Keng Shen

Peking Union Medical College Hospital, Peping, Beijing, China

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Publications (159)199.52 Total impact

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    ABSTRACT: To explore the genetic and molecular events that control subclones exhibiting distinct invasive/migratory capacities derived from human epithelial ovarian cancer (EOC) cell line A2780 and SKOV3. Single-cell subclones were isolated and established that were derived from the SKOV3 and A2780 cell lines through limiting dilution methodology. Transwell insert assays and MTT assays were performed to screen and identify the subclones exhibiting the highest and the lowest invasive/migratory capacities, and the selected subclones were renamed as A-H (A2780 high), A-L (A2780 low), S-H (SKOV3 high), and S-L (SKOV3 low). Their biological characteristics were evaluated. RNA-Seq was conducted on the targeted subclones. Compared with their corresponding counterparts, A-H/S-H cells exhibited significantly higher invasive/migratory capacities (P < 0.001 and = 0.001, respectively). A-H/S-H cells displayed a clear reduction in doubling time (P = 0.004 and 0.001, respectively), and a significant increase in the percentage of cells in S phase (P = 0.004 and 0.022, respectively). Additionally, the apoptotic rates of A-H/S-H cells were significantly lower than those of A-L/S-L cells (P = 0.002 and 0.026, respectively). At both mRNA and protein levels, caspase-3 and caspase-7 expression were reduced but Bcl-2 expression was increased in A-H/S-H cells. The TrkB (anoikis-related) and Beclin1 (autophagy-related) levels were consistently high and low, respectively, in both A-H/S-H cells. Resistance to chemotherapy in vitro and higher capacities on tumor formation in vivo was presented in both A-H/S-H cells. PI3K/AKT/mTOR pathway components, PIK3CA, PIK3CD, AKT3, ECM1, GPCR, mTOR and PRKCB were increased but that the Nur77 and PTEN were decreased in A-H/S-H cells, identified by RNA-Seq and consistently confirmed by RT-PCR and Western blot analyses. Heterogeneous cell subpopulations exhibiting distinct invasive and migratory capacities co-exist within the SKOV3 and A2780 cell lines. PI3K/AKT/mTOR pathway activation is associated with higher invasive and migratory capacities in subpopulations of human ovarian cancer cell lines. Inhibiting this pathway may be useful for the chemoprevention or treatment of EOC.
    Oncotarget 07/2015; · 6.63 Impact Factor
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    ABSTRACT: The purpose of this study was to evaluate the effects of salvage chemotherapy on recurrent or persistent ovarian clear cell carcinoma (CCC) with the goal of identifying a more rational treatment regimen for this lethal disease.The medical records of patients with CCC were retrospectively reviewed to select patients that were subsequently treated for recurrent or persistent disease.Of the 164 women with recurrent or persistent CCC, 485 chemotherapy courses with 1766 cycles were administered. Overall, the clinical benefit rate (CBR) was 39.4%, and the mean progression-free survival (PFS) was 4.5 months. Grade 3/4 toxicities occurred in 94 courses (19.4%). The CBR for TC was 45.1%, with a PFS of 3.7 months. Compared to that of TC, the CBRs for PC and CC were significantly lower (P = 0.020 and 0.021, respectively). The CBRs and PFS for PAF-C were slightly higher (P = 0.518 and 0.077, respectively), but showed a significantly higher adverse event rate (AER, P = 0.039). The CBR for bevacizumab was 50% with an extraordinarily long PFS (49.8 months). Gemcitabine and oxaliplatin had similar values for CBRs (44.4% and 44.1%) and PFS (2.5 and 3.4 months), respectively. Docetaxel (weekly) exhibited a notably low AER of 2.7%, and topotecan was associated with a relatively long PFS (7.7 months).For cis/carboplatin-pretreated patients, the existing active agents, such as oxaliplatin, gemcitabine, topotecan, and especially bevacizumab, are promising. Docetaxel (weekly) is well tolerated and might offer a particularly viable option for heavily pretreated patients. However, additional research to identify for a continued search for the optimal combination of chemotherapeutics or novel agents is still warranted.
