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ABSTRACT: OBJECTIVE: Venous thromboembolism (VTE) is a life-threatening complication that often occurs in ovarian tumors. However, the risk factors for VTE are still undetermined. METHODS: We retrospectively analyzed VTE occurrence and its potential risk factors in 254 Chinese patients with ovarian tumor at Fudan University Cancer Hospital from July 2007 to June 2011. RESULTS: The VTE incidence was 7.1% (13/183) in epithelial ovarian cancer (EOC), and no VTE was found in ovarian borderline or benign tumor. D-dimer levels were significantly higher in EOC than in ovarian benign and borderline tumors. Furthermore, D-dimer levels increased with the advancement of EOC stages. Correlation analysis suggested that D-dimer levels were well correlated with platelet counting (PLT), prothrombin time (PT), white blood cell counting (WBC), cancer antigen (CA) 125, and CA153. Univariate logistic regression analysis found that D-dimer levels greater than 788 μg/L, PLT levels greater than 261 × 10/L, PT greater than 11.7 seconds, CA125 greater than 760 U/mL, and ascites greater than 1500 mL are risk factors for VTE in EOC. Moreover, multivariate analysis grouped primary EOC, low differentiated grade, D-dimer greater than 788 μg/L, PT greater than 11.7 seconds, and CA125 greater than 760 U/mL as prediction factors for VTE. CONCLUSIONS: In addition to D-dimer and ascites, high levels of PLT, PT, and CA125, which are highly correlated with D-dimer, are independent risk factors for VTE.
International Journal of Gynecological Cancer 11/2012; · 1.65 Impact Factor
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Gong Yang,
Xue Xiao,
Daniel G Rosen, Xi Cheng,
Xiaohua Wu,
Bin Chang,
Guangzhi Liu,
Fengxia Xue,
Imelda Mercado-Uribe,
Paul Chiao,
Xiang Du,
Jinsong Liu
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ABSTRACT: NF-κB is a transcription factor known to promote tumorigenesis. However, NF-κB is also known to be proapoptotic and may potentially function as a tumor suppressor, although such a functional role has not been extensively investigated in human cancer.
A dominant-negative mutant of IκBα with mutations at S32A and S36A was used to inhibit the function of NF-κB in ovarian cancer cell lines. The transcription ability, tumorigenesis, apoptosis, and drug sensitivity were examined in derivative cell lines in comparison with parental cells. We also analyzed the association of nuclear expression of NF-κB p65 with patient survival in an ovarian cancer tissue array.
We show that NF-κB functions as a tumor suppressor in four ovarian cancer cell lines, but it functions as an oncogene in their aggressive chemoresistant isogenic variants. NF-κB can exert its proapoptotic or antiapoptotic effect by activating or repressing mitogen-activated protein kinase (MAPK) phosphorylation in parental or aggressive chemoresistant variant cell lines. We also show that the nuclear accumulation of p65 in epithelial cancer tissue is associated with a good response to chemotherapy and can predict longer overall survival for patients with ovarian cancer.
Our data provide strong evidence that NF-κB can function as a biphasic regulator, either suppressing or enhancing ovarian cancer growth through the regulation of MAPK and cellular apoptosis.
Clinical Cancer Research 02/2011; 17(8):2181-94. · 7.74 Impact Factor
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ABSTRACT: Recent retrospective trials stated that a benefit of surgery for recurrent ovarian cancer may be limited to patients in whom a complete cytoreduction (R0) could be achieved. Most of them pointed out there was no difference in survival between residual disease of 0.1-1 cm (R1) and >1 cm (R2). The aim of this study was to evaluate survival benefits from cytoreduction to R1.
Between 2002 and 2006, 123 patients with recurrent epithelial ovarian cancer undergoing secondary cytoreduction were identified from tumor registry databases.
The median age at recurrence was 51 years (range: 28-84). Fifty-one (41.5%) patients had R0, 46 (37.4%) patients had R1, and 26 (21.1%) patients had R2 resection. The median survival of the entire cohort was 31.7 months, with an estimated 5-year survival of 31.1%. The median survival and estimated 5-year survival for patients with R1 were 31.1 months and 23.9%, and there were significant differences in survival when compared to 15.6 months and 6.4% in R2 (chi(2) = 7.45, P = 0.006), 63.2 months (mean survival) and 54.4% in complete cytoreduction (chi(2) = 8.93, P = 0.0028).
