Central Pathology Review in SENTIX, a Prospective Observational International Study on Sentinel Lymph Node Biopsy in Patients with Early-Stage Cervical Cancer (ENGOT-CX2)

The quality of pathological assessment is crucial for the safety of patients with cervical cancer if pelvic lymph node dissection is to be replaced by sentinel lymph node (SLN) biopsy. Central pathology review of SLN pathological ultrastaging was conducted in the prospective SENTIX/European Network of Gynaecological Oncological Trial (ENGOT)-CX2 study. All specimens from at least two patients per site were submitted for the central review. For cases with major or critical deviations, the sites were requested to submit all samples from all additional patients for second-round assessment. From the group of 300 patients, samples from 83 cases from 37 sites were reviewed in the first round. Minor, major, critical, and no deviations were identified in 28%, 19%, 14%, and 39% of cases, respectively. Samples from 26 patients were submitted for the second-round review, with only two major deviations found. In conclusion, a high rate of major or critical deviations was identified in the first round of the central pathology review (28% of samples). This reflects a substantial heterogeneity in current practice, despite trial protocol requirements. The importance of the central review conducted prospectively at the early phase of the trial is demonstrated by a substantial improvement of SLN ultrastaging quality in the second-round review

The issue on environmental assessment of air quality of residential areas near traffic flows

A significant role in ensuring comfortable living conditions in the urban environment is played by the competent organization of the transport and road complex, which is aimed at ensuring road safety, reducing the load on highways for car density and improving the efficiency of traffic in the city when performing planning and technological measures. At the same time, the current state of the city’s traffic flows as sources of increased chemical pollution of the air environment requires an increase in the distance from streets and roads to residential buildings. This distance should be normalized by chemical and physical indicators of the state of atmospheric air and should be taken into account when red lines are established. In this article we analyze: functional state of the city, road network, composition and intensity of traffic flows for Tyumen. The traffic flows of the city are concentrated mainly in the central part of it. A particularly critical situation is formed at the intersections of cargo-loaded main streets at the hours of maximum traffic intensity and on the main highways of the city. We substitute the provision of regulatory requirements for the chemical pollution level at a distance from the border of the carriageway to the border of residential buildings in order to achieve sustainable urban development

The issue on environmental assessment of air quality of residential areas near traffic flows

A significant role in ensuring comfortable living conditions in the urban environment is played by the competent organization of the transport and road complex, which is aimed at ensuring road safety, reducing the load on highways for car density and improving the efficiency of traffic in the city when performing planning and technological measures. At the same time, the current state of the city’s traffic flows as sources of increased chemical pollution of the air environment requires an increase in the distance from streets and roads to residential buildings. This distance should be normalized by chemical and physical indicators of the state of atmospheric air and should be taken into account when red lines are established. In this article we analyze: functional state of the city, road network, composition and intensity of traffic flows for Tyumen. The traffic flows of the city are concentrated mainly in the central part of it. A particularly critical situation is formed at the intersections of cargo-loaded main streets at the hours of maximum traffic intensity and on the main highways of the city. We substitute the provision of regulatory requirements for the chemical pollution level at a distance from the border of the carriageway to the border of residential buildings in order to achieve sustainable urban development

On the concept “street lines” in urban planning practice

The article deals with the problem of street lines which determine specific conditions of usage and development of towns and cities. The city transport system is one of the complex and overwhelmingly important elements of the big city structure. The investigation of its constituents, development arrangement and planning system is one of the actual directions of theoretical research having significant practical meaning for efficient use of territories. Nowadays federal legislation pays great attention to providing complex and constant development of territories. One of the major instruments in achieving this goal is the usage of street lines. Planned objects marked by street lines have legal characteristics. This article reveals those characteristics

On the concept “street lines” in urban planning practice

The article deals with the problem of street lines which determine specific conditions of usage and development of towns and cities. The city transport system is one of the complex and overwhelmingly important elements of the big city structure. The investigation of its constituents, development arrangement and planning system is one of the actual directions of theoretical research having significant practical meaning for efficient use of territories. Nowadays federal legislation pays great attention to providing complex and constant development of territories. One of the major instruments in achieving this goal is the usage of street lines. Planned objects marked by street lines have legal characteristics. This article reveals those characteristics

China—Eastern Europe Agricultural Trade: (Dis)Advantages and Policy Responses

Assessment of the competitive advantages of goods and countries is one of the cornerstones of contemporary macroeconomics. In agriculture, this assessment is complicated by various factors, such as natural conditions, technological capabilities of agricultural production, and food security concerns. This study aimed to address the specific advantages of different countries by using a five-stage algorithm to calculate the Revealed Comparative Advantage (RCA), Relative Trade Advantage (RTA), Lafay (LI), and Domestic Resource Cost Advantage (DRC) indices for eight Eastern European countries and their trade with China in 37 categories of food and agricultural products. These products were grouped into four categories based on their revealed advantages. Competitive advantages of Eastern European countries were found in sectors that require technology and capital, such as crops, cereal products, edible goods, and animal feed. The study contributed to linking trade and competitive advantages with production capabilities of individual countries. It suggested promoting externally oriented advantages for competitive products and redirecting the supply of marginally competitive and non-competitive goods to domestic markets

Voiding recovery after radical parametrectomy in cervical cancer patients: An international prospective multicentre trial – SENTIX

