Current Gynecologic Oncology最新文献

{"title":"Laparoscopic versus open hysterectomy in type I endometrial cancer – a tertiary referral center experience","authors":"Khaled Gaballa, Omar Hamdy, B. Refky, M. Abdelkhalek","doi":"10.15557/cgo.2021.0007","DOIUrl":"https://doi.org/10.15557/cgo.2021.0007","url":null,"abstract":"Background: Surgery has been considered the cornerstone in the management of endometrial cancer, especially in its early stages. The use of minimally invasive surgeries in patients with endometrial cancers has been widely adopted worldwide. In this study, we discuss the outcomes of type I endometrial cancer patients who underwent laparoscopic hysterectomy at our center. Results: The patients were categorized into two groups: open surgery group (59 patients) and laparoscopy group (60 patients). There was no significant difference between both groups as regards the epidemiologic and clinicopathologic parameters. There was no statistical difference between the two groups in the FIGO stage (International Federation of Gynecology and Obstetrics). Operative time was significantly longer in the laparoscopy group compared to the open surgery group (p < 0.0001). No significant difference was found between both groups as regards the type of operation and blood loss. The rate of intraoperative complications was nearly similar in both groups. There was no significant statistical difference between the numbers of lymph node yield in both groups. Conclusion: The results in this study support the use of laparoscopy in early stage type I endometrial cancers without compromising the oncological outcomes regarding the disease-free and overall survival. We encourage further prospective multicenter randomized trials to consolidate these results.","PeriodicalId":38739,"journal":{"name":"Current Gynecologic Oncology","volume":"69 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90685995","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":"Magnetic resonance imaging-guided high-dose planned adaptive intensity-modulated radiation therapy for locally advanced cervical cancer","authors":"Y. Hama, E. Tate","doi":"10.15557/cgo.2021.0011","DOIUrl":"https://doi.org/10.15557/cgo.2021.0011","url":null,"abstract":"Magnetic resonance imaging-guided radiotherapy can accurately irradiate moving targets such as cervical cancer. An 82-year-old woman with locally advanced cervical cancer was referred for palliative radiotherapy. She had refused chemotherapy and brachytherapy, so she was treated with external beam radiotherapy to control her uterine bleeding and to alleviate pubic pain. Since her cervical cancer had no metastases, and she was expected to survive for a long time, curative doses of radiation (70–80 Gy/28 fractions) were administered by magnetic resonance imaging-guided planned adaptive intensity-modulated radiation therapy. Six months after intensity-modulated radiation therapy, the tumor disappeared without adverse events, and her symptoms were relieved. To the best of our knowledge, this is the first report of locally advanced cervical cancer treated with high-dose magnetic resonance imaging-guided adaptive intensity-modulated radiation therapy.","PeriodicalId":38739,"journal":{"name":"Current Gynecologic Oncology","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74638485","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":"Feasibility, accuracy and advantages of frozen section examination of ovarian masses with normal tumor markers. A tertiary referral center experience","authors":"Abeer Elfeky, O. Hamdy, S. Roshdy, Fayez Shahatto, M. Abdelaziz","doi":"10.15557/cgo.2021.0008","DOIUrl":"https://doi.org/10.15557/cgo.2021.0008","url":null,"abstract":"Introduction: Proper design of the operative plan for patients with ovarian masses is a must to avoid unnecessary surgical steps, the need for another surgery or empirical chemotherapy. We investigated the role of frozen section examination in this design. Methods: This was a prospective study in which 64 complex adnexal masses with normal tumor markers underwent frozen section examination. The patients were divided into two parallel groups: group A in which the decision whether to proceed for complete staging or not was built on the result of the examination, and group B in which the patients underwent panhysterectomy at baseline regardless of their frozen section examination result. Postoperative stay, estimated blood loss and the incidence of complications were compared. Results: When comparing the two groups, including patients with tumors that turned out to be benign, there were no significant differences in postoperative complications, but there were for the operative time (60 vs. 120 minutes, p = 0.004) and blood loss, which were significantly lower in group A (50 vs. 100 mL, p = 0.001), and hospital stay, which was statistically insignificantly shorter than in group B (1 day vs. 2 days, p = 0.062). The sensitivity of frozen section examination for benign, borderline, and malignant ovarian masses was 