Complete secondary cytoreduction is the strongest survival determinant in recurrent epithelial ovarian cancer, whereas patients with residual disease of 0.1-1 cm may also benefit from secondary cytoreduction.
Journal of Surgical Oncology 03/2010; 101(3):244-50. · 2.10 Impact Factor
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ABSTRACT: In this paper, a kind of novel carbon paste electrode modified with double modifiers-polyethylene glycol (PEG) and Cu(2)O (PEG/Cu(2)O CPME) in capillary zone electrophoresis with amperometric detection (CZE-AD) was applied to simultaneously determine three sugars: glucose, sucrose, fructose and ascorbic acid (AA). The catalytic electrochemical properties of PEG/Cu(2)O CPME could enhance sensitivity obviously compared with carbon paste electrode modified with only PEG or Cu(2)O at a relatively lower detection potential (+0.3 V versus SCE). Especially, the electrochemical detection response of AA increased obviously to the same level of saccharides by adding PEG into the Cu(2)O carbon paste modified electrode. The four analytes could be perfectly separated within 22 min, the linear ranges were from 1.0 x 10 (-6) to 5.0 x 10(-5) mol L(-1) and the detection limits were at 10(-7) mol L(-1) magnitude (S/N=3). The present working electrode was successfully employed to analyse beverage samples with recoveries in the range 93-107% and RSDs less than 4%. Above results demonstrated that capillary zone electrophoresis coupled with the PEG/Cu(2)O carbon paste modified electrode was of convenient preparation, high sensitivity, good repeatability and could be used in the rapid determination of practical samples.
Journal of Chromatography 09/2007; 1161(1-2):327-33. · 4.53 Impact Factor
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ABSTRACT: In this paper, a polyamide-modified carbon paste electrode in capillary zone electrophoresis with amperometric detection (CZE-AD) was firstly applied to the determination of four carbamate pesticides: fenobucarb, isoprocarb, metolcarb and carbaryl. The four carbamates were hydrolyzed in alkalescent aqueous solutions, resulting in the formation of 2-sec-butylphenol, 2-isopropylphenol, m-cresol and alpha-naphthol, which could be determined by amperometry after capillary electrophoretic separation. Under the selected optimum conditions, the four analytes could be perfectly separated within 23min. The linear ranges of 2-sec-butylphenol, 2-isopropylphenol and m-cresol were from 1.0x10(-7) to 2.0x10(-5)molL(-1) and that of alpha-naphthol was from 2.0x10(-7) to 2.0x10(-5)molL(-1) and their detection limits were 3.0x10(-8), 3.0x10(-8), 3.0x10(-8) and 6.0x10(-8)molL(-1), respectively (S/N=3). Fenobucarb, isoprocarb, metolcarb and carbaryl can be indirectly determined by this CZE-AD method with recovery of 105, 104, 110 and 98% and R.S.D. of 4, 3, 4 and 3%, respectively. Above results demonstrated that this method was of high sensitivity, good repeatability and could be used in the rapid determination of the pesticide residues.
Talanta 03/2007; 71(3):1083-7. · 3.79 Impact Factor
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ABSTRACT: To study the modality of multidisciplinary therapy and prognosis of cervical cancer patients with positive lymph nodes after radical surgery.
From January 1990 to June 2003, 215 patients with clinical stage I b1-II b node-positive cervical carcinoma who underwent radical hysterectomy and pelvic lymphadenectomy and were histologically confirmed to have lymph node involvement were analyzed. These patients were divided into four groups as chemoradiotherapy group (107 cases), radiotherapy group (45 cases), chemotherapy group (22 cases) and no adjuvant therapy group (41 cases). The prognosis and potential prognostic variables of the four groups were studied by survival analysis.
