Search

Sentinel lymph node (SLN) detection has been widely investigated in recent years as a part of the surgical staging of women with endometrial cancer (EC), gradually overtaking lymphadenectomy (LND) in this respect. In this study, thirty EC patients, assumed as stage I, were investigated using superparamagnetic iron oxide (SPIO) as a tracer for SLN detection followed by LND. The endpoints of this research were the proportion of successful SLN detection, the average number of SLNs per patient, the percentage of bilaterally detected SLNs, and the proportion of metastatic SLNs. Safety endpoints were the summary of all reported adverse events. SLNs were detected in all cases and bilaterally in 21 patients (70%). The diagnostic accuracy parameters of the SPIO detection of metastatic SLNs evaluated by Receiver Operating Characteristic (ROC) curve analysis with the area under the ROC curve (AUC) demonstrated a sensitivity of 80% and AUC of 0.9 (p < 0.001), confirming the SPIO technique's efficacy in women with EC. No adverse events were reported. SPIO nanoparticles as a tracer for SLN mapping in apparent early-stage EC patients demonstrated satisfactory accuracy parameters and safety; however, these data need to be evaluated by further research. [ABSTRACT FROM AUTHOR]

Simple Summary: Ovarian, fallopian tube, and primary peritoneal cancers are often diagnosed at advanced stages due to nonspecific symptoms. This makes early detection challenging and impacts patient outcomes. This study sought to clarify the role of HE4 and CA125 in the follow-up of ovarian cancer patients and, potentially, improve early detection and management of recurrences. By monitoring changes in these markers over time, the researchers hoped to find a more reliable way to identify cancer recurrence before it is visible on CT scans. The findings suggest that tracking increases in these markers can predict a relapse earlier than CT scans, potentially allowing for earlier treatment. Further research is required to refine follow-up strategies and enhance outcomes for ovarian cancer patients. Background: Ovarian, fallopian tube, and primary peritoneal cancers often share clinical characteristics and are typically diagnosed at advanced stages due to nonspecific symptoms. The utility of tumor markers, particularly CA125 and HE4, in the diagnosis and follow-up of these cancers remains an area of active investigation. Objectives: The CEEGOG (Central and Eastern European Gynecologic Oncology Group) OX-01 study aimed to evaluate HE4's role alongside CA125 in follow-up for advanced-stage ovarian, fallopian tube, and primary peritoneal cancers. It assessed the potential for detecting recurrence using marker elevation and imaging methods, examining the necessity of dynamic monitoring and current cut-off values' accuracy for early relapse detection. Methods: In this multicenter prospective cohort study, 117 eligible patients with Stage III–IV cancers were included. Patients had elevated CA125 or HE4 at diagnosis and achieved complete remission after first-line treatment. HE4 and CA125 levels were monitored every 3–4 months in the first two years and every six months thereafter. CT scans were performed if markers exceeded set thresholds or increased by over 20%. Results: During a median follow-up of 13.7 months, 73% of patients relapsed. Median HE4 levels were significantly higher in relapsed patients. A 10 IU/mL increase from baseline in CA125 had a sensitivity of 83% and specificity of 93%, while a 15 pmol/L increase in HE4 had a sensitivity of 74% and specificity of 92% for predicting relapse up to three months before CT scan detection. Conclusions: The study found that dynamic changes in HE4 and CA125 levels, rather than predefined cut-off values, are crucial for early relapse detection. These markers may offer a significant lead time over imaging, potentially enabling earlier intervention. Further research is needed to validate these findings. [ABSTRACT FROM AUTHOR]

Simple Summary: The aim of this survey of long-term survivors (LTS) with ovarian cancer was to enhance the knowledge on the patient characteristics and health concerns of this growing patient cohort in order to tailor follow-up care. Follow-up care is usually carried out within the first five years after initial diagnosis, before they are transferred to general physicians and gynecologists. Interestingly, in our cohort of 1044 LTS from 14 countries, most patients with a median survival time of eleven years after initial diagnosis still received regular follow-up care (94.2%). Forty-six percent still reported cancer- and therapy-related symptoms (i.e., gastrointestinal problems, fatigue, lymphedema, and neurological problems). The present analysis confirms the symptom checklist and clinical relevance of the GCIG consensus guideline on long-term survival with gynecological cancer. Follow-up care should be offered beyond the typical five years as specialized survivorship care with a focus on long-term side effects, lifestyle, and prevention. The aim of this survey was to increase the knowledge on the characteristics and health concerns of long-term survivors (LTS; survival > 5 years) after ovarian cancer in order to tailor follow-up care. This international survey was initiated by the NOGGO and was made available to members of ENGOT and GCIG. The survey is anonymous and consists of 68 questions regarding sociodemographic, medical (cancer) history, health concerns including distress, long-term side effects, and lifestyle. For this analysis, 1044 LTS from 14 countries were recruited. In total, 58% were diagnosed with FIGO stage III/IV ovarian cancer and 43.4% developed recurrent disease, while 26.0% were receiving cancer treatment at the time of filling in the survey. LTS who survived 5–10 years self-estimated their health status as being significantly worse than LTS who survived more than 10 years (p = 0.034), whereas distress also remained high 10 years after cancer diagnosis. Almost half of the cohort (46.1%) reported still having symptoms, which were mainly lymphedema (37.7%), fatigue (23.9%), pain (21.6%), polyneuropathy (16.9%), gastrointestinal problems (16.6%), and memory problems (15.5%). Almost all patients (94.2%) regularly received follow-up care. Specialized survivorship care with a focus on long-term side effects, lifestyle, and prevention should be offered beyond the typical five years of follow-up care. [ABSTRACT FROM AUTHOR]

The focus of the presented work was to isolate and characterize circulating endometrial cells (CECs) enriched from peripheral blood (PB) of patients with diagnosed endometriosis. The molecular characteristics of CECs could be supportive for an understanding of endometriosis pathogenesis and treatment decisions in the future. Material and Methods: Blood samples (n = 423) were tested for CECs presence. Subsequently, gene expression analysis (GEA) was carried out for CECs. In parallel, CECs presence and characteristics were tested during menstrual cycle (MC) phases in 11 patients. CECs were enriched by size-based separation. Results: CECs were present in 78.4% of the tested blood samples. In line with the revised American Fertility Society (rAFS) classification, CECs presence was confirmed in all the acknowledged endometriosis stages: minimal, mild, moderate, and severe. Surprisingly, CECs negativity rate was also reported for severe disease in 21.1% of cases. The CECs captured during MC phases displayed different cytomorphology, including epithelial, stromal, and stem cell-like characteristics. The highest CECs numbers were detected in the mid-secretory phase of MC, which corresponds to uterine lining decidualization. CECs captured during mid-secretory periods expressed genes KRT18, NANOG, and VIM in higher amounts when compared to the proliferative phase of MC, where genes KRT19 and ESR1 were mostly elevated. GEA of the super-positive CECs samples (1000 CECs/8 mL PB) revealed high expression of genes KRT18, VIM, NANOG, and FLT1. The expression of these genes was also elevated in the endometriosis tissue samples and endometrioma. Conclusion: The panel of the identified CEC genes could be tested in a prospective manner to confirm the role of CECs in endometriosis pathogenesis and diagnostics. [ABSTRACT FROM AUTHOR]