Background: The decision whether fertility-sparing surgical management may be successfully applied in women with cervical cancer who wish to preserve their fertility remains a great therapeutic challenge. Such management is possible if no node metastases are expected and the risk of cancer spread beyond the cervix is limited. Thus, precise evaluation of tumor size is necessary.
Objectives: The aim of the study was to establish cytologic, colposcopic and histologic eligibility criteria for fertility-sparing treatment in women with early-stage cervical cancer.
Material And Methods: The study included 119 women (aged 25-43 years) diagnosed and operated on due to malignant changes within the cervix. Each subject underwent cytologic and colposcopic examination, followed by histologic evaluation of a large, target section from the most suspicious area of the lesion.
Results: Histologic evaluation revealed stage IA1 in 60 (50.4%), IA2 in 53 (44.5%), and IB1 in 6 (5.1%) patients. Histologic compatibility between target sections and evaluation of the surgical material was 59 (98.4%), 51 (96.2%), and (100%) for stages IA1, IA2, and IB1, respectively
Conclusions: Proper colposcopic assessment of early-stage invasive cervical cancer (IA) allows to identify the most adequate area for large wedge biopsy That in turn makes it possible to establish proper histologic pre-treatment diagnosis, with an over 95% compatibility with the final histologic evaluation, what conditions fertility-sparing surgical treatment.
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http://dx.doi.org/10.17772/gp/2396 | DOI Listing |
Oncologist
January 2025
Léon Bérard Cancer Center, Department of Surgical and Medical Oncology-Lyon, Université Claude Bernard Lyon 1, Lyon, France.
Ovarian clear cell carcinoma (OCCC) accounts for ~10% of all epithelial ovarian cancers and is considered a different entity from the more common high-grade serous ovarian carcinoma (HGSC), with distinct clinical presentations, different risk, and prognostic factors, and specific molecular features. Most OCCCs are diagnosed at an early stage and show favorable outcomes, in contrast to those diagnosed at advanced stages, which exhibit intrinsic resistance to platinum-based chemotherapy regimens and a very poor prognosis. The standard treatment of advanced OCCC is currently based on primary debulking surgery followed by platinum-based chemotherapy according to recent international guidelines.
View Article and Find Full Text PDFJ Minim Invasive Gynecol
January 2025
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing 100730, China; National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing 100730, China; State Key Laboratory for Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Beijing 100730, China. Electronic address:
Study Objective: To explore the associations between adenomyosis patterns on transvaginal sonography (TVS) and surgical outcomes.
Design: A retrospective cohort study.
Setting: Peking Union Medical College Hospital, Beijing, China.
Cancers (Basel)
January 2025
Department of Molecular and Developmental Medicine, Obstetrics and Gynecological Clinic, University of Siena, 53100 Siena, Italy.
Endometrial cancer is the most common gynecological neoplasm with an increased incidence in the premenopausal population in recent decades. This raises the problem of managing endometrial cancer in fertile women who have not yet achieved pregnancy. In these women, after careful selection, hysterectomy may be postponed in favor of conservative management if specific requirements are met.
View Article and Find Full Text PDFTaiwan J Obstet Gynecol
January 2025
Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Medicine, Cheng-Hsin General Hospital, Taipei, Taiwan. Electronic address:
Uterine fibroids occur frequently in women during the reproductive age, and they are rarely associated with clinical meaning because of their benign characteristics and asymptomatic clinical presentation. Sometimes, uterine fibroids are symptomatic and associated with compression syndrome, infertility, chronic pelvic pain and heavy menstrual bleeding. All need further intervention and treatment.
View Article and Find Full Text PDFJAMA Netw Open
January 2025
Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston.
Importance: The goal of surgical deescalation is to minimize tissue damage, enhance patient outcomes, and reduce the adverse effects often associated with extensive or traditional surgical procedures. This shift toward less invasive techniques has the potential to revolutionize surgical practices, profoundly impacting the methods and training of future surgeons.
Objective: To evaluate adoption of surgical deescalation within the field of gynecologic oncology using The National Cancer Database.
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