Search

Currently, available data indicate the oncological safety and high efficiency of fertility preservation surgeries and reproductive technologies in patients with early ovarian cancer. The international scientific community is increasingly discussing the importance of timely patient information and the implementation of fertility preservation strategies in patients with early ovarian cancer. Research in this area should be continued due to the lack of reliable data.

Recent years have been marked by a gradual shift from the previous division of endometrial cancer (EC) into two main types to modern molecular biological classifications of this disease, one of which (at present, most likely, the most popular: Talhouk et al., 2017, 2019) is based on the use of a combination of genetic and immunohistochemical analysis. The study involved material from untreated EC patients, the number of which varied depending on the method used. The average age of patients was close to 55-60 years, and over 80% of patients were postmenopausal. Deparaffinized blocks of EC tissue were analyzed for POLE (DNA polymerase epsilon) mutations, evaluated by immunohistochemistry (IHC) the expression of the oncoprotein p53 and MMR (mismatch-repair) proteins / MLH1, MSH2, MSH6 and PMS2 /, and also helped to identify the type of disease without a characteristic molecular profile (WCMP). In addition to studying the expression of p53 and MMR proteins, the IHC method was also used to study the expression of estrogen (ER) and progesterone (PR) receptors, the Ki-67 proliferative activity index, and the severity of macrophage-lymphocytic infiltration of the EC tissue based on the analysis of the macrophage marker (CD68) and markers of lymphocytic cells (cytotoxic CD8 and regulatory FoxP3) using reagents from Ventana and Dako.

Objective Based on the SUCCOR study database, our primary objective was to identify the independent clinical pathological variables associated with the risk of relapse in patients with stage IB1 cervical cancer who underwent a radical hysterectomy. Our secondary goal was to design and validate a risk predictive index (RPI) for classifying patients depending on the risk of recurrence. Methods Overall, 1116 women were included from January 2013 to December 2014. We randomly divided our sample into two cohorts: discovery and validation cohorts. The test group was used to identify the independent variables associated with relapse, and with these variables, we designed our RPI. The index was applied to calculate a relapse risk score for each participant in the validation group. Results A previous cone biopsy was the most significant independent variable that lowered the rate of relapse (odds ratio [OR] 0.31, 95% confidence interval [CI] 0.17–0.60). Additionally, patients with a tumor diameter >2 cm on preoperative imaging assessment (OR 2.15, 95% CI 1.33–3.5) and operated by the minimally invasive approach (OR 1.61, 95% CI 1.00–2.57) were more likely to have a recurrence. Based on these findings, patients in the validation cohort were classified according to the RPI of low, medium, or high risk of relapse, with rates of 3.4%, 9.8%, and 21.3% observed in each group, respectively. With a median follow-up of 58 months, the 5-year disease-free survival rates were 97.2% for the low-risk group, 88.0% for the medium-risk group, and 80.5% for the high-risk group (p < 0.001). Conclusion Previous conization to radical hysterectomy was the most powerful protective variable of relapse. Our risk predictor index was validated to identify patients at risk of recurrence.

Cervical cancer is one of the most common gynecological malignancies and it is preventable through the yearly diagnosis and management of pre-cancerous cervical disease. The profile of miRNA expression in cervical epithelium cells is altered with cervical dysplasia development and further progression. The NOVAprep-miR-CERVIX is a new approach for the assessment of cervical dysplasia through the analysis of six marker miRNAs. This study aims to evaluate theperformance and diagnostic potency of the new method. Cytological smears from 226 women (NILM, n.114; HSIL, n.112) were included in the study. A VPH test was performed with RealBest DNAHPV HR screen Kit, six marker miRNAs (miR-21, -29b, -145, -451a, -1246, -1290) were assayed using NOVAprep-miR-CERVIX kit. Obtained data were analyzed using the Delta Ct method and random forest machine learning algorithm. The results of the quantitative analysis of six microRNAs were expressed as a miR-CERVIX parameter, which ranged from 0 to 1, where “0” corresponded to the healthy cervical epithelium, while “1” corresponded to high-grade squamous intraepithelial dysplasia. The average value of miR-CERVIX differed in groups of NILM and HSIL samples (0.34 vs. 0.72; p < 0.000005). An estimation of miR-CERVIX allowed for the differentiation between healthy and pre-cancerous samples with sensitivity of 0.79 and specificity of 0.79, as well as to confirm HSIL with specificity of 0.98. Interestingly, the HSIL group included HPV(+) and HPV(−) samples, which were statistically significantly different in terms of miR-CERVIX value. Analysis of CC-associated miRNAs in material of cervical smear might serve as an additional method for the evaluation of cervical dysplasia severity.

Objective: to summarize the experience of treatment patients with resistant forms of gestational trophoblastic neoplasia (GTN). Materials and methods: results of treatment of 15 patients with resistant forms of GTN treated in the N.N. Petrov Research Institute of Oncology through the period 01.01.10-12.11.19 were analyzed. Results: In three out of the 15 patients the tumor was initially characterized as the low-risk (3/15, 20%), the remaining 12 women were from the high-risk group (12/15, 80%). Four out of 12 high-risk patients were ultra-high risk (> 12 points according to the FIGO classification). In low-risk patients with resistant GTN forms EMA-CO therapy proved to be effective as the second line chemotherapy. In eight high-risk patients the combined treatment included the surgical component (hysterectomy in 3 cases, thoracotomy with metastasectomy in 3 cases, hysterotomy with excision of the tumor in 1 case, excision of the tumor from the abdominal wall - in 1 case). In three cases of ultra-high risk GTN, the EMA-EP chemotherapy proved effectiveness, in one of them - without a combination with surgical treatment. Combined treatment was performed in two other cases: in one case with chemotherapy was followed by thoracotomy, metastasectomy, in another - by a gamma knife radiotherapy of brain metastasis. Conclusion: even in cases of low-risk GTN careful monitoring of patients is required, despite adequate treatment among resistant forms. After the failure of methotrexate monochemotherapy with low-risk GTN patients can be successfully treated with EMA-CO chemotherapy. Only rare histological forms (epithelioid trophoblastic tumor, placental site trophoblastic tumor) are not sensitive to drug therapy and require surgical treatment. In cases of ultrahigh-risk GTN with resistance to 1st-line chemotherapy an EMA-EP regimen is effective with or without surgical intervention. Residual “tumor nodes” after completion of treatment and normalization of the HCG level do not always require surgical removal, their dynamic observation is possible, because according to the results of observations, when they were nevertheless excised, no histologically viable tumor tissue was found.

