The use and understanding of CA125 as a tumor marker for ovarian cancer: a questionnaire-based survey

2008 ◽  
Vol 18 (3) ◽  
pp. 439-445 ◽  
Author(s):  
E. L. Moss ◽  
J. Hollingworth ◽  
M. Holland ◽  
D. J. Murphy ◽  
I. Fernando ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Primary Care ◽  
Tumor Marker ◽  
Overall Response Rate ◽  
Cost Savings ◽  
Substantial Cost ◽  
Medical Specialties ◽  
Significant Difference ◽  
Level Of Understanding

The aim of this study was to assess the level of understanding of the role of the tumor marker CA125 in ovarian cancer among doctors of different grades specializing in obstetrics and gynecology (O&G), medicine, surgery, and primary care (general practitioners [GPs]). The study involves a questionnaire-based survey. Two hundred and fifty-nine questionnaires were distributed. An overall response rate of 47.1% was achieved. All grades of doctors and all major specialties were represented. There was a significant difference in the level of self-reported CA125 ordering between the medical specialties, O&G being the most frequent users and primary care the least (P< 0.001), and between the grade of doctors, senior house officers/preregistration house officers and GPs less than consultants and middle grade doctors (P< 0.001). Electronic literature was the first source of advice for the majority of respondents (38.5%). The knowledge of false-positive causes for a raised CA125 was low in medicine, surgery, and primary care specialties, as was the awareness of the sensitivity and specificity of CA125 in epithelial and nonepithelial ovarian cancers. The role of CA125 in ovarian cancer is poorly understood, especially among doctors working outside O&G. Guidelines should be developed to aid clinicians from all specialties in the most appropriate application of CA125 in their practice. Substantial cost savings could be made by the introduction of clear protocol-driven ordering in an attempt to reduce the number of inappropriate tests performed.

scholarly journals Views of general practitioners on the role of CA125 in primary care to diagnose ovarian cancer

2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Esther L Moss ◽  
Alison Moran ◽  
Timothy M Reynolds ◽  
Helen Stokes-Lampard
Keyword(s):  
Ovarian Cancer ◽  
Primary Care ◽  
General Practitioners

scholarly journals Role of Lymphadenectomy During Interval Debulking Surgery Performed After Neoadjuvant Chemotherapy in Patients With Advanced Ovarian Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
Minjun He ◽  
Yuerong Lai ◽  
Hongyu Peng ◽  
Chongjie Tong
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Residual Disease ◽  
Advanced Ovarian Cancer ◽  
Progression Free Survival ◽  
Debulking Surgery ◽  
Hazard Ratios ◽  
Significant Difference ◽  
Interval Debulking Surgery

ObjectiveThe role of lymphadenectomy in interval debulking surgery (IDS) performed after neoadjuvant chemotherapy (NACT) in advanced ovarian cancer remains unclear. We aimed to investigate the clinical significance of lymphadenectomy in IDS.MethodsWe retrospectively reviewed and analyzed the data of patients with advanced ovarian cancer who underwent NACT followed by IDS.ResultsIn 303 patients receiving NACT-IDS, lymphadenectomy was performed in 127 (41.9%) patients. One hundred and sixty-three (53.8%) patients achieved no gross residual disease (NGRD), and 69 (22.8%) had residual disease &lt; 1 cm, whereas 71 (23.4%) had residual disease ≥ 1cm. No significant difference in progression-free survival (PFS) and overall survival (OS) was observed between the lymphadenectomy group and the no lymphadenectomy group in patients with NGRD, residual disease &lt; 1 cm, and residual disease ≥ 1 cm, respectively. The proportions of pelvic, para-aortic and distant lymph node recurrence were 7.9% (10/127), 4.7% (6/127) and 5.5% (7/127) in the lymphadenectomy group, compared with 5.7% (10/176, P = 0.448), 4.5% (8/176, P = 0.942) and 5.1% (9/176, P = 0.878), respectively, in no lymphadenectomy group. Multivariate analysis identified residual disease ≥ 1 cm [hazard ratios (HR), 4.094; P = 0.008] and elevated CA125 levels after 3 cycles of adjuvant chemotherapy (HR, 2.883; P = 0.004) were negative predictors for OS.ConclusionLymphadenectomy may have no therapeutic value in patients with advanced ovarian cancer underwent NACT-IDS. Our findings may help to better the therapeutic strategy for advanced ovarian cancer. More clinical trials are warranted to further clarify the real role of lymphadenectomy in IDS.

