Minerva obstetrics and gynecology最新文献

{"title":"Vaginal delivery of the second twin: simulation to improve trainee knowledge and comfort.","authors":"Claudio Celentano, Daniela A Iaccarino, Barbara Matarrelli, Maurizio Rosati, Federico Prefumo","doi":"10.23736/S2724-606X.24.05614-8","DOIUrl":"https://doi.org/10.23736/S2724-606X.24.05614-8","url":null,"abstract":"<p><strong>Background: </strong>Vaginal delivery in twins is feasible but challenging. Successful vaginal delivery of a non-vertex second twin depends on knowledge of specific obstetrical maneuvers. Skill acquisition at the patient's bedside is difficult, making simulation training an integral part of obstetrics and gynecology residency programs.</p><p><strong>Methods: </strong>This prospective, randomized, controlled, single-center study involved obstetrics and gynecology residents. Group A attended a frontal lecture followed by practical simulation; Group B received digital home learning. One month later, both groups underwent a simulation test to identify fetal small parts using a birth simulator with a fetus model placed in a simulated amniotic cavity. Training was conducted with an actor facilitator and supervised by six specialists, focusing on obtaining information, using external and internal hands. A 25-question Likert scale questionnaire was administered via Google Forms. Metrics evaluated included time to reach foot/feet, number of attempts, and answers on Kirkpatrick levels 1-4.</p><p><strong>Results: </strong>Twenty-four participants were recruited and randomized into two groups, with five lost to follow-up at the time of the simulation test. Group A required less time for internal podalic version and breech extraction of the second twin (P=0.02) and fewer attempts to reach the foot/feet of the second twin (P=0.01). Supervisor evaluations of \"asking information\" and \"internal hand use\" were better in Group A.</p><p><strong>Conclusions: </strong>Simulation training for the vaginal delivery of a non-vertex second twin is feasible and has a favorable impact on resident performance.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immune biomarkers in cases of recurrent pregnancy loss and recurrent implantation failure.","authors":"Marcelo B Cavalcante, Manoel Sarno, Ricardo Barini","doi":"10.23736/S2724-606X.24.05549-0","DOIUrl":"https://doi.org/10.23736/S2724-606X.24.05549-0","url":null,"abstract":"<p><p>Reproductive failures, such as recurrent pregnancy loss (RPL) and recurrent implantation failures (RIF) are a major challenge for reproductive medicine. The current management of RPL and RIF cases identifies some causes for unsuccessful pregnancy in up to half of patients. Several studies have suggested that immune disorders are responsible for an important portion of unexplained cases of RPL and RIF. Moreover, the immune abnormalities responsible for reproductive failures can be classified into disorders related to autoimmunity and changes in cellular immunity. Antiphospholipid syndrome (APS), testing for antiphospholipid (aPL) antibodies, antinuclear antibodies, and antithyroid antibodies are identified as biomarkers of autoimmunity that can predict reproductive failure. The cellular immune response in cases of RPL and RIF can be investigated through the study of natural killer (NK) cells (uterine and peripheral blood) and T lymphocytes (T helper [Th]-1, Th-2, regulatory T and Th-17 cells). Several types of laboratory assays have been used to evaluate the endometrial immune microenvironment, such as the endometrial immune profile and decidualization score. However, the effectiveness of the treatment of RPL and RIF with immunomodulatory drugs has not yet been confirmed. Recently, a group of experts from the International Federation of Gynecology and Obstetrics and the European Society of Human Reproduction and Embryology recommended the investigation of some immune factors and treatment with immunosuppressants in women with RPL. In conclusion, it is important to consider immune abnormalities when managing women with RPL and RIF. The use of immunotherapies must be personalized and based on a specific diagnosis to obtain favorable outcomes.