Nowadays the treatment of patients with malignant neoplasms of the abdominal organs against the background of decompensated liver cirrhosis is largely an unsolved problem. Complications of portal hypertension syndrome such as ascites, hypersplenism, recurrent bleeding from the veins of the esophagus prevent the implementation of radical surgical treatment. Low trauma of endovascular methods of treatment, low level of complications and mortality are the main advantages of interventional techniques that make it possible to prepare a patient with portal hypertension syndrome for further radical treatment of oncological disease. The presented clinical case describes the results of a combined approach to the treatment of a patient with complications of portal hypertension syndrome and a competing disease a giant tumor of the uterus. The patient was denied in surgical treatment for the neoplasm due to the presence of decompensated cirrhosis. Liver transplantation is not possible due to the presence of cancer. Transjugular intrahepatic portosystemic shunting led to relief of diuretic-resistant ascites, regression of the degree of esophageal varicose veins, which made it possible to remove the tumor with extirpation of the uterus with appendages. Up to now the observation period for the patient is more than 12 years (4 figs, bibliography: 7 refs).

Background Previous studies on neoadjuvant therapy for BRCA1-driven ovarian cancer (OC) demonstrated higher efficacy of mitomycin C plus cisplatin combination as compared to standard drug schemes. These data call for evaluation of the utility of this regimen for the treatment of recurrent BRCA1-associated OC. Methods The study included 12 BRCA1 germ-line mutation carriers, whose disease relapsed after one (n = 4) or two (n = 8) lines of chemotherapy. The patients received cisplatin 100 mg/m2 and mitomycin C 10 mg/m2, given every four weeks, for 6 (n = 10), 8 (n = 1) or 5 (n = 1) cycles. Retrospective data on conventional treatment of OC relapses in BRCA1 heterozygotes (n = 47) served as a control. Results Grade 3–4 toxicities were observed in 4/12 (33%) cases. There were 6 complete responses (CR), 4 partial responses (PR) and 2 instances of stable disease (SD). Comparison of patients receiving mitomycin C plus cisplatin (n = 4) or conventional therapy (n = 44) at first relapse demonstrated marginal improvement of the progression-free survival (PFS) (16.6 months vs. 10.2 months, P = .067). Use of mitomycin C plus cisplatin (n = 8) for the treatment of second relapse resulted in significant prolongation of PFS as compared to standard regimens (n = 31) (14.8 months vs. 4.8 months, P = .002). Conclusions Mitomycin C plus cisplatin shows promising activity in recurrent BRCA1-driven ovarian cancer.

The aim of this study was to evaluate steroid receptors’ status of tumor tissue in different molecular biological types of endometrial cancer (EC), subdivided according to the current classification, and their colonization by lymphocytic and macrophage cells, taking into account body mass index of the patients. Materials and methods: Material from treatment-naive patients with EC (total n = 229) was included; the number of sick persons varied depending on the method used. The average age of patients was close to 60 years, and about 90% of them were postmenopausal. It was possible to divide the results of the work into two main subgroups: a) depending on the molecular biological type of the tumor (determined on the basis of genetic and immunohistochemical analysis), and b) depending on the value of the body mass index (BMI). The latter approach was used in patients with EC type demonstrating a defective mismatch repair of the incorrectly paired nucleotides (MMR-D) and with a type without characteristic molecular profile signs (WCMP), but was not applied (due to the smaller number of patients) in EC types with a POLE gene mutation or with expression of the oncoprotein p53. According to the data obtained, when comparing various types of EC, the lowest values of Allred ER and PR scores were revealed for POLE-mutant and p53 types, while the “triple-negative” variant of the tumor (ER-, PR-, HER2/neu-) was most common in POLE-mutant (45.5% of cases) and WCMP (19.4%) types of EC. The p53+ type of EC is characterized by inclination to the higher expression of the macrophage marker CD68 and lymphocytic Foxp3, as well as mRNA of PD-1 and SALL4. In addition to the said above, for WCMP type of EC is peculiar, on the contrary, a decrease in the expression of lymphocytic markers CD8 (protein) and PD-L1 (mRNA). When assessing the role of BMI, its value of >30.0 (characteristic for obesity) was combined with an inclination to the increase of HER-2/neu expression in the case of MMR-D EC type and to the decrease of HER-2 /neu, FOXp3 and ER expression in WCMP type. Conclusions: The accumulated information (mainly describing here hormonal sensitivity of the tumor tissue and its lymphocytic-macrophage infiltration) additionally confirms our earlier expressed opinion that the differences between women with EC are determined by both the affiliation of the neoplasm to one or another molecular biological type (subdivided according to the contemporary classification), as well as by body mass value and (very likely) the associated hormonal and metabolic attributes.

To evaluate the feasibility and oncological safety of ovarian preservation in early stage endometrial adenocarcinoma (EC) patients aged 40 and below.A total of 11 institutions from eight countries participated in the study. 169 of 5898 patients aged ≤40 years were eligible for the study. Patients with EC treated between March 2007 and January 2019 were retrospectively assessed.The median duration of follow-up after EC diagnosis was 59 months (4-187). Among 169 participants, ovarian preservation surgery (OPS) was performed in 54 (31.9%), and BSO was performed in 115 (68.1%) patients. Although patients younger than 30 years of age were more likely to have OPS than patients aged 30 to 40 years (20.4% vs. 9.6%, P = 0.021), there was no significant difference by the mean age. There were no other relevant baseline differences between OPS and BSO groups. The Kaplan-Meier analysis revealed no difference in either the overall survival (P = 0.955) or recurrence-free survival (P = 0.068) among patients who underwent OPS, and BSO.OPS appears to be safe without having any adverse impact on survival in women aged ≤40 years with FIGO Stage I EC.

