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Ding C, Wei W, Ding F, Ding J, Li B, Ma Q. Ultrasound diagnostic of intrauterine adhesions: Systematic review and meta-analysis. J Obstet Gynaecol Res 2024. [PMID: 39030921 DOI: 10.1111/jog.16027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 07/10/2024] [Indexed: 07/22/2024]
Abstract
PURPOSE To summarize and compare the accuracy of transvaginal ultrasound (TVS), 3D-TVS, and sonohysterography (SHG) for the diagnosis of intrauterine adhesions (IUA). METHODS The computer searches databases such as web of science, Medline, EMBASE, and PubMed collecting diagnostic studies of IUA via ultrasound. The retrieval time was included from inception to January 1, 2023. Two researchers independently screened the literature, extracted information, and used RevMan 5.3 to complete an assessment of the risk of bias in the included literature. Meta-analysis of included studies using Stata 16.0 and Meta Disc 1.4 software. RESULTS Thirteen studies were included. The analysis results of 2D-TVS are The sensitivity (SEN): 0.54 (95% CI [0.28078]), specificity (SPE): 0.96 (95% CI [0.78, 0.99]), and the area (AUC) under the operating characteristic curve (SROC): 0.83 (95% CI [0.80, 0.86]); the SEN, SPE, and AUC of 3D-TVS are: 0.96 (95% CI [0.90, 0.98]), 0.84 (95% CI [0.68, 0.93]), 0.97 (95% CI [0.95, 0.98]); and the SEN, SPE, and AUC of SHG are: 0.74 (95% CI [0.53, 0.88]), 0.97 (95% CI [0.94, 0.99]), 0.95 (95% CI [0.93, 0.97]). CONCLUSION The current results show that the diagnostic value of 3D-TVS for IUA is better than SHG and significantly higher than that of 2D-TVS. However, the analysis of subgroups is still limited by the number of included studies. In order to better explore the application of ultrasound in intrauterine adhesion, more high-quality studies are needed in the future.
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Affiliation(s)
- Caiyun Ding
- Department of Basic Medical Science, Wannan Medical College, Wuhu, People's Republic of China
| | - Wei Wei
- Department of Ultrasound, First Affiliated Hospital of Wannan Medical College, Wuhu, People's Republic of China
| | - Fengzhi Ding
- Department of Basic Medical Science, Wannan Medical College, Wuhu, People's Republic of China
| | - Jin Ding
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Wannan Medical College, Wuhu, People's Republic of China
| | - Bozheng Li
- Department of Ultrasound, First Affiliated Hospital of Wannan Medical College, Wuhu, People's Republic of China
| | - Qiang Ma
- Department of Ultrasound, First Affiliated Hospital of Wannan Medical College, Wuhu, People's Republic of China
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2
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Fascilla FD, Piscitelli D, De Palma D, Mongelli M, Murgia F, Carugno J, Vitagliano A, Bettocchi S. Rapidly evolving pelvic lymphangioleiomyomatosis (LAM) mimicking bilateral hydrosalpinx: report of a rare case and literature review. Acta Chir Belg 2024; 124:223-228. [PMID: 37395387 DOI: 10.1080/00015458.2023.2232687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/28/2023] [Indexed: 07/18/2023]
Abstract
Lymphangioleiomyomatosis (LAM) represents a rare neoplasm affecting almost exclusively women of reproductive age. This condition mainly affects the lungs, but extrapulmonary locations such as the pelvis and the retroperitoneum are possible. Clinical evaluation and ultrasound imaging are usually non-specific, and the diagnosis is obtained through surgical excision and histopathological examination. We report a very rare case of abdominal LAM in a young female patient. A thorough literature review of this rare condition with emphasis on gynecologic implications will be presented. The patient was referred for gynecologic consultation due to pelvic pain and infertility. Unfortunately, despite prompt diagnosis and treatment, the course of the disease was severe and led to patient's exitus in a short time. We encountered an extremely rare deadly pathology mimicking a very common gynecologic condition. The gynecologist must always be alert of possible unexpected conditions that will require prompt attention.
