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Selcuk I, Yalcin HR. Correspondence on 'Intrauterine manipulator use during laparoscopic hysterectomy for endometrial cancer: association for pathological factors and oncologic outcomes' by Yoshida et al. Int J Gynecol Cancer 2024:ijgc-2024-005617. [PMID: 38658018 DOI: 10.1136/ijgc-2024-005617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024] Open
Affiliation(s)
- Ilker Selcuk
- Gynecologic Oncology, Ankara City Hospital, Cankaya, Turkey
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2
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Rosati A, Certelli C, Ferrandina G, Fanfani F, Scambia G, Gallotta V. Minimally invasive adrenalectomy: a personalized surgical approach in recurrent cervical cancer. Int J Gynecol Cancer 2024:ijgc-2023-005241. [PMID: 38649233 DOI: 10.1136/ijgc-2023-005241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Affiliation(s)
- Andrea Rosati
- Department of Woman's and Child Health and Public Health Sciences, Gynecologic Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Camilla Certelli
- Department of Woman's and Child Health and Public Health Sciences, Gynecologic Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Gabriella Ferrandina
- Department of Woman's and Child Health and Public Health Sciences, Gynecologic Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Francesco Fanfani
- Department of Woman's and Child Health and Public Health Sciences, Gynecologic Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Giovanni Scambia
- Department of Woman's and Child Health and Public Health Sciences, Gynecologic Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Valerio Gallotta
- Department of Woman's and Child Health and Public Health Sciences, Gynecologic Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
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3
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Rodrigues M, Ivanova C, Felix A. Uterine inflammatory myofibroblastic tumor with myxoid predominance: diagnostic challenge. Int J Gynecol Cancer 2024:ijgc-2023-005142. [PMID: 38641365 DOI: 10.1136/ijgc-2023-005142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2024] Open
Affiliation(s)
| | | | - Ana Felix
- Instituto Portugues de Oncologia de Lisboa Francisco Gentil EPE, Lisboa, Portugal
- Universidade NOVA de Lisboa NOVA Medical School, Lisboa, Portugal
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Oliver-Perez MR, Caso-Maestro O, Conti-Nuño B, Bermejo R, Gil-Ibañez B, Tejerizo-Garcia A. Step by step abdominal wall closure in elective midline laparotomy. Int J Gynecol Cancer 2024:ijgc-2024-005500. [PMID: 38642922 DOI: 10.1136/ijgc-2024-005500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2024] Open
Affiliation(s)
- M Reyes Oliver-Perez
- Gynaecologic Oncology Unit, Department of Obstetrics and Gynaecology, Research Institute (i+12), Hospital Universitario 12 de Octubre, Madrid, Spain
- Universidad Complutense, Madrid, Spain
| | - Oscar Caso-Maestro
- Universidad Complutense, Madrid, Spain
- Department of Surgery, Research Institute (i+12), Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Beatrice Conti-Nuño
- Department of Obstetrics and Gynaecology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Rocio Bermejo
- Department of Obstetrics and Gynaecology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Blanca Gil-Ibañez
- Gynaecologic Oncology Unit, Department of Obstetrics and Gynaecology, Research Institute (i+12), Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Alvaro Tejerizo-Garcia
- Gynaecologic Oncology Unit, Department of Obstetrics and Gynaecology, Research Institute (i+12), Hospital Universitario 12 de Octubre, Madrid, Spain
- Universidad Complutense, Madrid, Spain
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5
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Uwins C, Assalaarachchi H, Bennett K, Read J, Tailor A, Crawshaw J, Chatterjee J, Ellis P, Skene SS, Michael A, Butler-Manuel S. MIRRORS: a prospective cohort study assessing the feasibility of robotic interval debulking surgery for advanced-stage ovarian cancer. Int J Gynecol Cancer 2024:ijgc-2024-005265. [PMID: 38561194 DOI: 10.1136/ijgc-2024-005265] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
OBJECTIVE To establish the feasibility and safety of robotic interval debulking surgery following the MIRRORS protocol (robot-assisted laparoscopic assessment prior to robotic or open surgery) in women with advanced-stage ovarian cancer. MIRRORS is the first of three planned trials: MIRRORS, MIRRORS-RCT (pilot), and MIRRORS-RCT. METHODS The participants were patients with stage IIIc-IVb epithelial ovarian cancer undergoing neo-adjuvant chemotherapy, suitable for interval debulking surgery with a pelvic mass ≤8 cm. The intervention was robot-assisted laparoscopic assessment prior to robotic or open interval debulking surgery (MIRRORS protocol). The primary outcome was feasibility of recruitment, and the secondary outcomes were quality of life (EORTC QLQC30/OV28, HADS questionnaires), pain, surgical complications, complete cytoreduction rate (%), conversion to open surgery (%), and overall and progression-free survival at 1 year. RESULTS Overall, 95.8% (23/24) of patients who were eligible were recruited. Median age was 68 years (range 53-83). All patients had high grade serous histology and were BRCA negative. In total, 56.5% were stage IV, 43.5% were stage III, 87.0% had a partial response, while 13.0% had stable disease by RECIST 1.1. Median peritoneal cancer index was 24 (range 6-38). Following MIRRORS protocol, 87.0% (20/23) underwent robotic interval debulking surgery, and 13.0% (3/23) had open surgery. All patients achieved R<1 (robotic R0=47.4%, open R0=0%). No patients had conversion to open. Median estimated blood loss was 50 mL for robotic (range 20-500 mL), 2026 mL for open (range 2000-2800 mL) (p=0.001). Median intensive care length of stay was 0 days for robotic (range 0-8) and 3 days (range 3-13) for MIRRORS Open (p=0.012). The median length of stay was 1.5 days for robotic (range 1-17), 6 days for open (range 5-41) (p=0.012). The time to chemotherapy was as follows 18.5 days for robotic (range 13-28), 25 days for open (range 22-28) (p=0.139). CONCLUSIONS Robotic interval debulking surgery appears safe and feasible for experienced robotic surgeons in patients with a pelvic mass ≤8 cm. A randomized controlled trial (MIRRORS-RCT) will determine whether MIRRORS protocol has non-inferior survival (overall and progression-free) compared with open interval debulking surgery.
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Affiliation(s)
- Christina Uwins
- Academic Department of Gynaecological Oncology, Royal Surrey NHS Foundation Trust, Guildford, Surrey, UK
- School of Biosciences and Medicine, University of Surrey, Guildford, UK
| | - Hasanthi Assalaarachchi
- Academic Department of Gynaecological Oncology, Royal Surrey NHS Foundation Trust, Guildford, Surrey, UK
| | - Kate Bennett
- Surrey Clinical Trials Unit, University of Surrey, Guildford, Surrey, UK
| | - James Read
- Department of General Surgery, Royal Surrey NHS Foundation Trust, Guildford, Surrey, UK
| | - Anil Tailor
- Academic Department of Gynaecological Oncology, Royal Surrey NHS Foundation Trust, Guildford, Surrey, UK
| | - James Crawshaw
- Department or Radiology, Royal Surrey NHS Foundation Trust, Guildford, Surrey, UK
| | - Jayanta Chatterjee
- Academic Department of Gynaecological Oncology, Royal Surrey NHS Foundation Trust, Guildford, Surrey, UK
| | - Patricia Ellis
- Academic Department of Gynaecological Oncology, Royal Surrey NHS Foundation Trust, Guildford, Surrey, UK
| | - Simon S Skene
- Surrey Clinical Trials Unit, University of Surrey, Guildford, Surrey, UK
| | - Agnieszka Michael
- School of Biosciences and Medicine, University of Surrey, Guildford, UK
- Surrey Clinical Trials Unit, University of Surrey, Guildford, Surrey, UK
- St Luke's Cancer Centre, Royal Surrey NHS Foundation Trust, Guildford, Surrey, UK
| | - Simon Butler-Manuel
- Academic Department of Gynaecological Oncology, Royal Surrey NHS Foundation Trust, Guildford, Surrey, UK
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6
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Bebia V, Luzarraga Aznar A, Cabrera S. Response to: Correspondence on 'Molecular profile is a strong predictor of the pattern of recurrence in patients with endometrial cancer' by Zhang and Sun. Int J Gynecol Cancer 2024:ijgc-2024-005544. [PMID: 38599781 DOI: 10.1136/ijgc-2024-005544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024] Open
Affiliation(s)
- Vicente Bebia
- Gynecologic Oncology Unit, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Catalunya, Spain
| | - Ana Luzarraga Aznar
- Gynecologic Oncology Unit, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Catalunya, Spain
| | - Silvia Cabrera
- Gynecologic Oncology Unit, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Catalunya, Spain
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Wess B, Kohler C, Plaikner A, El-Safadi S, Schwandner T, Meinhold-Heerlein I, Favero G. Comparative study using indocyanine green and patent blue dye for sentinel lymph node biopsy in patients with early-stage cervical cancer. Int J Gynecol Cancer 2024:ijgc-2023-005206. [PMID: 38485222 DOI: 10.1136/ijgc-2023-005206] [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] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Lymphatic involvement is the most important prognostic factor in early-stage cervical cancer. Sentinel lymph node biopsy is a viable alternative to systematic lymphadenectomy and may identify metastases more precisely. OBJECTIVE To compare two tracers (indocyanine green and patent blue) to detect sentinel nodes. METHODS A single-center, retrospective study of women treated due to early-stage cervical cancer (International Federation of Gynecology and Obstetrics 2009 IA1 with lymphovascular invasion, IA2, and IB1). Location and tracer of all detected sentinel nodes had been documented for a prospective, multicenter trial (SENTIX trial). All sentinel nodes were sent to frozen section and final analysis through ultrastaging using a standard protocol. RESULTS Overall, 103 patients were included. Bilateral detection rate for indocyanine green (93.2%) was significantly higher than for blue dye (77.7%; p=0.004). Their combined use significantly increased the bilateral detection to 99.0% (p=0.031). While 97.4% of all sentinel nodes were located below the common iliac vessels, no para-aortic nodes were labeled. Simultaneous bilateral detection with both tracers was found in 71.8% of the cases, of which the sentinel nodes were identical in 91.9%. Nine positive nodes were detected among seven patients (6.8%), all marked with indocyanine green while patent blue labeled six. Frozen section failed to detect one of three macrometastases and three of four micrometastases (sensitivity 43%; negative prediction value 96%). CONCLUSION Anatomical distribution and topographic localization of the sentinel nodes obtained with these tracers were not different. Indocyanine green provided a significantly higher bilateral detection rate and had superior sensitivity to detect positive nodes compared with patent blue. Combining indocyanine green and blue dye increased the bilateral detection rate significantly.
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Affiliation(s)
- Benedikt Wess
- University Hospitals Giessen and Marburg Campus Giessen, Giessen, Hessen, Germany
| | - Christhardt Kohler
- Department of Gynecology, University of Cologne, Koln, Germany
- Department of Special Operative and Oncologic Gynecology, Asklepios-Clinic Hamburg-Altona, Asklepios Hospital Group, Hamburg, Germany
| | - Andrea Plaikner
- Department of Special Operative and Oncologic Gynecology, Asklepios-Clinic Hamburg-Altona, Asklepios Hospital Group, Hamburg, Germany
| | | | | | | | - Giovanni Favero
- University Hospitals Giessen and Marburg Campus Giessen, Giessen, Hessen, Germany
- Asklepios Hospital Lich, Lich, Germany
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Cucinella G, Chiantera V. Laparoscopic para-aortic lymphadenectomy in cases of retro-aortic left renal vein. Int J Gynecol Cancer 2024; 34:648-649. [PMID: 37993173 DOI: 10.1136/ijgc-2023-004986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023] Open
Affiliation(s)
- Giuseppe Cucinella
- Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Palermo, 90133, Italy
| | - Vito Chiantera
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Sicilia, Italy
- Gynecology Oncology Unit, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania, Italy
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Bouvarel B, Colomban O, Frenel JS, Loaec C, Bourgin C, Berton D, Freyer G, You B, Classe JM. Clinical impact of CA-125 ELIMination rate constant K (KELIM) on surgical strategy in advanced serous ovarian cancer patients. Int J Gynecol Cancer 2024; 34:574-580. [PMID: 38242546 DOI: 10.1136/ijgc-2023-004872] [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] [Indexed: 01/21/2024] Open
Abstract
OBJECTIVES The modeled CA-125 elimination constant K (KELIM) is a pragmatic early marker of tumor chemosensitivity in ovarian cancer patients treated with neoadjuvant chemotherapy before interval surgery. The primary objective of this study was to assess the prognostic value of KELIM regarding the feasibility of complete surgery, and secondary objectives were to assess the prognostic value of KELIM for the risk of a platinum resistant relapse, progression free survival, and overall survival. METHODS The study was based on a retrospective cohort of 284 patients treated for an advanced serous high grade ovarian cancer, International Federation of Gynecology and Obstetrics (FIGO) stages III-IV, with neoadjuvant chemotherapy, followed by interval surgery, in a comprehensive cancer center. CA-125 concentrations at baseline and during neoadjuvant chemotherapy were collected. The KELIM predictive value regarding the tumor radiological response rate, likelihood of complete surgery, risk of subsequent platinum resistant relapse, progression free survival, and overall survival were assessed with univariate and multivariate tests. RESULTS In 232 patients, KELIM was an independent and major predictor of the probability of complete surgery and survival. The final logistic regression model, including KELIM (odds ratio (OR) 0.36, 95% confidence interval (CI)0.16 to 0.73, p=0.006) and complete surgery (no vs yes, OR 0.29, 95% CI 0.15 to 0.53, p<0.001), highlighted the complementary impact of chemosensitivity and surgical outcome relative to the complete surgery. In the multivariate analysis, KELIM and complete surgery were significantly associated with a lower risk of early relapse. In the case of an unfavorable KELIM, when surgical efforts allowed complete cytoreduction, median overall survival was similar to that reported in the case of a favorable KELIM (46.3 months (range 34.6-60.3) vs 46.5 months (range 40.6-68.7), respectively). CONCLUSION Primary tumor chemosensitivity, assessed by the modeled CA-125 KELIM, calculated during neoadjuvant chemotherapy, is a major parameter to consider for decision making regarding interval surgery. Complementary to the RECIST score and laparoscopy, this non-invasive tool, available online, helps tailor the interval surgery strategy according to patient tumor chemosensitivity.
