IntroductionPeriodontitis affects a significant portion of the global population and is associated with systemic health issues. Salivary biomarkers such as salivary matrix metalloproteinase-8 (MMP-8) and its activated form (aMMP-8) have been studied for their roles in tissue degradation and inflammation in periodontitis. This meta-analysis investigates the association between salivary MMP-8 and aMMP-8 levels and periodontitis.MethodsA systematic literature search was conducted utilizing PubMed, Embase, Web of Science, and Cochrane Library databases up to October 2023, yielding 35 studies that quantified MMP-8 or aMMP-8 in saliva from patients with periodontitis and healthy controls. Data were extracted, and standardized mean differences (SMD) with 95% confidence intervals (CI) were calculated. Heterogeneity was assessed, and subgroup analyses were performed based on saliva collection techniques. Meta-regression analysis evaluated the impact of publication year on heterogeneity.ResultsThe meta-analysis included 35 studies. Pooled results indicated significantly higher levels of MMP-8 and aMMP-8 in periodontitis cases compared to healthy controls (SMD: 2.71, 95% CI: 1.04–4.38, p = 0.002) with substantial heterogeneity (I2 = 94.5%). No significant difference was found between MMP-8 and aMMP-8 (p = 0.445). Subgroup analyses by saliva collection technique did not reduce heterogeneity significantly. Meta-regression showed that publication year did not impact heterogeneity. Small-study effects and publication bias were present, suggesting caution in interpreting the results.DiscussionThe findings support the potential of MMP-8 and aMMP-8 as biomarkers for periodontitis, although substantial heterogeneity and methodological differences among studies pose challenges. Standardized protocols and larger sample sizes are necessary to enhance the reliability of these biomarkers in clinical practice. Despite limitations, salivary diagnostics hold promise for non-invasive, early detection and monitoring of periodontitis.ConclusionSalivary MMP-8 and aMMP-8 levels are significantly associated with periodontitis, highlighting their potential as diagnostic biomarkers. However, methodological improvements and standardization are essential for their clinical application. Collaborative efforts and advancements in salivary diagnostics are crucial for improving periodontitis management and patient outcomes.

BACKGROUND AND AIMS:Blood-based biomarkers have been proposed as an alternative to liver biopsy for noninvasive liver disease assessment in chronic liver disease. Our aims for this systematic review were to evaluate the diagnostic utility of selected blood-based tests either alone, or in combination, for identifying significant fibrosis (F2-4), advanced fibrosis (F3-4), and cirrhosis (F4), as compared to biopsy in chronic liver disease. APPROACH AND RESULTS:We included a comprehensive search of databases including Ovid MEDLINE(R), EMBASE, Cochrane Database, and Scopus through to April 2022. Two independent reviewers selected 286 studies with 103,162 patients. The most frequently identified studies included the simple aspartate aminotransferase-to-platelet ratio index and fibrosis (FIB)-4 markers (with low-to-moderate risk of bias) in HBV and HCV, HIV-HCV/HBV coinfection, and NAFLD. Positive (LR+) and negative (LR-) likelihood ratios across direct and indirect biomarker tests for HCV and HBV for F2-4, F3-4, or F4 were 1.66-6.25 and 0.23-0.80, 1.89-5.24 and 0.12-0.64, and 1.32-7.15 and 0.15-0.86, respectively; LR+ and LR- for NAFLD F2-4, F3-4, and F4 were 2.65-3.37 and 0.37-0.39, 2.25-6.76 and 0.07-0.87, and 3.90 and 0.15, respectively. Overall, the proportional odds ratio indicated FIB-4 <1.45 was better than aspartate aminotransferase-to-platelet ratio index <0.5 for F2-4. FIB-4 >3.25 was also better than aspartate aminotransferase-to-platelet ratio index >1.5 for F3-4 and F4. There was limited data for combined tests. CONCLUSIONS:Blood-based biomarkers are associated with small-to-moderate change in pretest probability for diagnosing F2-4, F3-4, and F4 in viral hepatitis, HIV-HCV coinfection, and NAFLD, with limited comparative or combination studies for other chronic liver diseases.

