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Michael T. Deavers - One of the best experts on this subject based on the ideXlab platform.
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Concurrent primary peritoneal low-grade Serous Carcinoma and endometrial high-grade Serous Carcinoma.
International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists, 2015Co-Authors: Megan G. Lockyer, Michael T. Deavers, Neda Zarrin-khamehAbstract:A 64-yr-old postmenopausal woman with high-grade squamous intraepithelial lesion and atypical glandular cell of undetermined significance on her Pap test was found to have endometrial Serous Carcinoma (high grade) involving a polyp in a subsequent endometrial biopsy. She underwent hysterectomy and bilateral salpingo-oophorectomy with multiple biopsies of the peritoneum. Microscopic examination of the entirely submitted uterus showed no residual Serous Carcinoma. Multiple foci of low-grade Serous tumor with extensive calcifications and psammoma bodies were identified on the surfaces of the left fallopian tube, ovaries, and biopsies of the peritoneum, consistent with peritoneal primary low-grade Serous Carcinoma. To our knowledge, this is the first reported case of low-grade Serous Carcinoma of the peritoneum with a concurrent (high-grade) Serous Carcinoma of the endometrium arising from an endometrial polyp.
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Ovarian Serous Carcinoma associated with a distinct "corded and hyalinized" pattern
Archives of pathology & laboratory medicine, 2013Co-Authors: Jeannelyn S. Estrella, Judith K. Wolf, Michael T. DeaversAbstract:The “corded and hyalinized” pattern, described in endometrioid Carcinoma, has not been previously reported in association with Serous Carcinoma. We describe a unique case of Serous neoplasm of low malignant potential with low-grade Serous Carcinoma combined with a distinct pattern of high-grade Carcinoma characterized by cords of epithelioid and spindled cells enmeshed in a hyalinized, collagenous stroma. This pattern was the predominant architecture in the patient's recurrence and caused a diagnostic challenge, as the splenic recurrence was initially diagnosed as a second primary high-grade spindle cell neoplasm. Both ovarian and splenic tumors displayed positive immunohistochemical staining for cytokeratin 7, cytokeratin 8/18, estrogen receptor, and paired box gene 8 (PAX-8) in the conventional Serous Carcinoma and the corded and hyalinized component, confirming the diagnosis of recurrent Carcinoma. The behavior in this unique case of Serous Carcinoma associated with a distinct corded and hyalinized pat...
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hormonal therapy for recurrent low grade Serous Carcinoma of the ovary or peritoneum
Gynecologic Oncology, 2012Co-Authors: David M. Gershenson, Anais Malpica, Diane C. Bodurka, Kathleen M. Schmeler, Charlotte C. Sun, Revathy B Iyer, John J Kavanagh, Michael T. DeaversAbstract:Objective To determine whether hormonal therapies have efficacy in patients with recurrent low-grade Serous Carcinoma of the ovary or peritoneum.
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Neoadjuvant chemotherapy for low-grade Serous Carcinoma of the ovary or peritoneum.
Gynecologic oncology, 2007Co-Authors: Kathleen M. Schmeler, Michael T. Deavers, Anais Malpica, Diane C. Bodurka, Pedro T. Ramirez, Charlotte C. Sun, Robert L. Coleman, David M. GershensonAbstract:Abstract Objective. To evaluate the response of women with low-grade Serous Carcinoma of the ovary or peritoneum to platinum-based neoadjuvant chemotherapy. Methods. Using institutional databases, we identified 25 women with advanced low-grade Serous Carcinoma of the ovary or peritoneum treated with neoadjuvant platinum-based chemotherapy between 1989 and 2006. Demographic and clinical variables were abstracted from the medical records. Progression-free survival (PFS) and overall survival (OS) were estimated using the method of Kaplan and Meier. Results. Median patient age at diagnosis was 45 years (range 29–81). The majority of patients ( n =19, 76%) received a combination of a taxane and platinum drug. A median of six cycles of chemotherapy was administered (range 2–16). Of the 20 patients for whom pre- and post-neoadjuvant chemotherapy CA-125 levels were available, 50% had a >50% reduction after neoadjuvant chemotherapy. However, radiographic survey of the 24 patients evaluable at the completion of neoadjuvant chemotherapy demonstrated one patient (4%) with a complete response, 21 (88%) with stable disease and 2 (8%) with progression following neoadjuvant chemotherapy. Median PFS and OS for all patients were 21.4 and 56.1 months, respectively. Conclusions. The low response rate to platinum-based neoadjuvant chemotherapy observed indicates that low-grade Serous Carcinoma is not as responsive to conventional chemotherapy as high-grade Serous Carcinoma. Prospective clinical trials focused specifically on low-grade Serous Carcinoma are needed to make meaningful advances in the treatment of this disease.