Lack of Association of Cyp1B1*3 Polymorphism and Ovarian Cancer in a Caucasian Population

2004 ◽  
Vol 19 (2) ◽  
pp. 160-163 ◽  
Author(s):  
E. Cecchin ◽  
A. Russo ◽  
E. Campagnutta ◽  
L. Martella ◽  
G. Toffoli
Keyword(s):  
Ovarian Cancer ◽  
Genomic Dna ◽  
Blood Donors ◽  
Caucasian Population ◽  
Cancer Development ◽  
Carcinogenic Effect ◽  
Significant Difference ◽  
Healthy Female ◽  
Mixed Ethnicity

CYP1B1 is the enzyme with the highest efficiency of conversion of estradiol to 4-hydroxyestradiol in humans. This metabolite has a well-known carcinogenic effect interacting with genomic DNA and has been hypothesized to be partly responsible for the role played by estrogens in ovarian cancer development. A polymorphism has been described for this enzyme causing a Leu to Val substitution in position 432 (CYP1B1*3). The Val432 allele has a higher efficiency of conversion of estradiol to 4-hydroxyestradiol and has been reported to increase the risk of ovarian cancer. A previous study reported a higher, significant prevalence of CYP1B1*3 polymorphism in ovarian cancer patients of mixed ethnicity. The aim of this study was to investigate the role of CYP1B1*3 polymorphism as a risk factor for ovarian cancer in a Caucasian population. The polymorphism frequency was determined in 223 cases of ovarian cancer and compared with that of 280 healthy female blood donors. Genetic analysis was performed on genomic DNA from PBMC and RFLP methods were used for mutation detection. No significant difference between cases and controls was found. These results do not support a favoring role of CYP1B1*3 in ovarian cancer development in our population.

scholarly journals Expression III (I): A Cross Cultural Analysis of Ovarian Cancer Patient’s Preferences and Expectations on Physician-Patient Communication and Clinical Management in India and Germany

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Kar S ◽  
◽  
Alavi S ◽  
Oskay Ozcelik G ◽  
Keller M ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Information Needs ◽  
Economic Status ◽  
Information Source ◽  
Cultural Analysis ◽  
Indian Patients ◽  
Significant Difference ◽  
Physician Patient ◽  
Source Of Information

Background: The information level and expectations of the patients suffering from cancers should be taken as a basis for the treatment decisionmaking process. Nevertheless, there are lacking data in both developing and western countries. The objective of this survey was to identify similarities and differences between patients with ovarian cancer from India and Germany in regard to the information needs and expectations concerning physician-patientcommunication and treatment. Patients and Methods: This study was based on the European survey “Expression III”. The German subgroup was compared to an Indian cohort. The study was conducted in the state of Odisha, India using an English translation of the same questionnaire with 43 items. Results: Overall, 86 Indian patients (median age 52y, range 19-76 y) and 427 German patients (median age 62y, range 26-84y) participated in this survey. The most valuable suggestions made by German patients to improve the treatment of ovarian cancer was ‘the therapy shouldn’t lead to hair loss (49%)’, whereas the Indian patients whished for a treatment of shorter duration (47%). The majority of German (90%) and the Indian (79%) patients consider their treating physician to be most effective and patient-friendly information source. Fear of the future was the most difficult aspect of their illness to handle by both study populations (43% India / 55% Germany). Compared to 46% of German patients, not a single patient in India was involved in a study or clinical trial. Conclusions: The study underlines the key role of the physician as the most relevant source of information for patients in both countries. In spite of a significant difference in the socio-economic status, the expectations from their physicians found to be similar in many aspects.

scholarly journals Role of bone scintigraphy and tumor marker-Ca 15-3 in detection of bone metastases in patients with breast cancer

2005 ◽  
Vol 5 (1) ◽  
pp. 23-26 ◽  
Author(s):  
Amela Begić ◽  
Elma Kučukalić-Selimović ◽  
Nermina Obralić ◽  
Osman Durić ◽  
Nadir Lačević ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Tumor Marker ◽  
Bone Metastases ◽  
Bone Scintigraphy ◽  
Axial Skeleton ◽  
Disease Recurrence ◽  
Chi Square ◽  
Significant Difference ◽  
Total Body

