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Iavazzo C, Psomiadou V, Kokkali K, Fotiou A. Vaginal cleansing prior to office hysteroscopy. Arch Gynecol Obstet 2024:10.1007/s00404-024-07415-3. [PMID: 38433134 DOI: 10.1007/s00404-024-07415-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 02/04/2024] [Indexed: 03/05/2024]
Affiliation(s)
- Christos Iavazzo
- Metaxa Memorial Cancer Hospital, 51 Botassi Str., 18537, Piraeus, GR, Greece
| | - Victoria Psomiadou
- Metaxa Memorial Cancer Hospital, 51 Botassi Str., 18537, Piraeus, GR, Greece.
| | - Kalliopi Kokkali
- Metaxa Memorial Cancer Hospital, 51 Botassi Str., 18537, Piraeus, GR, Greece
| | - Alexandros Fotiou
- Metaxa Memorial Cancer Hospital, 51 Botassi Str., 18537, Piraeus, GR, Greece
- Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens Medical School, Attikon Hospital, 12462, Athens, Greece
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Psomiadou V, Lekka S, Panoskaltsis T, Tsouma H, Novkovic N, Trihia HJ, Tzaida O, Korfias D, Giannakas P, Iavazzo C, Papadimitriou C, Vlahos N, Vorgias G. Fallopian tube cytology as a diagnostic tool for adnexal malignancy: the CytoSaLPs score. J Am Soc Cytopathol 2023; 12:368-377. [PMID: 37422370 DOI: 10.1016/j.jasc.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/30/2023] [Accepted: 05/16/2023] [Indexed: 07/10/2023]
Abstract
INTRODUCTION During the past decade, the theory that high-grade extrauterine pelvic tumors originate from the fallopian tube has been strongly suggested. Our study aims to illuminate the possible role of tubal cytology as an accessory identification tool for gynecologic extrauterine malignancies, allowing in the long term the implementation of population-level cytologic tube evaluation during all benign gynecologic surgeries that do not result in salpingectomy. MATERIALS AND METHODS We ex vivo collect salpingeal epithelial cells from the fibria directly from fresh fallopian tube specimens from women undergoing salpingectomy for any indication. The cytomorphologic characteristics of the salpingeal cells are subsequently evaluated and categorized into malignant and non-malignant. Finally, the ipsilateral adnexa are examined with the SEE-FIM (Sectioning and Extensively Examining the FIMbriated End) protocol and the pathology reports are corelated with the cytologic findings. Our research protocol is ongoing and is designed to include a total of 300 patients in order to confirm the sensitivity and specificity of salpingeal cytology as a method in the early diagnosis of extrauterine gynecologic malignancies. RESULTS So far, we have obtained 343 salpingeal brushings from a total of 214 patients. The sensitivity of cytology regarding distinguishing malignant from non-malignant tumors is 69.64% (95% CI: 55.90%-81.22%), and its specificity 75.96% (95% CI: 70.59%-80.79%). Cytology's positive predictive value (PPV) is 16.33% (95% CI: 12.57%-20.67%), while the negative predictive value (NPP) reached 92.77% (95% CI: 89.56%-95.04%). In general, the diagnostic accuracy of the cytologic evaluation reaches 74.93% (95% CI: 66.99%-79.43%). CONCLUSIONS Salpingeal cytomorphologic evaluation appears to be a promising method for early detection of adnexal cancer.
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Affiliation(s)
- Victoria Psomiadou
- Gynecoligical Oncology Department, Metaxa Memorial Cancer Hospital of Piraeus, Athens, Greece.
| | - Sofia Lekka
- Gynecoligical Oncology Department, Metaxa Memorial Cancer Hospital of Piraeus, Athens, Greece
| | - Theodoros Panoskaltsis
- Second Department of Obstetrics and Gynecology, Medical School, University of Athens "Aretaieio" Hospital, Athens, Greece
| | - Helen Tsouma
- Cytopathology Laboratory, Metaxa Memorial Cancer Hospital of Piraeus, Athens, Greece
| | - Natasa Novkovic
- Cytopathology Laboratory, Metaxa Memorial Cancer Hospital of Piraeus, Athens, Greece
| | - Helen J Trihia
- Pathology Department of Metaxa Cancer Hospital of Piraeus
| | - Olympia Tzaida
- Pathology Department of Metaxa Cancer Hospital of Piraeus
| | - Dimitrios Korfias
- Gynecoligical Oncology Department, Metaxa Memorial Cancer Hospital of Piraeus, Athens, Greece
| | - Panagiotis Giannakas
- Gynecoligical Oncology Department, Metaxa Memorial Cancer Hospital of Piraeus, Athens, Greece
| | - Christos Iavazzo
- Gynecoligical Oncology Department, Metaxa Memorial Cancer Hospital of Piraeus, Athens, Greece
| | - Christos Papadimitriou
- Oncology Unit, Second Department of Surgery Aretaieion Hospital, The National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Vlahos
- Second Department of Obstetrics and Gynecology, Medical School, University of Athens "Aretaieio" Hospital, Athens, Greece
| | - George Vorgias
- Gynecoligical Oncology Department, Metaxa Memorial Cancer Hospital of Piraeus, Athens, Greece
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Fotiou A, Kokkali K, Psomiadou V, Iavazzo C. Feasibility and safety of same-day discharge after robotic-assisted hysterectomy for endometrial cancer. Updates Surg 2023:10.1007/s13304-023-01558-9. [PMID: 37430096 DOI: 10.1007/s13304-023-01558-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 06/03/2023] [Indexed: 07/12/2023]
Affiliation(s)
- Alexandros Fotiou
- Gynecologic Oncology Department, "Metaxa" Memorial Cancer Hospital, Botasi 51 Str, Piraeus, Greece.