Activity of the apolipoprotein B mRNA editing enzyme, catalytic-polypeptide-like (APOBEC) enzymes has been linked to specific mutational processes in human cancer genomes. A germline APOBEC3A/B deletion polymorphism is associated with APOBEC-dependent mutational signatures, and the deletion allele has been reported to confer an elevated risk of some cancers in Asian populations, while the results in European populations, so far, have been conflicting. We genotyped the APOBEC3A/B deletion polymorphism in a large population-based sample consisting of 11 106 Caucasian (Norwegian) individuals, including 7279 incident cancer cases (1769 breast, 1360 lung, 1585 colon, and 2565 prostate cancer) and a control group of 3827 matched individuals without cancer (1918 females and 1909 males) from the same population. Overall, the APOBEC3A/B deletion polymorphism was not associated with risk of any of the four cancer types. However, in subgroup analyses stratified by age, we found that the deletion allele was associated with increased risk for lung cancer among individuals <50 years of age (OR 2.17, CI 1.19-3.97), and that the association was gradually reduced with increasing age (P = 0.01). A similar but weaker pattern was observed for prostate cancer. In support of these findings, the APOBEC3A/B deletion was associated with young age at diagnosis among the cancer cases for both cancer forms (lung cancer: P = 0.02; dominant model and prostate cancer: P = 0.03; recessive model). No such associations were observed for breast or colon cancer.

Objectives: APOBEC3 subfamily proteins protect human cells from viral infection by introducing mutations to single-stranded DNA and edit genomic DNA by creating double-stranded DNA breaks. APOBEC3 activity is associated with two single-base substitution signatures (SBS), 2 and 13, out of 44 SBS cancer mutation signatures. A germline 30Kb deletion affecting APOBEC3A and APOBEC3B eliminates the coding region of the APOBEC3B gene and creates the APOBEC3A/B fusion transcript. The deletion has been associated with the risk of different cancer types. This study aimed to assess the risk association between the APOBEC3A/B deletion variant and ovarian cancer. Methods: To assess the APOBEC3A/B polymorphism status, DNA extracted from the blood samples of ovarian cancer patients (n=1,398), and healthy female controls (n=1,918) were genotyped using quantitative PCR high-resolution melting (qPCR-HRM) curves. Only participants without detected BRCA1/2 mutations were included for the present analysis. Results were technically validated by genotyping of 21% of the sample set for SNP (rs12628403), an SNP found to be in strong linkage disequilibrium with the deletion allele. Validation of findings from the present study was performed using mining the SNP rs12628403 from Genome-Wide Association Study of Ovarian Cancer Association Consortium (OCAC) derived from >18,000 cases and >26,000 controls. Results: Both ovarian cancer and control cohorts were in Hardy-Weinberg equilibrium for APOBEC3A/B deletion allele distribution (p=0.386 and p>0.4, with a MAF of 0.072 and 0.094, respectively). The deletion allele was associated with reduced risk for ovarian cancer, applying a dominant, allele or recessive models (OR: 0.75, 95% CI: 0.61-0.91, p=0.003; OR: 0.74, 95% CI: 0.62-0.89, p=0.001, and OR: 0.36, 95% CI: 0.10-0.99, p=0.034, respectively). Stratifying patients by age groups, a significantly reduced risk was found among individuals aged 50-59 and 60-69 years. The same association was seen applying dominant and allele models in subgroup analysis by histology; deletion was associated with a reduced risk in serous and non-serous ovarian cancers. The validation analysis with OCAC revealed a trend towards reduced cancer risk, although not reaching statistical significance. Conclusions: APOBEC3A/B deletion variant shows a risk-reducing effect for ovarian cancer in the study population. This pattern maintains in serous and non-serous ovarian cancer subgroups. Objectives: APOBEC3 subfamily proteins protect human cells from viral infection by introducing mutations to single-stranded DNA and edit genomic DNA by creating double-stranded DNA breaks. APOBEC3 activity is associated with two single-base substitution signatures (SBS), 2 and 13, out of 44 SBS cancer mutation signatures. A germline 30Kb deletion affecting APOBEC3A and APOBEC3B eliminates the coding region of the APOBEC3B gene and creates the APOBEC3A/B fusion transcript. The deletion has been associated with the risk of different cancer types. This study aimed to assess the risk association between the APOBEC3A/B deletion variant and ovarian cancer. Methods: To assess the APOBEC3A/B polymorphism status, DNA extracted from the blood samples of ovarian cancer patients (n=1,398), and healthy female controls (n=1,918) were genotyped using quantitative PCR high-resolution melting (qPCR-HRM) curves. Only participants without detected BRCA1/2 mutations were included for the present analysis. Results were technically validated by genotyping of 21% of the sample set for SNP (rs12628403), an SNP found to be in strong linkage disequilibrium with the deletion allele. Validation of findings from the present study was performed using mining the SNP rs12628403 from Genome-Wide Association Study of Ovarian Cancer Association Consortium (OCAC) derived from >18,000 cases and >26,000 controls. Results: Both ovarian cancer and control cohorts were in Hardy-Weinberg equilibrium for APOBEC3A/B deletion allele distribution (p=0.386 and p>0.4, with a MAF of 0.072 and 0.094, respectively). The deletion allele was associated with reduced risk for ovarian cancer, applying a dominant, allele or recessive models (OR: 0.75, 95% CI: 0.61-0.91, p=0.003; OR: 0.74, 95% CI: 0.62-0.89, p=0.001, and OR: 0.36, 95% CI: 0.10-0.99, p=0.034, respectively). Stratifying patients by age groups, a significantly reduced risk was found among individuals aged 50-59 and 60-69 years. The same association was seen applying dominant and allele models in subgroup analysis by histology; deletion was associated with a reduced risk in serous and non-serous ovarian cancers. The validation analysis with OCAC revealed a trend towards reduced cancer risk, although not reaching statistical significance. Conclusions: APOBEC3A/B deletion variant shows a risk-reducing effect for ovarian cancer in the study population. This pattern maintains in serous and non-serous ovarian cancer subgroups.