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interobserver and intraobserver variability of a two tier system for grading ovarian Serous Carcinoma
The American Journal of Surgical Pathology, 2007Co-Authors: Anais Malpica, Michael T. Deavers, Robert J. Kurman, Carmen Tornos, Robert A Soslow, Jeffrey D Seidman, Mark F Munsell, Erich Gaertner, David P FrishbergAbstract:Although grading has been demonstrated to be an important prognostic factor in ovarian Serous Carcinoma, there is no system universally used to perform this task. A few years ago, we proposed a two-tier system for grading ovarian Serous Carcinoma that is based primarily on the assessment of nuclear atypia (uniformity vs. pleomorphism) in the worst area of the tumor. Tumor grade in this two-tier system is correlated with survival. After being used by numerous pathologists and trainees at The University of Texas M.D. Anderson Cancer Center (MDACC) for 15 years, we have observed that this system is user-friendly and reproducible. We undertook this study to evaluate the interobserver and intraobserver variability among a group of 7 gynecologic pathologists and 2 general surgical pathologists using this grading system. A total of 80 cases of ovarian Serous Carcinoma, 40 low-grade and 40 high-grade, were circulated twice among these pathologists. Slides with examples of low-grade and high-grade Serous Carcinoma were sent with the unknowns. A website was used to provide diagnostic criteria, images of examples of ovarian low-grade and high-grade Carcinoma, and a log form to facilitate data entry. Statistical analysis demonstrated an overall kappa statistic among the different observers of 0.909. The intergrader kappa's ranged from 0.717 to 1.000 in the first round of the review and from 0.701 to 1.000 in the second round. Eight of the participants had an intragrader kappa ranging from 0.775 to 1.000 (excellent agreement), whereas a single participant had an intragrader kappa of 0.725 (good agreement). This study demonstrates that the two-tier grading system (the MDACC grading system) for ovarian Serous Carcinoma on the basis of the assessment of nuclear atypia is easy to learn and is highly reproducible. These findings would support its universal use, which would be beneficial for the standardization of clinical trials and protocols, thus facilitating the understanding of this disease and investigation into the treatment of patients affected by these tumors.
Anais Malpica - One of the best experts on this subject based on the ideXlab platform.
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hormonal therapy for recurrent low grade Serous Carcinoma of the ovary or peritoneum
Gynecologic Oncology, 2012Co-Authors: David M. Gershenson, Anais Malpica, Diane C. Bodurka, Kathleen M. Schmeler, Charlotte C. Sun, Revathy B Iyer, John J Kavanagh, Michael T. DeaversAbstract:Objective To determine whether hormonal therapies have efficacy in patients with recurrent low-grade Serous Carcinoma of the ovary or peritoneum.
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Neoadjuvant chemotherapy for low-grade Serous Carcinoma of the ovary or peritoneum.