| | - Kalliopi Kokkali
- Gynecologic Oncology Department, "Metaxa" Memorial Cancer Hospital, Botasi 51 Str, Piraeus, Greece
| | - Victoria Psomiadou
- Gynecologic Oncology Department, "Metaxa" Memorial Cancer Hospital, Botasi 51 Str, Piraeus, Greece
| | - Christos Iavazzo
- Gynecologic Oncology Department, "Metaxa" Memorial Cancer Hospital, Botasi 51 Str, Piraeus, Greece
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Psomiadou V, Lekka S, Panoskaltsis T, Tsouma H, Novkovic N, Trihia HJ, Tzaida O, Korfias D, Giannakas P, Iavazzo C, Papadimitriou C, Vlahos N, Vorgias G. The Utility of Fallopian Tube Cytology in the Early Detection of Extrauterine Serous Gynecological Malignancies: A Narrative Literature Review. Acta Cytol 2023; 67:519-527. [PMID: 37044076 DOI: 10.1159/000530600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 04/02/2023] [Indexed: 04/14/2023]
Abstract
INTRODUCTION The aim of the study was to analyze the published evidence for the use of fallopian tube brush cytology for the early detection of extrauterine serous gynecological cancer. METHODS We systematically searched the literature and, additionally, cross-checked on the bibliographies of selected articles. The inclusion criteria involved studies assessing the utility of fallopian tube brush cytology and its applications in the diagnosis, screening, or follow-up of extrauterine serous gynecological cancer. RESULTS The search strategy resulted in 21 abstracts or full-text articles, 5 of which met the inclusion criteria. The year of publication ranged from 2016 to 2022, and a total of 193 fallopian tube samples were investigated. Cytobrush, Tubebrush©, and Cytuity™ were used to obtain salpingeal samples for liquid-based cytology evaluation. CONCLUSIONS Our findings indicate that, at present, there is a lack of satisfying evidence-based data in the literature which would support the implementation of fallopian tube brush cytology as an adjunctive tool for early detection of extrauterine serous gynecological cancer. Thus, we believe that there is need for well-designed clinical studies to assess the effectiveness and diagnostic accuracy of the method as well as to validate the cytological criteria for the diagnosis and prediction of gynecological malignancies.
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Affiliation(s)
- Victoria Psomiadou
- Gynecological Oncology Department, Metaxa Memorial Cancer Hospital of Piraeus, Athens, Greece
| | - Sofia Lekka
- Gynecological Oncology Department, Metaxa Memorial Cancer Hospital of Piraeus, Athens, Greece
| | - Theodoros Panoskaltsis
- Second Department of Obstetrics and Gynecology, Medical School, University of Athens "Aretaieio" Hospital, Athens, Greece
| | - Helen Tsouma
- Cytopathology Laboratory, Metaxa Memorial Cancer Hospital of Piraeus, Athens, Greece
| | - Natasa Novkovic
- Cytopathology Laboratory, Metaxa Memorial Cancer Hospital of Piraeus, Athens, Greece
| | - Helen J Trihia
- Pathology Department of Metaxa Cancer Hospital of Piraeus, Athens, Greece
| | - Olympia Tzaida
- Pathology Department of Metaxa Cancer Hospital of Piraeus, Athens, Greece
| | - Dimitrios Korfias
- Gynecological Oncology Department, Metaxa Memorial Cancer Hospital of Piraeus, Athens, Greece
| | - Panagiotis Giannakas
- Gynecological Oncology Department, Metaxa Memorial Cancer Hospital of Piraeus, Athens, Greece
| | - Christos Iavazzo
- Gynecological Oncology Department, Metaxa Memorial Cancer Hospital of Piraeus, Athens, Greece
| | - Christos Papadimitriou
- Oncology Unit, 2nd Department of Surgery Aretaieion Hospital, The National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Vlahos
- Second Department of Obstetrics and Gynecology, Medical School, University of Athens "Aretaieio" Hospital, Athens, Greece
| | - George Vorgias
- Gynecological Oncology Department, Metaxa Memorial Cancer Hospital of Piraeus, Athens, Greece
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Iavazzo C, Psomiadou V, Fotiou A, Vrachnis N. Cost efficacy of sentinel lymph node biopsy in endometrial cancer patients: Re: Uptake and outcomes of sentinel lymph node mapping in women undergoing minimally invasive surgery for endometrial cancer: Re: Uptake and outcomes of sentinel lymph node mapping in women undergoing minimally invasive surgery for endometrial cancer. BJOG 2023; 130:426-427. [PMID: 35315201 DOI: 10.1111/1471-0528.17140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 02/12/2022] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Alexandros Fotiou
- 3rd Department of Obstetrics and Gynaecology, National and Kapodistrian University of Athens Medical School, Attikon Hospital, Athens, Greece
| | - Nikolaos Vrachnis
- 3rd Department of Obstetrics and Gynaecology, National and Kapodistrian University of Athens Medical School, Attikon Hospital, Athens, Greece.,Department of Vascular Biology, Molecular and Clinical Sciences Research Institute, St. George's University of London, London, UK
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Psomiadou V, Fotiou A, Iavazzo C. Female Iliac Vein Variations: Risk of Injury and May-Thurner Syndrome. J INVEST SURG 2022; 36:1. [PMID: 36096490 DOI: 10.1080/08941939.2022.2121989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
| | - Alexandros Fotiou
- 3rd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens Medical School, Attikon Hospital, Athens, Greece
