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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]

Endometrial cancer is one of the most common gynecological malignancies, especially in high-income regions of the world, and its incidence rates have continued to increase over the past decade. Its staging is surgical, with treatment planning based on the FIGO stage and histological subtype and grade. Imaging is obligatory in the diagnostic work-up process in order to allow more tailored treatment. Magnetic resonance tomography is the preferred imaging modality that may be used to aid in the preoperative risk stratification, surgical planning and individualized therapy.

To develop and validate a model based on MRI radiomics modals for predicting surgical high FIGO(IB3 and ≥ IIA2) and low FIGO(IB1, IB2, and IIA1) stages in patients with cervical carcinoma (CC). A total of 296 early-stage patients with CC (preoperative FIGO stages IB-IIA) confirmed by surgery and pathology were included in this retrospective study from two institutions For each patient,we extracted radiomics features from spectral attenuated inversion-recovery T2-weighted (SPAIR-T2W) and contrast-enhanced T1-weighted (CE-T1W) images.Manual segmentation was performed using the 3D Slicer software, while radiomics features were extracted, screened using the R software. A 2-stage feature extraction strategy involving univariate analysis and the Least Absolute Shrinkage Selection Operator technique was performed. A support vector machine-based model was eventually constructed. Predictive accuracy of the training and validation datasets was assessed in terms of area under the ROC curve (AUC). A total of 1130 features were extracted from SPAIR-T2WI and CET1WI images respectively, in which 8 and 7 features significantly were associated with FIGO staging. AUCs of the SPAIR-T2W and CE-T1W models were were 0.803 and 0.790, respectively, in the internal validation group. In the external validation group, the AUCs were 0.767 and 0.749, respectively, which increased to 0.771 in the combined model. Our study demonstrated the feasibility of radiomics features from SPAIR-T2W and CE-T1W images for the prediction of surgical FIGO stage in CC. Our proposed model thereby carries the potential as a non-invasive tool for the staging and treatment planning of this disease. A radiomics model provide a non-invasive and objective method for the detection of FIGO staging in patients with cervical cancer before surgery, thus providing a reference for the selection of treatment options for patients. [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]

Lianwei Li,1 Mengsi Zhang,2 Chao Na3 1Department of Gynecology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, 150081, People’s Republic of China; 2Medical Record Statistics Department, The Second Hospital of Heilongjiang Province, Harbin, Heilongjiang, 150028, People’s Republic of China; 3Integrated Traditional Chinese and Western Medicine Rehabilitation Medical Center, Heilongjiang Provincial hospital, Harbin, Heilongjiang, 150036, People’s Republic of ChinaCorrespondence: Chao Na, Integrated Traditional Chinese and Western Medicine Rehabilitation Medical Center, Heilongjiang Provincial Hospital, No. 82 Zhongshan Road, Xiangfang District, Harbin, Heilongjiang, 150036, People’s Republic of China, Tel +86-13313619817, Email nfnc8318@163.comPurpose: 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.Keywords: positive lymph nodes, FIGO staging, endometrial cancer, prediction

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]

