Abstract Background Lipid reprogramming in carcinoma is reported to have a role in carcinogenesis, prognosis, and therapy response. Autonomous or nonautonomous resources may contribute to lipid reprogramming. Nonautonomous lipid resources contributed by lipoproteins and their receptors have been reported in epithelial ovarian cancer (EOC), but the impact of autonomous lipid metabolites is unknown. This report reveals that a unique lipid class, ether-linked phosphatidylethanolamine (PE O–), enhanced chemoinsensitivity and progression in EOC, and potentially in other carcinomas. Method Unbiased bioinformatics analyses of data from the carcinoma databases CCLEC (Cancer Cell Line Encyclopedia Consortium) and GDSCC (Genomics of Drug Sensitivity in Cancer Consortium) and an in-house lipidomic database of human carcinoma lines were performed to identify relationships with chemoagent cytotoxicity. EOC cells (SKOV3 and OVCAR3) were treated with PE O– and/or alkylglycerone phosphate synthase (AGPS), an ether lipid-producing enzyme, inhibitor to observe cell growth, mobility, and chemosensitivity. The clinical impact of PE O– metabolic gene expression was determined by analysis of The Cancer Genome Atlas transcriptome to find an association with various clinical features of EOC. Results Glycerophospholipids were the consensus lipid class in lipid metabolism gene and chemosensitivity association analyses of the CCLEC/GDSCC database. In the lipidome database analyses of in-house human carcinoma cell lines, the glycerophospholipid, PE O–, was identified as the dominant lipid associated with cisplatin/paclitaxel sensitivity. In various hypothesis-driven cisplatin/paclitaxel sensitivity analyses of cell line lipidomes, PE O– remained the dominant lipid class. Tests of the effects of PE O– on cancer phenotypes showed that it enhanced cell growth and migratory activities and promoted insensitivity to cisplatin/paclitaxel. However, the AGPS inhibitor sensitized EOC cells to the chemocytotoxic effects of cisplatin/paclitaxel, whereas treatment with PE O– reversed this effect. Analysis of a TCGA-EOC transcriptome database showed that PE O– gene expression was positively correlated with progression in general or in those treated with platin- or taxel-based chemotherapies. Conclusion The expression of PE O– synthesis genes aggravated negative responses of EOC patients to therapy. PE O– facilitated human carcinoma cell line growth, mobility, and chemoinsensitivity.

This large-scale study aimed to determine the long-term influences of potential prognostic predictors and progression-free interval (PFI) criteria for grading platinum-sensitivity in ovarian clear cell carcinoma (OCCC). We retrospectively reviewed the medical records of OCCC patients presenting at nine tertiary centres (1995–2015), and evaluated patient characteristics, therapeutic factors, clinical outcomes, and hazard ratios for disease progression and death. We enrolled 536 patients (median follow-up, 36.6 months) and developed newly defined distributions of PFIs (seven and 14 months) for grading platinum sensitivity. In the multivariate model, preoperative CA125 levels and chemo-response independently predicted early-stage progression-free survival (PFS) risk. Post-progression cytoreduction correlated with reduced mortality risk. No unfavourable outcomes were observed with respect to coexisting endometriosis, fertility-sparing strategies, or platinum-based regimens. A PFI of <7 months, the strongest predictor of both post-progression mortality and second relapse risks, correlated with chemo-resistance, advanced tumour stage, and shortened post-progression survival. Chemotherapy regimens commonly used in front-line or relapse settings were limited in improving prognoses, especially in the advanced-stage cohort. Clinical trials of novel targeted agents and/or innovative biomarkers for chemoresistance should be comprehensively investigated and offered early to advanced-stage patients or those with OCCC progression occurring within seven months after receiving chemotherapy.

Ovarian cancer (OVCA) arises from three cellular origins, namely surface epithelial cells, germ cells, and stromal cells. More than 85% of OVCAs are EOCs (epithelial ovarian carcinomas), which are the most lethal gynecological malignancies. Cancer stem/progenitor cells (CSPCs) are considered to be cancer promoters due to their capacity for unlimited self-renewal and drug resistance. Androgen receptor (AR) belongs to the nuclear receptor superfamily and can be activated through binding to its ligand androgens. Studies have reported an association between AR expression and EOC carcinogenesis, and AR is suggested to be involved in proliferation, migration/invasion, and stemness. In addition, alternative AR activating signals, including both ligand-dependent and ligand-independent, are involved in OVCA progression. Although some clinical trials have previously been conducted to evaluate the effects of anti-androgens in EOC, no significant results have been reported. In contrast, experimental studies evaluating the effects of anti-androgen or anti-AR reagents in AR-expressing EOC models have demonstrated positive results for suppressing disease progression. Since AR is involved in complex signaling pathways and may be expressed at various levels in OVCA, the aim of this article was to provide an overview of current studies and perspectives regarding the relevance of androgen/AR roles in OVCA.