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Iavazzo C, Psomiadou V, Fotiou A, Vrachnis N. Open, laparoscopic and robotic myomectomies - comparison of outcomes. J Turk Ger Gynecol Assoc 2022; 23:211-212. [PMID: 35781517 PMCID: PMC9450924 DOI: 10.4274/jtgga.galenos.2022.2022-1-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
| | | | - Alexandros Fotiou
- Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens Medical School, Attikon Hospital, Athens, Greece
| | - Nikolaos Vrachnis
- Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens Medical School, Attikon Hospital, Athens, Greece.,Department of Vascular Biology, Molecular and Clinical Sciences Research Institute, St. George's University of London, London, UK
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Psomiadou V, Iavazzo C, Geramani E, Fotiou A, Karelis L, Valavanis C, Lekka S, Kokkali K, Vorgias G. Uterine angiolipoleiomyoma. A case report and systematic literature review. Folia Med (Plovdiv) 2022; 64:341-347. [DOI: 10.3897/folmed.64.e60937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 02/22/2021] [Indexed: 11/12/2022] Open
Abstract
Uterine angiolipoleiomyomas are rare, benign mixed mesenchymal lesions. A manifestation in the gynecological region is quite uncommon, with few cases described in the literature so far. We present an interesting case of a 59-year-old woman diagnosed with uterine angiolipoleiomyoma, and the results of the conducted systematic review of the literature. The patient presented with a pelvic mass masquerading as a leiomyoma on the ultrasound and postmenopausal vaginal bleeding. At laparotomy, a large uterus was noticed and the histopathology set the diagnosis of angiolipoleiomyoma. Immunohistochemistry revealed negativity for Melan-A and HMB-45 melanoma-specific antibodies and positivity for Van Gieson and orcein histochemical stains.
We systematically reviewed the literature. The eligible articles were those written in English, excluding animal studies and studies reporting angiolipoleiomyomas in other regions beside the uterus. The present case is one of the 10 cases of uterine angiolipoleiomyoma reported in the literature. In 8 out of 11 (72.7%) cases, uterine angiolipoleiomyomas arose from the corpus of the uterus, while in 2 (18.1%) cases they were located at the cervix, and in one case (9%) angiolipoleiomyoma was located in the broad ligament. Concerning symptoms, four of the patients (36.4%) presented with abdominal and pelvic pain, two (18.1%) with postmenopausal vaginal bleeding, one with menometrorrhagia (9%), and one with uterine prolapse and cystocele (9%). Immunohistochemical staining of uterine angiolipoleiomyomas was positive for SMA in 4 patients (36.4%), positive for desmin in 3 cases (27.3%), positive for anti-S-100 protein antibody in 2 patients (18.1%), while in one case (9%) immunopositivity was observed for CD31. Only our case (9%) was also tested for CD34, Van Gieson and orcein, the first of these being negative and the other two positive (at the blood vessels in a specialized pattern). Three of the patients (27.3%) were also tested for HMB-45 and all three were immunonegative.
In order to establish the diagnosis of uterine angiolipoleiomyomas, ultrasonography and additional MRI may help the preoperative prediction of a benign mass. Immunohistochemistry will show strong positivity of alpha-smooth muscle actin and desmin. Complete abdominal hysterectomy is the preferable treatment.
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Psomiadou V, Fotiou A, Iavazzo C. Primary versus interval debulking surgery in the management of ovarian cancer patients, current data summary. CLIN EXP OBSTET GYN 2022. [DOI: 10.31083/j.ceog4904097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Fotiou A, Psomiadou V, Prodromidou A, Iavazzo C. CRS and HIPEC in a patient with recurrent ovarian cancer after PDS and adjuvant chemotherapy, a case report and MDT discussion. EUR J GYNAECOL ONCOL 2022. [DOI: 10.31083/j.ejgo4302043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Iavazzo C, Fotiou A, Psomiadou V, Vrachnis N, Spiliotis J. Survival Benefit of Patients with Advanced Primary Fallopian Tube Cancer Undergoing Systematic Lymphadenectomy? Dilemmas and Queries. J INVEST SURG 2022; 35:1424-1425. [DOI: 10.1080/08941939.2022.2053252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- C. Iavazzo
- Department of Gynecologic Oncology, “Metaxa” Memorial Cancer Hospital, Piraeus, Greece
| | - A. Fotiou
- Third Department of Obstetrics and Gynecology, Attikon Hospital, National Kapodistrian University of Athens Medical School, Athens, Greece
| | - V. Psomiadou
- Department of Gynecologic Oncology, “Metaxa” Memorial Cancer Hospital, Piraeus, Greece
| | - N. Vrachnis
- Third Department of Obstetrics and Gynecology, Attikon Hospital, National Kapodistrian University of Athens Medical School, Athens, Greece
| | - J. Spiliotis
- Department of Surgical Oncology and HIPEC, European Interbalkan Medical Center, Thessaloniki, Greece