Objective: To investigate the difference of RDW and PON-1 expression in peripheral blood of patients with endometrial cancer in different FIGO stages and analyze their diagnostic value. Methods: 80 patients with endometrial cancer admitted to our hospital from January 2018 to January 2020 were selected as the study objects. All patients were divided into three groups according to FIGO stage: 23 patients in stage I group, 22 patients in stage II group, 18 patients in stage III group, and 17 patients in stage IV. In addition, 30 healthy volunteers who came to our hospital for physical examination at the same time were selected as the matched group to compare the expression levels of RDW and PON-1 of all subjects. The distribution width of peripheral red blood cells and the expression level of serum paraoxonase-1 were analyzed by using the ROC curve to determine the diagnostic value of endometrial cancer in different FIGO stages. 80 patients with endometrial cancer were followed up for two years. 25 patients who died within two years were divided into death group, and the remaining 55 patients were divided into survival group. The general clinical conditions, RDW and PON-1 expression levels in death group and survival group were compared. The prognostic value of RDW and PON-1 in endometrial cancer was analyzed by logistic regression analysis. Results: The levels of RDW and PON-1 in five groups were different. The level of RDW in Phase IV group was higher than that in Phase III group, Phase II group, Phase I group and matched group, while the level of PON-1 in Phase IV group was lower than that in Phase III group, Phase II group, Phase I group and matched group (P<0.05); The accuracy, sensitivity and positive predictive value of combined diagnosis of RDW and PON-1 were higher than those of single diagnosis of RDW and PON-1 (P<0.05). The area under the value curve of different stages of endometrial cancer diagnosed by RDW was 89.63, the optimal diagnostic color limit value was 75.73 %, the area under the curve of PON-1 was 78.89, the optimal diagnostic color limit value was 82.53 %, the area under the curve of the combination of RDW and PON-1 was 84.26, and the optimal diagnostic color limit value was 87.57 %; There was no difference in sex, age and pathological type between the survival group and the death group (P>0.05). There was difference in FIGO stage, grassroots infiltration, tissue differentiation, serum RDW and PON-1 expression between the two groups (P<0.05); The above indicators with statistical differences in univariate analysis were assigned. The results of logistic regression analysis showed that grass-roots infiltration, RDW and PON-1 were independent prognostic factors for endometrial cancer patients (P<0.05). Conclusion: The combination of RDW and PON-1 has a high diagnostic value in FIGO staging of endometrial carcinoma, and grass-roots infiltration, RDW and PON-1 are independent prognostic factors of endometrial carcinoma. In clinical practice, relevant measures should be taken for patients with grass root infiltration, increased RDW and decreased PON-1 level to improve the treatment plan and reduce the mortality of patients. [ABSTRACT FROM AUTHOR]

Abstract K. Muthulingeshkumar Objectives This article reports the clinical outcomes of uterine body cancers in South Indian population. The primary outcome of our study was overall survival (OS). The secondary outcomes were disease-free survival (DFS), patterns of recurrence, toxicities of radiation treatment, and the association of patient, disease, and treatment characteristics with survival and recurrence. Materials and Methods Records of the patients diagnosed as malignancy in uterus and treated with surgery alone or with adjuvant treatment from January 2013 to December 2017 were retrieved after Institute Ethics Committee approval. Demographic, surgical, histopathology, and adjuvant treatment details were retrieved. Patients of endometrial adenocarcinoma were stratified according to the European Society of Medical Oncology/European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology consensus for analysis and overall outcomes irrespective of histology were also analyzed. Statistical Analysis For the survival analysis, Kaplan–Meier survival estimator was used. Cox regression was used to test the significance of association of factors with outcomes in terms of hazard ratio (HR). Results A total of 178 patient records were retrieved. The median follow-up of all patients was 30 months (0.5–81 months). The median age of the population was 55 years. Most common histology was endometrioid type of adenocarcinoma (89%), sarcomas comprised only 4%. The mean OS of all patients was 68 months (n = 178), median was not reached. Five-year OS was 79 %. Five-year OS rates observed in low, intermediate, high-intermediate, and high-risk were 91, 88, 75, and 81.5%, respectively. The mean DFS was 65 months, median not reached. The 5-year DFS was 76%. The 5-year DFS rates observed were 82, 95, 80, and 81.5% for low, intermediate, high-intermediate, and high-risk, respectively. Univariate analysis using Cox regression showed increase in hazard for death in case of node positivity, HR 3.96 (p 0.033). The HR for disease recurrence was 0.35 (p = 0.042) in patients who had received adjuvant radiation therapy. No other factors had any significant impact on death or disease recurrence. Conclusion The survival outcomes in terms of DFS and OS were comparable with other Indian and Western data reported in the published literature.