91.9%, 76.9%, 53.3%, respectively, while the specificity was 85.2%, 87.5%, 95.9% and the overall diagnostic accuracy was 89.6%, 85.2%, 85.9%, respectively. Conclusion: The use of frozen section examination in the assessment of complex ovarian masses in patients with normal tumor markers offers an acceptable accuracy with a significant decrease of the operative time, blood loss as well as hospital stay.","PeriodicalId":38739,"journal":{"name":"Current Gynecologic Oncology","volume":"288 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76406222","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":"Stage FIGO IB1 lymphoepithelioma-like carcinoma of the uterine cervix in a 57-year-old female","authors":"J. Trawińska, Joanna Bielatowicz, Bogusław Gawlik, J. Skręt-Magierło, A. Skręt, A. Radkowski, M. Książek, E. Barnaś","doi":"10.15557/cgo.2021.0010","DOIUrl":"https://doi.org/10.15557/cgo.2021.0010","url":null,"abstract":"Lymphoepithelioma-like carcinoma (LELC) of the uterine cervix is a rare type of cervical cancer. The etiopathogenesis of cervical LELC involves consideration of the human papillomavirus (HPV) and Epstein–Barr virus infection. We present the case of a 57-year-old female diagnosed with a unique HPV-59 with the absence of Epstein–Barr virus, which is characteristic for European women. The treatment included a radical hysterectomy with nerve-sparing radical hysterectomy, which has not been used in patients with LELC so far. Complementary treatment included combined radiotherapy and cisplatin infusion.","PeriodicalId":38739,"journal":{"name":"Current Gynecologic Oncology","volume":"476 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77045870","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":"PARP inhibitors – a new direction in the treatment of breast and ovarian cancer","authors":"Karol Gawalski, M. Bizoń, Bohdan Dźwigała, K. Cendrowski, W. Sawicki","doi":"10.15557/cgo.2021.0009","DOIUrl":"https://doi.org/10.15557/cgo.2021.0009","url":null,"abstract":"Ovarian cancer, like breast cancer, may either develop spontaneously or as a result of a family history. BRCA1 and BRCA2 mutations significantly increase the risk of both cancers at all ages. It is estimated that 3–5% of women are BRCA mutation carriers. BRCA1 mutation carriers have a 65% risk of breast cancer and 39% risk of ovarian cancer. These risks are lower among BRCA2 mutation carriers, i.e. 45% and 11% for breast and ovarian cancer, respectively. In breast and ovarian cancer with BRCA mutations, blocking the function of poly(ADP-ribose) polymerase (PARP) enzymes, including PARP1 and PARP2, causes an accumulation of DNA damage that ultimately leads to cancer cell death. Based on this mechanism, PARP inhibitors have been used in the treatment of hereditary neoplasms, in which the proper functioning of DNA damage repair systems is disturbed. In clinical trials to date, PARP inhibitors significantly extended the progression-free survival in patients with confirmed BRCA mutations. Similar results have been obtained for patients without confirmed genetic background. Currently, PARP inhibitors are increasingly approved for use in the treatment of ovarian and breast cancer. From May 2021, the Ministry of Health has reimbursed maintenance therapy with PARP inhibitors in patients with known BRCA mutation status.","PeriodicalId":38739,"journal":{"name":"Current Gynecologic Oncology","volume":"2011 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86321263","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":"Wedge liver resection as part of cytoreductive surgery in advanced ovarian cancer – a safe and feasible procedure for a gynecologic oncologist","authors":"B. Banaś, P. Kołodziejczyk, K. Pityński, Michał Mleko, P. Richter","doi":"10.15557/cgo.2021.0006","DOIUrl":"https://doi.org/10.15557/cgo.2021.0006","url":null,"abstract":"Objective: In this study, we aimed to determine the learning curve for liver wedge resection performed as part of cytoreductive surgery in advanced ovarian malignant tumors. Materials and methods: This was a retrospective analysis of 120 women diagnosed with stage IIIC ovarian cancer according to the International Federation of Gynecology and Obstetrics (FIGO) classification: 22 underwent liver wedge resection as part of cytoreductive surgery (Group A), while 98 did not require liver surgery (Group B). In the study, the t-Student test was used for variables with normal distribution and the Mann−Whitney U test was utilized for increment and abnormally distributed variables. The variables categorized were shown as a number of cases (n) and a percentage (%), and compared using the chi-square test, with a p-value <0.05 considered significant. A cumulative sum control chart (CUSUM) method was used to investigate the learning curves in both groups and the entire cohort. Results: There were no significant differences in the operating time, intraoperative blood loss, postoperative hospitalization or minor and severe adverse effects between the Groups A and B. The operative