Sign in to use this feature.

Years

Between: -

Subjects

remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline

Journals

Article Types

Countries / Regions

Search Results (98)

Search Parameters:
Keywords = serous invasion

Order results
Result details
Results per page
Select all
Export citation of selected articles as:
16 pages, 2369 KiB  
Article
HMGB1 Deficiency Occurs in a Broad Range of Human Cancers and Is Often Associated with Unfavorable Tumor Phenotype
by Viktoria Chirico, Hena Sharifi, Maria Christina Tsourlakis, Seyma Büyücek, Clara Marie von Bargen, Katharina Möller, Florian Lutz, David Dum, Martina Kluth, Claudia Hube-Magg, Georgia Makrypidi-Fraune, Piero Caneve, Maximilian Lennartz, Morton Freytag, Sebastian Dwertmann Rico, Simon Kind, Viktor Reiswich, Eike Burandt, Till S. Clauditz, Patrick Lebok, Christoph Fraune, Till Krech, Sarah Minner, Andreas H. Marx, Waldemar Wilczak, Ronald Simon, Guido Sauter, Stefan Steurer and Kristina Jansenadd Show full author list remove Hide full author list
Diagnostics 2025, 15(15), 1974; https://doi.org/10.3390/diagnostics15151974 - 6 Aug 2025
Abstract
Background/Objectives: Aberrant expression of high-mobility group protein B1 (HMGB1) has been linked to cancer development and progression. Methods: To better comprehend the role of HMGB1 expression in cancer, a tissue microarray containing 14,966 samples from 134 different tumor entities and 608 [...] Read more.
Background/Objectives: Aberrant expression of high-mobility group protein B1 (HMGB1) has been linked to cancer development and progression. Methods: To better comprehend the role of HMGB1 expression in cancer, a tissue microarray containing 14,966 samples from 134 different tumor entities and 608 samples of 76 different normal tissue types was analyzed by immunohistochemistry. Results: Strong HMGB1 staining occurred in almost all normal cell types and in most cancers. Of 11,808 evaluable cancers, only 7.8% showed complete absence of HMGB1 staining (HMGB1 deficiency) while 9.9% showed 1+, 25.0% showed 2+, and 57.2% showed 3+ HMGB1 positivity. Absence of HMGB1 staining mostly occurred in pheochromocytoma (90.0%), seminoma (72.4%), gastrointestinal stromal tumor (28.6%), adrenal cortical carcinoma (25.0%), and Hodgkin’s lymphoma (25.0%). Low HMGB1 staining was linked to poor histologic grade (p < 0.0001), advanced pT stage (p < 0.0001), high UICC stage (p < 0.0001), and distant metastasis (p = 0.0413) in clear cell renal cell carcinoma, invasive tumor growth in urothelial carcinoma (pTa vs. pT2–4, p < 0.0001), mismatch repair deficiency (p = 0.0167) in colorectal cancers, and advanced pT stage in invasive breast carcinoma of no special type (p = 0.0038). Strong HMGB1 staining was linked to nodal metastases in high-grade serous ovarian carcinomas (p = 0.0213) and colorectal adenocarcinomas (p = 0.0137), as well as to poor histological grade in squamous cell carcinomas (p = 0.0010). Conclusions: HMGB1 deficiency and reduced HMGB1 expression occur in a broad range of different tumor entities. Low rather than strong HMGB1 staining is often linked to an aggressive tumor phenotype. Whether HMGB1 deficiency renders cells susceptible to specific drugs remains to be determined. Full article
(This article belongs to the Section Pathology and Molecular Diagnostics)
Show Figures

Figure 1

14 pages, 1778 KiB  
Article
PET/CT Volumetric Parameters as Predictors of the Peritoneal Cancer Index in Advanced Ovarian Cancer Patients
by Ariel Glickman, Blanca Gil-Ibáñez, Aida Niñerola-Baizán, Marta Tormo, Núria Carreras-Dieguez, Pere Fusté, Marta Del Pino, Eduardo González-Bosquet, Inmaculada Romero-Zayas, Cristina Celada-Castro, Tiermes Marina, Lydia Gaba, Adela Rodriguez Hernández, Adela Saco, Laura Buñesch, Josep Lluís Carrasco, Katherine Quintero, David Fuster, Berta Díaz-Feijóo, Aureli Torné and Pilar Paredesadd Show full author list remove Hide full author list
Diagnostics 2025, 15(14), 1818; https://doi.org/10.3390/diagnostics15141818 - 19 Jul 2025
Viewed by 379
Abstract
Background: Assessment of the peritoneal cancer burden is crucial for determining the optimal treatment in advanced ovarian cancer (AOC). Effective non-invasive methods to predict tumour load remain limited. This study aimed to assess the applicability of 2-[18F]FDG PET/CT volumetric parameters, metabolic [...] Read more.
Background: Assessment of the peritoneal cancer burden is crucial for determining the optimal treatment in advanced ovarian cancer (AOC). Effective non-invasive methods to predict tumour load remain limited. This study aimed to assess the applicability of 2-[18F]FDG PET/CT volumetric parameters, metabolic tumour volume (MTV), and total lesion glycolysis (TLG) for predicting the surgical peritoneal cancer index (PCI) in AOC before primary treatment. Methods: Patients with high-grade serous or undifferentiated AOC who underwent surgical PCI evaluation and 2-[18F]FDG PET/CT between 01/2013 and 12/2018 were included. MTV and TLG were calculated using thresholds of 40% and 50% (MTV40, MTV50, TLG40, and TLG50). Correlations between the peritoneal carcinomatosis MTV (car_MTV) and TLG (car_TLG) were analysed. The capacity of volumetric parameters to estimate PCIs above or below 14 and 20 was assessed for the whole abdominal cavity and in per-quadrant analysis, specifically for upper-abdomen areas 1, 2, and 3 (MTV40_1, 2, 3 and TLG40_1, 2, 3). Results: MTV40, MTV50, TLG40, and TLG50 significantly correlated with the PCI in the final study population (n = 45). MTV40 showed a Pearson coefficient of 0.41 (p = 0.003). MTV3_40 (AUC 0.79) and TLG3_40 (AUC 0.81) presented the highest AUCs for predicting a PCI above or below 14. The volumetric parameters allowed the prediction of a PCI greater or less than 20, with an AUC of 0.77 for MTV40_1 and 0.78 for TLG40_1. Conclusions: 2-[18F]FDG PET/CT MTV and TLG correlate significantly with the surgical PCI when assessing peritoneal carcinomatosis or quadrant-specific disease. This approach offers a reliable non-invasive method for evaluating tumour burden in AOC. Full article
(This article belongs to the Special Issue Exploring Gynecological Pathology and Imaging)
Show Figures

