Jia Li

Clinicopathologic characteristics and prognostic factors of patients with surgically treated high‐grade neuroendocrine carcinoma of the cervix: A multicenter retrospective study

AbstractObjectiveTo evaluate the prognostic factors and survival outcomes of patients with surgically treated high‐grade neuroendocrine carcinoma of the cervix (NECC).MethodsThis multicenter, retrospective study involved 98 cervical cancer patients with stage IA2–IIA2 and IIIC1/2p high‐grade NECC. We divided the patients into two groups based on histology: the pure and mixed groups. All clinicopathologic variables were retrospectively evaluated. Cox regression and Kaplan–Meier methods were used for analysis.ResultsIn our study, 60 patients were in the pure group and 38 patients were in the mixed group. Cox multivariate analysis showed that mixed histology was a protective factor impacting overall survival (OS) (P = 0.026) and progression free survival (PFS) (P = 0.018) in surgically treated high‐grade NECC. Conversely, survival outcomes were negatively impacted by ovarian preservation (OS: HR, 20.84; 95% CI: 5.02–86.57, P < 0.001), age >45 years (OS: HR, 4.50; 95% CI: 1.0–18.83, P = 0.039), tumor size >4 cm (OS: HR, 6.23; 95% CI: 2.34–16.61, P < 0.001), parity >3 (OS: HR, 4.50; 95% CI: 1.02–19.91, P = 0.048), and perineural invasion (OS: HR, 5.21; 95% CI: 1.20–22.53, P = 0.027). Kaplan–Meier survival curves revealed notable differences in histologic type (OS: P = 0.045; PFS: P = 0.024), chemotherapy (OS: P = 0.0056; PFS: P = 0.0041), ovarian preservation (OS: P = 0.00031; PFS: P = 0.0023), uterine invasion (OS: P < 0.0001; PFS: P < 0.0001), and depth of stromal invasion (OS: P = 0.043; PFS: P = 0.022).ConclusionPatients with mixed histologic types who undergo surgery for high‐grade NECC have a better prognosis. Meanwhile, ovarian preservation, tumor size >4 cm, parity >3, age >45 years and perineural invasion were poor prognostic predictors. Therefore, patients with high‐risk factors should be considered in clinical practice.

Insights into the Role of Oxidative Stress in Ovarian Cancer

Oxidative stress (OS) arises when the body is subjected to harmful endogenous or exogenous factors that overwhelm the antioxidant system. There is increasing evidence that OS is involved in a number of diseases, including ovarian cancer (OC). OC is the most lethal gynecological malignancy, and risk factors include genetic factors, age, infertility, nulliparity, microbial infections, obesity, smoking, etc. OS can promote the proliferation, metastasis, and therapy resistance of OC, while high levels of OS have cytotoxic effects and induce apoptosis in OC cells. This review focuses on the relationship between OS and the development of OC from four aspects: genetic alterations, signaling pathways, transcription factors, and the tumor microenvironment. Furthermore, strategies to target aberrant OS in OC are summarized and discussed, with a view to providing new ideas for clinical treatment.