Gynecologic oncology, 2007Co-Authors: Kathleen M. Schmeler, Michael T. Deavers, Anais Malpica, Diane C. Bodurka, Pedro T. Ramirez, Charlotte C. Sun, Robert L. Coleman, David M. GershensonAbstract:Abstract Objective. To evaluate the response of women with low-grade Serous Carcinoma of the ovary or peritoneum to platinum-based neoadjuvant chemotherapy. Methods. Using institutional databases, we identified 25 women with advanced low-grade Serous Carcinoma of the ovary or peritoneum treated with neoadjuvant platinum-based chemotherapy between 1989 and 2006. Demographic and clinical variables were abstracted from the medical records. Progression-free survival (PFS) and overall survival (OS) were estimated using the method of Kaplan and Meier. Results. Median patient age at diagnosis was 45 years (range 29–81). The majority of patients ( n =19, 76%) received a combination of a taxane and platinum drug. A median of six cycles of chemotherapy was administered (range 2–16). Of the 20 patients for whom pre- and post-neoadjuvant chemotherapy CA-125 levels were available, 50% had a >50% reduction after neoadjuvant chemotherapy. However, radiographic survey of the 24 patients evaluable at the completion of neoadjuvant chemotherapy demonstrated one patient (4%) with a complete response, 21 (88%) with stable disease and 2 (8%) with progression following neoadjuvant chemotherapy. Median PFS and OS for all patients were 21.4 and 56.1 months, respectively. Conclusions. The low response rate to platinum-based neoadjuvant chemotherapy observed indicates that low-grade Serous Carcinoma is not as responsive to conventional chemotherapy as high-grade Serous Carcinoma. Prospective clinical trials focused specifically on low-grade Serous Carcinoma are needed to make meaningful advances in the treatment of this disease.
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interobserver and intraobserver variability of a two tier system for grading ovarian Serous Carcinoma
The American Journal of Surgical Pathology, 2007Co-Authors: Anais Malpica, Michael T. Deavers, Robert J. Kurman, Carmen Tornos, Robert A Soslow, Jeffrey D Seidman, Mark F Munsell, Erich Gaertner, David P FrishbergAbstract:Although grading has been demonstrated to be an important prognostic factor in ovarian Serous Carcinoma, there is no system universally used to perform this task. A few years ago, we proposed a two-tier system for grading ovarian Serous Carcinoma that is based primarily on the assessment of nuclear atypia (uniformity vs. pleomorphism) in the worst area of the tumor. Tumor grade in this two-tier system is correlated with survival. After being used by numerous pathologists and trainees at The University of Texas M.D. Anderson Cancer Center (MDACC) for 15 years, we have observed that this system is user-friendly and reproducible. We undertook this study to evaluate the interobserver and intraobserver variability among a group of 7 gynecologic pathologists and 2 general surgical pathologists using this grading system. A total of 80 cases of ovarian Serous Carcinoma, 40 low-grade and 40 high-grade, were circulated twice among these pathologists. Slides with examples of low-grade and high-grade Serous Carcinoma were sent with the unknowns. A website was used to provide diagnostic criteria, images of examples of ovarian low-grade and high-grade Carcinoma, and a log form to facilitate data entry. Statistical analysis demonstrated an overall kappa statistic among the different observers of 0.909. The intergrader kappa's ranged from 0.717 to 1.000 in the first round of the review and from 0.701 to 1.000 in the second round. Eight of the participants had an intragrader kappa ranging from 0.775 to 1.000 (excellent agreement), whereas a single participant had an intragrader kappa of 0.725 (good agreement). This study demonstrates that the two-tier grading system (the MDACC grading system) for ovarian Serous Carcinoma on the basis of the assessment of nuclear atypia is easy to learn and is highly reproducible. These findings would support its universal use, which would be beneficial for the standardization of clinical trials and protocols, thus facilitating the understanding of this disease and investigation into the treatment of patients affected by these tumors.
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High-grade ovarian Serous Carcinoma exhibits significantly higher p16 expression than low-grade Serous Carcinoma and Serous borderline tumour
Histopathology, 2007Co-Authors: Ciaran J. O'neill, Michael T. Deavers, Hilary A. Mcbride, L E Connolly, Anais Malpica, W. G. MccluggageAbstract:Aims: A dualistic pathway of ovarian Serous carcinogenesis is now well established whereby high-grade Serous Carcinoma and low-grade Serous Carcinoma represent two distinct tumour types with a different underlying pathogenesis. The aim of this study was to compare expression of p16 INK4A (p16) in these two tumour types. We also included cases of Serous borderline tumour, since these are considered to represent a precursor lesion of low-grade Serous Carcinoma.