OBJECTIVE: Voiding dysfunctions represent a leading morbidity after radical hysterectomy performed in patients with early-stage cervical cancer. The aim of this study was to perform ad hoc analysis of factors influencing voiding recovery in SENTIX (SENTinel lymph node biopsy in cervIX cancer) trial. METHODS: The SENTIX trial (47 sites, 18 countries) is a prospective study on sentinel lymph node biopsy without pelvic lymphadenectomy in patients with early-stage cervical cancer. Overall, the data of 300 patients were analysed. Voiding recovery was defined as the number of days from surgery to bladder catheter/epicystostomy removal or to post-voiding urine residuum ≤50 mL. RESULTS: The median voiding recovery time was three days (5th–95th percentile: 0–21): 235 (78.3%) patients recovered in 30 days. In the multivariate analysis, only previous pregnancy (p = 0.033) and type of parametrectomy (p 7 days post-surgery. Type-B parametrectomy was associated with a higher risk of delayed voiding recovery than type-C1 (OR = 4.69; p = 0.023 vs. OR = 3.62; p = 0.052, respectively), followed by type-C2 (OR = 5.84; p = 0.011). Both previous pregnancy and type C2 parametrectomy independently prolonged time to voiding recovery by two days. CONCLUSIONS: Time to voiding recovery is significantly related to previous pregnancy and type of parametrectomy but it is not influenced by surgical approach (open vs minimally invasive), age, or BMI. Type B parametrectomy, without direct visualisation of nerves, was associated with longer recovery than nerve-sparing type C1. Importantly, voiding dysfunctions after radical surgery are temporary, and the majority of the patients recover in less than 30 days, including patients after C2 parametrectomy

Oncological outcome of surgical management in patients with recurrent uterine cancer. a multicenter retrospective cohort study-ceegog ex01 trial

Objectives To assess the survival of patients who have received an operation for recurrent cervical and endometrial cancer and to determine prognostic variables for improved oncologic outcome.Methods A retrospective multicenter analysis of the medical records of 518 patients with cervical (N = 288) or endometrial cancer (N = 230) who underwent surgery for disease recurrence and who had completed at least 1 year of follow-up.Results The median survival reached 57 months for patients with cervical cancer and 113 months for patients with endometrial cancer after surgical treatment of recurrence (p = 0.036). Histological sub-type had a significant impact on overall survival, with the best outcome in endometrial endometrioid cancer (121 months), followed by cervical squamous cell carcinoma, cervical adenocarcinoma, or other types of endometrial cancer (81 vs 35 vs 35 months; p<0.001). The site of recurrence did not significantly influence survival in cervical or in endometrial cancer. Cancer stage at first diagnosis, tumor grade, lymph node status at recurrence, progression-free interval after first diagnosis, and free resection margins were associated with improved overall survival on univariate analysis. On multivariate analysis, the stage at first diagnosis and resection margins were significant independent predictive parameters of an improved oncologic outcome.Conclusion Long-term survival can be achieved via secondary cytoreductive surgery in selected patients with recurrent cervical and endometrial cancer. An excellent outcome is possible even if the recurrence site is located in the lymph nodes. The possibility of achieving complete resection should be the main criterion for patient selection

Patterns of Lymph Node Metastases in Apparent Stage I Low-Grade Epithelial Ovarian Cancer: A Multicenter Study

Objective: The aim of this study was to determine\uc2\ua0oncological outcomes and incidence of lymph node (LN) metastases in women who underwent systematic pelvic and paraaortic lymphadenectomy for surgical staging of\uc2\ua0apparent stage I low-grade\uc2\ua0epithelial ovarian cancer (LGEOC). Materials and Methods: A\uc2\ua0retrospective study\uc2\ua0was performed at nine institutions across Europe and the US, and patients who underwent surgical staging for presumed stage I LGEOC between 2000 and 2016 were included. To ensure surgical quality, a minimum number of\uc2\ua0\ue2\u89\ua510\uc2\ua0pelvic and\uc2\ua0\ue2\u89\ua510 paraaortic LNs was required. Patients with preoperative radiologic or clinical evidence of extraovarian or LN disease, and those\uc2\ua0with\uc2\ua0nonepithelial\uc2\ua0histology,\uc2\ua0were excluded. Results: The overall incidence of LN metastases was 4.3% in the 163 evaluated patients, and\uc2\ua0the incidence of LN involvement in serous, endometrioid, and mucinous subtypes was\uc2\ua010.7, 1.5, and 0%, respectively. However, Upstaging due to LN involvement alone occurred in only 2.4% of the patients. Eighty-nine (54.6%) patients received adjuvant chemotherapy due to International Federation of Gynecology and Obstetrics stage\uc2\ua0IC or higher disease. The 5-year progression-free survival (PFS) and overall survival (OS) were 93.2% (95% confidence interval [CI] 89.4\ue2\u80\u9397.1%) and 94.5% (95% CI 90.9\ue2\u80\u9398.0%), respectively. There was no significant difference in PFS or OS between LN-negative and LN-positive patients. However, fewer patients received adjuvant chemotherapy in the LN-negative group.\uc2\ua0Multivariate analysis did not identify any independent prognostic factor of survival. Conclusion: The risk of LN involvement in nonserous apparent stage I LGEOC appears low, with a rate of\uc2\ua0<1% in this retrospective analysis, raising questions about the value of lymphadenectomy in those patients. Larger-scale prospective studies are warranted to evaluate the oncologic safety of omitting systematic LN staging in apparent stage I nonserous LGEOC