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Affiliation(s)
| | - Domenico Piscitelli
- Department of Anatomopathology, Policlinico of Bari, University of Bari "Aldo Moro", Bari, Italy
| | - Domenico De Palma
- Department of Emergency, "Di Venere" General Hospital, ASL BA, Bari, Italy
| | - Michele Mongelli
- Department of Interdisciplinary Medicine (DIM), Unit of Obstetrics and Gynecology, University of Bari "Aldo Moro", Policlinico of Bari, Bari, Italy
| | - Ferdinando Murgia
- Department of Obstetrics and Gynecology, "Miulli" General Hospital, Acquaviva delle Fonti (Bari), Italy
| | - Jose Carugno
- Obstetrics, Gynecology and Reproductive Science Department, Minimally Invasive Gynecology Division, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Amerigo Vitagliano
- Department of Interdisciplinary Medicine (DIM), Unit of Obstetrics and Gynecology, University of Bari "Aldo Moro", Policlinico of Bari, Bari, Italy
| | - Stefano Bettocchi
- Department of Obstetrics and Gynecology, University of Foggia, Azienda Ospedaliero-Universitaria "Ospedali Riuniti", Foggia, Italy
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3
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Zhang L, Liu L. Evaluation of multi-parameter MRI in preoperative staging of endometrial carcinoma. Eur J Radiol Open 2024; 12:100559. [PMID: 38559359 PMCID: PMC10980952 DOI: 10.1016/j.ejro.2024.100559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 03/11/2024] [Accepted: 03/15/2024] [Indexed: 04/04/2024] Open
Abstract
Background Endometrial carcinoma (EC) is a prevalent gynecological malignancy, necessitating accurate preoperative staging for effective treatment planning. This study explores the application value of multi-parameter MRI in diagnosing and staging endometrial cancer. Methods Seventy-six patients diagnosed with endometrial cancer underwent 3.0 T pelvic MRI within two weeks before surgery. Imaging data were analyzed based on FIGO clinical staging criteria. The study assessed the sensitivity, specificity, positive predictive value, and negative predictive value of MRI for each stage. Results Postoperative pathology confirmed 71 cases of endometrial adenocarcinoma, 3 serous adenocarcinoma, and 2 clear cell carcinomas. MRI staging showed a high consistency (Kappa value = 0.786) with postoperative pathology. The overall accuracy of MRI diagnosis was 86.8%. Sensitivity and specificity varied for each stage: IA (91.3%, 96.2%), IB (88.6%, 93.8%), II (97.4%, 89.2%), and III (84.2%, 100%). Conclusion While there was a slight misdiagnosis rate, the overall accuracy of preoperative MRI for endometrial cancer was high, aiding in precise diagnosis and clinical staging. MRI effectively identified myometrial infiltration, cervical involvement, paracentral extension, and lymph node metastasis. Further research with larger sample sizes is recommended for enhanced reliability.
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Affiliation(s)
- Lianbi Zhang
- Affiliated Yan'an Hospital, Kunming Medical University, Yunnan Province 650051, China
| | - Liqiong Liu
- Affiliated Yan'an Hospital, Kunming Medical University, Yunnan Province 650051, China
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Menendez-Santos M, Gonzalez-Baerga C, Taher D, Waters R, Virarkar M, Bhosale P. Endometrial Cancer: 2023 Revised FIGO Staging System and the Role of Imaging. Cancers (Basel) 2024; 16:1869. [PMID: 38791948 PMCID: PMC11119523 DOI: 10.3390/cancers16101869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 05/02/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
The FIGO endometrial cancer staging system recently released updated guidance based on clinical evidence gathered after the previous version was published in 2009. Different imaging modalities are beneficial across various stages of endometrial cancer (EC) management. Additionally, ongoing research studies are aimed at improving imaging in EC. Gynecological cancer is a crucial element in the practice of a body radiologist. With a new staging system in place, it is important to address the role of radiology in the EC diagnostic pathway. This article is a comprehensive review of the changes made to the FIGO endometrial cancer staging system and the impact of imaging in the staging of this disease.
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Affiliation(s)
- Manuel Menendez-Santos
- Department of Radiology, University of Florida College of Medicine-Jacksonville, Jacksonville, FL 32209, USA; (C.G.-B.); (M.V.)
| | - Carlos Gonzalez-Baerga
- Department of Radiology, University of Florida College of Medicine-Jacksonville, Jacksonville, FL 32209, USA; (C.G.-B.); (M.V.)
| | - Daoud Taher
- Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (D.T.); (R.W.); (P.B.)
| | - Rebecca Waters
- Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (D.T.); (R.W.); (P.B.)
| | - Mayur Virarkar
- Department of Radiology, University of Florida College of Medicine-Jacksonville, Jacksonville, FL 32209, USA; (C.G.-B.); (M.V.)
| | - Priya Bhosale
- Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (D.T.); (R.W.); (P.B.)
