• Asian Pacific Journal of Cancer Prevention
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• v.16 no.10
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• pp.4157-4160
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• 2015

Treatment of early stage ovarian cancer remains controversial despite advances in chemotherapeutic options. Over the past 30 years, molecular and clinicopathologic studies accelerated and treatment of ovarian cancer has undoubtedly improved although there is a debate as to whether this impacts outcome or not. More recently, the introduction of targeted therapy started a new era. Probably it is because early stage disease comprises a small portion of the epithelial ovarian cancer, studies have mostly ignored this group and still there is no clear consensus regarding systemic treatment of early-stage lesions. However this group of patients has the best chance of cure. In this review, we focus on current developments in the treatment of early stage ovarian cancer and query the options.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.9
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• pp.4525-4529
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• 2012

Objectives: To determine the prevalence and predicting factors of ovarian metastasis, and evaluate the histology of other ovarian neoplasms in women with early-stage cervical cancer. Methods: The medical records of women with cervical cancer stage IA-IIA who underwent primary surgical treatment at Siriraj Hospital, Mahidol University from January 2007 to December 2011 were used for the study. Demographic, clinical and histopathologic data of the women who underwent salpingo-oophorectomy were reviewed. Results: Of 264 women, the mean age was 52.3 years. The types of hysterectomy procedures were composed of 210 radical hysterectomy, 9 modified radical hysterectomy, 40 simple hysterectomy, and 5 abandoned hysterectomy. The prevalence of ovarian metastasis was 0.76% (2/264). All of ovarian metastatic patients were older than 60 years old, postmenopause, and had macroscopical stage IB1 cervical cancer. Others ovarian tumors were found in 7 patients including 1 synchronous ovarian carcinoma, 1 serous cystadenoma, 1 fibroma, and 4 teratoma. Conclusions: In cases of early-stage cervical carcinoma of the population studied, ovarian preservation could be another option in <60-year-old patients, with non-neuroendocrine cell type, stage IA, and no extracervical or ovarian lesions.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.22
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• pp.9781-9784
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• 2014

Background: The study aimed to evaluate changes in hematologic parameters, including white blood cell, platelet count, platelet indices, the platelet to lymphocyte and neutrophil to lymphocyte ratios in patients with early and advanced stages of epithelial ovarian cancers. Materials and Methods: The study included 100 patients with epithelial ovarian cancer who underwent primary staging exploratory laparotomy. Preoperative hematologic parameters, tumor histopathologic type, grade, stage and serum CA-125 levels were retrospectively analyzed. These parameters were compared between the patients with early (stage I-II) and advanced (stage III-IV) ovarian cancer. Results: White blood cell count and platelet indices, including mean platelet volume, platelet distribution width and platelet crit did not show a statistically significant difference between groups with early and advanced ovarian cancer. However, the neutrophil to lymphocyte ratio, platelet count, the platelet to lymphocyte ratio and CA-125 level showed a statistically significant difference between the two groups (p<0.05, p<0.01, p<0.001, p<0.01 respectively). Conclusions: It was found that the neutrophil to lymphocyte ratio, platelet count and the platelet to lymphocyte ratio increased with the increasing stage of ovarian cancer. Furthermore, it was seen that the platelet to lymphocyte ratio is an independent prognostic factor related to the stage of epithelial ovarian cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.24
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• pp.10735-10738
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• 2015

Background: Cancers of the breast, uterine cervix and ovary are common cancers amongst females of North East India. Not much is known about the descriptive epidemiology of these cancers in our population. The present retrospective analysis was therefore performed. Materials and Methods: The data set available at the hospital based cancer registry of a regional cancer center of North-East India, containing information on patients registered during the period of January 2010 to December 2012, was applied. A total of 2,925 cases of breast, uterine cervix and ovarian cancer were identified. Results: Of the total, 1,295 (44.3%) were breast cancers, 1,214 (41.5%) were uterine cervix and 416 (14.2%) ovarian cancer, median age (range) for breast, uterine cervix and ovary were 45 (17-85), 48 (20-91) and 45 years (7-80), respectively. Some 43.5% of cases with uterine cervix patients were illiterate, 5.4% and 5.7% stage I in breast and cervix respectively and 96.4% of ovarian cancers in advanced stage. Conclusions: Improvement of female education can contribute to increase the proportion of early stage diagnosis of breast and uterine cervix in our population. Any population-based intervention for the detection of cancers of breast, uterine cervix and ovarian cancer should be started early in our population.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.9
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• pp.4695-4698
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• 2012

