, respectively, and they were 13.4% (36/268) in patients at Federation International of Gynecology and Obstetrics (FIGO) stage I, and 22.2% (4/18) in patients at an advanced stage. Postoperative pathology revealed that 40 patients had micropapillary tumors, among whom ten patients (25%) had a recurrence, and 19 patients had complications with interstitial infiltration. Of these 19 patients, six had a recurrence (31.5%). Another 22 patients had complications with calcified sand bodies; among these, eight patients (36.4%) had a recurrence. All the differences were statistically significant (P < 0.05). There were four cancer-related deaths during the follow-up period. Late FIGO stage, conservative operation, and a high level of carbohydrate antigen 125 (CA125) were independent risk factors for the recurrence of BOTs.Conclusion: BOTs usually occur in women under 40 years, have an occult onset, and half of the patients have no obvious clinical manifestations. Serum CA125 level can be used as a tumor marker to detect BOTs and the risk of its recurrence. Operation mode and FIGO stage are important independent factors for the recurrence of BOTs. [ABSTRACT FROM AUTHOR]

Aim: We explored the role of miR-29b expression in endometrial cancer (EC) progression and patient prognosis. Materials & methods: Patients with primary or metastatic EC (n = 356), patients with endometrial benign tumors (n = 149) and healthy female subjects (n = 155) were collected. We assessed the diagnostic value of miR-29b expression for EC using a receiver operating characteristic curve. Results: The miR-29b expressions were lower in patients with primary or metastatic EC. Using miR-29b expression to diagnose EC produced 0.976 area under the curve, 96.1% sensitivity and 97.9% specificity. Cox proportional hazard regression model verified a low miR-29b expression and is an unfavorable prognostic indicator for EC. Conclusion: We conclude that downregulated miR-29b expression correlates with poor EC prognosis and is helpful to evaluate the EC prognosis. [ABSTRACT FROM AUTHOR]

Aim: We explored the role of miR-29b expression in endometrial cancer (EC) progression and patient prognosis.Materials& Methods: Patients with primary or metastatic EC (n = 356), patients with endometrial benign tumors (n = 149) and healthy female subjects (n = 155) were collected. We assessed the diagnostic value of miR-29b expression for EC using a receiver operating characteristic curve.Results: The miR-29b expressions were lower in patients with primary or metastatic EC. Using miR-29b expression to diagnose EC produced 0.976 area under the curve, 96.1% sensitivity and 97.9% specificity. Cox proportional hazard regression model verified a low miR-29b expression and is an unfavorable prognostic indicator for EC.Conclusion: We conclude that downregulated miR-29b expression correlates with poor EC prognosis and is helpful to evaluate the EC prognosis. [ABSTRACT FROM AUTHOR]

Introduction: Carcinoma cervix is widely prevalent among women in developing countries. Post contrast Magnetic Resonance Imaging (MRI) utilising spin echo T1 weighted sequence with fat suppression is widely practiced as part of evaluation of carcinoma cervix. However, it is unclear if such post contrast imaging provides any additional information other than adding to the cost of imaging. Aim: To find accuracy of T1 and T2 weighted non contrast MRI protocol in comparison with post contrast spin echo T1 weighted fat suppressed imaging in evaluating the local extent of the carcinoma cervix. Materials and Methods: A prospective study was conducted in the Department of Radiodiagnosis, JJM Medical College and Hospital, Davangere, Karnataka, India, between June 2016 and December 2016. A total of 45 females with a mean age of 50.7 years with biopsy proven cervical malignancy and predetermined clinical staging underwent MRI of pelvis. Prior to the scan, 10-15 ml of lignocaine jelly was instilled into the vagina. Sagittal T2 weighted images of the pelvis were acquired to identify the plane of the uterus and cervix. Axial and coronal imaging were planned perpendicular and parallel to the plane of cervix. Post contrast fat suppressed Spin Echo T1 weighted images were also obtained. Two radiologists evaluated the non contrast and contrast enhanced MR images of all patients separately. Interobserver variability and statistical significance was calculated. Results: There was 100% agreement between the two radiologists in interpreting non contrast scans and 91.1% interobserver agreement for post contrast images. Interruption of T2 hypointense cervical stroma with or without hyperintensity in adjacent parametrium, and interruption of the hypointense inner walls of urinary bladder and rectum could be more easily and reliably identified than the extension of enhancement outside the confines of the cervix. Four patients with a clinical staging of 1b and 2a who underwent surgery showed extension into parametrium on non contrast MRI image as well as peroperatively. In patients who had not underwent surgery, both the non contrast and post contrast MRI imaging findings were in agreement with each other. Twenty out of 45 cases showed pelvic nodes which were identified on both non contrast and post contrast images. Conclusion: Routine post contrast T1 weighted imaging provides no added advantage in comparison with non contrast T1 and T2 weighted imaging in evaluation of carcinoma cervix and need not be acquired routinely. However, only in selective cases with ambiguity on non contrast images, dynamic post contrast imaging may be used as a problem solving tool. [ABSTRACT FROM AUTHOR]

