We recently showed that the levels of secreted human leukocyte antigen-G (HLA -G), a nonclassical MHC class I antigen, are significantly elevated in malignan t effusions in ovarian carcinoma compared to benign ones. T...We recently showed that the levels of secreted human leukocyte antigen-G (HLA -G), a nonclassical MHC class I antigen, are significantly elevated in malignan t effusions in ovarian carcinoma compared to benign ones. The objective of this study was to evaluate the expression and clinical role of HLA-G in effusions an d corresponding solid tumors from patients diagnosed with advanced-stage ovaria n carcinoma. Effusions (=148), corresponding primary tumors (=66), and metastati c lesions (=122) were analyzed using immunohistochemistry with an anti-HLA-G m onoclonal antibody. HLA-G was detected in cancer cells in 49/148 (33%) effusio ns, 33/66 (50%) primary tumors, and 59/122 (48%) solid metastases. These diffe rences did not reach statistical significance. Expression in effusions and solid metastases significantly correlated (P = 0.029). HLA-G expression in tumor cel ls was significantly lower in effusions obtained during or following chemotherap y (P = 0.038). The presence of HLA-G-positive tumor cells in effusions obtaine d prior to the institution of chemotherapy correlated with better overall surviv al (P = 0.042). HLA-G expression in primary tumors and solid metastases did not correlate with any of the clinicopathologic parameters studied. HLA-G is expre ssed in a significant number of ovarian carcinomas at all anatomic sites. The re duced expression of HLA-G in post-chemotherapy effusions and its correlation w ith improved survival may be related to preferential susceptibility of HLA-G-e xpressing cells at this site. Our findings suggest a new role for HLA-G as a pr ognostic indicator in advanced-stage ovarian cancer in effusions.展开更多
Objective. To investigate the role of cytoreductive surgery in patients with nongenital cancers metastatic to the ovaries. Patients and methods. One hundred and fifty-four patients with nongenital cancers metastatic t...Objective. To investigate the role of cytoreductive surgery in patients with nongenital cancers metastatic to the ovaries. Patients and methods. One hundred and fifty-four patients with nongenital cancers metastatic to the ovaries treated in Hacettepe University Hospital, Gynecologic Oncology Unit between 1982 and 2004 years were retrospectively evaluated. Data were obtained from patients’ records and pathology reports. Demographic characteristics, prognostic factors, 5- year and median survivals were analyzed in all patients. Results. During study period, nongenital cancers metastatic to the ovaries constituted 9% of all malignant ovarian neoplasms. Primary cancers were breast (35), stomach (35) and colorectal (33) cancers, lymphoma (17), undetermined origin (16), appendix (7), ileum (4), pancreas (3), gallbladder cancer (2) and mesothelioma (2). Of patients, 67% were premenopausal and 33% were postmenopausal. Although most common presenting symptoms were abdominal distension with dyspeptic complaints in 46% , abdominal mass in 22% , and pressure symptoms in 8.4% , 15 patients (10% ) were asymptomatic and were diagnosed in routine control examinations. Total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH + BSO), omentectomy, and bilateral pelvic and para-aortic lymphadenectomy (BP-PALND) with cytoreduction were performed in 102 patients (66% ), TAH + BSO + omentectomy in 21 patients (14% ), TAH + BSO in 23 patients (15% ), minimal surgical effort including BSO or biopsy in 8 patients (5% ). Eighty-four percent of patients received adjuvant treatment according to the primary origins. Mean follow-up was 47.3 ± 5.9 months. Overall, 5 year survival was 36% and median survival was 42 months. Comparison of median survival times for the primary sites showed a significant overall differences (P = 0.0001) and were as follows: breast 54 months, stomach 18 months, colorectal 48 months, lymphoma 181 months, unknown primary 16 months, appendix 18 months, ileum 40 months, pancreas 3 months, gallbladder 8 months and mesothelioma 20 months. Median survival time of patients who underwent cytoreductive surgery was 48 months, compared with 26 months for patients with suboptimal cytoreductive surgery (P = 0.0039). The 5- year survival rate was 47% and 23% , respectively. Multivariate analysis identified age, menopausal status, primary site, diffuse peritoneal involvement and type of operation as prognostic factors. Conclusion. Presence of ovarian metastasis is associated with a poor prognosis in nongenital cancers. Surgery is essential for diagnosis of primary tumor and necessary for relief of symptoms. Cytoreductive surgery seems to have a beneficial effect on survival of selected patients, especially for patients with colorectal cancer metastatic to the ovary.展开更多
