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Yu J, Huang L, Dong T, Cao L. Prediction of outcomes after chemoradiotherapy for cervical cancer by neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio. J OBSTET GYNAECOL 2024; 44:2361858. [PMID: 38864403 DOI: 10.1080/01443615.2024.2361858] [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: 09/09/2023] [Accepted: 05/24/2024] [Indexed: 06/13/2024]
Abstract
BACKGROUND Cervical cancer ranks as the second most fatal tumour globally among females. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been widely applied to the diagnosis of cancers. METHODS The clinicopathologic data of 180 patients with stage IB2-IIB cervical cancer who underwent radical concurrent chemoradiotherapy from January 2018 to December 2019 were retrospectively analysed. Receiver operating characteristic (ROC) curves were plotted to analyse the optimal cut-off values of NLR and PLR for predicting the therapeutic effects of concurrent chemoradiotherapy. The associations of PLR and other clinicopathological factors with 1-year survival rates were explored through univariate analysis and multivariate Cox regression analysis, respectively. RESULTS NLR was significantly associated with the therapeutic effects of neoadjuvant therapy, with the optimal cut-off value of 2.89, area under the ROC curve (AUC) of 0.848 (95% confidence interval [CI]: 0.712-0.896), sensitivity of 0.892 (95% CI: 0.856-0.923) and specificity of 0.564 (95% CI: 0.512-0.592). PLR had a significant association with the therapeutic effects of neoadjuvant therapy, with the optimal cut-off value of 134.27, AUC of 0.766 (95% CI: 0.724-0.861), sensitivity of 0.874 (95% CI: 0.843-0.905) and specificity of 0.534 (95% CI: 0.512-0.556). Lymphatic metastasis ([95% CI: 1.435-5.461], [95% CI: 1.336-4.281], depth of invasion ([95% CI: 1.281-3.546], [95% CI: 1.183-3.359]) and tumour size ([95% CI: 1.129-3.451], [95% CI: 1.129-3.451]) were independent factors influencing the overall survival and disease-free survival (DFS) of patients with cervical cancer. NLR (95%CI: 1.256-4.039) and PLR (95%CI:1.281-3.546) were also independent factors affecting DFS. CONCLUSION NLR and PLR in the peripheral blood before treatment may predict DFS of patients with stage IB2-IIB cervical cancer.
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Affiliation(s)
- Jing Yu
- Department of Gynecological Oncology, Jiujiang, Jiangxi Province, China
| | | | - Ting Dong
- Department of Gynecological Oncology, Jiujiang, Jiangxi Province, China
| | - Lihua Cao
- Department of Nursing, Jiujiang, Jiangxi Province, China
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Di Donna MC, Cucinella G, Giallombardo V, Sozzi G, Bizzarri N, Scambia G, Pecorino B, Scollo P, Berretta R, Capozzi VA, Laganà AS, Chiantera V. Urinary, Gastrointestinal, and Sexual Dysfunctions after Chemotherapy, Radiotherapy, Radical Surgery or Multimodal Treatment in Women with Locally Advanced Cervical Cancer: A Multicenter Retrospective Study. Cancers (Basel) 2023; 15:5734. [PMID: 38136280 PMCID: PMC10741503 DOI: 10.3390/cancers15245734] [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: 11/09/2023] [Revised: 12/02/2023] [Accepted: 12/04/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Different strategies have been proposed for the treatment of locally advanced cervical cancer (LACC), with different impacts on patient's quality of life (QoL). This study aimed to analyze urinary, bowel, and sexual dysfunctions in a series of LACC patients who underwent chemotherapy, radiotherapy, radical surgery, or a combination of these treatments. METHODS Patients with LACC who underwent neoadjuvant radio-chemotherapy (NART/CT; n = 35), neoadjuvant chemotherapy (NACT; n = 17), exclusive radio-chemotherapy (ERT/CT; n = 28), or upfront surgery (UPS; n = 10) from November 2010 to September 2019 were identified from five oncological referral centers. A customized questionnaire was used for the valuation of urinary, gastrointestinal, and sexual dysfunctions. RESULTS A total of 90 patients were included. Increased urinary frequency (>8 times/day) was higher in ERT/CT compared with NACT/RT (57.1% vs. 28.6%; p = 0.02) and NACT (57.1% vs. 17.6%; p = 0.01). The use of sanitary pads for urinary leakage was higher in ERT/CT compared with NACT/RT (42.9% vs. 14.3%; p = 0.01) and NACT (42.9% vs. 11.8%; p = 0.03). The rate of reduced evacuations (<3 times a week) was less in UPS compared with NACT/RT (50% vs. 97.1%; p < 0.01), NACT (50% vs. 88.2, p < 0.01), and ERT/CT (50% vs. 96.4%; p < 0.01). A total of 52 women were not sexually active after therapy, and pain was the principal reason for the avoidance of sexual activity. CONCLUSIONS The rate and severity of urinary, gastrointestinal, and sexual dysfunction were similar in the four groups of treatment. Nevertheless, ERT/CT was associated with worse sexual and urinary outcomes.