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Immunohistochemical overexpression of p16 and p53 in uterine Serous Carcinoma and ovarian high-grade Serous Carcinoma
International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists, 2007Co-Authors: Andres Chiesa-vottero, Michael T. Deavers, Anais Malpica, Russell Broaddus, Gerard J. Nuovo, Elvio G. SilvaAbstract:The immunohistochemical expression pattern of p16 in biopsy samples has been useful as part of a panel to distinguish adenoCarcinomas arising from the endometrium from those arising from the endocervix. However, no information is available on the expression of p16 in uterine Serous Carcinoma (USC) or ovarian high-grade Serous Carcinoma that could be used for diagnostic purposes. Here, we retrospectively analyzed the immunohistochemical expression of p16 in 11 cases of USC (5 pure and 6 mixed with endometrioid adenoCarcinoma) and 10 cases of ovarian high-grade Serous Carcinoma and compared p16 expression with that of p53 in the same samples. p16 was strongly expressed by 100% of tumor cells in all 11 uterine specimens and in 5 of the 10 ovarian specimens; of the other 5 ovarian specimens, 4 showed strong positivity in 20% to 80% of tumor cells, and 1 case showed only weak expression. Positivity for p53 was strong and diffuse (100% of tumor cells) in 5 uterine tumors and in 3 ovarian tumors. p53 expression in 6 of the uterine specimens and 7 of the ovarian specimens was present in fewer tumor cells, of weak intensity, or both. We also performed human papilloma virus (HPV) DNA in situ hybridization in 4 uterine pure Serous Carcinomas; all 4 were negative. The negative results were confirmed by reverse transcriptase in situ polymerase chain reaction. We conclude that p16, owing to its diffuse expression in USC, should not be interpreted as indicating cervical origin or HPV-induced carcinogenesis; however, p16 may be a better marker (albeit unspecific) than p53 for identifying USC. The overexpression of p16 in USC is unrelated to HPV. Further studies are necessary to determine whether p16 expression is useful in the differential diagnosis of ovarian high-grade Serous Carcinoma.
Elvio G. Silva - One of the best experts on this subject based on the ideXlab platform.
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Immunohistochemical overexpression of p16 and p53 in uterine Serous Carcinoma and ovarian high-grade Serous Carcinoma
International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists, 2007Co-Authors: Andres Chiesa-vottero, Michael T. Deavers, Anais Malpica, Russell Broaddus, Gerard J. Nuovo, Elvio G. SilvaAbstract:The immunohistochemical expression pattern of p16 in biopsy samples has been useful as part of a panel to distinguish adenoCarcinomas arising from the endometrium from those arising from the endocervix. However, no information is available on the expression of p16 in uterine Serous Carcinoma (USC) or ovarian high-grade Serous Carcinoma that could be used for diagnostic purposes. Here, we retrospectively analyzed the immunohistochemical expression of p16 in 11 cases of USC (5 pure and 6 mixed with endometrioid adenoCarcinoma) and 10 cases of ovarian high-grade Serous Carcinoma and compared p16 expression with that of p53 in the same samples. p16 was strongly expressed by 100% of tumor cells in all 11 uterine specimens and in 5 of the 10 ovarian specimens; of the other 5 ovarian specimens, 4 showed strong positivity in 20% to 80% of tumor cells, and 1 case showed only weak expression. Positivity for p53 was strong and diffuse (100% of tumor cells) in 5 uterine tumors and in 3 ovarian tumors. p53 expression in 6 of the uterine specimens and 7 of the ovarian specimens was present in fewer tumor cells, of weak intensity, or both. We also performed human papilloma virus (HPV) DNA in situ hybridization in 4 uterine pure Serous Carcinomas; all 4 were negative. The negative results were confirmed by reverse transcriptase in situ polymerase chain reaction. We conclude that p16, owing to its diffuse expression in USC, should not be interpreted as indicating cervical origin or HPV-induced carcinogenesis; however, p16 may be a better marker (albeit unspecific) than p53 for identifying USC. The overexpression of p16 in USC is unrelated to HPV. Further studies are necessary to determine whether p16 expression is useful in the differential diagnosis of ovarian high-grade Serous Carcinoma.
