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lymphadenectomy in early ovarian cancer

Ka Yu Tse, Hextan Yuen Sheung Ngan, Peter Christopher Lim
Ever since the US Food and Drug Administration approval of the use of da Vinci surgical systems (Intuitive Surgical Inc., Sunnyvale, California) in gynaecology in 2005, robot-assisted surgery has been widely adopted in different countries. Some of the applications in benign and oncological gynaecology include myomectomy, sacrocolpopexy, tubal anastomosis, simple hysterectomy, radical hysterectomy, radical trachelectomy, pelvic and/or para-aortic lymphadenectomy and even debulking surgery for ovarian cancer and pelvic exenteration for recurrent cervical and vaginal cancer...
April 23, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
Ting Hou, Zhen Wang, Yidi Sun, Chenglin Liu, Junyi Li, Yixue Li
Most patients with early stage endometrioid adenocarcinoma are treated with hysterectomy and bilateral oophorectomy to prevent ovarian metastasis. But this surgical menopause leads to some long-term sequelae for premenopausal women, especially for young women of childbearing age. This population-based study was to evaluate the safety of ovarian preservation in young women with stage I endometrioid adenocarcinoma.Patients of age 50 or younger than 50 with stage I endometrioid adenocarcinoma were explored from the Surveillance, Epidemiology, and End Results program database during 2004 to 2013...
April 17, 2017: Combinatorial Chemistry & High Throughput Screening
Rainer Kimmig, Paul Buderath, Pawel Mach, Peter Rusch, Bahriye Aktas
OBJECTIVE: Whether pelvic and para-aortic lymphadenectomy is of therapeutic benefit in advanced ovarian cancer will remain unclear until the publication of the Arbeitsgemeinschaft Gynäkologische Onkologie lymphadenectomy in ovarian neoplasms (AGO LION) trial. In early ovarian cancer, however, lymphadenectomy seems mandatory for diagnostic and also therapeutic reasons. METHODS: Complete systematic lymphadenectomy is accompanied by morbidity which may be reduced by sentinel node biopsy already established for several solid tumors...
May 2017: Journal of Gynecologic Oncology
Ivan Salgado-Ceballos, Jazmín Ríos, Delia Pérez-Montiel, Lenny Gallardo, Salim Barquet-Muñoz, Rosa Salcedo-Hernández, Carlos Pérez-Plasencia, Luis Alonso Herrera, David Francisco Cantú de León
BACKGROUND: According to the International Federation of Gynecology and Obstetrics (FIGO) guidelines, every patient diagnosed with ovarian cancer (OC) should undergo a complete staging procedure to adequately assess tumor spread. The role of lymphadenectomy in the initial management of primary early mucinous ovarian cancer (MOC) remains unclear. OBJECTIVE: To describe the prevalence of pelvic and para-aortic node metastases in MOC. MATERIALS AND METHODS: The records of patients with MOC treated at our Institute during January 2005 to December 2011 were assessed...
March 14, 2017: International Journal of Surgery
Dimitrios Nasioudis, Tomi T Kanninen, Kevin Holcomb, Giovanni Sisti, Steven S Witkin
OBJECTIVE: The aim of this retrospective population-based study was to investigate the prevalence of lymph node metastasis in patients with apparent early stage malignant sex cord-stromal tumors (SCSTs) and the effect of regional lymph node sampling/lymphadenectomy (LND) on their survival. METHODS: A cohort of patients diagnosed with malignant SCSTs between 1988 and 2012 was drawn from the National Cancer Institute's Surveillance, Epidemiology, and End Results database...
May 2017: Gynecologic Oncology
Stephanie Schneider, Sebastian Heikaus, Philipp Harter, Florian Heitz, Christoph Grimm, Beyhan Ataseven, Sonia Prader, Christian Kurzeder, Thomas Ebel, Alexander Traut, Andreas du Bois
OBJECTIVE: The evolving knowledge of ovarian carcinogenesis sets the stage for our understanding of high-grade serous pelvic carcinoma (HGSC). Findings in prophylactic surgery introduced serous tubal intraepithelial carcinoma (STIC) as potential precursor of HGSC. The present study explores whether STIC instead should already be considered as an early stage of HGSC with a need for comprehensive staging and therapy. PATIENTS AND METHODS: We identified all consecutive patients with HGSC who received first-line therapy in our referral center for gynecologic oncology from January 2011 to April 2016...
March 2017: International Journal of Gynecological Cancer
H F Gu, Y Zhou, Y X Li, Y L Ou, J H Liu
Objective: To investigate the survival impact of systematic retroperitoneal lymphadenectomy (SL) and unsystematic lymphadenectomy (USL) in patients with epithelial ovarian cancer. Methods: Randomized control trial (RCT) and observational studies about the effects of SL and USL on patients with epithelial ovarian cancer were searched in major online databases including PubMed, Embase, Web of Science, and Cochrane Library. The literature search was performed up to January 2016. The results were analyzed using RevMan 5...