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Wang Y, Liu W, Lu Y, Ling R, Wang W, Li S, Zhang F, Ning Y, Chen X, Yang G, Zhang H. Fully Automated Identification of Lymph Node Metastases and Lymphovascular Invasion in Endometrial Cancer From Multi-Parametric MRI by Deep Learning. J Magn Reson Imaging 2024. [PMID: 38471960 DOI: 10.1002/jmri.29344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/27/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Early and accurate identification of lymphatic node metastasis (LNM) and lymphatic vascular space invasion (LVSI) for endometrial cancer (EC) patients is important for treatment design, but difficult on multi-parametric MRI (mpMRI) images. PURPOSE To develop a deep learning (DL) model to simultaneously identify of LNM and LVSI of EC from mpMRI images. STUDY TYPE Retrospective. POPULATION Six hundred twenty-one patients with histologically proven EC from two institutions, including 111 LNM-positive and 168 LVSI-positive, divided into training, internal, and external test cohorts of 398, 169, and 54 patients, respectively. FIELD STRENGTH/SEQUENCE T2-weighted imaging (T2WI), contrast-enhanced T1WI (CE-T1WI), and diffusion-weighted imaging (DWI) were scanned with turbo spin-echo, gradient-echo, and two-dimensional echo-planar sequences, using either a 1.5 T or 3 T system. ASSESSMENT EC lesions were manually delineated on T2WI by two radiologists and used to train an nnU-Net model for automatic segmentation. A multi-task DL model was developed to simultaneously identify LNM and LVSI positive status using the segmented EC lesion regions and T2WI, CE-T1WI, and DWI images as inputs. The performance of the model for LNM-positive diagnosis was compared with those of three radiologists in the external test cohort. STATISTICAL TESTS Dice similarity coefficient (DSC) was used to evaluate segmentation results. Receiver Operating Characteristic (ROC) analysis was used to assess the performance of LNM and LVSI status identification. P value <0.05 was considered significant. RESULTS EC lesion segmentation model achieved mean DSC values of 0.700 ± 0.25 and 0.693 ± 0.21 in the internal and external test cohorts, respectively. For LNM positive/LVSI positive identification, the proposed model achieved AUC values of 0.895/0.848, 0.806/0.795, and 0.804/0.728 in the training, internal, and external test cohorts, respectively, and better than those of three radiologists (AUC = 0.770/0.648/0.674). DATA CONCLUSION The proposed model has potential to help clinicians to identify LNM and LVSI status of EC patients and improve treatment planning. EVIDENCE LEVEL 3 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Yida Wang
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, China
| | - Wei Liu
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Yuanyuan Lu
- Department of Radiology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Rennan Ling
- Department of Radiology, Shenzhen People's Hospital, Second Clinical Medical College of Jinan University, First Affiliated Hospital of Southern University of Science and Technology, Shanghai, China
| | - Wenjing Wang
- Department of Radiology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Shengyong Li
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, China
| | - Feiran Zhang
- Department of Pathology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Yan Ning
- Department of Pathology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Xiaojun Chen
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Guang Yang
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, China
| | - He Zhang
- Department of Radiology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
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6
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Madár I, Szabó A, Vleskó G, Hegyi P, Ács N, Fehérvári P, Kói T, Kálovics E, Szabó G. Diagnostic Accuracy of Transvaginal Ultrasound and Magnetic Resonance Imaging for the Detection of Myometrial Infiltration in Endometrial Cancer: A Systematic Review and Meta-Analysis. Cancers (Basel) 2024; 16:907. [PMID: 38473269 DOI: 10.3390/cancers16050907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/16/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
In endometrial cancer (EC), deep myometrial invasion (DMI) is a prognostic factor that can be evaluated by various imaging methods; however, the best method of choice is uncertain. We aimed to compare the diagnostic performance of two-dimensional transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI) in the preoperative detection of DMI in patients with EC. Pubmed, Embase and Cochrane Library were systematically searched in May 2023. We included original articles that compared TVS to MRI on the same cohort of patients, with final histopathological confirmation of DMI as reference standard. Several subgroup analyses were performed. Eighteen studies comprising 1548 patients were included. Pooled sensitivity and specificity were 76.6% (95% confidence interval (CI), 70.9-81.4%) and 87.4% (95% CI, 80.6-92%) for TVS. The corresponding values for MRI were 81.1% (95% CI, 74.9-85.9%) and 83.8% (95% CI, 79.2-87.5%). No significant difference was observed (sensitivity: p = 0.116, specificity: p = 0.707). A non-significant difference between TVS and MRI was observed when no-myometrium infiltration vs. myometrium infiltration was considered. However, when only low-grade EC patients were evaluated, the specificity of MRI was significantly better (p = 0.044). Both TVS and MRI demonstrated comparable sensitivity and specificity. Further studies are needed to assess the presence of myometrium infiltration in patients with fertility-sparing wishes.