Figure 1

22 pages, 1442 KiB  
Article
Genome-Wide cfDNA Methylation Profiling Reveals Robust Hypermethylation Signatures in Ovarian Cancer
by Simone Karlsson Terp, Karen Guldbrandsen, Malene Pontoppidan Stoico, Lasse Ringsted Mark, Anna Poulsgaard Frandsen, Karen Dybkær and Inge Søkilde Pedersen
Cancers 2025, 17(12), 2026; https://doi.org/10.3390/cancers17122026 - 17 Jun 2025
Viewed by 568
Abstract
Background: Ovarian cancer remains the most lethal gynecological cancer, primarily due to its asymptomatic nature in early stages and consequent late diagnosis. Early detection improves survival, but current biomarkers lack sensitivity and specificity. Cell-free DNA (cfDNA) released from tumor cells captures tumor-associated epigenetic [...] Read more.
Background: Ovarian cancer remains the most lethal gynecological cancer, primarily due to its asymptomatic nature in early stages and consequent late diagnosis. Early detection improves survival, but current biomarkers lack sensitivity and specificity. Cell-free DNA (cfDNA) released from tumor cells captures tumor-associated epigenetic alterations and represents a promising source for minimally invasive biomarkers. Among these, aberrant DNA methylation occurs early in tumorigenesis and may reflect underlying disease biology. This study aimed to investigate genome-wide cfDNA methylation profiles in patients with ovarian cancer, benign ovarian conditions, and healthy controls to identify cancer-associated methylation patterns that may inform future biomarker development. Results: We performed genome-wide cfDNA methylation profiling using cell-free methylated DNA immunoprecipitation sequencing (cfMeDIP-seq) on plasma samples from 40 patients with high-grade serous ovarian carcinoma, 38 patients with benign ovarian conditions, and 38 healthy postmenopausal women. A total of 536 differentially methylated regions (DMRs) were identified between ovarian cancer and controls (n = 76), with 97% showing hypermethylation in ovarian cancer. DMRs were enriched in CpG islands and gene bodies and depleted in repetitive elements, consistent with known cancer-associated methylation patterns. Fifteen genes showed robust hypermethylation across analyses. These genes exhibited methylation across intronic, exonic, and upstream regulatory regions. Separate comparisons of ovarian cancer to each control group (benign and healthy) supported the reproducibility of these findings. Gene Ontology enrichment analysis revealed enrichment in gland development, embryonic morphogenesis, and endocrine regulation, suggesting biological relevance to ovarian tumorigenesis. Conclusions: This study identifies consistent cfDNA hypermethylation patterns in ovarian cancer, affecting genes involved in developmental regulation and hormone-related processes. Our findings underscore the potential of cfMeDIP-seq for detecting tumor-specific methylation signatures in plasma and highlight these 15 hypermethylated genes as biologically relevant targets for future studies on cfDNA methylation in ovarian cancer. Full article
(This article belongs to the Section Cancer Biomarkers)
Show Figures