October 11, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
María Martín-Cameán, Elsa Delgado-Sánchez, Antonio Piñera, Maria Dolores Diestro, Javier De Santiago, Ignacio Zapardiel
Nowadays, the standard management of advanced epithelial ovarian cancer is correct surgical staging and optimal tumour cytoreduction followed by platinum and taxane-based chemotherapy. Standard surgical staging consists of peritoneal washings, total hysterectomy, and bilateral salpingo-oophorectomy, inspection of all abdominal organs and the peritoneal surface, biopsies of suspicious areas or randomised biopsies if they are not present, omentectomy and para-aortic lymphadenectomy. After this complete surgical staging, the International Federation of Gynaecology and Obstetrics (FIGO) staging system for ovarian cancer is applied to determine the management and prognosis of the patient...
2016: Ecancermedicalscience
Victor Lago, Lucas Minig, Christina Fotopoulou
OBJECTIVES: This study aimed to determine the incidence of lymph node (LN) metastases in presumed stage I-II low-grade epithelial ovarian cancer (EOC). METHODS: Eligible studies were identified from MEDLINE and EMBASE (time frame, 2015-1975), that analyzed patients with clinical or radiologic presumed early-stage EOC who underwent a complete pelvic and para-aortic lymphadenectomy as part of their surgical staging. The number and site of dissected and involved LNs and the correlation with overall outcome are analyzed...
October 2016: International Journal of Gynecological Cancer
Sarah M Temkin, Edward J Tanner, Summer B Dewdney, Lori M Minasian
A growing awareness of the harms of overtreatment in cancer care has reached physicians, patients, health policy makers, and medical researchers. Overtreatment exposes patients to the risk of adverse events from procedures or medications that were not necessary. This review examines common practices in gynecologic malignancies that are unlikely to produce direct benefit to patients with these malignancies, but are likely to produce harms. Specifically, we will explore the utility of lymphadenectomy and adjuvant radiation for women with early-stage endometrial cancer; and screening for recurrence and continuous chemotherapy for advanced-stage ovarian cancer patients...
2016: Frontiers in Oncology
Sudeshna Chatterjee, Ling Chen, Ana I Tergas, William M Burke, June Y Hou, Jim C Hu, Cande V Ananth, Alfred I Neugut, Dawn L Hershman, Jason D Wright
OBJECTIVE: To examine utilization and efficacy of chemotherapy for stage I ovarian cancer. METHODS: We conducted a retrospective cohort study using the National Cancer Data Base to identify women with stage I ovarian cancer treated from 1998 to 2012. Patients were classified into three groups based on grade and stage: stage IA or IB grade 1 (low risk); stage IA or IB grade 2 (intermediate risk); and stage IA or IB grade 3 or any stage IC (high risk). Multivariable models were developed to examine predictors of chemotherapy use and survival...
June 2016: Obstetrics and Gynecology
Yoon Soon Lee
OBJECTIVE: The aim of this paper was to demonstrate the techiniqes of single-port laparoscopic transperitoneal infrarenal paraaortic lymphadenectomy as part of surgical staging procedure in case of early ovarian cancer and high grade endometrial cancer. METHODS: After left upper traction of rectosigmoid, a peritoneal incision was made caudad to inferior mesenteric artery. Rectosigmoid was mobilized, and then the avascular space of the lateral rectal portion was found by using upward traction of rectosigmoid mesentery...
May 2016: Journal of Gynecologic Oncology
Valerio Gallotta, Fabio Ghezzi, Enrico Vizza, Anna Fagotti, Marcello Ceccaroni, Francesco Fanfani, Vito Chiantera, Alfredo Ercoli, Cristiano Rossitto, Carmine Conte, Stefano Uccella, Giacomo Corrado, Giovanni Scambia, Gabriella Ferrandina
STUDY OBJECTIVE: To investigate the feasibility and safety of laparoscopic cytoreduction in ovarian cancer patients with localized carcinomatosis or lymph node involvement. DESIGN: Retrospective cohort study (Canadian Task Force classification II-2). SETTING: Multi-institutional study performed in 6 referral gynecologic oncology units. PATIENTS: Between June 2005 and December 2014, preoperatively presumed early-stage ovarian cancer patients, who accidentally revealed localized carcinomatosis or lymph node involvement at laparoscopic evaluation or at postoperative pathological examination managed by the laparoscopic approach...