The silent information regulator 2 related enzyme 2 (SIRT2) has been reported to have an important role in tumorigenesis. Although two distinct effects of SIRT2 have recently been revealed, which explain opposing expression patterns in different types of cancer, the specific function of SIRT2 in ovarian cancer remains unknown. The present study investigated the expression of SIRT2 in serous ovarian carcinoma (SOC) and its pathogenic mechanism. It was observed that SIRT2 expression in SOC was significantly downregulated when compared with ovarian surface epithelium via western blot and immunohistochemistry. Statistical analysis revealed that attenuated expression of SIRT2 was associated with the International Federation of Gynecology and Obstetrics classification of ovarian cancer. Reduced SIRT2 expression during tumorigenesis failed to repress cyclin-dependent kinase 4 expression, which eventually led to accelerated cell proliferation. Furthermore, the wound healing assay and Transwell assay determined that reduced expression of SIRT2 promoted SOC cell migration and invasion. In conclusion, the results of the current study suggest that SIRT2 has a tumor-suppressor function in ovarian cells and it might be a viable target for further SOC treatment. [ABSTRACT FROM AUTHOR]

The article focuses on patients with endometrial cancer and mentions hysteroscopy (HSC) and dilatation and curettage (D&C). Topics discussed include positive peritoneal cytology, diagnosis of endometrial cancer and endometrial biopsy. Other topics which includes peritoneal washings are also discussed.

Objectives: The aim of this study was to investigate the benefits of the newly revised "The international federation of gynecology and obstetrics (FIGO), 2009" sytem and whether there was a difference in new system comparison to 1988 FIGO staging system for endometrial carcinoma. Methods: A total of 132 patients who underwent complete surgical staging for endometrial cancer were enrolled retrospectively. Those patients' overall survival and disease free survival were compared with 1988 and 2009 staging system. Results: The five year overall survival (OS) rates for patients with 1988 FIGO stage 1 and 2 were 97% and 100%, respectively. In 2009 system, the OS rates for 1 and 2 were 97% and 100%, respectively. There was no statistically significant differences between stage 1 and stage 2 for OS rates in 1988 and 2009 as well. Conclusions: The newly revised system could be less complex for understanding, but it does not discriminate survival rates better, especially in earlier stages. A new staging system and uniform surgical staging could be discussed. [ABSTRACT FROM AUTHOR]