The 3-year disease-free survival (DFS) rate of the chemoradiotherapy group, chemotherapy group, radiotherapy group and no adjuvant therapy group were 60.7%, 53.5%, 47.4% and 36.0% respectively. The 3-year DFS rate of the chemoradiotherapy group was significantly higher than that of the no adjuvant therapy group (P = 0.001). However, the 3-year DFS rate of the chemotherapy group, radiotherapy group were not significantly higher than that of the no adjuvant therapy group (P = 0.060 and 0.159). Among the four groups, the pelvic recurrent rate of the chemoradiotherapy group (7.5%) was much lower than those of the other three groups (22.7%, 26.7%, 34.1%, respectively; P < 0.01). However, the distant metastases rate did not decrease significantly (16.8%, 18.2%, 15.6%, 22.0%, respectively; P > 0.05), neither did the distant metastasis with pelvic recurrent rate (P > 0.05). COX proportional hazard model analysis showed that tumor size, histological type, the number of positive lymph node and postoperative adjuvant therapy were independent survival predictors of the patients with positive lymph node (P < 0.05).
Chemoradiotherapy after radical surgery significantly improves the 3-year DFS, and decreases the pelvic recurrence in the cervical cancer patients with positive lymph node.
Zhonghua fu chan ke za zhi 08/2005; 40(8):539-43.
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ABSTRACT: To evaluate the transposed ovarian function and complications in cervical cancer patients with postoperative pelvic radiotherapy.
Sixty-two women with stage I-IIa cervical cancer were treated with radical hysterectomy and pelvic lymphadenectomy and transposition of both ovaries to paracolic gutters from 1997 to 2003 at the Cancer Hospital of Fudan University. Menopausal symptoms, levels of follicle-stimulating hormone (FSH) and E2 were evaluated to assess ovarian function.
Of 31 patients with stage IIa or poorly differentiated tumor or tumor > or = 2 cm in diameter, preoperative vaginal radiation was employed to deliver a dose of 15 Gy at point A. Postoperative pelvic radiation was performed in 15 patients. Totally 20% (6/30) of patients undergoing ovaries transposition without any radiation experienced ovarian failure within a mean of 15.7 months. In 35% (6/17) of patients with preoperative vaginal radiation, ovarian failure occurred within a mean of 12.0 months. When patients receiving postoperative pelvic radiation and ovaries transposition were considered together, 64% (9/14) experienced ovarian failure within a mean of 9.2 months (P < 0.05). Only 2 (3%) patients had cysts in transposed ovaries not requiring further surgery. There was no metastasis of the ovaries.
Lateral ovarian transposition is safe to patients with early stage cervical cancer. Both pre- and post-operative radiation significantly damages the ovarian function. Even ovaries transposition procedure also reduces the effectiveness.
Zhonghua fu chan ke za zhi 04/2005; 40(4):220-2.
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ABSTRACT: ObjectiveTo investigate the influence of positive lymph nodes on the prognosis for patients with stage Ib-IIb cervical carcinoma.
MethodsSixty-six patients with stage Ib∼IIb cervical carcinoma who underwent a radical hysterectomy and pelvic lymphadenectomy were
analyzed retrospectively. The potential prognostic factors were calculated by the Cox proportional hazard model.
ResultsThe 5-year survival of the patients with pelvic lymph node metastasis was 40.7%. The Cox proportional hazard model analysis
showed that cellular differentiation, the number of positive nodes and adjuvant therapy were independent prognostic factors
(P< 0.05). The 5-year survival of patients with 1 positive node was higher than that of those with 2 or more positive nodes
(56.5% vs 36.4%,P< 0.05). The distant metastasis rate in the former group (5.9%) was lower than the latter’s (32.7%) (P=0.05). However, there
was no significant difference of pelvic recurrence between the 2 groups (P> 0.05). The 5-year survival of the patients who had no adjuvant therapy (12.6%) was much lower than that (53.7%) of those
with adjuvant therapy (P< 0.05). However, there no obvious differences among the effect of adjuvant radiotherapy, chemotherapy and chemoradiotherapy
(P> 0.05).
