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).

Knowledge, attitudes and referral patterns of lynch syndrome: a survey of clinicians in australia.

This study assessed Australian clinicians' knowledge, attitudes and referral patterns of patients with suspected Lynch syndrome for genetic services. A total of 144 oncologists, surgeons, gynaecologists, general practitioners and gastroenterologists from the Australian Medical Association and Clinical Oncology Society responded to a web-based survey. Most respondents demonstrated suboptimal knowledge of Lynch syndrome.

Consideration for safe and effective gynaecological laparoscopy in the obese patient.

Background: The number of obese and morbidly obese patients within the developed world is dramatically increasing within the last 20 years. Apart from demographical changes, obese patients are especially prone to have oestrogen-dependent morbidities and neoplasias, of which laparoscopic treatment should be the standard of care. The increasing number of patients with BMI >40 is concerning, making it necessary to summarise considerations for safe and effective Gynaecological Laparoscopic Surgery.

Incidence, risk factors and estimates of a woman's risk of developing secondary lower limb lymphedema and lymphedema-specific supportive care needs in women treated for endometrial cancer.

Objectives: Few studies have assessed the risk and impact of lymphedema among women treated for endometrial cancer. We aimed to quantify cumulative incidence of, and risk factors for developing lymphedema following treatment for endometrial cancer and estimate absolute risk for individuals. Further, we report unmet needs for help with lymphedema-specific issues.

Improving treatment for obese women with early stage cancer of the uterus: rationale and design of the levonorgestrel intrauterine device ± metformin ± weight loss in endometrial cancer (feMME) trial.

Purpose: Endometrial adenocarcinoma (EC) is the most common gynaecologic cancer. Up to 90% of EC patients are obese which poses a health threat to patients post-treatment. Standard treatment for EC includes hysterectomy, although this has significant side effects for obese women at high risk of surgical complications and for women of childbearing age.

A European survey on awareness of post-surgical adhesions among gynaecological surgeons.

The present survey was conducted among gynaecological surgeons from several European countries to assess the actual knowledge and practice related to post-surgical adhesions and measures for reduction. From September 1, 2012 to February 6, 2013, gynaecological surgeons were invited to answer an 18-item online questionnaire accessible through the ESGE website. This questionnaire contained eight questions on care settings and surgical practice and ten questions on adhesion formation and adhesion reduction.

Quality of life of women with lower limb swelling or lymphedema 3-5 years following endometrial cancer.

Objective: To quantitatively assess and compare the quality of life (QoL) of women with a self-reported diagnosis of lower limb lymphedema (LLL), to women with lower limb swelling (LLS), and to women without LLL or LLS following treatment for endometrial cancer.

Methods: 1399 participants in the Australian National Endometrial Cancer Study were sent a follow-up questionnaire 3-5 years after diagnosis. Women were asked if they had experienced swelling in the lower limbs and, if so, whether they had received a diagnosis of lymphedema by a health professional.

The impact of risk-reducing hysterectomy and bilateral salpingo-oophorectomy on survival in patients with a history of breast cancer--a population-based data linkage study.

Prophylactic surgery including hysterectomy and bilateral salpingo-oophorectomy (BSO) is recommended in breast cancer susceptibility gene (BRCA)-positive women, whereas in women from the general population, hysterectomy plus BSO may increase the risk of overall mortality. The effect of hysterectomy plus BSO on women previously diagnosed with breast cancer is unknown. We used data from a population-base data linkage study of all women diagnosed with primary breast cancer in Queensland, Australia between 1997 and 2008 (n = 21,067).

Feasibility and outcomes of ureteroureterostomy and extravesical ureteroneocystostomy as part of radical surgery for infiltrating gynecologic disease.

Objective: Abdominopelvic infiltrative disease may require aggressive surgical procedures. This study reports on our experience with distal ureterectomy, ureteroureterostomy, and extravesical ureteroneocystostomy as part of radical surgery for infiltrating gynecologic disease.

Patients And Methods: Twenty-one women required surgery to the distal ureter at the Queensland Centre for Gynecological Cancer, Australia, from January 2006 to September 2012.

Nomogram to predict the probability of relapse in patients diagnosed with borderline ovarian tumors.

Objective: This study aimed to develop a nomogram predicting the probability of relapse in individual patients who have surgery for borderline ovarian tumors (BOTs).

Methods: This retrospective study included 801 patients with BOT diagnosed between 1985 and 2008 at 6 gynecologic cancer centers. We analyzed covariates that were associated with the risk of developing a recurrence by multivariate logistic regression.

Is Patient Education About Adhesions a Requirement in Abdominopelvic Surgery?

Over the past decades, our knowledge and understanding of adhesions and adhesion-related complications has increasingly grown and it has become evident that adhesions have significant implications for patients, physicians and the healthcare system. The question arises whether this has resulted in greater awareness of adhesion-related problems among practicing physicians and appropriate patient education on this topic in daily practice. The following article provides a brief overview of the important subject of adhesions, discusses current awareness of adhesions among patients and doctors and addresses the consequences of failure to provide patient education and consent from a medical perspective.

Prognostic value of elevated preoperative serum CA125 in ovarian tumors of low malignant potential: a multinational collaborative study (ANZGOG0801).

Objective: Previous studies on prognostic factors in ovarian tumors of low malignant potential (LMP) were too small for robust conclusions. We examined the prognostic impact of preoperative serum CA125 ≥ 50 U/ml levels in patients diagnosed with ovarian LMP tumors in a large multinational cohort.

