The potential predictive value of serum sRCAS1 levels for overall survival in endometrial cancer

Objectives: The main aim of the study was to evaluate the impact of levels of serum soluble receptor-binding cancer antigen expressed on SiSo cells (sRCAS1) on the overall survival (OS) rates in patients with endometrial cancer. Furthermore, we analyzed sRCAS1 levels according to the clinicopathological characteristics of the disease.  Material and methods: The study group comprised 43 patients who were being treated for endometrial cancer. We included 10 low-risk, 20 intermediate-risk and 13 high-risk endometrial cancers using the criteria of the European Society for Medical Oncology (ESMO), the European Society for Radiotherapy & Oncology (ESTRO) and the European Society of Gynaecological Oncology (ESGO). Serum sRCAS1 levels were obtained before and after surgery. Serum sRCAS1 levels were assessed using the ELISA method.  Results: In our univariate analysis, both the pre- and post-surgery high sRCAS1 groups of patients with endometrial cancer indicated a shortened OS. However, in our multivariate analysis, when patients’ age and disease-related risk was taken into consideration, only the post-surgery sRCAS1 levels remained as independent prognostic factors of a poor OS. Pre-treatment serum sRCAS1 levels were statistically significantly higher than post-surgery sRCAS1 levels; however, the difference between pre- and post-surgery sRCAS1 levels did not influence the patients’ OS rate. Pre- and post-surgery sRCAS1 levels did not differ according to tumor grade, stage of the disease or the disease-related risk group.  Conclusions: High post-surgery serum sRCAS1 levels seem to be an independent indicator of shortened overall survival in patients with endometrial cancer.

Current treatment options for advanced choriocarcinoma on the basis of own case and review of the literature

Choriocarcinoma is one of rare neoplasms of female reproductive organs. In the last decade only a few cases of this disease have been registered in Poland. The paper presents the current principles of diagnosis and treatment options for this rare disease based on the authors’ clinical experience (description of the case) and literature review. This paper provides basic information on epidemiology, FIGO classification, and also discusses the chemotherapy regimens used in the medical treatment of choriocarcinoma. Surgical options were also considered. A thematic review of the most important papers published in international journals in recent years has also been made

Role of cyclooxygenase-2 in cervical cancer

Concurrent radiation and chemotherapy is a standard treatment of patients with cervical cancer in FIGO stages IB2-IVA. Chemotherapy given in the same time as irradiation improved survival significant, but not involves all patients. Cancer recurrence is the most common treatment failure in patients with advanced tumor. Further improvement in the treatment of advanced cases is essential. The increasing knowledge about new biologic markers and better ability to predict risk of cancer recurrence is very important for construction of more effective treatment strategies. Currently, there is considerable interest of role of cyclooxgenase-2 in cervical neoplasia. A lot of cancers in different localizations appear to overexpress the cyclooxygenase-2, which may have an important role in carcinogenesis. Ongoing clinical trials, clinical studies have shown the positive therapeutic effect of COX-2 inhibitors and may allow to increase understanding of this novel targeted approach for cervical cancer control

Mięsak popromienny trzonu macicy – opis przypadku

StreszczenieNowotwory indukowane napromienianiem są rzadkim powikłaniem odległym radioterapii. Histologicznie są to w ogromnej większości mięsaki tkanek miękkich lub kości. Przypadki zlokalizowane w miednicy mniejszej są zwykle późno rozpoznawane i rokują źle. Opisujemy przypadek popromiennego mięsaka trzonu macicy u chorej leczonej 7 lat wcześniej napromienianiem z powodu raka szyjki macicy, która pomimo przeprowadzonego chirurgicznego leczenia radykalnego zmarła wkrótce z powodu gwałtownej progresji. Przedstawiamy krótki przegląd aktualnego piśmiennictwa o częstości występowania, najczęstszych typach histologicznych, a także możliwych mechanizmach powstania wtómych nowotworów popromiennych. Kontrola chorych po skutecznym leczeniu napromienianiem powinna być prowadzona przez wiele lat. Wiedza o możliwości rozwoju wtórnych nowotworów upowszechniona wśród lekarzy pierwszego kontaktu może pozwolić na wcześniejsze rozpoznanie i skuteczniejsze leczenie tych nowotworów.SummaryPostirradiation tumors are rare kind of late complication of radiation therapy. The most of them are histologicaly confirmed sarcomas of bones or soft tissues. The pelvic location of malignance are usualy recognised late and has poor prognosis. We report a case of the postirradiation sarcoma developing in uterus 7 years after radiation therapy for cervical cancer. The rapid progresion was cause of death of observed patient, nevertheless radical surgery treatment. A short references review, concerning frequency, the most common histological types and possible mechanisms of secondary postirradiation malignancies has been presented. According to reccurence, dissemination and secondary malignancies risks the follow-up after radiation therapy should last for many years. Acknowledgement of the nature of postirradiation malignancies among primary care doctors may result in earlier diagnosis and better treatmant efficacy

