1,720,980 research outputs found
Adjuvant chemotherapy vs radiation therapy after radical surgery in high risk positive node stage IB/IIA cervical cancer
No full textAbstract OBJECTIVE: The aim of this study was to evaluate whether the addition of adjuvant chemotherapy will improve the outcomes of high-risk patients with Stage IB, IIA squamous cervical carcinoma with positive pelvic and/or aortic nodes. MATERIALS AND METHODS: 127 patients with Stage IB and IIA cervical carcinoma treated with radical hysterectomy and systematic pelvic/aortic lymphadenectomy (RS) and who had lymph node involvement, confirmed at the final histological examination were enrolled from January 1987 to December 2001. All the patients received three cycles of adjuvant chemotherapy (AC) with cisplatin, bleomycin and vinblastine. The median patient age was 47.3. Seventy-seven patients had FIGO Stage IB1, 26 IB2 and 24 IIA. The results were compared with those obtained from a group of 136 patients with comparable age, stage and lymph node involvement, on whom radical surgery, systematic pelvic/aortic lymphadenectomy (RS) and adjuvant radiotherapy (RT) was performed on period 1971-1984. The followup period ranged from 7-13 years.RESULTS: Overall survival rate of the two groups (RS+AC) vs (RS+RT) at seven years was 69.3% and 59.5%, respectively (chi2 = 2.70; p = .10). Progression-free survival was 59.8% vs 50.0% (chi2 = 2.56; p = .10 ns). The best results were however obtained with the common iliac and over two lymph node metastases. CONCLUSIONS: Adjuvant chemotherapy in high-risk patients for lymph node positivity did not produce statistically significant results in terms of overall and disease-free survival vs adjuvant radiotherapy; however, a group of these patients, approximately 10%, could receive benefit from the treatment
HRT, TRANSVAGINAL ULTRASONOGRAPHY AND OUTPATIENT HYSTEROSCOPY FOR THE EVALUATION OF INTRAUTERINE PATHOLOGY IN POST-MENOPAUSAL WOMEN: A STUDY OF 10 YEARS.
No full textReliability of oupatient endometrial brush cytology vs biopsy in postmenopausal symptomatic women
No full textObjective To compare outpatient endometrial sampling cytology with conventional biopsy in postmenopausal women with abnormal uterine bleeding and/or abnormal endometrial thickness at ultrasound Method Between December 2003 and December 2009 a group of 1 056 postmenopausal women was referred to the Department of Gynecological Sciences Perinatology an Child Health 11 Faculty of Medicine University of Rome S Andrea Hospital Four hundred and eighty two patients (45 6%) had abnormal uterine bleeding and 602 (57 0%) showed an endometrial thickness > 5 mm at ultrasound Patients on hormonal therapy (n = 194) including hormonal replacement therapy (HRT) or tamoxifen (TMX) were enrolled in the study Endometrial cytologic sampling was per formed using a brush device (EBC) while endometrial histological sampling was retrieved using a Novak curette Histologic evaluation showed a) malignant neoplasia b) atypical hyperplasia c) benign pathology d) normal or atrophic endometrium The following points were investigated a) failure in performing a procedure for cervical stenosis or pelvic pain b) nondiagnostic specimens c) diagnostic accuracy Results Evidence in score pain differences between brush and curette endometrial samples were observed 50% of patients undergoing brush cytology had lower pain scores (chi square = 288 33 p = 001) whereas 60% of patients undergoing endometrial biopsy had higher pain scores (chi square = 264 84 p = 001) The failure rate in performing procedures was 8 0% vs 4 1% and the results were statistically significant on the McNemar test respectively p = 01 and p = 001 A nondiagnostic specimen was obtained in 3 9% of cases by EBC and 103% of cases by the Novak curette (p = 001) Cytological evaluation had a sensitivity of 100% specificity of 99% positive and negative predictive value of 97% and 100% for diagnosing malignant neoplasia Cytology had high diagnostic accuracy for atypical hyperplasia sensitivity 100% specificity 99% positive and negative predictive value 83% and 100% respectively Conclusions EBC is a reliable well tolerated outpatient diagnostic tool for endometrial sampling in detecting early stage cancer in postmenopausal patients at high risk for endometrial cance
La colposospensione sec. Burch complementare agli interventi laparotomici: proposta di uno score di valutazione
No full text[Use of low-dose danazol in adenosis of the breast].
No full textMammary adenosis is a very common affliction which, it has been calculated, affects between 7 and 15% of women of child-bearing age. The Authors report the results obtained during treatment of this condition with danazol in those different dosages (50, 100 and 200 mg per day). Results were evaluated at 3 and 6 months during therapy, and then 4 months after suspension of the treatment. Effects were evaluated in terms of changes in the symptomatic pain and in the actual clinical record. Side effects were also examined in terms of age and obstetric history. The therapy produced good results with all those dosages used. The lowest dosage gave the most favourable long-term effects, also in terms of the scarsity of side-effects
[Hysterectomy in obstetrics. Analysis and comparison of a group of cases from the Italian and the international literature (536 cases)].