Methods: This retrospective study included 940 patients with ovarian LMP tumors diagnosed between 1985 and 2008 at six gynecologic cancer centers.

Analysis of prognostic variables, development of predictive models, and stratification of risk groups in surgically treated FIGO early-stage (IA-IIA) carcinoma cervix.

Objectives: The objectives of the study were to evaluate clinicopathologic prognostic variables in surgically treated International Federation of Obstetrics and Gynecology early-stage (IA-IIA) cervical cancer, develop prognostic models, and note the role of adjuvant treatment, patterns of failure, and salvage survival (SS) in each group.

Methods: Records of 542 patients who received primary surgical treatment for International Federation of Obstetrics and Gynecology (IA-IIA) cervical cancer were reviewed. Ninety-eight patients who relapsed after primary treatment were identified and matched for stage and age with a control group.

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.

Neoadjuvant chemotherapy followed by radical vaginal trachelectomy and adjuvant chemotherapy for clear cell cancer of the cervix: a feasible approach and review.

Background: Clear cell adenocarcinoma of the cervix (CCAC) may affect pediatric and younger women in absence of diethylstilbestrol exposure and other classic predisposing factors for cervical cancer. Prognosis is similar for early-stage CCAC, squamous cell cancer and non-clear cell adenocarcinoma of the cervix. Vaginal radical trachelectomy (VRT) and abdominal radical trachelectomy (ART) with pelvic lymph node dissection have evolved as valuable fertility-preserving treatment options.

Pretreatment malnutrition and quality of life - association with prolonged length of hospital stay among patients with gynecological cancer: a cohort study.

Background: Length of hospital stay (LOS) is a surrogate marker for patients' well-being during hospital treatment and is associated with health care costs. Identifying pretreatment factors associated with LOS in surgical patients may enable early intervention in order to reduce postoperative LOS.

Methods: This cohort study enrolled 157 patients with suspected or proven gynecological cancer at a tertiary cancer centre (2004-2006).

Advanced cytoreductive surgery: Asia Pacific perspective.

The thoroughness of cytoreductive surgery is the largest contributor to survival for patients with advanced ovarian and primary peritoneal carcinoma. For many years the surgery undertaken by Gynaecologic Oncologists has been tailored to match their surgical training. Future surgical training of Gynaecologic Oncologists needs to be tailored to the surgery required to provide complete tumour removal to no residual disease.

Survey of surgical skills of RANZCOG trainees.

Background: In Australia, the Integrated Training Program (ITP) of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) offers training in obstetrics and gynaecology. There is anecdotal concern among trainees and Fellows that the surgical component of training is inadequate, with new specialists lacking the confidence and competence to perform many 'standard' surgical procedures. These concerns have not previously been quantified in Australia and New Zealand.

Comparison of different nutritional assessments and body-composition measurements in detecting malnutrition among gynecologic cancer patients.

Background: Few studies have assessed global nutritional assessment tools and body-composition measurements in gynecologic cancer patients.

Objective: We aimed to assess the convergent validity of different nutritional tools such as the scored Patient-Generated Subjective Global Assessment (PG-SGA), serum albumin, skinfold-thickness measurements, and total-body potassium (TBK) and body density measurements to identify gynecologic cancer patients at risk of malnutrition.

Design: We assessed the nutritional status of 194 patients with suspected or proven gynecologic cancer according to the SGA and the scored PG-SGA, and skinfold-thickness (n = 145), TBK (n = 51), and body density measurements (n = 42) before primary treatment.

Pap smear screening history of women with squamous cell carcinoma and adenocarcinoma of the cervix.

Background: Since the introduction of the Pap smear screening, the incidence of squamous cell carcinoma (SCC) has decreased significantly, but the incidence of adenocarcinoma (AC) relative to SCC has increased.

Aim: To compare the Pap smear history of patients with AC and SCC of the cervix.

Methods: Patients for the study were identified from the database of Queensland Centre for Gynaecological Cancer.

Laparoscopy in the treatment of ovarian tumours of low malignant potential.

Laparoscopy is increasingly used by gynaecologists for the investigation of adnexal masses. Uncertainty exists whether ovarian tumours of low malignant potential can effectively be treated by laparoscopy, whether staging bears a benefit for all patients, whether port-site metastases are a problem and how long patients need to be followed up after surgery. This review summarises the evidence to address these important questions.

Randomized trial of skin closure after laparotomy for gynaecological surgery.

Background: New suture materials may provide patients with a better cosmetic outcome at similar pain and wound complication rate.

Methods: To assess pain and cosmetic outcome among patients randomized to receive wound closure after laparotomy for gynaecological surgery using staples, polyglecaprone 25 or polyglecaprone 6211 subcuticular sutures.

Results: Overall, 90 patients (87.

Total laparoscopic hysterectomy: the Brisbane learning curve.

Background: Total laparoscopic hysterectomy (TLH) is becoming more commonly used for gynaecological malignancies.

Aims: To describe our experience with TLH since its introduction to our tertiary referral centre for gynaecological cancer in 2003.

Methods: Retrospective analysis of the first 120 consecutive cases of TLH performed at our gynaecological cancer centre.

A new prognostic model for FIGO stage 1 epithelial ovarian cancer.

Background: No consensus exists which patients with surgical stage 1 epithelial ovarian should receive postoperative chemotherapy. The purpose of this study was to evaluate the prognostic impact of preoperative CA-125 and to establish a prognostic index to identify patients in different risk categories.

Methods: Data of 600 surgically staged patients with FIGO stage 1 EOC treated in eleven gynecological cancer centers in Australia, the USA and Europe were analyzed.