Publications by authors named "Sergi Fernandez Gonzalez"

Objective: Management of endometrial cancer is advancing, with accurate staging crucial for guiding treatment decisions. Understanding sentinel lymph node (SLN) involvement rates across molecular subgroups is essential. To evaluate SLN involvement in early-stage (International Federation of Gynecology and Obstetrics 2009 I-II) endometrial cancer, considering molecular subtypes and new European Society of Gynaecological Oncology (ESGO) risk classification.

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: Neoadjuvant chemotherapy in breast cancer offers the possibility to facilitate breast and axillary surgery; it is a test of chemosensibility in vivo with significant prognostic value and may be used to tailor adjuvant treatment according to the response. : A retrospective single-institution cohort of 482 stage II and III breast cancer patients treated with neoadjuvant chemotherapy based on anthracycline and taxans, plus antiHEr2 in Her2-positive cases, was studied. Survival was calculated at 5 and 10 years.

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Purpose: In patients with clinically lymph node-negative (cN0) breast cancer, performing sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NACT) has been preferentially embraced in comparison to before NACT. However, survival outcomes associated with both strategies remain understudied. We aimed to compare the axillary lymphadenectomy (ALND) rate, disease-free survival (DFS), and overall survival (OS), between two strategies.

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High-grade serous ovarian cancer (HGSOC) is the deadliest gynecological malignancy. The most common form of metastatic spread of HGSOC is transcoelomic dissemination. In this process, detached cells from the primary tumor aggregate as tumorspheres and promote the accumulation of peritoneal ascites.

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Article Synopsis
  • Endometrial cancer is the most common gynecological cancer in developed countries, and its incidence is expected to rise, prompting the need to identify modifiable risk factors for prevention.
  • This study investigates the link between occupational pesticide exposure and endometrial cancer using data from 174 cancer cases and 216 control subjects in Spain, utilizing structured questionnaires and a job-exposure matrix to assess pesticide exposure.
  • The findings indicate a significant association between pesticide exposure and endometrial cancer, particularly for insecticides, fungicides, and herbicides, with the strongest links found in agricultural activities, suggesting a need for further exploration of pesticides’ role in cancer development.
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Background: Sentinel lymph node (SLN) biopsy has recently been accepted to evaluate nodal status in endometrial cancer at early stage, which is key to tailoring adjuvant treatments. Our aim was to evaluate the national implementation of SLN biopsy in terms of accuracy to detect nodal disease in a clinical setting and oncologic outcomes according to the volume of nodal disease.

Patients And Methods: A total of 29 Spanish centers participated in this retrospective, multicenter registry including patients with endometrial adenocarcinoma at preoperative early stage who had undergone SLN biopsy between 2015 and 2021.

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  • The study investigated the increasing prevalence of endometrial cancer and aimed to improve molecular classification and detection using non-invasive cervicovaginal samples.
  • It included 139 patients with endometrial cancer and 107 controls, analyzing a total of 339 samples through next-generation sequencing (NGS) to identify genetic mutations.
  • Results showed that 73% of cancer cases had detectable mutations, with varying prognoses based on specific mutations, highlighting the potential of using non-invasive methods for better diagnosis and treatment.
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Introduction: New approaches are being developed to early detect endometrial cancer using molecular biomarkers. These approaches offer high sensitivities and specificities, representing a promising horizon to develop early detection strategies.

Objective: To evaluate the effectiveness and cost-effectiveness of introducing molecular testing to detect endometrial cancer in women with postmenopausal bleeding compared to the current strategy using the national healthcare service perspective.

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Purpose: To evaluate the differences in nodal positivity if the sentinel lymph node biopsy (SLNB) is performed before or after neoadjuvant endocrine therapy (NET) in breast cancer patients, and its impact on prognosis.

Methods: A retrospective cohort study was performed in a single center including 91 postmenopausal cases with clinically node-negative and hormone receptor-positive/HER2-negative (HR + /HER2-) breast cancer, treated with NET and SLNB. SLNB was done pre-NET until 2014, and post-NET thereafter.