Abstract 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

The FIGO 2018 staging of cervix cancer recognizes a total of 11 categories of loco-regionally advanced cervix cancer (LRACC). Whilst incorporating imaging is an improvement over clinical staging (FIGO 2009), this had led to more categories of disease which are not prognostically discrete groups. We aimed to analyze survival according to 2018 FIGO stages of cervix cancer and identify isoprognostic groups of patients based on primary tumor volume and nodal status. Patients referred for radiotherapy with curative intent between 1996 and 2014 were eligible. Baseline clinico-pathological and follow up information was retrieved from an ethics-approved institutional prospective database. Patients were classified according to FIGO 2018 staging based on histo-pathology, MRI (tumor volume and local compartmental spread assessment) and PET results (nodal spread). Kaplan-Meier method was used to estimate survival at five years. Following survival analysis using recognized prognostic factors, isoprognostic categories were identified and merged to form 5 isoprognostic groups. Seven hundred and forty-four LRACC patients were included. The median (IQR) follow-up was 5.1 (2.6‐8.4) yrs. Stage migration occurred in most patients, showing heterogeneous 5 years survival according to 2018 FIGO stages. In contrast progressively worsening prognosis could be demonstrated in the 5 observed isoprognostic clusters (p < 0.002). Prognosis in LRACC depends on the interplay between primary tumor characteristics, type of local spread and nodal disease. A prospective study of survival and patterns of failure according to isoprognostic clusters would be useful to determine the most appropriate treatment modality and estimate survival as well as better patient selection for clinical trials. • Outcomes of cervix cancer patients treated with radiotherapy reported according to FIGO 2009 and FIGO 2018 staging criteria. • FIGO 2018 results in stage migration, but categories are numerous and prognosis heterogenous. • Prognosis in LRACC is an interplay between tumor volume and nodal status. • 5 distinct prognostic groups based on tumor volume and nodes have been fashioned. [ABSTRACT FROM AUTHOR]

Abstract Satinder Kaur Purpose The aim of this article was to study survival outcomes of early-stage cervical cancer patients and impact on survival after restaging them as per International Federation of Gynecology and Obstetrics (FIGO) 2018. Materials and Methods A retrospective study was conducted from June 1, 2013 to May 31, 2018 in a tertiary care hospital in North India. One-hundred patients of early-stage cervical cancer (as per FIGO 2009 staging) who had been treated by surgery followed by risk based tailored adjuvant therapy in our hospital were evaluated. The clinicopathological features and survival outcomes of these patients were analyzed. These patients were then restaged as per new FIGO 2018 staging and survival outcomes between two FIGO classifications were compared. Results The median age of the study population was 52.5 years with median follow-up of 62.1 months. Ninety percent of our patients had more than 2 years follow-up and 59% had more than 5 years follow-up. The overall survival and relapse-free survival were 87.5 and 91.4%, respectively. The study population was then reclassified according to new FIGO 2018 staging. It was seen that the patients with stage IB1and IB2 cervical cancer had overall survival of 91.1 and 90%, respectively. The overall survival of stage IB3 was 80% and the survival of stage IIIC1 was only 60%. Conclusion The new FIGO 2018 classification has a significant effect on survival outcome and in prognostication of patients with cervical cancer.

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]

Vulval cancer is a rare gynaecological cancer, predominantly seen in postmenopausal women. It accounts for about 4% of gynaecological malignancies. Most women present with vulval symptoms such as a painful lump, ulcer or itching, although some may be asymptomatic. It should be managed in experienced cancer centres where relevant expertise and experience is available to provide multidisciplinary, individualized care. Wide local excision of the lesion, usually with surgical staging of groin nodes through separate incisions is recommended for early disease. Locally advanced vulval cancers require complex and highly individualized treatment, which may be a combination of radical excision with reconstruction with or without radiotherapy. Sentinel lymph node assessment for staging is now standard of care, replacing en-bloc inguinofemoral lymphadenectomy for surgical staging of smaller, early-stage tumours, and groin dissection is omitted in these women if sentinel node biopsy is negative (GROINSS-V I study). Recent GROINSS-V II study has shown that radiotherapy is a safe alternative in patients with sentinel lymph node micro metastases (≤2 mm) with low groin recurrence rate and lower treatment-related morbidity. [ABSTRACT FROM AUTHOR]

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Abstract 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.

