We report on eight patients who developed brain metastases following uterine cervical cancer. The mean interval between diagnosis of the primary cancer and diagnosis of the brain metastasis was 28.4 months (range: 6.1-61.8 months). Nausea and vomiting due to increased intracranial pressure were the most frequent symptoms. Surgical excision of the brain lesions, followed by postoperative radiotherapy, was performed in three patients. The other five patients received only cranial radiotherapy. When the metastatic brain lesions were detected, other distant metastatic lesions were confirmed at the same time in five patients. The median survival time after diagnosis of the brain metastases was only 3.0 months.

A retrospective analysis was carried out to identify risk factors for survival and relapse in patients with FIGO stage I -IIB cervical adenocarcinoma (AC), who underwent radical hysterectomy, and to compare outcome and spread pattern with those of squamous cell carcinoma (SCC). One hundred and twenty-three FIGO stage I -IIB patients with AC and 455 patients with SCC, who all underwent primary radical hysterectomy, were reviewed. Among the patients with AC, Cox model identified tumour size (95% CI: 1.35 -30.71) and node metastasis (95% CI: 5.09 -53.44) as independent prognostic factors for survival, and infiltration to vagina (95% CI: 1.15 -5.76) and node metastasis (95% CI: 6.39 -58.87) as independent prognostic factors for relapse. No significant difference was found in survival or relapse between the AC and SCC groups, after adjusting for other clinicopathological characteristics using Cox model. No significant difference was found in the positive rates of lymph nodes or location of initial failure sites between the two groups, but ovarian metastatic rate was significantly higher in patients with pathologic stage IIB AC (P ¼ 0.02). Positive node is a common independent prognostic factor for survival and relapse of patients with AC. FIGO stage I -IIB patients with AC or SCC, who underwent radical hysterectomy, have similar prognosis and spread pattern, but different ovarian metastasis rates. At present, standard treatment options for patients with invasive carcinoma of the uterine cervix are as follows: radical hysterectomy followed by adjuvant radiotherapy or primary radiotherapy with concurrent cisplatin-containing chemotherapy, for the patients with the International Federation of Gynecology and Obstetrics (FIGO) stage IB -IIA disease, with equivalent results; and primary radiotherapy with concurrent chemotherapy for the patients with FIGO stage IIB -IVA disease. These therapeutic strategies have been widely accepted. On the other hand, approximately 85% of the patients with carcinoma of the uterine cervix have squamous lesions, and most of the remaining 10% have adenocarcinoma (AC) lesions (Benedet et al, 2003). To our knowledge, no practice guideline has referred to the treatment option based on the difference of histological types between AC and squamous cell carcinoma (SCC) It is not clear whether these histological types influence outcome or spread pattern, and there is still controversy, as conflicting results have appeared in the literature because of potential limitations of small cohorts of patients with AC. The question whether standard treatment for patients with SCC is also suitable for patients with AC remains unanswered. Additionally, over the last decade, the proportion of AC relative to SCC has doubled, and the rate of AC per population at risk has also increased (Smith et al, 2000). To establish a framework for designing therapeutic strategies, the present retrospective study was undertaken firstly to clarify the clinicopathological features of the surgically treated patients with common typ...

