Emergency endovascular nanopharmacologic treatment in advanced gynecological cancers.

INTRODUCTION: Advanced cases of uterine carcinomas with parametrial and fornix infiltration often cause massive genital bleeding, with severe anemia, fast deterioration, and a high risk of death for patients; women with advanced uterine cancer (UC) and genital massive bleeding were treated using an endovascular therapy in local anesthesia.

METHODS: Ten women with advanced UC and genital massive bleeding were hospitalized for a high risk of immediate death; after blood transfusions and resuscitation therapy, the patients were submitted to an experimental nanopharmacologic endovascular therapy in local anesthesia.

RESULTS: On average, the total operative time for the procedure was 38.6 minutes, the intrasurgical blood loss was of 37 mL, the postoperative analgesic request for 48 hours was just for 3 patients (all dismissed in the second day after pelvic artery embolization), the hemoglobin level at dismissal was of 6.5 g/L, and the duration of hospital stay was 1.4 days. All patients well tolerated the procedure, with no linked complications; clinical check was at the 10th and 30th days after dismissal, with no further recurrent genital bleeding in the follow-up course stopped at the visit in the 60th day.

CONCLUSIONS: Genital bleeding in advanced UC is a serious complication because it causes deterioration of the patient's general status and has a worse prognosis. The pelvic uterine embolization according to our endovascular nanopharmacologic methods is bloodless, less traumatic, and faster than a surgical procedure. Even if it requires experience in intervention radiology, it enables the continuation of external radiotherapy without delay and can replace laparotomic or laparoscopic treatment.