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Affiliation(s)
- István Madár
- Centre for Translational Medicine, Semmelweis University, 1088 Budapest, Hungary
- Department of Obstetrics and Gynecology, Semmelweis University, 1088 Budapest, Hungary
| | - Anett Szabó
- Centre for Translational Medicine, Semmelweis University, 1088 Budapest, Hungary
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary
| | - Gábor Vleskó
- Centre for Translational Medicine, Semmelweis University, 1088 Budapest, Hungary
- Department of Obstetrics and Gynecology, Semmelweis University, 1088 Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, 1088 Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, 1083 Budapest, Hungary
| | - Nándor Ács
- Centre for Translational Medicine, Semmelweis University, 1088 Budapest, Hungary
- Department of Obstetrics and Gynecology, Semmelweis University, 1088 Budapest, Hungary
| | - Péter Fehérvári
- Centre for Translational Medicine, Semmelweis University, 1088 Budapest, Hungary
- Department of Biostatistics, University of Veterinary Medicine, 1078 Budapest, Hungary
| | - Tamás Kói
- Centre for Translational Medicine, Semmelweis University, 1088 Budapest, Hungary
- Stochastics Department, Budapest University of Technology and Economics, 1111 Budapest, Hungary
| | - Emma Kálovics
- Centre for Translational Medicine, Semmelweis University, 1088 Budapest, Hungary
| | - Gábor Szabó
- Centre for Translational Medicine, Semmelweis University, 1088 Budapest, Hungary
- Department of Obstetrics and Gynecology, Semmelweis University, 1088 Budapest, Hungary
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7
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Pappa C, Le Thanh V, Smyth SL, Zouridis A, Kashif A, Sadeghi N, Sattar A, Damato S, Abdalla M, Laganà AS, Ferrari F, Kehoe S, Addley S, Soleymani majd H. Mixed Endometrial Epithelial Carcinoma: Epidemiology, Treatment and Survival Rates-A 10-Year Retrospective Cohort Study from a Single Institution. J Clin Med 2023; 12:6373. [PMID: 37835017 PMCID: PMC10573791 DOI: 10.3390/jcm12196373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/20/2023] [Accepted: 09/29/2023] [Indexed: 10/15/2023] Open
Abstract
Mixed endometrial carcinoma (MEEC) refers to rare endometrial tumours that are composed of two or more distinct histotypes, at least one of which is serous or clear cell. The aim of this study was to evaluate the epidemiology, treatment outcomes and survival rates of patients with mixed endometrial carcinoma. The medical records of 34 patients diagnosed with MEEC between March 2010 and January 2020 were reviewed retrospectively. Clinicopathological variables and treatment strategies were assessed, and overall survival and disease-free survival rates were evaluated. The histology of endometrioid and serous component was found in 26 (76.5%) patients, followed by serous and clear-cell components (5/34, 14.5%) and mixed endometrioid serous and clear-cell components (3/34, 8.8%). The median age at diagnosis was 70 years (range 52-84), and the median follow-up time was 55 months. The 5-year disease-free survival and the 5-year overall survival were 50.4% and 52.4%, respectively. Advanced disease stage was identified as an independent predictor of inferior disease-free (<0.003) and overall survival (p < 0.001). Except for stage, none of the traditional prognostic factors was associated with disease recurrence or death from disease. MEECs represent rare high-risk endometrial carcinomas with significant diagnostic and treatment challenges. Undoubtedly, the implementation of a molecular analysis can offer further diagnostic and management insights.
