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Interesting Contemporary Papers
Guest reviewer Christina Fotopoulou
1. du Bois A, Ewald-Riegler N, de Gregorio N, Reuss A, Mahner S, Fotopoulou C, Kommoss F,
Schmalfeldt B, Hilpert F, Fehm T, Burges A, Meier W, Hillemanns P, Hanker L, Hasenburg A,
Strauss HG, Hellriegel M, Wimberger P, Keyver-Paik MD, Baumann K, Canzler U, Wollschlaeger K,
Forner D, Pfisterer J, Schröder W, Münstedt K, Richter B, Kommoss S, Hauptmann S;
Arbeitsgmeinschaft Gynäkologische Onkologie (AGO) Study Group. Borderline tumours of the ovary:
A cohort study of the Arbeitsgmeinschaft Gynäkologische Onkologie (AGO) Study Group. Eur J
Cancer. 2013 May;49(8):1905-14. doi: 10.1016/j.ejca.2013.01.035. Epub 2013 Mar 13.
„In a multicentre evaluation of 950 patients with borderline tumors of the ovary multivariate analysis
revealed higher stage, incomplete staging, tumour residuals, and organ preservation as independent
prognostic factors for disease recurrence. Neither microinvasion nor micropapillary growth pattern
showed any significant impact”
2. Trillsch F, Mahner S, Woelber L, Vettorazzi E, Reuss A, Ewald-Riegler N, de Gregorio N,
Fotopoulou C, Schmalfeldt B, Burges A, Hilpert F, Fehm T, Meier W, Hillemanns P, Hanker L,
Hasenburg A, Strauss HG, Hellriegel M, Wimberger P, Baumann K, Keyver-Paik MD, Canzler U,
Wollschlaeger K, Forner D, Pfisterer J, Schroeder W, Muenstedt K, Richter B, Kommoss F,
Hauptmann S, du Bois A. Age-dependent differences in borderline ovarian tumours (BOT) regarding
clinical characteristics and outcome: results from a sub-analysis of the Arbeitsgemeinschaft
Gynaekologische Onkologie (AGO) ROBOT study. Ann Oncol. 2014 Jul;25(7):1320-7. doi:
10.1093/annonc/mdu119. Epub 2014 Mar 11.
“Despite favourable survival, young BOT patients with child-bearing potential are at higher risk for
disease recurrence. However, relapses usually remain BOT in the preserved ovaries as opposed to
older patients being at higher risk for malignant transformation in peritoneal or distant localisation.
Therefore, fertility-sparing approach can be justified for younger patients after thorough
consultation”.
3. Eskander RN, Chang J, Ziogas A, Anton-Culver H, Bristow RE. Evaluation of 30-Day Hospital
Readmission After Surgery for Advanced-Stage Ovarian Cancer in a Medicare Population. J Clin
Oncol. 2014 Nov 10. pii: JCO.2014.56.7743. [Epub ahead of print]
“Early readmission after surgery for ovarian cancer is common. There is a significant association
between 30-day readmission and 1-year mortality. These findings may catalyze development of
targeted interventions to decrease early readmission, improve patient outcomes, and control health
care costs”.
4. Ray-Coquard I1, Brown J, Harter P, Provencher DM, Fong PC, Maenpaa J, Ledermann JA, Emons
G, Rigaud DB, Glasspool RM, Mezzanzanica D, Colombo N. Gynecologic Cancer InterGroup (GCIG)
Consensus Review for Ovarian Sex Cord Stromal Tumors. Int J Gynecol Cancer. 2014 Nov;24(9
Suppl 3):S42-7. doi: 10.1097/IGC.0000000000000249.
“Sex cord stromal tumors (SCST) are rare cancers of the ovarian area in adults. They constitute a
heterogeneous group of tumors that develop from the sex cords and the ovarian stroma. These tumors
are detected typically at an early stage, and they may recur as late as 30 years after the initial
treatment. Because 70% of the patients present with stage I tumors, surgery represents the most
important therapeutic arm. There are no data to support any kind of postoperative adjuvant treatment
for patients with stage IA or IB SCSTs, given the indolent nature of these neoplasms and the overall
good prognosis. The long natural history of the disease may lead to repeated surgical procedure should
a relapse occurs. Platinum-based chemotherapy is currently used for patients with advanced stage
SCSTs or recurrent disease, with an overall response rate of 63% to 80%. The indolent nature of
SCSTs with the tendency for late recurrence requires long-term follow-up”.
