Poroid hidradenocarcinoma and atypical hidradenoma papilliferum of the vulva - Two cases.

Benign and malignant tumours may arise from eccrine and apocrine sweat glands. Hidradenocarcinoma is a rare malignant eccrine sweat gland tumour representing <0.01% of all skin cancers.

A Novel Method to Facilitate Uterine Delivery at Robotic Hysterectomy.

Minimally invasive platforms have afforded women undergoing hysterectomy the advantages of improved postoperative pain control, reduced complication rates, and shorter inpatient recovery time. In patients where malignancy has been confirmed or suspected, the necessity for uterine delivery per vagina is imperative to maintain these advantages without compromising oncological outcome.A previously unreported technique of enlarging the apical circumference of the vagina during robotic hysterectomy facilitates intact uterine passage after extended reflection of the bladder and/or rectum.

Effect of Total Laparoscopic Hysterectomy vs Total Abdominal Hysterectomy on Disease-Free Survival Among Women With Stage I Endometrial Cancer: A Randomized Clinical Trial.

Importance: Standard treatment for endometrial cancer involves removal of the uterus, tubes, ovaries, and lymph nodes. Few randomized trials have compared disease-free survival outcomes for surgical approaches.

Objective: To investigate whether total laparoscopic hysterectomy (TLH) is equivalent to total abdominal hysterectomy (TAH) in women with treatment-naive endometrial cancer.

Primary leiomyosarcoma of the omentum presenting as an ovarian carcinoma, case report and review of the literature.

Primary omental leiomyosarcoma is a rare tumor. We report a case of successfully resected omental leiomyosarcoma whose presentation mimicked ovarian carcinoma. Symptoms of abdominal distension and discomfort that lasted 8 months followed by pain lead to a diagnosis of a large mass in the abdomen.

Lower preoperative quality of life increases postoperative risk of adverse events in women with endometrial cancer: results from the LACE trial.

Objective: To examine the association between preoperative quality of life (QoL) and postoperative adverse events in women treated for endometrial cancer.

Methods: 760 women with apparent Stage I endometrial cancer were randomised into a clinical trial evaluating laparoscopic versus open surgery. This analysis includes women with preoperative QoL measurements, from the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire, and who were followed up for at least 6 weeks after surgery (n=684).

Carcinoma of the neovagina after male-to-female reassignment.

Background: Carcinoma of the neovagina is extremely rare, and only one other case has been reported after sex-reassignment surgery. Malignancies seem to be dependent on the original tissue and are thought to be associated with HPV infection or chronic irritation.

Case Report: A 53-year-old male-to-female transsexual presented 21 years after initial surgery with vaginal discharge that was found to be due to a moderately differentiated squamous cell carcinoma.

Improved surgical safety after laparoscopic compared to open surgery for apparent early stage endometrial cancer: results from a randomised controlled trial.

Aim: To compare Total Laparoscopic Hysterectomy (TLH) and Total Abdominal Hysterectomy (TAH) with regard to surgical safety.

Methods: Between October 2005 and June 2010, 760 patients with apparent early stage endometrial cancer were enroled in a multicentre, randomised clinical trial (LACE) comparing outcomes following TLH or TAH. The main study end points for this analysis were surgical adverse events (AE), hospital length of stay, conversion from laparoscopy to laparotomy, including 753 patients who completed at least 6 weeks of follow-up.

Risk factors to predict the incidence of surgical adverse events following open or laparoscopic surgery for apparent early stage endometrial cancer: results from a randomised controlled trial.

Aims: To identify risk factors for major adverse events (AEs) and to develop a nomogram to predict the probability of such AEs in patients who have surgery for apparent early stage endometrial cancer.

Methods: We used data from 753 patients who were randomised to either total laparoscopic hysterectomy or total abdominal hysterectomy in the LACE trial. Serious adverse events that prolonged hospital stay or postoperative adverse events (using common terminology criteria 3+, CTCAE V3) were considered major AEs.

The utility of serum CA-125 in predicting extra-uterine disease in apparent early-stage endometrial cancer.

Surgical staging in early-stage uterine cancer is controversial. Preoperative serum CA-125 may be of clinical value in predicting the presence of extra-uterine disease in patients with apparent early-stage endometrial cancer. Between October 6, 2005, and June 17, 2010, 760 patients were enrolled in an international, multicentre, prospective randomized trial (LACE) comparing laparotomy with laparoscopy in the management of endometrial cancer apparently confined to the uterus.

Quality of life after total laparoscopic hysterectomy versus total abdominal hysterectomy for stage I endometrial cancer (LACE): a randomised trial.

