BACKGROUND

Early-stage endometrial cancer often presents with favorable survival rates, but high-risk factors, including TP53 mutations and high-grade serous pathology, can lead to recurrence and poor prognosis. The standard primary treatment for endometrial cancer is surgical staging, and lymph node metastases significantly impact adjuvant therapy decisions. The subgroup of p53-abnormal (p53abn) indicates the worst prognosis and potential benefits from adjuvant chemotherapy. Molecular classification, while recommended, faces practical challenges due to resource constraints.

OBJECTIVES

The study aimed to assess the incidence of p53 abnormal expression in clinical stage 1 endometrial cancer cases that underwent surgery at a government tertiary hospital, and assess its relationship with clinicopathologic factors and pelvic and paraaortic lymph node metastasis (LNM).

METHODS

A cross-sectional retrospective analysis was conducted on clinical early-stage endometrial cancer cases that underwent surgical primary treatment between January 2018 and December 2022. Patient records were reviewed to gather demographics, surgical information, and pathological evaluations. Preoperative clinical staging was determined through imaging, and surgical staging involved comprehensive lymphadenectomy. Immunohistochemistry studies for p53 were carried out on formalin-fixed paraffin-embedded tissue samples.

RESULTS

A total of 233 endometrial cancer cases were included. The mean age at diagnosis was 53.7 years. Common comorbidities included hypertension (47.2%) and dyslipidemia (20.6%). Most cases were endometrioid histology (82.8%) and low-grade tumors (85.8%). Tumor grade (p=0.010), myometrial invasion (pCONCLUSION

Tumor grade, myometrial invasion, and LVSI were all significantly associated with lymph node involvement. While p53 immunohistochemical stains show promise in predicting metastasis and has been associated with tumor aggressiveness, this should still be correlated with clinicopathological parameters to carry out a more accurate risk stratification of early-stage patients.

Therapeutics ; Survival Rate ; Risk Factors ; Recurrence ; Prognosis ; Pathology ; Endometrial Neoplasms ; Immunohistochemistry ; Tumor Suppressor Protein P53 ; Lymph Node Excision ; Risk Assessment

BACKGROUND

Early-stage endometrial cancer often presents with favorable survival rates, but high-risk factors, including TP53 mutations and high-grade serous pathology, can lead to recurrence and poor prognosis. The standard primary treatment for endometrial cancer is surgical staging, and lymph node metastases significantly impact adjuvant therapy decisions. The subgroup of p53-abnormal (p53abn) indicates the worst prognosis and potential benefits from adjuvant chemotherapy. Molecular classification, while recommended, faces practical challenges due to resource constraints.

OBJECTIVES

The study aimed to assess the incidence of p53 abnormal expression in clinical stage 1 endometrial cancer cases that underwent surgery at a government tertiary hospital, and assess its relationship with clinicopathologic factors and pelvic and paraaortic lymph node metastasis (LNM).

METHODS

A cross-sectional retrospective analysis was conducted on clinical early-stage endometrial cancer cases that underwent surgical primary treatment between January 2018 and December 2022. Patient records were reviewed to gather demographics, surgical information, and pathological evaluations. Preoperative clinical staging was determined through imaging, and surgical staging involved comprehensive lymphadenectomy. Immunohistochemistry studies for p53 were carried out on formalin-fixed paraffin-embedded tissue samples.

RESULTS

A total of 233 endometrial cancer cases were included. The mean age at diagnosis was 53.7 years. Common comorbidities included hypertension (47.2%) and dyslipidemia (20.6%). Most cases were endometrioid histology (82.8%) and low-grade tumors (85.8%). Tumor grade (p=0.010), myometrial invasion (pCONCLUSION

Tumor grade, myometrial invasion, and LVSI were all significantly associated with lymph node involvement. While p53 immunohistochemical stains show promise in predicting metastasis and has been associated with tumor aggressiveness, this should still be correlated with clinicopathological parameters to carry out a more accurate risk stratification of early-stage patients.

Therapeutics ; Survival Rate ; Risk Factors ; Recurrence ; Prognosis ; Pathology ; Endometrial Neoplasms ; Immunohistochemistry ; Tumor Suppressor Protein P53 ; Lymph Node Excision ; Risk Assessment

Introduction: Physician burnout (BO) is an increasing global concern due to its rising prevalence and effect on patient care Objective: This study determined the prevalence of BO, compassion fatigue (CF), and compassion satisfaction (CS), among residents of obstetrics and gynecology in the Philippines, and identified the factors associated with these Methods: This was a cross‑sectional study, which used stratified random sampling. The strata comprised public and private hospitals that were subdivided into Luzon, Visayas, Mindanao, and National Capital Region. From these, 33 training hospitals were randomly selected, which served as clusters wherein all resident physicians of obstetrics and gynecology were invited to answer either an online or printed version of the Professional Quality of Life Scale Version 5 questionnaire Results: Majority of the 311 participants included had average level of BO (n = 281, 90.4%), CF (n = 237, 76.2%), and CS (n = 213, 68.5%). CS was negatively correlated with burnout (r = −0.31, P < 0.001) and CF (r = −0.34, P < 0.001), whereas BO and CS were positively correlated (r = +0.48, P < 0.001). Type of institution, sleeping hours, and interrupted leaves were the common factors that yield significant differences in BO (P = 0.037, P < 0.001, and P < 0.001) and CF (P = 0.002, P = 0.043, and P = 0.005). Significant differences were observed in CS scores in terms of age (P = 0.016), marital status (P = 0.038), child dependents (P = 0.006), level of training (P = 0.005), and location and type of institution (P ≤ 0.001 and P = 0.003). Conclusion There is a need to develop active awareness of BO and CF among resident physicians to effect interventions at the individual and institutional level.
Burnout, Psychological ; Compassion Fatigue

Fibroepithelial stromal polyp, more commonly known as acrochordon, skin tag, or soft fibroma is a type of mesenchymal tumor occurring among women of reproductive age. Fibroepithelial polyp, although the most common cutaneous tumor, is rare in the vulvovaginal region and there is currently no established protocol in approaching these kinds of lesions. Presented here is a series of cases of gradually enlarging labial masses among reproductive age women. These giant vulvar masses presented as solitary, flesh-colored, polypoid masses, initially non-tender but later becoming associated with local pain. Diagnosis is mainly through history, clinical examination aided by ultrasonography, and histopathologic examination, which would show a central fibrovascular core covered with squamous epithelium. Surgical excision serves as both diagnostic and therapeutic modality for these lesions. Vulvar fibroepithelial polyp do not seem to be as rare as literature says, they are relatively easy to diagnose and presents with benign clinical course.
Vulvar Neoplasms ; Vulvar Diseases