    Medicine 07/2015; 94(27):e1121. DOI:10.1097/MD.0000000000001121 · 4.87 Impact Factor
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    ABSTRACT: To identify a subset of patients with stage IA2-IB1 cervical cancer and small tumors (≤2cm) who could be suitable for less radical surgery. In a retrospective study, the medical records of women treated at nine hospitals in China were reviewed. Included women had undergone radical hysterectomy and pelvic lymph node dissection. The clinicopathologic factors associated with uterine isthmus invasion (UII), vaginal invasion (VI), parametrial invasion (PI), lymph node metastasis (LNM), and prognosis were analyzed. Overall, 1632 women were included. Tumor size greater than 2cm (measured postoperatively) was an independent predictor of VI (P=0.002), PI (P=0.001), and UII (P=0.021). Squamous cell carcinoma and superficial stromal invasion were associated with a low frequency of UII (P<0.001 for both). Among patients with adenocarcinoma, deep stromal invasion and lymphovascular space involvement (LVSI) were independently associated with UII (P=0.006 and P=0.004, respectively). Grade 2/3 disease (P=0.009), deep stromal invasion (P=0.015), and LVSI (P<0.001) were independently associated with LNM. LNM was the only independent adverse factor for survival (P<0.001). Women with stage IA2-IB1 cervical cancer with low-risk factors could be candidates for large-scale prospective clinical trials of less radical surgery and lymphadenectomy omission. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 06/2015; DOI:10.1016/j.ijgo.2015.03.042 · 1.56 Impact Factor
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    ABSTRACT: To investigate the benefits of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) in patients undergoing secondary cytoreductive surgery (SCRS) for recurrent epithelial ovarian cancer. Patients were identified and their clinical information was extracted by review of the gynaecologic oncology database of our hospital. 18F-FDG-PET scan and analysis were performed by nuclear medicine experts at our hospital. The PET group and the control group of patients evaluated by conventional imaging methods differed significantly with respect to the proportion of patients who underwent complete SCRS and the number of residual lesions (P=0.002 and 0.006, respectively). A Cox model showed that longer progression-free survival (PFS) correlated significantly with 18F-FDG-PET evaluation (RR=0.432, P=0.001), sensitivity to platinum-based chemotherapies (RR=0.604, P=0.034), and resection completeness (RR=0.679, P=0.039). Longer overall survival correlated significantly with sensitivity to platinum-based chemotherapy (RR=0.317, P=0.000) and the CA-125 level after two cycles of chemotherapy (RR=2.663, P=0.003). Surgical safety and complications did not significantly differ between the two groups of patients. 18F-FDG-PET is useful for evaluating patients with recurrent epithelial ovarian carcinoma. Patients who undergo PET-guided SCRS have a greater chance of complete tumour resection and a longer PFS. Advances in knowledge: Secondary cytoreductive surgery guided by PET results in fewer residual lesions. PET-guided secondary cytoreductive surgery is safe and can prolong PFS and OS in patients with recurrent ovarian cancer.
    The British journal of radiology 05/2015; 88(1052):20150109. DOI:10.1259/bjr.20150109 · 2.02 Impact Factor
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    ABSTRACT: Background To evaluate the outcomes of vulvar reconstruction using anterolateral thigh (ALT) flaps in patients with advanced and recurrent vulvar malignancies.Methods Totally 24 patients who received ALT-based vulvar reconstruction were retrospectively reviewed to evaluate the outcome focusing on quality of life and prognosis.ResultsFour patients received vulvar reconstruction at the time of primary surgery due to advanced stage, and 20 patients underwent vulvar reconstruction after recurrence. No patient experienced complete flap loss. Major complications happened in five patients (20.83%). Minor complications occurred in three patients (12.5%). All wounds healed favorable after appropriate treatment. The mean scale of verbal rating scale (VRS-4) was 1.58 before reconstruction while decreased to 0.13 after surgery (P < 0.0001). Mean performance status was 1.67 before surgery compared to 0.13 after surgery (P < 0.0001). Fourteen patients (58.33%) developed recurrence with a median interval of recurrence of 5 months after vulvar reconstruction. Ten patients (41.67%) are living with disease free in a median follow-up of 19.5 months. Overall 5 years survival was 56.4%.ConclusionALT flap based vulvar reconstruction method can improve the quality of life and might be considered as an appropriate option for reconstructing the vulvar defects in patients with advanced or recurrent vulvar malignancy. J. Surg. Oncol. © 2015 Wiley Periodicals, Inc.