A germline 29.5-kb deletion variant removes the 3’ end of the APOBEC3A gene and a large part of APOBEC3B , creating a hybrid gene that has been linked to increased APOBEC3 activity and DNA damage in human cancers. We genotyped the APOBEC3A/B deletion in hospital-based samples of 1398 Norwegian epithelial ovarian cancer patients without detected BRCA1/2 germline mutations and compared to 1,918 healthy female controls, to assess the potential cancer risk associated with the deletion. We observed an association between APOBEC3A/B status and reduced risk for ovarian cancer (OR = 0.75; CI = 0.61–0.91; p = 0.003) applying the dominant model. Similar results were found in other models. The association was observed both in non-serous and serous cases (dominant model: OR = 0.69; CI = 0.50–0.95; p = 0.018 and OR = 0.77; CI = 0.62–0.96; p = 0.019, respectively) as well as within high-grade serous cases (dominant model: OR = 0.79; CI = 0.59–1.05). For validation purposes, we mined an available large multinational GWAS-based data set of > 18,000 cases and > 26,000 controls for SNP rs12628403, known to be in linkage disequilibrium with the APOBEC3A/B deletion. We found a non-significant trend for SNP rs12628403 being linked to reduced risk of ovarian cancer in general and similar trends for all subtypes. For clear cell cancers, the risk reduction reached significance (OR = 0.85; CI = 0.69–1.00).