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Affiliation(s)
- Mariano Catello Di Donna
- Unit of Gynecologic Oncology, ARNAS “Civico-Di Cristina-Benfratelli”, 90127 Palermo, Italy; (M.C.D.D.); (V.G.)
- Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, 90133 Palermo, Italy
| | - Giuseppe Cucinella
- Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, 90133 Palermo, Italy
- Gynecologic Oncology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Naples, Italy
| | - Vincenzo Giallombardo
- Unit of Gynecologic Oncology, ARNAS “Civico-Di Cristina-Benfratelli”, 90127 Palermo, Italy; (M.C.D.D.); (V.G.)
| | - Giulio Sozzi
- Department of Obstetrics and Gynecology, Fondazione Istituto G. Giglio, 90015 Cefalù, Italy;
- Dipartimento della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Nicolò Bizzarri
- Gynecologic Oncology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito 1, 00168 Rome, Italy; (N.B.); (G.S.)
| | - Giovanni Scambia
- Gynecologic Oncology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito 1, 00168 Rome, Italy; (N.B.); (G.S.)
- Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Basilio Pecorino
- Maternal and Child Department, Obstetrics and Gynecology, Cannizzaro Hospital, 95100 Catania, Italy; (B.P.); (P.S.)
- Maternal and Child Department, University of Enna “Kore”, 94100 Enna, Italy
| | - Paolo Scollo
- Maternal and Child Department, Obstetrics and Gynecology, Cannizzaro Hospital, 95100 Catania, Italy; (B.P.); (P.S.)
- Maternal and Child Department, University of Enna “Kore”, 94100 Enna, Italy
| | - Roberto Berretta
- Department of Obstetrics and Gynecology, University of Parma, 43125 Parma, Italy; (R.B.); (V.A.C.)
| | - Vito Andrea Capozzi
- Department of Obstetrics and Gynecology, University of Parma, 43125 Parma, Italy; (R.B.); (V.A.C.)
| | - Antonio Simone Laganà
- Unit of Obstetrics and Gynecology, “Paolo Giaccone” Hospital, 90127 Palermo, Italy;
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133 Palermo, Italy
| | - Vito Chiantera
- Gynecologic Oncology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Naples, Italy
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133 Palermo, Italy
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Noh JJ, Kim K, Kim TJ, Kim T, Lee KH, Hwang JH, Hong DG, Kim MK, Lee B, Chang HK, Chun KC. Initial Experience of Articulating Laparoscopic Instruments for Benign Gynecologic Disease: A Single-Arm Multicenter Prospective Study (Korean Gynecologic Oncology Group 4002). J Pers Med 2023; 13:1433. [PMID: 37888044 PMCID: PMC10608162 DOI: 10.3390/jpm13101433] [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: 08/23/2023] [Revised: 09/23/2023] [Accepted: 09/24/2023] [Indexed: 10/28/2023] Open
Abstract
Laparoscopic surgery has evolved with technological advances in many aspects and increasing demand for its benefits in cosmetics, fast recovery, reduced complication rates and pain. However, it still possesses drawbacks such as limited surgical movement due to the nature of rigid laparoscopic instruments. In order to overcome such limitations, several laparoscopic jointed instruments have been developed. In this prospective multicenter, single-arm cohort study, we investigated the short-term safety and feasibility of the new articulating laparoscopic instruments in benign gynecologic surgery. A total of 113 patients who were diagnosed with benign gynecologic adnexal diseases underwent laparoscopic surgery with articulating laparoscopic instruments. Surgical outcomes, including intra/postoperative complication rates, operation time and estimated blood loss, as well as surgeon's subjective evaluation of the usage of the instruments, were evaluated. The results demonstrated that the articulating laparoscopic instruments had comparable usability and produced similar surgical outcomes to conventional laparoscopic surgery. The objective parameters, such as the operative time and complication rates, as well as the subjective parameters, such as the surgeon's own evaluation of the surgical instruments' usability, demonstrated potential benefits of the instruments in benign gynecological diseases. Overall, the study demonstrated that the use of this novel articulating device is feasible in gynecologic laparoscopic surgery.