Background: Epithelial ovarian cancer (EOC) are often diagnosed late due to lack of specific symptoms and efficient tumor markers. Neutrophil gelatinase-associated lipocalin/matrix metallopeptidase-9 (NGAL/MMP-9) complex are involved in the development and progression of various cancers and have potential as a biomarker for diagnosing ovarian cancer. Objectives: To compare the serum NGAL/MMP-9 complex levels in patients with EOC, benign ovarian tumor, and healthy controls, and determine the potential cut-off values of NGAL/MMP-9 complex for diagnosing EOC. Materials and Methods: The study included 50 patients each with EOC and benign ovarian tumor, along with 50 age-matched healthy controls (N = 150). The level of serum NGAL/MMP-9 complex was estimated based on sandwich ELISA. The mean and median of the three groups were compared, and the ROC curve was used to determine the optimum cut-off, sensitivity, and specificity of serum NGAL/MMP-9 complex levels in the diagnosis of EOC. Results: A significant difference was found in the median values of the NGAL/MMP-9 complex (malignant EOC: 67.5 ng/ml, benign ovarian tumor: 53.7 ng/ml, controls: 29.2 ng/ml; P < 0.01). NGAL/MMP-9 complex level was also significantly associated with the FIGO staging (Stages I and II: 42.9 ng/ml; Stages III and IV: 70.5 ng/ml; P < 0.003). At a 55.0 ng/ml cut-off value, the NGAL/MMP-9 complex had 82.0% sensitivity and 78.0% specificity in diagnosing EOC. Conclusion: The NGAL/MMP-9 complex may be a promising biomarker for determining the progression of EOC as well as in detecting advanced-stage ovarian cancer.

BackgroundInvisible cervical cancers on MRI can indicate less invasive surgery. Cervical cancers consist of squamous cell carcinoma (SCC) and non-SCC, each with different long-term outcomes. It is still unclear if surgical planning should be changed according to the histologic type of cervical cancer when it is not visible on MRI.PurposeThe purpose of the study was to determine if surgical planning for cervical cancer that is not visible on MRI is influenced by the histologic type.Materials and methodsBetween January 2007 and December 2016, 155 women had Federation of Gynecology and Obstetrics (FIGO) stage 1B1 cervical cancer that was not visible on preoperative MRI. They underwent radical hysterectomies and pelvic lymph node dissections. Among them, 88 and 67 were histologically diagnosed with SCC and non-SCC, respectively. The size of the residual tumor, depth of stromal invasion, parametrial invasion, vaginal invasion, lymphovascular invasion, and lymph node metastasis were compared between these patients using the t-test, Mann–Whitney U test, Chi-squared test, or Fisher’s exact test. The recurrence-free and overall 10-year survival rates were compared between the groups by Kaplan–Meier analysis.ResultsThe mean sizes of residual tumors were 8.4 ± 10.4 mm in the SCC group and 12.5 ± 11.9 mm in the non-SCC group (p = 0.024). The mean depth of stromal invasion in the SCC group was 12.4 ± 21.2% (0%–100%), whereas that in the non-SCC group was 22.4 ± 24.4 (0%–93%) (p = 0.016). However, there was no difference in parametrial or vaginal invasion, lymphovascular invasion, or lymph node metastasis (p = 0.504–1.000). The recurrence-free and overall 10-year survival rates were 98.9% (87/88) and 95.5% (64/67) (p = 0.246), and 96.6% (85/88) and 95.5% (64/67) (p = 0.872), respectively.ConclusionsThe non-SCC group tends to have larger residual tumors and a greater depth of stromal invasion than the SCC group, even though neither is visible on MRI. Therefore, meticulous care is necessary for performing parametrectomy in patients with non-SCC cervical cancer.

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]

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 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

Abstract 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

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]

