Gynecologic Oncology Reports最新文献

{"title":"Pembrolizumab-induced myasthenia gravis: Two patients’ experiences","authors":"Leslie Montag ,&nbsp;Rachael Piver ,&nbsp;Amy Vidalin ,&nbsp;Marian Johnson ,&nbsp;Bunja Rungruang ,&nbsp;Robert Higgins","doi":"10.1016/j.gore.2024.101453","DOIUrl":"https://doi.org/10.1016/j.gore.2024.101453","url":null,"abstract":"<div><p>Checkpoint inhibitors are increasingly used to treat patients with gynecologic malignancies and can cause rare and unusual side effects, also known as immunotoxicities, that are rarely observed in patients receiving traditional immunotherapy. If these are not identified and treated, they can cause disability and even death for patients undergoing treatment. This report describes the range of pembrolizumab-induced myasthenia gravis (MG) immunotoxicity through two cases. The first patient is an 85-year-old woman with recurrent vulvar carcinoma who completed two cycles of pembrolizumab. She had a severe presentation leading to respiratory failure. The second patient is an 80-year-old woman with recurrent serous endometrial carcinoma who developed isolated ocular myasthenia after her second cycle of pembrolizumab. The symptoms and physical examination findings described here illustrate the breadth of symptom severity associated with pembrolizumab-induced MG and importance of early identification and treatment to minimize symptoms and improve outcomes.</p></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"54 ","pages":"Article 101453"},"PeriodicalIF":1.2,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352578924001322/pdfft?md5=e05bf4254f7ca8e135ebe577f8f2445f&pid=1-s2.0-S2352578924001322-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141605471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changing the paradigm: Elimination – Not only of cervical cancer","authors":"Jacob Bornstein ,&nbsp;Koray Gorkem Sacinti ,&nbsp;Mario Preti ,&nbsp;Salem Billan ,&nbsp;Hosna Razeghian ,&nbsp;Colleen K. Stockdale","doi":"10.1016/j.gore.2024.101445","DOIUrl":"https://doi.org/10.1016/j.gore.2024.101445","url":null,"abstract":"<div><p>The WHO’s initiative to eliminate cervical cancer by 2030 does not address the increasing incidence of vulvar, anal, and oropharyngeal cancers linked to high-risk HPV. Currently, the prevention of these three cancers faces various obstacles, such as a lack of specialized screening programs, well-defined management guidelines, and widespread public awareness. Without any interventions, the incidence of these three cancers will likely rise in the upcoming years, increasingly affecting younger individuals. We recommend expanding the WHO’s initiative to include vulvar, anal, and oropharyngeal cancers. This involves developing screening and management protocols similar to those for cervical cancer, implementing gender-neutral HPV vaccination programs, establishing clear referral pathways to specialized centers, promoting public awareness, and providing education to healthcare providers and high-risk individuals.</p></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"54 ","pages":"Article 101445"},"PeriodicalIF":1.2,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352578924001243/pdfft?md5=339f2eda5181fb6ef7866d0eab76c04e&pid=1-s2.0-S2352578924001243-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141582984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between body mass index and molecular subtypes in endometrial carcinoma","authors":"DuPreez Smith ,&nbsp;Eun Young Kang ,&nbsp;Gregg S. Nelson ,&nbsp;Cheng-Han Lee ,&nbsp;Martin Köbel ,&nbsp;Christa Aubrey","doi":"10.1016/j.gore.2024.101447","DOIUrl":"https://doi.org/10.1016/j.gore.2024.101447","url":null,"abstract":"<div><h3>Objective</h3><p>This study aims to investigate the relationship between body mass index (BMI) and molecular subtypes of endometrial carcinoma using an immunohistochemistry (IHC)-based classification approach.</p></div><div><h3>Methods</h3><p>We analyzed a consecutive series of endometrial cancer cases undergoing surgical staging in southern Alberta (2019–2021). Molecular classification was determined through IHC-based molecular typing, incorporating p53 and mismatch repair (MMR), and further characterized with the addition of ER and PR. BMI associations with molecular classification were assessed using t-tests. Hormone receptor status was further examined in a separate cohort of MMRd endometrial cancer patients undergoing surgical staging at Foothills Medical Centre (Alberta, Canada).