Primary non-Hodgkin’s lymphoma masquerading as cervical cancer

Genital tract lymphomas are rare entities that can be diagnosed at advanced stages. The uterine cervix is not generally infiltratedby lymphoma. Nevertheless it can be seen as a consequence of either a systemic disease or primary disease. The infrequency ofprimary cervical lymphoma makes the diagnosis challenging

Effects of coffee consumption on gut recovery after surgery of gynecological cancer patients: a randomized controlled trial

BACKGROUND: Paralytic ileus that develops after elective surgery is a common and uncomfortable complication and is considered inevitable after an intraperitoneal operation

The role of changes in systemic inflammatory response markers during neoadjuvant chemotherapy in predicting suboptimal surgery in ovarian cancer

Aim: The aim of this study was to investigate the possibility of using the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, and platelet count and their dynamic changes during chemotherapy to predict suboptimal interval debulking surgery (IDS) in stage IIIC-IVA serous ovarian cancer (OC)

Does lymph node ratio have any prognostic significance in maximally cytoreduced node-positive low-grade serous ovarian carcinoma?

Purpose To determine the prognostic impact of the lymph node ratio (LNR) in node-positive low-grade serous ovarian cancer (LGSOC). Methods We retrospectively reviewed women with LGSOC who had undergone maximal cytoreduction followed by standard chemotherapy in 11 centers from Turkey during a study period of 20 years. Sixty two women with node-positive LGSOC were identified. LNR was defined as the number of metastatic lymph nodes (LNs) divided by the number of total LNs removed. We grouped patients pursuant to the LNR as LNR 0.09. The prognostic value of LNR was investigated by employing the univariate log-rank test and multivariate Cox-regression model. Results With a median follow-up of 45 months, the 5-year progression-free survival (PFS) rates were 61.7% for women with LNR 0.09 (p = 0.046) whereas, the 5-year overall survival (OS) rates were 72.8% for LNR 0.09 (p = 0.043). On multivariate analyses, lymphovascular space invasion (LVSI) (Hazard Ratio [HR] 4.18, 95% confidence interval [CI] 1.88-9.27; p 0.09 (HR 3.51, 95% CI 1.54-8.03; p = 0.003) were adverse prognostic factors for PFS. Additionally, LVSI (HR 6.56, 95% CI 2.33-18.41; p 0.09 (HR 7.20, 95% CI 2.33-22.26; p = 0.001) were independent prognostic factors for decreased OS. Conclusion LNR > 0.09 seems to be an independent prognosticator for decreased survival outcomes in LGSOC patients who received maximal cytoreduction followed by standard adjuvant chemotherapy

Management of Isolated Vaginal Metastasis in Squamous Cell Cervical Cancer: 23 Years' Experience at a Single Center

Aim: The aim of this study was to investigate the treatment options and survival of cervical cancer (CC) patients who develop isolated vaginal metastasis (IVM), and to establish risk factors for IVM. Patients and Methods: A total of 21 cases with IVM were evaluated retrospectively. In addition, 42 control patients diagnosed with CC without recurrence were matched. Tumor size, depth of stromal invasion (DOI), lymphovascular space invasion (LVSI), and size of vaginal and lymph node metastases were analyzed in accordance with the pathology reports. Patients who had IVM were investigated in terms of treatment options (chemotherapy (CT), radiotherapy (RT), or chemoradiotherapy (CRT)) and survival. Results: After detection of IVM, the 1-, 3-, and 5-year survival rates were 57.1, 23.8, and 9.5%, respectively. The mean survival time after metastasis detection was 23.1 +/- 31.3 months. LVSI, DOI >= 1/2, hemoglobin = 4 cm were independent risk factors for IVM. The 5-year survival rates were 30.0% for patients receiving RT, 17.1% for patients receiving CRT, and 0% for patients receiving CT. Conclusion: IVM typically develops within the first 2 years after the diagnosis of CC, and survival is generally poor. RT was the most effective treatment in patients with IVM. (C) 2016 S. Karger GmbH, Freibur

Evaluation of the optimal laparoscopic method for benign ovarian mass extraction: a transumbilical route using a bag made from a surgical glove versus a lateral transabdominal route employing a standard endobag

We compared two transumbilical (TU) routes of surgical specimen retrieval in women with ovarian masses treated via laparoscopy: a bag made from a surgical glove and lateral transabdominal (LTA) retrieval employing a standard endobag. A total of 109 women undergoing laparoscopic surgery to treat benign adnexal masses were retrospectively evaluated between 2014 and 2017. In total, 57 masses were removed via the TU route and 52 via the LTA route. We recorded the ovarian mass size; additional postoperative analgesic drug requirements. Postoperative incisional pain scores were assessed using a 10-cm visual analogue scale (VAS), time to discharge and procedure type. The mean VAS scores at 1h (5.0 +/- 1.7 vs. 6.3 +/- 1.3; p <.001); 12h (0.7 +/- 0.8 vs. 1.2 +/- 1.1; p=.004); and 24 h (0.1 +/- 0.3 vs. 0.7 +/- 0.6; p < .001) were lower in the TU-removal group. Furthermore, additional postoperative analgesic drug requirements were significantly higher in the LTA-removal group (10 (19.2%) vs. 3 (5.3%); p(-).03). During laparoscopic surgery, removal of an ovarian mass via an umbilical port (compared to a lateral port) causes less postoperative pain and does not increase the risk of wound complications such as infection or hernia.Impact statementWhat is already known on this subject? Laparoscopy has been used for the last 30 years. Constant improvement in the technique and equipment has allowed extensive, laparoscopic pelvic and abdominal surgery affording better outcomes than open surgery, an improved recovery, less pain, and fewer postoperative complications. However, mass removal remains a concern. Most laparoscopic specimens are larger than the initial trocar incision. Minimally invasive, adnexal mass surgery usually requires a trocar at least 10mm wide to remove the mass. Alternatively, adnexal mass extraction from the abdominal cavity can proceed via a suprapubic, umbilical, or vaginal route.What do the results of this study add? During laparoscopic surgery, ovarian mass removal through an umbilical port using an endobag made from a surgical glove is useful due to the method requiring little funds, is easy to do, and results in a lower amount of postoperative pain than a removal via a lateral port using a standard endobag.What are the implications of these findings for clinical practice and/or further research? A transumbilical route using a bag made from a surgical glove is easy, economical, and causes less postoperative pain to the patient than removal via a lateral port employing a standard endobag

Preoperative predictors of pelvic and para-aortic lymph node metastases in cervical cancer

Aim: This study investigated potential preoperative predictors of pelvic lymph node (PLN) and para-aortic LN (PaLN) involvement in cervical cancer (CC).Materials and Methods: This study retrospectively analyzed 283 patients diagnosed with early (stage IA1-IIA) CC who underwent retroperitoneal LN dissection between January 1992 and February 2015. Several risk factors that are believed to influence PLN and PaLN involvement in CC were analyzed as follows: age >50 years, lymphovascular space invasion (LVSI), tumor size >= 2 cm, hemoglobin <12 g/dL, and nonsquamous cell histologic type.Results: LVSI (odds ratio [OR] = 11.3, 95% confidence interval [CI] = 5.2-24.3) and tumor size (OR = 3.2, 95% CI = 1.4-7.2) were independent predictors of PLN involvement. None of the factors predicted PaLN involvement in a regression analysis. However, all nine patients who had PaLN involvement also had PLN involvement.Conclusion: LVSI and tumor size independently increase the risk of PLN involvement