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Sentinel node in gynecological cancers

H G Schnürch, S Ackermann, C D Alt, J Barinoff, C Böing, C Dannecker, F Gieseking, A Günthert, P Hantschmann, L C Horn, R Kürzl, P Mallmann, S Marnitz, G Mehlhorn, C C Hack, M C Koch, U Torsten, W Weikel, L Wölber, M Hampl
Purpose: This is an official guideline, published and coordinated by the Arbeitsgemeinschaft Gynäkologische Onkologie (AGO, Study Group for Gynecologic Oncology) of the Deutsche Krebsgesellschaft (DKG, German Cancer Society) and the Deutsche Gesellschaft für Gynäkologie und Geburtshilfe (DGGG, German Society for Gynecology and Obstetrics). The number of cases with vulvar cancer is on the rise, but because of the former rarity of this condition and the resulting lack of literature with a high level of evidence, in many areas knowledge of the optimal clinical management still lags behind what would be required...
October 2016: Geburtshilfe und Frauenheilkunde
Fabio Martinelli, Antonino Ditto, Giorgio Bogani, Mauro Signorelli, Valentina Chiappa, Domenica Lorusso, Edward Haeusler, Francesco Raspagliesi
STUDY OBJECTIVE: To report on detection-rate (DR) of sentinel-nodes (SLNs) in endometrial-cancer (EC) patients after hysteroscopic injection of indocyanine-green (ICG) and Laparoscopic near-infrared (L-NIR) fluorescence mapping. DESIGN: Prospectively collected data. DESIGN: classification: Canadian Task Force II-2 SETTING: Gynecologic oncology referral center. PATIENTS: Consecutive patients with apparent early-stage endometrioid EC scheduled for surgical treatment: total-laparoscopic-hysterectomy, bilateral salpingo-oophorectomy, SLNs mapping...
October 7, 2016: Journal of Minimally Invasive Gynecology
Jiri Slama, Daniela Fischerova, Michal Zikan, Roman Kocian, Anna Germanova, Filip Fruhauf, Ladislav Dusek, David Cibula
OBJECTIVE: The aim of our study was to compare the sensitivity of various methods and their combinations in the follow-up of patients with cervical cancer after fertility-sparing surgery (FSS). METHODS: Included were women with cervical cancer in stages IA2 to IB2 who underwent FSS, which includes pelvic lymphadenectomy, sentinel lymph node biopsy, abdominal radical trachelectomy, vaginal trachelectomy, or needle conization. Follow-up visits were scheduled at 3-month intervals and included symptom-oriented discussion, gynecological and physical examination, colposcopy, Papanicolaou test, human papillomavirus (HPV) DNA test, and ultrasound examination...
September 23, 2016: International Journal of Gynecological Cancer
Fabinshy Thangarajah, Wolfram Malter, Stefanie Hamacher, Matthias Schmidt, Stefan Krämer, Peter Mallmann, Verena Kirn
OBJECTIVES: Since the introduction of the sentinel node technique for breast cancer in the 1990s patient's morbidity was reduced. Tracer uptake is known to be dependent from lymph node integrity and activity of macrophages. The aim of this study was to assess whether radioactivity of the tracer can predict sentinel lymph node metastases. Furthermore, a potential association with Ki-67 index was examined. Non-invasive prediction of lymph node metastases could lead to a further decrease of morbidity...
September 22, 2016: Breast: Official Journal of the European Society of Mastology
Agnieszka Rychlik, Silvia Marin, Javier De Santiago, Ignacio Zapardiel
OBJECTIVE: Multiple tracers have been used to improve lymphatic mapping and to reduce the false-negative rate of the sentinel node detection in gynecologic cancers. Nowadays, 99mTc colloids combined with blue-dye technique is the most extended technique. New alternatives such as the fluorescent indocyanine green and near-infrared fluorescent imaging detection have been introduced in lymphatic mapping staging procedures because of its easier visualization compared with the previous tracers...
September 2016: International Journal of Gynecological Cancer
Lorna A Brudie, Faizan Khan, Michael J Radi, Sarfraz Ahmad
Endometrial serous carcinomas are very clinically aggressive, which constitutes 40% of all deaths and recurrences associated with endometrial cancer. Small-cell carcinoma of the endometrium is relatively rare but aggressive, and often presents a component of endometrioid carcinoma, and is not generally associated with serous carcinoma. Herein, we report a case of 74-year-old African-American female, who presented with intermittent post-menopausal bleeding for > 1-month. She underwent robotic-assisted laparoscopic hysterectomy, bilateral salpingo-oophorectomy, sentinel lymph node mapping, and pelvic-and-aortic lymphadenectomy...