    Journal of Surgical Oncology 05/2015; 111(8). DOI:10.1002/jso.23908 · 2.84 Impact Factor
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    ABSTRACT: Owing to the rarity of sex cord tumor with annular tubules (SCTAT), it is difficult to recognize SCTAT clinically and there is no standard treatment. The aim of our study was to investigate the treatment outcomes and prognosis of patients with ovarian SCTAT. A cohort of 13 patients with SCTAT diagnosed and treated in Peking Union Medical College Hospital was studied. Data on clinicopathological characteristics, treatment, and prognosis were retrospectively reviewed and analyzed. SCTAT accounted for 1.4% of ovarian sex cord stromal tumors, with an average onset age of 22.6 years. All patients presented with menstrual disturbances or isosexual precocity at disease onset. Initial surgery was unilateral salpingo-oophorectomy in 11 cases. Recurrence rate was 46.2%, and 38.5% of patients experienced multiple recurrences. The disease free interval gradually shortened with increasing numbers of recurrences. Recurrent tumors were mostly ipsilateral to the primary tumor and located in retroperitoneum. Surgery remained the main treatment for recurrent cases. Serum estradiol and progesterone levels usually elevated at disease onset, decreased dramatically after operation, and they elevated again with the development of recurrence. The median progression-free survival (PFS) was 97.8 months, and the 1-year and 5-year PFS were 92% and 67%, respectively. Five-year overall survival (OS) was 100%. Unilateral salpingo-oophorectomy is a feasible treatment for primary SCTAT cases with intact capsules and without PJS. Complete tumor resection is suggested for recurrent cases and long-term follow-up is strongly recommended. Despite the high risk of recurrence, SCTAT prognosis is relatively favorable.
    BMC Cancer 04/2015; 15(1):270. DOI:10.1186/s12885-015-1277-y · 3.32 Impact Factor
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    ABSTRACT: To profile the characteristic and prognostic implications of venous thromboembolism (VTE) in Chinese ovarian clear cell carcinoma (CCC) patients. We identified all of the cases between 2000 and 2012 by searching our institutional Ovarian CCC Database. A comprehensive review of the medical documentation was performed to collect relevant data. Kaplan-Meier models and Cox regression were employed for survival analysis. Of the 227 patients, 33 (14.5%) experienced VTE events. There was no significant difference between VTE and non-VTE group patients regarding age, serum cancer antigen 125 or tumor size. The optimal cytoreduction rate was higher in patients without VTE (70.1%) than in those with VTE (51.5%). VTE events were more likely to occur at presentation (36.4%) and recurrence (33.3%), followed by an adjuvant chemotherapy period (18.2%). VTE was more common in patients with advanced-stage disease than those with early-stage disease (P=0.003), whereas pulmonary embolism (PE) was 10-fold as common in advanced-stage disease as in early-stage disease (8.6% vs. 0.8%, P = 0.012). Patients with advanced disease tended to have thrombi in the proximal veins. Two patients died of PE, as confirmed by autopsy. Patients with VTE had reduced survival compared to those without VTE (median overall survival 54 vs. 140 months, P<0.001; median progression-free survival 17 vs. 43 months, P<0.001). Overall, 14.5% of the patients with ovarian CCC experienced VTE, mainly before their cancer diagnosis or at a time of recurrence. VTE adversely impacted patient survival.
