Publications by authors named "Guani B"
Effects of pretreatment strategies on fertility outcomes in patients with adenomyosis.
Front Reprod Health
December 2024
Adenomyosis is a commonly encountered pathology in women of reproductive age and frequently coexists with infertility. The effect of adenomyosis on fertility, particularly on fertilisation and intracytoplasmic sperm injection outcomes, is not well understood. Various pretreatment modalities have been used to improve pregnancy rates and live birth outcomes; however, because of a lack of high-quality evidence, there is no clear consensus on the best pretreatment option.
View Article and Find Full Text PDFArticle Synopsis
- Adenomyosis is a painful condition affecting women that can lead to symptoms like severe menstrual pain, heavy bleeding, and infertility, and new thermal ablation techniques present minimally invasive treatment options.
- Techniques like high-intensity focused ultrasound, microwave ablation, and radiofrequency ablation are found to effectively reduce symptoms and uterine size without compromising fertility or requiring lengthy hospital stays.
- Despite promising results regarding safety and effectiveness, further research is needed to compare these new treatments to traditional therapies to inform future medical decisions.
Adenomyosis is a benign condition commonly encountered in patients with infertility. While the definitive surgical management is hysterectomy, conservative surgical management is gaining attention in patients desiring future fertility. This review explores whether the surgical treatment of adenomyosis affects fertility outcomes for patients trying to conceive.
View Article and Find Full Text PDFPurpose: We found a need for balancing the application of clinical guidelines and tailored approaches to follow-up of cervical cancer (CC) patients in the lymph node micrometastatic (MICs) setting. This review aimed to determine the current knowledge of management of MIC-positive CC cases.
Methodology: We addressed prognostic and risk of recurrence monitoring impacts associated with MIC+ cases.
Objective: We aimed to assess disease-free survival (DFS), overall survival (OS) and treatment-related toxicity of two therapeutic strategies for treating bulky lymph nodes on imaging in patients with locally advanced cervical cancer (LACC): radiotherapy boost versus surgical debulking followed by radiotherapy.
Methods: We performed a systematic review of studies published up to October 2023. We selected studies including patients with LACC treated by external beam radiotherapy (EBRT) boost or lymph node debulking followed by EBRT (with or without boost).
Article Synopsis
- The study aimed to create a consensus on the surgical technique for sentinel lymph node dissection in cervical cancer by surveying expert gynecological oncology surgeons.
- A two-step modified Delphi method was employed, involving initial surveys and follow-up interviews, with a 70% agreement threshold for consensus.
- Findings indicated that experts reached consensus on 15 recommended practices, including the use of indocyanine green as a tracer and specific injection techniques, while recommending against certain procedures such as injecting directly into tumors.
Background: The goal of this study was to identify the risk factors for metastasis in the remaining non-sentinel lymph nodes (SLN) in the case of positive SLN in early-stage cervical cancer.
Methods: An ancillary analysis of two prospective multicentric databases on SLN biopsy for cervical cancer (SENTICOL I and II) was performed. Patients with early-stage cervical cancer (FIGO 2018 IA to IIA1), with bilateral SLN detection and at least one positive SLN after ultrastaging, were included.
Article Synopsis
- - Uterine Adenomyosis is a benign condition where endometrial-like tissue grows within the muscular layer of the uterus, causing pain and other symptoms, but there are no established guidelines for treatment options.
- - A hysterectomy is the most definitive treatment, but for those wanting to maintain fertility, the levonorgestrel-IUD shows the best results among conservative options, while other treatments like GnRH antagonists and dienogest may be promising but need more research.
- - This review examines current and emerging therapies for adenomyosis, utilizing a thorough literature search for various medical treatments and keywords relevant to the condition up to September 2022.
Background: Sentinel lymph node biopsy represents an alternative to pelvic lymphadenectomy for lymph node staging of early-stage cervical carcinoma, but prospective evidence on long-term oncological safety of sentinel lymph node biopsy alone versus pelvic lymphadenectomy is missing.
Objective: To investigate, with this meta-analysis, the impact of sentinel lymph node biopsy alone versus pelvic lymphadenectomy on survival for patients with early-stage cervical cancer.
Methods: A systematic literature review was performed.
Adenomyosis is a commonly diagnosed benign condition characterized by the presence of ectopic endometrial glands within the underlying myometrium. The most common presenting signs and symptoms are abnormal uterine bleeding, chronic pelvic pain, and infertility. The clinical relevance of this condition is evident in both medical and surgical care.
View Article and Find Full Text PDFIntroduction: The goal of this study was to compare the outcomes of preoperative brachytherapy followed by radical surgery versus radical surgery alone in cervical cancer with tumor between 2 and 4 cm (FIGO 2018 IB2).