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Affiliation(s)
- Barnabe Bouvarel
- Surgical Oncology, Institut de Cancerologie de l'Ouest, Saint Herblain, France
| | | | | | - Cécile Loaec
- Surgical Oncology, Institut de Cancerologie de l'Ouest, Saint Herblain, France
| | - Charlotte Bourgin
- Surgical Oncology, Institut de Cancerologie de l'Ouest, Saint Herblain, France
| | - Dominique Berton
- Medical Oncology, Institut de Cancerologie de l'Ouest, Saint Herblain, France
| | - Gilles Freyer
- Medical Oncology, Hospices Civils de Lyon, Lyon, France
| | - Benoit You
- Medical Oncology, Hospices Civils de Lyon, Lyon, France
| | - Jean-Marc Classe
- Surgical Oncology, Institut de Cancerologie de l'Ouest, Saint Herblain, France
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10
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Padilla-Iserte P, Montesinos-Albert M, Arnaez M, Lago V, Frasson M, Matute L, Domingo S. Laparoscopic sigmoidectomy with ghost ileostomy in ovarian cancer recurrence. Int J Gynecol Cancer 2024; 34:641-642. [PMID: 37973362 DOI: 10.1136/ijgc-2023-004853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Affiliation(s)
- Pablo Padilla-Iserte
- Department of Gynecologic Oncology, La Fe University and Polytechnic Hospital, Valencia, Spain
| | | | - Marta Arnaez
- Department of Gynecologic Oncology, University Hospital La Fe, Valencia, Spain
| | - Victor Lago
- Department of Gynecologic Oncology, Hospital Universitari i Politècnic La Fe, Valencia, Spain, Valencia, Spain
| | | | - Luis Matute
- Hospital Universitari i Politècnic La Fe, Valencia, Valenciana, Spain
| | - Santiago Domingo
- Department of Gynecology, Hospital Universitari i Politecnic La Fe, Valencia, Spain
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11
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Mokarram Dorri N, Blache G, Garnier J, Houvenaeghel G, El Hajj H, Lambaudie E. Rectal sparing in modified posterior exenteration: description of the technique in 10 steps. Int J Gynecol Cancer 2024:ijgc-2023-004994. [PMID: 38514099 DOI: 10.1136/ijgc-2023-004994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024] Open
Affiliation(s)
| | - Guillaume Blache
- Surgical Oncology Department, Paoli-Calmettes Institute, Marseille, France
| | - Jonathan Garnier
- Surgical Oncology Department, Paoli-Calmettes Institute, Marseille, France
| | - Gilles Houvenaeghel
- Surgical Oncology Department, Paoli-Calmettes Institute, Marseille, France
- Université Aix Marseille, Inserm, CNRS, Institut Paoli Calmettes, Marseille, France
| | - Houssein El Hajj
- Surgical Oncology Department, Paoli-Calmettes Institute, Marseille, France
| | - Eric Lambaudie
- Surgical Oncology Department, Paoli-Calmettes Institute, Marseille, France
- Université Aix Marseille, Inserm, CNRS, Institut Paoli Calmettes, Marseille, France
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Leitao MM, Iasonos A, Tomberlin M, Moukarzel LA, Price H, Bennetti G, Ramesh B, Chi DS, Long Roche K, Sonoda Y, Al-Niami A, Mueller JJ, Gardner GJ, Broach V, Jewell EL, Kim S, Feinberg J, Abu-Rustum NR, Zivanovic O. ARIA II: a randomized controlled trial of near-infrared Angiography during RectosIgmoid resection and Anastomosis in women with ovarian cancer. Int J Gynecol Cancer 2024:ijgc-2024-005395. [PMID: 38514101 DOI: 10.1136/ijgc-2024-005395] [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] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Ovarian cancer with extensive metastatic disease involving pelvic structures often requires rectosigmoid resection for complete gross resection; however, it is associated with increased surgical morbidity. There are limited data, and none in ovarian cancer, on near-infrared assessment of perfusion in rectosigmoid resections with anastomosis. PRIMARY OBJECTIVE To compare the rate of pelvic complications (pelvic abscesses, anastomotic leaks, and infections) within 30 days of surgery with and without near-infrared assessment of perfusion at time of rectosigmoid resection and re-anastomosis in patients undergoing cytoreductive surgery for ovarian cancer. STUDY HYPOTHESIS We hypothesize the use of near-infrared technology (intravenous indocyanine green and endoscopic near-infrared fluorescence imaging), compared with standard intra-operative assessment, to evaluate anastomotic perfusion at time of rectosigmoid resection and re-anastomosis will result in lower rates of post-operative pelvic complications. TRIAL DESIGN This is a planned multicenter randomized controlled trial. Patients who undergo rectosigmoid resection as part of their ovarian cytoreductive surgery will be randomized 1:1 to standard assessment of anastomosis with the surgeon's usual technique (control arm) or assessment with near-infrared angiography using indocyanine green and endoscopic fluorescence imaging (experimental arm). Randomization will occur after rectosigmoid resection has been completed and the surgeon declares their plan to create a diverting ostomy. Randomization will be stratified by plan for diverting ostomy. MAJOR INCLUSION/EXCLUSION CRITERIA Main inclusion criteria include patients with primary or recurrent ovarian, fallopian tube, or primary peritoneal cancer who are scheduled for cytoreductive surgery with suspected need for low-anterior rectosigmoid resection. PRIMARY ENDPOINT Rate of 30-day post-operative pelvic complications. SAMPLE SIZE 310 (155 per arm) ESTIMATED DATES FOR COMPLETING ACCRUAL AND PRESENTING RESULTS: Q2 2027 and Q4 2027, respectively. TRIAL REGISTRATION NCT04878094.
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Affiliation(s)
- Mario M Leitao
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of OB/GYN, Weill Cornell Medical College of Cornell University, New York, New York, USA
| | - Alexia Iasonos
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Morgan Tomberlin
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Lea A Moukarzel
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Hannah Price
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Gabrielle Bennetti
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Bhavani Ramesh
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Dennis S Chi
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of OB/GYN, Weill Cornell Medical College of Cornell University, New York, New York, USA
| | - Kara Long Roche
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of OB/GYN, Weill Cornell Medical College of Cornell University, New York, New York, USA
| | - Yukio Sonoda
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of OB/GYN, Weill Cornell Medical College of Cornell University, New York, New York, USA
| | - Ahmed Al-Niami
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of OB/GYN, Weill Cornell Medical College of Cornell University, New York, New York, USA
| | - Jennifer J Mueller
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of OB/GYN, Weill Cornell Medical College of Cornell University, New York, New York, USA
| | - Ginger J Gardner
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of OB/GYN, Weill Cornell Medical College of Cornell University, New York, New York, USA
| | - Vance Broach
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of OB/GYN, Weill Cornell Medical College of Cornell University, New York, New York, USA
| | - Elizabeth L Jewell
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of OB/GYN, Weill Cornell Medical College of Cornell University, New York, New York, USA
| | - Sarah Kim
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of OB/GYN, Weill Cornell Medical College of Cornell University, New York, New York, USA
| | - Jacqueline Feinberg
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of OB/GYN, Weill Cornell Medical College of Cornell University, New York, New York, USA
| | - Nadeem R Abu-Rustum
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of OB/GYN, Weill Cornell Medical College of Cornell University, New York, New York, USA
| | - Oliver Zivanovic
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of OB/GYN, Weill Cornell Medical College of Cornell University, New York, New York, USA
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13
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Verit FF, Bese T. Correspondence on 'The Cukurova score in the prediction of primary cytoreduction in ovarian cancer' by Khatib et al. Int J Gynecol Cancer 2024:ijgc-2024-005276. [PMID: 38453179 DOI: 10.1136/ijgc-2024-005276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024] Open
Affiliation(s)
- Fatma Ferda Verit
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Tugan Bese
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
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14
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Kahn RM, Chang SJ, Chi DS. Extra-abdominal cytoreductive techniques in ovarian cancer: how far can (should) we go? Int J Gynecol Cancer 2024; 34:379-385. [PMID: 38438179 DOI: 10.1136/ijgc-2023-004630] [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] [Indexed: 03/06/2024] Open
Abstract
Complex surgery is an essential component in the management of advanced ovarian cancer. Furthermore, achieving complete gross resection in cytoreductive surgery appears to be associated with significant survival benefits in patients with advanced ovarian cancer. The goal of this review is to demonstrate the advancement of surgical techniques in gynecologic oncology surgery, including resection of disease within the intrathoracic and inguinal regions. This progress has expanded the option of surgery to more patients, especially those who would have previously been deemed inoperable. In this review we describe the most notable studies and reports of surgical resection of ovarian cancer involving cardiophrenic/supradiaphragmatic lymph nodes, mediastinum, lung pleura or parenchyma, and the inguinal region. We also describe the growing role that video-assisted thoracic surgery has played in advanced ovarian cancer diagnosis and management. The studies, series, and reports described demonstrate that comprehensive surgical procedures outside of the abdomen or pelvis can be both safe and feasible in properly selected patients. They also suggest that resection of disease outside of the abdomen or pelvis may benefit appropriately selected patients. Future studies are necessary to identify which patients may benefit most from upfront surgery versus neoadjuvant chemotherapy when ovarian cancer metastasis is present in the thoracic or inguinal regions.
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Affiliation(s)
- Ryan M Kahn
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Suk-Joon Chang
- Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Korea (the Republic of)
| | - Dennis S Chi
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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15
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Ng JS, Ilancheran A. The role of surgery in gestational trophoblastic disease: an overview. Int J Gynecol Cancer 2024; 34:409-415. [PMID: 38438170 DOI: 10.1136/ijgc-2023-004584] [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] [Indexed: 03/06/2024] Open
Abstract
Gestational trophoblastic disease comprises a group of rare, and potentially malignant, conditions that arise from abnormal trophoblastic proliferation. When there is invasion and evidence of metastatic disease, gestational trophoblastic neoplasia is used. While chemotherapy is the mainstay of treatment for gestational trophoblastic neoplasia, the role of surgery has come full circle in recent years. Before the introduction of highly effective systemic treatment options, surgery was the default treatment. Surgery for gestational trophoblastic neoplasia often yielded unsatisfactory results and mortality remained high. In recent years, the role of adjuvant surgery in the management of gestational trophoblastic neoplasia has been examined with great interest. We aim to provide an overview of the various surgical approaches employed in managing gestational trophoblastic neoplasia, including their indications, techniques, and outcomes. Additionally, we discuss whether there is a role to do less in surgery for gestational trophoblastic neoplasia and describe our experience with a modified surgical technique for its treatment. By summarizing the current evidence, this article highlights the significant contributions of surgery to the holistic management of patients with gestational trophoblastic neoplasia and provides a framework on which to base management and treatment programs.