BACKGROUND:Epithelial ovarian cancer (EOC) is one of the most lethal gynecological malignancies and presents chemoresistance after chemotherapy treatment. Androgen receptor (AR) has been known to participate in proliferation. Yet the mechanisms of the resistance of this drug and its linkage to the AR remains unclear.METHODS:To elucidate AR-related paclitaxel sensitivity, co-IP, luciferase reporter assay and ChIP assay were performed to identify that AR direct-regulated ABCG2 expression under paclitaxel treatment. IHC staining by AR antibody presented higher AR expression in serous-type patients than other types. AR degradation enhancer (ASC-J9) was used to examine paclitaxel-associated and paclitaxel-resistant cytotoxicity in vitro and in vivo.RESULTS:We found AR/aryl hydrocarbon receptor (AhR)-mediates ABCG2 expression and leads to a change in paclitaxel cytotoxicity/sensitivity in EOC serous subtype cell lines. Molecular mechanism study showed that paclitaxel activated AR transactivity and bound to alternative ARE in the ABCG2 proximal promoter region. To identify AR as a potential therapeutic target, the ASC-J9 was used to re-sensitize paclitaxel-resistant EOC tumors upon paclitaxel treatment in vitro and in vivo.CONCLUSION:The results demonstrated that activation of AR transactivity beyond the androgen-associated biological effect. This novel AR mechanism explains that degradation of AR is the most effective therapeutic strategy for treating AR-positive EOC serous subtype.

Platinum-based therapy remains the cornerstone for cancer patient management; however, its efficacy varies. Theis study demonstrated the differential expressions of low-density lipoprotein receptor (LDLR) in subtypes of epithelial ovarian carcinoma (EOC) determines cisplatin sensitivity. It’s sensitive in serous EOCs (low LDLR), where insensitive in endometrioid and clear cell EOCs (high LDLR). Meanwhile, knocked-down or overexpressed LDLR in EOC could reversed the chemosensitivity pattern both in vitro and in vivo. Mechanistic dissection with transcriptome vs. lipidome trans-omics analyses elucidated the LDLR→LPC (Lyso-PhosphotidylCholine)→FAM83B (phospholipase-related)→FGFRs (cisplatin sensitivity and phospholipase-related) regulatory axis in cisplatin insensitivity. Implementing LPC-liposome encapsulated cisplatin could facilitate DNA-adduct formation via lipid droplets (LDs) delivery. Furthermore, Bioinformatics analyses found that the LDL/R→LD homeostasis alteration is critical for therapeutic prognosis. Lastly, using LPC-liposome-cisplatin improved cisplatin sensitivities in gastric cancer, renal cell carcinoma, hepatocellular carcinoma, cholangiocarcinoma, and pancreatic adenocarcinoma cells. In conclusion, this report discovered a LDL/R-reprogrammed transcriptome-lipidome network, by which impulses platinum insensitivity and disease outcome. The drug specific lipidome for liposome manufacture might be an efficienct pharmaceutics strategy for chemoagents. Significance LDLR reprograms cellular lipidome and transcriptome profiles to determines chemotherapy therapeutic efficacy. The LDLR-reduced LPC abundance disturbs phospholipids homeostasis of Lands cycle in LD, by which attenuates intracellular platinum transportation for DNA-adduct formation. Targeting LDLR-LD-lipidome with LPC-liposome-platinum could boost therapeutic efficacy for insensitivity.

