scholarly journals Novel diagnostic and therapeutic approaches to the treatment of ovarian cancer

2019 ◽  
Vol 72 (1-2) ◽  
pp. 11-16
Author(s):  
Srdjan Djurdjevic ◽  
Sanja Stojanovic ◽  
Marijana Basta-Nikolic ◽  
Dragan Nikolic
Keyword(s):  
Ovarian Cancer ◽  
Tumor Type ◽  
Cancer Antigen 125 ◽  
Blood Concentrations ◽  
Thoracic Computed Tomography ◽  
Gynecology And Obstetrics ◽  
Clinical Center ◽  
Fertility Sparing ◽  
Histological Tumor Type ◽  
Novi Sad

Introduction. Ovarian cancer is an intra-abdominal, chemosensitive, chronic disease and according to current protocols, it is primarily treated with surgery followed by adjuvant chemotherapy. In Serbia, 820 cases of ovarian cancer are newly diagnosed annually. The aim of the study is to present the results of surgical treatment in 304 patients with ovarian cancer, treated during a 15-year period (2003 - 2017) at the Clinic of Gynecology and Obstetrics, Clinical Center of Vojvodina in Novi Sad. Material and Methods. Before the operation, clinical, gynecological, ultrasonography examination and analysis of cancer antigen 125 blood concentrations were performed in all patients. Based on basic diagnostics, additional pelvic, abdominal and thoracic computed tomography or magnetic resonance imaging studies, together with colonoscopy if needed, were performed. The selection of the type and extent of surgical procedure was based on intraoperative assessment of the stage of disease, intraoperative histopathological confirmation of ovarian cancer, wish for fertility preservation and general patient?s condition. Exclusion criteria were histopathologically confirmed benign or borderline ovarian tumors, i. e. absence of cancer in the final microscopic specimen. Results. The patients? age ranged from 19 - 88 years, with a median of 53.4 years. According to the International Federation of Gynecology and Obstetrics staging, most patients had stage III - 98 (33.1%) and epithelial ovarian cancer - 240 (84.2%). The most common surgical procedures were hysterectomy with bilateral adnexectomy and omentectomy, whereas cytological analysis was performed in 138 (45.4%) treated patients. Complications were recorded in 13 (4.3%) operated patients with inflammation and wound seroma being the most common (4 patients - 1.3% of cases). Conclusion. Ovarian cancer treatment is planned individually, depending on the stage of the disease, histological tumor type, patient?s general condition, wish for fertility-sparing treatment and technical capacity of the institution where the treatment is performed.

scholarly journals Development of the city hospital in Novi Sad - part II

2019 ◽  
Vol 72 (7-8) ◽  
pp. 251-256
Author(s):  
Dusanka Dobanovacki ◽  
Nada Vuckovic ◽  
Radmila Gudovic ◽  
Vladimir Sakac ◽  
Milanka Tatic ◽  
...  
Keyword(s):  
Medical Rehabilitation ◽  
City Hospital ◽  
Financial Difficulties ◽  
Gynecology And Obstetrics ◽  
Clinical Center ◽  
Bed Capacity ◽  
1960S And 1970S ◽  
The 1960S ◽  
Novi Sad ◽  
Rehabilitation Clinic

At the end of the Second World War, the General State Hospital had seven departments, the same facilities, and the same bed capacity as in the pre-war period. In the newly formed state of Yugoslavia, intensive growth and modernization of the hospital began, despite the great financial difficulties. The hospital became the Main Provincial Hospital and new departments and services were established. Mainly during the 1960s and 1970s, ten new surgery departments were established, which later became independent clinics. The surgery departments occupied pavilions 1, 2, 3 and 4. Complex and contemporary abdominal and thoracic surgeries were performed. The Department of Internal Diseases became the Clinic of Internal Diseases and in 1964 it was moved to a newly equipped four-story building. The Clinic of Gynecology and Obstetrics was founded and it was moved into a modern, purpose-built facility with a 230 bed capacity for adult patients and 105 for newborns. Rapid progress has also been made in the development of the Clinic of Infectious Diseases, Clinic of Eye Diseases, Clinic of Ear, Nose and Throat Diseases, Neurology and Psychiatry Clinics, Clinic of Dermatovenereology Diseases, Medical Rehabilitation Clinic - as well as a modern laboratory, X-ray, blood transfusion, and polyclinic services. After the establishment of the Faculty of Medicine and the Clinical Center of Vojvodina, this large tertiary medical institution is the source of pride for Novi Sad. Founded 110 years ago, the hospital is still dedicated to providing better healthcare for patients.

scholarly journals Laparoscopic assisted vaginal hysterectomy at the clinic of gynecology and obstetrics in Novi Sad

2019 ◽  
Vol 72 (5-6) ◽  
pp. 143-147
Author(s):  
Srdjan Djurdjevic ◽  
Aleksandra Vejnovic ◽  
Milos Pantelic
Keyword(s):  
Vaginal Hysterectomy ◽  
Uterine Prolapse ◽  
Pelvic Lymphadenectomy ◽  
Artery Ligation ◽  
Gynecology And Obstetrics ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Clinical Center ◽  
Ureteral Injuries ◽  
Novi Sad ◽  
Laparoscopic Assisted