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Uterine papillary serous carcinoma (UPSC) is a rare and aggressive variant of endometrial carcinoma. Little is known about the pathological and biological features of this tumor. Human epidermal growth factor receptor 2 (HER2) and hormone receptor (HR) expression have an important role in tumor behavior and clinical outcome, but their relevance in UPSC is not clear. In the present study, the immunohistochemical expression of HER2 and HR was assessed in 27 patients with Stage I disease, 13 with Stage II disease, 25 with Stage III disease, and 6 with Stage IV disease. Correlations between HER2 and HR expression and the clinicopathological parameters of UPSC were evaluated using Cox's univariate and multivariate analyses. For all patients, the 5-year recurrence-free survival (RFS) and overall survival (OS) rates were 51% and 66%, respectively; in patients with Stage I, II, III and IV disease, the RFS and OS were 67%/81%, 59%/77%, 43%/54% and 0%/0%, respectively. Of all 71 patients, 14% (10/71) were positive for HER2 and 52% (37/71) were positive for HR. Overexpression of HER2 was correlated with lower OS (P = 0.01), whereas HR overexpression was correlated with higher OS (P = 0.008). In multivariate models, HER2, HR, and histologic subtype were identified as independent prognostic indicators for RFS (P = 0.022, P = 0.018, and P = 0.01, respectively), but HR was the only independent factor associated with OS (P = 0.044). Thus, HER2 and HR are prognostic variables in UPSC, with HR an independent prognostic factor for OS. (Cancer Sci 2012; 103: 926-932) E ndometrial carcinoma is the most common gynecological malignancy in the US and its occurrence in Japan has increased recently.(1,2) Endometrial carcinomas are conventionally divided into two subgroups, Types I and II. Type I endometrial carcinomas is associated with a hyperestrogenic state and tends to be well differentiated, whereas Type II endometrial carcinomas is not associated with a hyperestrogenic status and is high grade.(3) Uterine papillary serous carcinoma (UPSC), initially described by Hendrickson et al.,(4) is one of the Type II endometrial carcinomas. It comprises <10% of all endometrial carcinomas, but accounts for over 50% of all recurrences and deaths caused by this disease.(5-7) Despite aggressive treatment, locoregional and distant failures are common, even in patients treated by surgery for early stage disease. (5,(8)(9)(10) One study reported a 5-year overall survival (OS) rate for 129 patients with UPSC of 45.9%, with recurrence even occurring in four of 21 (19%) patients with Stage IA. Nonetheless, there is little information regarding the molecular basis for the aggressive biological behavior of UPSC.Human epidermal growth factor receptor type 2 (HER2) is a well-established tumor biomarker that is overexpressed in a wide variety of carcinomas, including breast, ovary, prostate, and lung. (11,12) Overexpression of HER2 is a significant factor in aggressive tumor behavior and poor clinical outcome.

[structure: see text] UCS1025A and B, novel pentacyclic polyketides with an unprecedented furopyrrolizidine skeleton, were isolated from the fungus Acremonium sp. KY4917. The structures and stereochemistry were elucidated by a combination of two-dimensional NMR and X-ray crystallographic analysis. UCS1025A showed unique chemical equilibria involving three tautomeric isomers and exhibited antimicrobial activity and antiproliferative activity against human tumor cell lines.

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ObjectiveThough there are no evidences that postoperative therapy improves overall survival (OS) in stage I–II endometrial carcinoma, many women receive postoperative radiation or chemotherapy. This study aimed to investigate the baseline risk of recurrence after complete resection without any adjuvant therapies and to suppose the validity of postoperative therapy for stage I–II endometrial carcinoma.MethodsCharts for patients with stage I–II endometrial carcinoma who underwent operation without postoperative therapy between January 2005 and December 2011 were retrospectively reviewed and the baseline risk of recurrence and prognosis were assessed. Risk classifications were performed according to European Society for Medical Oncology (ESMO) clinical practice guidelines and Japanese guideline written by Japan Society of Gynecologic Oncology Group.ResultsAmong 374 patients who underwent complete resection, 311 were evaluable. Five-year recurrence rates by ESMO and Japanese were 2.6% and 3.1% in low-risk, 9.2% and 6.6% in intermediate-risk and 13.5% and 13.8% in high-risk group (p=0.003 and 0.015, respectively). High-risk group had worse OS compared with low- and intermediate-risk groups (5-year OS, low: 97.9% and 97.6%, intermediate: 97.9% and 98.8%, and high: 89.5% and 87.5%; p=0.003 and 0.008, respectively). Independent predictive factors of recurrence were age over 60 years, type 2 (estrogen-independent) and peritoneal cytology.ConclusionESMO and Japanese risk classification similarly stratify the baseline risk of recurrence. Patients with stage I–II endometrial carcinoma, especially low- and intermediate-risk diseases, have low recurrence rate and favorable OS, and the benefit of postoperative therapy might be small.