Figure 1

19 pages, 3901 KiB  
Article
Clinical Application of Next-Generation Sequencing for Molecular Classification in the Management of Endometrial Cancer: An Observational Cohort Study
by Sabrina Paratore, Angela Russo, Giusi Blanco, Katia Lanzafame, Eliana Giurato, Giovanni Bartoloni, Marco D’Asta, Mirella Sapienza, Valeria Solarino, Valentina Vinci, Giulia Maria Bonanno, Giuseppe Ettore and Roberto Bordonaro
Cancers 2025, 17(11), 1806; https://doi.org/10.3390/cancers17111806 - 28 May 2025
Viewed by 845
Abstract
Background/Objectives: Endometrial cancer (EC) is the most common malignancy of the female genital tract. In 2013, The Cancer Genome Atlas analyzed the molecular profile of endometrial tumors identifying four risk classes (POLE ultramutated, mismatch repair-deficient, copy-number low-microsatellite stable, and copy-number high-serous-like. This classification [...] Read more.
Background/Objectives: Endometrial cancer (EC) is the most common malignancy of the female genital tract. In 2013, The Cancer Genome Atlas analyzed the molecular profile of endometrial tumors identifying four risk classes (POLE ultramutated, mismatch repair-deficient, copy-number low-microsatellite stable, and copy-number high-serous-like. This classification is reshaping the current understanding of EC, enabling more refined risk stratification and uncovering potential therapeutic targets tailored to specific molecular subgroups. In the context of these four categories, it is possible to identify different molecular alterations that correlate with different prognoses. Methods and Results: We retrospectively analyzed tissue samples from eighty-five EC patients, performing multigene profiling using a 50-gene next-generation sequencing (NGS) panel to categorize them into distinct molecular subtypes; we observed the following distribution: 5.9% POLE, 25.8% mismatch repair-deficient/microsatellite instability (MMRd/MSI), 11.8% p53abn/TP53mut, and 56.5% NSMP. A favorable concordance (97.6%) was shown in MSI NGS-based analysis and MMR IHC results, and the agreement rate of p53 IHC and TP53 mutation was 92.3%. When we analyzed the correlation between molecular subtypes and clinicopathological features, we found that molecular subtypes significantly differentiated by grade, FIGO stage, and lymphovascular invasion (LVSI). These findings seem to support the effectiveness of our NGS-based classifier and its reliability in distinguishing both MSI and TP53 mutated cancers. This study also explored mutations in PIK3CA, PTEN, KRAS, ERBB2, and ESR1 genes, noting their potential as targets for treatments. PIK3CA mutations were linked to favorable features, such as early disease stage and absence of LVSI. Conclusions: Our study highlights the potential of a medium-complexity NGS panel for supporting the molecular classification of endometrial cancer, complementing the existing diagnostic algorithms. By identifying additional biomarkers, we provided valuable insights into the genomic landscape of EC. However, further exploration of the molecular profiles is needed to validate these findings and improve the identification of patients at a higher risk of unfavorable outcomes. Full article
Show Figures

Figure 1

23 pages, 3116 KiB  
Article
Risk Factors for Recurrence in Serous Borderline Ovarian Tumors and Early-Stage Low-Grade Serous Ovarian Carcinoma
by Jingjing Zhang, Ming Wang and Yumei Wu
Curr. Oncol. 2025, 32(5), 263; https://doi.org/10.3390/curroncol32050263 - 30 Apr 2025
Viewed by 645
Abstract
Background: Tumor recurrence significantly impacts the quality of life and fertility of patients with serous borderline ovarian tumors (SBOT) and early-stage low-grade serous ovarian carcinoma (LGSOC). This study aims to characterize recurrence patterns, identify independent risk factors for recurrence, and develop a nomogram [...] Read more.
Background: Tumor recurrence significantly impacts the quality of life and fertility of patients with serous borderline ovarian tumors (SBOT) and early-stage low-grade serous ovarian carcinoma (LGSOC). This study aims to characterize recurrence patterns, identify independent risk factors for recurrence, and develop a nomogram to predict recurrence-free survival (RFS). Methods: We conducted a retrospective case-control study to investigate recurrence in patients undergoing fertility-sparing surgery (FSS) and radical surgery (RS). Logistic regression and Cox regression were used to identify risk factors. Kaplan–Meier analysis was applied to evaluate RFS. A nomogram was developed based on identified variables to predict RFS. Results: Tumor capsule disruption and micropapillary were associated with higher recurrence risk in the FSS group. Non-invasive implants were associated with higher recurrence risk in the RS group. The nomogram prediction model was developed based on identified risk factors. The area under the curve (AUC) for RFS predictions was 0.74 (95% CI: 0.62–0.85) at 3 years and 0.78 (95% CI: 0.67–0.89) at 5 years for the FSS group and 0.87 (95% CI: 0.76–0.98) at 3 years and 0.81 (95% CI: 0.65–0.97) at 5 years for the RS group. Conclusions: We identified the risk factors for recurrence of SBOT and early-stage LGSOC following FSS and RS procedures and developed a predictive model for forecasting RFS. This model provides valuable guidance for patients and clinicians in predicting recurrence risk for patients. Full article
(This article belongs to the Section Gynecologic Oncology)
Show Figures