Material And Methods: SENTICOL I and SENTICOL II were two French prospective multicentric trials evaluating sentinel node biopsy in early-stage cervical cancer between 2005 and 2012. Preoperative brachytherapy (low-dose rate or pulse-dose rate at the dose of 60Gy) could be performed 6 to 8 weeks prior to the radical hysterectomy, at the discretion of each center.
Background: The aim of this study was to assess current European practices in the management of patients with advanced epithelial ovarian cancer in 2021.
Methods: A 58-question electronic survey was distributed anonymously to the members of six European learned societies. Initial diagnostic workup and staging, pathological data, surgical data, treatments and follow-up strategies were assessed.
Article Synopsis
- * The article includes findings from a Delphi survey involving experts from France and Swiss-speaking regions to enhance the understanding of endometrial cancer’s histo-molecular and radiological characteristics.
- * It aims to guide clinicians and pathologists in applying the latest international recommendations tailored to the specific context in France.
Our aim was to assess the opinion of a panel of experts and obtain a consensus on the management of endometrial cancer in France and French Switzerland. A Delphi survey was carried out among a panel of French and French-speaking Swiss experts. The first questionnaire included 65 questions divided into eight categories: characterization of experts, histo-molecular characteristics and radiological data of endometrial cancer, and management of low-risk, intermediate-risk, intermediate-high-risk, high-risk, and metastatic cancers.
View Article and Find Full Text PDFUsually, a hydatidiform mole (HM) develops inside the uterus. The occurrence of HM in ruptured tubal pregnancy is exceptional. Cases reported in the literature are scarce.
View Article and Find Full Text PDFThis study’s objective was to compare the predictive validity of the three most utilized classification scores for endometriosis, #Enzian, EFI, and rASRM, in achieving a spontaneous pregnancy or pregnancy via assisted reproductive technology (ART) after surgery for endometriosis. The monocentric retrospective study was carried out from January 2012 to December 2021 at the gynaecology department of the cantonal hospital of Fribourg. Patients consulting for infertility and operated on for endometriosis with histological confirmation were included.
View Article and Find Full Text PDFIntroduction: Lymph node status is a major prognostic factor in early-stage cervical cancer. Predicting the risk of lymph node metastasis is essential for optimal therapeutic management. The aim of the study was to develop a web-based application to predict the risk of lymph node metastasis in patients with early-stage (IA1 with positive lymph vascular space invasion, IA2 and IB1) cervical cancer.
View Article and Find Full Text PDFSurgical management of patients with advanced ovarian cancer: Results of a French National Survey.
J Gynecol Obstet Hum Reprod
November 2022
Article Synopsis
- - The study explores the current practices in advanced stage ovarian cancer management in France to evaluate the benefits of centralizing care and to understand evolving practices in the field.
- - An anonymous survey was conducted among gynecological oncological surgeons, revealing that most respondents manage a low volume of cases personally, yet work in institutions that handle a higher number of cases annually.
- - Findings suggest that higher individual surgical volume is associated with fewer complications and that minimum volume thresholds at institutions could improve patient outcomes, highlighting the importance of both individual surgeon performance and center volume.
In patients with cervical cancer, the presence of tumoral lymph-vascular space invasion (LVSI) is the main risk factor for pelvic lymph node metastasis (PLNM). The objective of this study was to evaluate the presence of several markers of lymphangiogenesis in early-stage cervical cancer and their correlation with PLNM and tumoral recurrence. Seventy-five patients with early-stage cervical carcinoma underwent sentinel lymph node (SLN) sampling in association with complete pelvic lymph node dissection.
View Article and Find Full Text PDFObjective: In order to define the clinical significance of low-volume metastasis, a comprehensive meta-analysis of published data and individual data obtained from articles mentioning micrometastases (MIC) and isolated tumor cells (ITC) in cervical cancer was performed, with a follow up of at least 3 years.
Methods: We performed a systematic literature review and meta-analysis, following Cochrane's review methods guide and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The primary outcome was the disease-free survival (DFS), and the secondary outcome was the overall survival (OS).
Background: The prognosis of patients with cervical cancer is significantly worsened in case of lymph node involvement. The goal of this study was to determine whether pathologic features in conization specimens can predict the sentinel lymph node (SLN) status in early-stage cervical cancer.
Methods: An ancillary analysis of two prospective multicentric database on SLN biopsy for cervical cancer (SENTICOL I and II) was carried out.
Background: The aim of this study was to assess current French practices in the management of patients with advanced epithelial ovarian cancer.
Method: a 58-question electronic survey was distributed anonymously to the members of the SFOG (French Society of Gynaecological Oncology), GINECO-ARCAGY (National Investigators Group for Ovarian and Breast Cancer Studies in France) and FRANCOGYN (French research group in oncological and gynaecological surgery). Initial diagnostic workup and staging, pathological data, surgical data, treatments and follow-up strategies were assessed.