BACKGROUND:We designed a deep learning model for assessing 18F-FDG PET/CT for early prediction of local and distant failures for patients with locally advanced cervical cancer.METHODS:All 142 patients with cervical cancer underwent 18F-FDG PET/CT for pretreatment staging and received allocated treatment. To augment the amount of image data, each tumor was represented as 11 slice sets each of which contains 3 2D orthogonal slices to acquire a total of 1562 slice sets. In each round of k-fold cross-validation, a well-trained proposed model and a slice-based optimal threshold were derived from a training set and used to classify each slice set in the test set into the categories of with or without local or distant failure. The classification results of each tumor were aggregated to summarize a tumor-based prediction result.RESULTS:In total, 21 and 26 patients experienced local and distant failures, respectively. Regarding local recurrence, the tumor-based prediction result summarized from all test sets demonstrated that the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 71%, 93%, 63%, 95%, and 89%, respectively. The corresponding values for distant metastasis were 77%, 90%, 63%, 95%, and 87%, respectively.CONCLUSION:This is the first study to use deep learning model for assessing 18F-FDG PET/CT images which is capable of predicting treatment outcomes in cervical cancer patients.KEY POINTS:• This is the first study to use deep learning model for assessing 18 F-FDG PET/CT images which is capable of predicting treatment outcomes in cervical cancer patients. • All 142 patients with cervical cancer underwent 18 F-FDG PET/CT for pretreatment staging and received allocated treatment. To augment the amount of image data, each tumor was represented as 11 slice sets each of which contains 3 2D orthogonal slices to acquire a total of 1562 slice sets. • For local recurrence, all test sets demonstrated that the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 71%, 93%, 63%, 95%, and 89%, respectively. The corresponding values for distant metastasis were 77%, 90%, 63%, 95%, and 87%, respectively.

5584 Background: An Asian Gynecologic Oncology Group (AGOG) phase III randomized trial was conducted to determine whether maintenance chemotherapy after complete remission could improve progression-free survival (PFS) in FIGO stages III/IV ovarian cancer. Methods: Between June 2007 and September 2014, 45 patients were enrolled and randomized (1:1) with stratification factor of residual tumor and stage. One patient was found ineligible shortly after registration and randomization and was excluded without treatment. Twenty-three patients were randomized to arm A (4-weekly carboplatin AUC4 and liposomal doxorubicin 30 mg/m2) for six cycles and 21 patients were randomized to arm B (observation). The primary end-point was PFS. Overall survival (OS) was calculated as secondary end-point. Results: Enrollment was slow, therefore a decision of closing accrual was made by the AGOG Board meeting when 7+ years had lapsed. We ended the study after the last enrolled patient had completed 3-year follow-up. With a median follow-up of 80.1 months, 30 patients experienced cancer progression (14 [60.9%] for arm A and 16 [76.2%] for arm B). The median PFS was significantly better in arm A (38.9 months) than arm B (9.2 months) (log-rank p = 0.038), and the median OS was marginal better in arm A (not applicable, > 50 % of patients were alive at study end) than arm B (42.8 months) (log-rank p = 0.117). Overall rates of grade 3/4 adverse events were 60.9 % for arm A and 0.0 % for arm B (p < 0.001). Grade 3/4 including neutropenia were more frequent in arm A than arm B with 30.4% and 0.0%, respectively (p = 0.0094). Conclusions: Despite limitation in small sample size, it suggests that maintenance chemotherapy after complete remission could be beneficial significantly improving PFS in stages III/IV ovarian cancer. Clinical trial information: ACTRN12607000329460.

We retrospectively reviewed the records of 142 patients with stage IB–IIIB cervical cancer who underwent 18F-FDG-PET/CT before external beam radiotherapy plus intracavitary brachytherapy and concurrent chemotherapy. The patients were divided into training and validation cohorts to confirm the reliability of predictors for recurrence. Kaplan–Meier analysis was performed and a Cox regression model was used to examine the effects of variables on overall survival (OS), progression-free survival (PFS), distant metastasis-free survival (DMFS), and pelvic relapse-free survival (PRFS). High gray-level run emphasis (HGRE) derived from gray-level run-length matrix most accurately and consistently predicted the presence of pelvic residual or recurrent tumors for both cohorts. In multivariate analysis, stages IIIA–IIIB (P = 0.001, hazard ratio [HR] = 4.07) and a low HGRE (P < 0.0001, HR = 4.34) were prognostic factors for low OS, whereas a low HGRE (P = 0.001, HR = 2.86) and nonsquamous cell histology (P = 0.003, HR = 2.76) were prognostic factors for inferior PFS. The nonsquamous cell histology (P < 0.0001, HR = 9.19) and a low HGRE (P = 0.001, HR = 4.69) were predictors for low PRFS. In cervical cancer patients receiving definitive chemoradiotherapy, pretreatment textural features on 18F-FDG-PET/CT can supplement the prognostic information.

