Ovarian Cancer: Clinical Advances and Challenges

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Obstetrics & Gynecology".

Deadline for manuscript submissions: closed (25 November 2023) | Viewed by 3912

Special Issue Editors


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Guest Editor
Department of General Surgery and Medical Surgical Specialties, Gynecological Clinic, University of Catania, 95123 Catania, Italy
Interests: ovarian cancer; gynecologic oncology; minimally invasive surgery; abdominal surgery

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Guest Editor
Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
Interests: oncological gynecology; ovarian cancer; vulvar cancer; endometriosis; PCOS
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Special Issue Information

Dear Colleagues,

Ovarian cancer (OC) is the most lethal gynecological malignancy. Early-stage detection and diagnostic tools for OC screening are not efficient. To date, almost 75% of patients are diagnosed at an advanced stage of disease, with a five-year overall survival of about 30%.

In OC, therapeutic management is used with multidisciplinary approaches that include a combination of primary debulking surgery (PDS) and carboplatin plus paclitaxel-based chemotherapy.

Recently, a consequence of the knowledge of different molecular pathways influencing OC is that personalized surgery and target therapies are now a realness. Neoadjuvant chemotherapy before interval debulking surgery (IDS) and adjuvant treatment are considered a valid alternative to PDS in selected patients.

There is an increasing interest in using anti-angiogenic drugs, PARP-inhibitors (PARPi), and immunomodulation. Moreover, in recent years, minimally invasive surgical (MIS) techniques have been increasingly used in ovarian cancer, considering they provide several benefits compared to the open approach. The MIS approach is under investigation in selected cases of early-stage OC, IDS, and recurrent disease.

Our purpose is to report the most recent knowledge on the management of ovarian cancer, with a look at the different surgical approaches and new therapies to investigate a more accurate, individualized approach.

Dr. Carmine Conte
Dr. Luigi Della Corte
Guest Editors

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Keywords

  • ovarian cancer
  • minimally invasive surgery
  • recurrent ovarian cancer
  • advanced ovarian cancer
  • HIPEC
  • personalized treatment
  • target therapies

Published Papers (3 papers)