May 2016: Journal of Minimally Invasive Gynecology
Yuanqing Yao, Xiuli Li, Yizhuo Yang, Zhongyu Liu, Hong Yan, Zhifeng Yan, Li Chen, Jing Wang
OBJECTIVE: To apply robotic surgery of early ovarian malignancy tumors clinically and evaluate its feasibility in management for early ovarian cancer. METHODS: Using the da Vinci robotic surgical system, seven patients with early ovarian malignancy tumors (stage I) underwent robotic surgery from April 2012 to September 2013. The average age was 45.7 years. Robotic surgeries approaches contained salpingo-oophorectomy, para-aortic lymphadenectomy, pelvic lymphadenectomy, omentectomy and appendectomy...
August 2015: Zhonghua Fu Chan Ke za Zhi
Audrey Tieko Tsunoda, Carlos Eduardo Mattos da Cunha Andrade, Marcelo Andrade Vieira, Ricardo dos Reis
Cervical cancer remains the most frequent gynecological tumor in Brazil and other developing countries. Minimally invasive techniques, especially laparoscopy, have been increasingly employed in such tumors. This article aims to describe the main applications of laparoscopy in the treatment and staging of cervical cancer. In the early stages, it is possible to provide a fertility-preserving surgery in the form of radical trachelectomy and, in a study protocol, the function-preserving surgery, avoiding parametrectomy and the associated morbidity...
September 2015: Revista do Colégio Brasileiro de Cirurgiões
Tine H Schnack, Estrid Høgdall, Lotte Nedergaard, Claus Høgdall
OBJECTIVE: To compare clinical demographic and prognostic factors as well as overall survival in a nationwide cohort of patients diagnosed with ovarian clear cell carcinoma (oCCC) and high grade ovarian serous adenocarcinoma (oSAC) during 2005 to 2013. MATERIALS AND METHODS: Population-based prospectively collected data on oCCC (n = 179) and oSAC (n = 2363) cases were obtained from the Danish Gynecological Cancer Database. χ, Fischer or Wilcoxon-Mann-Whitney, multivariate logistic regression, univariate Kaplan-Meier, and multivariate Cox regression tests were used...
January 2016: International Journal of Gynecological Cancer
Salvatore Gueli Alletti, Carolina Bottoni, Francesco Fanfani, Valerio Gallotta, Vito Chiantera, Barbara Costantini, Francesco Cosentino, Alfredo Ercoli, Giovanni Scambia, Anna Fagotti
BACKGROUND: Laparoscopy has acquired an increasing role in the management of ovarian cancer. Laparoscopic cytoreduction could represent a new frontier for selected patients after neoadjuvant chemotherapy (NACT). OBJECTIVE: We sought to assess feasibility and early complication rate of minimally invasive (MI) interval debulking surgery (IDS) in stage III-IV epithelial ovarian cancer (EOC) patients after NACT. STUDY DESIGN: This is a phase II multicentric study in advanced EOC cases with clinical complete response after NACT, according to Gynecologic Cancer Intergroup and Response Evaluation Criteria In Solid Tumors criteria...
April 2016: American Journal of Obstetrics and Gynecology
Sofiane Bendifallah, Myriam Nikpayam, Marcos Ballester, Catherine Uzan, Raffaele Fauvet, Philippe Morice, Emile Darai
BACKGROUND: Surgical management of borderline ovarian tumors (BOTs) is similar to that of ovarian cancer apart from lymphadenectomy. However, the complete procedure including peritoneal washing, infracolic omentectomy and random peritoneal biopsies remains a subject of controversy especially in presumed early stage BOTs. To evaluate the prognostic value of complete surgical staging on recurrence rates, recurrence free (RFS) and overall survival (OS) in a multicentre cohort of BOTs. METHODS: This retrospective multicentre study included 428 patients with BOTs diagnosed from January 1980 to December 2008...
February 2016: Annals of Surgical Oncology
S P Somashekhar, K R Ashwin
Early cervical cancer includes a broad range of disease, from clinically undetectable micro invasive cancer to large, bulky tumours. The International Federation of Gynaecology and Obstetrics (FIGO) staging system stratifies stage I tumours into two categories, stage IA (microinvasive) and stage IB (gross tumour). There are several options for the treatment of early stage cervical cancer. Decisions about treatment depend on age, performance status and the stage of the cancer. Patients with stromal invasion of less than 3 mm (stage IA1) with no lymphovascular involvement are treated conservatively with simple hysterectomy and in selected patients who desire fertility, cone biopsy with negative surgical margins is an option...
2015: Reviews on Recent Clinical Trials
Ketura Preya A Wisner, Sarika Gupta, Sarfraz Ahmad, Robert W Holloway
Robotic-assisted laparoscopy is now the most common surgical method for treatment of early-stage endometrial, cervical, and a growing number of ovarian cancers in the U.S. Para-aortic and pelvic lymphadenectomy is integral to surgical staging and subsequent treatment planning. This article reviews current staging outcomes with robotic surgery for gynecologic cancers, and describes both trans-peritoneal, extra-peritoneal aortic dissection techniques, and the integration of pelvic sentinel lymph node mapping.
December 2015: Journal of Surgical Oncology
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