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Affiliation(s)
- Joseph S Ng
- Department of Obstetrics and Gynecology, National University of Singapore, Singapore
- Gynecologic Cancer Program, National University Cancer Institute, Singapore
| | - Arunachalam Ilancheran
- Department of Obstetrics and Gynecology, National University of Singapore, Singapore
- Gynecologic Cancer Program, National University Cancer Institute, Singapore
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16
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Chacon E, Chiva L. The art of bowel surgery in gynecologic cancer. Int J Gynecol Cancer 2024; 34:421-425. [PMID: 38438172 DOI: 10.1136/ijgc-2023-004595] [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] [Indexed: 03/06/2024] Open
Abstract
The field of gynecologic oncology has witnessed a profound transformation in the practice of bowel resection over the years. This evolution, driven by innovative techniques and expanded surgical skills, has redefined the role of the surgeon. This review article delves into the historical journey of bowel surgery, its contemporary importance in cytoreductive procedures for gynecologic cancers, and the general principles of digestive surgery. From pioneering surgeons such as Lane, Broca, and Billroth to the introduction of mechanical staplers, this narrative unfolds the remarkable advances in the field. It highlights the critical need for meticulous training, anatomic mastery, aseptic measures, vascular support, tension-free anastomoses, and precise surgical techniques. These principles underpin the success of bowel resection and anastomosis in the complex landscape of gynecologic oncology.
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Affiliation(s)
- Enrique Chacon
- Gynecology and Obstetrics, Clinica Universidad de Navarra, Pamplona, Spain
| | - Luis Chiva
- Gynecology and Obstetrics, Clinica Universidad de Navarra, Madrid, Spain
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17
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Manning-Geist B, Obermair A, Broach VA, Leitao MM, Zivanovic O, Abu-Rustum NR. Update on near infrared imaging technology: indocyanine green and near infrared technology in the treatment of gynecologic cancers. Int J Gynecol Cancer 2024; 34:416-420. [PMID: 38438171 PMCID: PMC10962647 DOI: 10.1136/ijgc-2023-004583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024] Open
Affiliation(s)
- Beryl Manning-Geist
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Andreas Obermair
- University of Queensland Queensland Centre for Gynaecological Cancer Research, Herston, Queensland, Australia
| | - Vance A Broach
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Mario M Leitao
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Oliver Zivanovic
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Nadeem R Abu-Rustum
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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18
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Kapikiran G, Bulbuloglu S. The effect of perceived social support on psychological resilience and surgical fear in surgical oncology patients. PSYCHOL HEALTH MED 2024; 29:473-483. [PMID: 36550681 DOI: 10.1080/13548506.2022.2159458] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
In our study, we examined the effect of perceived social support on psychological resilience and surgical fear in surgical oncology patients. This study was performed with 139 patients planning to have surgery at the oncology unit of a research and practice hospital in Turkey. The Personal Information Form, the Multi-Dimensional Perceived Social Support Scale, the Brief Resilience Scale, and the Surgical Fear Questionnaire were used in the data collection process. Of all surgical oncology patients participating in our study, 51.8% were aged 45-64 years, 60.4% were male, 41.7% were diagnosed with a malignancy in the last 4-7 months, 66.9% had comorbidities alongside the malignancy, and 21.6% had colorectal tumors whilst 20.1% had malignant tumors in the liver. Surgical oncology patients' psychological resilience had statistically significant relationships with their surgical fear and perceived social support (p = 0.000). It was determined that the independent variable of perceived social support explained 59% of the total variance (R2 = 0.593, p = 0.000) in the resilience dependent variable and 35% of the variance in the surgical fear dependent variable (R2 = 0.353, p = 0.000). The increase in perceived social support of surgical oncology patients increases their psychological resilience. The increasing psychological resilience of the patients and the increase in perceived social support also reduce their fear of surgery. In this context, it is recommended that patients who will undergo oncological surgery should increase their social support in the early period and take initiatives to increase their psychological resilience.
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Affiliation(s)
- G Kapikiran
- Department of Emergency Aid and Disaster Management, Faculty of Health Sciences, Malatya Turgut Ozal University, Malatya, Turkey
| | - S Bulbuloglu
- Surgical Nursing Division, Nursing Department, Faculty of Health Sciences, Istanbul Aydin University, Istanbul, Turkey
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Luzarraga Aznar A, Bebia V, López-Gil C, Villafranca-Magdalena B, Salazar-Huayna L, Castellvi J, Colàs E, Gil-Moreno A, Cabrera S. Molecular profile is a strong predictor of the pattern of recurrence in patients with endometrial cancer. Int J Gynecol Cancer 2024:ijgc-2023-005165. [PMID: 38378696 DOI: 10.1136/ijgc-2023-005165] [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] [Indexed: 02/22/2024] Open
Abstract
OBJECTIVES To investigate the pattern of first recurrence of disease in patients with endometrial cancer according to molecular classification, and to assess the independent role of molecular profiling in each type of failure. METHODS Retrospective single-center study including patients diagnosed with endometrial cancer stage I-IVB (International Federation of Gynecology and Obstetrics 2009) between December 1994 and May 2022, who underwent primary surgical treatment and had a complete molecular profile. First recurrence was classified as isolated or multiple, and as vaginal, pelvic, peritoneal, nodal, and distant according to its location. The log-rank test and univariate and multivariate adjusted Cox regression models were used for comparison between groups. RESULTS A total of 658 patients were included. Recurrence was observed in 122 patients (18.5%) with a recurrence rate of 12.4% among mismatch-repair deficient tumors, 14.5% among non-specific molecular profile, 2.1% among POLE-mutated, and 53.7% among p53-abnormal tumors. Recurrences were found to be isolated in 80 (65.6%) and multiple in 42 (34.4%) patients, with no differences in molecular subtype (p=0.92). Patients with p53-abnormal tumors had a recurrence mainly as distant (28.4%) and peritoneal (21.1%) disease, while patients with non-specific molecular profile tumors presented predominantly with distant failures (10.3%), and mismatch-repair deficient tumors with locoregional recurrences (9.4%).On multivariate analysis, p53-abnormal molecular profile was the only independent risk factor for peritoneal failure (OR=8.54, 95% CI 2.0 to 36.3). Vaginal recurrence was independently associated with p53-abnormal molecular profile (OR=6.51, 95% CI 1.1 to 37.4) and lymphovascular space invasion. p53-abnormal and non-specific molecular profiles were independent predictors for distant recurrence (OR=3.13, 95% CI 1.1 to 8.7 and OR=2.35, 95% CI 1.1 to 5.0, respectively), along with lymphovascular space invasion and high-grade tumors. Molecular profile was not independently associated with pelvic and nodal recurrences. CONCLUSIONS Endometrial cancer featured different patterns of recurrence depending on the molecular profile. p53-abnormal molecular profiling was the only independent risk factor for peritoneal relapse, while non-specific molecular profile showed a strong association with distant failures.
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Affiliation(s)
- Ana Luzarraga Aznar
- Department of Gynecologic Oncology, Universitat Autònoma de Barcelona (UAB), Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain
| | - Vicente Bebia
- Department of Gynecologic Oncology, Universitat Autònoma de Barcelona (UAB), Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain
| | - Carlos López-Gil
- Group of Biomedical Research in Gynecology, Vall Hebron Institute of Research Hospital, Vall d'Hebron Barcelona Hospital Campus. Universitat Autònoma de Barcelona (UAB). CIBERONC, Barcelona, Catalunya, Spain
| | - Beatriz Villafranca-Magdalena
- Group of Biomedical Research in Gynecology, Vall Hebron Institute of Research Hospital, Vall d'Hebron Barcelona Hospital Campus. Universitat Autònoma de Barcelona (UAB). CIBERONC, Barcelona, Catalunya, Spain
| | | | - Josep Castellvi
- Department of Pathology, Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain
| | - Eva Colàs
- Group of Biomedical Research in Gynecology, Vall Hebron Institute of Research Hospital, Vall d'Hebron Barcelona Hospital Campus. Universitat Autònoma de Barcelona (UAB). CIBERONC, Barcelona, Catalunya, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Antonio Gil-Moreno
- Department of Gynecologic Oncology, Universitat Autònoma de Barcelona (UAB), Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain
- Group of Biomedical Research in Gynecology, Vall Hebron Institute of Research Hospital, Vall d'Hebron Barcelona Hospital Campus. Universitat Autònoma de Barcelona (UAB). CIBERONC, Barcelona, Catalunya, Spain
- Department of Gynecology, Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain
| | - Silvia Cabrera
- Department of Gynecologic Oncology, Universitat Autònoma de Barcelona (UAB), Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
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20
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Dinoi G, Tarantino V, Bizzarri N, Perrone E, Capasso I, Giannarelli D, Querleu D, Giuliano MC, Fagotti A, Scambia G, Fanfani F. Robotic-assisted versus conventional laparoscopic surgery in the management of obese patients with early endometrial cancer in the sentinel lymph node era: a randomized controlled study (RObese). Int J Gynecol Cancer 2024:ijgc-2023-005197. [PMID: 38326228 DOI: 10.1136/ijgc-2023-005197] [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] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Nearly 65% of patients with endometrial cancer who undergo primary hysterectomy have concurrent obesity. Retrospective data show advantages in using robotic surgery in these patients compared with conventional laparoscopy, namely lower conversion rate, increased rate of same-day discharge, and reduced blood loss. Nevertheless, to date no prospective randomized controlled trials have compared laparoscopic surgery versus robotic-assisted surgery in morbidly obese patients. PRIMARY OBJECTIVE The robotic-assisted versus conventional laparoscopic surgery in the management of obese patients with early endometrial cancer in the sentinel lymph node era: a randomized controlled study (RObese) trial aims to find the most appropriate minimally invasive surgical approach in morbidly obese patients with endometrial carcinoma. STUDY HYPOTHESIS Robotic surgery will reduce conversions to laparotomy in endometrial cancer patients with obesity compared with those who undergo surgery with conventional laparoscopy. TRIAL DESIGN This phase III multi-institutional study will randomize consecutive obese women with apparent early-stage endometrial cancer to either laparoscopic or robot-assisted surgery. MAJOR INCLUSION/EXCLUSION RITERIA The RObese trial will include obese (BMI≥30 kg/m2) patients aged over 18 years with apparent 2009 Federation of Gynecology and Obstetrics (FIGO) stage IA-IB endometriod endometrial cancer. PRIMARY ENDPOINT Conversion rate to laparotomy between laparoscopic surgery versus robot-assisted surgery. SAMPLE SIZE RObese is a superiority trial. The clinical superiority margin for this study is defined as a difference in conversion rate of -6%. Assuming a significance level of 0.05 and a power of 80%, the study plans to randomize 566 patients. ESTIMATED DATES FOR COMPLETING ACCRUAL AND PRESENTING RESULTS Patient recruitment will be completed by 2026, and follow-up will be completed by 2029 with presentation of data shortly thereafter. Two interim analyses are planned: one after the first 188 and the second after 376 randomized patients. TRIAL REGISTRATION NCT05974995.
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Affiliation(s)
- Giorgia Dinoi
- UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
| | - Vincenzo Tarantino
- UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
| | - Nicolò Bizzarri
- UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
| | - Emanuele Perrone
- UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
| | - Ilaria Capasso
- UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
| | - Diana Giannarelli
- Facility of Epidemiology and Biostatistics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Denis Querleu
- UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
| | - Maria Consiglia Giuliano
- UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
| | - Anna Fagotti
- UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Scambia
- UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Fanfani
- UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
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21
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Al Laham O, Sharaf Aldeen R, Ibrahim Basha Z, Ali A, Alhanwt A. Dual unifocal primary Epithelioid Angiosarcoma: A case report and review of the literature unveiling a rare genre of neoplasia. Int J Surg Case Rep 2024; 115:109310. [PMID: 38281378 PMCID: PMC10839256 DOI: 10.1016/j.ijscr.2024.109310] [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: 12/27/2023] [Revised: 01/24/2024] [Accepted: 01/24/2024] [Indexed: 01/30/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Angiosarcomas are an exceedingly rare and malignant form of soft tissue sarcoma that are derived from endothelial cells. Overall, they comprise <1 % of the total number of soft tissue sarcomas. Due to nonspecific and misleading symptoms, the subsequent clinical presentations can easily result in misdiagnosis. This leads to life-threatening complications for patients. Contemplating this tumor as a differential diagnosis during the preoperative phase allows for essential time-sensitive therapeutic interventions to be accomplished. CASE PRESENTATION Herein, we present the seldom precedented case of a 66-year-old Middle Eastern male who came to our surgical clinic chiefly complaining of an exacerbation of chronic left hypochondriac pain accompanied by gradual inexplicable abdominal distention. Our diagnostic radiological evaluation demonstrated two isolated abdominal mass formations. CLINICAL DISCUSSION Sheer excision of the neoplastic masses with safety margins was successfully executed via open surgery. The stemming histopathological examination through Hematoxylin and Eosin and immunohistochemical staining established the definitive diagnosis of an Epithelioid Angiosarcoma. CONCLUSION Epithelioid Angiosarcomas belong to the category of profoundly rare tumors. The available published literature conveys this rarity through the scarcity of epidemiological parameters and studies. It necessitates being borne in mind when facing similar clinical scenarios so that apt therapeutic interventions can be achieved. Structured diagnostic methods, timely surgical interventions and proper techniques, and comprehensive follow-up patient surveillance protocols are, therefore, merited. After thorough review of the published literature, we reckon herewith that ours is the first documented case from our country of an Epithelioid Angiosarcoma.