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Affiliation(s)
- Joseph J Noh
- Gynecologic Cancer Center, Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Kidong Kim
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam 13620, Republic of Korea
| | - Tae-Joong Kim
- Gynecologic Cancer Center, Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Taehun Kim
- Department of Obstetrics and Gynecology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 07061, Republic of Korea
| | - Keun Ho Lee
- Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul 14662, Republic of Korea
| | - Jong Ha Hwang
- Department of Obstetrics and Gynecology, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon 22711, Republic of Korea
| | - Dae Gy Hong
- Department of Obstetrics and Gynecology, School of Medicine, Kyungpook National University, Daegu 41566, Republic of Korea
| | - Min Kyu Kim
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon 51353, Republic of Korea
| | - Banghyun Lee
- Department of Obstetrics and Gynecology, Inha University Hospital, Inha University College of Medicine, Incheon 22332, Republic of Korea
| | - Ha Kyun Chang
- Department of Obstetrics and Gynecology, Korea University Ansan Hospital, Korea University School of Medicine, Ansan 15355, Republic of Korea
| | - Kyoung Chul Chun
- Department of Obstetrics and Gynecology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang 10380, Republic of Korea
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Dio CD, Azenkoud I, Trezza A, Lentini E, D’Augè TG, Cuccu I, Bartolomeo GD, Firulli I, Canicchio A, Sgamba L, Muzii L. Early-stage cervical cancer treatment - what's new? PRZEGLAD MENOPAUZALNY = MENOPAUSE REVIEW 2023; 22:87-92. [PMID: 37674927 PMCID: PMC10477763 DOI: 10.5114/pm.2023.127774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 01/27/2023] [Indexed: 09/08/2023]
Abstract
The gold standard of treatment for patients with early-stage cervical cancer is radical hysterectomy, in agreement with the entire scientific community. During the last decade, growing evidence has supported the minimally invasive approach. Several studies have suggested that the minimally invasive approach could improve surgical and perioperative outcomes. Because of these findings, ESCO/ESTRO/ESP guidelines state that a "minimally invasive approach is favoured" in comparison with open surgery, as a grade B recommendation. Because of the lack of a grade A recommendation, this randomized Laparoscopic Approach to Cervical Cancer trial evaluated open vs. minimally invasive approach in the early stage. It demonstrated an increase in mortality among patients treated with minimally invasive surgery, revolutionizing current thinking on the primary surgical approach to early cervical cancer. The aim of this study is to analyse which is the best treatment for early cervical cancer and which approach is the most effective at the moment. Further studies are needed to state with certainty the appropriateness of the treatments offered to patients with early cervical cancer.
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Affiliation(s)
- Camilla Di Dio
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Ilham Azenkoud
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Angelo Trezza
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Emanuele Lentini
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Tullio Golia D’Augè
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Ilaria Cuccu
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Giorgia Di Bartolomeo
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Ilaria Firulli
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Andrea Canicchio
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Ludovica Sgamba
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Ludovico Muzii
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
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Save our surgeons (SOS) - an explorative comparison of surgeons' muscular and cardiovascular demands, posture, perceived workload and discomfort during robotic vs. laparoscopic surgery. Arch Gynecol Obstet 2023; 307:849-862. [PMID: 36401096 PMCID: PMC9676911 DOI: 10.1007/s00404-022-06841-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 11/01/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE Conventional laparoscopic surgery (CLS) imposes an increased risk of work-related musculoskeletal disorders. Technical innovations, such as robotic-assisted laparoscopic surgery (RALS), may provide ergonomic benefits. We compare the surgeon`s work-related demands of CLS vs RALS for benign hysterectomies. METHODS Five specialists (3 females, 2 males) each performed four RALS and four CLS as part of their daily clinical routine. During the surgical procedures, muscular demands were assessed by bipolar surface electromyograms of the descendent trapezius, extensor digitorum and flexor carpi radialis muscles as well as cardio-vascular demands by electrocardiography, and neck, arm and torso posture by gravimetrical position sensors. Additionally, the subjects rated their level of perceived workload (NASA TLX questionnaire with 6 dimension) and musculoskeletal discomfort (11-point Likert-scale, 0-10). RESULTS Muscular demands of the trapezius and flexor carpi radialis muscles were lower with RALS but extensor digitorum demands increased. Cardiovascular demands were about 9 heart beats per minute (bpm) lower for RALS compared to CLS with a rather low median level for both surgical techniques (RALS = 84 bpm; CLS 90 bpm). The posture changed in RALS with an increase in neck and torso flexion, and a reduction in abduction and anteversion position of the right arm. The perceived workload was lower in the physical demands dimension but higher in the mental demands dimension during RALS. Subjective musculoskeletal discomfort was rare during both surgical techniques. CONCLUSIONS This explorative study identified several potential ergonomic benefits related to RALS which now can be verified by studies using hypothesis testing designs. However, potential effects on muscular demands in the lower arm extensor muscles also have to be addressed in such studies.