Introduction. Laparoscopic assisted vaginal hysterectomy is a surgical procedure with uterine artery ligation followed by vaginal removal of the uterus. The first laparoscopic assisted vaginal hysterectomy was performed by Harry Reich in 1989. Material and Methods. The sample included 24 patients who underwent surgery at the Clinic of Gynecology and Obstetrics, Clinical Center of Vojvodina in Novi Sad in the period 2014 - 2017. The most common indications for laparoscopic assisted vaginal hysterectomy included mild uterine prolapse and uterine fibroids (15 patients, 62.5%). The surgery was carried out in two stages: the first, laparoscopic stage and the second, vaginal stage. The laparoscopic stage included mobilization of the bladder, ovaries and uterus to the level of uterine vessels. In the second stage, the cervix was approached vaginally and detached from the urinary bladder, after which the uterus with cervix and adnexa were removed through the vagina. Results. The average age of patients was 56.8 years; on average, the surgeries lasted 140 minutes and the mean blood loss was 190 ml. Two (8.3%) patients experienced bladder and ureteral injuries which were resolved by urologists. Laparoscopic assisted vaginal hysterectomy was the only procedure performed in 5 (20.8%) patients, whereas it was combined with anterior and/or posterior colporrhaphy in 14 (58.4%), with pelvic lymphadenectomy in 3 (12.5%) patients, and with uterine morcellation in 2 (8.3%) patients. Conclusion. There are no published controlled trials related to the use of laparoscopic assisted vaginal hysterectomy and total laparoscopic hysterectomy in Serbia. This paper presents the preliminary results of the laparoscopic assisted vaginal hysterectomy in 24 patients, comparing them with other techniques of hysterectomy conducted at the Clinic of Gynecology and Obstetrics, Clinical Center of Vojvodina in Novi Sad in the period 2014 - 2017. Laparoscopic assisted vaginal hysterectomy is a good option for surgical treatment of patient with combined pathology of genital organs.

Dynamic Prediction of Outcome for Patients With Ovarian Cancer: Application of a Joint Model for Longitudinal Cancer Antigen 125 Values

2018 ◽  
Vol 28 (1) ◽  
pp. 85-91 ◽  
Author(s):  
Yuting Cao ◽  
Yi Jiang ◽  
Xiao Lin ◽  
Jinsong Liu ◽  
Tao Lu ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Joint Model ◽  
Prognostic Models ◽  
Ca 125 ◽  
Newly Diagnosed ◽  
Cancer Antigen 125 ◽  
Step Method ◽  
Cancer Antigen ◽  
Dynamic Prediction ◽  
Gynecology And Obstetrics

ObjectiveIn clinical practice, gynecologic oncologists are interested in predicting the prognosis of patients through information from different sources. Recently, the overall survival (OS) of ovarian cancer patients has been widely and intensively researched, and a large number of risk factors have been determined, including the biomarker of cancer antigen 125 (CA-125). For newly diagnosed patients, it is critical to construct effective prognostic models to predict prognosis dynamically by combining their CA-125 values with adjusted clinical factors.Methods/MaterialsA total of 227 ovarian cancer participants entered this study. A 4-step method was used to construct a joint model to examine the association between longitudinal CA-125 measurements and OS time, to explore time-independent predictive factors influencing OS, and to obtain an accurate and credible dynamic prediction of OS for specific subjects.ResultsWe found that CA-125 values were greatly affected by observation time, menarche, Federation International of Gynecology and Obstetrics stage, and ascites at baseline. Similarly, CA-125 values, menopause, Federation International of Gynecology and Obstetrics stage, and surgery state at baseline were selected from the best Cox proportion hazard model and showed a strong correlation with OS. In addition, the analyses presented by the joint model depict that, as time goes by, increasing CA-125 was deemed to be a significant predictor of death.ConclusionsTogether, our results show that a joint model could be highly efficient in clinical consultation and diagnosis for patients newly diagnosed as having ovarian cancer. Longitudinal CA-125 values, which are measured over time, can be used to credibly predict OS after taking all adjusted covariates into account.

A prospective observational study on the effectiveness of risk of malignancy index score (RMI 3) in a tertiary care centre in Eastern India

2020 ◽  
Vol 11 (5) ◽  
pp. 54-60
Author(s):  
Apurba Mandal ◽  
Shibram Chattopadhyay ◽  
Sushanta Mondal ◽  
Arunava Biswas
Keyword(s):  
Ovarian Cancer ◽  
Adnexal Mass ◽  
Malignant Tumors ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Ca 125 ◽  
Tertiary Care Centre ◽  
Gynecology And Obstetrics ◽  
Risk Of Malignancy ◽  
Malignant Lesions