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ovarian reserve, metabolic and neuroendocrine profiles of cadets from Air Force Academy: a pilot study.","authors":"Alessandro Conforti, Giulia A Guadalupi, Giuseppe Perruolo, Renata S Auriemma, Raffaella DI Girolamo, Luigi Carbone, Federica Cariati, Maria G Orsi, Antonio Raffone, Ida Strina, Pietro Formisano, Maurizio Guida, Gianfrancesco Capuano, Francesca DI Rella, Salvatore Longobardi, Carlo Alviggi, Antonio Mollo","doi":"10.23736/S2724-606X.24.05542-8","DOIUrl":"https://doi.org/10.23736/S2724-606X.24.05542-8","url":null,"abstract":"<p><strong>Background: </strong>Intensive physical activity and rigid dietary regimes can act as modifiers of neuroendocrine axes in women, inducing hormonal disorders and related menstrual irregularities such as functional hypothalamic amenorrhea (FHA). It would be important to evaluate if such disturbances may worsen female fertility. The aim of this study was to evaluate ovarian reserve markers and neuroendocrine axis in young military academy female cadets with years of training and occurrence of FHA.</p><p><strong>Methods: </strong>This is a prospective pilot study involving young female cadets from the Military Academy training program. Ovarian reserve markers and metabolic and neuroendocrine factors in the early follicular phase were measured with blood tests and transvaginal ultrasound.</p><p><strong>Results: </strong>The study group consisted of 11 women belonging to the first year of training and the control group of 33 women belonging to the second to sixth year of training. No differences were found about ovarian reserve markers between the two groups. Moreover, the occurrence of FHA did not modify the ovarian reserve compared to eumenorrhea in both groups. Women from the study group showed significantly higher levels of fasting Insulin (42.18±26.14 uUI/mL versus 11.9±10.2 ng/mL, P value <0.001) and insulin-like growth factor 1 (310.06±67.90 uUI/mL versus 248.67±61.57 uUI/mL, P value = 0.015) compared with control group.</p><p><strong>Conclusions: </strong>Both intense physical training and FHA do not appear to impact the ovarian reserve of young female cadets. Although preliminary, these findings seem reassuring about the reproductive health of these women and their future fertility.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of endometriosis on oocyte quality in women undergoing assisted reproduction.","authors":"Parimala Chinta, Treasa Joseph, Nadia Imam, Nivedita Gupta, Hemapriya Mohan, Mohan S Kamath","doi":"10.23736/S2724-606X.24.05552-0","DOIUrl":"https://doi.org/10.23736/S2724-606X.24.05552-0","url":null,"abstract":"<p><p>Endometriosis is a chronic gynecological condition which can lead to infertility in women during reproductive age. Endometriosis influences the assisted reproductive technology (ART) outcomes by its impact on oocyte and embryo quality, oocyte numbers and subsequently the embryo numbers and endometrial receptivity. There has been clinical dilemma as to whether it is predominantly the oocyte, or the endometrium which affects the pregnancy outcomes in women with endometriosis. In this review we provide an overview of the effect of endometriosis on the oocyte molecular mechanism, the overall effect of endometriosis and its various stages as well as the effect of endometrioma on the oocyte quality in autologous study models. We have also provided a review of the donor oocyte models to study the effect of endometriosis on the endometrium. While initial small donor oocyte-based model studies suggested a possible major detrimental impact of oocyte quality on ART outcomes in women with endometriosis, the more recent studies have found minimal or no impact of oocyte quality on treatment outcomes. There is growing evidence to suggest an important contributory role of reduced oocyte yield on ART success in women with endometriosis. There is a need to explore whether oocyte yield and not the oocyte quality or endometrial receptivity, is the main reason for lower success in women with endometriosis following ART.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Membrane sweeping versus transcervical Foley catheter for induction of labor in women with a previous cesarean delivery: a randomized controlled trial.","authors":"Soon L Yong, Joyce C Ting, Xiu S Wong, George H Wong, Marcus Kang","doi":"10.23736/S2724-606X.24.05470-8","DOIUrl":"https://doi.org/10.23736/S2724-606X.24.05470-8","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare the effectiveness of membrane sweeping and transcervical Foley catheters for the induction of labor after one previous cesarean delivery.