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Affiliation(s)
- Omar Al Laham
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic..
| | - Rahaf Sharaf Aldeen
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic.; Department of Surgery, Al-Mouwasat University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic.; Department of Surgery, Al Assad University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic..
| | - Zein Ibrahim Basha
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic.; Department of Pathology, Al Assad University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic..
| | - Amad Ali
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic.; Department of Surgery, Al-Mouwasat University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic.; Department of Surgery, Al Assad University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic..
| | - Alaa Alhanwt
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic.; Department of Surgery, Al Assad University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic..
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22
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Chen T, Xu J, Xia B, Wang H, Shen Y. Secondary cytoreduction surgery for recurrent epithelial ovarian cancer patients after PARPi maintenance: A multicenter, randomized, controlled clinical trial. Int J Gynecol Cancer 2023:ijgc-2023-004978. [PMID: 38159938 DOI: 10.1136/ijgc-2023-004978] [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] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Poly ADP-ribose polymerase inhibitors (PARPi) treatment has radically changed the treatment strategy for epithelial ovarian cancer. Cancer progression with PARPi maintenance is a new problem that has arisen in clinical practice, and the value of secondary cytoreduction surgery remains unknown. PRIMARY OBJECTIVE To evaluate the benefits of secondary cytoreductive surgery and to clarify the sensitivity to platinum in patients with firstline or secondline recurrent epithelial ovarian cancer who have completed ≥6 months of PARPi maintenance. STUDY HYPOTHESIS Carefully selected patients who progress on PARPi maintenance will benefit from secondary cytoreductive surgery. TRIAL DESIGN This is a multicenter phase III trial. Eligible patients will be randomly assigned at a ratio of 1:1 to either the experimental or standard arm. Patients in the experimental arm will receive secondary cytoreductive surgery followed by platinum based chemotherapy, while patients in the standard arm will be provided with chemotherapy alone. MAJOR INCLUSION/EXCLUSION CRITERIA Patients diagnosed with firstline or secondline recurrent epithelial ovarian cancer who had previously received ≥4 cycles of platinum based chemotherapy in initial treatment followed by PARPi maintenance therapy for ≥6 months prior to recurrence. PRIMARY ENDPOINT Progression free survival. SAMPLE SIZE 400 patients. ESTIMATED DATES FOR COMPETING ACCRUAL AND PRESENTING RESULTS Accrual completion is expected in December 2024 with results mature after 2 years of follow-up in 2026. TRIAL REGISTRATION ClinicalTrials.gov NCT05607329.
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Affiliation(s)
- Tingting Chen
- Department of Gynecologic Oncology, Women's Hospital,Zhejiang University School of Medicine, Hangzhou, China
| | - Junfen Xu
- Department of Gynecologic Oncology, Women's Hosptial, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Bairong Xia
- Department of Gynecology, University of Science and Technology of China, Hefei, Anhui, China
| | - Hui Wang
- Department of Gynecologic Oncology, Women's Hosptial, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yuanming Shen
- Department of Gynecologic Oncology, Women's Hospital,Zhejiang University School of Medicine, Hangzhou, China
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23
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Ouasti S, Ilic J, Mimoun C, Bendifallah S, Huchon C, Ouldamer L, Lorenzini J, Lavoué V, Raimond E, Dion L, Costaz H, Dupre PF, Graesslin O, Uzan J, Kerbage Y, Chauvet P, Canlorbe G, Touboul C, Dabi Y. Adherence to ESGO guidelines and impact on survival in obese patients with endometrial cancer: a multicentric retrospective study. Int J Gynecol Cancer 2023; 33:1950-1956. [PMID: 37788899 DOI: 10.1136/ijgc-2023-004642] [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] [Indexed: 10/05/2023] Open
Abstract
OBJECTIVES Obesity is known to be both a major risk factor for endometrial cancer and associated with surgical complexity. Therefore, the management of patients with obesity is a challenge for surgeons and oncologists. The aim of this study is to assess the adherence to European Society of Gynaecological Oncology (ESGO) guidelines in morbidly obese patients (body mass index (BMI) >40 kg/m2). The secondary objectives were the impact on overall survival and recurrence-free survival. METHODS All the patients who were treated for an endometrial cancer in the 11 cancer institutes of the FRANCOGYN group were included and classified into three weight groups: morbid (BMI >40 kg/m2), obese (BMI 30-40), and normal or overweight (BMI <30). Adherence to guidelines was evaluated for surgical management, lymph node staging, and adjuvant therapies. RESULTS In total, 2375 patients were included: 1330 in the normal or overweight group, 763 in the obese group, and 282 in the morbid group. The surgical management of the morbid group was in accordance with the guidelines in only 30% of cases, compared with 44% for the obese group and 48% for the normal or overweight group (p<0.001); this was largely because of a lack of lymph node staging. Morbid group patients were more likely to receive the recommended adjuvant therapy (61%) than the obese group (52%) or the normal or overweight group (46%) (p<0.001). Weight had no impact on overall survival (p=0.6) and morbid group patients had better recurrence-free survival (p=0.04). CONCLUSION Adherence to international guidelines for surgical management is significantly lower in morbid group patients, especially for lymph node staging. However, morbidly obese patients had more often the adequate adjuvant therapies. Morbid group patients had a better recurrence-free survival likely because of better prognosis tumors.
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Affiliation(s)
- Samia Ouasti
- Department of Obstetrics Gynaecology and Reproductive Medicine, Sorbonne University - Tenon Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France
| | - Johanna Ilic
- Department of Obstetrics Gynaecology and Reproductive Medicine, Sorbonne University - Tenon Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France
| | - Camille Mimoun
- Department of Gynaecology, Hospital Group Saint-Louis Lariboisiere and Fernand-Widal, Paris, France
| | - Sofiane Bendifallah
- Department of Obstetrics Gynaecology and Reproductive Medicine, Sorbonne University - Tenon Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France
| | - Cyrille Huchon
- Department of Gynaecology, Hospital Group Saint-Louis Lariboisiere and Fernand-Widal, Paris, France
| | - Lobna Ouldamer
- Department of Gynaecology, Hôpital Bretonneau, Tours, France
| | | | - Vincent Lavoué
- Department og Gynecology and Obstetrics, Rennes 1 University, Rennes, France
| | - Emilie Raimond
- Department of Gyneacology and Obstetrics, Reims Champagne-Ardenne University, Reims, France
| | - Ludivine Dion
- Department of Gynecology and Obstetrics, Rennes 1 University, Rennes, France
| | - Hélène Costaz
- Departement of Oncology Surgery, Georges-François Leclerc Centre, Dijon, France
| | | | - Olivier Graesslin
- Department of Obstetrics and Gynecology, Université de Reims Champagne-Ardenne, Reims, France
| | - Jennifer Uzan
- Department of Gynaecology and Obstetrics, Centre Hospitalier Intercommunal de Créteil (CHI Créteil), Créteil, France
| | | | - Pauline Chauvet
- Department of Gynaecology, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Geoffroy Canlorbe
- Department of Gynecological and Breast Surgery and Oncology, Hopitaux Universitaires Pitie Salpetriere-Charles Foix, Paris, France
| | - Cyril Touboul
- Department of Obstetrics Gynaecology and Reproductive Medicine, Sorbonne University - Tenon Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France
| | - Yohann Dabi
- Department of Obstetrics Gynaecology and Reproductive Medicine, Sorbonne University - Tenon Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France
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Neveu J, Tremblay E, Mercier F, Garneau S, Cormier B. Developing a hyperthermic intraperitoneal chemotherapy (HIPEC) gynecologic oncology program: a Canadian experience. Int J Gynecol Cancer 2023; 33:1957-1965. [PMID: 38011988 PMCID: PMC10803971 DOI: 10.1136/ijgc-2023-004788] [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: 08/17/2023] [Accepted: 10/26/2023] [Indexed: 11/29/2023] Open
Abstract
Hyperthermic intraperitoneal chemotherapy (HIPEC) is a treatment option for epithelial ovarian cancer following cytoreductive surgery. The intraperitoneal spread of the disease makes the peritoneal cavity an ideal target for drug delivery. HIPEC has shown promising results in improving overall survival in epithelial ovarian cancer patients when performed during interval cytoreductive surgery. Recent studies have provided level 1 evidence supporting increased overall survival in stage III ovarian cancer patients treated with HIPEC during interval cytoreduction. Meta-analyses have further confirmed the survival improvement in women receiving HIPEC. Despite its inclusion in guidelines, many centers have been hesitant to implement HIPEC programs due to perceived obstacles, such as increased morbidity, cost, and resource requirements. Studies have shown that morbidity rates are acceptable in selected patients, and the addition of HIPEC to cytoreductive surgery is cost effective. Therefore, the main barrier to implementing HIPEC programs is related to resource requirements and logistics, but with proper preparation, these challenges can be overcome. Establishing a successful HIPEC program requires institutional support, a knowledgeable and dedicated team, adequate resources and equipment, and proper training and audit. This review aims to provide evidence based information to guide the development of successful HIPEC programs, including preoperative, anesthetic, and surgical considerations. It also reviews the different equipment and protocols for the perfusion and common postoperative events.
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Affiliation(s)
- Joannie Neveu
- Department of Obstetrics and Gynecology, Memorial University of Newfoundland, St John's, Newfoundland and Labrador, Canada
- H Bliss Murphy Cancer Center, Health Sciences Center General Hospital, St John's, Newfoundland and Labrador, Canada
| | - Elizabeth Tremblay
- Département d'obstétrique et gynécologie, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada
- Département d'obstétrique et gynécologie, Université de Montréal, Montréal, Québec, Canada
| | - Frederic Mercier
- Département d'obstétrique et gynécologie, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada
- Département de chirurgie, Université de Montréal, Montréal, Québec, Canada
| | - Sébastien Garneau
- Département d'obstétrique et gynécologie, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada
- Département d'anesthésie, Université de Montréal, Montréal, Québec, Canada
| | - Beatrice Cormier
- Département d'obstétrique et gynécologie, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada
- Département d'obstétrique et gynécologie, Université de Montréal, Montréal, Québec, Canada
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25
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Leitao M. Uterine transposition: a simple yet revolutionary means of fertility preservation for women with cancer. Int J Gynecol Cancer 2023; 33:1843-1844. [PMID: 37989481 DOI: 10.1136/ijgc-2023-005122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023] Open
Affiliation(s)
- Mario Leitao
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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Plaikner A, Siegler K, Köhler C. Surgical steps of laparoscopic-assisted simple vaginal trachelectomy. Int J Gynecol Cancer 2023; 33:1972-1973. [PMID: 37491109 DOI: 10.1136/ijgc-2023-004643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023] Open
Affiliation(s)
- Andrea Plaikner
- Department of Special Operative and Oncologic Gynecology, Asklepios Clinic Altona, Hamburg, Germany
| | - Kathrin Siegler
- Department of Special Operative and Oncologic Gynecology, Asklepios Clinic Altona, Hamburg, Germany
| | - Christhardt Köhler
- Department of Special Operative and Oncologic Gynecology, Asklepios Clinic Altona, Hamburg, Germany
- Department of Gynecology, German Red Cross Clinic Berlin Westend, Berlin, Germany
- Institute for Dysplasia and Cytology, MVZ Fürstenbergkarree Berlin, Berlin, Germany
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27
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Pavone M, Spiridon IA, Lecointre L, Seeliger B, Scambia G, Venkatasamy A, Querleu D. Full-field optical coherence tomography imaging for intraoperative microscopic extemporaneous lymph node assessment. Int J Gynecol Cancer 2023; 33:1985-1987. [PMID: 37945058 DOI: 10.1136/ijgc-2023-005050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023] Open
Affiliation(s)
- Matteo Pavone
- Institut Hospitalo-Universitaire (IHU) Strasbourg, Institute of Image-Guided Surgery, Strasbourg, France
- Dipartimento di Scienze per la salute della Donna e del Bambino e di Sanità Pubblica, UOC Ginecologia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Irene A Spiridon
- Institut Hospitalo-Universitaire (IHU) Strasbourg, Institute of Image-Guided Surgery, Strasbourg, France
- Department of Morpho-Functional Sciences I-Pathology, Grigore T Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Lise Lecointre
- Institut Hospitalo-Universitaire (IHU) Strasbourg, Institute of Image-Guided Surgery, Strasbourg, France
- Department of Gynecologic Surgery, Hôpitaux universitaires de Strasbourg, Strasbourg, France
| | - Barbara Seeliger
- Institut Hospitalo-Universitaire (IHU) Strasbourg, Institute of Image-Guided Surgery, Strasbourg, France
- Department of Digestive and Endocrine Surgery, University Hospitals of Strasbourg, Strasbourg, France
| | - Giovanni Scambia
- Dipartimento di Scienze per la salute della Donna e del Bambino e di Sanità Pubblica, UOC Ginecologia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Aïna Venkatasamy
- Institut Hospitalo-Universitaire (IHU) Strasbourg, Institute of Image-Guided Surgery, Strasbourg, France
| | - Denis Querleu
- Institut Hospitalo-Universitaire (IHU) Strasbourg, Institute of Image-Guided Surgery, Strasbourg, France
- Dipartimento di Scienze per la salute della Donna e del Bambino e di Sanità Pubblica, UOC Ginecologia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
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Ferragina F, Sottile AR, Cristofaro MG. Unusual presentation of pulmonary adenocarcinoma metastases in the mandibular condyle: A case report. Int J Surg Case Rep 2023; 113:109058. [PMID: 37992667 DOI: 10.1016/j.ijscr.2023.109058] [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: 10/02/2023] [Revised: 11/08/2023] [Accepted: 11/11/2023] [Indexed: 11/24/2023] Open
Abstract
INTRODUCTION Mandibular bone metastases should be suspected in all patients with temporomandibular joint disorder symptoms and lung cancer history. The purpose of this report is to present a case of metastasis to the mandibular condyle following pulmonary adenocarcinoma. CASE PRESENTATION In December 2020, a 71-year-old patient was evaluated by the Department of Maxillofacial Surgery for the presence of a large osteolytic lesion in the left mandibular condyle. There were no changes to the face or occlusion, and mandibular movements were preserved. After surgical removal, histology revealed pulmonary adenocarcinoma metastasis. DISCUSSION To date, only 7 cases of condylar metastases are described by lung cancer. This pathology's clinical and radiological features are almost always shaded and not specific. CONCLUSION This study also focuses on rare conditions, such as metastases to the mandibular condyle. It also stresses the importance of a multidisciplinary approach both in the diagnostic and therapeutic process.
