Diagnostic possibilities and limitations of urgent intraoperative pathologicanatomical studies in oncogynecology

Introduction. One of the variants of intravital pathological and anatomical diagnostics is intraoperative pathological and anatomical ("urgent") examination, which serves for tumor process verification. Urgent intraoperative pathological and anatomical examination is widely used when there are certain differential diagnostic difficulties and limitations of instrumental methods of examination.The purpose of the study — to analyze the possibilities, limitations and the accuracy of "urgent" pathologic and anatomical diagnostics in oncogynecological diseases. Materials and methods. We retrospectively analyzed medical records of 378 inpatients treated in the gynecologic oncology department of CHOKZO and NM for the period from January 2016 to January 2021. Results and discussion. Urgent histological examination was used to diagnose ovarian tumors (82%, n=310); to evaluate the extent of a tumor process in uterine body cancer, ovarian cancer, cervical cancer (peritoneal carcinomatosis, ingrowth into adjacent tissues and organs) (15%, n=57); less often to evaluate resection margin ablation in cervical cancer, uterine body cancer (3%, n=11). In a comparison of conclusions after urgent morphological examination and conduction of material, discrepancies were registered only in hypodiagnostic ovarian tumors (in 5.8% of all "urgent" ovarian tumor studies, n=18), when the question about the malignancy potential of a process cannot be reliably decided. The reliability of intraoperative morphological verification of the process is 94.2%. The sensitivity is 96%, specificity is 97%, which is consistent with the results of other studies. Conclusions. Intraoperative morphological diagnosis is a highly specific and highly sensitive method of investigation. There are limitations of this diagnostic method depending on the volume of tissue material, quality of cryostat sections, as well as tumor features (e.g., ovarian masses) consisting of heterologous morphological areas. A compliant, multidisciplinary approach is required to successfully meet the challenges of intraoperative examination.

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O&G RESIDENTS IN BRAZIL WOULD CONSIDER GYNECOLOGIC ONCOLOGY AS A SUBSPECIALTY IF IT WERE OFFICIALLY RECOGNIZED AND DON'T FEEL READY TO PERFORM RADICAL HYSTERECTOMIES: IGCS-0091 Cervical Cancer

International Journal of Gynecological Cancer ◽

10.1136/00009577-201505001-00028 ◽

2015 ◽

Vol 25 (Supp 1) ◽

pp. 36-36

Author(s):

L. Campbell ◽

W. Primo ◽

R. Miziara ◽

P. Brito ◽

L. Casulari

Keyword(s):

Cervical Cancer ◽

Gynecologic Oncology

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Quality of training in cervical cancer radical surgery: a survey from the European Network of Young Gynaecologic Oncologists (ENYGO)

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2021-002812 ◽

2022 ◽

pp. ijgc-2021-002812

Author(s):

Nicolò Bizzarri ◽

Andrei Pletnev ◽

Zoia Razumova ◽

Kamil Zalewski ◽

Charalampos Theofanakis ◽

...

Keyword(s):

Cervical Cancer ◽

Minimally Invasive ◽

Radical Surgery ◽

Gynecologic Oncology ◽

Laparoscopic Approach ◽

High Volume ◽

Lymph Node Biopsy ◽

European Network ◽

Before And After ◽

Level Of Training

BackgroundThe European Society of Gynaecological Oncology (ESGO) and partners are committed to improving the training for gynecologic oncology fellows. The aim of this survey was to assess the type and level of training in cervical cancer surgery and to investigate whether the Laparoscopic Approach to Cervical Cancer (LACC) trial results impacted training in radical surgery for gynecologic oncology fellows.MethodsIn June 2020, a 47-question electronic survey was shared with European Network of Young Gynaecologic Oncologists (ENYGO) members. Specialist fellows in obstetrics and gynecology, and gynecologic oncology, from high- and low-volume centers, who started training between January 1, 2017 and January 1, 2020 or started before January 1, 2017 but finished their training at least 6 months after the LACC trial publication (October 2018), were included.Results81 of 125 (64.8%) respondents were included. The median time from the start of the fellowship to completion of the survey was 28 months (range 6–48). 56 (69.1%) respondents were still fellows-in-training. 6 of 56 (10.7%) and 14 of 25 (56.0%) respondents who were still in training and completed the fellowship, respectively, performed ≥10 radical hysterectomies during their training. Fellows trained in an ESGO accredited center had a higher chance to perform sentinel lymph node biopsy (60.4% vs 30.3%; p=0.027). There was no difference in the mean number of radical hysterectomies performed by fellows during fellowship before and after the LACC trial publication (8±12.0 vs 7±8.4, respectively; p=0.46). A significant reduction in number of minimally invasive radical hysterectomies was noted when comparing the period before and after the LACC trial (38.5% vs 13.8%, respectively; p<0.001).ConclusionExposure to radical surgery for cervical cancer among gynecologic oncology fellows is low. Centralization of cervical cancer cases to high-volume centers may provide an increase in fellows’ exposure to radical procedures. The LACC trial publication was associated with a decrease in minimally invasive radical hysterectomies performed by fellows.