Background: This two-stage randomised controlled trial, comparing total laparoscopic hysterectomy (TLH) with total abdominal hysterectomy (TAH) for stage I endometrial cancer (LACE), began in 2005. The primary objective of stage 1 was to assess whether TLH results in equivalent or improved quality of life (QoL) up to 6 months after surgery compared with TAH. The primary objective of stage 2 was to test the hypothesis that disease-free survival at 4.

Surgical staging for patients presenting with grade 1 endometrial carcinoma.

Objective: To examine the impact of surgical staging of patients presenting with grade 1 endometrial cancer.

Methods: The charts of all patients who presented for surgery for endometrial cancer between March 1997 and July 2003 were analyzed for demographic data, final tumor histology, grade, stage, and complications.

Results: A total of 349 patients underwent surgical management for endometrial cancer.

Morbid obesity and endometrial cancer: surgical, clinical, and pathologic outcomes in surgically managed patients.

Objective: To evaluate surgical, clinical, and pathologic outcomes of patients with endometrial cancer managed with primary surgery when stratified by body mass index (BMI).

Methods: A review of 356 consecutive patients undergoing primary surgical management of endometrial carcinoma by a single gynecologic oncology service from 1997 to 2003 was undertaken. Patients were divided into three groups based on preoperative BMI.

Total laparoscopic hysterectomy for endometrial cancer: patterns of recurrence and survival.

Objective: The impact of laparoscopic surgery on the patterns of recurrence and on prognosis in patients with endometrial cancer remains unclear. The objective of the current study was to evaluate the effect of the laparoscopic approach on patterns of recurrence, disease-free (DFS), and overall survival (OS) in patients with endometrial cancer.

Methods: A retrospective review of patients presenting with stages 1-4 endometrial cancer who had a hysterectomy, bilateral salpingo-oophorectomy with or without surgical staging was performed.

Is there a prognostic difference between depth of myometrial invasion and the tumor-free distance from the uterine serosa in endometrial cancer?

Objective: The objective was to determine whether tumor-free distance from the uterine serosa is more predictive of patient outcome than depth of endometrial cancer invasion into the myometrium.

Methods: Patients with surgically staged endometrial adenocarcinoma between 1997 and 2000 were identified. Depth of myometrial invasion (DOI) was identified defined as the distance between endometrial-myometrial junction and deepest myometrial invasion.

Pre-emptive analgesia in gynecologic surgical procedures: preoperative wound infiltration with ropivacaine in patients who undergo laparotomy through a midline vertical incision.

Objective: We tested the hypothesis that local anesthetic that is injected before a vertical midline abdominal incision would decrease the use of postoperative opioids.

Study Design: Patients who would undergo abdominal surgical procedures with general anesthesia by a planned vertical midline incision were enrolled in the study. Patients were assigned randomly to receive either 0.

Should the presence of lymphvascular space involvement be used to assign patients to adjuvant therapy following hysterectomy for unstaged endometrial cancer?

Objective. Thegoal of this study was to determine the influence of LVSI (lymphvascular space involvement) on the risk of lymph node metastases from endometrial cancer.Methods.

Pain in the foot: calcaneal metastasis as the presenting feature of endometrial cancer.

Background: Ninety percent of endometrial cancer cases present with abnormal bleeding. Bone metastasis as the presenting feature is extremely rare.

Case: A 76-year-old woman presented with right heel pain.

Chylous ascites following treatment for gynecologic malignancies.

Background: Chylous ascites is a rare complication following abdominal radiation or para-aortic lymph node dissection in the management of gynecologic malignancies. Treatment options include dietary restriction with addition of medium-chain triglycerides, serial paracenteses, total parenteral nutrition, and somatostatin. Current opinion advocates that surgical exploration and peritoneo-venous shunts be reserved for refractory cases.

Total laparoscopic hysterectomy in the management of endometrial carcinoma.

Study Objective: To compare total laparoscopic hysterectomy (TLH) with open hysterectomy in the management of endometrial carcinoma.

Design: Retrospective chart review (Canadian Task Force classification II-3).

Setting: Gynecologic cancer center.

Ureteroileoneocystostomy: the use of an ileal segment for ureteral substitution in gynecologic oncology.

Objective: The aim of this study was to assess the results of the use of an ileal segment to restore the functional integrity of the renal tract where lower ureteric resection is necessary in gynecologic oncology surgery.

Methods: All patients in whom ureteroileoneocystostomy (UINC) was performed between March 1988 and December 2000 were identified and a retrospective review of their case notes was conducted.

Results: A total of 12 UINC procedures were performed on eight patients.