    PLoS ONE 03/2015; 10(3-3):e0121818. DOI:10.1371/journal.pone.0121818 · 3.23 Impact Factor
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    ABSTRACT: The aim of the study reported here was to investigate the protective effect of gonadotropin-releasing hormone analog (GnRHa) against cyclophosphamide (CTX)-induced gonadotoxicity. Eighty Fischer 344 rats were divided randomly into four groups (20 per group). One group received normal saline, one GnRHa, one CTX, and one GnRHa+CTX. Several parameters were used to observe the ovarian reserve, including ovary weight, follicle number and diameter, concentrations of estradiol (E2) and follicle-stimulating hormone (FSH), and expressions of sex hormone receptors. When treatment was finished, the number of small follicles in the GnRHa+CTX group was significantly higher than in the CTX-alone group. Thirty days after treatment, the ovary weight, percentage of small follicles, mean follicular diameter, and serum concentrations of E2 and FSH in the GnRHa+CTX group all recovered, approaching normal levels. Sex hormone receptors did not show significant differences between the four groups. Combination treatment with GnRHa could prevent CTX-induced damage to ovarian reserve.
    OncoTargets and Therapy 03/2015; 8:661-7. DOI:10.2147/OTT.S78729 · 2.31 Impact Factor
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    ABSTRACT: This study aimed to establish a nomogram by combining clinicopathologic factors with overall survival of stage IA-IIB cervical cancer patients after complete resection with pelvic lymphadenectomy. This nomogram was based on a retrospective study on 1,563 stage IA-IIB cervical cancer patients who underwent complete resection and lymphadenectomy from 2002 to 2008. The nomogram was constructed based on multivariate analysis using Cox proportional hazard regression. The accuracy and discriminative ability of the nomogram were measured by concordance index (C-index) and calibration curve. Multivariate analysis identified lymph node metastasis (LNM), lymph-vascular space invasion (LVSI), stromal invasion, parametrial invasion, tumor diameter and histology as independent prognostic factors associated with cervical cancer survival. These factors were selected for construction of the nomogram. The C-index of the nomogram was 0.71 (95% CI, 0.65 to 0.77), and calibration of the nomogram showed good agreement between the 5-year predicted survival and the actual observation. We developed a nomogram predicting 5-year overall survival of surgically treated stage IA-IIB cervical cancer patients. More comprehensive information that is provided by this nomogram could provide further insight into personalized therapy selection.
    Asian Pacific journal of cancer prevention: APJCP 01/2015; 16(9):3773-7. · 2.51 Impact Factor
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    ABSTRACT: The aim of our study is to investigate the differences in therapeutic effects and clinical significance between intravenous systematic chemotherapy and intra-arterial interventional chemotherapy in stage Ib2-IIb cervical carcinomas. A retrospective analysis was performed on 93 cases of intravenous and 118 cases of intra-arterial neoadjuvant chemotherapy for stage Ib2-IIb cervical carcinomas treated in Peking Union Medical College Hospital from the year 2001 to 2010. After neoadjuvant chemotherapy, the overall response rate was 84.9% versus (vs) 88.2% and the operability rate was 77.4% vs 81.4%, for intravenous vs intra-arterial (P>0.05). There were no significant differences in toxicities, surgical duration, perioperative blood loss, and operative complications between these two groups. Postoperative pathological examination revealed a significantly lower parametrial infiltration in the intra-arterial group (12.5% vs 38.1%, P<0.05), while the positive vaginal margin, lymph node metastasis, and intravascular tumor embolus showed no significant differences. The intravenous group and the intra-arterial group had similar recurrence rate (16.0% vs 12.3%), distant metastasis rate (9.1% vs 8.5%), and 5 year survival rate (79.5% vs 84.9%), without significant differences. Neoadjuvant chemotherapy with cisplatin and 5-fluorouracil are safe and effective for patients with locally advanced cervical carcinomas. The intravenous and the intra-arterial approaches present with similar chemotherapy efficacy and clinical outcome. Since it is more simple and economical, the intravenous systematic approach shows greater value in clinical application.