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Preventive vaccination against cervical cancer: Korean Society of Gynecologic Oncology Guideline

Journal of Gynecologic Oncology ◽

10.3802/jgo.2016.27.e30 ◽

2016 ◽

Vol 27 (3) ◽

Cited By ~ 6

Author(s):

Kyung-Jin Min ◽

Sang-Hoon Kwon ◽

Sunghoon Kim ◽

Hyun Jung Kim ◽

Seok Ju Seong ◽

...

Keyword(s):

Cervical Cancer ◽

Gynecologic Oncology ◽

Korean Society ◽

Preventive Vaccination

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Role of Minimally Invasive Surgery in Gynecologic Oncology: An Updated Survey of Members of the Society of Gynecologic Oncology

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000000450 ◽

2015 ◽

Vol 25 (6) ◽

pp. 1121-1127 ◽

Cited By ~ 75

Author(s):

Lesley B. Conrad ◽

Pedro T. Ramirez ◽

William Burke ◽

R. Wendel Naumann ◽

Kari L. Ring ◽

...

Keyword(s):

Cervical Cancer ◽

Endometrial Cancer ◽

Minimally Invasive Surgery ◽

Robotic Surgery ◽

Minimally Invasive ◽

Invasive Surgery ◽

Single Port ◽

Gynecologic Oncology ◽

Pelvic Lymphadenectomy ◽

Single Port Laparoscopy

ObjectivesTo evaluate the current patterns of use of minimally invasive surgical procedures, including traditional, robotic-assisted, and single-port laparoscopy, by Society of Gynecologic Oncology (SGO) members and to compare the results to those of our 2004 and 2007 surveys.MethodsThe Society of Gynecologic Oncology members were surveyed through an online or mailed-paper survey. Data were analyzed and compared with results of our prior surveys.ResultsFour hundred six (32%) of 1279 SGO members responded. Eighty-three percent of respondents (n = 337) performed traditional laparoscopic surgery (compared with 84% in 2004 and 91% in 2007). Ninety-seven percent of respondents performed robotic surgery (compared with 27% in 2007). When respondents were asked to indicate procedures that they performed with the robot but not with traditional laparoscopy, 75% indicated radical hysterectomy and pelvic lymphadenectomy for cervical cancer. Overall, 70% of respondents indicated that hysterectomy and staging for uterine cancer was the procedure they most commonly performed with a minimally invasive approach. Only 17% of respondents who performed minimally invasive surgery performed single-port laparoscopy, and only 5% of respondents indicated that single-port laparoscopy has an important or very important role in the field.ConclusionsSince our prior surveys, we found a significant increase in the overall use and indications for robotic surgery. Radical hysterectomy or trachelectomy and pelvic lymphadenectomy for cervical cancer and total hysterectomy and staging for endometrial cancer were procedures found to be significantly more appropriate for the robotic platform in comparison to traditional laparoscopy. The indications for laparoscopy have expanded beyond endometrial cancer staging to include surgical management of early-stage cervical and ovarian cancers, but the use of single-port laparoscopy remains limited.

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Quality of life and survival in advanced cervical cancer: A Gynecologic Oncology Group study

Gynecologic Oncology ◽

10.1016/j.ygyno.2012.01.047 ◽

2012 ◽

Vol 125 (2) ◽

pp. 315-319 ◽

Cited By ~ 22

Author(s):

Dana M. Chase ◽

Helen Q. Huang ◽

Lari Wenzel ◽

David Cella ◽

Richard McQuellon ◽

...

Keyword(s):

Quality Of Life ◽

Cervical Cancer ◽

Gynecologic Oncology ◽

Gynecologic Oncology Group ◽

Advanced Cervical Cancer ◽

Oncology Group ◽

Oncology Group Study

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Capecitabine in patients with platinum-pretreated advanced or recurrent cervical carcinoma: a retrospective study

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2018-000085 ◽

2019 ◽

Vol 29 (2) ◽

pp. 272-276 ◽

Cited By ~ 1

Author(s):

Giuseppa Maltese ◽

Stefano Lepori ◽

Ilaria Sabatucci ◽

Elisa Tripodi ◽

Domenica Lorusso

Keyword(s):

