Diagnosis and Management of Ovarian Cancer

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (28 February 2023) | Viewed by 8709

Special Issue Editors


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Guest Editor
Division of Gynaecology Oncology, Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
Interests: cancer biology and novel treatment in gynecologic cancers
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Guest Editor
Division of Gynaecology Oncology, Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Hong Kong
Interests: cancer biology and novel treatment in gynecologic cancers

Special Issue Information

Dear Colleagues, 

Ovarian cancer is the seventh most common cancer among women globally. Most epithelial ovarian cancers (EOCs) are diagnosed at a late stage. Despite cytoreductive surgery, chemotherapy, and targeted therapy, more than half of patients with advanced disease relapse in the first 2–3 years, and their prognosis is poor. Therefore, it is essential to identify an effective way for early diagnosis and to ensure that patients receive the most optimal treatment.

Scope

The aim of this Special Issue is to provide an overview on the updated and novel diagnostic and treatment options in EOCs. We invite authors to submit their original research, including preclinical, translational studies, and clinical trials. Review articles may also be considered. Potential topics include but are not limited to: 

  • Diagnostic tools for EOCs;
  • Use of imaging in EOCs;
  • Surgical management for EOCs;
  • Precision medicine in EOCs;
  • Roles of chemotherapy, immunotherapy, and other targeted agents in EOCs;
  • Resistance mechanisms to therapies in EOCs;
  • Management of side effects or complications from treatments in EOCs;
  • Monitoring for treatment response in EOCs.

Dr. Ka Yu Tse
Dr. Mandy Chu
Guest Editors

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Published Papers (3 papers)

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Research

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14 pages, 661 KiB  
Article
Comparison of Ultrasound Scores in Differentiating between Benign and Malignant Adnexal Masses
by Mar Pelayo, Irene Pelayo-Delgado, Javier Sancho-Sauco, Javier Sanchez-Zurdo, Leopoldo Abarca-Martinez, Virginia Corraliza-Galán, Carmen Martin-Gromaz, María Jesús Pablos-Antona, Julia Zurita-Calvo and Juan Luis Alcázar
Diagnostics 2023, 13(7), 1307; https://doi.org/10.3390/diagnostics13071307 - 30 Mar 2023
Cited by 8 | Viewed by 1938
Abstract
Subjective ultrasound assessment by an expert examiner is meant to be the best option for the differentiation between benign and malignant adnexal masses. Different ultrasound scores can help in the classification, but whether one of them is significantly better than others is still [...] Read more.
Subjective ultrasound assessment by an expert examiner is meant to be the best option for the differentiation between benign and malignant adnexal masses. Different ultrasound scores can help in the classification, but whether one of them is significantly better than others is still a matter of debate. The main aim of this work is to compare the diagnostic performance of some of these scores in the evaluation of adnexal masses in the same set of patients. This is a retrospective study of a consecutive series of women diagnosed as having a persistent adnexal mass and managed surgically. Ultrasound characteristics were analyzed according to IOTA criteria. Masses were classified according to the subjective impression of the sonographer and other ultrasound scores (IOTA simple rules -SR-, IOTA simple rules risk assessment -SRRA-, O-RADS classification, and ADNEX model -with and without CA125 value-). A total of 122 women were included. Sixty-two women were postmenopausal (50.8%). Eighty-one women had a benign mass (66.4%), and 41 (33.6%) had a malignant tumor. The sensitivity of subjective assessment, IOTA SR, IOTA SRRA, and ADNEX model with or without CA125 and O-RADS was 87.8%, 66.7%, 78.1%, 95.1%, 87.8%, and 90.2%, respectively. The specificity for these approaches was 69.1%, 89.2%, 72.8%, 74.1%, 67.9%, and 60.5%, respectively. All methods with similar AUC (0.81, 0.78, 0.80, 0.88, 0.84, and 0.75, respectively). We concluded that IOTA SR, IOTA SRRA, and ADNEX models with or without CA125 and O-RADS can help in the differentiation of benign and malignant masses, and their performance is similar to the subjective assessment of an experienced sonographer. Full article
(This article belongs to the Special Issue Diagnosis and Management of Ovarian Cancer)
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15 pages, 3377 KiB  
Article
Performance of IOTA Simple Rules Risks, ADNEX Model, Subjective Assessment Compared to CA125 and HE4 with ROMA Algorithm in Discriminating between Benign, Borderline and Stage I Malignant Adnexal Lesions
by Artur Czekierdowski, Norbert Stachowicz, Agata Smolen, Tomasz Łoziński, Paweł Guzik and Tomasz Kluz
Diagnostics 2023, 13(5), 885; https://doi.org/10.3390/diagnostics13050885 - 25 Feb 2023
Cited by 8 | Viewed by 3825
Abstract
BACKGROUND: Borderline ovarian tumors (BOTs) and early clinical stage malignant adnexal masses can make sonographic diagnosis challenging, while the clinical utility of tumor markers, e.g., CA125 and HE4, or the ROMA algorithm, remains controversial in such cases. OBJECTIVE: To compare the IOTA group [...] Read more.
BACKGROUND: Borderline ovarian tumors (BOTs) and early clinical stage malignant adnexal masses can make sonographic diagnosis challenging, while the clinical utility of tumor markers, e.g., CA125 and HE4, or the ROMA algorithm, remains controversial in such cases. OBJECTIVE: To compare the IOTA group Simple Rules Risk (SRR), the ADNEX model and the subjective assessment (SA) with serum CA125, HE4 and the ROMA algorithm in the preoperative discrimination between benign tumors, BOTs and stage I malignant ovarian lesions (MOLs). METHODS: A multicenter retrospective study was conducted with lesions classified prospectively using subjective assessment and tumor markers with the ROMA. The SRR assessment and ADNEX risk estimation were applied retrospectively. The sensitivity, specificity, positive and negative likelihood ratios (LR+ and LR−) were calculated for all tests. RESULTS: In total, 108 patients (the median age: 48 yrs, 44 postmenopausal) with 62 (79.6%) benign masses, 26 (24.1%) BOTs and 20 (18.5%) stage I MOLs were included. When comparing benign masses with combined BOTs and stage I MOLs, SA correctly identified 76% of benign masses, 69% of BOTs and 80% of stage I MOLs. Significant differences were found for the presence and size of the largest solid component (p = 0.0006), the number of papillary projections (p = 0.01), papillation contour (p = 0.008) and IOTA color score (p = 0.0009). The SRR and ADNEX models were characterized by the highest sensitivity (80% and 70%, respectively), whereas the highest specificity was found for SA (94%). The corresponding likelihood ratios were as follows: LR+ = 3.59 and LR− = 0.43 for the ADNEX; LR+ = 6.40 and LR− = 0.63 for SA and LR+ = 1.85 with LR− = 0.35 for the SRR. The sensitivity and specificity of the ROMA test were 50% and 85%, respectively, with LR+ = 3.44 and LR− = 0.58. Of all the tests, the ADNEX model had the highest diagnostic accuracy of 76%. CONCLUSIONS: This study demonstrates the limited value of diagnostics based on CA125 and HE4 serum tumor markers and the ROMA algorithm as independent modalities for the detection of BOTs and early stage adnexal malignant tumors in women. SA and IOTA methods based on ultrasound examination may present superior value over tumor marker assessment. Full article
(This article belongs to the Special Issue Diagnosis and Management of Ovarian Cancer)
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Review