Abstract Objectives: Cognitive computing has the potential to improve efficiency and accuracy of clinical trial enrollment using artificial intelligence. The cognitive computing clinical trial matching (CTM) system used for this study utilizes natural language processing to derive patient and tumor attributes from structured and unstructured electronic medical record (EMR) data. The attributes are matched to complex eligibility criteria in trial protocols. This CTM system has been implemented in our gynecologic oncology practice, for which there is lower representation of ethnic minorities, elderly, and uninsured in National Cancer Institute-sponsored trials. Methods: A clinical research coordinator (CRC) used the CTM system to screen patients for potential clinical trials one day prior to their clinic visit. Trial matches were shared with gynecologic oncology clinicians to raise awareness for study opportunities and assist in treatment decisions. Clinicians were surveyed regarding their experience with the CTM system prepared matches. The identical patients were evaluated by a clinician using the traditional manual screening method. Results: Seventeen patients with new diagnosis, recent resection, or restaging scans were screened for 41 potential gynecologic, phase I, and supportive care clinical trials. Trial screening by the CRC using the CTM system resulted in a total of 119 matched trials (mean: 7 trials/patient) compared to the clinician-generated list of 271 matched trials (mean: 16 trials/patient). The CRC using the CTM system spent an average of 18 minutes/patient (range: 7 to 40 minutes) compared to the clinician average of 22 minutes/patient (range: 7 to 37 minutes). A survey of 8 gynecologic oncology clinicians reported they were willing to spend an average of 8 minutes/patient (range: 1 to 15 minutes) to screen patients for trial eligibility. On independent review, discrepancies occurred when the clinician identified trials that the CRC excluded due to inclusion/exclusion criteria or were unknowingly closed to accrual. In addition, the CRC identified trials that were inadvertently missing from the clinician’s list of active protocols. Consistent with these observations, 100% of surveyed clinicians (8 of 8) agreed that “The CTM system has helped to include and exclude trials prior to discussion with patients.” Conclusions: Use of the CTM system by a CRC was superior to a clinician alone for the accuracy and efficiency of screening clinical trial eligibility. This process improved the identification of trials that a clinician might otherwise miss and the exclusion of trials that were not available or appropriate for patients. The CTM system can reduce the burden of clinicians and research staff to screen patients. Additional research is needed to determine if the process can improve clinical trial enrollment in gynecologic cancers. Citation Format: Thanh P. Ho, Jane M. Helgeson, Angela L. Andring, Jennifer C. Reed, Venessa L. Boyle, Nigar Sofiyeva, Konstantinos Leventakos, Tufia C. Haddad, Andrea E. Wahner Hendrickson, Saravut (John) Weroha. Implementation of cognitive computing to match clinical trials in gynecologic cancers: A single-institution experience [abstract]. In: Proceedings of the AACR Special Conference on Advancing Precision Medicine Drug Development: Incorporation of Real-World Data and Other Novel Strategies; Jan 9-12, 2020; San Diego, CA. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(12_Suppl_1):Abstract nr 01.

Objective:The aim of this study was to evaluate the hysteroscopy results in infertile patients and to compare the clinical pregnancy, live birth and abortion rates between patients with uterine cavity abnormalities treated with operative hysteroscopy and patients with normal uterine cavity.Methods: Three hundred and nineteen patients who underwent hysteroscopy for infertility between January 2010 and December 2015 were included in the study.The patients were divided into two main groups: diagnostic and operative.The patients who had normal uterine cavity in exploration and who did not require surgical intervention were referred as diagnostic hysteroscopy group.Patients who underwent surgical intervention during the procedure were named as operative hysteroscopy group.The operative hysteroscopy group was divided into groups as endometrial polyp, submucous myoma, septum, adhesions and T-shaped uterus.Demographic data, laboratory parameters and pregnancy outcomes after hysteroscopy were recorded.Clinical pregnancy, live birth and abortion rates were compared between the groups. Results:The demographic and laboratory characteristics of the diagnostic (n=74) and operative hysteroscopy (n=245) groups were similar.After operative hysteroscopy, 53.9% of the patients had clinical pregnancy and 41.3% of them had live birth.In the diagnostic hysteroscopy group, the clinical pregnancy rate was 55.2% and the live birth rate was 41.7%.There was no significant difference between the two groups in terms of clinical pregnancy and live birth rates.In addition, there was no difference between the two groups in terms of pregnancy acquisition methods and mean duration of conception.In the operative hysteroscopy subgroups, the highest rates of clinical pregnancy and live birth were in patients undergoing endometrial polyp and septum resection, and abortion rates were highest in T-shaped uterus and septum resection groups. Conclusion:We concluded that treatment of uterine cavity pathologies with operative hysteroscopy in infertile patients provided similar clinical pregnancy and live birth rates to patients who have normal uterine cavity.