Figure 1

29 pages, 4804 KiB  
Article
Upregulation of MMP3 Promotes Cisplatin Resistance in Ovarian Cancer
by Mariela Rivera-Serrano, Marienid Flores-Colón, Fatima Valiyeva, Loyda M. Meléndez and Pablo E. Vivas-Mejía
Int. J. Mol. Sci. 2025, 26(9), 4012; https://doi.org/10.3390/ijms26094012 - 24 Apr 2025
Viewed by 866
Abstract
Most women with ovarian cancer (OC) develop resistance to platinum chemotherapy, posing a significant challenge to treatment. Matrix metalloproteinase 3 (MMP3) is overexpressed in High-Grade Serous Ovarian Cancer (HGSOC) and is associated with poor survival outcomes; however, its role in platinum resistance remains [...] Read more.
Most women with ovarian cancer (OC) develop resistance to platinum chemotherapy, posing a significant challenge to treatment. Matrix metalloproteinase 3 (MMP3) is overexpressed in High-Grade Serous Ovarian Cancer (HGSOC) and is associated with poor survival outcomes; however, its role in platinum resistance remains underexplored. We evaluated the baseline and cisplatin-induced MMP3 transcript and protein levels in cisplatin-resistant OC cells, revealing significantly higher MMP3 levels in cisplatin-resistant cells than in cisplatin-sensitive cells. siRNA-mediated MMP3 knockdown in cisplatin-resistant OC cells significantly reduced viability, proliferation, and invasion, and these effects were further enhanced when combined with cisplatin treatment, indicating a possible synergistic impact on reducing cancer cell aggressiveness; however, chemical MMP3 inhibition did not replicate these effects. RNA sequencing of MMP3-siRNA-treated cisplatin-resistant HGSOC cells revealed 415 differentially expressed genes (DEGs) compared to the negative control, with an additional 440 DEGs identified in MMP3-siRNA HGSOC cells treated in combination with cisplatin. These DEGs were enriched in pathways related to cell cycle regulation, apoptosis, metabolism, stress response, and extracellular matrix organization. Co-immunoprecipitation-coupled mass spectroscopy (IP-MS) identified MMP3-interacting proteins that may contribute to cell survival and chemoresistance in cisplatin-resistant OC. While MMP3-siRNA monotherapy did not reduce tumor growth in vivo, its combination with cisplatin significantly inhibited tumor growth in a cisplatin-resistant HGSOC xenograft model. These findings underscore the multifaceted role of MMP3 in cisplatin resistance, suggesting its involvement in critical cellular processes driving chemoresistance and highlighting the challenges associated with direct MMP3 targeting in therapeutic strategies. Full article
(This article belongs to the Special Issue Resistance to Therapy in Ovarian Cancers)
Show Figures

Figure 1

11 pages, 2051 KiB  
Article
Ocular Ultrasound as a Key to Diagnosing Uveitis-Masked Syndromes: Tips and Tricks
by Valeria Albano, Rosanna Dammacco, Ilaria Lolli, Claudia Ventricelli, Enrico Settimo, Angelo Miggiano, Maria Grazia Pignataro, Paolo Ferreri, Francesco Boscia, Silvana Guerriero and Giovanni Alessio
Clin. Pract. 2025, 15(5), 84; https://doi.org/10.3390/clinpract15050084 - 23 Apr 2025
Viewed by 638
Abstract
Background and Objectives: Uveitis-masked syndromes or masquerade syndromes (UMSs) are a group of ocular conditions with several systemic underlying causes, malignant or nonmalignant, that mimic the inflammatory status of the uvea. They are often difficult to detect and diagnose with traditional techniques, [...] Read more.
Background and Objectives: Uveitis-masked syndromes or masquerade syndromes (UMSs) are a group of ocular conditions with several systemic underlying causes, malignant or nonmalignant, that mimic the inflammatory status of the uvea. They are often difficult to detect and diagnose with traditional techniques, such as ophthalmic exams. Ocular B (bidimensional)-ultrasound (OBU) is a non-invasive, repeatable, rapid ultrasound method effective in indirect signs that lead back to systemic diseases. It is comparable in effectiveness with other imaging tools. The cause of UMSs can often be serious, and therefore early diagnosis and prompt treatment are critical. This study aimed to identify the sonographic signs of these forms, which can help physicians discover the cause underlying UMS. Materials and Methods: This was a consecutive, retrospective, nonrandomized study. This study was conducted at the University Hospital Polyclinic of Bari, Italy, from January 2022 to December 2024. A total of 186 patients were included, from 10 to 85 years old. They all underwent B-scan ultrasonography (Quantel Medical ABSolu Ocular Ultrasound). Results: All patients reported blurred vision, which could be accompanied by visual reduction (<20/40, Snellen charts), photophobia, floaters, flashes, proptosis, and redness. In all cases, we noted peculiar ultrasonographic signs, which allowed us to discriminate the underlying systemic diagnosis, such as vitreous corpuscles, choroid thickening, and primitive or metastatic solid tumors. Finally, we identified different diseases, such as primary intraocular lymphoma (PIOL), other lymphoproliferative conditions, orbital plasmacytoma, uveal melanoma, metastasis, endogenous endophthalmitis, retinal detachment, central serous retinopathy, metallic foreign bodies, ocular amyloidosis, and drug-induced UMSs. The sensitivity and specificity of ocular ultrasound compared to multimodal ocular imaging in UMSs were as follows: for primary intraocular lymphoma (PIOL) and other lymphoproliferative conditions, 0.98 (95% CI, 0.80–1) and 0.68 (90% CI, 0.40–0.92), respectively; for orbital plasmacytoma, 0.64 (92% CI, 0.52–0.86) and 0.66 (93% CI, 0.48–0.89), respectively; uveal melanoma, 1.00 (98% CI, 0.88–1.00) and 0.98 (95% CI, 0.86–0.98), respectively; metastasis, 0.75 (95% CI, 0.53–0.85) and 0.85 (95% CI, 0.48–0.98), respectively; endogenous endophthalmitis, 1.00 (95% CI, 0.50–1.00) and 0.83 (95% CI, 0.48–0.98), respectively; retinal detachment, both were 1.00 (95% CI, 0.87–1.00 and 0.84–0.97, respectively); central serous retinopathy, 0.60 (80% CI, 0.41–0.88) and 0.85 (95% CI, 0.52–0.98), respectively; metallic foreign bodies, 1.00 (95% CI, 0.78–1.00) and 0.99 (95% CI, 0.99–1.00), respectively; ocular amyloidosis, 0.77 (82% CI, 0.52–0.90) and 0.83 (80% CI, 0.49–0.88), respectively; and drug-induced UMSs, 0.64 (95% CI, 0.49–0.88) and 0.85 (95% CI, 0.52–0.98), respectively. Conclusions: Diagnosing UMS accurately can be quite challenging, and many of its different types frequently go undetected. This complexity in identification often leads to underdiagnosis, meaning it is essential to improve awareness and understanding of the condition in order to achieve better recognition and treatment. Early detection of these forms is imperative. The use of OBU can help diagnose indirect signs of these forms early and treat them promptly. It compares well with other diagnostic imaging techniques, such as MRI, but this does not mean that it replaces them; it can offer added value in multimodal imaging. Full article
Show Figures

