Objective: This study evaluated the oncologic outcomes of laparoscopy and laparotomy in the management of early-stage ovarian cancer patients.
Methods: We conducted an observational study of women diagnosed with International Federation of Gynecology and Obstetrics (FIGO) 2014 stage I ovarian cancer who underwent surgery at the West China Second University Hospital from 2012 to 2020. Patients who received adjuvant chemotherapy before surgery, those with non-epithelial histopathological types, or those with insufficient data were excluded. Using propensity score matching, data from consecutive laparoscopic patients treated by laparoscopy were matched 1:2 with a cohort of patients undergoing open surgery. The operative and survival outcomes among the matched cohorts were examined using the Kaplan-Meier method.
Results: Among 200 eligible patients, 74 patients undergoing laparoscopy were compared with a cohort of 126 patients undergoing open surgery. Baseline characteristics were similar between groups after matching. Patients who had laparoscopy had a shorter operative time (P = 0.001), a shorter hospital stay (P <0.001), and lower blood loss (P = 0.001) than patients who had open surgery. The median (range) follow-up period was 43.0 (38.8-47.2) and 45.0 (36.0-54.0) months for cases and controls, respectively (P <0.001). There are no significant differences in progression-free survival (P = 0.430, log-rank test) and overall survival (P = 0.067, log-rank test) between the two groups.
Conclusions: There is no difference in prognosis between laparoscopic and open surgery in women with stage I epithelial ovarian cancer. Laparoscopic treatment of early-stage ovarian cancer is safe and feasible for stage I epithelial ovarian cancer patients.
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http://dx.doi.org/10.3389/fonc.2022.879889 | DOI Listing |
JAMA Netw Open
December 2024
Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, California.
Importance: Serial circulating tumor DNA (ctDNA) has emerged as a routine surveillance strategy for patients with resected colorectal cancer, but how serial ctDNA monitoring is associated with potential curative outcomes has not been formally assessed.
Objective: To examine whether there is a benefit of adding serial ctDNA assays to standard-of-care imaging surveillance for potential curative outcomes in patients with resected colorectal cancer.
Design, Setting, And Participants: In this single-center (City of Hope Comprehensive Cancer Center, Duarte, California), retrospective, case cohort study, patients with stage II to IV colorectal cancer underwent curative resection and were monitored with serial ctDNA assay and National Cancer Center Network (NCCN)-guided imaging surveillance from September 20, 2019, to April 3, 2024.
JAMA Netw Open
December 2024
Department of Surgery, University of Vermont, Burlington.
Importance: The 2009 US Preventive Services Task Force breast cancer screening guideline changes led to decreases in screening mammography, raising concern about potential increases in late-stage disease and more invasive surgical treatments.
Objective: To investigate the incidence of breast cancer by stage at diagnosis and surgical treatment before and after the 2009 guideline changes.
Design, Setting, And Participants: This population-based, epidemiologic cohort study of women aged 40 years or older used 2004 to 2019 data from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program.
Neuromodulation
December 2024
StimAire Corporation, Tucson, AZ, USA.
Introduction: Moderate-to-severe obstructive sleep apnea (OSA) affects a large segment of the US population and is characterized by repetitive and reversible obstruction of the upper airway during sleep. Untreated OSA is associated with increased incidence of heart attack, stroke, and motor vehicle accidents due to sleepiness. Continuous positive airway pressure is often prescribed, but most patients with OSA are nonadherent.
View Article and Find Full Text PDFVet Sci
December 2024
Programa de Pós-Graduação em Saúde, Bem-Estar e Produção Animal Sustentável na Fronteira Sul (PPG-SBPAS), Universidade Federal da Fronteira Sul (UFFS), Realeza 85770-000, Brazil.
Ovariohysterectomy (OVH) is a common procedure in bitches, where ovarian suspensory ligament (OSL) rupture facilitates hemostasis but may also have adverse effects. Given the importance of minimizing the surgical stress response, this study aimed to evaluate the impact of OSL rupture in 20 healthy bitches undergoing elective open OVH; a celiotomy via the ventral midline was performed, and hemostasis achieved using bipolar coagulation, either with OSL rupture (OSL-R) or without (OSL-NR). Pain was assessed over 24 h post-surgery using the Visual Analogue Scale and the Short Form of the Glasgow Composite Measure Pain Scale.
View Article and Find Full Text PDFNeurol Int
December 2024
Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119074, Singapore.
Intracranial hemorrhage associated with primary or metastatic brain tumors is a critical condition that requires urgent intervention, often through open surgery. Nevertheless, surgical interventions may not always be feasible due to two main reasons: (1) extensive hemorrhage can obscure the underlying tumor mass, limiting radiological assessment; and (2) intracranial hemorrhage may occasionally present as the first symptom of a brain tumor without prior knowledge of its existence. The current review of case studies suggests that advanced radiological imaging techniques can improve diagnostic power for tumoral hemorrhage.
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