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clinical behavior of stage ii iv low grade Serous Carcinoma of the ovary
Obstetrics & Gynecology, 2006Co-Authors: David M. Gershenson, Michael T. Deavers, Anais Malpica, Elvio G. Silva, Charlotte C. Sun, Robert L. Coleman, Anil K Sood, Diane C. BodurkaAbstract:Objective To analyze the clinical behavior of patients with stage II-IV low-grade Serous Carcinoma of the ovary seen at our institution who underwent primary surgery followed by platinum-based chemotherapy. Methods Patients with stage II-IV low-grade Serous Carcinoma of the ovary from 1978 to 2003 were identified using existing databases. Clinicopathologic information was obtained from medical records. Progression-free survival and overall survival were estimated by the method of Kaplan and Meier. The log-rank test was used to compare differences between survival curves. Univariable and multivariable analyses were performed using Cox proportional hazards regression. Results We identified 112 eligible patients. Median age was 43 years.; 90% had stage III disease. Preoperative serum CA 125 was elevated in 86% of patients. The most common sites of extraovarian disease were omentum, fallopian tubes, pelvic peritoneum, and uterus. Response rate to platinum-based chemotherapy in 10 evaluable patients (15% of patients with gross residual disease) was 80%, and 42 patients underwent second-look surgery: microscopically negative findings, 2 (5%); microscopically positive disease, 13 (33%); macroscopically positive disease, 24 (62%); and insufficient information, 3 (7%). Median progression-free survival and overall survival times were 19.5 and 81.8 months. Persistent disease after primary chemotherapy was the only factor associated with shorter overall survival time (hazard ratio 3.46, 95% confidence interval 2.00-5.97, P Conclusion Metastatic low-grade Serous Carcinoma of the ovary is characterized by young age at diagnosis and prolonged overall survival. Segregating women with this diagnosis in future clinical trials is warranted.
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Differential expression of WT-1 in Serous Carcinomas in the peritoneum with or without associated Serous Carcinoma in endometrial polyps.
The American journal of surgical pathology, 2005Co-Authors: Elizabeth D. Euscher, Michael T. Deavers, Anais Malpica, Elvio G. SilvaAbstract:Although differential WT-1 expression between ovarian and uterine Serous Carcinoma has been discussed in the literature, there have been no studies of WT-1 expression in Serous Carcinomas in the peritoneum with or without concurrent Serous Carcinoma in an endometrial polyp. This study addresses this issue and includes a small series of uterine and ovarian Serous Carcinomas for comparison. Nine peritoneal Serous Carcinomas with coexistent Serous Carcinoma in an endometrial polyp, 10 peritoneal Serous Carcinomas without Serous Carcinoma in an endometrial polyp, 9 uterine Serous Carcinomas, and 12 ovarian Serous Carcinomas were stained with antibody to WT-1. Ninety-two percent of ovarian Serous Carcinomas and 80% of peritoneal Serous Carcinomas without Serous Carcinoma involving an endometrial polyp expressed WT-1. In contrast, 12% of peritoneal Serous Carcinomas with Serous Carcinoma in an endometrial polyp expressed WT-1 with the Serous Carcinoma in the endometrial polyp staining concordantly. For uterine Serous Carcinoma without an endometrial polyp, only 11% expressed WT-1. Peritoneal Serous Carcinomas without coexistent Serous Carcinoma in an endometrial polyp have a WT-1 expression pattern similar to ovarian Serous Carcinoma while peritoneal Serous Carcinomas with coexistent Serous Carcinoma in an endometrial polyp have a staining pattern similar to uterine Serous Carcinoma. The difference in WT-1 expression among Serous Carcinomas suggests a difference in biology based on the site of origin. Additionally, the difference in WT-1 expression between peritoneal Serous Carcinomas with and without coexistent Serous Carcinoma in endometrial polyps suggests that peritoneal Serous Carcinoma may have different pathogenetic pathways.
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Grading ovarian Serous Carcinoma using a two-tier system.
