Background
Methods
Results
a. Case series on SCC transformation in MCTO | ||||||||||||
Country of study | Author (year) | Number of cases | Age | Stage | Grade | |||||||
I | II | III | IV | NA | 1 | 2 | 3 | NA | ||||
Japan | Yoshida et al. (2016) | 2 | 37–64 | 2 | 2 | |||||||
Japan | Tazo et al. (2016) | 2 | 45–53 | 2 | 2 | |||||||
Korea | Park et al. (2015) | 2 | 48–67 | 1 | 1 | 2 | ||||||
UK | Araujo et al.(2015) | 4 | 35–44 | 2 | 1 | 1 | 2 | 2 | ||||
China | Chiang et al.(2015) | 4 | 32–54 | 2 | 2 | 4 | ||||||
Turkey | Koc et al. (2015) | 12 | 28–62 | 8 | 1 | 2 | 1 | 12 | ||||
USA | Rojas et al. (2015) | 2 | 55–71 | 1 | 1 | 2 | ||||||
Korea | Choi et al.(2014) | 4 | 35–51 | 2 | 2 | 2 | ||||||
Pakistan | Hannan et al. (2014) | 3 | 50–66 | 2 | 1 | 3 | ||||||
Thailand | Oranratanaphan et al. (2013) | 4 | 34–70 | 2 | 2 | 4 | ||||||
UK | Powell et al. (2013) | 6 | 42–65 | 4 | 2 | 6 | ||||||
Turkey | Ulker et al.(2012) | 3 | 43–47 | 3 | 3 | |||||||
China | Chiang et al. (2011) | 3 | 32–54 | 1 | 2 | 1 | 2 | |||||
Japan | Sakuma et al.(2010) | 15 | 29–77 | 8 | 3 | 3 | 1 | 5 | 2 | 3 | 5 | |
India | Gupta et al. (2009) | 2 | 30–65 | 2 | 2 | |||||||
Korea | Park et al.(2008) | 12 | 29–75 | 6 | 1 | 5 | 2 | |||||
Japan | Iwasa et al.(2008) | 21 | 32–84 | 14 | 2 | 4 | 1 | 6 | 10 | 5 | ||
UK | Hurwitz et al.(2007) | 12 | 27–69 | 8 | 2 | 2 | 1 | 3 | 8 | |||
Japan | Yamaguchi et al.(2007) | 11 | 29–67 | 7 | 1 | 2 | 1 | 11 | ||||
India | Bal et al. (2007) | 4 | 35–45 | 4 | 4 | |||||||
Korea | Park et al. (2007) | 5 | 31–75 | 3 | 1 | 1 | 5 | |||||
USA | Dos Santos et al. (2007) | 17 | 37–75 | 8 | 5 | 4 | 17 | |||||
Korea | Rim et al. (2006) | 7 | 19–71 | 6 | 1 | 1 | 1 | 2 | 3 | |||
China | Wen et al. (2006) | 2 | 32–52 | 2 | 1 | 1 | ||||||
Thailand | Tangjitgamol et al. (2003) | 4 | 42–74 | 2 | 1 | 1 | 4 | |||||
Japan | Sumi et al. (2001) | 3 | 53–72 | 1 | 1 | 1 | 3 | |||||
China | Chen et al. (2001) | 3 | 30–65 | 2 | 1 | 3 | ||||||
Japan | Hirai et al. (2000) | 3 | 61–72 | 2 | 1 | 3 | ||||||
Japan | Emoto et al. (2000) | 5 | 39–73 | 1 | 5 | 5 | ||||||
China | Shen et al. (1998) | 10 | 30–82 | 2 | 1 | 3 | 2 | 2 | 10 | |||
Japan | Yoshioka et al. (1998) | 4 | 41–68 | 3 | 1 | 4 | ||||||
Japan | Kikkawa et al. (1998) | 37 | 28–87 | 19 | 5 | 13 | 9 | 7 | 6 | 5 | ||
China | Tseng et al. (1996) | 26 | 21–77 | 13 | 2 | 10 | 1 | 2 | 12 | 12 | ||
Turkey | Zorlu et al. (1996) | 3 | 28–42 | 3 | 3 | |||||||
USA | Pins et al. (1996) | 16 | 21–75 | 7 | 6 | 3 | 2 | 7 | 7 | |||
Japan | Hirakawa et al. (1989) | 28 | 32–84 | 18 | 3 | 5 | 1 | 1 | 14 | 10 | 3 | 1 |
Japan | Kimura et al. (1989) | 6 | 37–80 | 2 | 3 | 1 | 2 | 3 | 1 | |||