</p></div><div><h3>Results</h3><p>Among 289 cases, comprising various histological subtypes, the pNSMP subtype exhibited the highest average BMI (33.93 kg/m²) compared to the p53 abnormal subtype (30.40 kg/m², p = 0.02). The MMRd subtype had an average BMI of 33.22 kg/m². While there were no significant BMI differences between FIGO grade 1 and grade 2/3 tumours in the pNSMP or MMRd, a trend toward higher BMI in grade 1 tumours versus grade 2/3 tumours in the MMRd was observed (p = 0.13). A separate cohort of 53 MMRd endometrial carcinomas revealed that FIGO grade 1 tumours were associated with higher BMI (p &lt; 0.05) and more frequent ER/PR expression compared to grade 2/3 tumours (p &lt; 0.05).</p></div><div><h3>Conclusions</h3><p>This study suggests an association between obesity and NSMP endometrial carcinoma. The relationship between BMI and low-grade MMRd endometrial carcinomas with increased ER/PR expression warrants further exploration.</p></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"54 ","pages":"Article 101447"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352578924001267/pdfft?md5=3e7bdefb3bdc224eb0cc4725370a4e91&pid=1-s2.0-S2352578924001267-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141541236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient reported opioid usage following vulvar surgery in gynecologic oncology","authors":"Katelyn Tondo-Steele,&nbsp;Cynthia Stroup,&nbsp;Shitanshu Uppal,&nbsp;Alli Straubhar","doi":"10.1016/j.gore.2024.101446","DOIUrl":"https://doi.org/10.1016/j.gore.2024.101446","url":null,"abstract":"<div><h3>Background</h3><p>There remains a paucity of data for vulvar surgery outcomes in gynecologic oncology in the era of Enhanced Recovery After Surgery (ERAS) ®. As such, the primary objective is to assess the impact of patient and procedural factors on patient reported postoperative opioid usage following vulvar surgery. Secondary objective is to create a tailored opioid prescribing algorithm for this population.</p></div><div><h3>Methods</h3><p>A retrospective cohort study was performed of patients who underwent vulvar surgery for a gynecologic malignancy between 3/2019–7/2022. Covariates of interest included a history of risk factors for opioid usage, age, anatomic location of the vulvar resection, radicality of surgery, groin dissection, use of postoperative non-steroidal anti-inflammatory drugs (NSAIDs), and complications. Logistic regression models evaluated the effects that sociodemographic characteristics and procedural factors have on opioid usage. Linear regression models were created to determine prescribing guidelines.</p></div><div><h3>Results</h3><p>A total of 100 patients were included. Following surgery, 35 patients (35 %) were not sent home with an opioid prescription, 39 patients (39 %) reported using at least one opioid pill from their prescription, and 26 patients (26 %) reported not using any opioid pills from their prescription. In the regression models, patient age (p &lt; 0.006) had a significant impact on opioid use, while all other factors did not. Contraindications to NSAIDs did not have a statistically significant impact (p = 0.1) but was deemed clinically meaningful and included in the final model. Proposed opioid prescribing guidelines were created.</p></div><div><h3>Conclusion</h3><p>In conclusion, most patients after vulvar surgery require little to no opioids. Identifiable preoperative factors can aid providers to manage postoperative pain while minimizing unnecessary opioid prescriptions.</p></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"54 ","pages":"Article 101446"},"PeriodicalIF":1.2,"publicationDate":"2024-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352578924001255/pdfft?md5=6cbb97950b89248892182f5a7b079c3f&pid=1-s2.0-S2352578924001255-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141541235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of baseline lymphopenia on outcomes of definitive treatment for locally advanced cervical cancer","authors":"Einsley-Marie Janowski ,&nbsp;Emilee Hall ,&nbsp;Ruyun Jin ,&nbsp;Bethany Horton ,&nbsp;Kristin Walker ,&nbsp;Matthew Mistro ,&nbsp;Timothy Showalter ,&nbsp;Kara Romano","doi":"10.1016/j.gore.2024.101448","DOIUrl":"https://doi.org/10.1016/j.gore.2024.101448","url":null,"abstract":"<div><h3>Objectives</h3><p>The purpose of this study is to evaluate the association between lymphopenia and survival in women with locally advanced cervical cancer (LACC) treated with definitive chemoradiation (CRT).