The American journal of surgical pathology, 2004Co-Authors: Anais Malpica, Michael T. Deavers, Diane C. Bodurka, Edward N. Atkinson, David M. Gershenson, Elvio G. SilvaAbstract:In this study, we evaluate a two-tier system for grading ovarian Serous Carcinoma. This system is based primarily on the assessment of nuclear atypia with the mitotic rate used as a secondary feature. The study included 50 cases of low-grade ovarian Serous Carcinoma and 50 cases of high-grade ovarian Serous Carcinoma retrieved from the files of the Department of Pathology at the University of Texas M. D. Anderson Cancer Center from a 28-year period. Cases assigned to the low-grade category were characterized by the presence of mild to moderate nuclear atypia. As a secondary feature, they tended to show up to 12 mitoses per 10 high power fields (HPFs), whereas those in the high-grade category had marked nuclear atypia and as a secondary feature more than 12 mitoses per 10 HPFs. For comparison, the tumors were also graded using the Shimizu/Silverberg and the FIGO grading systems. Patients in the low-grade ovarian Serous Carcinoma group ranged in age from 19 to 75 years (mean 41.7 years) while patients in the high-grade ovarian Serous Carcinoma group ranged in age from 27 to 76 years (mean 55 years). All of the cases except one were advanced FIGO stage. Using the Shimizu/Silverberg system, the low-grade ovarian Serous Carcinoma cases were distributed as follows: grade 1, 47 cases; grade 2, 3 cases. Using the FIGO grading system, 35 cases were grade 1 and 15 cases were grade 2. Regarding the high-grade ovarian Serous Carcinoma group using the Shimizu/Silverberg system, 14 of the cases were grade 2 and 36 cases were grade 3. Using the FIGO grading system, 1 case was grade 1, 38 cases were grade 2, and 11 cases were grade 3. Most of the patients in both groups were treated with total abdominal hysterectomy and bilateral salpingo-oophorectomy and also received cisplatinum-based chemotherapy. On follow-up, 37 patients in the low-grade ovarian Serous Carcinoma group had died of disease at a median 4.2 years after diagnosis compared with 46 patients in the high-grade ovarian Serous Carcinoma group who died of disease at a median of 1.7 years. Eight patients in the low-grade ovarian Serous Carcinoma group and 4 patients in the high-grade ovarian Serous Carcinoma group were alive with disease at median follow-ups of 4.3 and 3.85 years, respectively. Four patients with low-grade Serous Carcinoma were alive without evidence of disease after a follow-up that ranged from 4.4 to 22.6 years (median 6.85 years), and one died of other causes 14 years after the diagnosis of her ovarian tumor. On multivariate analysis, residual tumor and tumor grade based on the M. D. Anderson two-tier system for grading ovarian Serous Carcinoma were found to be significant independent prognostic factors (P = 0.003 and 0.04, respectively). Of interest, 60% of the low-grade ovarian Serous Carcinomas in this study were associated with a Serous neoplasm of low malignant potential, whereas this association was present in only 2% of the high-grade ovarian Serous Carcinomas. This finding could reflect a difference in the pathogenesis of ovarian Serous Carcinomas of different grades. In summary, there is usually a good correlation between the two-tier grading system herein presented and the Shimizu/Silverberg and the FIGO grading systems. Because this system is based on defined criteria that are easy to follow and because it involves only two diagnostic categories, it should provide better reproducibility in the grading of ovarian Serous Carcinoma. However, additional studies are required to validate these statements.
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OVARIAN Serous NEOPLASMS OF LOW MALIGNANT POTENTIAL ASSOCIATED WITH FOCAL AREAS OF Serous Carcinoma
Modern pathology : an official journal of the United States and Canadian Academy of Pathology Inc, 1997Co-Authors: Elvio G. Silva, Anais Malpica, Carmen S. Tornos, David M. GershensonAbstract:This is a study of 12 cases of Stage III ovarian Serous neoplasms of low malignant potential associated with focal areas (< 50%) of Serous Carcinoma. The purpose of this study was to assess the prognosis of Serous tumors that had areas of Serous Carcinoma but were predominantly of low malignant potential. Eleven Serous Carcinomas were low grade, and one was high grade. All of the patients underwent surgical resection of the neoplasm and then chemotherapy. Eight patients died of disease after a follow-up of 17 to 94 months (mean, 52 mo). Three patients had no evidence of disease at 60, 69, and 75 months. One patient is alive with progressive disease at 58 months. Serous neoplasms of low malignant potential associated with focal areas (< 50%) of Serous Carcinoma are aggressive neoplasms that have a prognosis similar to that of Serous Carcinoma.
Joyce F Liu - One of the best experts on this subject based on the ideXlab platform.