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Affiliation(s)
- Francesco Ferragina
- Department of Experimental and Clinical Medicine, Unit of Maxillofacial Surgery, "Magna Graecia" University, Viale Europa, 88100 Catanzaro, Italy.
| | - Angelo Ruggero Sottile
- Department of Experimental and Clinical Medicine, Unit of Maxillofacial Surgery, "Magna Graecia" University, Viale Europa, 88100 Catanzaro, Italy
| | - Maria Giulia Cristofaro
- Department of Experimental and Clinical Medicine, Unit of Maxillofacial Surgery, "Magna Graecia" University, Viale Europa, 88100 Catanzaro, Italy
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29
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Nasser S, Bilir E, David A, Gultekin M, Sehouli J. Building research competency across low and middle resource settings: an ENGOT initiative and NOGGO mentorship program at the ESGO 2022 in Berlin. Int J Gynecol Cancer 2023:ijgc-2023-005019. [PMID: 38016756 DOI: 10.1136/ijgc-2023-005019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023] Open
Affiliation(s)
- Sara Nasser
- Department of Gynecology with Center of Oncological Surgery, Charité Universitatsmedizin Berlin, Berlin, Germany
- Gynecologic Oncology, Pan-Arabian Research Society of Gynecological Oncology, Berlin, Germany
| | - Esra Bilir
- Department of Gynecologic Oncology, Koc University School of Medicine, Istanbul, Turkey
- Department of Global Health, Koc University Graduate School of Health Sciences, Istanbul, Turkey
| | - Atallah David
- Department of Obstetrics and Gynecology, Hôtel-Dieu de France University Hospital, Beirut, Lebanon
| | - Murat Gultekin
- Department of Obstetrics and Gynecology, Division of Gynaecological Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Jalid Sehouli
- Department of Gynecology with Center of Oncological Surgery, Charité Universitatsmedizin Berlin, Berlin, Germany
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30
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Castillo MH, Marrufo C. Total uterine inversion due to pedunculated vaginal tumor. Int J Gynecol Cancer 2023:ijgc-2023-004712. [PMID: 37989479 DOI: 10.1136/ijgc-2023-004712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023] Open
Affiliation(s)
| | - Carlos Marrufo
- Oncology Gynecology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
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Marcu I, Melnyk M, Nekkanti S, Nagel C. Pelvic floor dysfunction survivorship needs and referrals in the gynecologic oncology population: a narrative review. Int J Gynecol Cancer 2023:ijgc-2023-004810. [PMID: 37935522 DOI: 10.1136/ijgc-2023-004810] [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] [Indexed: 11/09/2023] Open
Abstract
The population of survivors of gynecologic malignancies continues to grow. The population of gynecologic oncology survivors has a high prevalence of pelvic floor disorders. Gynecologic oncology patients identify several survivorship needs, including a need for more focused pelvic floor disorder sequelae care. The increasing focus on patient needs following cancer treatment has led to the development of survivorship care plans and other strategies for addressing post-treatment transitions and sequelae. Common themes in patient survivorship care are patient needs for flexible and integrated care, and it is unclear if survivorship care plans in their current state improve patient outcomes. Patient referrals, specifically to urogynecologists, may help address the gaps in survivorship care of pelvic floor dysfunction.The objective of this review is to discuss the burden of pelvic floor disorders in the gynecologic population and to contextualize these needs within broader survivorship needs. The review will then discuss current strategies of survivorship care, including a discussion of whether these methods meet survivorship pelvic floor disorder needs. This review addresses several gaps in the literature by contextualizing pelvic floor disorder needs within other survivorship needs and providing a critical discussion of current survivorship care strategies with a focus on pelvic floor disorders.
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Affiliation(s)
- Ioana Marcu
- Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Megan Melnyk
- School of Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Silpa Nekkanti
- Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Christa Nagel
- Obstetrics and Gynecology, Division of Gynecologic Oncology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
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Gil-Ibanez B, Davies-Oliveira J, Lopez G, Díaz-Feijoo B, Tejerizo-Garcia A, Sehouli J. Impact of gynecological cancers on health-related quality of life: historical context, measurement instruments, and current knowledge. Int J Gynecol Cancer 2023; 33:1800-1806. [PMID: 37696648 DOI: 10.1136/ijgc-2023-004804] [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] [Indexed: 09/13/2023] Open
Abstract
Gynecologic cancers, comprising 14.4% of newly diagnosed cancer cases in women globally, are substantial causes of both mortality and morbidity, with a profound impact on the quality of life (QoL) of survivors. Over the past few decades, advancements in interdisciplinary and interprofessional care have contributed to an increase in the average life expectancy of gynecological cancer patients. However, the disease and its treatments have a profound impact on patients, leading to physical changes and psychological consequences, including psychosocial and psychosexual effects, which negatively affect their QoL.The primary objective of management strategies is to minimize harm while improving survival rates and enhancing QoL during the survivorship stage. QoL measures play a crucial role in enhancing our comprehension of how cancer and its treatments affect individuals. Consequently, various measurement instruments, such as the EORTC QLQ 30, PROMIS-29, FACT-G, and QOL-CS, have been developed to assess health-related quality of life (HRQoL). Pre- and post-treatment HRQoL measurements have been shown to be predictive factors for post-operative complications and prognostic factors for overall survival and progression-free survival in gynecological oncology patients. Patient-reported outcomes related to HRQoL are essential tools for measuring patient outcomes and enabling patient-centered clinical decision-making.This article focuses on HRQoL, providing a historical context, summarizing measurement instruments, and discussing the current understanding of the impact of gynecological cancers on HRQoL.
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Affiliation(s)
- Blanca Gil-Ibanez
- Gynecologic Oncology and Minimally Invasive Surgery Unit, Gynecology and Obstetrics Department, Hospital Universitario 12 de Octubre, Madrid, Spain
- i+12 Research Institute, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Jennifer Davies-Oliveira
- Division of Cancer Sciences, The University of Manchester, Manchester, UK
- Department of Obstetrics and Gynaecology, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Gregorio Lopez
- Gynecologic Oncology and Minimally Invasive Surgery Unit, Gynecology and Obstetrics Department, Hospital Universitario 12 de Octubre, Madrid, Spain
- i+12 Research Institute, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Berta Díaz-Feijoo
- Institute Clinic of Gynecology, Obstetrics and Neonatology, Hospital Clinic de Barcelona, Institutd'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Alvaro Tejerizo-Garcia
- Gynecologic Oncology and Minimally Invasive Surgery Unit, Gynecology and Obstetrics Department, Hospital Universitario 12 de Octubre, Madrid, Spain
- i+12 Research Institute, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Jalid Sehouli
- Department of Gynecology with Center of Oncological Surgery, European Competence Center of Ovarian Cancer, Charité, University of Berlin, Berlin, Germany
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Mitric C, Kosa SD, Kim SR, Nelson G, Laframboise S, Bouchard-Fortier G. Cost impact analysis of enhanced recovery after minimally invasive gynecologic oncology surgery. Int J Gynecol Cancer 2023; 33:1786-1793. [PMID: 37524497 DOI: 10.1136/ijgc-2023-004528] [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] [Indexed: 08/02/2023] Open
Abstract
OBJECTIVE The implementation of a peri-operative care program based on enhanced recovery after surgery principles for minimally invasive gynecologic oncology surgery led to an improvement in same day discharge from 29% to 75% at our center. This study aimed to determine the program's economic impact. METHODS Our initial enhanced recovery quality improvement program enrolled consecutive patients undergoing minimally invasive hysterectomy at a single center during a 12-month period and compared them to a pre-intervention cohort. The primary outcome was overall costs. The secondary outcomes were surgical and post-operative visit costs. The surgical visit costs included pre-operative and operating room, post-operative stay, pharmacy, and interventions costs. The 30-day post-operative visit costs included clinic and emergency room, and readmission costs. The costs for every visit were collected from the case-cost department and expressed in 2020 Canadian dollars (CAD). RESULTS A total of 96 and 101 patients were included in the pre- and post-intervention groups, respectively. The median total cost per patient for post-intervention was $7252 compared with $8381 pre-intervention (p=0.02), resulting in a $1129 cost reduction per patient. The total cost for the program implementation was $134 per patient for a total cost of $13 106. The median post-operative stay cost was $816 post-intervention compared with $1278 pre-intervention (p<0.05). Statistically significant savings for the post-intervention group were also found for operative visit, operating room costs, and pharmacy (p<0.05). On multivariate analysis, surgical approach was the only factor associated with operating room costs, whereas both surgical approach and group (pre- vs post-intervention) impacted the total and post-operative stay costs (p<0.05). CONCLUSION In addition to increasing the same day discharge rate after minimally invasive gynecologic oncology surgery, an enhanced recovery-based peri-operative care program led to significant reductions in cost.