Japan | Kashimura et al. (1989) | 7 | 49–78 | 5 | 1 | 1 | 7 | |||||
Netherlands | Chadha et al. (1988) | 16 | 35–73 | 8 | 1 | 5 | 2 | 8 | 1 | 5 | 2 | |
UK | Ribeiro et al. (1987) | 6 | 25–64 | 5 | 1 | 1 | 2 | 3 | ||||
Japan | Tamaya et al. (1984) | 2 | 30–61 | 2 | 2 | |||||||
UK | Stamp et al. (1983) | 18 | 36–76 | 18 | 18 | |||||||
Australia | Curling et al. (1979) | 10 | 46–73 | 6 | 2 | 2 | 6 | 2 | 2 | |||
Spain | Amerigo et al. (1978) | 5 | 42–59 | 2 | 2 | 1 | 5 | |||||
USA | Krumerman et al. (1976) | 4 | 51–65 | 2 | 1 | 1 | 4 | |||||
b. Case reports on SCC transformation in MCTO | ||||||||||||
Country of study | Author (year) | Age | Stage | Stage | ||||||||
UK | Gooneratne et al. (2015) | 63 | II | 3 | ||||||||
USA | Black et al. (2015) | 74 | I | NA | ||||||||
India | Srivastava et al. (2015) | 60 | II | 2 | ||||||||
Greece | Kalampokas et al. (2014) | 56 | I | 1 | ||||||||
USA | Yarmohammadi et al. (2014) | 48 | III | 3 | ||||||||
India | Patni et al. (2014) | 53 | I | NA | ||||||||
Korea | Yun et al. (2013) | 30 | I | 1 | ||||||||
Turkey | Balik et al. (2013) | 66 | III | 2 | ||||||||
Pakistan | Chaudhry et al. (2013) | 43 | I | 2 | ||||||||
India | Mandal et al. (2012) | 56 | III | 1 | ||||||||
Turkey | Avci et al. (2012) | 52 | I | 2 | ||||||||
USA | Song et al. (2012) | 73 | II | 1 | ||||||||
Serbia | Amidzic et al. (2012) | 80 | I | 1 | ||||||||
USA | Baughn et al. (2011) | 58 | I | NA | ||||||||
Turkey | Kahraman et al. (2011) | 63 | I | NA | ||||||||
India | Prasad et al. (2011) | 40 | III | 1 | ||||||||
Nigenia | Badmos et al. (2011) | 46 | II | NA | ||||||||
Japan | Ito et al. (2011) | 78 | II | NA | ||||||||
USA | Parithivel et al. (2011) | 68 | II | 3 | ||||||||
USA | Alatassi et al. (2011) | 49 | II | NA | ||||||||
India | Madan et al. (2010) | 37 | I | 1 | ||||||||
Greece | Korkontzelos et al. (2010) | 56 | I | NA | ||||||||
Japan | Hosokawa et al. (2010) | 52 | I | NA | ||||||||
Germany | Budiman et al. (2010) | 41 | I | 3 | ||||||||
Korea | Lim et al. (2009) | 68 | III | NA | ||||||||
Iran | Shariat-Torbaghan et al. (2009) | 63 | IV | 3 | ||||||||
Brazil | Silva et al. (2009) | 75 | I | 1 | ||||||||
China | Wang et al. (2008) | 39 | III | 2 | ||||||||
China | Ding et al. (2008) | 62 | III | NA | ||||||||
Japan | Mekaru et al. (2008) | 33 | I | NA | ||||||||
India | Santwani et al. (2008) | 40 | I | NA | ||||||||
Turkey | Arioz et al. (2007) | 31 | II | 2 | ||||||||
UK | Sanghera et al. (2006) | 48 | II | NA | ||||||||
Greece | Filippakis et al. (2006) | 41 | I | NA | ||||||||
USA | Spannuth et al. (2005) | 52 | II | 3 | ||||||||
China | Lai et al. (2005) | 47 | III | NA | ||||||||
UK | Karanjgaokar et al. (2005) | 66 | III | 2 | ||||||||