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Psomiadou V, Lekka S, Tsouma E, Liakea A, Trihia H, Tzaida O, Iavazzo C, Papadimitriou C, Panoskaltsis T, Vorgias G, Vlahos N. 565 Fallopian tube cytological findings in women undergoing salpingectomy. Eur J Obstet Gynecol Reprod Biol 2022. [DOI: 10.1016/j.ejogrb.2021.11.388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Psomiadou V, Fotiou A, Prodromidou A, Iavazzo C. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) in treatment of advanced ovarian cancer. A review of the literature. EUR J GYNAECOL ONCOL 2022. [DOI: 10.31083/j.ejgo4301004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Iavazzo C, Psomiadou V, Fotiou A, Vrachnis N. Concerns about transcervical radiofrequency ablation of uterine fibroids. J Gynecol Obstet Hum Reprod 2022; 51:102325. [DOI: 10.1016/j.jogoh.2022.102325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 01/18/2022] [Indexed: 10/19/2022]
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Kokkali K, Iavazzo C, Souka E, Lekka S, Fotiou A, Geramani E, Psomiadou V, Vorgias G. Crohn’s Disease of the Vulva: a Case Report. Folia Med (Plovdiv) 2021; 63:990-993. [DOI: 10.3897/folmed.63.e58002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 10/06/2020] [Indexed: 11/12/2022] Open
Abstract
Crohn’s disease is a multi-systemic chronic inflammatory disease that can affect various organs besides the gastrointestinal tract such as joints, uvea, and the skin. Vulvar Crohn’s disease is a rare entity occurring with vulvar lesions that show typical Crohn’s disease granulomatous inflammation but are not contiguous with the gastrointestinal involvement. Vulvar Crohn’s disease can be easily confused with other granulomatous diseases and awareness that such involvement may precede gastrointestinal symptoms must be raised. Few cases of vulvar Crohn’s disease have been reported in the literature to date. Here, we report a case of a 43-year-old woman with a 6-month history of a vulvar lesion; the patient was diagnosed with Crohn’s disease of the large bowel just over a year ago.
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Iavazzo C, Karavioti E, Kokkali K, Souka E, Psomiadou V, Lekka S, Geramani E, Fotiou A, Vorgias G. Sarcomatoid Squamous Cell Carcinoma Of The Vulva:A Case Report. Clin Ter 2021; 172:392-394. [PMID: 34625766 DOI: 10.7417/ct.2021.2345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background A sarcomatoid squamous cell carcinoma of the vul-va is a very rare malignancy of the female genital tract . It has been characterized as an aggressive disease typically associated with early development of local recurrences as well as distant metastases. Case A 77-year old woman presented to our hospital with an aggravated vulvar mass, complaining about pruritus and pain. The patient underwent a radical vulvectomy with bilateral inguinal lymph node dissection and bilateral pelvic lymph node sampling. The histo-pathologic examination was consistent with a sarcomatoid squamous cell carcinoma of the vulva with an identical microscopic and im-munohistochemical appearance. The FIGO stage was IB and further management was decided to be radiotherapy. Conclusion A sarcomatoid squamous cell carcinoma is a rare entity with an aggressive biological behavior. To date, there have been only a few cases of the disease reported in the literature. Therefore a more systematic collection and closer study of such cases would be helpful for achieving an early diagnosis and more effective therapeutic strategies in the future.
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Affiliation(s)
- C Iavazzo
- Department of Gynecologic Oncology, Metaxa Cancer Hospital, Piraeus, Greece
| | - E Karavioti
- Department of Gynecologic Oncology, Metaxa Cancer Hospital, Piraeus, Greece
| | - K Kokkali
- Department of Gynecologic Oncology, Metaxa Cancer Hospital, Piraeus, Greece
| | - E Souka
- Department of Pathology, Metaxa Cancer Ho-spital, Piraeus, Greece
| | - V Psomiadou
- Department of Gynecologic Oncology, Metaxa Cancer Hospital, Piraeus, Greece
| | - S Lekka
- Department of Gynecologic Oncology, Metaxa Cancer Hospital, Piraeus, Greece
| | - E Geramani
- Department of Gynecologic Oncology, Metaxa Cancer Hospital, Piraeus, Greece
| | - A Fotiou
- Department of Gynecologic Oncology, Metaxa Cancer Hospital, Piraeus, Greece
| | - G Vorgias
- Department of Gynecologic Oncology, Metaxa Cancer Hospital, Piraeus, Greece
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Blontzos N, Iavazzo C, Giovannopoulou E, Galanopoulos G, Psomiadou V, Vorgias G. Primary Peritoneal Serous Carcinoma Detected by Abnormal Cervical Smear: a Case Report. Folia Med (Plovdiv) 2021; 62:195-199. [PMID: 32337890 DOI: 10.3897/folmed.62.e47875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 07/30/2019] [Indexed: 11/12/2022] Open
Abstract
Primary peritoneal serous carcinoma (PPSC) is a rare malignancy, the clinical characteristics of which resemble ovarian serous carcinoma. We present a rare case of PPSC detected by an abnormal cervical smear, the first one with an absence of ovarian tissue at the time of the initial diagnosis.
A 59-year-old asymptomatic woman presented with glandular atypia on routine Papanicolaou smear. Endocervical and endometrial curettage showed an adenocarcinoma with focal squamous differentiation and uncertain further classification. The patient had a past surgical history of bilateral salpingoophorectomy due to endometriosis. Abdominal MRI depicted omental multinodularity, great amount of ascites and possible endometrial tumor. The patient underwent total hysterectomy, omentectomy and biopsies of implants on Douglass pouch. Surgical and histological findings were consistent with primary peritoneal serous carcinoma.
Abnormal pap smear could rarely be suggestive of extrauterine malignancies, such as peritoneal cancer.