Cervical Cancer ◽

Adverse Events ◽

Cervical Carcinoma ◽

Overall Response Rate ◽

Response Rate ◽

Gynecologic Oncology ◽

Recurrent Cervical Cancer ◽

Oral Capecitabine ◽

Overall Response ◽

Dismal Prognosis

BackgroundCervical cancer is a common malignancy among women and, when recurring, presents a dismal prognosis. After platinum failure, second-line treatments report response rates ranging from 3–15%, a median progression-free survival of about 3 months and a median overall survival of about 5.5 months.To retrospectively evaluate the activity and safety of capecitabine in patients with advanced/recurrent cervical carcinoma.MethodsA retrospective review of medical records of recurrent cervical cancer patients, who had failed a previous platinum–paclitaxel treatment and received oral capecitabine 1250 mg/m2 twice daily continuously from day 1 to day 14 every 21 days, was performed from December 2013 to March 2018 at the Gynecologic Oncology Unit of the Fondazione IRCCS National Cancer Institute of Milan, Italy. The response rate was evaluated every three cycles according to Response Evaluation Criteria In Solid Tumors (RECIST) version 1.1 criteria. Common Terminology Criteria for Adverse Events version 4.0 were used to evaluate adverse events.ResultsWe retrospectively analyzed 35 patients with recurrent cervical carcinoma, treated with oral capecitabine. All patients had previously received and failed a combination of carboplatin plus paclitaxel as first-line therapy for advanced/recurrent disease. Median age at the first capecitabine administration was 53 years (range 27–82). All patients were evaluable for response: the overall response rate was 34.2% (2.8% complete responses and 31.4% partial responses) with a clinical benefit rate of 57% (overall response rate plus 22.8% stabilizations of disease). The most common grade 1–2 adverse events per patient were fatigue (71.3%), hand-foot syndrome (57.0%), diarrhea (31.3%), constipation (17.0%), and nausea (10.4%). Only three patients (8.5%) reported grade 3 adverse events.ConclusionsOur data suggest that oral capecitabine should be considered an active and safe treatment in patients with recurrent cervical carcinoma after platinum failure. Based on these results, we consider capecitabine as warranting further clinical evaluation.

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Circulating Tumor Cells In Advanced Cervical Cancer: NRG Oncology—Gynecologic Oncology Group Study 240 (NCT 00803062)

Molecular Cancer Therapeutics ◽

10.1158/1535-7163.mct-20-0276 ◽

2020 ◽

Vol 19 (11) ◽

pp. 2363-2370 ◽

Cited By ~ 1

Author(s):

Krishnansu S. Tewari ◽

Michael W. Sill ◽

Bradley J. Monk ◽

Richard T. Penson ◽

David H. Moore ◽

...

Keyword(s):

Cervical Cancer ◽

Tumor Cells ◽

Circulating Tumor Cells ◽

Gynecologic Oncology ◽

Gynecologic Oncology Group ◽

Advanced Cervical Cancer ◽

Oncology Group ◽

Oncology Group Study

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Efficacy and safety of bevacizumab in recurrent sex cord-stromal ovarian tumors: Results of a phase 2 trial of the Gynecologic Oncology Group

Cancer ◽

10.1002/cncr.28421 ◽

2013 ◽

Vol 120 (3) ◽

pp. 344-351 ◽

Cited By ~ 40

Author(s):

Jubilee Brown ◽

William E. Brady ◽

Julian Schink ◽

Linda Van Le ◽

Mario Leitao ◽

...

Keyword(s):

Gynecologic Oncology ◽

Ovarian Tumors ◽

Gynecologic Oncology Group ◽

Phase 2 ◽

Efficacy And Safety ◽

Oncology Group ◽

Phase 2 Trial

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Utilization of Diagnostic Studies in the Pretreatment Evaluation of Invasive Cervical Cancer in the United States: Results of Intergroup Protocol ACRIN 6651/GOG 183

Journal of Clinical Oncology ◽

10.1200/jco.2004.00.5397 ◽

2005 ◽

Vol 23 (30) ◽

pp. 7454-7459 ◽

Cited By ~ 52

Author(s):

Marco A. Amendola ◽

Hedvig Hricak ◽

Donald G. Mitchell ◽

Bradley Snyder ◽

Dennis S. Chi ◽

...

Keyword(s):

United States ◽

Cervical Cancer ◽

Data Analysis ◽

Diagnostic Tests ◽

Gynecologic Oncology ◽

Invasive Cervical Cancer ◽

The United States ◽

Patterns Of Care ◽

Clinical Staging ◽

Gynecologic Oncology Group

Purpose To review the current utilization of diagnostic tests prescribed by the International Federation of Gynecology and Obstetrics (FIGO) clinical staging guidelines in the pretreatment work-up of invasive cervical cancer, and to compare the data with those of previous patterns of care studies. Patients and Methods This interdisciplinary American College of Radiology Imaging Network/Gynecologic Oncology Group prospective clinical trial was conducted between March 1, 2000, and November 11, 2002. Twenty-five participating institutions, all from the United States, enrolled a total of 208 patients. Only patients scheduled for surgery with biopsy-confirmed cervical cancer of clinical FIGO stage IB or higher were eligible. The patterns of care data analysis was based on 197 patients who met all inclusion criteria. The conventional FIGO-recommended tests used for pre-enrollment FIGO clinical stage classification were at the discretion of the treating physician; overall frequency of use was tabulated for each test. Results Use of cystoscopy (8.1%) and sigmoidoscopy or proctoscopy (8.6%) was significantly lower than in 1988 to 1989 (P < .0001 in each instance). Intravenous urography was used in only 1% of patients as compared with 42% in 1988 to 1989 and 91% in 1983. No patient included in the data analysis had barium enema or lymphangiography. Only 26.9% of patients had examination under anesthesia for FIGO clinical staging. Conclusion There is a large discrepancy between the diagnostic tests recommended by FIGO and the actual tests used for cervical cancer staging, suggesting a need to reassess the relevance of the FIGO guidelines to current clinical practice in the United States.

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