BackgroundRadical trachelectomy is considered a viable option for fertility preservation in patients with low-risk, early-stage cervical cancer. Standard approaches include laparotomy or minimally invasive surgery when performing radical trachelectomy.Primary ObjectiveTo compare disease-free survival between patients with FIGO (2009) stage IA2 or IB1 (≤2cm) cervical cancer who underwent open versus minimally invasive (laparoscopic or robotic) radical trachelectomy.Study HypothesisWe hypothesize that minimally invasive radical trachelectomy has similar oncologic outcomes to those of the open approach.Study DesignThis is a collaborative, multi-institutional, international, retrospective study. Patients who underwent a radical trachelectomy and lymphadenectomy between January 1, 2005 and December 31, 2017 will be included. Institutional review board approval will be required. Each institution will be provided access to a study-specific REDCap (Research Electronic Data Capture) database maintained by MD Anderson Cancer Center and will be responsible for entering patient data.Inclusion CriteriaPatients with squamous, adenocarcinoma, or adenosquamous cervical cancer FIGO (2009) stages IA2 and IB1 (≤2 cm) will be included. Surgery performed by the open approach or minimally invasive approach (laparoscopy or robotics). Tumor size ≤2 cm, by physical examination, ultrasound, MRI, CT, or positron emission tomography (at least one should confirm a tumor size ≤2 cm). Centers must contribute at least 15 cases of radical trachelectomy (open, minimally invasive, or both).Exclusion CriteriaPrior neoadjuvant chemotherapy or radiotherapy to the pelvis for cervical cancer at any time, prior lymphadenectomy, or pelvic retroperitoneal surgery, pregnant patients, aborted trachelectomy (intra-operative conversion to radical hysterectomy), or vaginal approach.Primary EndpointThe primary endpoint is disease-free survival measured as the time from surgery until recurrence or death due to disease. To evaluate the primary objective, we will compare disease-free survival among patients with FIGO (2009) stage IA2 or IB1 (≤2cm) cervical cancer who underwent open versus minimally invasive radical trachelectomy.Sample SizeAn estimated 535 patients will be included; 256 open and 279 minimally invasive radical trachelectomy. Previous studies have shown that recurrence rates in the open group range from 3.8% to 7.6%. Assuming that the 4.5-year disease-free survival rate for patients who underwent open surgery is 95.0%, we have 80% power to detect a 0.44 HR using α level 0.10. This corresponds to an 89.0% disease-free survival rate at 4.5 years in the minimally invasive group.

Aims were to compare the characteristics of hormonal and metabolic status, a set of proinflammatory and antiinflammatory markers, as well as factors associated with DNA damage/ genome integrity in endometrial cancer (EC) patients, divided on the basis of the contemporary classification that distinguishes four molecular-biological types of this tumor. Materials and methods: The study involved material from untreated EC patients, the number of which varied depending on the method used. The average age of patients was close to 60 years and about 90% of them were in postmenopausal period. In the course of evaluation of pro-inflammatory and antiinflammatory factors (levels of cytokines IL-6 and TNF, myo-kine myostatin and adipokine prefilin / Pref-1 /, the ratio of neutrophils/lymphocytes in the blood), an enzyme immunoassay and hematological analysis were used, while the study of the expression of lipoxygenases’ mRNA (“pro-inflammatory” alox5 and “anti-inflammatory” alox15) in omental adipose tissue was based on real-time PCR methodology. Besides, the comet tail moment and % of DNA in the tail of comets of mononuclear cells, the level of 8-hydroxy-2-deoxyguanosine in circulation and the telomere length of mononuclear cells were, respectively, measured as an indicators of DNA damage or genome integrity. Results and conclusions: According to the data obtained, the differences between EC patients are determined not only by the propensity for overweight or lack of it, but also by belonging of the individual case to one or another molecular-biological type established on the basis of genetic and immu-nohistochemical analysis of the tumor tissue. Altogether this may indicate certain specificity of stimuluses leading to the development of particular endometrial cancer variant.

Background Cisplatin, mitomycin C and anthracyclines demonstrate high activity in BRCA1-deficient tumors. This study aimed to evaluate the efficacy of the triplet combination of these drugs in BRCA1-driven high-grade serous ovarian carcinomas (HGSOCs). Methods Ten HGSOC patients with germ-line BRCA1 mutation received neoadjuvant chemotherapy (NACT) consisting of mitomycin C 10 mg/m2 (day 1), doxorubicin 30 mg/m2 (days 1 and 8) and cisplatin 80 mg/m2 (day 1), given every 4 weeks (MAP regimen). The comparator group included 16 women, who received standard NACT combination of paclitaxel 175 mg/m2 and carboplatin (6 AUC), given every 3 weeks (TCbP scheme). Results None of the patients treated by the MAP scheme demonstrated complete pathologic response in ovaries, while 4 women showed absence of tumor cells in surgically excised omental specimens. When chemotherapy response scores (CRS) were considered, poor responsiveness (CRS 1) was not observed in the MAP group, but was common for the TCbP regimen (6/16 (38 %) for ovaries and 5/16 (31 %) for omentum; p = 0.05 and 0.12, respectively). Median treatment-free interval (TFI) was not reached in women treated by the MAP, but was 9.5 months for the TCbP scheme (p = 0.1). The rate of the recurrence within 1 year after the completion of the treatment was 4/10 (40 %) for the MAP and 10/13 (77 %) for the TCbP (p = 0.1). Conclusions The attempt to intensify NACT by administering combination of 3 drugs did not result in high rate of complete pathologic responses. However, there was a trend towards higher efficacy of the MAP regimen versus conventional TCbP scheme with regard to CRS and clinical outcomes.

IntroductionComprehensive updated information on cervical cancer surgical treatment in Europe is scarce.ObjectiveTo evaluate baseline characteristics of women with early cervical cancer and to analyze the outcomes of the ESGO quality indicators after radical hysterectomy in the SUCCOR database.MethodsThe SUCCOR database consisted of 1272 patients who underwent radical hysterectomy for stage IB1 cervical cancer (FIGO 2009) between January 2013 and December 2014. After exclusion criteria, the final sample included 1156 patients. This study first described the clinical, surgical, pathological, and follow-up variables of this population and then analyzed the outcomes (disease-free survival and overall survival) after radical hysterectomy. Surgical-related ESGO quality indicators were assessed and the accomplishment of the stated recommendations was verified.ResultsThe mean age of the patients was 47.1 years (SD 10.8), with a mean body mass index of 25.4 kg/m2 (SD 4.9). A total of 423 (36.6%) patients had a previous cone biopsy. Tumor size (clinical examination) ConclusionsIn this European cohort, the rate of adjuvant therapy after radical hysterectomy is higher than for most similar patients reported in the literature. The majority of centers were already following the European recommendations even 5 years prior to the ESGO quality indicator implementations.