Graphical abstract

6 pages, 1151 KiB  
Case Report
Synchronous Metastasizing High-Grade Papillary Serous Carcinoma of the Fallopian Tube and Triple-Negative Primary Breast Cancer in a BRCA1 Mutation Carrier
by Mihnea-Andrei Nicodin, Tudor-Petru Nicodin, Anca Popescu, Elena Rusu, Cosmin Alec Moldovan, Alice Elena Munteanu, Mariam Dalaty and Ovidiu Vasile Nicodin
J. Mind Med. Sci. 2025, 12(1), 20; https://doi.org/10.3390/jmms12010020 - 15 Apr 2025
Viewed by 537
Abstract
Patients with a BRCA1 germline mutation often represent a challenge for medical healthcare, since they develop malignancies that tend to be more aggressive and which need to be addressed in multidisciplinary teams with more individualized therapies. We report a case of a 37-year-old [...] Read more.
Patients with a BRCA1 germline mutation often represent a challenge for medical healthcare, since they develop malignancies that tend to be more aggressive and which need to be addressed in multidisciplinary teams with more individualized therapies. We report a case of a 37-year-old woman with a BRCA1 mutation who was diagnosed and treated for high-grade papillary serous carcinoma of the fallopian tube. Eight years later, her regular check-up imaging revealed a latero-aortic lymphadenopathy and a right breast tumor. She underwent a fine needle breast biopsy which was positive for invasive non-specific type carcinoma with negative estrogen, progesterone and Her2 receptors in immunohistochemistry tests. The patient underwent debulking surgery for metastatic lymphadenopathy, followed by chemotherapy with Carboplatin and Paclitaxel, and a modified right mastectomy with axillary lymphadenectomy. She subsequently initiated therapy with the PARP inhibitor Olaparib. No evidence of tumor recurrence was detected during the six-month postoperative follow-up period. The primary goal of this paper is to emphasize the complexity and challenges of managing patients with BRCA1 mutations who develop synchronous malignancies. This case report aims to highlight the increasing role of precision medicine and the importance of personalized, multidisciplinary therapeutic strategies, which include surgery, chemotherapy, and targeted therapies. Full article
Show Figures