Background & objectives: Imaging has been added to the International Federation of Gynecology and Obstetrics (FIGO) 2018 staging system of cervical carcinoma. This study was performed to assess the impact of imaging in staging and to ascertain the prevalence and pattern of nodal metastasis on contrastenhanced computed tomography (CECT) in patients with cervical carcinoma who were treated based on FIGO 2009 staging system. Methods: This retrospective study was conducted to evaluate all patients with biopsy-proven cervical carcinoma who underwent CECT of abdomen at a tertiary cancer centre in north India from April 2017 to April 2019 and for whom either baseline or follow up scans were available. In patients with enlarged or necrotic lymph nodes, the location, size and pattern of infiltration of adjacent organs were recorded. Results: A total of 602 patients of cervical carcinoma had undergone CT during the study period, of whom 138 (22.9%) underwent CT at baseline and 464 (77.1%) patients during follow up. The FIGO (2009) stage distribution at the time of presentation was stage IB: 109 (18.1%); stage IIA: 14 (2.3%), stage IIB: 118 (19.6%), stage IIIA: 12 (2%), stage IIIB: 277 (46%), stage IVA: 20 (3.3%) and stage IVB: 52 (8.6%). Ninety of the 138 (65.22%) patients underwent a stage shift according to the FIGO 2018 because of the presence of enlarged lymph nodes at baseline scan. Sixteen (2.7%) patients had infiltrative nodal masses most commonly involving the blood vessels (n=14) followed by ureter (n=8), bones (n=5), muscle and bowel (n=3, each). The majority (14/16) of these patients presented with vague abdominal pain, discomfort and vomiting, while two had bone pain. Interpretation & conclusions: CECT at baseline helps in accurately assessing the stage in cervical carcinoma. It helps in the identification of lymph node metastasis in cervical carcinoma, which is crucial for guiding accurate management. [ABSTRACT FROM AUTHOR]

Cervical cancer (CC) patients have a poor prognosis due to the high recurrence rate. However, there are still no effective molecular signatures to predict the recurrence and survival rates for CC patients. Here, we aimed to identify a novel signature based on three types of RNAs [messenger RNA (mRNAs), microRNA (miRNAs), and long non-coding RNAs (lncRNAs)]. A total of 763 differentially expressed mRNAs (DEMs), 46 lncRNAs (DELs), and 22 miRNAs (DEMis) were identified between recurrent and non-recurrent CC patients using the datasets collected from the Gene Expression Omnibus (GSE44001; training) and The Cancer Genome Atlas (RNA- and miRNA-sequencing; testing) databases. A competing endogenous RNA network was constructed based on 23 DELs, 15 DEMis, and 426 DEMs, in which 15 DELs, 13 DEMis, and 390 DEMs were significantly associated with disease-free survival (DFS). A prognostic signature, containing two DELs (CD27-AS1, LINC00683), three DEMis (hsa-miR-146b, hsa-miR-1238, hsa-miR-4648), and seven DEMs (ARMC7, ATRX, FBLN5, GHR, MYLIP, OXCT1, RAB39A), was developed after LASSO analysis. The built risk score could effectively separate the recurrence rate and DFS of patients in the high- and low-risk groups. The accuracy of this risk score model for DFS prediction was better than that of the FIGO (International Federation of Gynecology and Obstetrics) staging (the area under receiver operating characteristic curve: training, 0.954 vs 0.501; testing, 0.882 vs 0.656; and C-index: training, 0.855 vs 0.539; testing, 0.711 vs 0.508). In conclusion, the high predictive accuracy of our signature for DFS indicated its potential clinical application value for CC patients.

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]

Background Cervical cancer is a widespread health issue in India, particularly affecting women as the second most common cancer. The burden of cervical cancer in the country necessitates accurate staging for treatment optimization. The revised International Federation of Gynecology and Obstetrics (FIGO) staging system is vital for this purpose, emphasizing the extent of parametrial and pelvic sidewall involvement. Cervical cancer's propensity to infiltrate neighboring pelvic organs, including the bladder, necessitates precise staging. In India, traditional methods like cystoscopy have been relied upon, but they have limitations. Recent advancements in medical imaging, notably the increased use of computed tomography (CT) scans, provide a non-invasive alternative for staging and evaluating bladder involvement. This study aimed to evaluate the utility and accuracy of CT scans in assessing bladder involvement. Methods This cross-sectional study examined 127 newly diagnosed cervical carcinoma cases in women over a two-year period from August 2021 to July 2023. Patients underwent CT scans (plain) and cystoscopy, and bladder involvement was determined following the revised FIGO staging. Data collected comprised patient demographics, medical history, clinical symptoms, and FIGO staging. Cystoscopy was performed using an Olympus CYF-5 flexible cystoscope, and CT scans utilized a 64-slice multidetector CT scanner. Radiological reports detailed primary tumor characteristics and proximity to the bladder. Statistical analysis encompassed descriptive statistics, and calculation of sensitivity, specificity, positive predictive value, and negative predictive value for CT scans in comparison to cystoscopy. Statistical significance was considered at p < 0.05. Results In our study, the mean participant age was 45.3 years, with 61.4% falling in the 40-60 years age group. Socioeconomic status (SES) varied, with 37.8% classified as low SES, 48.8% as middle SES, and 13.4% as high SES. Parity data showed that 76.4% had three or more pregnancies. Among presenting symptoms, abnormal vaginal bleeding (65.4%) was the most prevalent, and squamous cell carcinoma (78.7%) was the predominant histological type. The prevalence of bladder involvement was 9.4% by cystoscopy and 30.7% by CT scans. CT scan demonstrated a high sensitivity (100%) but lower specificity (76.52%), with 78.80% overall accuracy. Conclusion A combined approach, using CT scans as a screening tool and cystoscopy as a confirmatory method, could provide the most comprehensive and reliable assessment of bladder involvement in cervical carcinoma patients, ultimately contributing to improved patient care and management., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Agrawal et al.)