Breast cancer is one of the most frequent types of cancer affecting women. After hematogenous spreading of cancer, axial skeleton is most frequently involved. Bone scintigraphy is commonly performed in detection and evaluation of bone metastases. In breast cancer, marker Ca15-3 is widely accepted in follow-up and detection of disease recurrence. Aim of the study was to correlate levels of tumor marker Ca 15-3 and presence of bone metastases detected by bone scintigraphy. Study included 25 patients with breast cancer, previously surgically treated. All patients underwent total body scintigraphy. Ca 15-3 was measured by radioimmunoassay. Presence, number and location of bonemetastases were correlated with Ca 15-3 levels. Bone scintigraphy revealed bone metastases in 16 (64%) patients. 11 (44%) patients with metastases and 1 patient (4%) without scintigraphically visible metastases had elevated Ca 15-3 levels. Significant difference in distribution of metastases was found for spine (t=3.930, p=0.008). Correlation between intensity of radiopharmaceutical uptake and level of Ca 15-3 in patients was positive (r =0.405). A weak correlation was found between number of metastases and level of Ca 15-3 (r=0.139). Significant differences in Ca 15-3 level was found in patients with metastases compared to patients without metastases (chi square 0, p =1.0). Since no significant correlation was found between level of Ca 15-3 and number of metastases, we consider scintigraphy an appropriate method for assessment of bone metastases in breast cancer.

scholarly journals Videoconference Interviews: A Timely Primary Care Residency Selection Approach

2020 ◽  
Vol 12 (6) ◽  
pp. 737-744
Author(s):  
Rebecca McAteer ◽  
Shala Sundaram ◽  
Shantie Harkisoon ◽  
Julia Miller
Keyword(s):  
Primary Care ◽  
Residency Program ◽  
Selection Process ◽  
Cost Savings ◽  
Cost Effective ◽  
Structured Interview ◽  
Recruitment Process ◽  
Medical Specialties ◽  
Application Service ◽  
Program Costs

ABSTRACT Background Videoconference interviews (VCIs) are increasingly being used in the selection process of residency program candidates across a number of medical specialties, but nevertheless remain an underutilized approach, particularly in the field of primary care. Objective This retrospective data review with cost analysis explores financial and acceptability outcomes of VCI implementation over a 9-year period. Methods VCIs were incorporated into the recruitment process at a community-based academic family medicine residency program in 2011, whereby suitable candidates were selected for VCIs after Electronic Residency Application Service (ERAS) application review. Based on the outcome of VCI, candidates were invited via a structured interview tool for a subsequent in-person interviews to determine final rank decisions. Costs of the interview process were tracked, as well as perceptions of VCIs. Results VCI implementation over 9 years demonstrated a median 48% reduction of in-person interviews—or 95 applicants eliminated out of a total 195 VCIs performed. This represents a mean annual direct cost savings estimated at $9,154, equating to a 55% reduction in allocated program costs, in addition to indirect cost savings to both applicants and the program. Conclusions Compared to exclusively in-person interviewing, the utilization of VCIs is potentially more cost-effective for residency programs and candidates, while creating a more personal experience for applicants early in the recruitment process. Limited data of acceptability among faculty and candidates is generally favorable but remains mixed.

scholarly journals Study of leucine-rich alpha-2-glycoprotein-1 marker serum level in cases of malignant epithelial ovarian tumors

2020 ◽  
Vol 10 (1) ◽  
pp. 12
Author(s):  
Abd Elfatah Agameia ◽  
Rania Shafik Swelem ◽  
Hossam Hassan El Sokkary ◽  
Ghada Shehata Elsayed
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Tumor Marker ◽  
Histopathological Examination ◽  
Mean Value ◽  
Ovarian Tumors ◽  
Controlled Study ◽  
Control Group ◽  
Group I ◽  
Significant Difference

