GYNOCARE Update: Modern Strategies to Improve Diagnosis and Treatment of Rare Gynecologic Tumors—Current Challenges and Future Directions

More than 50% of all gynecologic tumors can be classified as rare (defined as an incidence of ≤6 per 100,000 women) and usually have a poor prognosis owing to delayed diagnosis and treatment. In contrast to almost all other common solid tumors, the treatment of rare gynecologic tumors (RGT) is often based on expert opinion, retrospective studies, or extrapolation from other tumor sites with similar histology, leading to difficulty in developing guidelines for clinical practice. Currently, gynecologic cancer research, due to distinct scientific and technological challenges, is lagging behind. Moreover, the overall efforts for addressing these challenges are fragmented across different European countries and indeed, worldwide. The GYNOCARE, COST Action CA18117 (European Network for Gynecological Rare Cancer Research) programme aims to address these challenges through the creation of a unique network between key stakeholders covering distinct domains from concept to cure: basic research on RGT, biobanking, bridging with industry, and setting up the legal and regulatory requirements for international innovative clinical trials. On this basis, members of this COST Action, (Working Group 1, “Basic and Translational Research on Rare Gynecological Cancer”) have decided to focus their future efforts on the development of new approaches to improve the diagnosis and treatment of RGT. Here, we provide a brief overview of the current state-of-the-art and describe the goals of this COST Action and its future challenges with the aim to stimulate discussion and promote synergy across scientists engaged in the fight against this rare cancer worldwide

GYNOCARE Update: Modern Strategies to Improve Diagnosis and Treatment of Rare Gynecologic Tumors—Current Challenges and Future Directions

More than 50% of all gynecologic tumors can be classified as rare (defined as an incidence of ≤6 per 100, 000 women) and usually have a poor prognosis owing to delayed diagnosis and treatment. In contrast to almost all other common solid tumors, the treatment of rare gynecologic tumors (RGT) is often based on retrospective studies, expert opinion, or extrapolation from other tumor sites with similar histology, leading to difficulty in developing guidelines for clinical practice. Currently, gynecologic cancer research, due to distinct scientific and technological challenges, is lagging behind. Moreover, the overall efforts for addressing these challenges are fragmented across different European countries and indeed, worldwide. The GYNOCARE, COST Action CA18117 (European Network for Gynecological Rare Cancer Research) programme aims to address these challenges by creating a unique network between key stakeholders covering distinct domains from concept to cure: basic research on RGT, biobanking, bridging with industry, and setting up the legal and regulatory requirements for international innovative clinical trials. On this basis, members of this COST Action, (Working Group 1, “Basic and Translational Research on Rare Gynecological Cancer”) have decided to focus their future efforts on the development of new approaches to improve the diagnosis and treatment of RGT. Here, we provide a brief overview of the current state of-the-art and describe the goals of this COST Action and its future challenges with the aim to stimulate discussion and promote synergy across scientists engaged in the fight against this rare cancer worldwide

Radiographic analysis of the Brooker-Wills interlocking nail in the treatment of comminuted femoral fractures.

Forty-three patients with 43 comminuted femoral shaft fractures treated with the Brooker-Wills interlocking nail were followed through bony union to determine the device\u27s ability to maintain length and rotational control of these difficult injuries. Only severely comminuted fractures, types III and IV, were included. Implant complications were also studied. Average shortening for type III and type IV fractures measured 0.43 and 0.51 cm, respectively. Overall average shortening measured 0.47 cm (range, 0.0-2.2 cm). Maximal shortening occurred in a 72-year-old osteopenic female. Six of the 23 femurs stabilized with the smaller 13- and 14-mm-diameter nails shortened more than 1.0 cm, whereas lesser degrees of shortening tended to occur with larger-diameter implants. The proximal locking diagonal screw provided adequate proximal control and was never found to be the cause of fracture shortening. Rod deformation occurred in nine patients (21%) and was seen only in 13.0- and 14.0-mm-diameter rods. The distal lock was found to control rotation clinically but played only a minor role in preventing shortening. Distal shortening appeared to be controlled by bone-rod contact at the metaphysis, as nailings within 0.5 cm of the epiphyseal scar resulted in the least amount of shortening. Although this intramedullary device produced adequate clinical and radiographic results in comminuted femoral shaft fractures in the young, multiply injured patient, we caution against the use of the 13.0- and 14.0-mm implants. In addition, the efficacy of this implant is unproved in the osteopenic patient

P14.12: Maternal characteristics, ultrasound- and serum-markers at 11-13 + 6 weeks in pregnancies without pre-eclampsia resulting small for gestational age neonates

ObjectivesSmall for gestational age (SGA) newborns are generally defined as those with a birthweight below the 10th percentile for the specific gestational age. Our aim was to investigate whether the first trimester maternal biophysical, ultrasound and serum markers show any difference between SGA and appropriate for gestational age (AGA) fetuses in pregnancies not complicated with pre-eclampsia.MethodsThis is a retrospective analysis of the data from a prospective study (TÁMOP 4.2.4. A/2-11-1-2012-0001 ‘NationalExcellence Program’) for adverse pregnancy outcomes by first-trimester screening. MoM levels of serum analytes (pregnancy-associated plasma protein A (PAPP-A), human chorionic gonadotrophin (B-hCG), mean arterial pressure (MAP), body mass index (BMI), parity, smoking status, maternal history and uterine artery Doppler pulsatility index (UAPI), obtained between 11 and 13 + 6 weeks gestation, were compared between the groups of pregnancies that ended up in the delivery of alive SGA or AGA newborns. Neonates born between 24-41 weeks were included, but pregnancies with pre-eclampsia or large for gestational age (LGA) fetuses were excluded.Results1112 women were recruited in the study population, out of which 720 were selected for the analysis. Overall 40 SGA fetuses were compared with 680 controls. There were significant differences between the maternal socioeconomic status, BMI, smoking status, while there were no significant differences between the maternal age and parity. Among the first trimester markers the PAPP-A level was significantly lower and the UAPI was significantly higher in the SGA group, while there was no significant difference in the B-hCG and MAP levels between the two groups.ConclusionsThere are significant differences in the first trimester markers when comparing the two groups of pregnancies resulting SGA and AGA neonates. Further prospective studies are required to develop a cost effective screening method for SGA neonates at the 11-13 + 6 weeks