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  • 1.
    Bohr Mordhorst, Louise
    et al.
    Örebro University Hospital. Department of Oncology, Örebro University Hospital, Örebro, Sweden.
    Ahlin, Cecilia
    Department of Oncology, Örebro University Hospital, Örebro, Sweden.
    Sorbe, Bengt
    Örebro University Hospital. Department of Oncology, Örebro University Hospital, Örebro, Sweden.
    Prognostic impact of the expression of Hedgehog proteins in cervical carcinoma FIGO stages I-IV treated with radiotherapy or chemoradiotherapy2014In: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 135, no 2, p. 305-311Article in journal (Refereed)
    Abstract [en]

    Objective: Hedgehog signaling proteins were assessed in patients with cervical carcinoma receiving chemoradiation. Associations between five Hedgehog proteins and prognosis were studied.

    Methods: In all, 131 cases of cervical carcinomas (FIGO stages I-IV) were immunohistochemically (IHC) analyzed for Patched (PTCH), Smoothened (SMO), and GLI1, GLI2 and GLI3 protein expression. Associations between Hedgehog protein expressions, clinicopathological factors, and clinical outcome data were examined.

    Results: Positive IHC staining for the five Hedgehog proteins was recorded in 8% to 37% of the tumor cells. The highest frequency was noted for SMO and the lowest for all. There was a significant association between low SMO- and GLI2-expression and KRAS-mutation. Tumors with overexpressed SMO had a higher frequency of residual tumor or local recurrences than tumors with low SMO expression. Patients with tumors expressing PTCH in more than 75% of the cells had significantly (P = 0.023) better recurrence-free survival than patients with tumors with low expression. The opposite situation was true for SMO. For GLI2, there was a statistically significant difference with regard to overall (P = 0.004) and distant (P = 0.015) relapse rate for groups with expression of GLI2 in the range of 5-25% compared to higher rates.

    Conclusions: A predictive and prognostic value was found for PTCH, SMO, and GLI2 with regard to residual carcinoma, local recurrences, and for GLI2 distant relapses. The Hedgehog signaling pathway also seems to play an important role in cervical carcinogenesis together with HPV16-infection and KRAS-mutation.

  • 2.
    Lillsunde-Larsson, Gabriella
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital.
    Helenius, Gisela
    Örebro University, School of Medicine, Örebro University, Sweden. Örebro University Hospital, Region Örebro County, Örebro, Sweden.
    Andersson, Sören
    Örebro University Hospital, Region Örebro County, Örebro, Sweden.
    Sorbe, Bengt
    Örebro University Hospital, Region Örebro County, Örebro, Sweden.
    Karlsson, Mats G.
    Örebro University Hospital. Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital, Region Örebro County, Örebro, Sweden.
    Prognostic impact of human papilloma virus (HPV) genotyping and HPV-16 subtyping in vaginal carcinoma2013In: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 129, no 2, p. 406-411Article in journal (Refereed)
    Abstract [en]

    Objective

    The objectives of this study are to investigate the human papilloma virus (HPV) distribution in vaginal cancer and to evaluate HPV-genotype as well as HPV16-variant impact on prognosis.

    Methods

    Sixty-nine patients diagnosed with primary vaginal carcinoma (1975-2002) were included in the study. Detection of twelve high-risk HPV (hr HPV) and two low-risk HPV (lr HPV) was performed with realtime-PCR. Samples positive for HPV-16 were analyzed for variants in the E6-gene with PCR and pyrosequencing.

    Results

    53.6% (37/69) of the tumors were found to be HPV-positive, mostly for HPV-16 (N=26). Other HPV-types were HPV-18 (N=2), HPV-31 (N=2), HPV-33 (N=2), HPV-45 (N=1), HPV-52 (N=2), HPV-56 (N=1) and HPV-58 (N=1). Only European subtypes of HPV-16 were represented and the two most common HPV-16-variants were E-p (N=13) and E-G350 (N=11). Patients with HPV-positive tumors (N=37) had a significantly (log-rank test=3341; p = 0.0008) superior 5-year overall survival rate as well as cancer-specific survival rate and progression-free survival rate (p = 0.0002; p = 0.0004), compared with patients with HPV-negative tumors (N=32). Interestingly, patients with HPV-16-positive tumors had a superior overall survival compared with patients with tumors containing other HPV-genotypes. In a Cox proportional multivariate analysis age, tumor size, and HPV-status were independent and significant prognostic factors with regard to overall survival rate.