Pierwotny chłoniak rozlany z dużych komórek B szyjki macicy — opis przypadku

We present a case of a 54-year-old woman treated for stage IIAE primary diffuse large B-cell lymphoma (DLBCL) of the uterine cervix. The CHOP chemotherapy regimen was started. After the diagnosis of lymphoma of DLBCL CD20+ type was confirmed, rituximab was added to the therapy. Within systemic therapy, the patient received two cycles of CHOP and six cycles of R-CHOP altogether. After treatment completion, total remission of the lesions was observed on computed tomography. Twenty-four months after therapy completion, the patient is disease-free with no signs of recurrence.Celem pracy była analiza przypadku 54-letniej pacjentki leczonej z powodu pierwotnego chłoniaka B-komórkowego szyjki macicy w stopniu IIAE. Leczenie rozpoczęto od chemioterapii według schematu CHOP. Po potwierdzeniu rozpoznania chłoniaka rozlanego z dużych komórek B CD20+ do leczenia dołączono rytuxymab. Łącznie, w ramach leczenia systemowego, chora otrzymała dwie serie chemioterapii według schematu CHOP oraz sześć serii chemioimmunoterapii według schematu R-CHOP. Efektem leczenia była całkowita remisja zmian nowotworowych. W dwadzieścia cztery miesiące po zakończeniu leczenia nie stwierdza się cech nawrotu choroby

The possible use of the blood serum concentration measurements of sHLA-G in women with endometrial and cervical cancers during radiotherapy as an indicator of the status of the tumour microenvironment

Background: The selective suppression of cytotoxic immune cells constitutes a crucial event in the development of malignancy. This phenomenon increases in accordance with the growth of a tumor and is just one result of the increased expression in the cancer milieu of those proteins, such as human leukocyte antigen G (HLA-G) and its soluble form (sHLA-G). Given that radiotherapy may influence immune system activity, we aimed to measure (sHLA-G) serum levels both before and after the radiotherapy due to endometrial or cervical cancer.   Methods: We assessed the sHLA-G blood serum concentration levels in a group of 43 patients (28 and 15 diagnosed with cervical cancer and endometrial cacer respectively), who received primary or adjuvant radiotherapy. We assessed the blood serum concentrations of the sHLA-G through a series of measurements taken before and four days after the latest radiation dosage using an ELISA kit.   Results: Median serum sHLA-G levels significantly decreased after radiotherapy (5.63 U/ml; range 0.00 – 344.55; vs 5.57 U/ml; 0.00 –94.02; P = 0.045). The changes of sHLA-G levels didn’t influence patients’ survival. Pretreatment and post-treatment sHLA-G levels were negatively correlated with patients’ age (R Spearman = -0.45, P = 0.041; R Spearman = -0.46. P = 0.038).   Conclusions: The detected levels of sHLA-G blood serum concentrations may supply clinically applicable information regarding the status of the tumor microenvironment — that is, the size and  the degree of  suppression of the tumor environment — where the tumor-immune cell interaction is realized. Finally, this information may also prove helpful in the treatment of cancer

Irradiation-induced bone sarcoma in a patient treated for cervix cancer 28 years earlier

AIM OF THE STUDY: To present a case of a patient with cervical carcinoma in stage IIA who was diagnosed with pelvic bone sarcoma 28 years after radiotherapy. CASE PRESENTATION: A 37-year-old woman with IIA cervix cancer was treated with external beam irradiation and brachytherapy. The patient had undergone conventionally fractionated external beam irradiation using the “box” technique, with the total dose of 50 Gy and brachytherapy with radium applicators (intrauterine tube and fornix applicator) with the dose of 60 Gy calculated at point A. After treatment she was followed up for 2 years. Twenty-six years later, inoperable pelvic bone sarcoma was diagnosed within the irradiated field. The clinical course was aggressive and rapid progression during chemotherapy was observed. CONCLUSIONS: For patients receiving radiotherapy, long-term careful follow-up is mandatory due to second cancer risk. In the case of any suspicious symptoms, such patients need proper diagnosis to detect any disease as early as possible

Endometrial carcinoma: Preliminary assessment of postoperational tolerance in pulsatile brachytherapy

W grupie 110 chorych operowanych z powodu raka trzonu macicy oceniono tolerancję uzupełniającej pulsacyjnej brachyterapii dopochwowej. Wczesny odczyn popromienny o lekkim przebiegu w pochwie i w odbytnicy wystapił łąpznie u 9 chorych (8.2%), późny u 6 chorych (5.5%). U jednej chorej wystapił odczyn popromienny w odbytnicy w stopniu czwartym. W okresie obserwacji nie stwierdzono wznowy w pochwie.Pulsacyjna brachyterapia dopochwpwa jest bezpieczną i skuteczną metodą uzupełniającego leczenia chorych operowanych z powodu raka trzonu macicy.In a group of 110 patients operated on for endometrial carcinoma the tolerance of a supplementary pulsatile intravaginal brachytherapy was assessed. Early light post-radiation reaction in the vagina and in the anus was found in a total of 9 (8.2%) patients, whereas late reaction occurred in 6 (5.5%) patients. One patient showed the fourth degree post-radiation reaction in the anus. During the follow-up no remission was observed in the vagina.Pulsatile brachytherapy is a safe and effective supplementary method of treatment in patients operated on for endometrial carcinoma