PracticeUpdate: Haematology & Oncology

ASCO 2016 11

• The investigators concluded that stromal TILs have prognostic value for patients with ovarian cancer both pre- and post- neoadjuvant chemotherapy. Cohort profile: African Collaborative Center for Microbiome and Genomics Research (ACCME) study. SN Adebamowo, E Dareng, A Famooto, et al • This multicentre prospective cohort study has enrolled 10,300 women in Nigeria to examine associations between cervical cancer and several relevant parameters, including genomics, epigenomics, HPV genotype, cervical cytokines, vaginal pH, and the vaginal microenvironment. At baseline, the mean age of the study participants was 40 years, 76% of the participants were married, and 30% of the participants were HPV-positive. • The trial withmore than 10,000 participants offers new opportunities of translational research in biomarker discovery that addresses high-impact public health challenges affecting women’s health in third-world countries Phase II study of anastrozole in recurrent estrogen/progesterone-positive endometrial cancer: The PARAGON trial – ANZGOG 0903. LR Mileshkin, RJ Edmondson, R O’Connell, et al • In an open-label arm of the phase 2 PARAGON trial, investigators assessed the effect of anastrozole on quality of life (QOL) in patients with ER/PR-positive metastatic hormone-naive endometrial cancer. At 3 months, the clinical benefit rate in patients treated with anastrozole was 44% (95% CI, 34–55%). Compared with patients who progressed on therapy, those who achieved clinical benefit also had significant improvements in QOL domains, including emotional functioning (39 vs 6%; P = 0.002), cognitive functioning (45 vs 19%; P = 0.021), fatigue (47 vs 19%; P = 0.015) and global health status (42 vs 9%; P = 0.003). • Anastrozole provided a significant clinical benefit, which was associated with improved QoL, in patients with ER/PR- positive endometrial cancer. Less versus more radical surgery in stage IB1 cervical cancer: A population-based study of long-term survival. MM Leitao, Y Sonoda, GJ Gardner, et al • In this retrospective study, the 10-year disease-specific survival (DSS) rate was evaluated in 2838 young (< 45 years of age) women with stage IB1 cervical cancer who had been treated with less radical surgery or more radical surgery. Less radical surgery

© ASCO/Todd Buchanan 2016

was defined as conization, trachelectomy, or simple hysterectomy; more radical surgery was defined as modified radical or radical hysterectomy. The researchers found no significant difference in the 10-year DSS rate between less and more radical surgery (92.8 ± 0.1% vs 92.3 ± 0.7%; P = 0.80) for all tumours, or for tumours stratified according to size. Neither approach was independently associated with the10-year DSS rate. • The conclusions reached are that less radical surgery does not appear to compromise 10-year DSS in patients with stage IB1 cervical cancer. Use of next-generation sequencing panels to predict recurrence in low-grade, early-stage endometrioid endometrial carcinoma. K Kurnit, B Fellman, DL Urbauer, et al • In this retrospective study, next-generation sequencing was used to profile samples from patients with low-grade, early-stage endometrioid endometrial cancer to identify variables associated with recurrence-free survival (RFS). Mutations in CTNNB1 and TP53 were associated with reduced rates of RFS (HR ,4.65; 95% CI, 2.33–9.30; P <  0.001). • Mutations in CTNNB1 and TP53 are independent predictors of poor RFS in patients with low-grade, early-stage endometrioid endometrial cancer. Impact of body mass index on surgical costs and morbidity for women with endometrial carcinoma/hyperplasia. RS Suidan, W He, CC Sun, et al • Investigators assessed whether body mass index (BMI) affected surgical complications and costs in 1112 patients with endometrial cancer and endometrial hyperplasia. Patients with BMI ≥ 40 had a higher rate

of wound infection following laparotomy compared with patients with BMI 30–39 or BMI ≤ 29 (14% vs 5% vs 5%; P < 0.01). These patients also experienced a higher rate of thromboembolic complications (3% vs 0.2% vs 0.3%; P < 0.01). The rates of wound infections and thromboembolic complications were not increased in patients with BMI ≥ 40 who underwent minimally invasive surgery. Other complications and median 30-day costs were not significantly different among the three BMI groups. However, median costs were higher for patients with complications. • Minimally invasive surgery may reduce costs and minimise complications in patients with endometrial cancer and BMI ≥ 40. Prognosis after local recurrence in vulvar cancer: A subset analysis of the AGO-CaRE-1 study. LL Woelber, C Eulenburg, J Kosse, et al • In this subgroup analysis of the retrospective AGO CaRE-1 study, investigators evaluated the rate of cancer recurrence in 1249 patients with primary squamous cell vulvar cancer. Following a median of 39.4 months, disease had recurred in 28.8% of the patients. In the 53.6% of patients with recurrent disease who suffered vulvar recurrence, nodal involvement was a negative prognostic factor (HR, 2.47; 95% CI, 1.52–4.03) and complete tumour resection was a positive prognostic factor (HR, 0.33; 95% CI, 0.17–0.63). Over the course of the study, a second recurrence developed in 30.1% of patients with a vulvar recurrence. • The investigators concluded that the prognosis for patients with isolated vulvar recurrence is worse than previously appreciated.

DECEMBER 2016