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Article Synopsis
  • Screenwide is a case-control study conducted in Spain from 2017 to 2021 that looked at women with endometrial and ovarian cancers, along with BRCA1/2 and MMR pathogenic variant carriers, to identify risk factors and molecular biomarkers for these cancers.
  • Participants provided detailed personal and medical information, along with biological samples like blood and self-collected vaginal specimens, to facilitate comprehensive analyses.
  • Preliminary findings from a pilot study indicate that certain genetic variants associated with tumors can be effectively detected in less invasive samples, suggesting potential for improved early detection strategies for gynecological cancers.
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  • * It compared two groups of hospitals, finding that those with higher recurrence rates (group B) had significant odds ratios indicating worse outcomes for recurrences, death, and disease-specific mortality.
  • * Key factors linked to better outcomes included higher surgical volume, increased participation in clinical trials, more frequent MRI use, greater reliance on sentinel lymph node biopsies, and a positive learning curve with fewer early recurrences.
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  • * A study compared two groups of patients: one receiving standard wound closure and the other receiving closed-incisional negative pressure therapy (ciNPT) during surgery, revealing a substantial reduction in complications (6.9% with ciNPT vs. 31.8% with standard closure).
  • * Results showed that ciNPT not only lowered infection rates and other complications but also reduced hospital stays, suggesting it should be considered for patients at high risk of wound issues.
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This retrospective analysis aimed to assess the risk factors for recurrence in patients diagnosed with early-stage cervical cancer (≤IB1 or IIA1, FIGO 2009) undergoing robot-assisted radical hysterectomy in Spain and Portugal between 2009 and 2018. A second primary objective was to audit the oncological outcomes according to quality indicators (QI) proposed by the European Society of Gynecology Oncology (ESGO). The study population included 239 women.

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In general terms, fetal growth restriction (FGR) is considered the impossibility of achieving the genetically determined potential size. In the vast majority of cases, it is related to uteroplacental insufficiency. Although its origin remains unknown and causes are only known in 30% of cases, it is believed to be related to an interaction of environmental and genetic factors with either a fetal or maternal origin.

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Purpose: To find a group of cN2 patients or patients with high axillary burden who become ypN0 after neoadjuvant chemotherapy (NACT) and who may benefit from avoiding a lymphadenectomy.

Methods: A retrospective observational cohort study was conducted with 221 clinically staged N2 patients or patients with at least 3 suspicious lymph nodes found by ultrasound at diagnosis. The predictive factors for ypN0 analysed were age, MRI-determined tumour size, histological subtype, the Nottingham histologic grade, surrogate molecular subtype, ki-67 and vascular invasion when present.

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A pathologic complete response (pCR) in the axilla occurs in 30%-40% of patients with initially node-positive breast cancer after neo-adjuvant chemotherapy (NACT). Debate persists about whether to perform systematic axillary lymphadenectomy (ALND) in patients with initial node-positive disease and clinical complete response after NACT. We aimed to identify predictive factors of axillary pCR (ypN0) after NACT.

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Pregnancy induces a number of immunological, hormonal, and metabolic changes that are necessary for the mother to adapt her body to this new physiological situation. The microbiome of the mother, the placenta and the fetus influence the fetus growth and undoubtedly plays a major role in the adequate development of the newborn infant. Hence, the microbiome modulates the inflammatory mechanisms related to physiological and pathological processes that are involved in the perinatal progress through different mechanisms.

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  • The study aimed to examine the ovarian reserve in women with BRCA1 and BRCA2 mutations by measuring anti-mullerian hormone levels, and how these levels affect reproductive outcomes.
  • It involved 135 women, including those with BRCA mutations and healthy controls, and the results showed mutation-positive women had lower anti-mullerian hormone levels compared to mutation-negative and other carriers.
  • Despite the lower hormone levels in mutation-positive women, infertility rates did not significantly differ among the groups, suggesting that mutation status may not have a profound impact on fertility.
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Introduction And Hypothesis: There is a distinct lack of literature on postoperative management after anterior colporrhaphy (AC). Our traditional postoperative protocol consisted of 24 h of indwelling catheterisation followed by 24 h of self-intermittent catheterisation. We hypothesised that a new protocol consisting of only 24 h of indwelling catheterisation might produce better results without additional complications.

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Background: In patients with breast cancer who are candidates for neoadjuvant therapy (NAT), the timing of when to perform sentinel lymph node biopsy (SLNB) remains under discussion. The aim of this study was to compare the advantages and disadvantages of SLNB performed before and after NAT.

Patients And Methods: One hundred seventy-two patients, T1c to T3 and N0 (clinically and according to ultrasound) candidates for NAT were included.

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Introduction And Hypothesis: For the treatment of stress urinary incontinence (SUI), various retropubic and transobturator techniques have demonstrated high cure rates. Single-incision tapes, such as Contasure-Needleless® (C-NDL), have demonstrated similar cure rates to the inside-out transobturator sling (TVT-O®). The aim of this study was to analyse if C-NDL® is equally as effective as an outside-in transobturator sling (Monarc®) for the treatment of SUI.

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