</p></div><div><h3>Methods</h3><p>We retrospectively reviewed patients with LACC treated at a single institution from 2004 to 2021. Patient and treatment characteristics were recorded along with baseline absolute lymphocyte counts (ALC). Overall survival (OS), progression free survival (PFS), and local control (LC) were calculated from start of treatment to date of last follow-up. Cox regression and competing risks regression model were performed to evaluate whether baseline ALC was associated with OS, PFS, or LC.</p></div><div><h3>Results</h3><p>246 patients met study inclusion criteria with stage IB – IV disease with a median follow up of 2.8 years (range 0.2–13.4 years). 5-year OS, PFS, and LC were 68.4 % (95 % CI 61.7–75.9), 57.2 % (95 % CI 50.4–64.8), and 79.0 % (95 % CI 73.0–84.4), respectively. Baseline lymphopenia (ALC &lt; 1000 cells/mm3) was present in 12.5 % of patients. OS was improved in the patients without lymphopenia, with a 5-year OS of 69.0 % (95 % CI 61.6–77.3) versus 63.0 % (95 % CI 47.6–83.3)in the lymphopenia group (<em>p</em> = 0.233), though this did not meet statistical significance. PFS also trended towards improvement in patients without baseline lymphopenia, with a 5-year PFS of 58.5 % (95 % CI 51.2–66.8) versus 48.5 % (95 % CI 32.8–71.7), <em>p</em> = 0.220. No significant difference was found for LC in the patients without lymphopenia, <em>p</em> = 0.745.</p></div><div><h3>Conclusions</h3><p>In this single institution experience of LACC treated with definitive CRT, we found that baseline lymphopenia trends toward inferior OS and PFS.</p></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"54 ","pages":"Article 101448"},"PeriodicalIF":1.2,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352578924001279/pdfft?md5=1b5668676d995733b37b14725fb0990d&pid=1-s2.0-S2352578924001279-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141479296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical Pap screening among women living with HIV in Puerto Rico and the United States – Medical Monitoring Project, 2018–2021","authors":"Marievelisse Soto-Salgado ,&nbsp;Lorena González-Sepúlveda ,&nbsp;Maritza Cruz-Cortés ,&nbsp;Michael I. Rivera-Morales ,&nbsp;Sharee Umpierre ,&nbsp;Jane R. Montealegre ,&nbsp;Ana P. Ortiz","doi":"10.1016/j.gore.2024.101443","DOIUrl":"https://doi.org/10.1016/j.gore.2024.101443","url":null,"abstract":"<div><p>Our objective was to determine the prevalence of cervical Pap screening among women living with HIV (WLWH) in Puerto Rico (P.R.) and other selected United States (U.S.) jurisdictions. Additionally, we sought to compare selected characteristics of WLWH who underwent cervical Pap screening between P.R. and the other U.S. jurisdictions. We analyzed data from the 2018–2021 cycles of CDC’s Medical Monitoring Project (MMP), a national surveillance system among adults with HIV residing in P.R. (n = 218) and 22 other MMP jurisdictions (n = 3,653). Weighted percentages and 95 % confidence intervals (CIs) for selected characteristics were estimated. Prevalence ratios with predicted marginal means were calculated. An estimated 91.6 % and 84.6 % of WLWH underwent cervical Pap screening in P.R. and the other 22 MMP jurisdictions, respectively (Prevalence Ratio = 1.08, 95% CI = 1.03–1.13). Among WLWH who underwent cervical Pap screening, those in P.R. were more likely to be 50+ years of age, have a household annual income below $20,000, engage in binge drinking, never smoke, and have Medicaid/other public insurance than those in the other 22 MMP jurisdictions (p &lt; 0.05). No differences were found between P.R. and the other 22 MMP jurisdictions in the percentage reporting higher than the median HIV-stigma score, experiencing HIV health care discrimination, and having ≥ 1 sexual partner in the past 12 months. Although cervical Pap screening rates among WLWH were higher in P.R. than in the other 22 MMP jurisdictions, both surpass the Healthy People 2030 target. Future research should assess adherence and compliance with updated cervical cancer screening guidelines.</p></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"54 ","pages":"Article 101443"},"PeriodicalIF":1.2,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S235257892400122X/pdfft?md5=6eefb02c47aa711b63b19e1c2d58c243&pid=1-s2.0-S235257892400122X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141479466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and feasibility of an exercise therapy intervention for older women with advanced epithelial ovarian cancer referred to neoadjuvant chemotherapy prior to possible interval debulking surgery","authors":"Eva Jespersen ,&nbsp;Cristina Daviu Cobián ,&nbsp;Trine L. Jørgensen ,&nbsp;Lisbeth R. Minet ,&nbsp;Tine H. Schnack ,&nbsp;Anders Vinther","doi":"10.1016/j.gore.2024.101441","DOIUrl":"https://doi.org/10.1016/j.gore.2024.101441","url":null,"abstract":"<div><h3>Objective</h3><p>This study describes the development and examines the feasibility of an exercise therapy program for women aged 70 years or older with advanced EOC, receiving neoadjuvant chemotherapy (NACT) before possible major surgery.