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Affiliation(s)
- Christina Pappa
- Department of Gynaecological Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, UK; (C.P.); (V.L.T.); (A.Z.); (A.K.); (S.K.)
| | - Valentina Le Thanh
- Department of Gynaecological Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, UK; (C.P.); (V.L.T.); (A.Z.); (A.K.); (S.K.)
| | - Sarah Louise Smyth
- Department of Gynaecological Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, UK; (C.P.); (V.L.T.); (A.Z.); (A.K.); (S.K.)
| | - Andreas Zouridis
- Department of Gynaecological Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, UK; (C.P.); (V.L.T.); (A.Z.); (A.K.); (S.K.)
| | - Ammara Kashif
- Department of Gynaecological Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, UK; (C.P.); (V.L.T.); (A.Z.); (A.K.); (S.K.)
| | - Negin Sadeghi
- Department of Gynaecological Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, UK; (C.P.); (V.L.T.); (A.Z.); (A.K.); (S.K.)
| | - Alisha Sattar
- Department of Gynaecological Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, UK; (C.P.); (V.L.T.); (A.Z.); (A.K.); (S.K.)
| | - Stephen Damato
- Department of Gynaecological Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, UK; (C.P.); (V.L.T.); (A.Z.); (A.K.); (S.K.)
| | - Mostafa Abdalla
- Gynaecology—Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK;
| | - Antonio Simone Laganà
- Unit of Obstetrics and Gynecology, “Paolo Giaccone” Hospital, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy;
| | - Federico Ferrari
- Department of Clinical and Experimental Sciences, University of Brescia, 25136 Brescia, Italy;
| | - Sean Kehoe
- Department of Gynaecological Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, UK; (C.P.); (V.L.T.); (A.Z.); (A.K.); (S.K.)
| | - Susan Addley
- Department of Gynaecological Oncology, University Hospitals of Derby and Burton NHS Foundation Trust, Derby DE22 3NE, UK;
| | - Hooman Soleymani majd
- Department of Gynaecological Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, UK; (C.P.); (V.L.T.); (A.Z.); (A.K.); (S.K.)
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8
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Zouridis A, Zarrindej K, Rencher J, Pappa C, Kashif A, Smyth SL, Sadeghi N, Sattar A, Damato S, Ferrari F, Laganà AS, Abdalla M, Kehoe S, Addley S, Soleymani Majd H. The Prognostic Characteristics and Recurrence Patterns of High Grade Endometrioid Endometrial Cancer: A Large Retrospective Analysis of a Tertiary Center. J Clin Med 2023; 12:jcm12093141. [PMID: 37176582 PMCID: PMC10179027 DOI: 10.3390/jcm12093141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 04/09/2023] [Accepted: 04/17/2023] [Indexed: 05/15/2023] Open
Abstract
High grade endometrioid endometrial cancer (HGEEC) is a heterogeneous group of tumors with unclear prognostic features. The aim of the present study is to evaluate the independent risk factors for recurrence and mortality and to describe the recurrence patterns of HGEEC. Ninety-six consecutive cases of HGEEC treated with primary surgery in a single Tertiary Center were retrospectively reviewed. Clinicopathological and treatment details were recorded, and all patients were closely followed up. Disease-free, overall and cancer-specific survival rates were 83.8%, 77.8% and 83.6%, respectively. Cervical stromal involvement was independently related to recurrence (HR = 25.67; 95%CI 2.95-223.30; p = 0.003) and cancer-related death (HR = 15.39; 95%CI 1.29-183.43; p = 0.031) after adjusting for other pathological and treatment variables. Recurrence rate was 16%, with 60% of these cases having lung metastases and only one case with single vaginal vault recurrence. 81.81% of the recurrences presented with symptoms and not a single recurrence was diagnosed in routine follow-up clinical examination. In conclusion, the recurrence pattern may suggest that patient-initiated follow-up (PIFU) could be considered a potential alternative to clinical-based follow-up for HGEEC survivors, especially for patients without cervical involvement and after two years from treatment. Additional caution is needed in patients with cervical stromal involvement.