UK | Mechery et al. (2004) | 51 | I | 3 | ||||||||
Japan | Takemori et al. (2003) | 69 | II | NA | ||||||||
USA | Powell et al. (2003) | 67 | III | NA | ||||||||
Canada | Do et al. (2002) | 44 | II | 2 | ||||||||
Canada | Mayer et al. (2002) | 37 | II | 2 | ||||||||
USA | Noumoff et al. (2001) | 36 | I | 3 | ||||||||
Japan | Takeuchi et al. (2000) | 72 | II | NA | ||||||||
France | Kurtz et al. (1999) | 34 | III | NA | ||||||||
Japan | Isoda et al. (1999) | 56 | II | NA | ||||||||
USA | Lee et al. (1999) | 50 | II | 1 | ||||||||
UK | As et al. (1997) | 33 | II | 2 | ||||||||
USA | Griffiths et al. (1995) | 76 | III | 2 | ||||||||
USA | Kung et al. (1994) | 44 | I | 3 | ||||||||
USA | Rose et al. (1993) | 42 | III | NA | ||||||||
USA | Christopherson et al. (1989) | 26 | III | 1 | ||||||||
USA | Selim et al. (1984) | 43 | I | NA | ||||||||
Japan | Mitui et al. (1983) | 72 | III | 1 |
Retrospective chart review
Case | Age (years) | Symptoms | Elevated tumor marker | Diameter (cm) | Surgery | Optimal debulking | Rupture | Grade | Stage | Adjuvant therapy | Follow-up (status, months) |
---|---|---|---|---|---|---|---|---|---|---|---|
1 | ≥45 | Accidental finding | – | 7 | TH + LSO + BPLND + omentectomy | Y | N | 3 | IA | TC × 1 | LOST, 3 |
2 | ≥45 | Pain | CA125(179.5 U/mL), CEA (6.1 ng/mL) | 12 | TH + BSO + omentectomy + BPLND + BPALND + peritoneal tumor resection | Y | N | 2 | IIB | TC × 6 | NED, 72 |
3 | ≥45 | Pain, distension | CA125(363.8 U/mL), CEA (25.2 ng/mL) | 15 | TH + BSO + appendectomy | Y | N | 2 | IIIB | TC × 1 | DOD, 9 |
4 | ≥45 | Pain, distension, fever | CA125(62.9 U/mL), SCC (7.3 ng/mL) | 20 | TH + BSO + omentectomy + partial peritoneal resection | N | Preoperative | 2 | IIIC | – | LOST, 24 |
5 | ≥45 | Pain, vaginal bleeding | CA125(144.7 U/mL), SCC (15.1 ng/mL), CA199(119.1 U/mL), CEA (40.9 ng/mL) | 25 | TH + BSO + tumor resection + sigmoidectomy | N | Intraoperative | 3 | IIIC | – | DOD, 15 |
6 | <45 | Accidental finding | CA125 (42.8 U/mL), CA199(97.1 U/mL) | 5 | Initial surgery: Left ovarian cystectomy Restaging surgery: LSO + omentectomy + BPLND + BPALND | Y | N | 3 | IC | TC × 3 | NED, 8 |
Antibody | Source | Dilution | Case 1 | Case 2 | Case 3 | Case 4 | Case 5 | Case 6 |
---|---|---|---|---|---|---|---|---|
Ki67 | Abcam | 1:250 | ++ | ++ | ++ | +++ | ++ | ++ |
p16 | Abcam | 1:100 | – | – | – | – | – | – |
p63 | Abcam | 1:500 | + | ++ | ++ | ++ | + | ++ |
CK8/18 | Dako | prediluted | +++ | +++, 5% | ++ | +++ | +++ | +++ |
CK5/6 | Dako | prediluted | +++ | ++ | +++ | +++ | ++ | +++ |
p53 | Abcam | 1:100 | +, focal | +++ | – | ++ | ++ | +++ |
Systematic review
Results | |
---|---|
Age, years (n = 434)a | 53.5 (13.9, 19–87) |