    OncoTargets and Therapy 11/2014; 7:2155-2160. DOI:10.2147/OTT.S67633 · 2.31 Impact Factor
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    ABSTRACT: Purpose To investigate tumor heterogeneity in the recurrence of epithelial ovarian cancer demonstrated by polycomb group (PcG) proteins. Methods Tissue microarrays containing matched primary and recurrent ovarian tumors from the same patients were constructed for detection of PcG protein expression. Survival analyses of clinicopathological parameters and expression of PcG proteins were performed on progression-free survival (PFS) and overall survival (OS) of patients. Genetic and epigenetic heterogeneity was explored in aspects of gene copy number and microRNA (miRNA) profiling. Results PcG proteins were heterogeneously expressed in primary versus recurrent tumors (P<0.05). In univariate survival analysis of the ovarian carcinoma cohorts, a significant association of intensive expression of BMI1 and EZH2 in first-onset lymph node metastases with shortened PFS was demonstrated (P=0.010, P=0.019); and a significant association of intensive expression of BMI1 and EZH2 in recurrent tumors with shortened OS was demonstrated (P=0.042, P=0.047). Importantly, BMI1 and EZH2 expression provided significant independent prognostic parameters in multivariate analyses (P<0.05). Gene amplification did not always coincide with PcG protein expression. Eight miRNAs were found to be downregulated in recurrent tumors, among which miR-298 might indirectly regulate the expression of EZH2 through transcription factor ILF3. Conclusion Tumor heterogeneity exists in the recurrence of epithelial ovarian cancer, manifested by PcG protein expression and underlying genetic and epigenetic alterations. Intensive expression of BMI1 and EZH2 are predictors of earlier relapse and shorter OS, independent of grade and chemotherapy sensitivity. EZH2 and miR-298 have great potential to be new targets for treatment of recurrent ovarian cancer.
    OncoTargets and Therapy 09/2014; 7:1705-16. DOI:10.2147/OTT.S67570 · 2.31 Impact Factor
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    ABSTRACT: Objective: This study aimed to analyze the clinicopathological features of pure and mixed-type ovarian clear cell carcinoma (CCC) in Chinese patients. Methods: Patients with ovarian CCC treated in our institution between 1982 and 2012 were identified by reviewing the database and medical charts. Patients were assigned into 2 groups based on histology (pure or mixed). Comparison of clinicopathological parameters was performed to determine the similarities and/or differences between pure and mixed CCC. Kaplan-Meier model was used in survival analysis. Results: Of 341 patients with ovarian CCC, 46 (13.5%) mixed tumors were identified, and the most common combination was clear cell/endometrioid, accounting for 56.5%. Patients with mixed-type CCC tended to have higher level of serum cancer antigen 125 (P = 0.023) and advanced tumor stage (P = 0.001). No difference was observed in other features including age, tumor size, residual disease, lymph node metastasis, and coexisting endometriosis. Tumor recurrence occurred in 47.8% and 58.1% in patients with pure and mixed histology, respectively (P = 0.209). Two groups had comparable platinum-sensitive disease (42.1% in pure and 44.0% in mixed type, P = 0.860). Patients with pure CCC had an improved median survival (105 vs 56 months), although statistical significance was not achieved. Histology subclassification of mixed tumor revealed that patients with clear cell/endometrioid histology had better survival outcome than those with clear cell/serous type (median survival, 140 vs 43 months, P = 0.004; median progression-free survival, 49 vs 12 months, P = 0.001). Conclusions: Patients with mixed CCC tended to have elevated serum cancer antigen 125 and advanced tumor stage. However, no significant difference was observed between the pure and mixed tumors regarding prognosis.