Ultrasound is the primary imaging modality in gynecological oncology. Over the last decade, there has been a massive technology development which led to a dramatic improvement in the quality ultrasound imaging. If performed by an experienced sonographer, ultrasound has an invaluable role in the primary diagnosis of gynecological cancer, in the assessment of tumor extent in the pelvis and abdominal cavity, in the evaluation of the treatment response, and in follow-up. Ultrasound is also a valuable procedure for monitoring patients treated with fertility-sparing surgery. Furthermore, it is an ideal technique to guide tru-cut biopsy for the collection of material for histology. Taking into consideration that besides its accuracy, the ultrasound is a commonly available, non-invasive, and inexpensive imaging method that can be carried out without any risk or discomfort to the patient; it is time to reconsider its role in gynecologic oncology and to allocate resources for a specialized education of future experts in ultrasound imaging in gynecology. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives To identify major factors in the under- and overestimation of cervical and myometrial invasion by endometrial cancer at preoperative staging by ultrasound. Methods This prospective study involved all patients with histologically confirmed endometrial cancer referred consecutively for surgical staging between January 2009 and December 2011. All patients underwent transvaginal ultrasound examination, obtaining metric and perfusion data, and the results were compared with final histology: myometrial invasion was defined at histology in the final pathology report as being either < or ≥ 50%, while cervical stromal invasion was reported as being either present or absent, and sonographic over-/underestimation was determined relative to these. Results Enrolled prospectively into the study were 210 patients. The proportion of cases with sonographic underestimation, relative to final histology, of myometrial invasion (i.e. false-negative estimation of no or superficial invasion < 50%) and of cervical invasion (i.e. false-negative finding of absence of stromal invasion) was comparable: 8.6% ( n = 18) and 10.5% ( n = 22), respectively. Myometrial invasion was overestimated by ultrasound (i.e. false-positive estimation of deep invasion ≥ 50%) in 15.7% ( n = 33) of cases, and cervical invasion was overestimated (i.e. false-positive finding of presence of stromal invasion) in 4.8% ( n = 10) of cases. These outcomes correspond to positive and negative predictive values of 67.6% (95% CI, 57.7-76.6) and 83.3% (95% CI, 74.9-89.8), respectively, for the subjective assessment of myometrial invasion, and 60.0% (95% CI, 38.2-79.2) and 88.1% (95% CI, 82.5-92.4), respectively, for that of cervical stromal invasion. The staging error in subjective assessment was not related to body mass index ( BMI), to the position of the uterus in the pelvis or to image quality. Cervical and myometrial invasion were more often underestimated in well-differentiated endometrial cancers that were smaller in size, with thick minimum tumor-free myometrium and lower perfusion, and more often overestimated in moderately and poorly differentiated cancers that were larger in size, with thin minimum tumor-free myometrium and richer perfusion. Conclusion The accuracy of subjective assessment of myometrial and cervical invasion by ultrasound was significantly influenced by tumor size, density of tumor vascularization, tumor vessel architecture and histological grading, while it was not significantly affected by BMI, uterine position and image quality. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

Different treatment options are available for patients with gynecological cancers. Imaging plays an important role in assessment of patients with common cancers involving uterine body, cervix and ovaries, from detection to evaluation of the extent of disease. The purpose of this review is to highlight the role of cross-sectional imaging techniques in treatment stratification and overall management of patients with endometrial, cervical and ovarian cancers. Several imaging techniques used are described, including ultrasound, computed tomography (CT), MRI and PET/CT. Specific imaging appearances of the most common uterine, cervical and ovarian cancers are discussed. Imaging findings corresponding to the 2009 revised International Federation of Gynecology and Obstetrics (FIGO) staging of gynecologic malignancies are also described. In the multidisciplinary evaluation of patients with gynecologic malignancies, the role of the radiologist has become central for accurate diagnosis and evaluation of extent of disease to achieve better treatment selection and planning. [ABSTRACT FROM AUTHOR]

Müllerian adenosarcomas most commonly arise in the uterine corpus from the eutopic endometrium. Occasionally, they arise in the cervix, vagina, broad and round ligaments, and ovaries and rarely in extragenital sites, usually in association with endometriosis. The authors report a rare case of extraendometrial, intramural adenosarcoma of low grade arising from a subserosal adenomyoma in a 46-year-old woman who presented with vaginal bleeding. No evidence of eutopic endometrial origin was identified; the adenosarcoma showed only limited myometrial invasion and no serosal involvement. Because of its subserosal location, the tumor would be overstaged as IC (deeply myoinvasive) in the new FIGO staging system. Stage IC tumors would normally be considered for adjuvant treatment, which would be inappropriate in this case. To avoid overstaging and inappropriate treatment, it is important to recognize that adenosarcoma can, rarely, arise in adenomyomas (or adenomyosis). [ABSTRACT FROM AUTHOR]