No full textThe Authors made a comparison between the frequency of obstetric hysterectomies carried out at the "La Sapienza" University Obstetrics and Gynaecology Departments and of those reported in international publications regarding Great Britain, USA, Australia, Saudi Arabia and Libya. Data obtained covered the 462 hysterectomies effected out of the 442,174 births from 1972 to 1895. Results were compared as under: general frequency per number of births, reasons for surgery, type of operation carried out, age of the patient, gestation period, obstetrical history and complications
[Medium term treatment and prophylaxis of dysfunctional metrorrhagia in adolescence].
No full textThe authors compared the therapeutic effectiveness of these different pharmacological methods of preventing dysfunctional menometrorrhagia in adolescents, which were: 1) chorionic gonadotropin, 2) cyclofenil, 3) ovariostatics. Therapy was given during 2 menstrual cycles, and effects were evaluated both during the treatment and for the succeeding 2 cycles. Parameters followed were: a) clinical recovery, b) persistence of spotting, c) effectiveness in inducing ovulation. The results were equally good both in treatment with ovariostatics and ovulation inducers. The latter proved however, more effective during follow-up. Side-effects were very rare, so much so that, in no case was it necessary to suspend treatment
Occurrence of malignancy in endometrial polyps during postmenopause
No full textObjective.: To evaluate the occurrence of endometrial polyp malignancy in pre- and postmenopausal women with or without symptoms. Materials and Methods: A retrospective study was performed on 351 patients with endometrial polyps diagnosed by hysteroscopy. Results: Histological findings of biopsies obtained by operative hysteroscopy confirmed the presence of a simple endometrial polyp in 179 cases, polyps with typical simple hyperplasia in 42 cases, polyps with typical complex hyperplasia in 24 cases. polyps with atypical complex hyperplasia in three cases; carcinomatous polyps in seven cases; atrophic polyps in 17 cases; functional polyps in 56 cases; and inadequate sample in 23 cases. All seven patients with adenocarcinoma were symptomatic; six out of seven patients with adenocarcinoma were in postmenopause and one was in premenopause. The association between menopausal status and symptoms, and the presence of a malignant lesion was statistically significant (p < 0.001). Conclusions: This: study revealed that prevalence of endometrial polyp malignant transformation was <= 2.84% in postmenopausal and symptomatic patients
Follow-up in a long-term randomized trial with neoadjuvant chemotherapy for squamous cell cervical carcinoma
No full textObjective To assess the role of neoadjuvant chemotherapy to achieve radical surgery in a lamer number of patients with locally advanced/or bulky Stage 1B cervical carcinoma We conducted a trial to determine whether neoadjuvant chemotherapy would improve disease-free survival and overall survival in Stage IB-III cervical cancer Design Prospective randomized clinical study with long-term follow-up Setting Department of Gynecology. Pernatology and Child Health. II Faculty University of Rome "La Saptenza" Methods 288 patients with squamous cell carcinoma of the uterine cervix. FIGO Stage IB-IIIB were randomized to one of the following treatments three courses of neoadjuvant chemotherapy with cisplatin. vinerstine. bleomycin (NACT arm. n = 159). conventional surgery or exclusive radiotherapy (CONV arm. n = 129) There was no difference in as:e. FIGO stage, tumor size and lymph node involvement between the two groups (p = its) Two hundred and thirty-four patients in Stage IB-IIb (n = 129 NACT arm and n = 105 CONV arm) and 24 patients in Stan Ill (NACT arm) who proved to be chemosensitive underwent radical hysterectomy Six Stage III patients. non responders to chemotherapy. and 24 patients, Stage III of the CONV arm, underwent radiotherapy Follow-up extended for seven years. Results The study was performed on disease-free survival related to several prognostic factors age. FIGO stage, tumor size, grading, parametrial involvement, lymph node status and surgical margins Recurrence of disease occurred in 49 (32.1%) patients of the NACT arm (n = 153) and in 39 (37 1%) patients of the CONV arm (n = 105) Statistically significant differences in the recurrence of the disease were related to FIGO stage (p < 003). grading (p < 05), paremetrial involvement (p < 002) lymph node status (p < .0001) and tumor size (p < .002) No statistical significance was related to age and surgical margins (p = its) Disease-free and overall survival in the two groups were, respectively, 65 4% vs 53 5% (p = ns) and 704% 65 9% (p = ns
[Destructive cesarean section: hysterectomy for obstetric reasons and post-abortive hysterectomy. Analysis of 35 cases].
No full textThe Authors examined surgical case studies for the 20-year period from February 1968 to February 1988 concerning hysterectomies performed for obstetric reasons at the "La Sapienza" University of Rome, Obstetrics and Gynaecology Department; these numbered 35 out of 69,677 births. They also considered hysterectomies carried out during caesarean sections, during birth or the postpartum period, during the puerperium and after miscarriage. They also analyzed reasons for the action taken, the type of operation, the length of the gestation period, the mother's age, and transfusions given
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