time, total blood loss, and incidence of adverse effects showed a similar learning curve for Group B and the entire cohort. Conclusion: It is safe and feasible for gynecologic oncologists to perform wedge liver resections as part of cytoreductive surgery in women with advanced ovarian tumors.","PeriodicalId":38739,"journal":{"name":"Current Gynecologic Oncology","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89836939","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":"The value of fertility-sparing surgery for young females with epithelial ovarian cancer: a comparative study","authors":"W. Etman, M. F. Abohashim, Ramadan M. Ali, O. Abd-Elaziz, Doaa Mandour, Rehab Hemeda, O. Harb, Walid A. Abdelsalam","doi":"10.15557/cgo.2021.0003","DOIUrl":"https://doi.org/10.15557/cgo.2021.0003","url":null,"abstract":"Background: Epithelial ovarian cancer is increasingly often diagnosed in young females who wish to preserve their fertility. Fertilitypreserving surgeries, where conservation of the uterus and contralateral ovary was performed, might be beneficial for patients with stage I epithelial ovarian cancer, but their safety is still controversial. In the present study, we aimed to compare radical surgery and fertility-saving surgery in females with stage IA–C epithelial ovarian cancer for recurrence and survival rates, as well as to evaluate reproductive and obstetric outcomes for stage I epithelial ovarian cancer females who were managed with fertility-saving surgery. Materials and methods: We prospectively identified 60 patients aged ≤40 years who were diagnosed with stage I epithelial ovarian cancer. The patients in the fertility-preservation group underwent salpingo-oophorectomy on the side of the affected ovary in addition to incisional biopsy or wedge excision of the ovary on the other side. The patients in the radical surgery group underwent total hysterectomy and bilateral salpingo-oophorectomy. We followed up all patients for 5 years to assess their reproductive and oncological outcomes. Results: Patients in the fertility preservation surgery group were significantly younger (30 ± 4 versus 35 ± 5 years) (p < 0.001), their tumor sizes were smaller (3.4 ± 1.3 versus 6.0 ± 2.6 cm) (p < 0.001), of lower grade (p = 0.011), earlier stage (p < 0.001) and had more mucinous histology than patients in the radical surgery group. There were no statistically significant differences between both groups regarding tumor recurrence or survival rates. Of 25 patients who underwent fertility preservation surgery, 18 (72%) attempted to conceive. A total of 15/18 (83%) pregnancies were recorded, including 13 live births, 1 miscarriage, and 1 intrauterine fetal death. Conclusion: Fertility-sparing surgery could be an adequate alternative to radical surgery for young females with stage I epithelial ovarian cancer.","PeriodicalId":38739,"journal":{"name":"Current Gynecologic Oncology","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73793248","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":"The prognostic factors of survival and recurrence in patients with serous ovarian and uterine cancers treated in a single institution for 17 years","authors":"G. Demirtas, M. Gökçü","doi":"10.15557/cgo.2021.0002","DOIUrl":"https://doi.org/10.15557/cgo.2021.0002","url":null,"abstract":"Objective: In this study, we aimed to identify the prognostic factors of survival and recurrence in ovarian and uterine serous cancer patients. Materials and methods: This was a retrospective study conducted at Tepecik Research and Education Hospital, İzmir, Turkey, between January 2002 and January 2019. The medical files of 2,027 endometrial and 821 ovarian patients who underwent examination for endometrial cancer and epithelial ovarian cancer were examined retrospectively by the same author. The data of eligible 385 and 49 patients diagnosed with ovarian and uterine serous carcinoma, respectively, were identified for analysis from the hospital database. Descriptive, univariate, and multivariate Cox regression and binary logistic regression analyses of patients were performed. Results: The mean age of ovarian serous cancer patients (n = 385) was 53.9 ± 10.9 years. The mean age of uterine serous cancer patients (n = 49) was 67.2 ± 10.6 years. A total of 81 ovarian serous cancer patients (21.0%) had stage 1, while 24 (6.2%) had stage 2, and 31 (8.1%) had stage 4 disease. A total of 26 uterine serous carcinoma patients (53.1%) had stage 1 disease, 6 (12.2%) had stage 2, 10 (20.4%) had stage 3, and 7 (14.3%) had stage 4 disease. For ovarian serous patients, stage, grade, optimality, neoadjuvant chemotherapy, adjuvant chemotherapy cycle number, and recurrence had impact on both overall and disease-free survival (p < 0.05). For uterine serous cancer patients, optimality was the only prognostic factor for both survival and recurrence (p = 0.01 and p = 0.01, respectively). Conclusion: In ovarian serous cancer patients, we found that disease stage, grade, optimality, neoadjuvant chemotherapy, and adjuvant