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Re GL, Cucinella G, Zaccaria G, Crapanzano A, Salerno S, Pinto A, Casto AL, Chiantera V. Role of MRI in the assessment of cervical cancer. Semin Ultrasound CT MR 2023; 44:228-237. [DOI: 10.1053/j.sult.2023.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
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7
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Chiofalo B, Laganà AS, Ghezzi F, Certelli C, Casarin J, Bruno V, Sperduti I, Chiantera V, Peitsidis P, Vizza E. Beyond Sentinel Lymph Node: Outcomes of Indocyanine Green-Guided Pelvic Lymphadenectomy in Endometrial and Cervical Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3476. [PMID: 36834170 PMCID: PMC9963568 DOI: 10.3390/ijerph20043476] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/08/2023] [Accepted: 02/14/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The aim of our study was to compare the number of lymph nodes removed during indocyanine green (ICG)-guided laparoscopic/robotic pelvic lymphadenectomy with standard systematic lymphadenectomy in endometrial cancer (EC) and cervical cancer (CC). METHODS This is a multicenter retrospective comparative study (Clinical Trial ID: NCT04246580; updated on 31 January 2023). Women affected by EC and CC who underwent laparoscopic/robotic systematic pelvic lymphadenectomy, with (cases) or without (controls) the use of ICG tracer injection within the uterine cervix, were included in the study. RESULTS The two groups were homogeneous for age (p = 0.08), Body Mass Index, International Federation of Gynaecology and Obstetrics (FIGO) stages (p = 0.41 for EC; p = 0.17 for CC), median estimated blood loss (p = 0.76), median operative time (p = 0.59), and perioperative complications (p = 0.66). Nevertheless, the number of lymph nodes retrieved during surgery was significantly higher (p = 0.005) in the ICG group (n = 18) compared with controls (n = 16). CONCLUSIONS The accurate and precise dissection achieved with the use of the ICG-guided procedure was associated with a higher number of lymph nodes removed in the case of systematic pelvic lymphadenectomy for EC and CC.
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Affiliation(s)
- Benito Chiofalo
- Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, 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
| | - Fabio Ghezzi
- Department of Obstetrics and Gynecology, “Filippo Del Ponte” Women and Children Hospital, University of Insubria, 21100 Varese, Italy
| | - Camilla Certelli
- Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, Italy
| | - Jvan Casarin
- Department of Obstetrics and Gynecology, “Filippo Del Ponte” Women and Children Hospital, University of Insubria, 21100 Varese, Italy
| | - Valentina Bruno
- Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, Italy
| | - Isabella Sperduti
- Biostatistical Unit, IRCCS “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
| | - Panagiotis Peitsidis
- Department of Obstetrics and Gynecology, Helena Venizelou Hospital, 115 21 Athens, Greece
| | - Enrico Vizza
- Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, Italy
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Moufawad G, Laganà AS, Habib N, Chiantera V, Giannini A, Ferrari F, Vitagliano A, Della Corte L, Bifulco G, Sleiman Z. Learning Laparoscopic Radical Hysterectomy: Are We Facing an Emerging Situation? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20032053. [PMID: 36767419 PMCID: PMC9915887 DOI: 10.3390/ijerph20032053] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/12/2023] [Accepted: 01/19/2023] [Indexed: 05/29/2023]
Abstract
Despite wide screening campaigns and early detection, cervical cancer remains the fourth most common cancer among women. Radical hysterectomy, whether by open, laparoscopic or by robotic-assisted techniques, is the mainstay treatment. However, for adequate surgical results and good oncological prognosis, a gynecological surgeon should be trained to perform those procedures. The learning curve of radical hysterectomy, especially by laparoscopy, is influenced by several factors. The LACC trial, the decrease in cervical cancer incidence and radical hysterectomy procedures have widely reduced the learning curve for surgeons. This article mainly discusses the learning curve of laparoscopic radical hysterectomy for cervical cancers, and how several factors are influencing it negatively, with the need to have medical authorities reset specific surgical training programs and allocate them to special oncological centers.