5. AlHilli MM, Mariani A, Bakkum-Gamez JN, Dowdy SC, Weaver AL, Peethambaram PP, Keeney
GL, Cliby WA, Podratz KC. Risk-scoring models for individualized prediction of overall survival in
low-grade and high-grade endometrial cancer. Gynecol Oncol. 2014 Jun;133(3):485-93. doi:
10.1016/j.ygyno.2014.03.567. Epub 2014 Mar 29.
“ A retrospective evaluation of 1281 patients over 10 years: In low-grade patients, independent
factors predictive of compromised OS included age, cardiovascular disease, pulmonary dysfunction,
stage, tumor diameter, pelvic lymph node status, and grade 2 or higher 30-day postoperative
complications. Among high-grade patients, age, ASA score, stage, lymphovascular space invasion,
adjuvant therapy, para-aortic nodal status, and cervical stromal invasion were independent predictors
of compromised OS”.
6. Moir-Meyer GL, Pearson JF, Lose F; The Australian National Endometrial Cancer Study Group,
Scott RJ, McEvoy M, Attia J, Holliday EG; The Hunter Community Study; Studies of Epidemiology
and Risk Factors in Cancer Heredity, Pharoah PD, Dunning AM, Thompson DJ, Easton DF, Spurdle
AB, Walker LC. Rare germline copy number deletions of likely functional importance are implicated
in endometrial cancer predisposition. Hum Genet. 2014 Nov 9. [Epub ahead of print]
“There were 34 miRNA regions deleted in at least one case but not in controls, the most frequent of
which encompassed hsa-mir-661 and hsa-mir-203. Our study implicates rare germline deletions of
functional and regulatory regions as possible mechanisms conferring endometrial cancer risk, and
has identified specific regulatory elements as candidates for further investigation”.
7. Nogami Y, Banno K, Irie H, Iida M, Kisu I, Masugi Y, Tanaka K, Tominaga E, Okuda S,
Murakami K, Aoki D.The efficacy of preoperative positron emission tomography-computed
tomography (PET-CT) for detection of lymph node metastasis in cervical and endometrial cancer:
clinical and pathological factors influencing it. Jpn J Clin Oncol. 2014 Nov 2. pii: hyu161. [Epub
ahead of print]
“The efficacy of positron emission tomography/computed tomography regarding the detection of
lymph node metastasis in cervical and endometrial cancer is not established and has limitations
associated with the region of the lymph node, the size of metastasis lesion in lymph node and the
pathological type of primary tumor. The indication for the imaging and the interpretation of the
results requires consideration for each case by the pretest probability based on the information
obtained preoperatively”.
8. Thomson CA, E Crane T, Wertheim BC, Neuhouser ML, Li W, Snetselaar LG, Basen-Engquist
KM, Zhou Y, Irwin ML. Diet quality and survival after ovarian cancer: results from the women's
health initiative. J Natl Cancer Inst. 2014 Oct 21;106(11). pii: dju314. doi: 10.1093/jnci/dju314. Print
2014 Nov.
“Our results suggest that overall higher prediagnosis diet quality may protect against mortality after
ovarian cancer”.
9. Arem H1, Park Y, Pelser C, Ballard-Barbash R, Irwin ML, Hollenbeck A, Gierach GL, Brinton LA,
Pfeiffer RM, Matthews CE. Prediagnosis body mass index, physical activity, and mortality in
endometrial cancer patients. J Natl Cancer Inst. 2013 Mar 6;105(5):342-9. doi: 10.1093/jnci/djs530.
Epub 2013 Jan 7.
“Our findings suggest that higher prediagnosis BMI increases risk of overall and disease-specific
mortality among women diagnosed with endometrial cancer, whereas physical activity lowers risk.
Intervention studies of the effect of these modifiable lifestyle factors on mortality are needed”.
10. Castanon A, Landy R, Brocklehurst P, Evans H, Peebles D, Singh N, Walker P, Patnick J, Sasieni
P; PaCT Study Group. Risk of preterm delivery with increasing depth of excision for cervical
intraepithelial neoplasia in England: nested case-control study. BMJ. 2014 Nov 5;349:g6223. doi:
10.1136/bmj.g6223.
“The risk of preterm birth is at most minimally affected by a small excision. Larger excisions,
particularly over 15 mm or 2.66 cm(3), are associated with a doubling of the risk of both preterm and
very preterm births. The risk does not decrease with increasing time from excision to conception.
Efforts should be made to excise the entire lesion while preserving as much healthy cervical tissue as
possible. Close obstetric monitoring is warranted for women who have large excisions of the cervical
transformation zone”.