ConclusionThe prognosis of patients with stage lb∼llb node-positive cervical carcinoma who underwent radical surgery was poor. Adjuvant
therapy can increase the survival rate, decrease the pelvic recurrence and distant metastasis.
Chinese Journal of Clinical Oncology 09/2004; 1(5):342-347.
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ABSTRACT: This study was performed to address patient selection criteria and the role of secondary cytoreductive surgery (SCR) in patients with epithelial ovarian carcinoma (EOC) who had relapsed tumors after a progression-free interval > or = 3 months.
One hundred seventeen patients with relapsed EOC after a clinical complete remission duration > or = 3 months who underwent SCR were entered on this prospective trial. Survival curves were generated using the Kaplan-Meier method, and statistical comparisons were performed using log-rank tests, logistic stepwise regression analyses, and a Cox stepwise regression model.
The median patient age at the time of relapse was 53 years (range, 20-78 years). The median survival was 22 months and the estimated 5-year survival rate for the entire cohort was 17.2%. Tumor was confined to a solitary site in 33 patients and to > or = 2 sites in 84 patients. After they underwent SCR, 11 patients were rendered macroscopically disease free, 61 patients had residual disease that measured < or = 1 cm in greatest dimension, and 45 patients had bulky intraabdominal residual disease. Survival was influenced by the extent of relapse disease (solitary site vs. multiple sites; P < 0.0001), the size of residual disease after SCR (0 cm vs. < or = 1 cm [P = 0.1211], < or = 1 cm vs. > 1 cm [P = 0.0002], and 0 cm vs. > 1 cm [P = 0.0011]), Eastern Cooperative Oncology Group performance status (0 vs. 1 [P = 0.134], 1 vs. 2 [P = 0.007], and 0 vs. 2 [P = 0.0012]), and the number of cycles of salvage chemotherapy (1-2 cycles vs. 3-5 cycles [P = 0.0144]; 1-2 cycles vs. > or = 6 cycles [P < 0.0001]; and 3-5 cycles vs. > or = 6 cycles [P = 0.0009]). The outcome of SCR was influenced by the extent of relapse disease (multiple sites [51.2%] vs. solitary sites [87.9%]; relative risk [RR] = 9.1237; P = 0.0002) and by the use of bowel resection (yes [60.9%] vs. no [37.5%]; RR = 0.3828; P = 0.0106).
SCR was found to be safe for patients with relapsed EOC who achieved a clinical complete remission that lasted > or = 3 months, with resectability similar to that of primary debulking surgery. Optimal surgical outcomes were achieved easily in patients who apparently had solitary tumor sites, with bowel resection making it possible to remove bulky tumors that involved the intestine. A survival benefit was provided by optimal SCR, particularly when surgery was supported by multiple courses of salvage chemotherapy.
Cancer 03/2004; 100(6):1152-61. · 4.77 Impact Factor
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ABSTRACT: Pelvic lymph nodes metastasis is an important prognostic factor for patients with cervical carcinoma. However, the relationships between the number of positive nodes, site of metastases nodes, adjuvant therapy and the prognosis is controversial. The purpose of this study was to investigate the influence of positive lymph nodes on the prognosis of Chinese women with stage IB1-IIB cervical carcinoma.
Between January 1992 and December 1997, 398 women with International Federation of Gynecology and Obstetrics (FIGO) stage IB1-IIB cervical carcinoma underwent radical surgery in Cancer Hospital, Fudan University. Of these sixty-six patients (16.6%) who were histologically confirmed to have positive pelvic lymph nodes were analyzed retrospectively. The survival was estimated using Kaplan-Meier method. The differences in survival were compared with Log-rank test. Multivariate analyses were performed with the Cox proportional hazard model.
The 5-year survival of the patients with pelvic lymph nodes metastases was 40.7%. Cox proportional hazard model analysis showed that cellular differentiation, the number of positive nodes and adjuvant therapy to be the independent prognostic factors (P < 0.05). The 5-year survival of patients with one positive node was higher than that of those with two or more positive nodes (56.5% vs. 36.4%, P < 0.05). The distant metastasis rate in the former group (5.9%) was lower than the latter's (32.7%) (P = 0.05). However, there was no significant difference of pelvic recurrence between the two groups (P > 0.05). The number of positive nodes positively correlated with the level of positive nodes (P < 0.01). The 5-year survival of the patients who had no adjuvant therapy (12.6%) was much lower than that (53.7%) of those with adjuvant therapy (P < 0.05). However, there was no obvious difference between adjuvant radiotherapy, chemotherapy and chemo-radiotherapy (P > 0.05).
