Mutational analysis of the WNT gene family in women with Mayer-Rokitansky-Kuster-Hauser syndrome.

The aim of this study is to determine if Müllerian agenesis has a genetic basis linked to the WNT genes. Genomic DNA analyses for mutations in the coding sequences of four members of this family in a series of 11 women with Mayer-Rokitansky-Kuster-Hauser syndrome found four variants in the coding sequence of these genes, but causal mutations were not observed. This supports the hypothesis that mutations in the coding sequence of WNT4, WNT5A, WNT7A, and WNT9B are not responsible for the Mayer-Rokitansky-Kuster-Hauser syndrome.

The sentinel lymph node procedure for patients with preoperative diagnosis of ductal carcinoma in situ: risk factors for unsuspected invasive disease and for metastatic sentinel lymph nodes.

Background: Occult invasive disease could be found at definitive histology in patients initially diagnosed with large ductal carcinoma in situ (DCIS). Sentinel lymph node (SLN) biopsy is a reliable and minimally invasive procedure providing axillary information and avoiding a second operation in this particular group of patients. The aim of our study was to assess the value of SLN biopsy in patients with large DCIS who are at highest risk for being upstaged to invasive carcinoma.

Spontaneous rectovaginal fistula during bevacizumab therapy for ovarian cancer: a case report.

Recent studies have demonstrated efficacy of bevacizumab for recurrent ovarian cancer, but few data on its use and gastrointestinal potential complications when administered as adjuvant chemotherapy after cytoreductive surgery are available. In this study, we report the first case of a rectovaginal fistula in this indication.

[Models to predict non sentinel lymph node status in breast cancer patients with metastatic sentinel lymph node].

In breast cancer, nine models have been developed to predict non SN status in patients with SN metastasis. Four models are nomograms: the Memorial Sloan-Kettering Cancer Center nomogram (MSKCC nomogram), the nomogram of Degnim et al. (Mayo nomogram), the nomogram of Pal et al.

Laparoscopic-assisted uterovaginal anastomosis for uterine cervix atresia with partial vaginal aplasia.

This case report describes the surgical technique of laparoscopic-assisted uterovaginal anastomosis. At a tertiary university hospital, a girl with uterine cervix atresia and vaginal aplasia underwent laparoscopic-assisted uterovaginal anastomosis. We assessed feasibility and anatomic outcome.

Limits of lymphoscintigraphy for sentinel node biopsy in women with endometrial cancer.

Objective: Lymph node status in endometrial cancer is a major prognostic factor. Sentinel lymph node (SLN) biopsy using radiocolloid and blue dye labeling has emerged as an alternative to systematic lymphadenectomy. This technique requires a preoperative lymphoscintigraphy.

Genital prolapse repair using porcine skin implant and bilateral sacrospinous fixation: midterm functional outcome and quality-of-life assessment.

Objectives: To evaluate the midterm anatomic and functional outcome of genital prolapse repair by the vaginal route using a porcine skin implant (Pelvicol) and bilateral sacrospinous fixation.

Methods: From May 2001 to June 2006, 101 patients with Stage III-IV genital prolapse were treated using a porcine skin collagen implant and bilateral sacrospinous fixation. The functional results were evaluated using the Pelvic Floor Distress Inventory short form, Pelvic Organ Prolapse Distress Inventory-6, Colorectal Anal Distress Inventory-8, Urogenital Distress Inventory-6, Pelvic Floor Impact Questionnaire-7 (including Urinary Impact Questionnaire-7, Pelvic Organ Prolapse Impact Questionnaire-7, and Colo-Rectal-Anal Impact Questionnaire-7), and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire.

Serous and mucinous ovarian tumors express different profiles of MMP-2, -7, -9, MT1-MMP, and TIMP-1 and -2.

Matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) play key roles in tumorigenesis, but little is known of their expression according to mucinous or serous type. This study aimed to evaluate the immunohistochemical expression of MMP-2, -7, -9, MT1-MMP, TIMP-1 and -2 in these tumors. A tissue microarray was set up including 99 serous (25 benign, 27 borderline, 47 malignant) and 79 mucinous (25 benign, 44 borderline, 10 malignant) ovarian tumors.

Diagnostic accuracy of physical examination, transvaginal sonography, rectal endoscopic sonography, and magnetic resonance imaging to diagnose deep infiltrating endometriosis.

Objective: To compare the value of physical examination, transvaginal sonography (TVS), rectal endoscopic sonography (RES), and magnetic resonance imaging (MRI) for the assessment of different locations of deep infiltrating endometriosis (DIE).

Design: Retrospective longitudinal study.

Setting: Tertiary university gynecology unit.

[Colorectal endometriosis and fertility].

Endometriosis is a common gynaecological condition affecting 10 to 15% of the female population. Deep infiltrating endometriosis (DIE) is diagnosed in 20% of women with endometriosis. Moreover, bowel endometriosis is found in five to 12% of patients with endometriosis.

Impact of delayed arterial cord blood sampling for lactate assay: a prospective observational study.

Background: Umbilical cord sampling at delivery provides important data on the newborn's metabolism.

Objective: To evaluate the impact of delayed sampling on arterial cord blood lactate values.

Methods: Observational study of 168 consecutive deliveries at a tertiary teaching hospital.

Dynamic contrast-enhanced MR imaging of ovarian neoplasms: current status and future perspectives.

MR imaging is useful for characterizing ovarian tumors. Dynamic contrast-enhanced MR imaging is a promising new technique useful for characterizing perfusion and angiogenesis of ovarian masses. This article describes the dynamic contrast-enhanced MR imaging technique examines the current and future applications of this technique in patients with ovarian tumors.

Value of magnetic resonance imaging for the diagnosis of ovarian tumors: a review.

This article reviews the value of magnetic resonance imaging (MRI) for the diagnosis of ovarian tumors especially when ultrasonography is indeterminate. Although ultrasonography is the first imaging technique used to investigate suspected pelvic masses, it has a limited capacity for tissue characterization. In addition to morphological characteristics, many tissue parameters such as T1, T2, perfusion, and diffusion contribute to signal intensity, so MRI is able to identify various types of tissue contained in pelvic masses.

[Clinical practice guidelines 2008 for the surgical treatment, medical first-line and consolidation treatments of patients with epithelial ovarian cancer--update. According to the methodology of Standards, Options: Recommendations (SOR)].

Context: Ovarian cancers represent the 4th cause of mortality by cancer for women in France and were responsible of more than 3,000 deaths in 2005. The Standards, Options: Recommendations (SOR) project has been undertaken by the French National Federation of Cancers Centers is now part of the French National Cancer Institute since the 1st of may 2008. The project involves the development and updating of evidence-based clinical practice guidelines (CPG) in oncology.

Pain and complications of directional vacuum-assisted stereotactic biopsy: comparison of the Mammotome and Vacora techniques.

Objective: The aim of our study is to compare the Mammotome and Vacora methods of stereotactic directional vacuum-assisted biopsy in terms of pain and complications.

Materials And Methods: From June 2001 to May 2005, 1114 consecutive patients underwent directional stereotactic vacuum-assisted breast biopsy (DVAB) for nonpalpable mammographically detected breast lesions (BI-RADS 3, 4 or 5). Respectively 967 and 147 patients underwent the Mammotome and Vacora procedures.

Preoperative concurrent radiation therapy and chemotherapy for bulky stage IB2, IIA, and IIB carcinoma of the uterine cervix with proximal parametrial invasion.

Purpose: To evaluate toxicity, local tumor control, and survival after preoperative chemoradiation for operable bulky cervical carcinoma.

Methods And Materials: Between December 1991 and July 2006, 92 patients with operable bulky stage IB2, IIA, and IIB cervical carcinoma without pelvic or para-aortic nodes on pretreatment imaging were treated. Treatment consisted of preoperative external beam pelvic radiation therapy (EBRT) and concomitant chemotherapy (CT) during the first and fourth weeks of radiation combining 5-fluorouracil and cisplatin.