The International Federation of Gynecology and Obstetrics ( FIGO) staging of tumours of the uterine corpus, cervix and vulva was revised in 2009. The greatest impact of the revised staging was on carcinomas of the uterine corpus. Uterine sarcomas are now staged separately. Changes to the staging system for vulvar carcinomas largely reflect the significance of lymph node status. Only minor amendments have been introduced for cervical carcinomas, which remain the only gynaecological tumours to be staged clinically. These revisions, based on recent evidence, require careful, more detailed assessment of several histological parameters at each anatomical site. The present review deals with the evidence and rationale underpinning the revisions, and includes practical guidance on tumour staging. This covers the assessment and measurement of myoinvasion and evaluation of cervical, parametrial, serosal and vaginal involvement in carcinomas of the uterine corpus; the identification and accurate measurement of stromal invasion in cervical and vulvar carcinomas; the assessment of unusual variants of carcinoma at each of these sites; and the assessment of lymph node involvement. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this retrospective study was to evaluate the behavior and treatment outcomes of uterine carcinosarcomas in relation to their clinical and pathogenic features and to determine the optimal treatment strategy. Secondary objectives were to identify parameters predictive of survival. Materials and Methods: The hospital records of all 25 patients of uterine carcinosarcoma operated between 2000 and 2008 in Gujarat cancer research institute, Ahmedabad, were reviewed. Patients who presented with clinical evidence of recurrent disease or those who had incomplete medical records were excluded from our analysis. The status of these patients was updated up to November, 2010. Patients were classified according to the new 2009 FIGO staging system for endometrial carcinoma, to see what difference the assigned stage has on survival with the old treatment strategy. Survival was calculated by Kaplan-Meier method and compared by Log-Rank test. Median survival time was derived with the Brookmeyer 95% confidence interval. For comparison of qualitative data, Chi-Square test and Fisher extract χ2 were used. Results: Median age of patients was 56 years (range, 36-77 years). Only 36% of patients had stage I at diagnosis and another 36% were stage III. Most of the tumors (56%) were with homologous sarcomatous components and 64% of tumors were high grade (grade 2/3) at diagnosis. Fifty-two percent patients received postoperative adjuvant treatment. Twelve patients had no postoperative treatment: two were lost to follow-up immediately after surgery, four could not receive adjuvant treatment on account of severe medical complications and age factor which could have increased morbidity, and six patients declined treatment. Four of these patients expired within one year of diagnosis, two other within 18 months, and rest were lost to follow-up. The difference in survival of 13 patients who had taken adjuvant treatment was significantly more than the group who had not taken adjuvant therapy (P=0.025). The overall 3-year disease-free survival of 13 patients who had taken adjuvant therapy was 40%. However, these adjuvant treatment modalities had borderline statistical significance on overall survival of patients (P=0.075). The only statistically significant predictor of survival in this study was stage of the disease (P=0.035). Conclusions: This highly aggressive uterine malignancy warrants comprehensive surgical staging to assess tumor dissemination followed by systematic adjuvant therapy in patients with both early and advanced disease. The value of pelvic Radiotherapy in addition to systemic treatment remains ill-defined. Stage is the significant predictor of survival for the disease. Our results indicate that in this highly aggressive malignancy, further exploration of potential outcome benefits of postoperative treatment, especially chemoradiation, is warranted in larger group of patients after comprehensive surgical staging. [ABSTRACT FROM AUTHOR]

Aims: (1) To map the extent of disease in women with stage I and II carcinoma cervix by multislice spiral computed tomography (CT), magnetic resonance imaging (MRI) and sentinel nodes. (2) To assess accuracy of each modality individually and in conjunction with FIGO clinical staging. Design and Setting: Prospective, single-blind study. Departments of Obstetrics and Gynaecology, Radiodiagnosis, and Pathology, UCMS and GTBH and Division of Radiological Imaging and Bioinformatics, INMAS, Delhi. Material and Method: The study was conducted on 25 women with cervical cancer FIGO stage I and II. Each woman underwent clinical staging, multislice spiral CT and MRI which was compared to the gold-standard histopathology/cytology. The overall accuracy of each modality and improvement of clinical staging by CT/MRI were noted. Sentinel nodes were evaluated by intracervical Patent Blue V dye injection. Statistical Analysis: Sensitivity, specificity, positive and negative predictive values were calculated by 2×2 contingency tables. Results: The accuracy of staging by FIGO, CT and MRI was 68%, 52% and 80%, respectively. MRI and CT improved the overall accuracy of FIGO staging to 96% and 80%, respectively. Sentinel nodes were identified in 89% of patients with 91% accuracy. Conclusion: MRI emerges as the most valuable stand-alone modality improving accuracy of FIGO staging to 96%. Sentinel lymph-node evaluation appears promising in evaluating spread beyond cervix. [ABSTRACT FROM AUTHOR]