文摘We recently showed that the levels of secreted human leukocyte antigen-G (HLA -G), a nonclassical MHC class I antigen, are significantly elevated in malignan t effusions in ovarian carcinoma compared to benign ones. The objective of this study was to evaluate the expression and clinical role of HLA-G in effusions an d corresponding solid tumors from patients diagnosed with advanced-stage ovaria n carcinoma. Effusions (=148), corresponding primary tumors (=66), and metastati c lesions (=122) were analyzed using immunohistochemistry with an anti-HLA-G m onoclonal antibody. HLA-G was detected in cancer cells in 49/148 (33%) effusio ns, 33/66 (50%) primary tumors, and 59/122 (48%) solid metastases. These diffe rences did not reach statistical significance. Expression in effusions and solid metastases significantly correlated (P = 0.029). HLA-G expression in tumor cel ls was significantly lower in effusions obtained during or following chemotherap y (P = 0.038). The presence of HLA-G-positive tumor cells in effusions obtaine d prior to the institution of chemotherapy correlated with better overall surviv al (P = 0.042). HLA-G expression in primary tumors and solid metastases did not correlate with any of the clinicopathologic parameters studied. HLA-G is expre ssed in a significant number of ovarian carcinomas at all anatomic sites. The re duced expression of HLA-G in post-chemotherapy effusions and its correlation w ith improved survival may be related to preferential susceptibility of HLA-G-e xpressing cells at this site. Our findings suggest a new role for HLA-G as a pr ognostic indicator in advanced-stage ovarian cancer in effusions.
文摘Objective. To investigate the role of cytoreductive surgery in patients with nongenital cancers metastatic to the ovaries. Patients and methods. One hundred and fifty-four patients with nongenital cancers metastatic to the ovaries treated in Hacettepe University Hospital, Gynecologic Oncology Unit between 1982 and 2004 years were retrospectively evaluated. Data were obtained from patients’ records and pathology reports. Demographic characteristics, prognostic factors, 5- year and median survivals were analyzed in all patients. Results. During study period, nongenital cancers metastatic to the ovaries constituted 9% of all malignant ovarian neoplasms. Primary cancers were breast (35), stomach (35) and colorectal (33) cancers, lymphoma (17), undetermined origin (16), appendix (7), ileum (4), pancreas (3), gallbladder cancer (2) and mesothelioma (2). Of patients, 67% were premenopausal and 33% were postmenopausal. Although most common presenting symptoms were abdominal distension with dyspeptic complaints in 46% , abdominal mass in 22% , and pressure symptoms in 8.4% , 15 patients (10% ) were asymptomatic and were diagnosed in routine control examinations. Total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH + BSO), omentectomy, and bilateral pelvic and para-aortic lymphadenectomy (BP-PALND) with cytoreduction were performed in 102 patients (66% ), TAH + BSO + omentectomy in 21 patients (14% ), TAH + BSO in 23 patients (15% ), minimal surgical effort including BSO or biopsy in 8 patients (5% ). Eighty-four percent of patients received adjuvant treatment according to the primary origins. Mean follow-up was 47.3 ± 5.9 months. Overall, 5 year survival was 36% and median survival was 42 months. Comparison of median survival times for the primary sites showed a significant overall differences (P = 0.0001) and were as follows: breast 54 months, stomach 18 months, colorectal 48 months, lymphoma 181 months, unknown primary 16 months, appendix 18 months, ileum 40 months, pancreas 3 months, gallbladder 8 months and mesothelioma 20 months. Median survival time of patients who underwent cytoreductive surgery was 48 months, compared with 26 months for patients with suboptimal cytoreductive surgery (P = 0.0039). The 5- year survival rate was 47% and 23% , respectively. Multivariate analysis identified age, menopausal status, primary site, diffuse peritoneal involvement and type of operation as prognostic factors. Conclusion. Presence of ovarian metastasis is associated with a poor prognosis in nongenital cancers. Surgery is essential for diagnosis of primary tumor and necessary for relief of symptoms. Cytoreductive surgery seems to have a beneficial effect on survival of selected patients, especially for patients with colorectal cancer metastatic to the ovary.