Figure 1

10 pages, 206 KiB  
Article
Clinical Characteristics, Surgical Management, and Outcomes of Borderline Ovarian Tumours: A Retrospective Observational Study from North East London
by Kshitij Jamdade, Amal Hashi and Nandita Deo
J. Clin. Med. 2025, 14(7), 2383; https://doi.org/10.3390/jcm14072383 - 30 Mar 2025
Cited by 1 | Viewed by 856
Abstract
Background: Borderline ovarian tumours (BOTs) are a unique subset of epithelial ovarian neoplasms characterised by atypical epithelial proliferation without stromal invasion. BOTs are typically diagnosed at an early stage, primarily affect women of reproductive age, and have a favourable prognosis. This study aims [...] Read more.
Background: Borderline ovarian tumours (BOTs) are a unique subset of epithelial ovarian neoplasms characterised by atypical epithelial proliferation without stromal invasion. BOTs are typically diagnosed at an early stage, primarily affect women of reproductive age, and have a favourable prognosis. This study aims to evaluate the clinical characteristics, surgical management, and outcomes of BOTs in a North East London cohort. Methods: A retrospective, multicentric analysis was conducted on 69 patients with histologically confirmed BOTs managed between January 2018 and December 2022 across the Barts Health NHS Trust hospitals. Clinical and demographic data, surgical details, histopathological findings, and recurrence rates were analysed. We used descriptive and exploratory statistical methods. Results: The mean age at diagnosis was 44 years, with 46.37% under 40, including 18 nulliparous women. Most tumours (91.3%) were FIGO stage I, with mucinous histology predominating (56.52%), followed by serous BOTs (27.53%). Ultrasound and MRI demonstrated 65.45% and 81.5% sensitivities for borderline or malignant features, respectively. Surgical approaches included open surgery (75.4%), laparoscopy (17.4%), and robotic-assisted procedures (2.9%). Fertility-sparing surgery (FSS) was performed in all nulliparous women under 40 years of age. Recurrence occurred in 2 cases, both in patients with prior FSS performed over a decade earlier. Conclusions: FSS is a viable option for young women, especially if nulliparous and under the age of 40, with recurrence rates comparable to radical procedures. Most patients were diagnosed early (FIGO I) with excellent prognoses. MRI proved most sensitive for diagnosis, while long-term follow-up with transvaginal ultrasound and CA-125 monitoring is crucial for detecting recurrences. Full article
(This article belongs to the Section Oncology)
11 pages, 221 KiB  
Article
Factors Affecting Recurrence in 165 Patients with Serous Borderline Ovarian Tumours: The Pattern of Micro-Invasion Is Main Prognostic Factor
by Zehra Ozturk Basarır, Tufan Arslanca, Yesim Ozkaya Ucar, Sevgi Ayhan and Bülent Ozdal
J. Clin. Med. 2025, 14(6), 2050; https://doi.org/10.3390/jcm14062050 - 18 Mar 2025
Viewed by 469
Abstract
Background: The aim of this study was to evaluate the serous borderline ovarian tumours (BOTs), the recurrence rates, and the factors affecting recurrence. Methods: A total of 165 patients diagnosed with serous BOT between 2004 and 2019 were included. The patients [...] Read more.
Background: The aim of this study was to evaluate the serous borderline ovarian tumours (BOTs), the recurrence rates, and the factors affecting recurrence. Methods: A total of 165 patients diagnosed with serous BOT between 2004 and 2019 were included. The patients were evaluated in respect of age, preoperative CA125 levels, FIGO stage, tumour size, stromal micro-invasion, the presence of non-invasive implants, surgical procedures, and lymphadenectomy performed, or all that affects disease-free survival. Results: Early-stage BOT (stage I–II) was determined in 149 (90.3%) patients. Conservative surgery was performed in 57 (34.5%) patients. The non-invasive implantation was detected in 19 (11.5%) patients, and micro-invasion was determined in 31 (18.8%) patients. The median follow-up was 120 months, and recurrence was observed in 8 (4.8%) patients. The 5-year disease-free survival rate was 95.2%, and the 10-year disease-free survival rate was also 95.2%. Univariate analysis showed that elevated preoperative CA125 levels and the presence of micro-invasion were associated with poor disease-free survival outcomes. In the multivariate analysis, the presence of micro-invasion was the only independent poor prognostic factor (HR: 8.944, 95%CI: 2.060–38.833; p:0.003). Conclusions: The micro-invasion was the main factor for recurrence in patients with serous BOT. Full article
(This article belongs to the Section Obstetrics & Gynecology)
13 pages, 247 KiB  
Article
Optimizing Final Pathology Determination in Endometrial Cancer: The Role of PET/CT, MRI, and Biopsy in Serous, Mixed Cell, Clear Cell, and Grade 3 Endometrioid Subtypes
by Gözde Şahin, Ayşe HazırBulan, Işık Sözen, Nilüfer Çetinkaya Kocadal, İsmet Alkış, Aytül Hande Yardımcı, Burcu Esen Akkaş and Hilal Serap Arslan
Diagnostics 2025, 15(6), 731; https://doi.org/10.3390/diagnostics15060731 - 14 Mar 2025
Viewed by 1045
Abstract
Background: Accurate and timely diagnosis of endometrial cancer is crucial for guiding effective treatment and improving patient survival. Endometrial cancer diagnosis, staging, metastasis detection, and treatment planning utilize endometrial biopsy, magnetic resonance imaging (MRI), and positron emission tomography-computed tomography (PET/CT) scanning as crucial [...] Read more.