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Iavazzo C, Psomiadou V, Fotiou A, Prodromidou Α, Douligeris A, Lekka S, Korfias D, Karavioti E, Vorgias G. Concurrent gynecologic surgery and panniculectomy in morbidly obese women with gynecologic cancer, a single-center experience. Arch Gynecol Obstet 2021; 304:1271-1278. [PMID: 33740102 DOI: 10.1007/s00404-021-06033-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 03/13/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE As the prevalence of obesity has been rising during the past decades worldwide and especially in Greece, surgeons have faced significant challenges concerning the treatment of morbidly obese women with gynecologic cancer. Panniculectomy is a safe procedure that offers better visualization of pelvic anatomy and prevention of major complications in these women. METHODS Aim of this study is to describe a single-center experience of surgical treatment of morbidly obese women with gynecologic cancer and concurrent panniculectomy. We, also, review the literature for articles that report concurrent gynecologic surgery and panniculectomy, to summarize the complications that were encountered. RESULTS From 2015 to 2018, 38 obese women were treated with concurrent panniculectomy at the time of gynecologic surgery for cancer in a single institution. Median age was 55.62 years old, median BMI 43.79 kg/m2, median blood loss 243.75 ml and median operative time approximately 200 min. Twenty-nine patients had endometrial cancer, one patient had concurrent endometrial cancer and fallopian tube cancer, six patients had borderline ovarian cancer, and two had adult granulosa ovarian tumour. Intraoperative and postoperative complications were documented. Five patients suffered from wound infection and were treated with antibiotics and one patient died after wound infection, wound dehiscence, and renal failure. CONCLUSION For selected obese patients, concurrent panniculectomy with surgical treatment of gynecological cancer is a safe and efficient procedure.
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Affiliation(s)
- C Iavazzo
- Gynecologic Oncology Department, Metaxa Memorial Cancer Hospital, 51, Botassi Str., 18537, Piraeus, Greece
| | - V Psomiadou
- Gynecologic Oncology Department, Metaxa Memorial Cancer Hospital, 51, Botassi Str., 18537, Piraeus, Greece
| | - Alexandros Fotiou
- Gynecologic Oncology Department, Metaxa Memorial Cancer Hospital, 51, Botassi Str., 18537, Piraeus, Greece.
| | - Α Prodromidou
- Gynecologic Oncology Department, Metaxa Memorial Cancer Hospital, 51, Botassi Str., 18537, Piraeus, Greece
| | - A Douligeris
- Gynecologic Oncology Department, Metaxa Memorial Cancer Hospital, 51, Botassi Str., 18537, Piraeus, Greece
| | - S Lekka
- Gynecologic Oncology Department, Metaxa Memorial Cancer Hospital, 51, Botassi Str., 18537, Piraeus, Greece
| | - D Korfias
- Gynecologic Oncology Department, Metaxa Memorial Cancer Hospital, 51, Botassi Str., 18537, Piraeus, Greece
| | - E Karavioti
- Gynecologic Oncology Department, Metaxa Memorial Cancer Hospital, 51, Botassi Str., 18537, Piraeus, Greece
| | - G Vorgias
- Gynecologic Oncology Department, Metaxa Memorial Cancer Hospital, 51, Botassi Str., 18537, Piraeus, Greece
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Psomiadou V, Iavazzo C, Douligeris A, Fotiou A, Prodromidou A, Blontzos N, Karavioti E, Vorgias G. An Alternative Treatment for Vaginal Cuff Wart: a Case Report. Acta Medica (Hradec Kralove) 2021; 63:49-51. [PMID: 32422116 DOI: 10.14712/18059694.2020.15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Human papillomavirus (HPV) has been directly related to acuminate warts and cervical cancer, the second most common neoplasia among women. Given the lack of treatment against the virus itself, many medications have been utilised, mainly aiming in modifying the host's immunological response. We present the case of a 54 years old postmenopausal patient with a history of vaginal cuff wart and HPV persistence that we managed in our clinic for 6 months with a mix of curcumin, aloe vera, amla and other natural ingredients. As the patient was found to be intolerant to imiquimod (one of the most common conservative methods of treatment) we attempted the use of curcumin, which was applied to the area of the wart three times per week for 6 months. Both clinical and colposcopical improvement was noted in regular clinic visits with regression of the lesion. The outcome of this case encourages our view that curcumin should be considered as a significant treatment modality against HPV infection and acuminate warts.
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Affiliation(s)
- Victoria Psomiadou
- Department of Gynecologic Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - Christos Iavazzo
- Department of Gynecologic Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece.
| | - Athanasios Douligeris
- Department of Gynecologic Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - Alexandros Fotiou
- Department of Gynecologic Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - Anastasia Prodromidou
- Department of Gynecologic Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - Nikolaos Blontzos
- Department of Gynecologic Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - Evgenia Karavioti
- Department of Gynecologic Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - George Vorgias
- Department of Gynecologic Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
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Prodromidou A, Iavazzo C, Psomiadou V, Douligeris A, Machairas N, Paspala A, Bakogiannis K, Vorgias G. Safety and efficacy of synchronous panniculectomy and endometrial cancer surgery in obese patients: a systematic review of the literature and meta-analysis of postoperative complications. J Turk Ger Gynecol Assoc 2020; 21:279-286. [PMID: 31927811 PMCID: PMC7726461 DOI: 10.4274/jtgga.galenos.2019.2019.0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Panniculectomy combined with gynaecological surgery constitutes an alternative approach for endometrial cancer (EC) in obese patients. The present study aimed to assess the current knowledge concerning the safety and efficacy of combining panniculectomy in surgical management of EC. Four electronic databases were systematically searched for articles published up to May 2019. A total of five studies, of which two were non-comparative and three comparative, were included. Meta-analysis of complications among panniculectomy and conventional laparotomy group revealed no difference in either intra- or post-operative complication rates. Moreover, no difference was reported in surgical site complications (p=0.59), while wound breakdown rates were significantly elevated in the laparotomy group (p=0.02). Panniculectomy combined surgery for the management of EC appears to be a safe procedure and results in comparable outcomes compared with conventional laparotomy with regard to complications and improved wound breakdown rates.