Objective: To determine the predictive role of serum levels of YKL-40 and cancer antigen (CA) 72-4 in the diagnosis of endometrial cancer (EC). Materials and Methods: Forty-one patients with EC and 21 women with uterine polyps were evaluated between January and December 2015 in a prospective study. Results: Age, body mass index, preoperative serum YKL-40 and CA 72-4 levels were significantly higher in the malignant group compared with the control group. Serum YKL-40 levels were significantly higher in patients with superficial myometrial invasion and no lymph node involvement (p=0.042; p=0.004). No relationship between clinicopathologic factors and serum CA 72-4 levels was found. Conclusion: Serum CA 72-4 and YKL-40 levels are increased in women with EC compared with uterine polyps. Preoperative serum YKL-40 levels may be associated with favorable prognostic factors. The determination of YKL-40 before surgery may be helpful in the evaluation of the regional lymph nodes.

OBJECTIVE:Premature ovarian insufficiency is a lack of ovarian functions in patients younger than 40 years old. Genetic causes leading to accelerated follicle depletion may result in premature ovarian insufficiency. We aimed to determine genetic etiology of nonsyndromic premature ovarian insufficiency cases from Turkey. MATERIALS AND METHODS:We analyzed 86 nonsyndromic premature ovarian insufficiency cases and 26 matched control female participants. Participants have been investigated in cytogenetic analysis followed by FMR1 repeat size expansions and search of variants for nine premature ovarian insufficiency-associated genes. RESULTS:Four cases had a structural cytogenetic abnormality. Two cases revealed with premutation size FMR1 triplet repeat expansion. Four cases carried variants in which two were very rare in FSHR and PDPK1, and three were novel in NR5A1, PDPK1, and POF1B genes. Six novel variants have been identified in NOBOX, NR5A1, POF1B, and PDPK1 in control population assigned to be benign alterations. CONCLUSION:Mosaicism of sex chromosomes was responsible in 4.6% and FMR1 premutation in 2.4% of premature ovarian insufficiency cases, while the association of premature ovarian insufficiency-related genes was found very subtle. Novel variants in NR5A1, PDPK1, and POF1B may necessitate further evaluation for their association with premature ovarian insufficiency via functional studies.

Objective: To compare the serum AMH levels between women with and without insulin resistance (IR) in polycystic ovary syndrome (PCOS). Study design: 293 women with PCOS according to the Rotterdam criteria were enrolled into our study. Insulin resistance was diagnosed according to the Homeostatic model assessment insulin resistant (HOMA-IR) formula and the cut-off point was set to more than 2.5. Women were grouped according to the presence of insulin resistance (IR) (HOMA-IR >= 2.5). Serum AMH and other hormones were compared between the IR(+) and IR(-) groups. Additionally, AMH percentiles were (<25,25-75,>75) constructed: HOMA-IR and BMI values in women with/without IR were compared in different percentiles. Further, HOMA-IR, BMI and AMH values were measured across different PCOS phenotypes. Results The prevalence of IR was 45%. The prevalence of IR was 57% in women with BMI >= 25. Serum AMH levels were not significantly different among women with and without IR. Also, HOMA-IR values were not significant among different AMH percentiles. However, in each AMH percentile BMI were found to be higher in women with IR than in women without IR. The median HOMA-IR values were the highest in women with BMI >= 25 in both IR (+) and IR (-) groups. No significant difference was found among PCOS phenotypes in terms of HOMA-IR and BMI. Positive correlations were found between BMI, free testosterone and HOMA-IR. However, no correlation was found between AMH and HOMA-IR. Conclusion: The serum AMH levels between women with IR and without IR in PCOS were not significantly different. Also, we did not reveal a correlation between serum AMH levels and IR in women with PCOS. IR was not correlated with different PCOS phenotypes either. We found a positive correlation between BMI and IR. IR should be investigated in women with PCOS having a BMI >= 25, independent of their phenotype or AMH levels. (C) 2018 Elsevier B.V. All rights reserved.