Background: The aim of this study was to compare the level of LRG1 in epithelial ovarian cancer (EOC) cases with benign ovarian masses and to evaluate results in relation to CA125.Methods: An observational prospective controlled study was done on 70 patients admitted to El Shatby Maternity University Hospital, Oncology department categorized as follows: study group (group I) included 35 patients, with epithelial ovarian malignancy confirmed by histopathological examination and control group (group Il) included 35 patients with benign ovarian tumors confirmed by histopathological examination. Determination of Serum LRGI level by using enzyme-linked immuno sorbent assay with CA125 tumor marker analysis were done for all cases of both groups.Results: As regard comparison between the two studied groups according to CA125 and LRGI. CA125 in group I ranged from 14.90 to 4600 with a mean value 856.73±1104.03, in group II ranged from 7.45 to 523 with a mean value of 51.97±86.14. LRGI in group I ranged from 62.46 to 653.98 with a mean value of 130.86±119.78, in group Il ranged from 47.73 to 261.78 with a mean value of 77.35±38.75. There was statistically significant difference between the two studied groups regarding CA125 and LRGI (p≤0.05).Conclusions: LRG1 can be used as promising tumor marker to diagnose epithelial malignant ovarian cancer with or without CA125 tumor marker as it was significantly higher in epithelial ovarian cancer patients.

Prevalence and clinical implications of mismatch repair (MMR) deficiency in unselected non-serous epithelial ovarian cancer (EOC) patients (pts).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 1521-1521
Author(s):  
Mariana Scaranti ◽  
Krithika Murali ◽  
Cecilia Orbegoso ◽  
Katherine Vroobel ◽  
Susana N. Banerjee ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Endometrial Cancer ◽  
Significant Proportion ◽  
Disease Free Survival ◽  
Figo Stage ◽  
Significant Difference ◽  
Serous Epithelial Ovarian Cancer ◽  
Average Body Mass ◽  
Mixed Histology

1521 Background: It has previously been reported that 6-7% of clear cell (CC) and endometrioid (E) ovarian cancers are MMR deficient (MMRd). The prevalence of MMRd in other histological subtypes and correlation with germline (g) MMR (Lynch Syndrome) mutations in unselected non-serous EOC pts is less clear. MMRd in solid tumors has been associated with enhanced response to immunotherapy, hence knowledge of MMR status has therapeutic and familial implications. We aimed to study the prevalence and implications of MMRd and gMMRd in unselected pts with non-serous EOC. Methods: Routine immunohistochemistry (IHC) was performed for the MMR proteins MLH1, MSH2, MSH6 and PMS2 in all non-serous EOC pts from June 2016; retrospective MMR IHC testing in pts in follow-up was performed. Pts with MMRd tumors were referred for gMMR testing. Results: We analyzed 66 unselected pts with non-serous EOC. Median age was 56.4 years (yrs). The majority had E ovarian cancer (54.5%) followed by CC (25.8%), mixed histology (12.1%), mucinous (4.5%) and mullerian (3%) subtypes. Endometriosis was noted in 45.5% of pts, and 75% were FIGO stage I and II at diagnosis. Seventeen pts (25.8%) had concurrent endometrial cancer, all Grade I. On IHC, 15.2% were MMRd: 5 E, 2 CC, 2 mixed and 1 mullerian-type. Of these, 3 pts (30%) had gMMR mutation, 2/3 did not meet the Revised Bethesda criteria for testing. A lower average body mass index (Kg/m2) was noted in MMRd 25.9 versus 30.1 in MMR proficient (MMRp). Median age at diagnosis was 53.5 yrs in the MMRd and 57.7 yrs in MMRp. A higher frequency of concurrent endometrial cancer was observed on the MMRd group (60%) versus (20%) on MMRp (p = 0.007). No statistically significant difference in overall survival or disease-free survival was observed between the MMRd and MMRp population. Conclusions: Our study has shown a higher prevalence of somatic MMRd in non-serous EOC (15.2%) than in previously published literature with a significant proportion found to carry gMMR mutations (4.5%). These interim findings support the role of universal MMR IHC testing in non-serous EOC regardless of family history. [Table: see text]

scholarly journals The Role of Thrombocytosis as a Prognostic Factor for Epithelial Ovarian Cancer

2021 ◽  
pp. 153-156
Author(s):  
Andrijono ◽  
Heru Prasetyo ◽  
Eka R Gunardi ◽  
Gatot Purwoto ◽  
Hariyono Winarto
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Prognostic Factor ◽  
Epithelial Ovarian Cancer ◽  
Cancer Registry ◽  
Hazard Ratio ◽  
Advanced Stage ◽  
Significant Difference ◽  
Mean Time