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Affiliation(s)
- Graziella Moufawad
- Department of Obstetrics and Gynecology, Lebanese American University Medical Center-Rizk Hospital, Beirut 1100, Lebanon
| | - 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
| | - Nassir Habib
- Obstetrics and Gynecology Department, Francois Quesnay Hospital, 78200 Mantes-La-Jolie, France
| | - 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
| | - Andrea Giannini
- Department of Medical and Surgical Sciences and Translational Medicine, PhD Course in “Translational Medicine and Oncology”, Sapienza University, 00185 Rome, Italy
| | - Federico Ferrari
- Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy
- Division of Obstetrics and Gynecology, ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Amerigo Vitagliano
- Unit of Obstetrics and Gynecology, Department of Biomedical and Human Oncologic Science, University of Bari, 70100 Bari, Italy
| | - Luigi Della Corte
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, 80138 Naples, Italy
| | - Giuseppe Bifulco
- Department of Public Health, University of Naples Federico II, 80138 Naples, Italy
| | - Zaki Sleiman
- Department of Obstetrics and Gynecology, Lebanese American University Medical Center-Rizk Hospital, Beirut 1100, Lebanon
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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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Pecorino B, Laganà AS, Chiantera V, Ferrara M, Di Stefano AB, Di Donna MC, Sorrentino F, Nappi L, Mikuš M, Scollo P. Progression Free Survival, Overall Survival, and Relapse Rate in Endometrioid Ovarian Cancer and Synchronous Endometrial-Ovarian Endometrioid Cancer (SEO-EC): Results from a Large Retrospective Analysis. Medicina (B Aires) 2022; 58:medicina58121706. [PMID: 36556908 PMCID: PMC9784653 DOI: 10.3390/medicina58121706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/14/2022] [Accepted: 11/21/2022] [Indexed: 11/24/2022] Open
Abstract
Background and Objectives: We aimed to evaluate Progression Free Survival (PFS), Overall Survival (OS), and relapse rate in women affected by endometrioid ovarian cancer and synchronous endometrial-ovarian endometrioid cancer (SEO-EC). As secondary outcome, we assessed whether systematic pelvic and para-aortic lymphadenectomy could be considered a determinant of relapse rate in this population. Materials and Methods: We performed a retrospective analysis of women with diagnosis of endometrioid ovarian cancer or SEO-EC between January 2010 to September 2020, and calculated PFS, OS and relapse rate. Results: In almost all the patients (97.6%) who underwent systematic pelvic and para-aortic lymphadenectomy, there were no lymph node metastases confirmed by histology. We did not find a significant difference (p = 0.6570) for the rate of relapse in the group of women who underwent systematic pelvic and para-aortic lymphadenectomy (4/42; 9.5%) compared with the group of women who did not undergo the same procedure (1/21; 4.8%). During a median follow-up was 23 months, both PFS and OS were excellent. Conclusions: Women affected by early-stage low-grade endometrioid cancer and SEO-EC without apparent lymph node involvement at pre-operative imaging showed a very low rate of lymph node metastasis and similar relapse rate with or without lymphadenectomy.