Dynamic contrast-enhanced magnetic resonance imaging: a useful tool for characterizing ovarian epithelial tumors.

Purpose: To evaluate the utility of dynamic contrast enhancement (DCE) MRI for distinguishing among benign, borderline and invasive epithelial ovarian tumors.

Materials And Methods: We analyzed preoperative MRI studies of 37 patients with ovarian epithelial tumors (10 benign, 11 borderline, and 16 invasive). A DCE-MRI sequence was acquired and regions of interest (ROIs) were drawn in the ovarian tumors and adjacent myometrium.

External validation of a laparoscopic-based score to evaluate resectability of advanced ovarian cancers: clues for a simplified score.

Background: The relevance of laparoscopy-based score in identifying patients with advanced ovarian cancer for optimal cytoreductive surgery has been evaluated.

Methods: 55 patients with stage III-IV ovarian cancer, having undergone both laparoscopy and laparotomy for cytoreductive surgery, were retrospectively analyzed. Seven parameters were assessed: omental cake, peritoneal carcinosis, diaphragmatic carcinosis, mesenteric retraction, bowel infiltration, stomach infiltration, liver metastases.

Laparoscopic sentinel node mapping using combined detection for endometrial cancer: a study of 33 cases--is it a promising technique?

Background: To evaluate the feasibility of a laparoscopic sentinel node (SN) procedure based on combined method in patients with endometrial cancer.

Methods: Thirty-three patients (median age 66.1 years) with endometrial cancer of apparent stage I or stage II underwent a laparoscopic SN procedure based on combined radiocolloid and patent blue injected pericervically.

Limits of day-before lymphoscintigraphy to localize sentinel nodes in women with cervical cancer.

Background: Lymph node status in cervical cancer is a major prognostic factor. Sentinel lymph node (SN) biopsy using radiocolloid and blue dye labeling and preoperative lymphoscintigraphy has emerged as a potential alternative to systematic lymphadenectomy. The aim of this study was to evaluate the contribution of preoperative lymphoscintigraphy to SN biopsy.

Sentinel lymph node biopsy in gynaecological cancers: the importance of micrometastases in cervical cancer.

Lymph node metastases is a recognized prognostic factor in women with cervical cancer. However, there is a need for consensual histological definition of micrometastases in this indication which could give rise to a classification system similar to that used in breast cancer. We thus conducted a MEDLINE and EMBASE database analysis to evaluate the concept of micrometastases in cervical cancer.

Sentinel lymph node evaluation in endometrial cancer and the importance of micrometastases.

The presence of lymph node (LN) metastases has a major impact on the prognosis of women with endometrial cancer and compromises recurrence-free time. LN assessment has become the standard of care in the surgical staging of patients and plays a crucial role in decision making. Sentinel lymph node (SLN) detection improves the accuracy of lymphatic drainage mapping compared to pelvic node dissection used alone.

The lateral infraureteral parametrium: myth or reality?

Objective: The objective of the study was to describe the surgical anatomy of infraureteral parametrium.

Study Design: Findings of laparoscopic dissections during 12 type III radical hysterectomies were compared with findings obtained by bilateral pelvic dissections of 5 fresh and 5 embalmed female cadavers and to magnetic resonance imaging of 10 healthy controls.

Results: Two anatomical entities of the parametrium were distinguished: (1) the lateral mesometrium corresponding to the blade containing vessels and lymph nodes of the uterus; and (2) the infraureteral parametrium extending dorsally from cervix and vagina.

Factors influencing the use and accuracy of frozen section diagnosis of epithelial ovarian tumors.

Objective: The objective of the study was to study factors influencing the use and accuracy of frozen section diagnosis (FSD) of ovarian tumors.

Study Design: Surgery was performed in 414 patients with epithelial ovarian tumors between 2001 and 2006. Factors were identified by univariate and multivariate analysis.