Background: Accurate and timely diagnosis of endometrial cancer is crucial for guiding effective treatment and improving patient survival. Endometrial cancer diagnosis, staging, metastasis detection, and treatment planning utilize endometrial biopsy, magnetic resonance imaging (MRI), and positron emission tomography-computed tomography (PET/CT) scanning as crucial diagnostic modalities. Aggressive subtypes such as serous, mixed cell, clear cell, and grade 3 endometrioid carcinomas present considerable diagnostic and therapeutic obstacles given their unfavorable prognosis, underscoring the importance of accurate preoperative evaluation. Methods: A retrospective analysis was conducted using data from seventy patients diagnosed with serous, mixed cell, clear cell, or grade 3 endometrioid endometrial cancer, who received surgical treatment from 2020 to 2023. To assess the diagnostic capabilities of each modality in determining final pathology and disease staging, a comparison was performed using results from preoperative endometrial biopsy, MRI, PET/CT, and postoperative histopathology. Cohen’s kappa coefficient was employed to determine the level of agreement observed between pre- and postoperative results. Results: Endometrial biopsy demonstrated moderate yet statistically significant concordance with definitive histopathological diagnoses (κ = 0.537, p < 0.001); however, diagnostic errors were observed, especially in instances of mixed and clear cell carcinomas. MRI demonstrated efficacy in identifying local tumor invasion, yet its capacity to detect distant metastases was demonstrably limited. PET/CT was most effective in identifying distant metastases and omental involvement in advanced-stage disease. Conclusions: Definitive pathological diagnosis and staging of endometrial carcinoma are effectively established using endometrial biopsy and MRI. The utility of PET/CT is particularly pronounced in identifying distant metastases in patients with serous carcinoma and advanced-stage disease. Integrating biopsy, MRI, and PET/CT into a multimodal diagnostic strategy enhances diagnostic accuracy and enables personalized treatment planning, particularly for aggressive tumor subtypes. Full article
(This article belongs to the Section Medical Imaging and Theranostics)
15 pages, 262 KiB  
Review
Molecular Biomarkers in Borderline Ovarian Tumors: Towards Personalized Treatment and Prognostic Assessment
by Stefania Drymiotou, Efthymia Theodorou, Kathrine Sofia Rallis, Marios Nicolaides and Michail Sideris
Cancers 2025, 17(3), 545; https://doi.org/10.3390/cancers17030545 - 6 Feb 2025
Viewed by 1402
Abstract
Borderline Ovarian Tumours (BOTs) are a heterogenous group of ovarian neoplasms which have increased mitotic activity but lack stromal invasion. We performed a narrative review of the literature, aiming to identify prognostic molecular biomarkers that can potentially be used for treatment personalisation. We [...] Read more.
Borderline Ovarian Tumours (BOTs) are a heterogenous group of ovarian neoplasms which have increased mitotic activity but lack stromal invasion. We performed a narrative review of the literature, aiming to identify prognostic molecular biomarkers that can potentially be used for treatment personalisation. We identified and discussed BRAF/KRAS, Cancer Antigen 125 (Ca 125), Calprotectin, p16ink4a, and Microsatellite instability (MSI) as the most studied biomarkers related to BOTs. Overall, BRAF and KRAS mutations are associated with earlier-stage and favourable prognosis; KRASmt may indicate extraovarian disease in serous BOT (sBOT). Ca125, the only currently clinically used biomarker, can be assessed pre-operatively and has an established role in post-operative surveillance, especially when it is raised pre-operatively or a high potential for malignant transformation is suspected post-operatively. p16ink4a expression trends could also indicate the malignant transformation of the tumour. Calprotectin has an inferior specificity to Ca125 and is not yet established as a biomarker, whilst there is very limited evidence available for MSI. As new evidence is coming along with artificial intelligence platforms, these biomarkers can be integrated and used towards the development of a precision model for treatment stratification and counselling in women diagnosed with BOTs. Full article
(This article belongs to the Special Issue Diagnostic Biomarkers in Cancers Study)
12 pages, 1951 KiB  
Case Report
Successful Treatment of Unilateral Pulmonary Edema as Minimally Invasive Mitral Valve Surgery Complication—Case Presentation
by Marius Mihai Harpa, Sânziana Flamind Oltean, Hussam Al Hussein, David Emanuel Anitei, Iulia Alexandra Puscas, Cosmin Marian Bănceu, Mihaly Veres, Diana Roxana Opriș, Radu Alexandru Balau and Horatiu Suciu
J. Clin. Med. 2024, 13(24), 7654; https://doi.org/10.3390/jcm13247654 - 16 Dec 2024
Cited by 3 | Viewed by 1450
Abstract
Background/Objectives: In recent decades, the advantages of minimizing surgical trauma have led to the development of minimally invasive surgical procedures. While the benefits often outweigh the risks, several challenges are encountered that are not present in conventional surgical approaches. Unilateral pulmonary edema (UPE) [...] Read more.
Background/Objectives: In recent decades, the advantages of minimizing surgical trauma have led to the development of minimally invasive surgical procedures. While the benefits often outweigh the risks, several challenges are encountered that are not present in conventional surgical approaches. Unilateral pulmonary edema (UPE) after mitral interventions performed through a right-sided approach is a rare but potentially life-threatening event. Methods: We present the case of a 49-year-old patient who underwent endoscopic mitral valve repair. Immediately following ICU admission, the patient’s oxygen saturation suddenly dropped, and serous discharge was exteriorized from the endotracheal tube, with a thoracic X-ray revealing right-sided unilateral pulmonary edema. Results: The therapeutical course was complex. The patient developed hemodynamic instability, leading to cardiac arrest, which required cardiopulmonary resuscitation and the initiation of peripheral veno-arterial extracorporeal membrane oxygenation (VA-ECMO). The endotracheal cannula was replaced with a right-sided double-lumen cannula, and the patient was placed on two ventilators operating independently. The patient was weaned off extracorporeal membrane oxygenation (ECMO) on the fifth day and extubated on the sixth postoperative day. Conclusions: We successfully treated this patient using ECMO and independent lung ventilation. Several cases have been described in the literature, but the pathogenesis and risk factors of UPE remain unclear. Management depends on the severity of UPE, but a deeper understanding of its underlying mechanisms could provide cardiac surgeons with enhanced strategies for preventing UPE and implementing timely interventions. Full article
Show Figures