Purpose Analysis of circulating tumor DNA (ctDNA) offers an unbiased and noninvasive way to assess the genetic profiles of tumors. This study aimed to analyze mutations in ctDNA and their correlation with tissue mutations in patients with a variety of cancers. Methods We included 21 cancer patients treated with surgical resection for whom we collected paired tissue and plasma samples. Next-generation sequencing (NGS) of all exons was performed in a targeted human comprehensive cancer panel consisting of 275 genes. Results Six patients had at least one mutation that was concordant between tissue and ctDNA sequencing. Among all mutations ( n = 35) detected by tissue and blood sequencing, 20% ( n = 7) were concordant at the gene level. Tissue and ctDNA sequencing identified driver mutations in 66.67% and 47.62% of the tested samples, respectively. Tissue and ctDNA NGS detected actionable alterations in 57.14% and 33.33% of patients, respectively. When somatic alterations identified by each test were combined, the total proportion of patients with actionable mutations increased to 71.43%. Moreover, variants of unknown significance that were judged likely pathogenic had a higher percentage in ctDNA exclusively. Across six representative genes ( PIK3CA, CTNNB1, AKT1, KRAS, TP53 , and MET ), the sensitivity and specificity of detection using mutations in tissue sample as a reference were 25 and 96.74%, respectively. Conclusions This study indicates that tissue NGS and ctDNA NGS are complementary rather than exclusive approaches; these data support the idea that ctDNA is a promising tool to interrogate cancer genetics.

Breast and cervical cancer are the most common cancers affecting women. The symptom distresses experienced by cancer survivors are critical factors influencing their quality of life (QOL). This study investigated the QOL of breast and cervical cancer survivors, their physical, psychological and social conditions.

AimsSingle-incision vaginal mesh (SIVM) procedures for pelvic organ prolapse (POP) differed in mesh fabrication and implantation that may affect treatment outcomes. We aim to evaluate and compare the safety and effectiveness of two SIVM procedures, and explore factors that may have associations with surgical effectiveness. MethodsOur data of using two SIVM procedures for a total (anterior and posterior) vaginal mesh repair were studied. Patients who had stage 2 POP and underwent either Elevate (n=85) using anchored, lightweight meshes or Prosima procedures (n=95) using non-anchored, original meshes were assessed. A detailed comparison of 1 year outcomes was made. ResultsOf the 180 patients, 172 (95.6%) attended the 1-year follow-up. Demographic data were similar between groups except a higher average age (64.5 vs 60.4, P=0.001) was noted in the Elevate (n=84) group compared to the Prosima (n=88) group. Surgical results were also similar except a significantly higher objective cure (POP stage 1) rate (89.3% vs 78.4%, P=0.042) was noted in the Elevate group. The safety profile favored Elevate with a lower, but not statistically significant, rate (4.7% vs 12.5%, P=0.106) of vaginal mesh exposure. After a statistical analysis, we found anatomic recurrence (POP stage 2) after the SIVM procedures had strong (P<0.05) associations with early surgical cases, Prosima procedure, advanced cystocele (Ba>+3cm), and prior prolapse repair, respectively. ConclusionsBeyond a learning curve, Elevate performed better than Prosima in POP repair regarding surgical effectiveness. Meanwhile, several predisposing factors that may affect recurrence after SIVM procedures were found.

Nanotopography modulates cell characteristics and cell behavior. Nanotopological cues can be exploited to investigate the in-vivo modulation of cell characteristics by the cellular microenvironment. However, the studies explaining the modulation of tumor cell characteristics and identifying the transition step in cancer progressiveness are scarce. Here, we engineered nanochips comprising of Tantalum oxide nanodot arrays of 10, 50, 100 and 200 nm as artificial microenvironments to study the modulation of cancer cell behavior. Clinical samples of different types of Ovarian cancer at different stages were obtained, primary cultures were established and then seeded on different nanochips. Immunofluorescence (IF) was performed to compare the morphologies and cell characteristics. Indices corresponding to cell characteristics were defined. A statistical comparison of the cell characteristics in response to the nanochips was performed. The cells displayed differential growth parameters. Morphology, Viability, focal adhesions, microfilament bundles and cell area were modulated by the nanochips which can be used as a measure to study the cancer progressiveness. The ease of fabrication of nanochips ensures mass-production. The ability of the nanochips to act as artificial microenvironments and modulate cell behavior may lead to further prospects in the markerless monitoring of the progressiveness and ultimately, improving the prognosis of Ovarian cancer.