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10 pages, 764 KiB  
Article
Association between Preoperative 18-FDG PET-CT SUVmax and Next-Generation Sequencing Results in Postoperative Ovarian Malignant Tissue in Patients with Advanced Ovarian Cancer
by Jung Min Ryu, Yoon Young Jeong, Sun-Jae Lee, Byung Wook Choi and Youn Seok Choi
J. Clin. Med. 2023, 12(6), 2287; https://doi.org/10.3390/jcm12062287 - 15 Mar 2023
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Abstract
This study investigated the association between maximum standardized uptake values (SUVmax) on preoperative 18-FDG PET-CT and next-generation sequencing (NGS) results in post-surgical ovarian malignant tissue in patients with advanced ovarian cancer. Twenty-five patients with stage IIIC or IV ovarian cancer who underwent both [...] Read more.
This study investigated the association between maximum standardized uptake values (SUVmax) on preoperative 18-FDG PET-CT and next-generation sequencing (NGS) results in post-surgical ovarian malignant tissue in patients with advanced ovarian cancer. Twenty-five patients with stage IIIC or IV ovarian cancer who underwent both preoperative 18-FDG PET-CT and postoperative NGS for ovarian malignancies were retrospectively enrolled. Two patients had no detected variants, 21 of the 23 patients with any somatic variant had at least one single nucleotide variant (SNV) or insertion/deletion (indel), 10 patients showed copy number variation (CNV), and two patients had a fusion variant. SUVmax differed according to the presence of SNVs/indels, with an SUVmax of 13.06 for patients with ≥ 1 SNV/indel and 6.28 for patients without (p = 0.003). Seventeen of 20 patients with Tier 2 variants had TP53 variants, and there was a statistically significant association between SUVmax and the presence of TP53 variants (13.21 vs. 9.35, p = 0.041). Analysis of the correlation between the sum of the Tier 1 and Tier 2 numbers and SUVmax showed a statistically significant correlation (p = 0.002; Pearson’s r = 0.588). In conclusion, patients with advanced ovarian cancer with SNVs/indels on NGS, especially those with TP53 Tier 2 variants, showed a proportional association with tumor SUVmax on preoperative PET-CT. Full article
(This article belongs to the Special Issue Ovarian Cancer: Clinical Advances and Challenges)
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9 pages, 2064 KiB  
Article
Molecular Mechanism of Curcumin Derivative on YAP Pathway against Ovarian Cancer
by Nan Zheng, Shan Liu, Huiting Zeng, Huajun Zhao and Lixu Jin
J. Clin. Med. 2022, 11(23), 7220; https://doi.org/10.3390/jcm11237220 - 05 Dec 2022
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Abstract
The purpose of this study is to study the effect of curcumin derivative WZ10 on the proliferation, invasion and apoptosis of ovarian cancer OVCAR3 cells, and to explore its mechanism. MTT assay was used to detect the effect of WZ10 on the proliferation [...] Read more.
The purpose of this study is to study the effect of curcumin derivative WZ10 on the proliferation, invasion and apoptosis of ovarian cancer OVCAR3 cells, and to explore its mechanism. MTT assay was used to detect the effect of WZ10 on the proliferation of ovarian cancer OVCAR3 cells; Annexin V/PI double staining flow cytometry was used to detect the effect of WZ10 on cell apoptosis; Transwell method was used to detect the effect of WZ10 on cell invasiveness; Western blot was used to investigate the effect of WZ10 Mechanisms affecting OVCAR3 activity in ovarian cancer in vitro. Our results show that WZ10 treatment could significantly inhibit the proliferation and invasion of OVCAR3 cells, induce apoptosis of OVCAR3 cells in a dose-dependent manner. After knockdown of Hippo expression with sh-RNA, further combined treatment with WZ10 had no significant image on ovarian cancer OVCAR3 cells. In conclusion: WZ10 can significantly inhibit the proliferation of OVCAR3 cells, reduce cell invasion and proliferation by downregulating the activation of Hippo-YAP pathway, and induce cell apoptosis. Full article
(This article belongs to the Special Issue Ovarian Cancer: Clinical Advances and Challenges)
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20 pages, 3319 KiB  
Systematic Review
Hyperthermic Intraperitoneal Chemotherapy (HIPEC): New Approaches and Controversies on the Treatment of Advanced Epithelial Ovarian Cancer—Systematic Review and Meta-Analysis
by Luigi Della Corte, Carmine Conte, Mario Palumbo, Serena Guerra, Dario Colacurci, Gaetano Riemma, Pasquale De Franciscis, Pierluigi Giampaolino, Anna Fagotti, Giuseppe Bifulco and Giovanni Scambia
J. Clin. Med. 2023, 12(22), 7012; https://doi.org/10.3390/jcm12227012 - 09 Nov 2023
Cited by 3 | Viewed by 1205
Abstract
Background: Hyperthermic intraperitoneal chemotherapy (HIPEC) after cytoreductive surgery has been extensively studied in patients with peritoneal carcinomatosis, and it holds promise as a therapeutic strategy, but its role remains elusive. The aim of this study was to assess the existing evidence for the [...] Read more.
Background: Hyperthermic intraperitoneal chemotherapy (HIPEC) after cytoreductive surgery has been extensively studied in patients with peritoneal carcinomatosis, and it holds promise as a therapeutic strategy, but its role remains elusive. The aim of this study was to assess the existing evidence for the use or not of HIPEC in primary debulking surgery (PDS), interval debulking surgery (IDS), and recurrent ovarian cancer (ROC), evaluated in terms of survival rates and post-surgical morbidity. Methods: Medline, Pubmed, Cochrane, and Medscape were systematically searched for any article comparing the use of HIPEC treatment with any other therapy in patients with ovarian cancer in PDS, IDS, and ROC. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines were followed. We only considered English-language published studies. Results: We included 14 studies, including two RCTs with a total of 1813 women, published between 2003 and 2023 with a recruitment period between 1998 and 2020. In PDS, there were no differences in progression-free survival (PFS) between HIPEC and controls [MD −5.53 months [95% CI −19.91 to 8.84 months]; I2 = 96%]. Conversely, in patients treated with NACT, pooled results showed a significant survival advantage in terms of progression-free survival (PFS) and overall survival (OS) in the combined HIPEC plus IDS group rather than surgery alone [PFS: MD 4.68 months (95% CI 3.49 to 5.86 months, I2 = 95%); OS: MD 11.81 months (95% CI 9.34 to 14.27 months); I2 = 97%]. Concerning ROC patients, pooled MD did not show either a significant PFS difference between intervention and controls [MD 2.68 months (95% CI 433 to 9.70 months); I2 = 95%], and OS significant difference (MD 6.69 months [95% CI −9.09 to 22.47 months]; I2 = 98%). Severe post-operative complications (≥grade 3) were available in 10 studies, accounting for 1108 women. Overall, there was a slightly but significantly increased risk with the combined approach compared to controls [RR 1.26 (95% CI 1.02 to 1.55); I2 = 0%]. Conclusions: The combination of HIPEC with cytoreductive surgery prolongs OS and PFS in advanced epithelial ovarian cancer after NACT with acceptable morbidity. However, additional trials are still needed to determine the effectiveness of HIPEC in primary and recurrence settings. In the era of personalized medicine, the correlation between the efficacy of HIPEC and biological and molecular findings represents a challenge for the future of ovarian cancer. Full article
(This article belongs to the Special Issue Ovarian Cancer: Clinical Advances and Challenges)
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