</p><p><strong>Methods: </strong>An open-label, prospective, randomized controlled trial was performed at Sibu Hospital, Sarawak, Malaysia between 15^th February 2018 and 30^th August 2018. Pregnant women aged 18 or above at term who had one previous uncomplicated lower segment cesarean section and required induction of labor were randomized to membrane sweeping or transcervical Foley catheter insertion.</p><p><strong>Results: </strong>A total of 60 women were recruited in the study, of whom 30 were randomized to the membrane sweeping group and 30 to the Foley catheter group. The number of women who achieved a Bishop Score ≥8 was significantly higher in the Foley catheter arm than in the membrane sweeping arm (76.7% versus 43.3%; P=0.008). Compared with membrane sweeping, transcervical Foley catheter insertion significantly improved Bishop scores and allowed more women to achieve a favorable cervix that permitted an amniotomy by 48 hours of labor induction (P<0.05). The mode of delivery, intrapartum oxytocin use, maternal complications and neonatal outcomes were similar in both groups. No women had a uterine rupture or uterine hyperstimulation.</p><p><strong>Conclusions: </strong>Although transcervical Foley catheter insertion is superior to membrane sweeping in terms of the efficacy of labor induction, both methods did not show a statistically significant difference in vaginal delivery rates and their overall complication rates were similar.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An update on epigenetic mechanisms in endometriosis.","authors":"Kyle N LE, Ariel Benor, Alan Decherney","doi":"10.23736/S2724-606X.24.05631-8","DOIUrl":"https://doi.org/10.23736/S2724-606X.24.05631-8","url":null,"abstract":"<p><p>The etiopathogenesis of endometriosis, a chronic debilitating disease affecting nearly 10% of women, has evaded elucidation until the recent epigenetic discoveries. Although still deemed multifactorial, endometriosis is likely predisposed in women with genetic and epigenetic alterations, which are activated by environmental factors. There are many epigenetic changes that have recently been associated with endometriosis: DNA methylation and phosphorylation, modifications to histones and non-coding RNA, and chromatin remodeling and organization. Gene markers, such as HOXA10, SF-1, and GATA transcription factors, are also debatably correlated to endometriosis. An improved understanding of the etiopathogenesis of endometriosis may propel our field toward our objectives: sooner and more efficient detection as well as targeted therapy. In this comprehensive review, we will identify and discuss the current literature on epigenetic changes seen in endometriosis. A primary computerized search was performed on PubMed and Google scholar of publications from 1990 to 2022. We searched for keyword terms such as \"endometriosis\" and \"endometriosis epigenetics.\" We also looked through the references of prior articles to find other relevant articles to this topic. Articles were categorized by type of epigenetic change found such as DNA hypo- or hyper- methylation, histone hyper- or hypo-acetylation, chromatin remodeling, and non-coding RNA-mediated down-regulation and the research was elaborated in sections based on the type of epigenetic change. There are many articles on TET, DNMTs, EZH2, HDACs, HATs, let-7 family, miRNAs, Hox proteins, GATA family, sirtuins (e.g. SIRT1, SIRT3), ARID1A, SF-1, USF1, USF2, STRA6, ESR1, ESR2, PGR, ALDHIA2, and CTCF; however, the studies analyzed in this review were heterogeneous in comparison populations, analysis methods, tissues types (e.g. endometriomas, ectopic endometriotic tissue, eutopic endometrial tissue). Due to this, it is difficult to synthesize over-arching conclusions based on the current literature; however, there are many epigenetic changes and genes linked to endometriosis as noted in the literature.