Cervical cancer ranks as the fourth leading cause of cancer death in women worldwide. In Taiwan, although the universal health insurance system has achieved 99.9% coverage and ensured easy access to medical care, some cervical cancer patients continue to delay initiation of definitive treatment after diagnosis. This study focused on cervical cancer patients who delayed treatment for at least 4 months, and examined the characteristics, related factors, and survival in these patients.Data on patients with a new confirmed diagnosis of cervical cancer by the International Federation of Gynecology and Obstetrics (FIGO) staging system between 2005 and 2010 were obtained from the National Health Insurance Research Database and the Taiwan Cancer Registry. Logistic regression analysis was performed to analyze the association of various factors with treatment delay. The Cox proportional hazards model was used to analyze the effects of various factors on mortality risk.The rate of treatment delay for cervical cancer decreased steadily from 6.46% in 2005 to 2.48% in 2010. Higher rates of treatment delay were observed among patients who were aged ≥75 years (9.91%), had severe comorbidity, had stage IV (9.50%), diagnosing hospital level at nonmedical center, or at public hospital ownership. Factors that correlated with treatment delay were age ≥75 years (odds ratio [OR] = 2.42), higher comorbidity Charlson comorbidity index (CCI) 4-6, or ≥7 (OR = 1.60, 2.00), cancer stage IV (OR = 2.60), the diagnosing hospital being a regional, district hospital, or other (OR = 3.00, 4.01, 4.60), and at public hospital ownership. Those who delayed treatment had 2.31 times the mortality risk of those who underwent timely treatment (P < 0.05).Delayed cervical cancer treatment in Taiwan was associated with age, comorbidity, cancer stage, diagnosing hospital level, and hospital ownership. Delaying treatment for ≥4 months substantially raised mortality risk in cervical cancer patients.

MOTIVATIONOvarian cancer is the fifth leading cause of cancer deaths in women in the western world for 2013. In ovarian cancer, benign tumors turn malignant, but the point of transition is difficult to predict and diagnose. The 5-year survival rate of all types of ovarian cancer is 44%, but this can be improved to 92% if the cancer is found and treated before it spreads beyond the ovary. However, only 15% of all ovarian cancers are found at this early stage. Therefore, the ability to automatically identify and diagnose ovarian cancer precisely and efficiently as the tissue changes from benign to invasive is important for clinical treatment and for increasing the cure rate. This study proposes a new ovarian carcinoma classification model using two algorithms: a novel discretization of food sources for an artificial bee colony (DfABC), and a support vector machine (SVM). For the first time in the literature, oncogene detection using this method is also investigated.RESULTSA novel bio-inspired computing model and hybrid algorithms combining DfABC and SVM was applied to ovarian carcinoma and oncogene classification. This study used the human ovarian cDNA expression database to collect 41 patient samples and 9600 genes in each pathological stage. Feature selection methods were used to detect and extract 15 notable oncogenes. We then used the DfABC-SVM model to examine these 15 oncogenes, dividing them into eight different classifications according to their gene expressions of various pathological stages. The average accuracyof the eight classification experiments was 94.76%. This research also found some oncogenes that had not been discovered or indicated in previous scientific studies. The main contribution of this research is the proof that these newly discovered oncogenes are highly related to ovarian or other cancers.AVAILABILITY AND IMPLEMENTATIONhttp://mht.mis.nchu.edu.tw/moodle/course/view.php?id=7.

Background T-type Ca2+ channels (TCC) are important for pain transmission, especially the CaV3.2 subtype. In this study, we examined the effects of intrathecal TCC blockers in the L5/6 spinal nerve ligation pain rat model. Methods Under isoflurane anaesthesia, rats received right L5/6 spinal nerve ligation and intrathecal catheters (attached to an infusion pump) were sited. After surgery, saline, mibefradil, ethosuximide or NiCl2 were given intrathecally for seven days. The right hindpaw withdrawal thresholds to von Frey hair stimuli and withdrawal latencies to radiant heat were measured before and once daily for seven days after surgery. Double immunofluorescence and western blotting were used to examine the expression of CaV3.2 in dorsal root ganglion (DRG) and spinal cord. Results On post-ligation day seven, rats receiving mibefradil, ethosuximide or NiCl2 had significant higher median withdrawal thresholds (15.0, 10.2, and 10.9 g) and latencies (8.0, 7.6 and 7.6 s) than saline-treated rats (1.6 g and 4.3 s, respectively). CaV3.2 was expressed in parvalbumin+, IB4+, CGRP+ and VR1+ neurones in DRG and most neurones in spinal dorsal horn. CaV3.2 was up-regulated in the right L5/6 DRG and spinal cord seven days after nerve ligation. Conclusions In this study, we demonstrated that intrathecal TCC blockers attenuate the development of nerve injury-induced mechanical allodynia and thermal hyperalgesia. Our data suggest that continuous intrathecal infusion of TCC or CaV3.2 blockers may be a promising alternative for the management of nerve injury-induced pain.