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Affiliation(s)
- Andreas Zouridis
- Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, UK
| | | | - Joshua Rencher
- Royal Berkshire NHS Foundation Trust, Reading RG1 5AN, UK
| | - Christina Pappa
- Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, UK
| | - Ammara Kashif
- Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, UK
| | | | - Negin Sadeghi
- Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, UK
| | - Alisha Sattar
- Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, UK
| | - Stephen Damato
- Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, UK
| | - Federico Ferrari
- Department of Clinical and Experimental Sciences, University of Brescia, 25136 Brescia, Italy
| | - Antonio Simone Laganà
- Unit of Gynecologic Oncology, ARNAS "Civico-Di Cristina-Benfratelli", Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy
| | - Mostafa Abdalla
- Gynaecology-Guy's and St Thomas' NHS Foundation Trust, London SE1 9RT, UK
| | - Sean Kehoe
- Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, UK
| | - Susan Addley
- University Hospitals of Derby and Burton NHS Foundation Trust, Derby DE22 3NE, UK
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9
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Levine EM, Fernandez CM. The Expanding Role of Sonography in the Clinical Practice of Modern Obstetrics and Gynecology: A Clinical Perspective. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2023. [DOI: 10.1177/87564793231153641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A list of gynecologic diagnoses is provided, which shows the use of sonography in significantly assisting the practice of modern clinical gynecology. The clinical value of this technology to assist in formulating diagnoses for the presenting patients is discussed. Sonography has become a necessary tool for today’s practice of gynecology, and women’s health, in general.
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Affiliation(s)
- Elliot M. Levine
- School of Medicine, Rosalind Franklin University, North Chicago, IL, USA
- Advocate Illinois Masonic Medical Center, Chicago, IL, USA
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10
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Fertility-Sparing Strategies for Early-Stage Endometrial Cancer: Stepping towards Precision Medicine Based on the Molecular Fingerprint. Int J Mol Sci 2023; 24:ijms24010811. [PMID: 36614253 PMCID: PMC9821405 DOI: 10.3390/ijms24010811] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 12/15/2022] [Accepted: 12/29/2022] [Indexed: 01/09/2023] Open
Abstract
Endometrial cancer represents the fifth most common cancer in women, and the most common gynecological malignancy in developed countries [...].
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11
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Yang L, Yang H, Zhao H, Hu Z, Shen Z, Zhao L, Tan S, Zhu L, Xu R, Liu H, Ding C, Qin Y, Zhao Y. Resection of inferior vena cava, abdominal aorta, bilateral common iliac arteries, and bilateral partial external iliac arteries with artificial vessel replacement during radical endometrial cancer surgery: a case report. BMC Womens Health 2022; 22:554. [PMID: 36578004 PMCID: PMC9798542 DOI: 10.1186/s12905-022-02120-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 12/07/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Endometrial carcinoma (EC) is a common malignant tumor of the female reproductive system, often accompanied by lymph node metastasis. Artificial vascular implantation is a common surgical treatment for mediastinal tumors and abdominal aortic aneurysms but is rarely used in gynecological surgery. CASE PRESENTATION A 54-year-old female patient was first admitted to the hospital in January 2018 due to "irregular vaginal bleeding over 3 months". CT showed a mass in the uterine cavity, and several swollen lymph nodes in the retroperitoneum and pelvic cavity. The initial diagnosis was an endometrial malignant tumor. We performed radical endometrial cancer surgery with parallel resection of inferior vena cava, abdominal aorta, bilateral common iliac arteries, bilateral external iliac arteries, and artificial vessel replacement, which was successful, with good postoperative recovery and no lesion progression at 3 years postoperative follow-up. CONCLUSION This is an early case of gynecological clinical use of prostheses. Through multidisciplinary cooperation, the surgical resection rate of patients with EC in radical surgery was improved without serious fatal complications and achieved a high long-term postoperative survival rate.
