Practice patterns in diagnostics, staging, and management strategies of gallbladder cancer among Nordic tertiary centers.

Background And Objective: Gallbladder cancer (GBC) is a rare malignancy in the Nordic countries and no common Nordic treatment guidelines exist. This study aimed to characterize the current diagnostic and treatment strategies in the Nordic countries and disclose differences in these strategies.

Methods: This was a survey study with a cross-sectional questionnaire of all 19 university hospitals providing curative-intent surgery for GBC in Sweden, Norway, Denmark, and Finland.

Sacral Neuromodulation: Foray into Chronic Pelvic Pain in End Stage Endometriosis.

Excision of all endometriotic lesions is the method of choice in the treatment of severe endometriosis resistant to medical therapy. The infiltrating nature of the disease as well as extensive surgery may, however, cause chronic pain that cannot be relieved by either surgery or hormonal treatment. As a pilot treatment, we tested the effect of sacral neuromodulation (SNM) for four endometriosis patients suffering chronic pelvic pain and pelvic organ dysfunction after radical surgical treatment.

Overall Survival and Metastasis Resections in Patients with Metastatic Colorectal Cancer Using Electronic Medical Records.

Purpose: Treatment for patients with metastatic colorectal cancer is chemotherapy commonly combined with monoclonal antibodies against vascular endothelial growth factor (bevacizumab) or epidermal growth factor receptor (cetuximab or panitumumab), the efficacy of which has been proven in randomized controlled trials. The objective of the current retrospective study was to analyze the impact of targeted therapy, adverse events, and dose reduction on overall survival (OS) and metastasis resection rates.

Methods: A hospital-based electronic informatics center was used to gather clinical data and outcome information in a "real-life" setting in a single academic hospital.

[Endometriosis-associated bowel symptoms].

Background: In endometriosis endometrial tissue appears outside the uterine cavity causing dysmenorrhea, infertility, chronic abdominal pain and bowel symptoms.

Material And Methods: The prevalence of bowel symptoms and the influence of surgical treatment of endometriosis on them were studied in 82 patients. The data were collected from patient records and by questionnaires.

A prospective comparison of integrated FDG-PET/contrast-enhanced CT and contrast-enhanced CT for pretreatment imaging of advanced epithelial ovarian cancer.

Objective: The use of tumor debulking surgery in the management of epithelial ovarian cancer (EOC), which is often disseminated in the peritoneal cavity at the time of diagnosis, has a significant impact on prognosis. We compared (18)F-fluorodeoxyglucose (FDG) positron emission tomography/contrast-enhanced computed tomography (PET/CT) to contrast-enhanced CT for the detection of dissemination into the abdominal cavity preventing successful primary debulking surgery.

Methods: Forty-one women with EOC underwent preoperative whole-body low-dose FDG-PET/CT followed by diagnostic high dose contrast-enhanced CT scan, and the results were compared with systematically recorded surgical findings as a reference standard.

[Mesenterial fibrosis--could it be desmoidi?].

Desmoid tumors are rare benign fibrous tumors, which have a tendency to invade locally. A minority of desmoids are mesenterial. The symptoms of mesenterial desmoids are misleading, and diagnosis can be delayed.

Is perioperative visual estimation of intra-abdominal tumor spread reliable in ovarian cancer surgery after neoadjuvant chemotherapy?

Objective: Most cases of epithelial ovarian cancer (EOC) are diagnosed in an advanced stage. When the disease has spread intra-abdominally, complete surgical tumor debulking is the single most important prognostic factor. Neoadjuvant chemotherapy (NACT) before surgery can cause fibrosis and adhesions in the peritoneal cavity and may interfere with the perioperative evaluation of tumor spread.

FDG PET/CT in staging of advanced epithelial ovarian cancer: frequency of supradiaphragmatic lymph node metastasis challenges the traditional pattern of disease spread.

Objective: Epithelial ovarian cancer (EOC) spreads intra-abdominally and to the retroperitoneal lymph nodes. A greater number of distant metastases are revealed by (18)F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) compared to conventional imaging methods. We aimed to investigate the presence and anatomic distribution of supradiaphragmatic lymph node metastasis (LNM) detected with pretreatment FDG PET/CT.

Serum HE4 Profile During Primary Chemotherapy of Epithelial Ovarian Cancer.

Objective: Human epididymis protein 4 (HE4) is a promising novel serum biomarker for the detection of early-stage epithelial ovarian cancer (EOC) and for the differential diagnosis between benign and malignant ovarian tumors. The objective of the present study was to determine the value of HE4 for monitoring the response to primary therapy in patients with advanced disease.

Methods: Serum HE4 and cancer antigen (CA) 125 levels of 10 patients with advanced EOC and one patient with adenocarcinoma of unknown origin were measured preoperatively and during first-line chemotherapy.

Staging of gastric cancer: a study with spiral computed tomography, ultrasonography, laparoscopy, and laparoscopic ultrasonography.

In this study, we evaluated and compared the value of spiral computed tomography, transabdominal ultrasonography, laparoscopy, and laparoscopic ultrasonography in staging gastric cancer in 37 patients; there was a special interest in the additional information provided by laparoscopic ultrasonography. Although laparoscopy was unreliable or hindered by adhesions in 11% of the patients, the benefit of laparoscopy for staging was evident especially for the detection of peritoneal carcinomatosis that was missed by the other diagnostic modalities. Laparoscopic ultrasonography did not change the stage of the disease nor the decision whether to proceed with laparotomy for any of the patients.