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

Background: Cervical cancer remains a health-care burden in our country. Majority of women afflicted with this cancer are diagnosed in advanced stage. Several groups like the Philippine Society for Cervical Pathology and Colposcopy (PSCPC) have put forth efforts to decrease and eventually eliminate cervical cancer through improvement in level of awareness on the disease and community-based cervical cancer screening programs using visual inspection using acetic acid (VIA). Data on the prevalence of premalignant lesions using this screening method are limited in our country. Thus, the initiative of the society (PSCPC) to embark on this study. Objective: The objective of this study was to determine the prevalence of premalignant cervical lesions among women screened in community-based screening program using VIA in Metro Manila. Methodology: A retrospective cross-sectional study with collection of data from medical records of cervical screening programs done by the PSCPC from March 2017 to December 2019 was done. VIA was done for screening. All VIA-positive women underwent colposcopy and those with abnormal findings had colposcopically guided cervical punch biopsy. Results: A total of 1072 women were screened with a positivity rate of 14.6%. One hundred and fifty-six women were VIA positive and 79 of these women underwent colposcopically guided biopsy. Premalignant cervical lesions were seen in 21 women. The prevalence rate of premalignant cervical lesions in VIA-positive women was 13.5%. The prevalence of premalignant cervical lesions among all women screened was 2%. Risk factors associated with premalignant lesions were early coitarche and smoking. Conclusion The prevalence of premalignant cervical lesions among women who underwent community-based cervical cancer screening using VIA is lower compared to other studies at 2%.

Growing teratoma syndrome is a rare phenomenon. Presented is a case of a 36 year old, G2P2 (2002) who consulted for abdominal enlargement and subsequently underwent exploratory laparotomy, peritoneal fluid cytology, left salpingooophorectomy, right oophorocystectomy, infracolic omentectomy and random peritoneal biopsy. Histopathology revealed immature teratoma of the ovary, FIGO grade III, stage IIIC. She received adjuvant chemotherapy using Bleomycin, Etoposide, Cisplatin. After the second cycle of chemotherapy, new lesions were appreciated in the right ovary and at the cul de sac for which she underwent exploratory laparotomy, peritoneal fluid cytology, total hysterectomy with right salpingooophorectomy, tumor debulking, infragastric omentectomy, random peritoneal biopsy. Histopathologic study showed mature teratoma. No further treatment was given. Presently, patient has no evidence of disease for 5 months.
Teratoma, Ovarian ; Teratoma ; Ovarian Neoplasms ; Syndrome

OBJECTIVE: To determine the risk of postpartum hemorrhage among patients who were treated with nifedipine for tocolysis of preterm labor.

METHODS: A prospective cohort study was conducted with 66 pregnant women admitted for preterm labor. One group of women was given nifedipine to give time for the administration of corticosteroids for fetal lung maturity and/or control of preterm labor and another group was not given nifedipine as they were admitted in advanced stage of labor (ie, more than or equal to 4 cm cervical dilatation). Independent/paired sample t-test, Mann-Whitney U/Wilcoxon signed rank test, and Fisher's exact test were used to determine the difference of mean, median, and frequency between and within groups, respectively. STATA 12.0 was used for data analysis.

RESULTS: There was more blood loss during delivery, which was statistically significant, among those who received nifedipine compared to those who have not taken the medicine (350 mL versus 250 mL, p = 0.021). Furthermore, the decreases in hemoglobin and hematocrit were also lower among those who did not receive nifedipine compared to those who received nifedipine for tocolysis (8.5 mg/dL versus 16.0 mg/dL, p = 0.014 and 0.03 versus 0.05, p = 0.010), again, statistically significant.

CONCLUSION: Nifedipine used as tocolytic appear to increase blood loss during delivery, which was statistically significant. Greater amount of blood loss may be anticipated among those with nifedipine intake thus helping the obstetrician in preparing for active management of postpartum hemorrhage and preventing maternal morbidity and mortality.

Human ; Female ; Adult (a Person 19-44 Years Of Age) ; Nifedipine ; Obstetric Labor, Premature ; Postpartum Hemorrhage ; Tocolytic Agents ; Nifedipine-adverse Effects