OBJECTIVE:A high dose of prolonged gonadotropins can yield higher numbers of oocytes and embryos. The high dose or prolonged regimens can be associated with ovarian hyperstimulation syndrome (OHSS), multiple gestations, emotional stress, economical burden and treatment dropout. In mild stimulation lower doses and shorter duration times of gonadotropin are used in contrast to the conventional long stimulation protocol in IVF. It has been proposed that supraphysiologic levels of hormones may adversely affect endometrium and oocyte/embryo. Also it has been proposed that oxidative stress (OS) may alter ovarian hormone dynamics and could be further affected by additional exogenous hormonal stimulation. Therefore our aim was to compare follicular fluid total antioxidant capacity (TAC) in antagonist mild and long agonist stimulations. MATERIALS AND METHODS:Forty patients received antagonist mild stimulation, starting on the 5th day of their cycle and forty patients received long agonist treatment. Seventy-five patients undergoing their first IVF cycle were included in the final analysis. Follicular fluid (FF) samples were analyzed for estradiol (E2), antimullerian hormone (AMH) and TAC. RESULTS:FF-Total antioxidant capacity (TAC) levels were higher in the long agonist group as opposed to the antagonist group [1.07 ± 0.04 mmol Trolox equivalent/L vs 1 ± 0.13 mmol Trolox equivalent/L] (Fig. 1). Pregnancy rates were not significantly different between the two treatments. The FF-TAC levels were not different among infertility etiologies (Fig. 3). FF-TAC levels did not have a direct correlation with pregnancy but a positive correlation with the total gonadotropin dose was observed. CONCLUSION:Patients with good ovarian reserves and under the age of 35 effectively responded to mild stimulation treatment. Using lower amounts of gonadotropin, yielded less FF-TAC levels in patients who underwent antagonist mild protocol. In patients under the age of 35, antagonist mild stimulation is a patient friendly and effective procedure when undergoing their first IVF cycle.

BACKGROUND:Postpartum Depression affects a considerable number of women worldwide. This condition inflicts severe consequences to mother and child health. Thus far, available treatments have low response and high relapse rates. We designed this trial to evaluate a safe and more efficacious innovative therapy.AIMS:To report a feasible and ethical study design to assess the safety and efficacy of a high frequency repetitive Transcranial Magnetic Stimulation 10 Hz (rTMS) compared to sham rTMS in women with moderate to severe Post-Partum Depression using standard treatment (sertraline).To conduct an ancillary, exploratory, randomized, active controlled, double blind study with a hypothesis to assess the safety and efficacy of 10 Hz rTMS compared to sertraline.METHODS:A multicenter, parallel arm, randomized, placebo-controlled, double-blind design to assess safety and efficacy of 10 Hz rTMS compared to sham.An ancillary study will be conducted with parallel arm, randomized, active controlled and double dummy design to assess safety and efficacy of 10 Hz rTMS compared to sertraline.

The aim of the present study was to evaluate the usefulness of nestin as a discriminative marker between benign and malignant ovarian tumors.

The perimenopausal period starts with climacteric symptoms and lasts until the end of the first postmenopausal year. Clinical, terminological and laboratory variations make this period difficult to diagnose. Most of the patients undergo unnecessary and early hormone therapy when only laboratory findings are taken into consideration. Evaluation of the perimenopausal patients mainly with gestagen response was aimed in our study regardless of the laboratory findings.

