Jitti Hanprasertpong

Microsatellite instability and oncological outcomes in Thai patients with endometrial cancer

Here, we determined the frequency of microsatellite instability (MSI) and the impact of MSI-high (MSI-H) on clinical outcomes of Thai patients with endometrial cancer (EC). Tissue samples of 110 Thai patients with EC, who had undergone surgical staging, were tested for mismatch repair (MMR) gene deficiency, and the patients were grouped into MSI-H and MSI-stable (MSI-S) groups; 24.5% had MSI-H. Unlike MSI-S group patients, MSI-H group patients had synchronous and metachronous cancer. They showed better 3-year disease-free survival (DFS) than those in the MSI-S group (

Addition of chemotherapy to radiation is associated with improved survival in older patients with cervical cancer: a Surveillance, Epidemiology, and End Results database analysis

We evaluated the effectiveness of chemoradiation compared with radiotherapy alone in older patients with cervical cancer and determined the age sub-group wherein chemotherapy loses its significance using the Surveillance, Epidemiology, and End Results database. Women aged ≥65 years with cervical cancer who received definitive radiotherapy or chemoradiation were identified on the basis of the 2000-2019 Surveillance, Epidemiology, and End Results data. Overall and cancer-specific survival were compared in treatment groups, with survival prognostic factors assessed using multivariate analysis. Exploratory sub-group analyses at 5-year age increments determined the age threshold at which chemotherapy benefits became non-significant, with a multivariate p value ≥ .05 indicating reduced impact on overall and cancer-specific survival. A total of 1832 patients were included in the study. Of these, 563 patients received radiotherapy, and 1269 patients received chemoradiation. The median age of the cohort was 74 years (Q1-Q3, 69.00-80.00). The 5-year overall and cancer-specific survival rates were 40.52% and 53.47%, respectively. In the multivariate analysis, chemotherapy significantly improved both overall (HR 0.47, p 75 years (HR 0.63, p 85 years (HR 0.72, p = 0.14). Chemotherapy was beneficial for women aged ≥65 years with cervical cancer who underwent radiotherapy. However, in patients aged >80 years, chemotherapy had no significant impact on cancer-specific survival.

Safety and Prognostic Impacts of Ovarian Preservation during Radical Hysterectomy for Early‐Stage Adenocarcinoma and Adenosquamous Cervical Cancer

Objective. To identify the incidence of ovarian metastasis and the impact of ovarian preservation on oncological outcomes for early‐stage adenocarcinoma and adenosquamous cervical cancer. Methods. 281 patients with stages IA2‐IB1 adenocarcinoma and adenosquamous cervical cancer who underwent radical hysterectomy with pelvic lymphadenectomy (RHND) were included in the study. The incidence of ovarian metastasis was evaluated from 173 patients who underwent oophorectomy during RHND. Subgroup analysis was performed for patients less than 50 years (196 of 281 patients) who were classified into two groups, ovarian preservation and nonovarian preservation groups. 5‐year recurrence‐free survival (5‐yr RFS) and 5‐year overall survival (5‐yr OS) were evaluated and compared between these groups. Results. There was no evidence of ovarian metastasis, synchronous ovarian cancer, or ovarian recurrence during follow‐up. In patients less than 50 years of age, there were no statistically significant differences in the 5‐yr RFS (P = 0.363), or 5‐yr OS (P = 0.974) between the ovarian preservation and nonovarian preservation groups. In Kaplan–Meier analysis, the ovarian preservation group seemed to have a slightly better OS in long‐term follow‐up (after 15 years); however, the difference was not statistically significant. Conclusions. Ovarian preservation was safe in adenocarcinoma and adenosquamous cervical cancer stages IA2‐B1. However, the impact of ovarian preservation on oncological outcomes needs to be further investigated.