August 2016: Gynecologic Oncology Reports
Christhardt Köhler, Tariane Foiato, Simone Marnitz, Achim Schneider, Xin Le, Nasuh Utku Dogan, Tatiana Pfiffer, Anna Elena Jacob, Andrea Mölgg, Ingke Hagemann, Giovanni Favero
STUDY OBJECTIVE: To report the presence of tattoo ink affected pelvic lymph nodes in women with early cervical cancer and to discuss its potential oncological and surgical consequences. DESIGN CLASSIFICATION: Prospective observational study. SETTING: University Hospital in Hamburg, Germany. BACKGROUND: Skin tattoos on the feet, legs, and lower abdominal wall are progressively gaining popularity. Consequently, the number of tattooed women with cervical cancer has significantly increased in the last decade...
July 28, 2016: Journal of Minimally Invasive Gynecology
Anna Fagotti, Luigi Pedone Anchora, Carmine Conte, Vito Chiantera, Enrico Vizza, Lucia Tortorella, Daniela Surico, Pierandrea De Iaco, Giacomo Corrado, Francesco Fanfani, Valerio Gallotta, Giovanni Scambia
Nowadays cervical cancer is frequently diagnosed at early stage. For these patients lymph node metastasis (LNM) is considered the most important prognostic factor. During the last decade many efforts have been made to reduce rate of complications associated with lymphadenectomy (LND). A great interest has arisen in sentinel lymph node (SLN) biopsy as a technique able to decrease number of LND performed and, at the same time, to assess lymph nodal status. High diagnostic performances have been reached thanks to SLN surgical algorithm...
August 2016: Cancer Medicine
Benjamin E Greer, Wui-Jin Koh
For the first time, NCCN Guidelines are available for vulvar cancer, a rare gynecologic cancer. Early-stage cancers can be managed by surgery and observation, and many of these patients can be cured. Lymph node status drives treatment and correlates with survival. Positive groinal nodes require additional therapy, including radiation plus chemotherapy, depending on stage. Sentinel lymph node biopsy is recommended in selected patients.
May 2016: Journal of the National Comprehensive Cancer Network: JNCCN
Sho Takeshita, Yukiharu Todo, Kazuhira Okamoto, Satoko Sudo, Katsushige Yamashiro, Hidenori Kato
OBJECTIVE: A causal relationship between removal of circumflex iliac nodes distal to the external iliac nodes (CINDEIN) and lower leg edema has been recently suggested. The aim of this study was to elucidate the incidence of CINDEIN metastasis in cervical cancer. METHODS: A retrospective chart review was carried out for 531 patients with cervical cancer who underwent lymph node dissection between 1993 and 2014. CINDEIN metastasis was pathologically identified by microscopic investigation...
July 2016: Journal of Gynecologic Oncology
Fady Khoury-Collado, Caryn St Clair, Nadeem R Abu-Rustum
UNLABELLED: : Lymph node removal for staging, as part of the initial surgical management of patients with endometrial carcinoma, remains a controversial topic in gynecologic oncology. There is currently wide variability among clinical practices, with surgical approaches ranging from no nodal evaluation to comprehensive pelvic and aortic lymphadenectomy. Lymphatic mapping has emerged as an increasingly popular option over the past few years, with several attractive features in its concept, innovative surgical approach, and encouraging preliminary results...
April 2016: Oncologist
Alessandro Buda, Tiziana Dell'Anna, Francesca Vecchione, Debora Verri, Giampaolo Di Martino, Rodolfo Milani
Sentinel lymph node (SLN) mapping is emerging as an effective method for surgical staging of different gynecologic malignancies. Near-infrared (NIR) technology using a fluorescent dye such as indocyanine green (ICG) represents an interesting and feasible method for SLN mapping even in traditional open surgeries by applying video telescope operating microscope (VITOM) system technology. We report our preliminary experience in 12 women who underwent surgical nodal staging for early-stage vulvar and uterine or cervical cancer...
May 2016: Journal of Minimally Invasive Gynecology
José Carlos Sadalla, Jurandyr Moreira de Andrade, Maria Luiza Nogueira Dias Genta, Edmund Chada Baracat
Cervical cancer is the most common gynecological cancer in Brazil. Among women, it is the second most frequent, second only to breast cancer. It is the fourth leading cause of cancer death in the country, with estimated 15,590 new cases (2014) and 5,430 deaths (2013). In order to update information to improve outcomes, reduce morbidity and optimize the treatment of this cancer, this article will address the advancement of knowledge on cervical cancer. The topics covered include the role of surgery in different stages, treatment of locally advanced carcinomas, fertility preservation, the role of the sentinel lymph node technique, indications and techniques of radiotherapy and chemotherapy, and some special situations...