Objective: To determine whether thrombocytosis is a prognostic factor for epithelial ovarian cancer and its relationship with 3-year overall survival in epithelial ovarian cancer patients.Methods: This study is a retrospective cohort study using medical record of patients with epithelial ovarian cancer registered in cancer registry of Oncology Division in Obstetrics and Gynecology Department, Dr. Cipto Mangunkusumo National General Hospital from January 2014 - July 2016. Data were collected when subjects were first until diseases outcomes identified in 3 years.Results: : Out of 220 subjects, 132 (60%) were patients with advanced stage epithelial ovarian cancer (stage II/III/IV). 94 (42.7%) subjects had thrombocytosis. Patients with advanced stage of disease had higher risk of having thrombocytosis than the ones with earlier stage (p=0.005; OR=2.329). Correlation between thrombocytosis and 3-year overall survival was known to be insignificant (p=0.555). There was shorter mean time survival between patients with thrombocytosis and the ones without but the there was no significant difference in hazard ratio between the two groups (p  = 0.399).Conclusion :Thrombocytosis is not a prognostic factor in patients with epithelial ovarian cancer. There is also no significant difference of 3-year overall survival between patients with or without thrombocytosis.Keywords: epithelial ovarian carcinoma, prognosis,  thrombocytosis.   Abstrak Tujuan: Membuktikan bahwa trombositosis sebagai faktor prognosis kesintasan pada pasien kanker ovarium jenis epitelial dan hubungannya terhadap kesintasan 3 tahun pasien kanker ovarium  jenis epitelial.Metode: Penelitian ini merupakan studi kohort retrospektif menggunakan data rekam medis pasien kanker ovarium epitelial yang terdaftar pada cancer registry Departemen Obstetri dan Ginekologi Divisi Onkologi Rumah Sakit Cipto Mangunkusumo pada tahun Januari 2014-Juli 2016. Pengamatan dilakukan saat subjek pertama kali didiagnosis akhir pengamatan selama 3 tahun.Hasil: Didapatkan 220 subjek penelitian yang merupakan populasi terjangkau dan memenuhi kriteria inklusi dan eksklusi. Dari 220 subjek penelitian, 132 (60%) dari 220 subjek penelitian merupakan pasien dengan kanker ovarium stadium lanjut (Stadium II/III/IV). Trombositosis didapatkan pada 94 orang subjek penelitian (42,7%). Pasien dengan kanker stadium lanjut memiliki risiko trombositosis yang lebih tinggi dibandingkan subjek pada stadium awal (p=0,005;OR=2,329). Trombositosis secara statistik tidak bermakna pada kesintasan 3 tahun (p=0,555). Terdapat mean time survival yang lebih rendah pada pasien dengan trombositosis tetapi tidak ada perbedaan hazard ratio yang bermakna antara subjek dengan atau tanpa trombositosis (p=0,399).Kesimpulan : Trombositosis bukan merupakan faktor prognostik pada pasien kanker ovarium jenis epitelial dan tidak terdapat hubungan antara trombositosis dan 3 tahun pada pasien dengan kanker ovarium jenis epithelial.Kata kunci: karsinoma ovarium epithelial,  prognosis, trombositosis

scholarly journals BREAST CANCER

2006 ◽  
Vol 13 (03) ◽  
pp. 338-340
Author(s):  
MUMTAZ BEGUM ◽  
GHAZALA RUBY ◽  
RUKHASHAN KHURSHID ◽  
Saleem Akhtar
Keyword(s):  
Breast Cancer ◽  
Tumor Marker ◽  
Cancer Patients ◽  
Immunoglobulin G ◽  
Cathepsin D ◽  
Stage Iii ◽  
Ca 15.3 ◽  
Significant Difference

CA 15.3 is a useful parameter in the management of patients in different stages ofthe breast cancer. Objectives: (1) To evaluate the level of CA 15-3 in stage III carcinoma of breast. (2) To study therole of immunoglobulin G and cathepsin D. Patients & Methods: Serum CA 15-3 was assayed in a group of 25 femalebreast cancer patients with stage III. Method used for determination of CA 15-3 is IMMULITE Automated ImmunoassaySystem. Result: 25 patients were taken in the study. It was observed that the level of CA 15-3 and cathepsin D issignificantly increased in patients as compared to control subjects. Although the level of IgG was also increased butit shows no significant difference. Conclusion: It is concluded that CA 15-3 can be used as tumor marker especiallyin the 3 stage rd of breast cancer and also for monitoring the treatment. IgG shows the role of body defense mechanismsystem in breast cancer. Whereas protease like cathepsin D shows the extent of metastasis.

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