169,785 research outputs found
Cytoreductive surgery followed by HIPEC repetition for secondary ovarian cancer recurrence.
No full textSecondary and tertiary cytoreductive surgery was associated with improved overall survival in platinum-sensitive recurrent ovarian cancer (ROC). Hyperthermic intraoperative intra-peritoneal chemotherapy (HIPEC) is considered an attractive method in the treatment of ROC to deliver chemotherapy with enhanced effect directly at the tumor site. However, another deserving aspect is the feasibility and the oncologic role of HIPEC repetition. Twelve patients affected by secondary ovarian cancer recurrence previously submitted to cytoreduction followed by HIPEC were enrolled for the present study to receive tertiary cytoreduction followed by HIPEC repetition. The median operative time, including time for HIPEC procedure, was 360 min (range 240–540). Average EBL was 325 ml (from 100 to 500 ml). The median hospital stay was of 5 days, from 4 to 10. Low-grade post operatory complications occurred in 2 patients (16.6%) and high-grade complication in 1 case (8.3%). Our study report encouraging data about safety of HIPEC repetition in ovarian cancer treatment
Oncovascular surgery in gynecologic oncology: en bloc metastatic lymph node and infiltrated inferior vena cava resection followed by patch reconstruction
No full textAdvanced or recurrent gynecologic cancers with retro-
peritoneal lymphatic disease may involve the inferior
vena cava (IVC) and achieving radical debulking of
the disease in this scenario is challenging.1 2 The
concept ‘oncovascular surgery’ defines the case of
tumor resection with simultaneous reconstruction of
the great vessels when the tumor infiltrates or firmly
adheres to the great vessels.3
The aim of this video is to demonstrate the surgical
procedures for radical en bloc resection of metastatic
lymph nodes and the infiltrated IVC with simultaneous
vascular reconstruction.
The indication for the debulking surgery was a
first isolated recurrence of endometrioid endometrial
cancer grade 2 (first diagnosis International Feder-
ation of Gynecology and Obstetrics (FIGO) stage IB
followed by pelvic external beam radiotherapy) in a patient with good performance status. Bulky precaval
lymph nodes with infiltration of the IVC were identi-
fied, while other distant metastases were excluded.
The multidisciplinary tumor board approved surgery as a treatment option. The lymph node metastasis infiltrated the
IVC with absence of a reliable dissection plane. After systemic
heparin infusion and proximal and distal clamping of the vessel,
we performed an en bloc resection of metastatic lymph nodes
along with the infiltrated portion of the IVC. Subsequent vascular
reconstruction was performed with a bovine patch. A running poly-
propylene suture (Prolene 5/0) was used to fix the patch in place
(Figure 1). An intravascular heparin bolus was injected at the end
of the procedure. Complete removal of macroscopic disease was
achieved. No intra- operative or post- operative complications were
observed.
Tumor debulking with en bloc vascular resection and subsequent
reconstruction is a feasible procedure but requires accurate pre-operative
planning and an experienced surgical team. Gynecologic
oncologists need to be familiar with the concept of ‘oncovascular
surgery’ in order to provide the best curative treatment even in the
challenging case of advanced cancers with vascular involvemen
Proteomic Biomarkers for Early Detection and Patients’ Stratification in Ovarian Cancer: A Brief Overview.
No full textLaparo-assisted vaginal radical hysterectomy as a safe option for minimal invasive surgery in early stage cervical cancer: A systematic review and meta-analysis (vol 166, Pg 188, 2022)
No full text
Going Beyond Counting First Authors in Author Co-citation Analysis
No full textThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Finasteride in the treatment of hirsutism: new therapeutic perspectives.
No full textOBJECTIVE: To determine of the clinical and hormonal effects of finasteride (Proscar; Merck, Sharp, and Dohme, Rahway, NJ) in the treatment of idiopathic hirsutism and hirsutism in patients with polycystic ovary syndrome (PCOS). DESIGN: Controlled clinical study. SETTING: Istitute of Obstetrics and Gynecology, University of Naples "Federico II." PATIENTS: Ten women affected by idiopathic hirsutism and 15 women with PCOS. INTERVENTIONS: Finasteride was administered orally at a daily dose of 5 mg for a period of 6 months. MAIN OUTCOME MEASURES: Rating of hirsutism with the Ferriman-Gallwey method; serum androgen assays. RESULTS: Finasteride produced a reduction in the average hirsutism scores ( > 50% in all patients), whereas no change was observed in serum T, androstenedione, and DHEAS levels. A significant reduction was measured in serum dihydrotestosterone and 3 alpha, 17 beta-androstenediol glucuronide levels. CONCLUSIONS: This study demonstrates that symptomatic hirsutism has to be considered as a skin disease associated with the increased activity of the 5 alpha-reductase. It also indicates that the selective 5 alpha-reductase inhibitor, finasteride, is very effective and well tolerated in the treatment of both idiopathic hirsutism and of hirsutism in patients with PCOS
Liquid Biopsy in Endometriosis: A Systematic Review
No full textDespite laparoscopy being a standardized option to diagnose pelvic endometriotic implants, non-invasive biomarkers are necessary to avoid the discomfort of invasive procedures. Recent evidence suggests a potential role of microRNAs (miRNAs) as feasible biomarkers for the early diagnosis of endometriosis. Following the recommendations in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we systematically searched PubMed, EMBASE, Scopus, Cochrane Library, and Science Direct in January 2023. We provided no restriction on the country and year of publication, and considered English published articles. We selected studies including patients with endometriosis and describing miRNA regulation in the context of endometriosis. Overall, 45 studies fulfilled the inclusion criteria, and 2045 patients with endometriosis and 1587 controls were screened. Patients were analyzed concerning miRNAs expression and sources, stage of disease, and symptoms, and compared to controls. Among DEMs, the ones with the widest delta between endometriosis patients and controls—Relative Expression ≥ 4 Log2(ratio)—were miR-145, miR-191, miR-195, miR-21-5p, miR-106b-5p, miR-195-5p, miR-451a, miR-200c, miR-20a-5p, and miR-15a-5p. Although the epigenetic regulation is partially unclear, miRNAs are valid biomarkers to diagnose endometriotic lesions in symptomatic and non-symptomatic women. MiRNAs modulation should be clarified, especially during therapies or relapse, to plan targeted management protocols
Laparo-assisted vaginal radical hysterectomy as a safe option for Minimal Invasive Surgery in early stage cervical cancer: A systematic review and meta-analysis.
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