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Affiliation(s)
- Anastasia Prodromidou
- Department of Obstetrics and Gynecology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - Christos Iavazzo
- Department of Obstetrics and Gynecology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - Victoria Psomiadou
- Department of Obstetrics and Gynecology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - Athanasios Douligeris
- Department of Obstetrics and Gynecology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - Nikolaos Machairas
- Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - Anna Paspala
- Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | | | - George Vorgias
- Department of Obstetrics and Gynecology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
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Psomiadou V, Prodromidou A, Fotiou A, Lekka S, Iavazzo C. Robotic interval debulking surgery for advanced epithelial ovarian cancer: current challenge or future direction? A systematic review. J Robot Surg 2020; 15:155-163. [PMID: 33037532 DOI: 10.1007/s11701-020-01155-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 09/30/2020] [Indexed: 11/24/2022]
Abstract
We evaluated the effectiveness, safety and efficacy of robotic interval debulking surgery (IDS) in advanced epithelial ovarian cancer (EOC) treated with neoadjuvant chemotherapy (NACT). We conducted a systematic review of the published relevant studies. Α total of 102 patients were evaluated. Mean operative time ranged from 164 to 312 min (mean ± SD: 246 ± 61 min) while mean estimated blood loss ranged from 106.9 to 262.5 ml (mean ± SD: 168 ± 68 ml) and postoperative blood transfusion rate was 19% (n = 19/98). Complete cytoreduction rate (R0 resection) was achieved in 75 patients (76.5%), whereas residual disease ≤ 1 cm in 21 women (21.5%). Mean hospital stay was 2.4 days. No intraoperative and six postoperative (14.6%) complications were reported. Laparotomy conversion rate was 9.2% (9/98) mostly in the terms of achieving complete cytoreduction and 30-day mortality rate was 9.2% (n = 9/98). The median overall survival varied from 39.7 to 47.2 months, while the progression-free survival ranged from 20.6 to 21.2 months during a median follow-up period from 2 to 86 months (median 25.3 months). A total of 60 women (61%) developed disease recurrence. One of the studies reported significantly improved OS and PFS in patients who underwent robotic IDS when compared to those who had laparotomy either during or before the addition of robotic surgery in the management of advanced ovarian cancer disease (47.2 vs 37.8 vs 37.9, p = 0.004 for OS and 20.6 vs 13.9 vs 11.9, p = 0.005 for PFS, respectively). The same was also observed when controlling the parameters of age and stage for patients in the robotic arm (p = 0.02). Robotic interval debulking surgery can be considered in the management of advanced ovarian cancer patients after receiving neoadjuvant chemotherapy. Larger meta-analyses including multicenter randomized control trials are necessary to specify the exact profile of the patients that could benefit from this treatment strategy.
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Affiliation(s)
- Victoria Psomiadou
- Department of Gynecologic Oncology, Metaxa Cancer Hospital, Mpotasi 51, 18537, Piraeus, Greece
| | - Anastasia Prodromidou
- Department of Gynecologic Oncology, Metaxa Cancer Hospital, Mpotasi 51, 18537, Piraeus, Greece
| | - Alexandros Fotiou
- Department of Gynecologic Oncology, Metaxa Cancer Hospital, Mpotasi 51, 18537, Piraeus, Greece
| | - Sofia Lekka
- Department of Gynecologic Oncology, Metaxa Cancer Hospital, Mpotasi 51, 18537, Piraeus, Greece.