Background: Adnexal mass is a common presentation in today’s gynecological practice. The incidence of ovarian cancer is increasing day by day and diagnosis is often difficult to be made pre operatively with inadequate surgical exploration is a regular occurrence. Aims and Objectives: To assess and validate the importance of RMI-3 score as pre-operative diagnostic tool of differentiating benign from malignant adnexal mass for starting first line therapy of ovarian cancer and to find out the incidences of ovarian malignancy among study population. Material and Methods: The study was conducted in the Department of Gynecology and Obstetrics on (n=115) patients attending GOPD and indoor with adnexal mass fulfilling the inclusion and exclusion criteria using purposive sampling technique. All the selected cases underwent ultrasonography and serum CA- 125 level estimation necessary for calculating RMI score. A score of >200 was taken as suggestive of malignancy and confirmatory diagnosis was performed by histopathological examination obtained from staging laparotomy of adnexal mass. The individual scores were then correlated with final outcomes with statistical analyses. Results: The study revealed benign ovarian tumors are more under 50 years (78.46%) and patients with normal BMI are diagnosed with maximum of malignancy (n = 28). History of tubal ligation carried less risk of malignancy (p<0.0001). Histologically malignant tumors found mostly in 71.4% postmenopausal group whereas 94.1% benign pathology were present in perimenopausal group and there is no association found between parity and histopathology (p=0.058). Bilateral (p=0.013), multilocular (p=0.000) tumors with solid areas (p<0.0001) and thick papillary projections (p<0.0001) had statistically significant association with malignant lesions. RMI score (>200) had more efficacy than serum CA-125 level (>46) in differentiating malignant lesions from benign one in terms of specificity (96% vs 83.87%) and positive predictive value (95% vs 79.17%). Conclusions: RMI-3 score is a simple, reliable and effective tool in differentiating benign from malignant adnexal masses thereby help in quick referral and management of cases with increase chances of survival of the patients.

scholarly journals BARD1 Autoantibody Blood Test for Early Detection of Ovarian Cancer

Genes ◽  
2021 ◽  
Vol 12 (7) ◽  
pp. 969
Author(s):  
Maxim Pilyugin ◽  
Magda Ratasjka ◽  
Maciej Stukan ◽  
Nicole Concin ◽  
Robert Zeillinger ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Early Detection ◽  
Blood Test ◽  
Menopausal Status ◽  
Clinical Samples ◽  
Average Risk ◽  
Healthy Controls ◽  
Cancer Antigen 125 ◽  
Cancer Syndrome ◽  
Ovarian Cancer Screening

Background: Ovarian cancer (OC) is the most lethal gynaecological cancer. It is often diagnosed at an advanced stage with poor chances for successful treatment. An accurate blood test for the early detection of OC could reduce the mortality of this disease. Methods: Autoantibody reactivity to 20 epitopes of BARD1 and concentration of cancer antigen 125 (CA125) were assessed in 480 serum samples of OC patients and healthy controls. Autoantibody reactivity and CA125 were also tested for 261 plasma samples of OC with or without mutations in BRCA1/2, BARD1, or other predisposing genes, and healthy controls. Lasso statistic regression was applied to measurements to develop an algorithm for discrimination between OC and controls. Findings and interpretation: Measurement of autoantibody binding to a number of BARD1 epitopes combined with CA125 could distinguish OC from healthy controls with high accuracy. This BARD1-CA125 test was more accurate than measurements of BARD1 autoantibody or CA125 alone for all OC stages and menopausal status. A BARD1-CA125-based test is expected to work equally well for average-risk women and high-risk women with hereditary breast and ovarian cancer syndrome (HBOC). Although these results are promising, further data on well-characterised clinical samples shall be used to confirm the potential of the BARD1-CA125 test for ovarian cancer screening.

scholarly journals 532 Fertility and pregnancy outcomes after fertility-sparing treatment in ovarian cancer patients

2020 ◽  
Author(s):  
Flavia Sorbi ◽  
Emanuele Arturo Fera ◽  
Roberto Domenico Cincotta ◽  
Fambrini Massimiliano ◽  
Irene Ladisa ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cancer Patients ◽  
Pregnancy Outcomes ◽  
Fertility Sparing

Fertility preservation in women with early ovarian cancer

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Daniel Necula ◽  
Daria Istrate ◽  
Jérôme Mathis
Keyword(s):  
Ovarian Cancer ◽  
Fertility Preservation ◽  
Low Grade ◽  
Term Survival ◽  
Organizational Issues ◽  
Fertility Sparing Surgery ◽  
Fertility Sparing ◽  
Early Ovarian Cancer ◽  
Reproductive Techniques

AbstractFertility preservation is an important option to consider for young women with low-grade early ovarian cancer. Fertility-sparing surgery (“FSS”) permits the conservation of the uterus and one of the ovaries. This technique is considered safe for stages IA G1, G2 and probably safe for IC G1 epithelial and non-epithelial ovarian cancers. There are still uncertainties and FSS is not fully accepted for stage IC G1, G2 and clear cell carcinoma. The difficulty in choosing the best option lies in the fact that there is a lack of prospective randomized studies, due to ethical and organizational issues. Retrospective studies and reviews showed reassuring results for FSS in terms of relapse and long term survival. The spontaneous pregnancy rate seems to decrease after FSS, but chemotherapy does not seem to have an impact on fertility rates. Compared with the general population, assisted reproductive techniques are considered safe and with similar fertility results.

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