Objective: To analyze differential diagnostic accuracy of urinary human epidydimis secretory protein 4 (HE4) in patients with ovarian tumors. Materials and methods: In the case-control study 23 patients with ovarian cancer, 37 patients with benign ovarian tumors and 18 women in the control group were included. Serum CA125 values and urinary concentrations of HE4were assessed quantitatively. Urinary creatinine concentrations and glomerular filtration rate were also determined and used to calculate ratios to HE4. Results: Higher urinary HE4 concentrations were observed in patients with late stage ovarian cancer (p=0.001) and also in patients with early stage ovarian cancer when compared to patients with benign ovarian tumors (p=0.044). On analysis where all ovarian cancer patients were included, higher diagnostic accuracy was observed with calculated ratio of HE4 to glomerular filtration rate (GFR) to unchanged urinary HE4 concentrations -AUC 0.861 vs. 0.858. When discriminatory accuracy was calculated for urinary HE4/GFR ratio and unchanged urinary HE4 concentrations, the last demonstrated a higher area under the curve - 0.701 vs. 0.602. The urinary HE4/creatinine ratio had lower discriminatory characteristics than unchanged concentrations of urinary HE4. However, HE4 serum concentration was more accurate for discrimination of patients with benign and malignant ovarian tumors when compared to urinary HE4 and CA125 in sera (AUCs were 0.868 for serum HE4 and 0.856 and 0.653 for urinary HE4 and CA125, respectively). Conclusions: Ovarian cancer patients have higher urinary concentrations of human epidydimis secretory protein 4 than patients with benign ovarian tumors. Urinary HE4 has comparable discriminatory accuracy with serum HE4 for benign and malignant ovarian tumors and can be recommended as a non-invasive ovarian cancer risk assessment method.

• Reproductive and Developmental Biology
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• v.37 no.1
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• pp.41-49
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• 2013

Ovarian cancer is the most lethal world-wide gynecological disease among women due to the lack of molecular biomarkers to diagnose the disease at an early stage. In addition, there are few well established relevant animal models for research on human ovarian cancer. For instance, rodent models have been established through highly specialized genetic manipulations, but they are not an excellent model for human ovarian cancer because histological features are not comparable to those of women, mice have a low incidence of tumorigenesis, and they experience a protracted period of tumor development. However, the laying hen is a unique and highly relevant animal model for research on human ovarian cancer because they spontaneously develop epithelial cell-derived ovarian cancer (EOC) as occurs in women. Our research group has identified common histological and physiological aspects of ovarian tumors from women and laying hens, and we have provided evidence for several potential biomarkers to detect, monitor and target for treatment of human ovarian cancers based on the use of both genetic and epigenetic factors. Therefore, this review focuses on ovarian cancer of laying hens and relevant regulatory mechanisms, based on genetic and epigenetic aspects of the disease in order to provide new information and to highlight the advantages of the laying hen model for research in ovarian carcinogenesis.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.2
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• pp.1057-1060
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• 2013

Recent investigations have confirmed up-regulation of serum miR-21 and its diagnostic and prognostic value in several human malignancies. In this study, we examined serum miR-21 levels in epithelial ovarian cancer (EOC) patients, and explored its association with clinicopathological factors and prognosis. The results showed significantly higher serum miR-21 levels in EOC patients than in healthy controls. In addition, increased serum miR-21 expression was correlated with advanced FIGO stage, high tumor grade, and shortened overall survival. These findings indicate that serum miR-21 may serve as a novel diagnostic and prognostic marker, and be used as a therapeutic target for the treatment of EOC.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.16
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• pp.6973-6979
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• 2015