</p></div><div><h3>Methods</h3><p>In this feasibility study, patients participated in a mainly home-based exercise therapy program, including progressive resistance training, physical activity, and support from the supervising physiotherapist. The program included both supervised virtual and face-to-face sessions and self-administered daily exercise. Clinician-reported, patient-reported and physical performance measures were collected before and after NACT. Retention, adherence, and compliance to the program was monitored, and patient acceptability was explored in semi-structured interviews.</p></div><div><h3>Results</h3><p>Fifteen patients, median age of 77 years (range 70–85) completed the exercise therapy program concurrently to receiving NACT lasting a median of 12 weeks. Patients were physically frail at baseline but improved at follow-up on measures of performance status, level of frailty, patient-reported physical fitness, lower body strength, aerobic functional capacity, basic mobility, balance, and number of steps per day. High levels of participation were found to both supervised and self-administered exercise. Patient interviews highlighted the homebased setting, the individualised tailoring of exercises and the support from the physiotherapist as reasons to complete the exercise therapy program as prescribed.</p></div><div><h3>Conclusions</h3><p>The exercise therapy program was found to be feasible and acceptable in women aged 70 years or older with advanced EOC, receiving NACT before possible major surgery. The observed improvements and the positive experiences perceived by the patients support future application in research and clinical practice.</p></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"54 ","pages":"Article 101441"},"PeriodicalIF":1.2,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352578924001206/pdfft?md5=e73b2b87b3a47f235f92598c157d8ff2&pid=1-s2.0-S2352578924001206-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141479295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prescribers and patients drive maintenance therapy patterns in a community oncology practice: National guidelines versus the real-world experience","authors":"Dana M. Chase ,&nbsp;Laura Iadeluca ,&nbsp;Jonathan Lim ,&nbsp;Wan-Yu Tseng ,&nbsp;Purva Bulsara ,&nbsp;Gregory Patton","doi":"10.1016/j.gore.2024.101440","DOIUrl":"https://doi.org/10.1016/j.gore.2024.101440","url":null,"abstract":"<div><h3>Objective</h3><p>Previous studies have shown that first-line (1L) maintenance therapy (MT) with poly(ADP-ribose) polymerase inhibitors and/or bevacizumab improves outcomes among patients with advanced ovarian cancer (OC); however, these treatments are underutilized. This study aimed to provide a real-world understanding of MTs among patients with advanced OC who received 1L platinum-based chemotherapy (PBC).</p></div><div><h3>Methods</h3><p>A retrospective chart review using iKnowMed electronic health records to identify patients aged ≥18 years with advanced OC who initiated 1L PBC between January 1, 2018–December 31, 2020. Following 1L PBC, patients could have received MT or active surveillance (AS). Kaplan–Meier methods were used to estimate time to treatment discontinuation (TTD), real-world progression-free survival (rwPFS), and overall survival (OS).</p></div><div><h3>Results</h3><p>Of the 600 chart-reviewed patients included, 239 (39.8 %) received MT and 315 (52.5 %) received AS. Patients who were &lt;65 years of age, or those with higher-stage disease or those who had received neoadjuvant treatment, were more likely to initiate MT than AS. Genetic testing rates were low across both cohorts. Median (95 % confidence interval [CI]) TTD for the MT cohort was 13.6 months (11.0, 21.2). Median (95 % CI) rwPFS was 26.9 months (21.3, not reached) and 11.3 months (9.5, 13.0) for the 1L MT and AS cohorts, respectively (p &lt; 0.0001). OS at 36 months was 82.4 % in the 1L MT cohort and 58.0 % in the 1L AS cohort.</p></div><div><h3>Conclusions</h3><p>This study reinforces clinical trial findings that 1L MT improves outcomes in patients with advanced OC; however, genetic testing rates and 1L MT remained low.