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Office endometrial sampling: effectiveness and predictive factors of success in Novak versus Endosampler devices.","authors":"M Carolina Carneiro, Patrícia G Ferreira, Susana M Saraiva, Cátia D Rodrigues, Susana Leitão, Cristina M Costa, Maria da Soledade Ferreira","doi":"10.23736/S2724-606X.23.05358-7","DOIUrl":"10.23736/S2724-606X.23.05358-7","url":null,"abstract":"<p><strong>Background: </strong>The study aimed to evaluate the rate of endometrial sampling (ES) failure, predictive factors of success, and reliability as diagnostic methods of Endosampler versus Novak.</p><p><strong>Methods: </strong>A retrospective single-center study was carried out with all patients who underwent ES via Endosampler or Novak in 2020 and 2021. Demographic data, personal background, and histopathologic results were evaluated.</p><p><strong>Results: </strong>Eighty-six patients underwent ES by Novak and 90 by Endosampler. The failure rate of ES was 43.2% with lower values for Endosampler (33.3% vs. 53.5%, P<0.05). Age, biopsy device, menopausal status, indication for biopsy, and amount of sample collected were predictive factors of failure. Analyzing each device, Endosampler was only affected by menopausal status. Only 50% in Novak and 62.5% in the Endosampler group of endometrial neoplasia cases were detected by these methods. Analyzing the performance for endometrial neoplasia (EN), we obtained higher values of sensitivity and accuracy for Endosampler (62.5% vs. 50.0% and 83.3% vs. 72.7%), respectively.</p><p><strong>Conclusions: </strong>In our study, the failure rate obtained was in line with other previous studies. Menopausal status, age, type of biopsy device, indication for biopsy, and amount of sample collected affected ES performance. Analyzing diagnostic performance for EN, we found that these methods have better reliability for positive results than for negative ones, which may indicate the need for further evaluation in cases of high clinical suspicion. In short, we obtain a higher rate of success rate in Endosampler devices and better performance in diagnosing EN, which is the major objective of an ES.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"522-531"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138445435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pelvic exenteration: a retrospective study in a tertiary referral cancer center in the UK.","authors":"Konstantinos Palaiologos, Rebecca Karkia, Zoi Nikoloudaki, Ahmed Mohamed, Rebecca Lavelle, Susanne Booth, Marina Flynn, Christopher Helbren, Matthew Simms, Theo Giannopoulos","doi":"10.23736/S2724-606X.24.05337-5","DOIUrl":"10.23736/S2724-606X.24.05337-5","url":null,"abstract":"<p><strong>Background: </strong>Pelvic exenteration (PE) is an extensive surgery that is indicated in cases of recurrent advanced gynecological cancer with curative and sometimes palliative intent. The procedure is associated with both high morbidity and mortality and as such is considered a highly specialist procedure. The aim of the study was to analyze surgical outcomes in women who underwent PE for advanced gynecological malignancy in a tertiary cancer referral center over 11 years.</p><p><strong>Methods: </strong>This is an observational retrospective single-center study. There were 17 patients included who underwent PE in Hull Royal Infirmary Hospital (Hull, UK) between 2010 and 2021. The main outcome measures were the perioperative complications, overall survival (OS), and recurrence free survival (RFS). Cumulative survival rates were reported at 1, 3 and 5 years. Univariate Cox regression analysis was undertaken to analyze factors that are prognostic for OS and RFS. Hazard Ratios (HR) with 95% confidence intervals (95% CI) were computed from the results of the Cox regression analyses. Kaplan-Meier survival curves were generated to visually display estimates of OS and RFS over the follow-up period.</p><p><strong>Results: </strong>The median age at the time of surgery was 63.0 (IQR: 48.0-71.0). All patients received surgery with curative intent and complete tumor resection (R0) was achieved in 94.1% of cases. An overall 5-year survival was achieved in 63.7% of patients. Mean overall survival (OS) was 8.4 years (95% CI: 7.78-9.02). The RFS was 5.0 years (95% CI: 4.13-5.87). Both OS and RFS were significantly negatively affected by the hospital stay (P=0.020 and P=0.035, respectively), but not by the type of surgery (P=0.263 and P=0.826, respectively).</p><p><strong>Conclusions: </strong>The results of the study demonstrated stable and comparable outcomes in patients undergoing pelvic exenteration.