Introduction/Background MicroRNAS are short molecules that regulate gene expression. The microRNA expression profile changes in cells during neoplastic transformation. In particular, characteristic changes in microRNA are observed in the cells of the cervical epithelium during the development of intraepithelial neoplasia. These changes are compounded in invasive cervical cancer cells. Accordingly, microRNAS can serve as diagnostic or prognostic biomarkers in patients with cervical dysplasia of varying severity. In this study, we analyzed microRNA in patients with low grade squamous intraepithelial lesions (LSIL) and compared the data obtained with the clinical course of the disease. Methodology Total RNA was isolated from the epithelium of patients with low grade squamous intraepithelial lesions and divided into two pools: ”persistence” (n=10) and ”recovery” (n= 10), depending on the data of repeated cytological examination conducted after 6–9 months. In the obtained samples, we performed a comprehensive screening analysis of 85 micro-RNA expression (Cancer focus miRCURY RT-PCR panel, Exiqon, Denmark). Results The results of microRNA profiling showed different levels of expression of 9 molecules in the compared groups. In cases of persistent cervical epithelial atypia during dynamic observation, miR-126-3p Mir-16-5p miR-182-5p miR-200c-3p, miR-205-5p, miR-223-3p, miR-24-3p molecules were expressed significantly more actively than in the group of samples obtained from patients whose cervical epithelium condition normalized during observation. The reverse situation was observed for miR-192-5p and miR let-7f-5p. Conclusion MicroRNA molecules whose expression level correlates with the prognosis of cervical epithelial dysplasia can serve as useful biomarkers and be used to personalize the treatment of this common gynecological disease. Validation of the microRNA estimation method requires more extensive research. Disclosures The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Introduction/Background In our study, we evaluated the peritoneal carcinomatosis index (PCI) and to study the influence of PCI on the cytoreductive surgery outcomes in patients with advanced ovarian cancer. Methodology We analyzed the results of 133 patients with serous high-grade ovarian cancer FIGO IIIC-IVB stages. PCI was evaluated at 13 regions (score 0–3 for each region) via pelvic MRI, chest and abdominal CT and staging laparoscopy (S-LPS.) Results Were performed 23% (31/133) of primary and 77% (102/133) of interval debulking surgery (DS), 68% (90/133) of them were optimal (no residual disease, ODS) and 32% (43/133) were suboptimal (residual tumor of > 1 cm, SDS). The frequency of ODS for PCI 0–15 score was 60–86%, for PCI 15–20 score - 9%, PCI> 20 score – 0%. Preoperative and intraoperative determination of the PCI was equal in 58%. In 19.8% PCI was overestimated during preoperative examination, while the use of laparoscopy evaluated PCI allowed to perform an ODS in these cases. In 21% PCI was underestimated and S-LPS helped to avoid SDS in 89% because of noting a diffuse bowel mesentery involvement. Conclusion A combination of MRI/CT scans and staging laparoscopy in PCI evaluating is an effective treatment modality which can improve the cytoreductive outcomes in patients with advanced ovarian cancer. Disclosures No conflict of interest exits in the submission of this study. We confirm that no funding source were used in this study.

Introduction/Background In our study, we evaluated the long-term results of neoadjuvant dose-dense platinum-based chemotherapy in patients with locally advanced cervical cancer FIGO IB2, IIB stage. Methodology A cohort of 119 consecutive patients with median age of 43 (range 27–68) years was studied. All patients had verified locally-advanced (cT1B2Nx,0M0; cT2BNx,0M0) cervical cancer and received 3 dose-dense intravenous neoadjuvant AP (cisplatin 75 mg/m2, doxorubicin 35 mg/m2; n=75) or TP (cisplatin 60 mg/m2 and paclitaxel 60 mg/m2; n=30) chemotherapy cycles. Results The median follow-up was 28 (4 - 48) months for AP and 17 (3 - 30) months for TP group, accordingly. The overall survival rates in FIGO IB2 stage for AP and TP groups were 100%. For FIGO IIB stage the overall survival rate in AP group was 94%, in TP group - 97%. The disease-free survival rate in FIGO IB2 stage for AP group was 78%, for TP group - 100%. For FIGO IIB stage the disease-free survival rate in the AP group was 87%, in TP group - 100%. Conclusion The dose-intensive chemotherapy is an effective treatment modality for locally-advanced cervical cancer and may be a feasible alternative for standard treatment approach. It deserves further study in larger patient cohort with evaluation of the long-term results.

The spectrum of BRCA1 and BRCA2 mutations in Slavic countries is characterized by a high prevalence of founder alleles. We analyzed a large data set of Russian breast cancer (BC) and ovarian cancer (OC) patients, who were subjected to founder mutation tests or full-length BRCA1 and BRCA2 analysis. The most commonly applied test, which included four founder mutations (BRCA1: 5382insC, 4153delA, 185delAG; BRCA2: 6174delT), identified BRCA1 or BRCA2 heterozygosity in 399/8533 (4.7%) consecutive BC patients, 230/2317 (9.9%) OC patients, and 30/118 (25.4%) women with a combination of BC and OC. The addition of another four recurrent BRCA1 mutations to the test (BRCA1 C61G, 2080delA, 3819del5, 3875del4) resulted in evident increase in the number of identified mutation carriers (BC: 16/993 (1.6%); OC: 34/1289 (2.6%); BC + OC: 2/39 (5.1%)). Full-length sequencing of the entire BRCA1 and BRCA2 coding region was applied to 785 women, very most of whom demonstrated clinical signs of BRCA-driven disease, but turned out negative for all described above founder alleles. This analysis revealed additional BRCA1 or BRCA2 mutation carriers in 54/282 (19.1%) BC, 50/472 (10.6%) OC, and 13/31 (42%) BC + OC patients. The analysis of frequencies of founder and “rare” BRCA1 and BRCA2 pathogenic alleles across various clinical subgroups (BC vs. OC vs. BC + OC; family history positive vs. negative; young vs. late-onset; none vs. single vs. multiple clinical indicators of BRCA1- or BRCA2-associated disease) revealed that comprehensive BRCA1 and BRCA2 analysis increased more than twice the number of identified mutation carriers in all categories of the examined women. Full-length BRCA1 and BRCA2 sequencing is strongly advised to Slavic subjects, who have medical indications for BRCA1 and BRCA2 testing but are negative for recurrent BRCA1 and BRCA2 mutations.

Cervical cancer screening is based on cytologic analysis and high-risk human papillomavirus (HR-HPV) testing, each having their drawbacks. Implementation of new biomarker-based methods may improve screening accuracy. Here, the levels of 25 microRNAs (miRNAs, miRs) and 12 mRNAs involved in cervical carcinogenesis in 327 air-dried Papanicolaou-stained cervical smears from patients with cervical precancerous lesions, cancer, or without the disease were estimated by real-time PCR. Using logistic regression analysis, small-scale miRNA-based, mRNA-based, and combined molecular classifiers were built based on paired ratios of miRNA or mRNA concentrations; their ability to detect high-grade cervical lesions and cancer was then compared. Combined mRNA-miRNA classifiers manifested a better combination of sensitivity and specificity than miRNA- and mRNA-based classifiers. The best classifier, combining miR-375, miR-20, miR-96, CDKN2A, TSP4, and ECM1, predicted high-grade lesions with diagnostic sensitivity of 89.0%, specificity of 84.2%, and a receiver-operating characteristic area under the curve of 0.913. Additionally, in a subsample of the same specimens, the levels of MIR124-2 and MAL promoter methylation, HR-HPV genotypes, and viral loads were analyzed. The relative high-grade lesion risk estimated by the classifier correlated with the frequency of MAL and MIR124-2 methylation but not with the HR-HPV genotype or viral load. The results support the feasibility of cellular biomarker-based methods for cervical screening and patient management.