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16 pages, 331 KiB  
Review
Through the Looking Glass: Updated Insights on Ovarian Cancer Diagnostics
by Sourav Chakraborty, Priti S. Shenoy, Megha Mehrotra, Pratham Phadte, Prerna Singh, Bharat Rekhi and Pritha Ray
Diagnostics 2023, 13(4), 713; https://doi.org/10.3390/diagnostics13040713 - 14 Feb 2023
Cited by 3 | Viewed by 2499
Abstract
Epithelial ovarian cancer (EOC) is the deadliest gynaecological malignancy and the eighth most prevalent cancer in women, with an abysmal mortality rate of two million worldwide. The existence of multiple overlapping symptoms with other gastrointestinal, genitourinary, and gynaecological maladies often leads to late-stage [...] Read more.
Epithelial ovarian cancer (EOC) is the deadliest gynaecological malignancy and the eighth most prevalent cancer in women, with an abysmal mortality rate of two million worldwide. The existence of multiple overlapping symptoms with other gastrointestinal, genitourinary, and gynaecological maladies often leads to late-stage diagnosis and extensive extra-ovarian metastasis. Due to the absence of any clear early-stage symptoms, current tools only aid in the diagnosis of advanced-stage patients, wherein the 5-year survival plummets further to less than 30%. Therefore, there is a dire need for the identification of novel approaches that not only allow early diagnosis of the disease but also have a greater prognostic value. Toward this, biomarkers provide a gamut of powerful and dynamic tools to allow the identification of a spectrum of different malignancies. Both serum cancer antigen 125 (CA-125) and human epididymis 4 (HE4) are currently being used in clinics not only for EOC but also peritoneal and GI tract cancers. Screening of multiple biomarkers is gradually emerging as a beneficial strategy for early-stage diagnosis, proving instrumental in administration of first-line chemotherapy. These novel biomarkers seem to exhibit an enhanced potential as a diagnostic tool. This review summarizes existing knowledge of the ever-growing field of biomarker identification along with potential future ones, especially for ovarian cancer. Full article
(This article belongs to the Special Issue Diagnosis and Management of Ovarian Cancer)
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