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"509-515"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140294037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insights on estetrol, the native estrogen: from contraception to hormone replacement therapy.","authors":"Christian Battipaglia, Alessandro D Genazzani, Rossella E Nappi, Antonio La Marca","doi":"10.23736/S2724-606X.24.05594-5","DOIUrl":"10.23736/S2724-606X.24.05594-5","url":null,"abstract":"<p><p>Estetrol (E4) is a natural estrogen that has recently emerged as new option for contraception and hormone replacement therapy (HRT). Unlike other estrogens, E4 primarily stimulates nuclear estrogen receptor alpha (ERα) and does not activate membrane ERα. For this reason, this novel estrogen has tissue-specific effects across various organs such as liver, vascular endothelium, mammary glands, brain, vagina, and uterus. The selective activation of the nuclear ERα results in distinct pharmacological properties that contribute to its unique therapeutic profile. Moreover, E4 shows minimal interaction with the hepatic cytochrome P450 enzyme system, leading to a favorable pharmacokinetic profile and a reduced potential for drug-drug interactions. Currently, E4 is commercially available in combination with drospirenone as a combined oral contraceptive and its application in HRT is undergoing late-stage clinical development. Many studies have demonstrated that E4 has a lower impact on hemostatic and metabolic parameters compared to other estrogens, potentially reducing the risk of adverse effects commonly associated with hormonal therapies such as thromboembolic events or dyslipidemia. Beyond its role in contraception and HRT, E4 shows promising therapeutic potential in other medical fields, including neuroprotection in neonatal hypoxic-ischemic encephalopathy, enhancement of hematopoietic stem cell transplantation outcomes and prostate cancer management. This review synthesizes the latest evidence on E4 primarily focusing on its pharmacological characteristics and clinical applications. The findings suggest that E4 versatility and peculiar mechanism of action may represent an important therapeutic option for a broad spectrum of medical conditions.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"590-603"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142291098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic prediction of primary cytoreducibility of epithelial ovarian cancer.","authors":"Tullio Golia D'Augè, Ilaria Cuccu, Emanuele DE Angelis, Violante DI Donato, Ludovico Muzii, Ottavia D'Oria, Vito Chiantera, Sandro Gerli, Donatella Caserta, Aris R Besharat, Antonio S Laganà, Giorgio Bogani, Alessandro Favilli, Andrea Giannini","doi":"10.23736/S2724-606X.24.05452-6","DOIUrl":"10.23736/S2724-606X.24.05452-6","url":null,"abstract":"<p><p>Ovarian cancer affects thousands of women every year and represents the female cancer with the highest mortality rate. Effectively, it is a severe disease that requires a multidisciplinary approach for optimal treatment. Surgery currently is the cornerstone of its treatment and numerous methods have been analyzed and developed to predict the possibility of obtaining a residual tumor of 0 (RT=0). This review aimed to analyze the available data in the literature about minimally invasive surgical methods to predict an RT=0 in patients with advanced epithelial ovarian carcinoma undergoing primary debulking surgery. An accurate review of the literature has been performed on the available data about the surgical criteria of cytoreducibility during primary debulking surgery. An accurate assessment of the extent of intra- and extra-abdominal pathology is essential to guide the surgeon in the most appropriate therapeutic choice for patients with ovarian cancer and multidisciplinary approaches that combine different methodologies such as radiological methods (magnetic resonance imaging, positron emission tomography and computed tomography), surgical (mini-laparotomy, laparoscopy) and serological (CA-125, HE4) data provide a complete picture in determining the extent of the tumor and an enormous aid in personalizing the therapeutic approach.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"548-557"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}