BACKGROUND: Minimally invasive radical trachelectomy has emerged as an alternative to open radical hysterectomy for patients with early-stage cervical cancer desiring future fertility. Recent data suggest worse oncologic outcomes after minimally invasive radical hysterectomy than after open radical hysterectomy in stage I cervical cancer. OBJECTIVE: We aimed to compare 4.5-year disease-free survival after open vs minimally invasive radical trachelectomy. STUDY DESIGN: This was a collaborative, international retrospective study (International Radical Trachelectomy Assessment Study) of patients treated during 2005–2017 at 18 centers in 12 countries. Eligible patients had squamous carcinoma, adenocarcinoma, or adenosquamous carcinoma; had a preoperative tumor size of ≤2 cm; and underwent open or minimally invasive (robotic or laparoscopic) radical trachelectomy with nodal assessment (pelvic lymphadenectomy and/or sentinel lymph node biopsy). The exclusion criteria included neoadjuvant chemotherapy or preoperative pelvic radiotherapy, previous lymphadenectomy or pelvic retroperitoneal surgery, pregnancy, stage IA1 disease with lymphovascular space invasion, aborted trachelectomy (conversion to radical hysterectomy), or vaginal approach. Surgical approach, indication, and adjuvant therapy regimen were at the discretion of the treating institution. A total of 715 patients were entered into the study database. However, 69 patients were excluded, leaving 646 in the analysis. Endpoints were the 4.5-year disease-free survival rate (primary), 4.5-year overall survival rate (secondary), and recurrence rate (secondary). Kaplan-Meier methods were used to estimate disease-free survival and overall survival. A post hoc weighted analysis was performed, comparing the recurrence rates between surgical approaches, with open surgery being considered as standard and minimally invasive surgery as experimental. RESULTS: Of 646 patients, 358 underwent open surgery, and 288 underwent minimally invasive surgery. The median (range) patient age was 32 (20–42) years for open surgery vs 31 (18–45) years for minimally invasive surgery (P=.11). Median (range) pathologic tumor size was 15 (0–31) mm for open surgery and 12 (0.8–40) mm for minimally invasive surgery (P=.33). The rates of pelvic nodal involvement were 5.3% (19 of 358 patients) for open surgery and 4.9% (14 of 288 patients) for minimally invasive surgery (P=.81). Median (range) follow-up time was 5.5 (0.20–16.70) years for open surgery and 3.1 years (0.02–11.10) years for minimally invasive surgery (P

Endometriosis (EM) is a common disease in women of reproductive and perimenopausal age, characterized by the formation of ectopic foci of endometrial proliferation. The pathogenesis of the disease is multifactorial and has not been fully studied. Non-invasive examination methods have relative diagnostic value; therefore, current therapeutic approaches frequently do not provide a complete recovery. This situation determines the interest in studying the molecular and genetic background of EM and in searching for new diagnostic and prognostic markers. In this review, we briefly discuss the prevailing theories of EM etiology, taking into consideration modern scientific concepts. A separate chapter highlights the data of the genome-wide associative studies (GWAS) that indicate the possibilities of involving a number of genes in the pathogenesis of EM (WNT4, CDKN2BAS, FN1). The main part of the review is focused on the analysis of the gene expression studies comparing the ectopic and eutopic endometrium of women with EM. Considering the clinical significance, the results of three studies comparing expression profile of the eutopic endometrium of healthy women versus patients with EM are presented in detail. In conclusion, the prospects of the development and clinical application of heritable and expressed EM markers are assessed.

ObjectivesCisplatin and mitomycin C exert high activity towards BRCA1-deficient cells. This study aimed to evaluate the efficacy of a combination of these drugs in hereditary BRCA1-associated ovarian cancer (OC).MethodsTwelve OC patients, who could not be treated by primary debulking surgery owing to extensive tumor spread, were given neoadjuvant cisplatin (100 mg/m2) and mitomycin C (10 mg/m2) every 4 weeks for 3 (n = 9), 2 (n = 2), or 4 (n = 1) cycles.ResultsThe decrease of tumor burden and complete surgical cytoreduction were achieved in all patients. Pathologic complete response, defined as the absence of tumor cells in surgically removed tissues, was observed in 2 (17%) of 12 cases. Retrospective analysis of 62 OC in BRCA1 mutation carriers subjected to conventional neoadjuvant chemotherapy schemes revealed 36 objective tumor responses (58%) and 37 instances (60%) of complete cytoreductive surgery; however, none of these patients demonstrated pathologic complete response.ConclusionsThe combination of cisplatin plus mitomycin C showed promising results in BRCA1-driven OC and therefore deserves further clinical evaluation.

The article presents the world experience of cytoreductive surgery for ovarian cancer (OC) according to literature data and also estimates the thirteen-year experience of the Oncogynecology Department of the N.N. Petrov National Medical Research Center of Oncology in the treatment of OC patients. Materials and methods: In order to analyze the results of treatment for thirteen years it is proposed a comparative evaluation of results of primary and interval cytoreductive operations in 213 patients with OC. For this purpose all patients depending on the start of treatment were divided into two groups: a group of patients with an advanced OC where treatment started with neoadjuvant chemotherapy and a group of patients with an advanced OC where primary cytoreductive surgery was performed at the start of treatment. In these groups the long-term results of treatment were studied: platinum-free interval and life expectancy. Results: When studying the effect of a number of neoadjuvant chemotherapy courses on long-term results of treatment it was established that the best results for platinum-free interval were obtained in a 3-course group of neoadjuvant chemotherapy - platinum-free interval was 9.6 months compared to 6.9 and 4.7 months in groups of 4 and> 5 courses although the differences in the groups did not reach statistically significant rates (p = 0.337). The increase in a number of postoperative chemotherapy courses in our study also statistically was unreliable and had a negative effect on survival: patients from the neoadjuvant chemotherapy group with> 3 courses of postoperative chemotherapy had 9.6 months versus 11.7 months in patients with 3 courses p = 0.787); life expectancy was 35.6 months compared to 30.9 months respectively (p = 0.968). The same tendency was also observed in patients from the primary cytoreduction group: in the group of patients with> 3 courses of postoperative chemotherapy platinum-free interval was 10.2 months compared to 16.3 months in patients with 3 courses (p = 0.312); life expectancy was 54.4 months compared with 48.7 months respectively (p = 0.435). The Kaplan-Meier survival estimation revealed a statistically significant improvement in life expectancy index for patients from the primary cytore-duction group (median survival time 53.7 months, 95 % CI 41.9-73.6 months) compared to patients in the neoadjuvant chemotherapy group (median life expectancy 33.0 months, 95 % CI 20.6-42.0 months, p