Background: Ovarian cancer is the third most common cause of cancer in Indian women. Despite an initial 70-80% response rate, most patients relapse within 1-2 years and develop chemoresistance. Hence, identification or repositioning of drugs to resensitise ovarian cancer cells to existing chemotherapy is needed. Traditionally immortalized cell lines have been used in research, but these may contain genetic aberrations and chromosomal abnormalities serving as poor indicators of normal cell phenotype and progression of early-stage disease. The use of primary cells, maintained for only short periods of time in vitro, may serve as the best representative for studying in vivo conditions of the tissues from which they are derived. In this study we have attempted to evaluate the effect of metformin (an antidiabetic drug) in primary ovarian cancer cells because of its promising effect in other solid tumours. Materials and Methods: Primary cultures of epithelial ovarian cancer cells established from ascitic fluid of untreated ovarian cancer patients were used. The cells were treated with metformin at doses standardized by MTT assay and its ability to induce apoptosis was studied. The cells were analysed for apoptosis and apoptosis related proteins by flow cytometry and western blotting respectively. Results: Metformin induced apoptosis in ovarian cancer cells, provoking cell cycle arrest in the G0/G1 and S phase. It induced apoptosis in ovarian cancer cells by, down-regulating Bcl-2 and up-regulating Bax expression. Conclusions: Metformin was able to induce apoptosis in primary ovarian cancer cells by modulating the expression of Bcl-2 family proteins. These data are relevant to ongoing translational research efforts exploring the chemotherapeutic potential of metformin.

• Journal of Yeungnam Medical Science
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• v.37 no.3
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• pp.179-185
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• 2020

Background: Approximately 100,000 women are diagnosed with cancer each year in Korea. According to a survey by the Korean central cancer registry in 2016, uterine cervical cancer, uterine corpus cancer, and ovarian cancer were the 5th, 7th, and 8th most prevalent cancers respectively among Korean women. The present study aims to review the clinico-pathologic characteristics of patients who were treated for major gynecological malignancies at Yeungnam University Medical Center. Methods: Patients with invasive gynecological cancers from January 2012 to February 2019 were retrospectively identified. We analyzed the clinical features, demographic profiles, pathologic data, treatment modality used, adjuvant treatment used, complications, recurrence, and survival outcomes. Results: A total of 287 patients (cervical cancer 115; corporal cancer 86; and ovarian, tubal, or primary peritoneal cancer 90) were included. Most cervical (82.7%) and corporal cancers (89.5%) were diagnosed in the early stages (stage I or II), while more than half (58.9%) the cases of ovarian, tubal or peritoneal cancers were diagnosed in the advanced stages (stage III or IV). Surgical complications were observed in 12.2% of cervical cancers, 16.3% of uterine corpus cancers, and 11.1% of ovarian, tubal, and peritoneal cancers, respectively. The 5-year overall survival rate was 94.1%, 91.0%, and 77.1% for cervical, corporal, and ovarian, tubal, or peritoneal cancers, respectively. Conclusion: Surgical treatment was satisfactory in terms of the incidence of complications, and survival outcomes were generally good. Clinicians should be aware of the clinical and histopathological characteristics of patients with gynecological cancers to be able to provide optimal strategies and counseling.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.12
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• pp.4839-4841
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• 2015

We conducted a retrospectively reviewed of the literature published of patients underwent fertility-preserving treatments for cervical, endometrial and ovarian cancers using the WANFANG database in Chinese. A majority were retrospective studies and case reports. With cervical cancer, radical trachelectomy(RT) in combination with pelvic lymphadenectomy could preserve the fertility of patients with early stage IA1-IB1 cancers, Tumor size ${\leq}2cm$ should be emphasized as the indication of RT in considering of the higher recurrent rate in patients with tumor size >2cm. For endometrial cancers, there is much experience on it. Given accurate pretreatment assessment, hormonal therapy is feasible management option to preserve fertility in young patients with early stage lesions that limited to the endometrium and well differentiated. High dose progestin have been applied, oral medroxyprogesterone acetate (MPA), 250-500mg/day, megestrol acetate 160-480mg/day. Other therapies that have been used in a limited number of cases include GnRH analog, intrauterine devices (IUDS) containing progestogen, usually combination of these therapies. All patients should be followed up by ultrasound and/or MRI evaluation, and endometrial curettage at intervals of 3 months. With ovarian cancer, in China, fertilitypreserving surgery in patients with stage IA (grade G1) of epithelial ovarian tumor and patients with germ cell tumor and borderline ovarian tumor have been successfully performed.