    International Journal of Gynecological Cancer 09/2014; DOI:10.1097/IGC.0000000000000275 · 1.95 Impact Factor
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    ABSTRACT: Objective To analyze and compare the clinicopathological features and prognosis of ovarian clear cell carcinoma (CCC) with or without endometriosis in Chinese patients. Design Comparative study based on a retrospective review of medical charts. Setting A general university hospital. Patient(s) Two hundred ten patients diagnosed and treated with ovarian CCC between 2000 and 2012. Intervention(s) Patients were divided into two groups depending on coexisting endometriosis. A comparison of clinicopathological characteristics was performed. The Kaplan-Meier model and Cox regression were employed in survival analysis. Main Outcome Measure(s) Clinicopathological parameters and survival outcomes. Result(s) Of 210 patients, 79 (37.6%) were confirmed to have concurrent endometriosis. Patients with endometriosis were 8 years younger than those without. They were more likely to present at early stage (78.5%) with resectable tumors in primary surgery (with optimal cytoreduction rate at 89.9%) and platinum-sensitive disease (51.7%). Median overall survival for patients with endometriosis was 115 months, an increase of 52 months when compared with 63 months for patients without endometriosis. The 5-year survival rate in patients with endometriosis was 70.2%, while it was 52.6% for those without. Univariate and multivariate analysis showed that coexisting endometriosis was not an independent predictor of survival outcome. Tumor stage and optimal debulking were the independent prognostic factors for both overall survival and progression-free survival. Conclusion(s) Patients with ovarian CCC and coexisting endometriosis had distinct clinicopathological features and better survival outcome. However, endometriosis per se did not confer improved survival.
    Fertility and Sterility 09/2014; DOI:10.1016/j.fertnstert.2014.08.008 · 4.59 Impact Factor
  • HaiXia Li · JianFang Zeng · Keng Shen
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    ABSTRACT: Ovarian cancer is one of the major causes of death in women worldwide. Despite improvements in conventional treatment approaches, such as surgery and chemotherapy, a majority of patients with advanced ovarian cancer experience relapse and eventually succumb to the disease; the outcome of patients remains poor. Hence, new therapeutic strategies are urgently required. The phosphatidylinositol 3-kinase (PI3K)/AKT/mammalian target of rapamycin (mTOR) is activated in approximately 70 % of ovarian cancers, resulting in hyperactive signaling cascades that relate to cellular growth, proliferation, survival, metabolism, and angiogenesis. Consistent with this, a number of clinical studies are focusing on PI3K pathway as an attractive target in the treatment of ovarian cancer. In this review, we present an overview of PI3K pathway as well as its pathological aberrations reported in ovarian cancer. We also discuss inhibitors of PI3K pathway that are currently under clinical investigations and the challenges these inhibitors face in future clinical utility.
    Archives of Gynecology and Obstetrics 08/2014; 290(6). DOI:10.1007/s00404-014-3377-3 · 1.28 Impact Factor
  • Ting Gui · Dongyan Cao · Jiaxin Yang · Keng Shen
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    ABSTRACT: Most patients with ovarian cancers relapse, and treatment failure has often been attributed to chemoresistance in tumor cells. Emerging evidence indicates that tumor heterogeneity may play an equally important role. Although the idea of tumor heterogeneity is not new, little attention has been focused on applying it to understand and control ovarian cancer progression. Recent advances in understanding its generation model, original basis, consequent problems, and derived therapies provide great potential for tumor heterogeneity to be a new insight in treatment of ovarian cancers.
    Histology and histopathology 07/2014; 30(2). · 2.24 Impact Factor
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    ABSTRACT: Objectives: Quality of life (QoL) and sexual health have become increasingly important in cervical cancer survivors (CCSs). The aims of this review were to summarize research findings of QoL and sexual function in CCSs after treatment on the basis of self-reported questionnaires and to update the current knowledge of overall QoL and sexual function in CCSs. Methods: Studies from electronic database between May 1966 and May 2013 were rated on their internal validity as methodological assessment. Thirty-two studies were included, wherein 15 studies had a relatively good methodology. Results: Anorectal function, urinary symptoms, and lymphedema were commonly reported as physical symptoms. As to psychosocial domains, the studies illustrated that anxiety decreased with age, whereas depression generally increased with age. Sexual function was involved in most of the studies. Vaginal dryness, dyspareunia, short vagina, and sexual dissatisfaction were prominent issues of sexual dysfunction and vaginal changes in CCSs. In terms of treatment modality, radiotherapy was thought to be associated with worse QoL and sexual function in CCSs. Conclusions: The studies showed that QoL and sexual function in CCSs were compromised compared with the general population to different extents. Quality of life and sexual function should be paid with more attention in patients with cervical cancer after treatment.