| | - Christos Iavazzo
- Department of Gynecologic Oncology, Metaxa Cancer Hospital, Mpotasi 51, 18537, Piraeus, Greece
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Psomiadou V, Iavazzo C, Douligeris A, Prodromidou A, Galati E, Novkovic N, Karelis L, Oikonomidis E, Karavioti E, Vorgias G, Kalinoglou N. Tubal cancer in a young woman camouflaged as bilateral salpingitis. J OBSTET GYNAECOL 2019; 40:1178-1180. [PMID: 31791170 DOI: 10.1080/01443615.2019.1674260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Victoria Psomiadou
- Department of Gynecologic Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - Christos Iavazzo
- Department of Gynecologic Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - Athanasios Douligeris
- Department of Gynecologic Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - Anastasia Prodromidou
- Department of Gynecologic Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - Elpis Galati
- Department of Gynecologic Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - Natasa Novkovic
- Department of Gynecologic Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - Loukas Karelis
- Department of Gynecologic Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - Emmanouil Oikonomidis
- Department of Gynecologic Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - Evgenia Karavioti
- Department of Gynecologic Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - George Vorgias
- Department of Gynecologic Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - Nikolaos Kalinoglou
- Department of Gynecologic Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
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Blontzos N, Iavazzo C, Giovannopoulou E, Novkovic N, Psomiadou V, Vorgias G. Recurrence of Bartholin gland mucinous adenocarcinoma managed with posterior exenteration: a case report. J OBSTET GYNAECOL 2019; 40:1029-1030. [PMID: 31607196 DOI: 10.1080/01443615.2019.1650011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Nikolaos Blontzos
- Department of Gynecology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - Christos Iavazzo
- Department of Gynecology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | | | - Natasa Novkovic
- Department of Pathology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - Victoria Psomiadou
- Department of Gynecology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - George Vorgias
- Department of Gynecology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
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Mortaki D, Gkegkes ID, Psomiadou V, Blontzos N, Prodromidou A, Lefkopoulos F, Nicolaidou E. Vaginal microbiota and human papillomavirus: a systematic review. J Turk Ger Gynecol Assoc 2019; 21:193-200. [PMID: 31564082 PMCID: PMC7495129 DOI: 10.4274/jtgga.galenos.2019.2019.0051] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Accumulating evidence indicates the potential correlation between the vaginal microbioma and the acquisition and persistence of human papillomavirus (HPV) infection. This study aims to demonstrate the potential relationship through a systematic review of the current literature. A search was conducted on the following medical databases: PubMed and Scopus. Nineteen studies met the inclusion criteria and were incorporated in the present review. A total of 12.204 patients and their demographic characteristics were studied. Commercially available DNA tests and polymerase chain reaction (PCR) were used for the detection of different HPV subtypes, while the identification of the microbiomes was performed through specific diagnostic methods and PCR assay. The most frequently encountered species were classified based on their protective or detrimental impact on the progression of HPV infection. The beneficial role of some types of Lactobacillus (Lactobacillus gasseri, Lactobacillus jensenii, Lactobacillus crispatus) is generally supported. On the other hand, high microbial diversity and specific microorganisms such as Sneathia, Anaerococcus tetradius, Peptostreptococcus, Fusobacterium and Gardnerella vaginalis were found to be implicated with higher frequency and severity of disease, potentially resulting in pre-cancerous and cancerous cervical lesions.The role of vaginal microbiota appears to play an as yet not fully understood role in the susceptibility to HPV infection and its natural history.
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Affiliation(s)
- Despoina Mortaki
- First Department of Dermatology and Venereology, National and Kapodistrian University of Athens School of Medicine “A. Syggros” Hospital for Skin and Venereal Diseases, Athens, Greece,Hellenic Society for Lower Genital Tract Disorders, Athens, Greece
| | - Ioannis D. Gkegkes
- Department of Surgery, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK,Hellenic Society for Lower Genital Tract Disorders, Athens, Greece
| | - Victoria Psomiadou
- Clinic of Gynaecological Oncology, Metaxa Cancer Hospital, Piraeus, Greece,Hellenic Society for Lower Genital Tract Disorders, Athens, Greece
| | - Nikos Blontzos
- Clinic of Gynaecological Oncology, Metaxa Cancer Hospital, Piraeus, Greece,Hellenic Society for Lower Genital Tract Disorders, Athens, Greece
| | - Anastasia Prodromidou
- Clinic of Gynaecological Oncology, Metaxa Cancer Hospital, Piraeus, Greece,Hellenic Society for Lower Genital Tract Disorders, Athens, Greece
| | - Fotis Lefkopoulos
- Clinic of Gynaecological Oncology, Metaxa Cancer Hospital, Piraeus, Greece,Hellenic Society for Lower Genital Tract Disorders, Athens, Greece
| | - Electra Nicolaidou
- First Department of Dermatology and Venereology, National and Kapodistrian University of Athens School of Medicine “A. Syggros” Hospital for Skin and Venereal Diseases, Athens, Greece,Hellenic Society for Lower Genital Tract Disorders, Athens, Greece
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Douligeris A, Prodromidou A, Psomiadou V, Iavazzo C, Vorgias G. Abdominal radical trachelectomy during pregnancy: A systematic review of the literature. J Gynecol Obstet Hum Reprod 2019; 49:101607. [PMID: 31276846 DOI: 10.1016/j.jogoh.2019.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 06/25/2019] [Accepted: 07/01/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Lack of large trials or randomized studies characterize any type of treatment for cervical cancer during pregnancy experimental. OBJECTIVE To accumulate the existing evidence on abdominal radical trachelectomy (ART) during pregnancy. SEARCH STRATEGY Medline, Scopus and Google Scholar databases were thoroughly searched up to September 2018 for relevant studies in this field using the terms "Radical Trachelectomy", "Pregnancy", "Cervical cancer", "fertility sparring". SELECTION CRITERIA Observational studies and case reports which addressed cases of pregnant women who underwent ART for cervical cancer during pregnancy were included. MAIN RESULTS A total of ten studies which recruited 19 patients were finally included. At the time of ART, the gestational age of patients ranged from 7th to 22th weeks. Mean operative time of ART was 351.8 min while mean blood loss was 1,040.35 ml and 5 patients (50%) received blood transfusion. Fetal loss rate was 21.1% (n = 4) and from the completed deliveries 7 (46,66%) were preterm. Postoperative maternal related complication rate was 23.1% (n = 3/13). The mean follow-up was 16.89 months (SD 12.69), whereas all cases were free of disease without evidence of recurrence during their follow-up. CONCLUSIONS According to the existing evidence, ART may be a tolerable option for pregnant women with early-stage cervical cancer with acceptable oncological and obstetrical outcomes. Future multicenter randomized trials are of particular importance to elucidate the optimal treatment option.