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phase ii study of the wee1 inhibitor adavosertib in recurrent uterine Serous Carcinoma
Journal of Clinical Oncology, 2021Co-Authors: Joyce F Liu, Niya Xiong, Susana M Campos, Alexi A Wright, C N Krasner, Susan Schumer, Neil S Horowitz, Jennifer Taylor Veneris, Nabihah Tayob, Stephanie MorrisseyAbstract:PURPOSEUterine Serous Carcinoma (USC) is a distinct histologic subtype of endometrial cancer, with molecular characteristics suggesting frequent cell-cycle dysregulation paired with a high level of...
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uterine Serous Carcinoma molecular features clinical management and new and future therapies
Gynecologic Oncology, 2021Co-Authors: Elizabeth K Lee, Amanda N. Fader, Alessandro D Santin, Joyce F LiuAbstract:Uterine Serous Carcinoma (USC) is an aggressive subtype of endometrial cancer. Multimodality treatment with surgery, radiotherapy, and chemotherapy is commonly used, given its propensity for extrauterine spread, distant recurrences, and poor prognosis. However, the use of molecularly-based therapy is expanding. Here, we review key molecular features of USC, discuss current management, and assess the landscape of novel therapies and combinations.
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a phase ii trial of the wee1 inhibitor adavosertib azd1775 in recurrent uterine Serous Carcinoma
Journal of Clinical Oncology, 2020Co-Authors: Joyce F Liu, Niya Xiong, Susana M Campos, Alexi A Wright, C N Krasner, Susan Schumer, Neil S Horowitz, Jennifer Taylor Veneris, Nabihah Tayob, Stephanie MorrisseyAbstract:6009Background: Uterine Serous Carcinoma (USC) is an aggressive subtype of endometrial Carcinoma characterized by TP53 mutations ( > 90%), often concomitantly with oncogenic mutations or amplificat...
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assessment of a chemotherapy response score crs system for tubo ovarian high grade Serous Carcinoma hgsc
International Journal of Gynecological Pathology, 2019Co-Authors: Helena M Ditzel, Joyce F Liu, Kyle C Strickland, Emily E Meserve, Elizabeth H Stover, Panagiotis A Konstantinopoulos, Ursula A Matulonis, Michael G Muto, Colleen M. FeltmateAbstract:A chemotherapy response score (CRS) system was recently described to assess the histopathologic response and prognosis of patients with tubo-ovarian high-grade Serous Carcinoma (HGSC) receiving neoadjuvant chemotherapy. The current study was performed as an independent assessment of this CRS system.
Robert A Soslow - One of the best experts on this subject based on the ideXlab platform.
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chromosomal instability in fallopian tube precursor lesions of Serous Carcinoma and frequent monoclonality of synchronous ovarian and fallopian tube mucosal Serous Carcinoma
Gynecologic Oncology, 2008Co-Authors: Shannon Salvador, Robert A Soslow, Allan G Rempel, Blake Gilks, David G Huntsman, Dianne MillerAbstract:Abstract Objectives Pelvic Serous Carcinomas are classified according to the location of greatest mass of tumor as ovarian, peritoneal or fallopian tube. Recent studies suggest these cancers may arise in the fallopian tube. This study explores the relationship between ovarian cancers and fallopian tube mucosal involvement. Methods Sixteen consecutive cases of epithelial ovarian malignancy were prospectively identified and the fallopian tubes submitted in toto for histopathological examination for tubal mucosal involvement. Immunohistochemical staining for p53 and Ki-67, and fluorescent in situ hybridization (FISH) analysis for chromosomal copy number changes were performed on 10 cases. Three cases of mucosal epithelial abnormalities identified in risk-reducing salpingectomy specimens were similarly characterized. Results Of sixteen cases, twelve were high-grade Serous Carcinoma, stage III, and four cases were stage I, two borderline mucinous, one borderline Serous, and one low-grade mucinous Carcinoma. Ten cases of high-grade Serous Carcinoma showed either unilateral fallopian tube mucosal involvement ( n = 7) or tubal obliteration ipsilateral to the dominant ovarian mass ( n = 3), compared to none of the other Carcinomas. FISH analysis showed similar copy number changes in the ovarian and fallopian tube mucosal Carcinoma in 3 cases, suggesting a unifocal origin; one case had differences suggesting multifocal origin of cancer. One case had equivocal FISH results. From risk-reducing salpingectomy cases, the multiple foci of tubal intraepithelial Carcinoma and focus of invasive Carcinoma showed similar gene copy number changes within each case, suggesting monclonality. Both cases of epithelial atypia/dysplasia showed gene copy number changes. Conclusions Fallopian tube mucosal and ovarian tumors have similar genetic abnormalities in most cases, indicating a monoclonal origin that may originate either from the ovary, peritoneum or fallopian tube. In situ epithelial lesions of the fallopian tube from risk-reducing salpingectomies show gene copy abnormalities consistent with these being early lesions of Serous Carcinoma and suggest that chromosomal instability is a very early event in Serous carcinogenesis.
