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        Lymphadenectomy for primary ovarian cancer: a systematic review and meta-analysis

        Tatsuyuki Chiyoda,Manabu Sakurai,Toyomi Satoh,Satoru Nagase,Mikio Mikami,Hidetaka Katabuchi,Daisuke Aoki 대한부인종양학회 2020 Journal of Gynecologic Oncology Vol.31 No.5

        Objective: To assess the effectiveness of lymphadenectomy at primary debulking surgery(PDS) on the survival of patients with epithelial ovarian cancer (EOC). Methods: We searched PubMed, Ichushi, and the Cochrane Library. Randomized controlledtrials (RCTs) and retrospective cohort studies comparing survival of women with EOCundergoing lymphadenectomy at PDS with that of women without lymphadenectomy wereincluded. We performed a meta-analysis of overall survival (OS), progression-free survival(PFS), and adverse events. Results: For advanced-stage EOC, 2 RCTs including 1,074 women and 7 cohort studiescomprising 3,161 women were evaluated. Meta-analysis revealed that lymphadenectomy wasassociated with improved OS (hazard ratio [HR]=0.80; 95% confidence interval [CI]=0.70–0.90). However, meta-analysis of 2 RCTs revealed no significant difference in OS betweenthe lymphadenectomy and no-lymphadenectomy groups (OS: HR=1.02; 95% CI=0.85–1.22). For early-stage EOC, 1 RCT comprising 268 women and 4 cohort studies comprising 14,228women were evaluated. Meta-analysis showed that lymphadenectomy was associatedwith improved OS (HR=0.75; 95% CI=0.68–0.82). A RCT of early-stage EOC reported thatlymphadenectomy was not associated with improved OS (HR=0.85; 95% CI=0.49–1.47). Surgery-related deaths were similar in both groups (risk ratio [RR]=1.00; 95% CI=0.99–1.01);however, blood transfusion was required less frequently in the no-lymphadenectomy group(RR=0.74; 95% CI=0.63–0.86). Conclusions: Meta-analysis of RCTs and observational studies suggest thatlymphadenectomy was associated with improved OS in advanced- and early-stage EOC. However, results from RCTs demonstrate that lymphadenectomy was not associated withimproved OS in advanced- and early-stage EOC.

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        TP53 variants in p53 signatures and the clonality of STICs in RRSO samples

        Tomoko Akahane,Kenta Masuda,Akira Hirasawa,Yusuke Kobayashi,Arisa Ueki,Miho Kawaida,Kumiko Misu,Kohei Nakamura,Shimpei Nagai,Tatsuyuki Chiyoda,Wataru Yamagami,Shigenori Hayashi,Fumio Kataoka,Kouji Ban 대한부인종양학회 2022 Journal of Gynecologic Oncology Vol.33 No.4

        Objective: Precursor lesions may be identified in fallopian tube tissue after risk-reducing salpingo-oophorectomy (RRSO) in patients with pathogenic variants of . Serous tubal intraepithelial carcinoma (STIC) is considered a precursor of high-grade serous carcinoma, whereas the significance of the p53 signature remains unclear. In this study, we investigated the relationship between the p53 signature and the risk of ovarian cancer. Methods: We analyzed the clinicopathological findings and conducted DNA sequencing for variants of p53 signatures and STIC lesions isolated using laser capture microdissectionin 13 patients with pathogenic variants of who underwent RRSO and 17 control patients with the benign gynecologic disease. Results: pathogenic variants were detected significantly higher in RRSO group than control (p<0.001). No difference in the frequency of p53 signatures were observed between groups (53.8% vs 29.4%; p=0.17). sequencing and next-generation sequencing analysis in a patient with STIC and occult cancer revealed 2 mutations causing different p53 staining for STICs and another mutation shared between STIC and occult cancer. Conclusion: The sequence analysis for revealed 2 types of p53 signatures, one with a risk of progression to STIC and ovarian cancer with pathological variants in and the other with a low risk of progression without pathological variants in as seen in control.

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