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Affiliation(s)
- Athanasios Douligeris
- Department of Gynecological Oncology, Metaxa Memorial Cancer Hospital, Botasi 51, postal code: 18537, Piraeus, Greece.
| | - Anastasia Prodromidou
- Department of Surgical Oncology, Metaxa Memorial Cancer Hospital, Botasi 51, postal code: 18537, Piraeus, Greece.
| | - Victoria Psomiadou
- Department of Gynecological Oncology, Metaxa Memorial Cancer Hospital, Botasi 51, postal code: 18537, Piraeus, Greece.
| | - Christos Iavazzo
- Department of Gynecological Oncology, Metaxa Memorial Cancer Hospital, Botasi 51, postal code: 18537, Piraeus, Greece.
| | - George Vorgias
- Department of Gynecological Oncology, Metaxa Memorial Cancer Hospital, Botasi 51, postal code: 18537, Piraeus, Greece.
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Prodromidou A, Iavazzo C, Fotiou A, Psomiadou V, Douligeris A, Vorgias G, Kalinoglou N. Short- and long term outcomes after abdominal radical trachelectomy versus radical hysterectomy for early stage cervical cancer: a systematic review of the literature and meta-analysis. Arch Gynecol Obstet 2019; 300:25-31. [PMID: 31062151 DOI: 10.1007/s00404-019-05176-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Accepted: 04/24/2019] [Indexed: 12/09/2022]
Abstract
PURPOSE Cervical cancer (CC) ranks 2nd for mortality among women of reproductive age in the United States. Abdominal radical trachelectomy (ART) is a fertility sparing approach that has been proposed in women with early stage CC who wish to preserve their fertility. The aim of the present meta-analysis was to evaluate the short- and long-term outcomes of RH vs ART for early stage CC. METHODS A total of 5 electronic databases were searched for articles published up to December 2018. Prospective and retrospective trials reporting outcomes for women who underwent ART or RH for the management of early stages CC, were considered eligible for inclusion. Statistical meta-analysis was performed using the RevMan 5.3 software. RESULTS A total of 5 studies which included 840 women who underwent ART or radical trachelectomy (RH) were included in the present meta-analysis. Among them, 324 underwent ART whereas the remaining 516 had RH. Despite the fact that ART was associated with significantly prolonged operative time compared to RH (840 patients MD 36.82 min, 95% CI 20.15-53.49, p < 0.001), neither 5-year OS nor 5-year DFS were different among the two groups (714 patients OR 1.39, 95% CI 0.53-3.62, p = 0.51 and 682 patients OR 1.08, 95% CI 0.52-2.25, p = 0.84, respectively). CONCLUSIONS ART is a more complex and time consuming technique, but equally safe compared to RH in terms of oncological outcomes for selected women with early stage CC and allows for more CC survivors of childbearing age to preserve their fertility.
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Affiliation(s)
- Anastasia Prodromidou
- Department of Gynecological Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece.
- Department of Surgical Oncology, Metaxa Memorial Anticancer Hospital, Mpotasi 51, Piraeus, Greece.
| | - Christos Iavazzo
- Department of Gynecological Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - Alexandros Fotiou
- Department of Gynecological Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - Victoria Psomiadou
- Department of Gynecological Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - Athanasios Douligeris
- Department of Gynecological Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - Georgios Vorgias
- Department of Gynecological Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - Nikolaos Kalinoglou
- Department of Gynecological Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
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Galati E, Psomiadou V, Lefkopoulos F, Douligeris A, Prodromidou A, Karavioti E, Iavazzo C, Rodolakis A, Vorgias G. Radical abdominal trachelectomy and pelvic lymphadenectomy in a nulliparous patient with cervical adenocarcinoma: A case report. Case Rep Womens Health 2019; 23:e00124. [PMID: 31193447 PMCID: PMC6529822 DOI: 10.1016/j.crwh.2019.e00124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 05/06/2019] [Accepted: 05/13/2019] [Indexed: 11/18/2022] Open
Abstract
Cancer of the cervix is the fourth most common malignancy among women in the world and the sixth most common among women in Europe. Almost half of patients with an early-stage invasive cervical carcinoma are under 40 years of age, while the average age at first pregnancy in European countries is over 28 years. Therefore many women with cervical cancer have not started or completed their family at the time of diagnosis and ask for fertility-sparing surgery. Radical trachelectomy is a safe alternative to standard care (radical hysterectomy) for patients diagnosed with early-stage cervical cancer and is a reasonable choice in well selected cases. We present the case of a 23-year-old patient diagnosed with a cervical adenocarcinoma and treated with abdominal trachelectomy. Cervical cancer is currently the fourth most common female malignancy in the world Almost half of the patients with an early stage disease are under 40 years old. The average age of first pregnancy in European countries is above 28 years old. Radical trachelectomy (RT) is a safe and appropriate fertility sparing procedure. We report a case of a young patient managed with radical abdominal trachelectomy.
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Affiliation(s)
| | | | | | | | | | | | - Christos Iavazzo
- Corresponding author at: Nosokomeio Metaxa, Gynaecological Oncology, 51, Botassi Str., Piraeus, GR 18537, Greece.
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Prodromidou A, Iavazzo C, Fotiou A, Psomiadou V, Drakou M, Vorgias G, Kalinoglou N. The application of fibrin sealant for the prevention of lymphocele after lymphadenectomy in patients with gynecological malignancies: A systematic review and meta-analysis of randomized controlled trials. Gynecol Oncol 2019; 153:201-208. [DOI: 10.1016/j.ygyno.2019.01.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 01/03/2019] [Accepted: 01/08/2019] [Indexed: 12/14/2022]
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