chemotherapy cycle number had impact on overall and disease-free survival in both univariate and multivariate Cox regression analysis, whereas disease stage and optimality were the only significant prognostic factors for recurrence in ovarian serous cancer patients. However, in patients with uterine serous carcinomas, optimal surgery was the only independent prognostic factor both for survival and recurrence.","PeriodicalId":38739,"journal":{"name":"Current Gynecologic Oncology","volume":"363 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76585783","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":"Nerve-sparing surgery in current gynecologic oncology","authors":"P. Gruszecki, K. Pityński","doi":"10.15557/cgo.2021.0005","DOIUrl":"https://doi.org/10.15557/cgo.2021.0005","url":null,"abstract":"Nerve-sparing surgery is currently a very important topic in gynecologic oncology. In this review, it is shown that radical hysterectomy is not the only operation where the nerve-sparing technique can be used. Most surgical procedures in modern gynecologic oncology should spare the autonomic nerve structures. The review includes recently published articles precisely describing the nerve-sparing techniques in paraaortic and pelvic lymphadenectomy, and the modern approach to radical nerve-sparing hysterectomy. It has been shown in the literature that the quality of life of patients is directly dependent on the operation technique and its extension. As mentioned above, the nerve-sparing technique needs to be used not only in surgical procedures for cervical cancer, but more extensively also for endometrial and ovarian cancers. Modern techniques demonstrate that such an operation can be suitable both for the radicality and improved quality of life. Results of such operations are comparable to the old – not nerve-sparing techniques – both in terms of progression-free survival and overall survival. Nerve-sparing surgery in gynecologic oncology is our future. Better quality of life and greater patient satisfaction should be our goals. Studies are needed for better examination and comparison of the presented systematic nerve-sparing operations of lymphadenectomy in ovarian and endometrial cancers, and also combined with nerve-sparing radical hysterectomy.","PeriodicalId":38739,"journal":{"name":"Current Gynecologic Oncology","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87105631","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":"Nomothetic EORTC IN-PATSAT 32 and idiographic GAS questionnaires in the assessment of surgical treatment in patients with endometrial cancer","authors":"J. Trawińska, J. Skręt-Magierło, Renata Raś, Bogusław Gawlik, A. Skręt, Sławomir M Januszek, E. Barnaś","doi":"10.15557/cgo.2021.0001","DOIUrl":"https://doi.org/10.15557/cgo.2021.0001","url":null,"abstract":"Introduction: Identification and attainment of the goals of cancer patients is an important aspect of personalized treatment. Aim of the study: The study aimed to assess the following aspects in patients treated surgically for endometrial cancer: 1) level of satisfaction with hospitalization using the EORTC IN-PATSAT32 nomothetic questionnaire; 2) degree of goals attainment using the Goal Attainment Scaling (GAS) idiographic questionnaire; 3) correlation between these evaluation methods. Material and method: The study included 123 patients with endometrial cancer (FIGO I–II) treated surgically at the Department of Obstetrics and Gynecology in Rzeszów in 2012–2014. EORTC IN-PATSAT32 and GAS questionnaires were used. The collected material was analyzed using the Statistica 10.0 software. Results: The overall level of satisfaction measured with the IN-PATSAT32 scale was 72.2 ± 20.5. The technical skills were rated the highest in nurses (74.5 ± 17.6) and doctors (69.3 ± 17.8), while the lowest score was awarded for hospital assess (54.7 ± 23.3). The overall satisfaction with care was 72.2 ± 20.5. In the personalized GAS scale, the patients listed individual expectations before the surgery, assigning ranks to their importance. For most of them, it was a very high (A) or high (B) rank. The patients assigned the highest ranks to quick mobilization, success of the operation, and willingness to be healthy. The average value of the level of goal attainment on the discharge date was 63.7 ± 9.4 points. Statistically significant correlations between the questionnaires were found for the level of goal attainment and the assessment of various aspects of hospital care. Conclusions: The study proved that the EORTC IN-PATSAT32 questionnaire was correlated with GAS questionnaire, and additionally provided knowledge about individual goals of care and the degree of their attainment. The use of nomothetic and idiographic tools gives wider possibilities in the planning and implementation of personalized care.","PeriodicalId":38739,"journal":{"name":"Current Gynecologic Oncology","volume":"66 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89263830","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}