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Affiliation(s)
- Cristina Mitric
- Division of Gynecologic Oncology, Princess Margaret Cancer Centre/University Health Network/Sinai Health System, Toronto, Ontario, Canada
- Department of Obstetrics and Gynaecology, Division of Gynecology Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Sarah Daisy Kosa
- Department of Health Research Methods, Evidence, and Impacts, McMaster University, Hamilton, Ontario, Canada
| | - Soyoun Rachel Kim
- Division of Gynecologic Oncology, Princess Margaret Cancer Centre/University Health Network/Sinai Health System, Toronto, Ontario, Canada
- Department of Obstetrics and Gynaecology, Division of Gynecology Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Gregg Nelson
- Department of Obstetrics & Gynecology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Stephane Laframboise
- Division of Gynecologic Oncology, Princess Margaret Cancer Centre/University Health Network/Sinai Health System, Toronto, Ontario, Canada
- Department of Obstetrics and Gynaecology, Division of Gynecology Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Geneviève Bouchard-Fortier
- Division of Gynecologic Oncology, Princess Margaret Cancer Centre/University Health Network/Sinai Health System, Toronto, Ontario, Canada
- Department of Obstetrics and Gynaecology, Division of Gynecology Oncology, University of Toronto, Toronto, Ontario, Canada
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Mauro J, Filipello F, Tripodi E, Di Guardia G, Buda A. Serous endometrial cancer confined to a polyp with malignant pleural effusion. Int J Gynecol Cancer 2023; 33:1812-1818. [PMID: 37931974 DOI: 10.1136/ijgc-2023-004942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023] Open
Affiliation(s)
- Jessica Mauro
- Gynecologic Oncology, Ospedale Michele e Pietro Ferrero, Verduno, Cuneo, Italy
- University of Udine, Udine, Italy
| | - Federica Filipello
- Division of Pathology, Ospedale Michele e Pietro Ferrero, Verduno, Cuneo, Italy
| | - Elisa Tripodi
- Gynecologic Oncology, Ospedale Michele e Pietro Ferrero, Verduno, Cuneo, Italy
| | - Giuseppe Di Guardia
- Division of Radiology, Ospedale Michele e Pietro Ferrero, Verduno, Cuneo, Italy
| | - Alessandro Buda
- Gynecologic Oncology, Ospedale Michele e Pietro Ferrero, Verduno, Cuneo, Italy
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Allanson ER, Burling M, Simcock B, Nicklin J, Sykes PH. The Australian Society of Gynaecological Oncology Western Pacific Liaison group. Int J Gynecol Cancer 2023; 33:1819-1820. [PMID: 37612036 DOI: 10.1136/ijgc-2023-004845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023] Open
Affiliation(s)
- Emma R Allanson
- The Division of Obstetrics and Gynaecology, The University of Western Australia, Perth, Western Australia, Australia
| | - Michael Burling
- Department of Gynaecology Oncology, Westmead Hospital, Westmead, New South Wales, Australia
| | - Bryony Simcock
- Department of Obstetrics and Gynaecology, University of Otago Christchurch, Christchurch, New Zealand
| | - Jim Nicklin
- Queensland Centre for Gynaecological Cancer, Herston, Queensland, Australia
| | - Peter H Sykes
- Department of Obstetrics and Gynaecology, University of Otago Dunedin School of Medicine, Dunedin, New Zealand
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Luzarraga Aznar A, Pérez-Benavente A, Cabrera S, Bebia V, Gil-Moreno A, Angeles MA. Inguinofemoral lymphadenectomy technique in 10 steps. Int J Gynecol Cancer 2023; 33:1823-1824. [PMID: 37491110 DOI: 10.1136/ijgc-2023-004765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023] Open
Affiliation(s)
| | - Assumpció Pérez-Benavente
- Gynecologic Oncology Unit, Gynecology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Silvia Cabrera
- Gynecologic Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Vicente Bebia
- Gynecologic Oncology, Hospital Vall d'Hebron, Barcelona, Spain
| | - Antonio Gil-Moreno
- Gynecologic Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Martina Aida Angeles
- Department of Gynecological Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
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dos Santos da Luz JC, Claudia Voges A, Guariglia D'Agostino L. Adjuvant electrochemotherapy of malignant ocular melanoma in a dog. Vet Res Forum 2023; 14:575-578. [PMID: 37901350 PMCID: PMC10612393 DOI: 10.30466/vrf.2023.1983391.3721] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 05/14/2023] [Indexed: 10/31/2023]
Abstract
Melanocytoma and malignant melanoma are the most typical eye tumors in dogs and cats. Due to the presence of melanin, the general appearance is often highly pigmented in a nodular formation with well-defined borders. Electrochemotherapy (ECT) is a therapy combining reversible electroporation and anti-neoplastic drugs to enhance their cytotoxic effects through increasing cellular uptake by the electroporated tumor cells. In this article, the use of adjuvant ECT for the treatment of canine ocular melanoma is reported. The pre-surgical exams (blood count, renal and liver functions, echocardiogram, and electrocardiogram) were within the normal range, as were the chest radiography and abdominal ultrasound without signs of metastases. On the day of the surgery, an excisional biopsy of the tumor was performed without safety margins by keratectomy associated with conjunctivectomy and adjuvant ECT in the surgical site and peri-tumoral region. The animal was followed for approximately 7 months and remained without evidence of tumor recurrence. A complete resolution of corneal opacification was also observed. To our knowledge, this is the first report of the use of ECT in an ocular neoplasm. From a comparative oncology perspective, this report opens the way for future therapeutic approaches in superficial ocular cancers in veterinary and human medicine.
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Affiliation(s)
| | - Ana Claudia Voges
- Independent Veterinary Ophthalmologist Practitioner, Mogi das Cruzes, Brazil;
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Plaikner A, Siegler K, Hertel H, Jacob A, Petzel A, Schubert M, Blohmer JU, Böhmer G, Marnitz S, Ragosch V, Domröse C, Oppelt P, Jülicher A, Schneider A, Willems A, Favero G, Köhler C. Fertility sparing therapy in women with lymph node negative cervical cancer >2cm - oncologic and fertility outcomes of neoadjuvant chemotherapy followed by radical vaginal trachelectomy. Int J Gynecol Cancer 2023; 33:1542-1547. [PMID: 37696645 DOI: 10.1136/ijgc-2023-004669] [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] [Indexed: 09/13/2023] Open
Abstract
OBJECTIVE Simple or radical trachelectomy are accepted fertility sparing therapies for patients diagnosed with cervical cancer ≤2 cm. In patients with larger tumors a fertility sparing concept is considered experimental. The aim of our study is to present oncological and fertility outcomes of laparoscopic pelvic lymphadenectomy followed by neoadjuvant chemotherapy and subsequent radical vaginal trachelectomy. These procedures were performed in two centers in patients diagnosed with cervical cancer of diameter >2 cm. METHOD We retrospectively analyzed the demographic, histological, fertility and follow-up data of all patients with cervical cancer assessed as stage IB2, IB3 or IIA1 under the International Federation of Gynecology and Obstetrics (FIGO) 2018 system. These patients had undergone pelvic lymphadenectomy, followed by neoadjuvant chemotherapy and radical vaginal trachelectomy between February 2006 and June 2020 at Charité University Berlin and Asklepios Hospital, Hamburg. RESULTS A total of 31 patients (mean age 29.5 years, range; 26-40) underwent neoadjuvant chemotherapy followed by radical vaginal trachelectomy in case of proven tumor-free lymph nodes. Twenty-six (84%) of these patients were nulliparous. Across all 31 patients, the initial tumor stages were FIGO 2018 stage IB2 (n=27), IB3 (n=3) and IIA1 (n=1).Lymphadenectomy was completed in all but one patient (sentinel) with a median of 33 (range; 11-47) pelvic lymph nodes. The neoadjuvant chemotherapy regimen was two cycles of paclitaxel, ifosfamide and cisplatin in 17 patients; three cycles of paclitaxel, ifosfamide and cisplatin in eight patients; two cycles of paclitaxel and cisplatin in four patients; two cylces cisplatin monoagent in one patient; and two cycles of paclitaxel and cisplatin followed by two cycles of paclitaxel, ifosfamide and cisplatin in one patient. Residual tumor was histologically confirmed in 17 specimens (55%). The median residual tumor size following neoadjuvant chemotherapy was 12 mm (range; 1-60). Fertility could be preserved in 27 patients (87%); two patients underwent adjuvant chemoradiation after radical vaginal trachelectomy due to high-risk histological features; two other patients underwent radical hysterectomy with adjuvant chemoradiation therapy following neoadjuvant chemotherapy. Of 18 (67%) patients seeking motherhood, 13 became pregnant (72%). There were 12 live births in 10 women, with a median fetal weight of 2490 grams (range; 1640-3560) and five miscarriages. After a median follow-up of 94.5 months (range; 6-183) three recurrences (11.1%) were detected, one patient (3.7%) died of the disease. CONCLUSION Neoadjuvant chemotherapy followed by radical vaginal trachelectomy may be offered to patients seeking motherhood with cervical cancer >2 cm and histopathologically tumor-free lymph nodes, the rate of healthy baby pregnancy on discharge was 10/18 women (55%). This fertility-preserving strategy is associated with higher recurrence and death compared with what was published in the literature for women undergoing radical vaginal trachelectomy for tumors up to 2 cm.
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Affiliation(s)
- Andrea Plaikner
- Department of Special Operative and Oncologic Gynecology, Asklepios Klinik Altona, Hamburg, Hamburg, Germany
| | - Kathrin Siegler
- Department of Special Operative and Oncologic Gynecology, Asklepios Klinik Altona, Hamburg, Hamburg, Germany
| | - Hermann Hertel
- Department of Obstetrics and Gynecology, Hannover Medical School, Hannover, Niedersachsen, Germany
| | - Anna Jacob
- Department of Gynecology, Asklepios Clinic Wandsbek, Hamburg, Germany
| | - Anja Petzel
- Institute for Dysplasia and Cytology, MVZ Kreuzberg, Berlin, Germany
| | - Melanie Schubert
- Department of Obstetrics and Gynecology, University Hospital of Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Jens-Uwe Blohmer
- Charité University Medicine, Department of Gynecology, Charité, Campus Mitte, Berlin, Germany
| | - Gerd Böhmer
- Institute for Dysplasia and Cytology, IZD Hannover, Hannover, Germany
| | - Simone Marnitz
- Department of Radiooncology, Radiation Oncology Vosspalais, Private Clinic, Berlin, Germany, Berlin, Berlin, Germany
| | - Volker Ragosch
- Department of Obstetrics, Asklepios Clinic Altona, Hamburg, Germany
| | - Christian Domröse
- Department of Obstetrics and Gynecology, Medical Faculty of the University of Cologne, Köln, Nordrhein-Westfalen, Germany
| | - Peter Oppelt
- Department for Gynecology, Obstetrics and Gynecological Endocrinology, Johannes Kepler University Linz, Linz, Austria
| | - Anne Jülicher
- Institute for Dysplasia and Cytology, MVZ Fürstenbergkarree, Berlin, Germany
| | - Achim Schneider
- Institute for Dysplasia and Cytology, MVZ Fürstenbergkarree, Berlin, Germany
| | - Anne Willems
- Institute for Dysplasia and Cytology, MVZ Köpenick, Germany
| | - Giovanni Favero
- Department of Gynecology and Obstetrics, Asklepios Hospital Lich, Lich, Germany
| | - Christhardt Köhler
- Department of Special Operative and Oncologic Gynecology, Asklepios Klinik Altona, Hamburg, Hamburg, Germany
- Institute for Dysplasia and Cytology, MVZ Fürstenbergkarree, Berlin, Germany
- Department of Gynecology, German Red Cross Clinic Berlin Westend, Berlin, Germany
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Gil-Ibanez B, Tejerizo-Garcia A, Oliver MR, Madariaga A, Maiz Jimenez M, Gil Garcia A, Lopez-Gonzalez G. Side effects screening and early intervention to impact in quality of life of patients with gynecological cancers (HALIS study). Int J Gynecol Cancer 2023; 33:1645-1648. [PMID: 37748803 DOI: 10.1136/ijgc-2023-004802] [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] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Advances in the treatment of gynecological cancers have led to increased survival in patients with gynecological cancers. Nevertheless, patients may still experience prevalent long term consequences, including lower limb lymphedema, depression, anxiety, sexual dysfunction, malnutrition, and sarcopenia, that negatively impact their quality of life. PRIMARY OBJECTIVE To assess the impact on self-perceived quality of life of systematic screening and early treatment of lower limb lymphedema, anxiety and depression, sexual dysfunction, and sarcopenia and malnutrition compared with standard practice. STUDY HYPOTHESIS Systematic screening with validated questionnaires leading to early diagnosis and treatment of side effects will have a positive impact on quality of life. TRIAL DESIGN This prospective clinical trial will randomize candidates for surgery to either standard of care or systematic screening every 2 months for 2 years. Quality of life data will be collected every 4 months. After randomization, patients in the control group will follow standard usual care. Their screening scales will not be considered. In the experimental group, positive screenings will generate an alert to the physician, and patients will be referred to the corresponding specific area (rehabilitation unit, psycho-oncology unit, sexual health unit, or nutrition unit). MAJOR INCLUSION AND XCLUSION CRITERIA Patients aged ≥18 years with ovarian, cervical, or endometrial cancer who are candidates for surgery will be included. PRIMARY ENDPOINT Self-reported quality of life questionnaire score. SAMPLE SIZE 168 patients will be randomized to detect a difference of 6 points in the questionnaires. ESTIMATED DATES FOR COMPLETING ACCRUAL AND PRESENTING RESULTS Study completion is estimated for January 2026 and the results will be presented in May 2026. TRIAL REGISTRATION NUMBER NCT05918770.