Recent studies have shown that changes in the expression levels of certain microRNAs correlate with the degree of severity of cervical lesions. The aim of the present study was to develop a microRNA-based classifier for the detection of high-grade cervical intraepithelial neoplasia (CIN ≥2) in cytological samples from patients with different high-risk human papillomavirus (HR-HPV) viral loads. For this purpose, raw RT-qPCR data for 25 candidate microRNAs, U6 snRNA and human DNA in air-dried PAP smears from 174 women with different cervical cytological diagnoses, 144 of which were HR-HPV-positive [40 negative for intraepithelial lesion or malignancy (NILM), 34 low-grade squamous intraepithelial lesions (L-SIL), 57 high-grade squamous intraepithelial lesions (H-SIL), 43 invasive cancers], were statistically processed. The expression level changes of various individual microRNAs were found to be significantly correlated with the cytological diagnosis but the statistical significance of this correlation was critically dependent on the normalization strategy. We developed a linear classifier based on the paired ratios of 8 microRNA concentrations and cellular DNA content. The classifier determines the dimensionless coefficient (DF value), which increases with the severity of cervical lesion. The high- and low-grade CINs were better distinguished by the microRNA classifier than by the measurement of individual microRNA levels with the use of traditional normalization methods. The diagnostic sensitivity of detecting high-grade lesions (CIN ≥2) with the developed microRNA classifier was 83.4%, diagnostic specificity 81.2%, ROC AUC=0.913. The analysis can be performed with the same nucleic acid preparation as used for HPV testing. No statistically significant correlation of the DF value and HR-HPV DNA load was found. The DF value and the HR HPV presence and viral DNA load may be regarded as independent criteria that can complement each other in molecular screening for high-grade cervical intraepithelial neoplasia. Although it has several limitations, the present study showed that the small-scale analysis of microRNA signatures performed by simple PCR-based methods may be useful for improving the diagnostic/prognostic value of cervical screening.

Aim: Evaluation of changes that have occurred in the ideas in endometrial cancer over the past 10-20 years and their potential applications. Materials and methods: Analysis of modern publications including databases of PubMed and Russian scientific electronic library (http://elibrary.ru) with the use of the information received as a result of own studies. Conclusions: A shifts in the incidence of endometrial cancer, a reform of the views on molecular-biological typing of this tumor, changes in the ratio of its morphological variants as well as in the risk and anti-risk factors were discussed. According to our own data in a group of 144 endometrial carcinomas (endometrioid and non-endometrioid) the frequency of POLEe mutations was equal to 2.8% that might change after increasing of the number of patients. Rapidly accumulating information in this field can be useful for improving approaches to preventing and treatment of endometrial carcinoma.

To study the role of retroperitoneal lymphadenectomy in epithelial ovarian cancer (OC) the work was divided into two parts. In the first part for a retrospective analysis 852 patients with stage I-IV OC, who were treated from January 2000 to January 2014, were selected to investigate the localization of the first relapse of the disease. In the second part, prospective from August 2016 to April 2017, in 28 patients with stage I-IV OC the surgical stage of the combined treatment was supplemented by iliac-pelvic and para-aortic lymphadenectomy; in this group the results of surgical staging were studied. The incidence of isolated recurrence in para-aortic lymph nodes in the group of early OC was 3/28 (11%), in pelvic 2/28 (7%), whereas in the group of advanced OC - in para-aortic lymph nodes 9/24 (37%), in iliac-pelvic 10/24 (42%), combined in pelvic and para-aortic lymph nodes 5/24 (21%). In the prospective group the lesion of pelvic and para-aortic lymph nodes was observed in 2/28 (7%) of patients with the presumed I stage of the disease and in 2/28 (7%) with the presumed stage II, which resulted in re-staging of the disease. In 2 cases the clinical IA and IB stages were re-staged to IIIA and this required 6 courses of chemotherapy. In 2/28 (7%) patients metastases to para-aortic lymph nodes were detected in the absence of pelvic lesions.

Ovarian carcinomas (OC) often demonstrate rapid tumor shrinkage upon neoadjuvant chemotherapy (NACT). However, complete pathologic responses are very rare and the mechanisms underlying the emergence of residual tumor disease remain elusive. We hypothesized that the change of somatic BRCA1 status may contribute to this process. The loss-of-heterozygosity (LOH) at the BRCA1 locus was determined for 23 paired tumor samples obtained from BRCA1 germ-line mutation carriers before and after NACT. We observed a somatic loss of the wild-type BRCAI allele in 74% (17/23) of OCs before NACT. However, a retention of the wild-type BRCA1 copy resulting in a reversion of LOH status was detected in 65% (11/17) of those patients after NACT. Furthermore, we tested 3 of these reversion samples for LOH at intragenic BRCA1single nucleotide polymorphisms (SNPs) and confirmed a complete restoration of the SNP heterozygosity in all instances. The neoadjuvant chemotherapy for BRCA1-associated OC is accompanied by a rapid expansion of pre-existing BRCA1-proficient tumor clones suggesting that continuation of the same therapy after NACT and surgery may not be justified even in patients initially experiencing a rapid tumor regression. (C) 2017 Elsevier B.V. All rights reserved.

The sensitivity of cytological screening of cervical cancer, despite the ongoing technical improvements, remains quite low. It was showed that among women with smears, regarded as questionable cytological data of ASCUS, from 5% to 10%, in fact, they had severe dysplasia. The use of new molecular diagnostic methods can improve the effectiveness of screening of cervical cancer by improving the accuracy of diagnosis of the degree of dysplasia. Neoplastic transformation of the cervix epithelium is accompanied by specific changes in the profile of siRNA expression, the evaluation of which has a great diagnostic potential. In this study, the expression of 18 miRNA was analyzed. The correlation of the expression of five miRNAs (miR-375, miR-20a, miR-196b, miR145 and miR-126) with the degree of neoplasia of the cervix was established, which allowed them to be recommended for further investigation for the purpose of introduction as a diagnostic test at the stage of cytological screening.