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Affiliation(s)
- Basilio Pecorino
- Maternal and Child Department, Obstetrics and Gynecology Cannizzaro Hospital, University of Enna “Kore”, 95126 Catania, Italy
| | - Antonio Simone Laganà
- Unit of Gynecologic Oncology, ARNAS “Civico-Di Cristina-Benfratelli”, 90127 Palermo, Italy
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133 Palermo, Italy
- Correspondence:
| | - Vito Chiantera
- Unit of Gynecologic Oncology, ARNAS “Civico-Di Cristina-Benfratelli”, 90127 Palermo, Italy
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133 Palermo, Italy
| | - Martina Ferrara
- Maternal and Child Department, Obstetrics and Gynecology Cannizzaro Hospital, University of Enna “Kore”, 95126 Catania, Italy
| | - Andrea Benedetto Di Stefano
- Maternal and Child Department, Obstetrics and Gynecology Cannizzaro Hospital, University of Enna “Kore”, 95126 Catania, Italy
| | - Mariano Catello Di Donna
- Unit of Gynecologic Oncology, ARNAS “Civico-Di Cristina-Benfratelli”, 90127 Palermo, Italy
- Department of Surgical, Oncological and Oral Sciences (Di. Chir. On. S.), University of Palermo, 90133 Palermo, Italy
| | - Felice Sorrentino
- Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynaecology, University of Foggia, 71121 Foggia, Italy
| | - Luigi Nappi
- Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynaecology, University of Foggia, 71121 Foggia, Italy
| | - Mislav Mikuš
- Department of Obstetrics and Gynecology, University Hospital Centre Zagreb, 10 000 Zagreb, Croatia
| | - Paolo Scollo
- Maternal and Child Department, Obstetrics and Gynecology Cannizzaro Hospital, University of Enna “Kore”, 95126 Catania, Italy
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Allahqoli L, Laganà AS, Mazidimoradi A, Salehiniya H, Günther V, Chiantera V, Karimi Goghari S, Ghiasvand MM, Rahmani A, Momenimovahed Z, Alkatout I. Diagnosis of Cervical Cancer and Pre-Cancerous Lesions by Artificial Intelligence: A Systematic Review. Diagnostics (Basel) 2022; 12:2771. [PMID: 36428831 PMCID: PMC9689914 DOI: 10.3390/diagnostics12112771] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/06/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The likelihood of timely treatment for cervical cancer increases with timely detection of abnormal cervical cells. Automated methods of detecting abnormal cervical cells were established because manual identification requires skilled pathologists and is time consuming and prone to error. The purpose of this systematic review is to evaluate the diagnostic performance of artificial intelligence (AI) technologies for the prediction, screening, and diagnosis of cervical cancer and pre-cancerous lesions. MATERIALS AND METHODS Comprehensive searches were performed on three databases: Medline, Web of Science Core Collection (Indexes = SCI-EXPANDED, SSCI, A & HCI Timespan) and Scopus to find papers published until July 2022. Articles that applied any AI technique for the prediction, screening, and diagnosis of cervical cancer were included in the review. No time restriction was applied. Articles were searched, screened, incorporated, and analyzed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. RESULTS The primary search yielded 2538 articles. After screening and evaluation of eligibility, 117 studies were incorporated in the review. AI techniques were found to play a significant role in screening systems for pre-cancerous and cancerous cervical lesions. The accuracy of the algorithms in predicting cervical cancer varied from 70% to 100%. AI techniques make a distinction between cancerous and normal Pap smears with 80-100% accuracy. AI is expected to serve as a practical tool for doctors in making accurate clinical diagnoses. The reported sensitivity and specificity of AI in colposcopy for the detection of CIN2+ were 71.9-98.22% and 51.8-96.2%, respectively. CONCLUSION The present review highlights the acceptable performance of AI systems in the prediction, screening, or detection of cervical cancer and pre-cancerous lesions, especially when faced with a paucity of specialized centers or medical resources. In combination with human evaluation, AI could serve as a helpful tool in the interpretation of cervical smears or images.
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Affiliation(s)
- Leila Allahqoli
- Midwifery Department, Ministry of Health and Medical Education, Tehran 1467664961, Iran
| | - 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
| | - Afrooz Mazidimoradi
- Neyriz Public Health Clinic, Shiraz University of Medical Sciences, Shiraz 7134814336, Iran
| | - Hamid Salehiniya
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand 9717853577, Iran
| | - Veronika Günther
- University Hospitals Schleswig-Holstein, Campus Kiel, Kiel School of Gynaecological Endoscopy, Arnold-Heller-Str. 3, Haus 24, 24105 Kiel, Germany
| | - 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
| | - Shirin Karimi Goghari
- School of Industrial and Systems Engineering, Tarbiat Modares University (TMU), Tehran 1411713114, Iran
| | - Mohammad Matin Ghiasvand
- Department of Computer Engineering, Amirkabir University of Technology (AUT), Tehran 1591634311, Iran
| | - Azam Rahmani
- Nursing and Midwifery Care Research Centre, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran 141973317, Iran
| | - Zohre Momenimovahed
- Reproductive Health Department, Qom University of Medical Sciences, Qom 3716993456, Iran
| | - Ibrahim Alkatout
- University Hospitals Schleswig-Holstein, Campus Kiel, Kiel School of Gynaecological Endoscopy, Arnold-Heller-Str. 3, Haus 24, 24105 Kiel, Germany
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