November 2015: Revista da Associação Médica Brasileira
Maria E J Leermakers, Noortje Pleunis, Dorry Boll, Ralph H Hermans, Nicole P M Ezendam, Johanna M A Pijnenborg
OBJECTIVES: Vulvar carcinoma is mainly treated surgically and has an overall good prognosis. Despite the development of minimally invasive surgical procedures in recent years, morbidity remains significant. The aim of the study was to determine the incidence and risk factors of erysipelas after surgical treatment for vulvar carcinoma. METHODS: This retrospective observational study was performed within the Comprehensive Cancer Centre South. The study included patients (N = 116) who underwent surgery for primary vulvar carcinoma between 2005 and 2012...
March 2016: International Journal of Gynecological Cancer
Hua Tu, He Huang, Jihong Liu
OBJECTIVE: To systematically review the clinical value of sentinel lymph node biopsy (SLNB) in diagnosis of lymph node metastasis in early-stage squamous cell carcinoma of vulva. METHODS: Cochrane library, biomedical database (EMbase), PubMed, China national knowledge internet (CNKI), Wang Fang database, «Gynecologic Oncology», «National Medical Journal of China» and «Chinese Journal of Obstetrics and Gynecology» were searched for literatures from 1990 to 2014 concerning SLNB application in early-stage vulvar squamous cell carcinoma...
September 1, 2015: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Sahar Salehi, Karin Stålberg, Janusz Marcickiewicz, Per Rosenberg, Henrik Falconer
Endometrial cancer is the most common gynecological cancer in developed countries and the observed rise in incidence is mainly caused by life style factors including obesity and diabetes. The management of the disease has undergone major changes in the past 5-10 years. Morphological and genetic studies constitute the basis for the new classification of the disease, and data emerging from the Cancer Genome Atlas suggest that genomic patterns differ within the two types of endometrial cancer. The prognosis seems to be related to occult lymphatic spread but the role of lymphadenectomy is heavily debated...
2015: Läkartidningen
Satoru Sagae, Bradley J Monk, Eric Pujade-Lauraine, David K Gaffney, Kailash Narayan, Sang Young Ryu, Mary McCormack, Marie Plante, Antonio Casado, Alexander Reuss, Adriana Chávez-Blanco, Henry Kitchener, Byung-Ho Nam, Anuja Jhingran, Sarah Temkin, Linda Mileshkin, Els Berns, Suzy Scholl, Corinne Doll, Nadeem R Abu-Rustum, Fabrice Lecuru, William Small
OBJECTIVE: Cervical cancer is responsible for more than a quarter of a million deaths globally each year, mostly in developing countries, making therapeutic advances in all health care settings a top priority. The Gynecologic Cancer InterGroup (GCIG) is a worldwide collaboration of leading national research groups that develops and promotes multinational trials in gynecologic cancer. In recognition of the pressing need for action, the GCIG convened an international meeting with expert representation from the GCIG groups and selected large sites in low- and middle-income countries...
January 2016: International Journal of Gynecological Cancer
Giorgio Bogani, Antonino Ditto, Fabio Martinelli, Mauro Signorelli, Stefania Perotto, Domenica Lorusso, Francesco Raspagliesi
Endometrial cancer is the most common gynecologic malignancy in the developed countries. Although the high incidence of this occurrence no consensus, about the role of retroperitoneal staging, still exists. Growing evidence support the safety and efficacy of sentinel lymph node mapping. This technique is emerging as a new standard for endometrial cancer staging procedures. In the present paper, we discuss the role of sentinel lymph node mapping in endometrial cancer, highlighting the most controversies features...
October 2015: Journal of Gynecologic Oncology
Mohamed M Farghali, Ihab S Allam, Ibrahim A Abdelazim, Osama S El-Kady, Ahmed R Rashed, Waheed Y Gareer, Mohammed S Sweed
BACKGROUND: Endometrial carcinoma is the most common gynecological cancer and its treatment is still controversial, especially in its early stages. There are conflicting data about the efficacy of retroperitoneal lymphadenectomy during abdominal hysterectomy and bilateral salpingoophrectomy treatment. Lymphadenectomy carries a risk of severe complications, especially in women with co-morbidities. Selective lymphadenectomy has been widely employed for staging evaluation of endometrial carcinoma because it is simple and seems to provide reliable data regarding nodal metastasis...
2015: Asian Pacific Journal of Cancer Prevention: APJCP
Jung Yun Lee, Kidong Kim, Taek Sang Lee, Sokbom Kang, Seok Ju Seong, Jae Weon Kim, Byoung Gie Kim
OBJECTIVE: To identify current practice patterns for unresolved issues in the surgical and adjuvant management of endometrial cancer in Korea. METHODS: We designed and conducted a survey of all 218 active members of the Korean Gynecologic Oncology Group to try to identify how they would manage various case scenarios for endometrial cancer. Data were collected using an Internet survey database. RESULTS: A total of 108 members (49.5%) responded to the survey...
October 2015: Journal of Gynecologic Oncology
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