    International Journal of Gynecological Cancer 07/2014; DOI:10.1097/IGC.0000000000000207 · 1.95 Impact Factor
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    ABSTRACT: Objective The aim of the study was to identify the role of neoadjuvant chemotherapy (NACT) in the treatment of the patients with advanced stage ovarian yolk sac tumor (OYST). Methods The comparative study was based on 53 cases with advanced stage OYST registered at Peking Union Medical College Hospital from 1995 to 2010. Twenty one cases were treated with NACT followed by interval debulking surgery (IDS). Thirty two cases were treated with primary debulking surgery (PDS). Data on patient characteristics, treatment and survival were analyzed and compared between two groups to assess the outcome of NACT. Results After NACT, the overall status of the patients was improved significantly. Patients in NACT had better optimal cytoreduction rate and less peri-operative morbidities. Seven patients (13.2%) suffered from relapse. There was a significantly better PFS for patients with ovarian tumor size > 20 cm in the NACT than those underwent PDS. Residual disease > 2 cm was the independent risk factor of relapse. Conclusions NACT is the better treatment option for some patients with advanced stage OYST, especially for those with unresectable tumors and poor general condition.
    Gynecologic Oncology 07/2014; 134(1). DOI:10.1016/j.ygyno.2014.02.029 · 3.69 Impact Factor
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    ABSTRACT: The aim of this study is to evaluate the accuracy of magnetic resonance imaging (MRI) in the preoperative assessments of primary tumor size, parametrial invasion, and pelvic lymph node metastasis in patients with early-stage cervical cancer.
    International Journal of Gynecological Cancer 07/2014; 24(7). DOI:10.1097/IGC.0000000000000169 · 1.95 Impact Factor
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    ABSTRACT: Objective To explore appropriate treatment modality of microinvasive cervical cancer (MIC) and to analyze prognosis and risk factors of recurrence. Methods A cohort of 324 Chinese patients with MIC diagnosed and treated at Peking Union Medical College Hospital was retrospectively reviewed. Demographic features, treatment modalities, pathologic parameters, risk factors of residual disease, survival and risk factors of recurrence were analyzed. Results Of all patients, 280 cases were staged IA1 and 44 cases staged IA2 MIC. Twenty-five cases (7.7%) were found to have lympho-vascular space involvement (LVSI), but no parametrial involvement or ovarian metastasis was detected. Only one staged IA2 patient with LVSI was found to have lymph node metastasis. 32.4% patients (82/253) had residual diseases after conization. No significant difference of LVSI, lymph node metastasis and residual disease after coniztion was found between stage IA1 and IA2 MIC patients. Multivariate logistic analysis showed positive margin was the only independent risk factor of residual disease after conization (odds ratio [OR], 4.18; p<0.001). Recurrence occurred in five cases, but no mortality was found. Progression-free survival for stage IA1 patients treated by conization or hysterectomy was similar (92.3% and 98.8%, p=0.07). Cox regression analysis revealed LVSI as an independent risk factor for recurrence in stage IA1 patients (OR, 12.14; p=0.01). Conclusion For stage IA1 patients with negative resection margin and no LVSI, conization can be an ideal treatment modality. For stage IA2 patients, more conservative surgery such as simple hysterectomy may be considered. LVSI is an independent risk factor for recurrence in patients with stage IA1 cervical cancer.
    Journal of Gynecologic Oncology 06/2014; 25(4). DOI:10.3802/jgo.2014.25.4.293 · 1.60 Impact Factor
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    ABSTRACT: To study the clinical features, treatment and prognosis of struma ovarii.
    Zhonghua fu chan ke za zhi 06/2014; 49(6):451-454.