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Affiliation(s)
- Blanca Gil-Ibanez
- Gynecologic Oncology and Minimally Invasive Gynecologic Surgery Unit (Departament of Obstetrics and Gynecology), Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Alvaro Tejerizo-Garcia
- Gynecologic Oncology and Minimally Invasive Gynecologic Surgery Unit (Departament of Obstetrics and Gynecology), Hospital Universitario 12 de Octubre, Madrid, Spain
| | - M Reyes Oliver
- Gynecologic Oncology and Minimally Invasive Gynecologic Surgery Unit (Departament of Obstetrics and Gynecology), Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Ainhoa Madariaga
- Medical Oncology and Hematology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Maria Maiz Jimenez
- Endocrinology and Nutrition Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Alejandra Gil Garcia
- Physical Medicine and Rehabilitation Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Gregorio Lopez-Gonzalez
- Gynecologic Oncology and Minimally Invasive Gynecologic Surgery Unit (Departament of Obstetrics and Gynecology), Hospital Universitario 12 de Octubre, Madrid, Spain
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Muruzábal JC, Veiga N, Aguirre S, Guelbenzu JJ, Ramírez E. Video assisted thoracoscopic surgery and its applicability in patients with advanced ovarian cancer. Int J Gynecol Cancer 2023; 33:1658-1659. [PMID: 37146995 DOI: 10.1136/ijgc-2023-004359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023] Open
Affiliation(s)
| | - Nadia Veiga
- Ginecología Oncológica, Hospital Universitario de Navarra, Pamplona, Navarra, Spain
| | - Sara Aguirre
- Ginecología Oncológica, Hospital Universitario de Navarra, Pamplona, Navarra, Spain
| | - Juan José Guelbenzu
- Cirugía Torácica, Hospital Universitario de Navarra, Pamplona, Navarra, Spain
| | - Elena Ramírez
- Cirugía Torácica, Hospital Universitario de Navarra, Pamplona, Navarra, Spain
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41
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Veiga N, Muruzábal JC, Aguirre S, Lapeña S, Tarrio O, Vicaría I. Laparoscopic transperitoneal para-aortic lymphadenectomy in double inferior vena cava vascular anomalies. Int J Gynecol Cancer 2023; 33:1475-1476. [PMID: 37137524 DOI: 10.1136/ijgc-2023-004361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Affiliation(s)
- Nadia Veiga
- Ginecología, Hospital Universitario de Navarra, Pamplona, Spain
| | | | - Sara Aguirre
- Ginecología, Hospital Universitario de Navarra, Pamplona, Spain
| | - Sonia Lapeña
- Ginecología, Hospital Universitario de Navarra, Pamplona, Spain
| | - Orencio Tarrio
- Ginecología, Hospital Universitario de Navarra, Pamplona, Spain
| | - Iván Vicaría
- Radiología, Hospital Universitario de Navarra, Pamplona, Navarra, Spain
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Mazina V, Devins K, Philp L, Bercow AS, James K, Bregar A, Sisodia RC, Oliva E, Del Carmen M. Patterns of spread and genetic alterations of primary endometrioid carcinomas of the ovary. Int J Gynecol Cancer 2023; 33:1434-1439. [PMID: 37567599 DOI: 10.1136/ijgc-2023-004627] [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] [Indexed: 08/13/2023] Open
Abstract
OBJECTIVE The primary objective was to characterize the rate of lymph node involvement in a cohort of patients with primary ovarian endometrioid adenocarcinoma. Additionally, we sought to quantify the recurrence rate, genetic alterations, and impact of lymphadenectomy on survival in this group of patients. METHODS Patients diagnosed with primary endometrioid adenocarcinoma of the ovary without synchronous carcinomas of the female genital tract between 2012 and 2021 were identified. Demographic and disease-related data were collected from pathology reports and clinical records. Kaplan-Meier survival analysis using log rank test and Cox regression was performed. RESULTS Sixty-three patients met inclusion criteria. Median age was 60 (range 22-90) years. Histologic grade was 1 in 20 (32%), 2 in 27 (43%), and 3 in 16 (25%) tumors. International Federation of Gynecology and Obstetrics (FIGO) stage after surgery included IA/B (n=20, 32%), IC (n=23, 37%), II (n=16, 25%), and III (n=4, 6%). Forty-one (65%) patients had pelvic and 33 (52%) had both pelvic and para-aortic lymphadenectomy. All assessed lymph nodes were negative for metastatic carcinoma. No patients with clinically pelvis-confined disease had tumors upstaged by either lymphadenectomy or omentectomy. Twenty-eight patients (44%) had germline mutational status documented; two had a germline BRCA mutation, confirmed to be pathogenic by molecular studies. Complete staging did not significantly impact progression free or overall survival, after adjusting for age and histologic grade in a Cox proportional hazards model. The recurrence rate was 15% for patients with grade 1 endometrioid carcinoma, 7% for grade 2, and 31% for grade 3, respectively. CONCLUSION There were no lymph node metastases in patients with comprehensively staged primary endometrioid ovarian carcinoma. Staging did not impact survival and may be omitted, regardless of grade. Germline BRCA mutations are rare in ovarian endometrioid carcinoma compared with reported rates in high-grade serous carcinomas.
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Affiliation(s)
- Varvara Mazina
- Gynecologic Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Kyle Devins
- Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Lauren Philp
- Gynecologic Oncology, Princess Margaret Hospital Cancer Centre, Toronto, Ontario, Canada
| | - Alexandra S Bercow
- Gynecologic Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Kaitlyn James
- Deborah Kelly Center for Clinical Research, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Amy Bregar
- Gynecologic Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Rachel Clark Sisodia
- Gynecologic Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Esther Oliva
- Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Marcela Del Carmen
- Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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43
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Holloway RW, Thaker P, Mendivil AA, Ahmad S, Al-Niaimi AN, Barter J, Beck T, Chambers SK, Coleman RL, Crafton SM, Crane E, Ramez E, Ghamande S, Graybill W, Herzog T, Indermaur MD, John VS, Landrum L, Lim PC, Lucci JA, McHale M, Monk BJ, Moore KN, Morris R, O'Malley DM, Reid TJ, Richardson D, Rose PG, Scalici JM, Silasi DA, Tewari K, Wang EW. A phase III, multicenter, randomized study of olvimulogene nanivacirepvec followed by platinum-doublet chemotherapy and bevacizumab compared with platinum-doublet chemotherapy and bevacizumab in women with platinum-resistant/refractory ovarian cancer. Int J Gynecol Cancer 2023; 33:1458-1463. [PMID: 37666539 DOI: 10.1136/ijgc-2023-004812] [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] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Treatment options for patients with platinum-resistant/refractory ovarian cancers are limited and only marginally effective. The development of novel, more effective therapies addresses a critical unmet medical need. Olvimulogene nanivacirepvec (Olvi-Vec), with its strong immune modulating effect on the tumor microenvironment, may provide re-sensitization to platinum and clinically reverse platinum resistance or refractoriness in platinum-resistant/refractory ovarian cancer. PRIMARY OBJECTIVE The primary objective is to evaluate the efficacy of intra-peritoneal Olvi-Vec followed by platinum-based chemotherapy and bevacizumab in patients with platinum-resistant/refractory ovarian cancer. STUDY HYPOTHESIS This phase III study investigates Olvi-Vec oncolytic immunotherapy followed by platinum-based chemotherapy and bevacizumab as an immunochemotherapy evaluating the hypothesis that such sequential combination therapy will prolong progression-free survival (PFS) and bring other clinical benefits compared with treatment with platinum-based chemotherapy and bevacizumab. TRIAL DESIGN This is a multicenter, prospective, randomized, and active-controlled phase III trial. Patients will be randomized 2:1 into the experimental arm treated with Olvi-Vec followed by platinum-doublet chemotherapy and bevacizumab or the control arm treated with platinum-doublet chemotherapy and bevacizumab. MAJOR INCLUSION/EXCLUSION CRITERIA Eligible patients must have recurrent, platinum-resistant/refractory, non-resectable high-grade serous, endometrioid, or clear-cell ovarian, fallopian tube, or primary peritoneal cancer. Patients must have had ≥3 lines of prior chemotherapy. PRIMARY ENDPOINT The primary endpoint is PFS in the intention-to-treat population. SAMPLE SIZE Approximately 186 patients (approximately 124 patients randomized to the experimental arm and 62 to the control arm) will be enrolled to capture 127 PFS events. ESTIMATED DATES FOR COMPLETING ACCRUAL AND PRESENTING RESULTS Expected complete accrual in 2024 with presentation of primary endpoint results in 2025. TRIAL REGISTRATION NCT05281471.
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Affiliation(s)
| | - Premal Thaker
- Obstetrics and Gynecology, Washington University in Saint Louis, Saint Louis, Missouri, USA
| | | | - Sarfraz Ahmad
- AdventHealth Cancer Institute, Orlando, Florida, USA
| | | | - James Barter
- Holy Cross Hospital, Silver Spring, Maryland, USA
| | - Tiffany Beck
- Hoag Cancer Center, Newport Beach, California, USA
| | | | | | - Sarah M Crafton
- West Penn Hospital, Allegheny Health Network, Pittsburgh, Pennsylvania, USA
| | - Erin Crane
- Levine Cancer Institution, Atrium Health, Charlotte, North Carolina, USA
| | - Eskander Ramez
- Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Sharad Ghamande
- Augusta University Medical College of Georgia, Augusta, Georgia, USA
| | - Whitney Graybill
- Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Thomas Herzog
- Cancer Center, University of Cincinnati, Cincinnati, Ohio, USA
| | | | - Veena S John
- Northwell Health Cancer Institute, Lake Success, New York, USA
| | - Lisa Landrum
- Indiana University Simon Comprehensive Cancer Center, Indianapolis, Indiana, USA
| | | | - Joseph A Lucci
- McGovern Medical School, University of Texas Health Sciences Center at Houston, Houston, Texas, USA
| | - Michael McHale
- Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, California, USA
| | - Bradley J Monk
- University of Arizona and Creighton University School of Medicine, HonorHealth Research Institute, Phoenix, Arizona, USA
| | | | | | - David M O'Malley
- James Cancer Center, The Ohio State University, Columbus, Ohio, USA
| | | | - Debra Richardson
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Peter G Rose
- Gynecology Oncology Desk A-81, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Jennifer M Scalici
- Mitchell Cancer Institute, University of South Alabama, Mobile, Alabama, USA
| | - Dan-Arin Silasi
- Mercy St Louis/Diavid C Pratt Cancer Center, St Louis, Missouri, USA
| | - Krishnansu Tewari
- Chao Family Comprehensive Cancer Center, University of California Irvine, Irvine, California, USA
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Ribeiro R, Kondo W, Erzinger FL. Management of vascular injuries in gynecologic oncology surgery. Int J Gynecol Cancer 2023; 33:1477-1478. [PMID: 37666536 DOI: 10.1136/ijgc-2023-004682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2023] Open
Affiliation(s)
- Reitan Ribeiro
- Department of Gynecology Oncology, Erasto Gaertner Hospital, Curitiba, Brazil
| | - William Kondo
- Department of Gynecology, Vital Batel Hospital, Curitiba, Brazil
| | - Fabiano L Erzinger
- Department of Vascular Surgery, Erasto Gaertner Hospital, Curitiba, Brazil
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Capozzi VA, Rotondella I, De Finis A, Scarpelli E, Ghi T, Berretta R. Rectovaginal fistula repair by Martius flap after exclusive chemoradiation in a patient with advanced cervical cancer. Int J Gynecol Cancer 2023; 33:1473-1474. [PMID: 36958754 DOI: 10.1136/ijgc-2023-004365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023] Open
Affiliation(s)
- Vito Andrea Capozzi
- Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Isabella Rotondella
- Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Alessandra De Finis
- Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Elisa Scarpelli
- Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Tullio Ghi
- Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Roberto Berretta
- Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
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Mohr S, Imboden S, Siegenthaler F, Mueller MD. Complementary use of indocyanine green and technetium to enhance sentinel lymphadenectomy in vulvar cancer. Int J Gynecol Cancer 2023:ijgc-2023-004562. [PMID: 37648407 DOI: 10.1136/ijgc-2023-004562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
Affiliation(s)
- Stefan Mohr
- Department of Obstetrics and Gynecology, Inselspital, Bern University Women's Hospital, University of Bern, Bern, Switzerland
| | - Sara Imboden
- Department of Obstetrics and Gynecology, Inselspital, Bern University Women's Hospital, University of Bern, Bern, Switzerland
| | - Franziska Siegenthaler
- Department of Obstetrics and Gynecology, Inselspital, Bern University Women's Hospital, University of Bern, Bern, Switzerland
| | - Michael David Mueller
- Department of Obstetrics and Gynecology, Inselspital, Bern University Women's Hospital, University of Bern, Bern, Switzerland
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Capasso I, Garzon S, Kumar S, Weaver AL, Mc Gree M, De Vitis LA, Uccella S, Petersen I, Glaser G, Langstraat C, Scambia G, Fanfani F, Mariani A. Prognostic factors in patients with endometrial cancer with isolated lymphatic recurrence. Int J Gynecol Cancer 2023; 33:1169-1178. [PMID: 37321674 DOI: 10.1136/ijgc-2023-004435] [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] [Indexed: 06/17/2023] Open
Abstract
OBJECTIVE To analyze the clinicopathological features and outcomes in patients with endometrial cancer with isolated lymphatic recurrence after lymphadenectomy, stratified by different isolated lymphatic recurrence sites and treatment approaches. METHODS We retrospectively reviewed all surgically treated patients with endometrial cancer, identifying those with recurrence. We defined primary isolated lymphatic recurrence as the first and unique evidence of recurrence in lymph node-bearing areas, without concomitant vaginal, hematogenous, or peritoneal recurrence. Isolated lymphatic recurrences were classified as pelvic, para-aortic, distant, or multiple sites. Our primary outcome was cause-specific survival after diagnosis of the recurrence. RESULTS Among 4216 patients with surgically staged endometrial cancer, we identified 66 (1.6%) women with isolated lymphatic recurrence. The overall median cause-specific survival for patients with isolated lymphatic recurrence was 24 months. Although cause-specific survival was not significantly different between the four isolated lymphatic recurrence groups (p=0.21), 7 of 15 (47%) patients with isolated lymphatic recurrence in the para-aortic area were long-term survivors. At multivariate Cox regression, the absence of lymphovascular space invasion and grade 1 histology in the primary tumor were significantly associated with improved cause-specific survival. In addition, patients with isolated lymphatic recurrence who underwent surgery for recurrence (with/without other associated therapies) had improved cause-specific survival compared with patients who did not undergo surgery, also after adjusting for age. CONCLUSIONS Low-grade histology and absence of lymphovascular space invasion in the primary tumor were predictors of improved prognosis in patients with endometrial cancer with isolated lymphatic recurrence. In addition, in this retrospective cohort, patients with isolated lymphatic recurrence who were selected for eradicative surgical treatment had improved cause-specific survival.