<45 years | 121 |
≥45 years | 313 |
Tumor size, cm (n = 316)a | 14.8 (5.9, 3.5–40) |
Preoperative tumor markersb | |
SCC-Ag, ng/mL (n = 78) | 7.4 (3.0, 20.0) |
CA125, U/mL(n = 104) | 64.4 (34.2, 143.0) |
CA19–9,U/mL (n = 65) | 144.0 (45.1, 943.5) |
CEA, ng/mL (n = 51) | 6.9 (2.5, 23.0) |
Clinical manifestation (n = 204) | |
Abdominal/pelvic pain | 139 |
Mass | 53 |
Abdominal bloating | 49 |
Physical examination | 10 |
Urinary frequency | 6 |
Weight loss | 11 |
Change in bowel habits | 20 |
Fever | 7 |
FIGO staging (n = 414) | |
I | 207 |
II | 78 |
III | 111 |
IV | 18 |
Histological grade (n = 203) | |
1 | 54 |
2 | 84 |
3 | 65 |
Variable | Univariate HR (95% CI) | P value |
---|---|---|
Age (n = 370) | ||
<45 (n = 105) | Reference | |
≥45 (n = 265) | 1.91 (1.26–2.89) | <0.01* |
Diameter (cm) (n = 265) (n = 265) | ||
≤10 (n = 67) | Reference | |
>10 (n = 198) | 1.08 (0.70–1.68) | 0.73 |
Stage (n = 348) | ||
I (n = 172) | Reference | |
II (n = 70) | 6.92 (3.98–12.06) | <0.01* |
III (n = 92) | 9.32 (5.58–15.59) | <0.01* |
IV (n = 14) | 16.45(7.95–34.02) | <0.01* |
Grade (n = 169) | ||
1 (n = 43) | Reference | |
2 (n = 69) | 1.60 (0.81–3.15) | 0.17 |
3 (n = 57) | 1.76 (0.89–3.49) | 0.10 |
Surgery | Univariate HR (95% CI) | P value | Stage-adjusted HR (95% CI) | P value |
---|---|---|---|---|
Hysterectomy (325) | ||||
Yes (232) vs No (93) | 0.60 (0.42–0.85) | < 0.01* | 0.51 (0.36–0.74) | < 0.01* |
\Lymphadenectomy (325) | ||||
Yes (69) vs No (256) | 0.69 (0.43–1.09) | 0.11 | 0.76 (0.47–1.22) | 0.25 |
Omentectomy (313) | ||||
Yes (120) vs No (193) | 1.04 (0.72–1.48) | 0.85 | 0.66 (0.45–0.98) | 0.04 |
Treatment | Univariate HR (95% CI) | P value | Stage-adjusted HR (95% CI) | P value |
---|---|---|---|---|
Chemotherapy (170) | ||||
Yes (118) vs No (52) | 0.60 (0.40–0.91) | 0.02* | 0.56 (0.37–0.86) | 0.01* |
Radiotherapy (170) | ||||
Yes (50) vs No (120) | 0.80 (0.52–1.21) | 0.29 | 0.89 (0.57–1.38) | 0.60 |
Chemoradiotherapy (170) | ||||
Yes (31) vs No (139) | 0.71(0.43–1.16) | 0.17 | 0.73 (0.44–1.21) | 0.22 |
Drug (n = 103) | Univariate HR (95% CI) | P value | Stage-adjusted HR (95% CI) | P value |
---|---|---|---|---|
Platinum derivatives (n = 92) | 0.43 (0.21–0.87) | 0.02* | 0.41 (0.20–0.84) | 0.02* |
Taxanes (n = 29) | 1.09 (0.61–1.98) | 0.78 | 1.10 (0.60–2.00) | 0.76 |
Vinca alkaloids (n = 21) | 0.59 (0.30–1.20) | 0.14 | 0.48 (0.23–1.01) | 0.05 |
Alkylating agents (n = 15) | 1.05 (0.53–2.09) | 0.88 | 0.84 (0.38–1.84) | 0.66 |
5-FU (n = 16) | 0.77 (0.36–1.62) | 0.50 | 0.82 (0.39–1.75) | 0.61 |
Bleomycin (n = 36) | 0.94 (0.55–1.61) | 0.82 | 0.85 (0.48–1.50) | 0.57 |
VP-16 (n = 12) | 0.76 (0.33–1.78) | 0.53 | 0.82 (0.35–1.92) | 0.64 |