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Affiliation(s)
- Linlin Yang
- grid.452826.fDepartment of Gynaecology, Yunnan Cancer Hospital (The Third Affiliated Hospital of Kunming Medical University), 650118 Kunming, China
| | - Hongying Yang
- grid.452826.fDepartment of Gynaecology, Yunnan Cancer Hospital (The Third Affiliated Hospital of Kunming Medical University), 650118 Kunming, China
| | - He Zhao
- grid.452826.fDepartment of Gynaecology, Yunnan Cancer Hospital (The Third Affiliated Hospital of Kunming Medical University), 650118 Kunming, China
| | - Zaoxiu Hu
- grid.452826.fDepartment of Gynaecology, Yunnan Cancer Hospital (The Third Affiliated Hospital of Kunming Medical University), 650118 Kunming, China
| | - Zhenglei Shen
- grid.452826.fDepartment of Gynaecology, Yunnan Cancer Hospital (The Third Affiliated Hospital of Kunming Medical University), 650118 Kunming, China
| | - Lingfeng Zhao
- grid.452826.fDepartment of Gynaecology, Yunnan Cancer Hospital (The Third Affiliated Hospital of Kunming Medical University), 650118 Kunming, China
| | - Shufen Tan
- grid.452826.fDepartment of Gynaecology, Yunnan Cancer Hospital (The Third Affiliated Hospital of Kunming Medical University), 650118 Kunming, China
| | - Lei Zhu
- grid.452826.fDepartment of Gynaecology, Yunnan Cancer Hospital (The Third Affiliated Hospital of Kunming Medical University), 650118 Kunming, China
| | - Ruolan Xu
- grid.452826.fDepartment of Gynaecology, Yunnan Cancer Hospital (The Third Affiliated Hospital of Kunming Medical University), 650118 Kunming, China
| | - Hui Liu
- grid.452826.fDepartment of Gynaecology, Yunnan Cancer Hospital (The Third Affiliated Hospital of Kunming Medical University), 650118 Kunming, China
| | - Chunyan Ding
- grid.452826.fDepartment of Gynaecology, Yunnan Cancer Hospital (The Third Affiliated Hospital of Kunming Medical University), 650118 Kunming, China
| | - Yan Qin
- grid.452826.fDepartment of Gynaecology, Yunnan Cancer Hospital (The Third Affiliated Hospital of Kunming Medical University), 650118 Kunming, China
| | - Yanfei Zhao
- grid.452826.fDepartment of Gynaecology, Yunnan Cancer Hospital (The Third Affiliated Hospital of Kunming Medical University), 650118 Kunming, China
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12
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Alcazar JL. Transvaginal ultrasound versus magnetic resonance imaging in local staging of endometrial cancer. JOURNAL OF CLINICAL ULTRASOUND : JCU 2022; 50:1379-1380. [PMID: 36353907 PMCID: PMC9828055 DOI: 10.1002/jcu.23331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 08/26/2022] [Indexed: 06/16/2023]
Affiliation(s)
- Juan Luis Alcazar
- Department of Obstetrics and GynecologyClinica Universidad de NavarraPamplonaSpain
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13
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Giannini A, Bogani G, Vizza E, Chiantera V, Laganà AS, Muzii L, Salerno MG, Caserta D, D’Oria O. Advances on Prevention and Screening of Gynecologic Tumors: Are We Stepping Forward? Healthcare (Basel) 2022; 10:1605. [PMID: 36141217 PMCID: PMC9498501 DOI: 10.3390/healthcare10091605] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 12/03/2022] Open
Abstract
According to 2020 comprehensive global cancer statistics published by the International Agency for Research on Cancer, gynecologic malignancies accounted overall for 16 [...].
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Affiliation(s)
- Andrea Giannini
- Department of Medical and Surgical Sciences and Translational Medicine, Sapienza University, 00189 Rome, Italy
| | - Giorgio Bogani
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, 00185 Rome, Italy
| | - Enrico Vizza
- Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCSS-Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Vito Chiantera
- Unit of Gynecologic Oncology, ARNAS “Civico-Di Cristina-Benfratelli”, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy
| | - Antonio Simone Laganà
- Unit of Gynecologic Oncology, ARNAS “Civico-Di Cristina-Benfratelli”, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy
| | - Ludovico Muzii
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, 00185 Rome, Italy
| | - Maria Giovanna Salerno
- Obstetrics and Gynecological Unit, Department of Woman’s and Child’s Health, San Camillo-Forlanini Hospital, 00152 Rome, Italy
| | - Donatella Caserta
- Gynecology Division, Department of Medical and Surgical Sciences and Translational Medicine, Sant’Andrea University Hospital, Sapienza University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy
| | - Ottavia D’Oria
- Department of Medical and Surgical Sciences and Translational Medicine, Sapienza University, 00189 Rome, Italy
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