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Affiliation(s)
- Ilaria Capasso
- Department of Gynecologic Oncology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Women, Children and Public Health Sciences, Gynecologic Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Lazio, Italy
| | - Simone Garzon
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Verona, Italy
| | - Sanjeev Kumar
- Department of Gynecologic Oncology, Baptist Memorial Hospital for Women, Memphis, Tennessee, USA
| | - Amy L Weaver
- Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota, USA
| | - Michaela Mc Gree
- Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Stefano Uccella
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Verona, Italy
| | - Ivy Petersen
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | - Gretchen Glaser
- Department of Gynecologic Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | - Carrie Langstraat
- Department of Gynecologic Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | - Giovanni Scambia
- Department of Women, Children and Public Health Sciences, Gynecologic Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Lazio, Italy
| | - Francesco Fanfani
- Department of Women, Children and Public Health Sciences, Gynecologic Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Lazio, Italy
| | - Andrea Mariani
- Department of Gynecologic Oncology, Mayo Clinic, Rochester, Minnesota, USA
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Perrone AM, Coada CA, Ravegnini G, De Leo A, Damiano G, De Crescenzo E, Tesei M, Di Costanzo S, Genovesi L, Rubino D, Zamagni C, De Iaco P. Post-operative residual disease and number of cycles of neoadjuvant chemotherapy in advanced epithelial ovarian carcinoma. Int J Gynecol Cancer 2023; 33:1270-1278. [PMID: 37429642 PMCID: PMC10423511 DOI: 10.1136/ijgc-2022-004249] [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: 12/23/2022] [Accepted: 05/18/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND The optimal number of neoadjuvant chemotherapy cycles in patients with advanced ovarian cancer is still disputed. OBJECTIVE To evaluate the impact of the number of neoadjuvant chemotherapy cycles and role of optimal cytoreduction on the prognosis of patients with advanced ovarian cancer. METHODS Clinical and pathological details were examined. Patients were evaluated combining the number of cycles of neoadjuvant chemotherapy-namely, 'interval debulking surgery' after up to four neoadjuvant chemotherapy cycles, and 'delayed debulking surgery' after more than four cycles of therapy. RESULTS A total of 286 patients were included in the study. Complete cytoreduction with no residual peritoneal disease (CC0) was achieved in 74 (74%) patients with interval debulking surgery and 124 (66.7%) patients with delayed interval debulking. Of those with residual disease, there were 26/88 (29.5%) patients in the interval debulking surgery group and 62/88 (70.5%) patients in the delayed debulking surgery group. Comparison of patients with delayed debulking-CC0 and interval debulking-CC0 showed no difference in progression-free survival (p=0.3) or overall survival (p=0.4), while significantly worse outcomes were observed in patients with interval debulking-CC1 (p=0.02 and p=0.04, respectively). Specifically, patients with interval debulking-CC1 had an approximately 67% increased risk of disease progression (p=0.04; HR=2.01 (95% CI 1.04 to 4.18)) and a 69% higher risk of death than patients with delayed debulking-CC0 (p=0.03; HR=2.34 (95% CI 1.11 to 4.67)). CONCLUSION Increasing the number of neoadjuvant chemotherapy cycles does not worsen patient outcomes if complete resection is achieved. Nevertheless, additional prospective trials are necessary to establish the optimum number of neoadjuvant chemotherapy cycles.
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Affiliation(s)
- Anna Myriam Perrone
- Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | | | - Gloria Ravegnini
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Antonio De Leo
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Solid Tumor Molecular Pathology Laboratory, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Giuseppe Damiano
- Infertility and IVF Unit, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy
| | - Eugenia De Crescenzo
- Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Marco Tesei
- Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Stella Di Costanzo
- Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Lucia Genovesi
- Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Daniela Rubino
- Division of Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Claudio Zamagni
- Division of Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Pierandrea De Iaco
- Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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Cibula D, Rosaria Raspollini M, Planchamp F, Centeno C, Chargari C, Felix A, Fischerová D, Jahnn-Kuch D, Joly F, Kohler C, Lax S, Lorusso D, Mahantshetty U, Mathevet P, Raj Naik M, Nout RA, Oaknin A, Peccatori F, Persson J, Querleu D, Rubio Bernabé S, Schmid MP, Stepanyan A, Svintsitskyi V, Tamussino K, Zapardiel I, Lindegaard J. ESGO/ESTRO/ESP Guidelines for the management of patients with cervical cancer - Update 2023. Radiother Oncol 2023; 184:109682. [PMID: 37336614 DOI: 10.1016/j.radonc.2023.109682] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
In 2018, the European Society of Gynecological Oncology (ESGO) jointly with the European Society for Radiotherapy and Oncology (ESTRO) and the European Society of Pathology (ESP) published evidence-based guidelines for the management of patients with cervical cancer. Given the large body of new evidence addressing the management of cervical cancer, the three sister societies jointly decided to update these evidence-based guidelines. The update includes new topics to provide comprehensive guidelines on all relevant issues of diagnosis and treatment in cervical cancer. To serve on the expert panel (27 experts across Europe) ESGO/ESTRO/ESP nominated practicing clinicians who are involved in managing patients with cervical cancer and have demonstrated leadership through their expertise in clinical care and research, national and international engagement, profile, and dedication to the topics addressed. To ensure the statements were evidence based, new data identified from a systematic search was reviewed and critically appraised. In the absence of any clear scientific evidence, judgment was based on the professional experience and consensus of the international development group. Before publication, the guidelines were reviewed by 155 independent international practitioners in cancer care delivery and patient representatives. These updated guidelines are comprehensive and cover staging, management, follow-up, long-term survivorship, quality of life and palliative care. Management includes fertility sparing treatment, early and locally advanced cervical cancer, invasive cervical cancer diagnosed on a simple hysterectomy specimen, cervical cancer in pregnancy, rare tumors, recurrent and metastatic diseases. The management algorithms and the principles of radiotherapy and pathological evaluation are also defined.
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Affiliation(s)
- David Cibula
- Department of Obstetrics and Gynecology, Charles University, First Faculty of Medicine, Prague, Czech Republic; General University Hospital in Prague, Prague, Czech Republic.
| | | | | | - Carlos Centeno
- Department of Palliative Medicine, University of Navarra, Pamplona, Spain
| | - Cyrus Chargari
- Service d'Oncologie Radiothérapie, Hôpital Universitaire Pitié Salpêtrière, Paris, France
| | - Ana Felix
- Instituto Portugues de Oncologia de Lisboa Francisco Gentil EPE, Lisboa, Portugal; Universidade Nova de Lisboa, Lisboa, Portugal
| | - Daniela Fischerová
- Department of Obstetrics and Gynecology, Charles University, First Faculty of Medicine, Prague, Czech Republic; General University Hospital in Prague, Prague, Czech Republic
| | - Daniela Jahnn-Kuch
- Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Florence Joly
- François Baclesse Centre de Lutte Contre le Cancer, Caen, France
| | - Christhardt Kohler
- Asklepios Clinic Altona, Hamburg, Germany; Asklepios Comprehensive Tumor Center, Hamburg, Germany
| | - Sigurd Lax
- Hospital Graz II, Graz, Austria; Johannes Kepler Universitat Linz, Linz, Austria
| | - Domenica Lorusso
- Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy; Catholic University of Sacred Heart, Rome, Italy
| | - Umesh Mahantshetty
- Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India
| | | | - Mr Raj Naik
- Northern Gynaecological Oncology Centre, Gateshead, UK
| | - Remi A Nout
- Radiotherapy, Erasmus MC Cancer Centre, Rotterdam, the Netherlands; University Medical Center, Rotterdam, the Netherlands
| | - Ana Oaknin
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | - Jan Persson
- Department of Obstetrics and Gynecology, Lund University Hosptial, Lund, Sweden; Skåne University Hospital Lund, Lund, Sweden
| | - Denis Querleu
- Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy; University Hospitals Strasbourg, Strasbourg, France
| | | | - Maximilian P Schmid
- Department of Radiation Oncology, Medical University of Vienna, Wien, Austria
| | - Artem Stepanyan
- Gynecologic Oncology, Nairi Medical Center, Yerevan, Armenia
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50
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Levin G, Harrison R, Ledermann J, Meyer R, Coleman RL, Ramirez PT. Evaluating open access publication and research impact in gynecologic oncology. Int J Gynecol Cancer 2023:ijgc-2023-004460. [PMID: 37220951 DOI: 10.1136/ijgc-2023-004460] [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] [Indexed: 05/25/2023] Open
Abstract
OBJECTIVE To evaluate whether a citation advantage exists for open access (OA) publications in gynecologic oncology. METHOD A cross-sectional study of research and review articles published in the International Journal of Gynecological Cancer (IJGC) and in Gynecologic Oncology during 1980-2022. Bibliometric measures were compared between OA publications and non-OA publications. The role of authors in low/middle-income countries was assessed. We analyzed article characteristics associated with a high citations per year (CPY) score. RESULTS Overall, 18 515 articles were included, of which 2398 (13.0%) articles were published OA. The rate of OA has increased since 2007. During 2018-2022, the average proportion of articles published OA was 34.0% (range 28.5%-41.4%). OA articles had higher CPY (median (IQR), 3.0 (1.5-5.3) vs 1.3 (0.6-2.7), p<0.001). There was a strong positive correlation between OA proportion and impact factor; IJGC - r(23)=0.90, p<0.001, Gynecologic Oncology - r(23)=0.89, p<0.001. Articles by authors from low/middle-income countries were less common among OA articles than among non-OA articles (5.5% vs 10.7%, p<0.001). Articles by authors from low/middle-income countries were less common in the high CPY group than for articles without a high CPY score (8.0% vs 10.2%, p=0.003). The following article characteristics were found to be independently associated with a high CPY: publication after 2007, (adjusted odds ratio (aOR)=4.9, 95% CI 4.3 to 5.7), research funding reported (aOR=1.6, 95% CI 1.4 to 1.8), and being published OA (aOR=1.5, 95% CI 1.3-1.7). Articles written by authors in Central/South America or Asia had lower odds of having high CPY (Central/South America, aOR=0.5, 95% CI 0.3 to 0.8; Asia, aOR=0.6, 95% CI 0.5 to 0.7). CONCLUSION OA articles have a higher CPY, with a strong positive correlation between OA proportion and impact factor. OA publishing has increased since 2007, but articles written by authors in low/middle-income countries are under-represented among OA publications.
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Affiliation(s)
- Gabriel Levin
- Lady Davis Institute for Medical Research, Montreal, Quebec, Canada
- The Department of Gynecologic Oncology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Jerusalem, Israel
| | - Ross Harrison
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, Oregon, USA
| | | | - Raanan Meyer
- Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer, Israel
- Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Robert L Coleman
- Sarah Cannon Research Institute (SCRI), HCA Healthcare, Nashville, Tennessee, USA
| | - Pedro T Ramirez
- Department of Obstetrics and Gynecology, Houston Methodist Hospital, Houston, Texas, USA
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