The prognosis of patients with stage IB1-IIB node-positive cervical carcinoma who underwent radical surgery alone was very poor. Adjuvant therapy increases the survival rate, decreases the pelvic recurrence and distant metastasis.
World Journal of Surgical Oncology 02/2004; 2:47. · 1.12 Impact Factor
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ABSTRACT: Pelvic lymph node metastasis was the important prognostic factor for the patients with cervical carcinoma. However, the relationship among the number of positive nodes, site of metastatic nodes, adjuvant therapy, and the prognosis were unknown. The purpose of this study was to investigate the variables that could predict the prognosis of the patients with stage Ib-IIb node-positive cervical carcinoma.
Sixty-six patients with stage Ib-IIb cervical carcinoma who underwent radical hysterectomy and pelvic lymphadenectomy were analyzed retrospectively. Potential prognostic variables were studied by Cox proportional hazard model.
The 5-year survival rate of the patients with pelvic lymph node metastasis was 40.7%. Cox proportional hazard model analysis showed cellular differentiation, number of positive nodes, and adjuvant therapy were the important prognostic factors (P< 0.05). The 5-year survival rate of patients with one positive node (56.5%) was higher than that (36.4%) of those with two or more positive nodes (P< 0.05). The former's distant metastatic rate (5.9%) was lower than the latter's (32.7%) (P=0.05). However, there was no difference of pelvic recurrence between them (P >0.05). The 5-year survival rate of the patients who had no adjuvant therapy (12.6%) was much lower than that (53.7%) of those with adjuvant therapy (P< 0.05). However, the differences of the effects among adjuvant radiotherapy, chemotherapy, and chemoradiotherapy were not obvious (P >0.05).
The prognosis of patients with stage Ib-IIb node-positive cervical carcinoma who underwent radical surgery was poor. Adjuvant therapy can improve the survival rate, decrease the pelvic recurrence and distant metastasis.
Ai zheng = Aizheng = Chinese journal of cancer 11/2003; 22(11):1219-23.
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ABSTRACT: The purpose of this study was to identify the prognostic factors for disease-free survival (DFS) and recurrence patterns in Chinese women with squamous cell carcinoma of the vulva treated with primary surgery. From 1980 through 2002, 100 patients with invasive squamous cell carcinoma of the vulva treated with primary surgery were included in this retrospective study. Survival analyses included the Kaplan-Meier method, log-rank test, and Cox proportional hazards model. The 5- and 10-year DFS rates were 66.5% and 45.2%, respectively. Among all the tumor-related variables age, International Federation of Gynecology and Obstetrics stage, lymphovascular space invasion, and lymph node status were found to be significant predictors of DFS for the univariate analysis. Multivariate analysis proved that age (risk ratio, 6.572; 95% confidence interval, 1.759-24.546) and lymph nodes metastasis (risk ratio, 4.178; 95% confidence interval, 1.358-12.855) were the most significant prognostic factors of DFS (P < 0.05). The overall recurrence rate was 34.0% (34/100). Among the patients with recurrences, the locations of the recurrent disease were as follows: local recurrence in 20 (58.8%), groin recurrence in 2 (5.9%), local and groin in 1 (2.9%), distant metastases in 5 (14.7%), and local recurrence and distant metastases in 5 (14.7%); data were missing for 1 (2.9%) patients. Older age and lymph nodes metastases were the independent predictors of poor prognosis for patients with invasive squamous cell carcinoma of the vulva treated with primary surgery. Local recurrence was the main recurrence pattern after primary surgery which would be improved by multidisciplinary treatment.
International Journal of Gynecological Cancer 19(1):158-62. · 1.65 Impact Factor