In 24 patients (mean age 48 years) with locally advanced cervical cancer there were studied the efficacy and toxicity of 3 cycles of neoadjuvant dose-intensive chemotherapy with cisplatin (75 mg/m2) and doxorubicin (35 mg/m2) administered intravenously on the first day of a two- week cycle with the support of colony-stimulating factors. An important criterion for the inclusion in this study of patients with locally advanced cervical cancer (T1b2-2bN0-1M0) was the absence of infiltration of the anterior parameters according to the gynecological examination and MRI studies. An objective response to treatment was registered in 72.7 % of cases. Progression of the disease was not detected in any case. Conducting neoadjuvant drug therapy allowed performing radical surgical intervention in 95.4 % of patients. The pathomorphlogical response of tumor of varying severity was 40.9 %. In 9.1 % complete clinical regression of tumor was confirmed by a complete pathomor-phological response (CR). The dose-intensive regimen of chemotherapy did not lead to a significant increase of complications on the drug and surgical stages. An analysis showed that dose-intensive neoadjuvant chemotherapy is a highly effective method in treatment for locally advanced cervical cancer.

Objective of the study was to compare the characteristics of endometrial cancer (EC) in patients observed in years 1965 - 1969, 1995 - 1999 and 2012 - 2015. Results. The research was conducted on the basis of the same institution and it showed that over the past 50 years (1965 to 2015) an increase in the average age of women with primary EC. Despite the increase by through the decades in relatively favorable endometrial adenocarcinomas in relation to non-endometrioid tumors, with the increasing age of patients the incidence of non-endometrioid carcinomas increased especially due to women older than 60 years compared with patients younger than 50 years. This was reflected in such characteristics as stage of the process (according to FIGO), degree of tumor differentiation, proportion of serous carcinomas and expression of HER-2/neu. Conclusion. Taken into account contemporary renewal of molecular-biological classification of endometrial cancer types the data collected in this study may also have practical value in particular for decisions related to personalized conservative therapy options.

Increased frequency of endometrial cancer (EC) since the beginning of this century exceeds that of breast cancer and to a large extent can be attributed to dynamics of parameters, which characterize hormonal and metabolic status of ill women and molecular genetic landscape of transforming endometrium. During the past few years there are suggested several options for a personalized assessment of the risk of EC. The aim of this article is to propose and justify own version of this score with the idea of its further not only retrospective but also prospective testing both in relation to the risk of developing endometrial cancer as well as an additional marker helping to predict tumor response to treatment.

Total number of 648 endometrial cancer patients who had undergone hysterectomy, bilateral salpingo-ophorectomy and bilateral pelvic lymphadenectomy with laparoscopic and open access constituted the study group. Ultrasound examination of the pelvis was carried out for all patients after surgery to identify lymphocysts. The overall incidence of lymphocysts was 320/648 (49.4%): 179/320 (55.9%) after open surgery and 141/320 (44.06%) after laparoscopy (р=0,01). The majority of lymphocysts were asymptomatic. Symptomatic lymphocysts occurred in 5.6% of patients. Several risk factors for the development of symptomatic lymphocysts were determined.

On the basis of the Departments of Oncogynecology and Radiology of the N.N. Petrov Research Institute of Oncology there was performed a comparative analysis of the results of detection of the sentinel lymph node using a fluorescent method with Indocyanine Green (ICG) and a radioisotope method with 99m-labeled colloidal radiopharmaceutical in endometrial cancer patients undergoing laparoscopic hysterectomy with lymphadenectomy from June 2016 to December 2016. The study included 19 patients with early endometrial cancer. Specificity and sensitivity of methods of radiation diagnostics (ultrasound and MRI) in the detection of metastatic involvement of pelvic lymph nodes are also presented.

The study included 160 patients with advanced ovarian cancer (OC) who underwent combined treatment from January 2000 to January 2013 at the N.N. Petrov Research Institute of Oncology. Compared to non-mutated patients, BRCA-positive patients were characterized by a longer platinum-free interval (BFI) (14 months [95% CI 9.6-36.4 months] versus 8 months [95% Ci 4.8-12.4 months]; P = 0.006), with the largest median of the BFI were established using the CAP scheme - 33.5 months versus 12 months using the TCbP scheme. Half of patients with a mutation in the BRCA1 gene (20/40 (50%)) had an isolated recurrence in the pelvic area versus 35/120 (29.2%) of patients without mutations (p = 0.00001). The progression of distant foci in the first recurrence of the disease in patients with mutations was significantly lower (15/40 (37.5%) versus 84/120 (70%), p = 0.00001). In addition 85% of recurrences in BRCA-positive patients were platinum-sensitive. Only the age of patients with advanced OC was an independent prognostic factor of BFI since the start of treatment (p = 0.00001).

BRCA1 and BRCA2 germ-line mutations are associated in increased cancer risk both in women and in men. This article summarizes clinical recommendation of European Society for Medical Oncology (ESMO), National Comprehensive Cancer Network (NCCN) and other professional societies regarding inclusion criteria for BRCA-testing, diagnostic activities aimed to detect early cancers in BRCA1/2 mutation carriers as well as approaches to prevention of BRCA-driven cancers. The adjustment of existing clinical recommendations to health care realities in Russian Federation is discussed

Objectives To compare disease-free survival (DFS) between patients who underwent open (ORT) versus minimally invasive (MIS) radical trachelectomy (RT) [laparoscopic (LRT) or robotic (RRT)]. Methods Eligibility criteria included 1) RT and pelvic lymphadenectomy with/without sentinel lymph node mapping, 2) 1/2005 to 12/2017 3) squamous, adenocarcinoma, or adenosquamous histology, 4) stage IA2-IB1, 5) tumors ≤2 cm, 6) 15 or more cases per center. Results A total of 698 patients [open (n=388) vs. MIS (310)] were included. The median follow-up time was 40.9 months (range, 1–179.1) [MIS 38.6 (range, Conclusions Surgical approach in radical trachelectomy for low-risk cervical cancer was not associated with differences in recurrence rates or survival. MIS had worse perioperative outcomes.

Comparative analysis of changes in hormonal-metabolic status of patients with endometrial cancer seen in the Research Institute of Oncology named after N.N. Petrov for over 50 years is presented. Over the past half century there was a gradual evolution of some indicators characterizing patients with endometrial cancer: increased age at the time of diagnosis from 57,43 ± 0,91 years in 1965-1967 to 60,66 ± 0,73 years 2012-2015 and changes in the anthropometric characteristics (in addition to increasing growth, increased body weight, circumference of waist and hip, the proportion of women with high body mass index). Also, increased manifestations of disorders of lipid and carbohydrate metabolism, including triglyceride levels, blood glucose and insulinemia were revealed. Reflecting the dynamics of processes occurring with the female population in general, the revealed changes, at the same time, represent an important component of conditions conducive to the increase in the incidence of endometrial cancer.