Figure 1

19 pages, 5819 KiB  
Article
Serous Ovarian Carcinoma: Detailed Analysis of Clinico-Pathological Characteristics as Prognostic Factors
by Lamia Sabry Aboelnasr, Hannah Meehan, Srdjan Saso, Ernesto Yagüe and Mona El-Bahrawy
Cancers 2024, 16(21), 3611; https://doi.org/10.3390/cancers16213611 - 25 Oct 2024
Viewed by 2268
Abstract
Background/Objectives: Serous ovarian carcinoma (SOC) is the most common subtype of epithelial ovarian cancer, with high-grade (HGSOC) and low-grade (LGSOC) subtypes presenting distinct clinical behaviours. This study aimed to evaluate histopathologic features in SOC, correlating these with prognostic outcomes, and explore the potential [...] Read more.
Background/Objectives: Serous ovarian carcinoma (SOC) is the most common subtype of epithelial ovarian cancer, with high-grade (HGSOC) and low-grade (LGSOC) subtypes presenting distinct clinical behaviours. This study aimed to evaluate histopathologic features in SOC, correlating these with prognostic outcomes, and explore the potential clinical implications. Methods: We analysed 51 SOC cases for lymphovascular space invasion (LVSI), tumour border configuration (TBC), microvessel density (MVD), tumour budding (TB), the tumour–stroma ratio (TSR), the stromal type, tumour-infiltrating lymphocytes (TILs), and tertiary lymphoid structures (TLSs). A validation cohort of 54 SOC cases from The Cancer Genome Atlas (TCGA) was used for comparison. Results: In the discovery set, significant predictors of aggressive behaviour included LVSI, high MVD, high TB, and low TILs. These findings were validated in the validation set where the absence of TLSs, lower peritumoural TILs, immature stromal type, and low TSR were associated with worse survival outcomes. The stromal type was identified as an independent prognostic predictor in SOC across both datasets. Inter-observer variability analysis demonstrated substantial to almost perfect agreement for these features, ensuring the reproducibility of the findings. Conclusions: The histopathological evaluation of immune and stromal features, such as TILs, TLSs, TB, TSR, and stromal type, provides critical prognostic information for SOC. Incorporating these markers into routine pathological assessments could enhance risk stratification and guide treatment, offering practical utility, particularly in low-resource settings when molecular testing is not feasible. Full article
(This article belongs to the Special Issue Tumor-Associated Microenvironments and Inflammation)
Show Figures

Figure 1

18 pages, 52608 KiB  
Article
Robotic Rectosigmoid Resection with Totally Intracorporeal Colorectal Anastomosis (TICA) for Recurrent Ovarian Cancer: A Case Series and Description of the Technique
by Valerio Gallotta, Luca Palmieri, Francesco Santullo, Camilla Certelli, Claudio Lodoli, Carlo Abatini, Miriam Attalla El Halabieh, Marco D’Indinosante, Alex Federico, Andrea Rosati, Carmine Conte, Riccardo Oliva, Anna Fagotti and Giovanni Scambia
J. Pers. Med. 2024, 14(10), 1052; https://doi.org/10.3390/jpm14101052 - 11 Oct 2024
Cited by 2 | Viewed by 1642
Abstract
Background: Most patients with ovarian cancer relapse within 2 years. Prospective randomized trials, such as DESKTOP III and SOC-I, have shown the role of secondary cytoreduction in improving oncological outcomes in selected patients, when complete tumor resection is achieved. Recent retrospective series suggest [...] Read more.
Background: Most patients with ovarian cancer relapse within 2 years. Prospective randomized trials, such as DESKTOP III and SOC-I, have shown the role of secondary cytoreduction in improving oncological outcomes in selected patients, when complete tumor resection is achieved. Recent retrospective series suggest that minimally invasive surgery is a feasible option in oligometastatic recurrences, such as rectal ones. Methods: Five patients with an isolated rectal recurrence infiltrating the bowel wall underwent a robotic rectosigmoid resection with totally intracorporeal colorectal anastomosis. The procedure began with retroperitoneal access to manage the vascular structures, followed by visceral resection with a minimally invasive approach. The standard steps of an en-bloc pelvic resection, including intracorporeal end-to-end anastomosis, were performed. The treatment data were evaluated. Results: The mean age of the patients was 54 years, and their mean body mass index was 30. All patients had at least one previous abdominal surgery and 60% had high-grade serous ovarian cancer at their initial diagnosis. Their mean platinum-free interval was 17.4 months. Complete secondary cytoreduction was achieved in all cases, with histopathology confirming bowel infiltration. The mean procedure duration was 294 min, with an estimated blood loss of 180 mL. No intraoperative complications occurred. The mean hospital stay was 8 days. One patient had a grade 2 postoperative complication. The mean follow-up period was 14 months, with only one patient experiencing a recurrence at the level of the abdominal wall. Conclusions: Robotic rectosigmoid resection is a viable option for complete cytoreduction in isolated recurrent ovarian cancer. Full article
(This article belongs to the Special Issue Advanced Minimally Invasive Surgery in Gynecology: 2nd Edition)
Show Figures

Figure 1

Back to TopTop