How accurate is frozen section histology of pelvic lymph nodes in patients with endometrial cancer?

Objective: Recent prospective data support the trend towards systematic retroperitoneal lymphadenectomy in patients with high-risk endometrial cancer. Because para-aortic node involvement in the absence of pelvic node involvement is uncommon, a reliable finding of negative pelvic lymph nodes (PLN) at intraoperative frozen section examination might allow omitting para-aortic dissection. We analyzed the diagnostic accuracy of frozen section examination of PLN in patients with endometrial cancer.

Assessment of risk factors for survival of neonates born after second-trimester PPROM.

Objective: Assess fetal risk factors which impact survival of infants delivered after second-trimester PPROM.

Study Design: Clinical records of 87 patients, who all had second-trimester rupture of membranes between 14+0 and 24+6 weeks of gestation treated January 1998 to July 2005 were reviewed regarding perinatal outcome. This study is based on 25 surviving infants.

Neonatal outcome and two-year follow-up after expectant management of second trimester rupture of membranes.

Objective: To assess neonatal outcome and 2-year follow-up of pregnancies complicated by second trimester preterm premature rupture of membranes (PPROM).

Methods: A retrospective review of obstetric and neonatal records for 87 pregnancies (56 singletons, 6 twins, 1 triplet) with PPROM between 14+0 and 24+6 weeks of gestation. Patients received antibiotics and steroids for fetal lung maturity once they reached 24 weeks of gestation.

Where to look for the sentinel lymph node in cervical cancer.

Objective: The aim of this study was to analyze lymphatic spread to pelvic, parametrial, and paraaortic lymph nodes in patients with cervical cancer.

Study Design: We reviewed 619 patients with invasive cervical cancer treated by radical abdominal hysterectomy and systematic pelvic or pelvic and paraaortic lymphadenectomy between 1971 and 2005. The present study included 61 patients with one positive lymph node (10%) and 59 patients with two positive lymph nodes (10%) at any location.

Long-term follow-up after neoadjuvant chemotherapy for high-risk cervical cancer during pregnancy.

Background: We report on a patient with a high-risk cervical cancer during pregnancy treated with neoadjuvant chemotherapy (NACT) followed by radical surgery.

Case: A 38-year-old woman was diagnosed with FIGO stage IIA cervical cancer at 19 weeks' gestation. She received four cycles of cisplatin (50 mg/m2) and vincristine (1 mg/m2) at 3-week intervals starting at 23 weeks' gestation.

Is intraoperative frozen section analysis of pelvic lymph nodes accurate after neoadjuvant chemotherapy in patients with cervical cancer?

Objective: Intraoperative frozen section examination of pelvic lymph nodes is frequently used in patients with cervical cancer, some of whom have received neoadjuvant chemotherapy (NACT). However, NACT can cause necrosis, fibrosis, or keratinization of tumor deposits in extirpated lymph nodes, and it is unclear whether intraoperative frozen section analysis of extirpated nodes is accurate after NACT. We analyzed the accuracy of frozen section examination of pelvic lymph nodes in patients after NACT for cervical cancer.

Isolated recurrence at the residual uterine cervix after abdominal radical trachelectomy for early cervical cancer.

Background: We report an isolated recurrence at the residual cervix shortly after abdominal radical trachelectomy for cervical cancer.

Case: A 34-year-old woman underwent radical abdominal trachelectomy and pelvic lymphadenectomy for FIGO stage IB1 squamous cell cervical cancer. The tumor measured 10 mm in maximum diameter with 4 mm of invasion.

Ectopic (pelvic) kidney mimicking bulky lymph nodes at pelvic lymphadenectomy.

Background: Ectopic (pelvic) kidney is the most common congenital renal anomaly with an incidence of 1 in 500 to 1 in 2000. A pelvic kidney can be encountered at pelvic or paraaortic lymphadenectomy.

Case Reports: In two patients undergoing pelvic lymphadenectomy, lobulated tumors near the pelvic brim were initially interpreted as bulky lymph node conglomerates.

Placement of a retropubic drain with the tension-free vaginal tape operation.

Intraoperative bleeding and postoperative hematomas are recognized complications of the tension-free vaginal tape (TVT) operation. We devised a connector to attach a drain to the end of the TVT needle. The drain is pulled upward with the tape itself and is left in the space of Retzius in the tract created by the needle.

T1 breast cancer: identification of patients at low risk of axillary lymph node metastases.

Objective: The status of the axillary lymph nodes is one of the most important prognostic factors in patients with breast cancer. A panel of molecular markers of tumor aggressiveness in addition to conventional clinical and histopathologic features were analyzed in an attempt to identify a subgroup of patients with a low risk of axillary lymph node metastases.

Material And Methods: Data from 358 patients with T1 breast cancer who underwent level I/II axillary lymph node dissection (ALND) were investigated.

[The tension-free vaginal tape operation for the treatment of stress incontinence].

The tension-free vaginal tape (TVT) operation and similar procedures are the newest development in the surgical treatment of female stress incontinence. In contrast to the Burch colposuspension and abdominovaginal sling procedures, the operation aims at supporting the midurethra and not the bladder neck. The only ongoing prospective randomized trial comparing TVT with the Burch colposuspension, conducted by the UK and Ireland TVT Trial Group, shows comparable 2-year results.

Groin recurrence after micrometastasis in a sentinel lymph node in a patient with vulvar cancer.

Background: The sentinel lymph node concept is attractive in vulvar cancer because of the potential to avoid the morbidity associated with formal groin dissection.

Case: An 84-year-old patient with a T2 carcinoma of the anterior vulva underwent surgery including bilateral sentinel node excision after identification with technetium-labeled nanocolloid. Frozen section histology showed a tumor deposit <1 mm in diameter in a left groin node whereas four nodes in the right groin were apparently negative.