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interobserver and intraobserver variability of a two tier system for grading ovarian Serous Carcinoma
The American Journal of Surgical Pathology, 2007Co-Authors: Anais Malpica, Michael T. Deavers, Robert J. Kurman, Carmen Tornos, Robert A Soslow, Jeffrey D Seidman, Mark F Munsell, Erich Gaertner, David P FrishbergAbstract:Although grading has been demonstrated to be an important prognostic factor in ovarian Serous Carcinoma, there is no system universally used to perform this task. A few years ago, we proposed a two-tier system for grading ovarian Serous Carcinoma that is based primarily on the assessment of nuclear atypia (uniformity vs. pleomorphism) in the worst area of the tumor. Tumor grade in this two-tier system is correlated with survival. After being used by numerous pathologists and trainees at The University of Texas M.D. Anderson Cancer Center (MDACC) for 15 years, we have observed that this system is user-friendly and reproducible. We undertook this study to evaluate the interobserver and intraobserver variability among a group of 7 gynecologic pathologists and 2 general surgical pathologists using this grading system. A total of 80 cases of ovarian Serous Carcinoma, 40 low-grade and 40 high-grade, were circulated twice among these pathologists. Slides with examples of low-grade and high-grade Serous Carcinoma were sent with the unknowns. A website was used to provide diagnostic criteria, images of examples of ovarian low-grade and high-grade Carcinoma, and a log form to facilitate data entry. Statistical analysis demonstrated an overall kappa statistic among the different observers of 0.909. The intergrader kappa's ranged from 0.717 to 1.000 in the first round of the review and from 0.701 to 1.000 in the second round. Eight of the participants had an intragrader kappa ranging from 0.775 to 1.000 (excellent agreement), whereas a single participant had an intragrader kappa of 0.725 (good agreement). This study demonstrates that the two-tier grading system (the MDACC grading system) for ovarian Serous Carcinoma on the basis of the assessment of nuclear atypia is easy to learn and is highly reproducible. These findings would support its universal use, which would be beneficial for the standardization of clinical trials and protocols, thus facilitating the understanding of this disease and investigation into the treatment of patients affected by these tumors.
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Familial Papillary Serous Carcinoma of the Cervix, Peritoneum, and Ovary: A Report of the First Case
Gynecologic oncology, 1998Co-Authors: Edward J. Kaplan, Thomas A. Caputo, Peter U. F. Shen, Robert I. Sassoon, Robert A SoslowAbstract:Abstract Objective. We report an occult primary papillary Serous Carcinoma of the endocervix that was encountered in a woman whose mother and identical twin sister died of papillary Serous Carcinomas (PSCs) of the peritoneum and ovary, respectively. Methods. The medical records and the histologic material belonging to the patient, her sister, and her mother were reviewed. Results. The cervical PSC was histologically similar to the peritoneal and ovarian Carcinomas. The patient has recurred with peritoneal Carcinomatosis 24 months following surgery and postoperative radiotherapy and chemotherapy. Conclusions. Primary papillary Serous Carcinoma of the cervix is a very rare adenoCarcinoma variant; there have been approximately 30 such cases reported, and, to our knowledge, this is the first documented case of familial peritoneal/ovarian/uterine papillary Serous Carcinoma. The prophylaxis achieved through bilateral oophorectomy in individuals with a family history of ovarian cancer does not address the risk of PSCs arising in the uterus, cervix, or peritoneum.