Vulval cancer is a rare gynaecological cancer, predominantly seen in postmenopausal women. It accounts for about 4% of gynaecological malignancies. Most women present with vulval symptoms such as a painful lump, ulcer or itching, although some women may be asymptomatic. It is best managed in experienced cancer centres where relevant expertize and experience is available to provide multidisciplinary, individualized care for these women. The majority of vulval cancers are squamous cell cancers. Wide local excision of the lesion, usually with surgical staging of groin nodes, through separate incisions is recommended for early disease. Locally advanced vulval cancers require complex and highly individualized treatment, which may be a combination of radical excision with reconstruction with or without radiotherapy. Sentinel lymph node dissection is now becoming a standard of care instead of en-bloc inguino-femoral lymphadenectomy for surgical staging of smaller, early stage tumours. Radiotherapy is often required as adjuvant treatment following surgery, or for treatment of recurrent disease. [ABSTRACT FROM AUTHOR]

The aim of the study was to compare the frequency of positive peritoneal washings in endometrial cancer patients after either hysteroscopy (HSC) or dilatation and curettage (D&C).

OBJECTIVE: This study aimed at exploring and contrasting the clinical significances and values of MRI, CT and contrast-enhanced ultrasonography in FIGO staging of cervical carcinoma. PATIENTS AND METHODS: The contrast-enhanced ultrasonography, CT and MRI imaging data of 348 patients with cervical carcinoma confirmed by clinical pathology were analyzed retrospectively and contrasted with pathological findings. RESULTS: The total accuracy of MRI in cervical carcinoma staging was 79.89% (278/348), and the diagnostic accuracy of MRI in stage IB, stage II, stage III and stage IV of cervical carcinoma was 74.29% (26/35), 75.74% (153/202), 85.25% (52/61), 94.00% (47/50), respectively. The total accuracy of CT in cervical carcinoma staging was 73.28% (255/348), and the diagnostic accuracy of CT in stage IB, stage II, stage III and stage IV of cervical carcinoma was 60.00% (21/35), 69.80% (141/202), 78.69% (48/61), 94.00% (45/50), respectively. The total accuracy of contrast-enhanced ultrasonography in cervical carcinoma staging was 57.47% (200/348), and the diagnostic accuracy of contrast-enhanced ultrasonography in stage IB, stage II, stage III and stage IV of cervical carcinoma was 37.14% (13/35), 50.99% (103/202), 70.49% (43/61), 82.00% (41/50), respectively. The accuracy of MRI in the diagnosis of stage IB, stage II of cervical carcinoma was higher than that of CT and contrast-enhanced ultrasonography (p<0.05), and the diagnostic accuracy of CT was higher than that of contrast-enhanced ultrasonography (p<0.05). The differences among the three methods were statistically significant. CONCLUSIONS: According to the results of pathological sections, there were statistically significant differences among the sensitivity and specificity of MRI, CT and contrast-enhanced ultrasonography in the diagnosis of stage IB and stage II (p<0.05). MRI has high diagnostic values in the differentiation and diagnosis of cervical carcinoma staging. [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.