Objective The objective of this study was to assess prospectively the clinical outcomes of low-dose prophylactic extended-field, intensity-modulated radiotherapy (IMRT) plus concurrent weekly cisplatin for patients with stage IB2-IIIB cervical cancer, positive pelvic lymph nodes (PLNs), and negative para-aortic lymph nodes (PALNs). Methods Thirty-two patients with stage IB2-IIIB cervical cancer with positive PLN and negative PALN were included prospectively. All lymph nodes were assessed with positron emission tomography. The PALN field, including lymphatics from the superior border of L1 to the L4-L5 interphase, was irradiated concurrently with pelvic IMRT with a prescribed dose of 40 Gy in 25 fractions. Chemotherapy consisted of cisplatin delivered weekly at a dose of 40 mg/m 2 . Using historical controls treated with pelvic radiotherapy, the survival curves were compared to assess the difference between the 2 treatment periods. Results Thirty-one patients completed the allocated extended-field IMRT, and all finished the planned pelvic IMRT and brachytherapy. Acute ≥ grade 3 gastrointestinal, genitourinary, and hematologic toxicities were seen in 2, 1, and 18 patients, respectively. During a median follow-up of 33 months, 5 patients developed out-field distant recurrences. One patient had a late grade 3 gastrointestinal complication, and 1 patient had genitourinary toxicity. The 3-year actuarial overall survival, disease-free survival, and distant metastasis–free survival for the study cohort and historic controls were 87% versus 62% ( P = 0.02), 82% versus 54% ( P = 0.02), and 79% versus 57% ( P = 0.01), respectively. Conclusions Extended-field IMRT of 40 Gy to the PALN plus concurrent cisplatin can effectively eradicate subclinical disease at the PALN and improve the outcome for patients with PLN-positive stage IB2-IIIB cervical cancer.

1 Department of Materials Science and Engineering, National Chiao Tung University, Hsinchu 300, Taiwan 2 Department of Obstetrics and Gynecology, China Medical University and Hospital, 91 Hsueh Shih Road, Taichung 404, Taiwan 3 College of Medicine, China Medical University, Taichung 40402, Taiwan 4 Institute of Chemical Kinetics & Combustion, Siberian Branch of Russian Academy of Sciences, Novosibirsk 630090, Russia 5 Institute of Electrical Control Engineering, National Chiao Tung University, 1001 University Road, EE772, Hsinchu 300, Taiwan 6 Institute of Organic Chemistry, Siberian Branch of Russian Academy of Sciences, Novosibirsk 630090, Russia

OBJECTIVE:Use of vaginal meshes for treatment of pelvic organ prolapse (POP) remains controversial. A trend toward abdominal approaches and the development of new meshes has been noted. We compared the 1-year results of two different approaches using new lightweight meshes. MATERIALS AND METHODS:Sixty-nine (95.8%) of 72 women with POP Stage ≥ 2, who underwent laparoscopic sacrocolpopexy (LSC) (n = 39) or a total vaginal mesh (TVM) procedure (n = 30) using lightweight polypropylene meshes, were studied. Baseline and follow-up assessments included a pelvic examination and a composite condition-specific questionnaire. A detailed comparison of 1-year outcomes was made. Data were analyzed using appropriate statistical methods. RESULTS:Compared to the TVM group, the LSC group was characterized by a younger age (53.7 years vs. 64.1 years, p < 0.001) and a longer operating time (264 minutes vs. 177.6 minutes, p < 0.001). Objective anatomic success (POP Stage ≤ 1) rates were similar between groups after statistical adjustment, i.e., 84.6% (33/39) and 86.7% (26/30) after LSC and TVM (p = 0.94), respectively. However, the dominant recurrence sites were different with anterior (n = 6) most frequent after LSC and apical (n = 4) most frequent after TVM. Reoperations were needed for the four (13.3%) apical recurrences in the TVM group. No serious complications were noted. We found "cystocele as the dominant prolapse" (p = 0.016; odds ratio = 6.94) and "suspension of prolapsed (POP Stage ≥ 2) uterus" (p = 0.025; odds ratio = 7.00) significantly affected recurrence after LSC and TVM, respectively. CONCLUSION:POP repair by LSC or TVM using the new lightweight polypropylene meshes seems to be safe and has comparable outcomes, but limitations may vary.