Ming Wang

Real‐world study of lymphadenectomy in patients with advanced epithelial ovarian cancer

AbstractBackgroundThe evidence on the role of retroperitoneal lymphadenectomy is limited to less common histology subtypes of epithelial advanced ovarian cancer.MethodsThis retrospective cohort study utilized data from the Surveillance, Epidemiology, and End Results Program from January 1, 2010, to December 31, 2019. Patients with stage III–IV epithelial ovarian cancer were included and divided into two groups based on whether they received retroperitoneal lymphadenectomy. The primary outcomes are overall survival (OS) and cause‐specific survival (CSS).ResultsAmong the 10 184 included patients, 5472 patients underwent debulking surgery with retroperitoneal lymphadenectomy, while 4712 patients only underwent debulking surgery. No differences were found in the baseline information between the two groups after propensity score matching. Retroperitoneal lymphadenectomy during debulking surgery was associated with improved 5‐year OS (43.41% vs. 37.49%, p < 0.001) and 5‐year CSS (46.43% vs. 41.79%, p < 0.001). Subgroup analysis further validate the retroperitoneal lymphadenectomy increased the 5‐year OS and CSS in patients with high‐grade serous cancer. Although the results were not validated in the less common ovarian cancer (including endometrial cancer, mucinous cancer, low‐grade serous cancer, and clear cell cancer), the tendency showed patients with the above four subtypes may benefit from the lymphadenectomy which is restricted for small sample size after propensity score matching.ConclusionsThis study revealed that retroperitoneal lymphadenectomy could further improve the survival outcome during debulking surgery in patients with advanced epithelial ovarian cancer. The conclusion was affected by the histology subtypes of ovarian cancer and further studies are needed to validate the conclusion in less common ovarian cancer.

The Prognosis Prediction Model for Endometrial Cancer Based on DNA Methylation Signature

ABSTRACT Background DNA methylation alteration is a common event during the carcinogenesis and progression of endometrial cancer (EC). Our study aimed to investigate the value of DNA methylation‐related genes in predicting the prognosis and immunotherapy response for EC patients. Methods The clinical information and the expression of DNA methylation‐related genes of 544 endometrial cancers were obtained from the Cancer Genome Atlas (TCGA) database. The univariate Cox regression analysis and the LASSO regression analysis were subsequently used to identify prognosis‐related methylation regulators and construct a risk model. Gene functional enrichment analysis, immune infiltration analysis, drug sensitivity analysis, and molecular feature analysis were performed in different subgroups. Results 25 methylation‐Related gene signatures were found in EC patients and are correlated to tumor differentiation and tumor metastasis. By LASSO‐Cox regression analyses, a recurrence prediction model and a prognostic‐related model were constructed based on methylation‐related genes in the TCGA training cohort. The Area Under the Curve (AUC) values of the recurrence prediction model were 0.671, 0.708, and 0.689 for 1‐, 3‐, and 5‐year time points, respectively, while those of the prognostic model were 0.731, 0.717, and 0.725. The relationship of risk score (RS) with ER/PR‐related genes, immune checkpoint expressions, and IC50s of paclitaxel, cisplatin, tamoxifen, and cetuximab was investigated. The results showed That patients in the low‐risk group are more effective in cetuximab and immune checkpoint blockade (ICB) treatment. Conclusions The model based on the methylation‐related genes showed promising outcomes in predicting the recurrence and treatment response of EC. The patients with high‐risk scores showed a poorer prognosis and may benefit more from the treatment of cetuximab or immune checkpoint inhibitors.

The accuracy of DNA methylation detection in endometrial cancer screening: A systematic review and meta‐analysis

AbstractObjectiveDNA methylation is the hallmark of early endometrial cancer and can be detected through non‐invasive methods. The present study systematically reviewed the efficacy of DNA methylation detection for endometrial cancer screening through exfoliative cytology.MethodsA systematic literature review was performed through the following databases from inception to October 7, 2024: PubMed, Embase, and the Cochrane Library. Studies on DNA methylation detection for endometrial cancer screening through exfoliative cytology were included. The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. The relevant variables included cytologic sample type, methylated genes, and marker performance (i.e., AUC value, sensitivity, specificity, and the corresponding 95% confidence interval [CI]), as well as the bias risk assessment according to the Cochrane Collaboration tool (Cochrane Intervention Systematic Review Guide 5.1.0).ResultsA total of 31 genes were selected from 20 studies as methylation markers for endometrial cancer detection in cytologic specimens. A total of 19 methylation markers for endometrial cancer detection with an area under the curve value from 0.80 to 0.97 were selected from 10 studies.ConclusionCytology‐based DNA methylation markers are feasible and accurate non‐invasive methods for the early detection of endometrial cancer screening in high‐risk populations.

The impact of bladder volume on dosimetric outcomes in VMAT for cervical cancer patients after surgery

This study aimed to investigate the impact of bladder volume on dosimetric outcomes of organs at risk (OARs) in postoperative volumetric-modulated arc therapy (VMAT) for patients with cervical cancer. The study included 71 cervical cancer patients who received radical hysterectomy and postoperative VMAT between January 2020 and January 2023. Patients were divided into 3 groups according to average bladder volume observed in computed tomography simulation positioning images: Group A (<300 mL), Group B (300-500 mL), and Group C (≥500 mL). The study compared dosimetric parameters(V₃₀, V₄₀, V₄₅, and D The median follow-up of the cohort was 33 months, with a median patient age of 48 years. Group A demonstrated the highest V₄₀ and V₄₅ values for the bladder (p<0.05). Conversely, Group C displayed the highest values for the V₄₀ and V₄₅ of the rectum, as well as the V₄₅ and D Bladder volume significantly affects dosimetry of the bladder, rectum, and sigmoid colon in postoperative VMAT for cervical cancer patients. A recommended bladder volume of 300-500 mL helps reduce radiation-induced cystitis and proctitis.

Association of Cervical Dysbacteriosis, HPV Oncogene Expression, and Cervical Lesion Progression

The main findings of this study were that we clarified the associations of the different bacterial species with the expression of human papillomavirus (HPV) oncogenes at different stages of cervical cancer. Along with the severity of cervical lesions, the abundance of the genus and species of Lactobacillus obviously declined, while the aerobic and anaerobic bacteria, as well as the prevalence and expression of HPV E6/E7 oncogene, were increased dramatically.