    Conclusions

    HPV-status is of prognostic importance in vaginal carcinoma and varies with viral genotype. In this era of HPV-vaccination, genotypes other than those included in the vaccination program could still lead to vaginal carcinoma with unfavorable prognosis.

  • 3.
    Nelson, G.
    et al.
    Department of Gynecologic Oncology, Tom Baker Cancer Centre, Calgary AB, Canada.
    Altman, A. D.
    Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, Winnipeg MB, Canada.
    Nick, A.
    Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston TX, USA.
    Meyer, L. A.
    Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston TX, USA.
    Ramirez, P. T.
    Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston TX, USA.
    Achtari, C.
    Department of Obstetrics and Gynecology, Lausanne University Hospital, Lausanne, Switzerland.
    Antrobus, J.
    Department of Anesthesiology, Borders General Hospital, Melrose, United Kingdom.
    Huang, J.
    Anesthesiologists of Greater Orlando, Orlando FL, USA.
    Scott, M.
    Department of Anaesthesia and Intensive Care Medicine, Royal Surrey County NHS Foundation Hospital, Guildford, United Kingdom; Surrey Peri-operative Anaesthesia Critical Care Research group (SPACeR) Clinical Academic Group, FHMS, University of Surrey, Guildford, United Kingdom.
    Wijk, Lena
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Obstetrics and Gynecology, Örebro University Hospital, Örebro, Sweden.
    Acheson, N.
    Department of Gynaecologic Oncology, Royal Devon & Exeter NHS Foundation Trust, Exeter, United Kingdom.
    Ljungqvist, Olle
    Örebro University, School of Medicine, Örebro University, Sweden. Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Dowdy, S. C.
    Division of Gynecologic Surgery, Mayo Clinic College of Medicine, Rochester MN, USA.
    Guidelines for postoperative care in gynecologic/oncology surgery: Enhanced Recovery After Surgery (ERAS (R)) Society recommendations - Part II2016In: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 140, no 2, p. 323-332Article in journal (Refereed)
  • 4.
    Nelson, G.
    et al.
    Department of Gynecologic Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada.
    Altman, A. D.
    Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, Winnipeg MB, Canada.
    Nick, A.
    Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston TX, United States.
    Meyer, L. A.
    Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston TX, United States.
    Ramirez, P. T.
    Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston TX, United States.
    Achtari, C.
    Department of Obstetrics and Gynecology, Lausanne University Hospital, Lausanne, Switzerland.
    Antrobus, J.
    Department of Anesthesiology, Borders General Hospital, Melrose, United Kingdom.
    Huang, J.
    Anesthesiologists of Greater Orlando, Orlando FL, United States.
    Scott, M.
    Department of Anaesthesia and Intensive Care Medicine, Royal Surrey County NHS Foundation Hospital, Guildford, United Kingdom; Surrey Peri-operative Anaesthesia Critical Care Research group (SPACeR), Clinical Academic Group, FHMS, University of Surrey, Guildford, United Kingdom.
    Wijk, Lena
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Obstetrics and Gynecology,, Örebro University Hospital, Örebro, Sweden.
    Acheson, N.
    Department of Gynaecologic Oncology, Royal Devon & Exeter NHS Foundation Trust, Exeter, United Kingdom.
    Ljungqvist, Olle
    Örebro University, School of Medicine, Örebro University, Sweden. Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Dowdy, S. C.
    Division of Gynecologic Surgery, Mayo Clinic College of Medicine, Rochester MN, United States.
    Guidelines for pre- and intra-operative care in gynecologic/oncology surgery: Enhanced Recovery After Surgery (ERAS (R)) Society recommendations - Part I2016In: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 140, no 2, p. 313-322Article in journal (Refereed)
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