Endometriosis is a chronic disease characterized by the growth of endometrial tissue outside of the uterine cavity. Endometriosis affects up to 10% of women of reproductive age and has great social impact. The diagnostics of endometriosis are based on clinical appearance, ultrasound, and magnetic resonance imaging (MRI), however, a diagnosis is frequently hampered by the absence of objective criteria. Adenomyosis (AM) is a particular type of endometriosis wherein the spread of the ectopic endometrial gland is limited by the uterine myometrium. Alteration of the microRNA expression profile in the eutopic endometrium can be associated with AM, and may be assayed for diagnostic purposes. In the presented study, we aimed to explore the diagnostic potency of this approach. Eutopic endometrium specimens were collected from patients (n = 33) and healthy women (n = 30). The microRNA expression was profiled to select individual microRNAs with AM-associated expression alterations. A new method of two-tailed RT-qPCR microRNA analysis was applied to assay potential markers. The expression ratios of reciprocally dysregulated microRNAs were calculated, and the diagnostic potency of these parameters was evaluated by receiver operation curve (ROC) analysis. Mir-10b, miR-200c and miR-191 were significantly dysregulated in the eutopic endometrium of AM patients. The expression ratio of reciprocally dysregulated microRNAs allowed us to diagnose AM with a range of sensitivity from 65% to 74%, and of specificity from 72% to 86%. The analysis of microRNAs from the eutopic endometrium might present a promising low-invasive method of AM diagnostics.

The article analyzes the role of risk factors from the point of view of modern ideas on the viral etiology of precancer and cancer of the cervix. Particular attention is paid to the role of vaginal biocenosis, as a cofactor in the development of preinvasive cervical neoplasia. The results of own studies showing that violation of the biocenosis of the vagina can cause cytological changes similar to the signs of mild dysplasia. It was studied the influence of treatment of vaginal biocenosis on the regression of early neoplastic changes of the cervix.

The question hidden in the title of this manuscript (whether the topic develops or remains constant) is important for all areas of science. It is also a serious problem for endometrial cancer (EC) study. In recent times the incidence of EC gradually increases in parallel with obesity epidemics. The main point of this review was evaluation of changes in EC area in last few decades, which are not only seen in tumor incidence, but also in its biology, hormonal-metabolic characteristics of patients and in the ratio of risk and anti-risk factors. One can hope that data accumulated recently and summarized here under the notion of EC evolution will find its use for advancement of EC prevention and treatment.

Background. Up to date the coincidence of endometrial carcinoma and obesity is widespread. Obesity has unfavorable action on surgical treatment results. Objective. To evaluate the effectiveness of laparoscopic technique for surgical treatment of endometrial carcinoma in obese patients. Methods. We have prospectively evaluated the results of surgical treatment from 97 obese patients with low metastasis risk endometrial carcinoma from 2010 to 2014 years. Results. Laparoscopic surgery associated with low intraoperative blood loss (26.4 ± 7.1 ml vs 267.2 ± 45.0 ml, p < 0.0001), on the other hand laparoscopic surgery not prolongs operating time (108.8 ± 7.5 min vs 104.3 ± 13.5 min, p = 0.38). Obese patients after laparoscopic surgery have low complications rate (1.5 % vs. 48.3 %, p = 0.002). Conclusions. Laparoscopy is effective option for surgical treatment of low metastasis risk endometrial cancer patients with obesity.

Epithelial ovarian cancer (EOC) is a common malignant disease, which remains asymptomatic for a prolonged period of time and is usually diagnosed at advanced stages. Cytoreductive surgery is a backbone of EOC treatment. Wherever possible, EOC patients are subjected to primary debulking surgery (PDS) with the aim to remove all visible tumor lumps. Some patients cannot undergo PDS due to extensive disease spread and/or high risk of perioperative morbidity, therefore they are subjected to neoadjuvant chemotherapy (NACT) before the surgery. Therapy given before surgery or as adjuvant treatment usually consists of combination of carboplatin and paclitaxel. Gemcitabine, topotecan, pegylated liposomal doxorubicin and poly ADP ribose polymerase inhibitors (PARPi) are commonly used for the management of EOC relapses. Consideration of BRCA1/2 germ-line and somatic status is getting increasingly important for the proper treatment planning.

Background: As endometrial cancer (EC) prevalence increases with obesity, we aimed to determine whether EC characteristics depend upon obesity type: ‘standard’ (SO) or ‘metabolically healthy obesity’ (MHO). Patients & methods: 258 EC patients were included. Data on anthropometry, blood hormones, lipids and glucose, and tumor features were collected. Results: EC clinicopathologic characteristics and clinical stage correlate differently with BMI and obesity type. BMI is related inversely with tumor grade while SO patients are characterized by a more advanced clinical stage than those with MHO. Besides typical insulin resistance signs, EC patients with SO often display a higher serum leptin/adiponectin ratio compared with MHO patients. Historical data suggest a gradual increase in EC patient height and weight, and a decrease in MHO prevalence. Conclusion: It is currently unknown whether the latter observation reflects the evolution of EC, or obesity alongside the current epidemic. Regardless, the reduced MHO prevalence demonstrates the need for more intensive preventive measures aimed at obesity and obesity-associated conditions, including different EC subtypes., Worldwide prevalence of uterine body or endometrial cancer (EC) has increased notably. Recently, the WHO documented an obesity epidemic in several countries. Concurrently, many studies showed a high (37–66%) obesity rate in EC patients. There is currently no mention of a potentially distinctive correlation of EC with obesity types. In general, these types of obesity can be subdivided into ‘standard’ (SO; with metabolic disturbances, initially with insulin resistance signs) and ‘nonstandard’, or metabolically healthy obesity (MHO; without mentioned disturbances). The present paper concludes, first, that EC patients with SO (especially if BMI is ≥30) generally have more advanced tumor stage than patients with MHO. Second, in an EC group (2012–2014) a decrease in MHO frequency versus 1998–2000 group was observed. Altogether, this underlines the need for additional cancer preventive efforts in the obese female population.

Results of numerous retrospective studies have confirmed that the degree of cytoreduction and the size of the residual tumor after the primary surgery are the most important factors affecting overall life expectancy as well as the time to progression in patients with ovarian cancer (OC). The article presents the immediate results of the first 16 extensive cytoreductive surgeries in advanced OC performed at the Oncogynecology Department of the N.N. Petrov National Medical Research Center of Oncology.