</p></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"54 ","pages":"Article 101440"},"PeriodicalIF":1.2,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S235257892400119X/pdfft?md5=741da3c18305d365a67f1353470d4922&pid=1-s2.0-S235257892400119X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141479294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case report of two long term ovarian cancer survivors with brain metastases following multimodal treatment including chemotherapy, radiotherapy and maintenance olaparib: An institutional case series and literature review","authors":"Yukari Tsuchino,&nbsp;Tatsuyuki Chiyoda,&nbsp;Mitsuyo Jisaka,&nbsp;Tomomi Sakamaki,&nbsp;Momo Hirata,&nbsp;Mio Takahashi,&nbsp;Takuma Yoshimura,&nbsp;Kensuke Sakai,&nbsp;Michiko Wada,&nbsp;Wataru Yamagami","doi":"10.1016/j.gore.2024.101444","DOIUrl":"https://doi.org/10.1016/j.gore.2024.101444","url":null,"abstract":"<div><p>Brain metastasis from ovarian cancer is a very rare condition with a poor prognosis. However, due to its rarity, there is no established treatment strategy. We present a case series of brain metastasis with ovarian cancer, focusing on two long-term survivors treated with multimodal therapy. Among the nine cases, the median survival time after brain metastases was six months (range: 0–58 months). Eight patients had high-grade serous carcinoma (HGSC). Three of the four patients who underwent genetic testing tested positive for germline <em>BRCA2</em> (g<em>BRCA2</em>) mutation. Two patients survived longer than 4 years after the diagnosis of brain metastases. Both of these patients received chemotherapy, radiation therapy, and olaparib, a molecularly targeted drug, as maintenance therapy. This case series suggests that patients with g<em>BRCA2</em> mutation-positive HGSC may be at a high risk of developing brain metastases. A multidisciplinary approach, including PARP inhibitors, may improve the prognosis of patients with brain metastases from ovarian cancer.</p></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"54 ","pages":"Article 101444"},"PeriodicalIF":1.2,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352578924001231/pdfft?md5=5e480a0ec11da6d831553fbdcb7d0c2a&pid=1-s2.0-S2352578924001231-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141481515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An uncommon case of POLE mutated uterine carcinosarcoma − complemented by a review of literature","authors":"C. Ebner ,&nbsp;A. Frosch ,&nbsp;K. Leitner ,&nbsp;R. Soucek ,&nbsp;C. Marth ,&nbsp;AG. Zeimet","doi":"10.1016/j.gore.2024.101442","DOIUrl":"https://doi.org/10.1016/j.gore.2024.101442","url":null,"abstract":"<div><p>Carcinosarcomas are high-grade endometrial cancers which enclose mesenchymal and epithelial differentiated components. The vast majority of these cancers belong to the p53 abnormal molecular subgroup and usually come with an unfavorable prognosis. POLE mutant carcinosarcomas are a rarity and only make up about 5% of this histologic subtype. Recent literature even suggests that this number is still an overestimation and the result of misclassification of undifferentiated or dedifferentiated endometrial cancers.</p><p>Here we present a case of a 56-years old patient diagnosed with carcinosarcoma of the uterus. Hysterectomy, bilateral salpingo-oophorectomy with pelvic lymph node staging was performed and complete molecular workup of the tumor revealed an abnormal p53 expression as well as a pathologic POLE mutation. NGS was performed separately on the epithelial and mesenchymal component of this high-grade cancer and both components shared two identical <em>POLE</em> mutations, a known pathologic mutation, and a variant of unknown significance (VUS). This finding hints to a clonal origin of both histologic components of this tumor and supports conversion theory as mechanism of carcinosarcoma emergence. The cancer was correctly staged as FIGO 2023 Stage IAm_POLEmut and according to ESGO-ESTRO-ESP guidelines adjuvant chemotherapy no longer considered and our patient entered follow-up after a detailed discussion.</p></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"54 ","pages":"Article 101442"},"PeriodicalIF":1.2,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352578924001218/pdfft?md5=2a4d4720fe4a06d92d8b3f8d64e44e13&pid=1-s2.0-S2352578924001218-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141479464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}