Objective: This study aimed to investigate the role of telomerase activity in the development of endometriosis-related infertility by evaluation of the serum telomerase in eutopic and ectopic endometrial tissue.Study design: Eutopic endometrium, cystic wall/ovarian cortex, and venous blood were assessed in forty-seven patients. The following groups of patients were identified: females with endometriosis requiring surgical intervention and healthy control females. Patients with histopathologically confirmed endometriosis were further subdivided in the infertile (n = 14) and fertile (n = 17) groups. Patients who underwent hysterectomy and oophorectomy for benign gynecological conditions were enrolled in the healthy control group (n = 16). Telomerase activity was evaluated with three-group, endometriosis-based and fertility-based designs. Analyses were performed regardless the menstrual cycle phase (Phase G), in proliferative (Phase P) (n = 22) and secretory phases (Phase S) (n = 25).Telomeric Repeat Amplification Protocol PCR was applied for telomerase activity assessment.All statistical analyses were performed with STATA 14.2, GraphPad Prisma 7.01.Results: In analyses of the eutopic endometrium, with three-group design, a significant difference was not found in Phase G and P (p = 0.58 and p = 0.33, respectively). However, a statistical difference was shown in Phase S (p = 0.008). A significant difference was not established in Phase G, P and S of endometriosisbased design (p = 0.35, p = 1.0, p = 0.13, respectively). No difference was detected in Phase G and P of fertility-based design (p = 0.66 and p = 0.14, respectively), whereas in secretory phase difference was approved (p = 0,049).Telomerase activity was not established in ectopic endometrium and in serum assessment.Conclusions: Telomerase activity is useless as a biomarker in peripheric blood analysis. The absence of activity in cystic wall approves the high differentiation of endometriosis tissue, what is the possible reason of low malignancy risk. The high rate of telomerase activity in the eutopic endometrium of the infertile group may be considered as a cause of endometriosis-related infertility. (C) 2017 Elsevier B.V. All rights reserved.

"An unusual case of Meckel–Gruber syndrome (MKS) associated with visceroatrial heterotaxy and facial anomalies." Journal of Obstetrics and Gynaecology, 36(4), pp. 524–525

The aim of this study was to evaluate the risk factors for recurrence of borderline ovarian tumours. This study investigated 127 women who were finally diagnosed with borderline epithelial ovarian tumours. Most of them were diagnosed in stage I (83.4%). With a median follow-up of 81.8 months (range: 14-205), the median time to recurrence was 22.4 months (range: 3-74). Five-year recurrence-free survival (RFS) and overall survival (OS) rates were 85.8% and 97.6%, respectively. In multivariate analysis, invasive implants and fertility-sparing surgery were found to be independent prognostic factors for 5-year RFS. Overall, 20 patients (15.7%) experienced relapse within the observation period. Although there is no consensus about high-risk category of borderline ovarian tumours, invasive implants and conservative surgery were closely related to the recurrence. Patients presenting these risk factors should undergo closer follow-up.

OBJECTIVE:The purpose of this study was to investigate the outcomes and prognostic factors of metastasectomy in patients with metastatic ovarian tumors from extragenital primary sites.MATERIALS AND METHODS:All patients with pathologically confirmed metastatic ovarian tumors between January 1997 and June 2015 were included in this study. A total of 131 patients were identified. The data were obtained from the patients' medical records. Clinicopathological features were evaluated by both univariate and multivariate analyses.RESULTS:The primary sites were colorectal region (53.4%), stomach (26%), and breast (13%). Preoperative serum CA 125 and CA 19-9 levels were elevated in 29.4% and 39.8% of the patients, respectively. Cytoreductive surgery was performed in 41.2% of the patients. Seventy-three (55.7%) patients had no residual disease after surgery. Sixty-six (49.6%) patients had combined metastases at the time of the surgery to sites including the liver, pancreas, lung, bone, lymph nodes, bladder, or the intestine. With a median follow-up of 33 months, the median survival time was 22 months. The estimated 5-year survival probability is 0.26. On univariate analysis, primary cancer site, combined metastasis outside the ovaries, residual disease, preoperative serum CA 125 and CA 19-9 levels, and histologic type were significant parameters for overall survival. Furthermore, residual disease, preoperative serum CA 19-9 level, and primary cancer site were found to be independent prognostic factors on multivariate analysis.CONCLUSIONS:The most common primary sites for ovarian metastasis are gastrointestinal tract. Metastasectomy may have beneficial effects on survival, especially if the residual disease is less than 5 mm. Prospective studies warranted to evaluate the value of metastasectomy in patients with ovarian metastasis.