Role of CD44 and CD24 Expression on 2-years Disease Free Survival in Patients with Advanced Epithelial Ovarian Carcinoma.

OBJECTIVE: Ovarian cancer is one of the most common cancers with a high mortality rate worldwide. Despite optimal surgical therapy and chemotherapy, recurrence is still common. Cancer stem cells expressing CD44 and CD24 are thought to be contributing factors in recurrence. METHODS: A cohort retrospective study with survival analysis was carried out on advanced ovarian cancer patients who underwent optimal debulking surgery followed by 6 cycles of chemotherapy at Cipto Mangunkusumo General Hospital and Fatmawati General Hospital from January 2019 to March 2023. Immunohistochemical examination was performed on tumor tissue with CD44 and CD24 expression were assessed using the H-Score method then determined the cut off-point expression level using the ROC curve. Furthermore, the relationship between these expression levels with the disease-free survival was assessed using the survival curve. RESULTS: There were 48 subjects who were included in the study. There were high expression levels of CD44 in 47.9% and CD24 in 50% of cases. High CD44 expression had mean and median survival of 13.2 ± 1.8 and 11 months (HR 5.05, 95% CI 1.84- 13.85). High CD24 expression had mean and median survival of 13.5 ± 2.4 and 7 months (HR 7.73, 95% CI 2.58 - 23.15). The combination of the two high expressions had mean and median survival of 10.44 ± 1.88 and 7 months. CONCLUSION: High expression of CD44 and CD24 will shorten the disease-free survival of patients with advanced ovarian cancer.

Histopathological and biomarker complete response after neoadjuvant chemotherapy of advanced stage yolk sac tumor of the ovary: A case report and literature review.

INTRODUCTION: Yolk sac tumor is the second most common germ cell ovarian carcinoma. Neoadjuvant chemotherapy (NACT) is proposed as an alternative option for patients with advanced disease who are not eligible for primary debulking. We presented a case with a systematic review of advanced yolk sac tumors of the ovary with poor performance who gain benefit from NACT. CASE PRESENTATION: A 24-year-old female underwent NACT followed by surgery after being diagnosed with an advanced yolk sac tumor. A literature search was done based on the clinical question using the Patient/Problem, Intervention, Comparison, and Outcome (PICO) approach. Pubmed and Google Scholar were used to search the literature. DISCUSSION: Out of 111 manuscripts found, 2 articles were retrieved for detailed evaluation. The patient showed a complete response in tumor size, histopathology, and tumor markers after the NACT procedure followed by surgery. CONCLUSIONS: NACT is a suitable option for advanced yolk sac tumors of the ovary.