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Neoadjuvant Chemotherapy in Advanced Ovarian Cancer: A Single-Institution Experience and a Review of the Literature.

OBJECTIVES: The aim of this study was to evaluate the role of neoadjuvant chemotherapy (NACT) in advanced ovarian carcinoma patients unable to undergo a complete resection during primary debulking surgery. METHODS: From February 2005 to October 2015, all consecutive cases of advanced-stage epithelial ovarian carcinoma at the University of Bari were retrospectively recorded. Of them, patients treated with NACT were collected. Kaplan-Meier and Cox proportional hazards analyses were used to determine the predictors of survival. RESULTS: Seventy-eight women with advanced-stage epithelial ovarian

Fallopian tube intraluminal tumor spread from noninvasive precursor lesions: a novel metastatic route in early pelvic carcinogenesis.

Pelvic serous carcinoma is usually advanced stage at diagnosis, indicating that abdominal spread occurs early in carcinogenesis. Recent discovery of a precursor sequence in the fallopian tube, culminating in serous tubal intraepithelial carcinoma (STIC), provides an opportunity to study early disease events. This study aims to explore novel metastatic routes in STICs. A BRCA1 mutation carrier (patient A) who presented with a STIC and tubal intraluminal shedding of tumor cells upon prophylactic bilateral salpingo-oophorectomy (PBSO) instigated scrutiny of an additional 23 women who underwent a

Image-guided drainage of tuboovarian abscesses of gastrointestinal or genitourinary origin: a retrospective analysis.

PURPOSE: To analyze the authors' success with image-guided drainage of tuboovarian abscesses (TOAs). MATERIALS AND METHODS: Retrospective analysis of patients with image-guided TOA drainage from 1999 to 2008 was performed. Patient recovery without salpingo-oophorectomy was considered clinical success. A total of 57 TOAs were drained in 49 female patients (mean age, 43; range, 12 to > 89). RESULTS: Thirty-three (58%) TOAs were drained percutaneously using computed tomography guidance and 24 were ultrasound guided (21 transvaginally, three transabdominally). Fifty-three TOAs were drained with

A Rare Case of Sequential Contralateral Tubal Pregnancies.

Bilateral tubal ectopic pregnancies are the rarest form of extrauterine pregnancy, with an incidence higher in women who are undergoing ovul … egnancy was raised given the <50% rise in β-hCG over 48 hours, and she underwent laparoscopic right salpingectomy for a confirmed right tubal ectopic pregnancy. Five days later, she returned to the emergency room for evaluation of weakness, dizziness, and increased vaginal bleeding. Repeat evaluation revealed an elevated β-hCG at 2,410.89 mIU/mL. A pelvic ultra …

Cost-effectiveness Analysis of Genotype-Specific Surveillance and Preventive Strategies for Gynecologic Cancers Among Women With Lynch Syndrome.

IMPORTANCE: With the expansion of multigene testing for cancer susceptibility, Lynch syndrome (LS) has become more readily identified among … my (hyst-BSO) and at surveillance initiation, and a 2-stage surgical approach (ie, hysterectomy and salpingectomy at age 40 years and delayed oophorectomy at age 50 years [hyst-BS]) was included. Extensive 1-way and probabilistic sensitivity analyses were performed. INTERVENTIONS: Hyst-BSO at ages 35 years, 40 years, or 50 years with or without annual surveill …

Age as a risk factor for perioperative complications in women undergoing pelvic reconstructive surgery.

OBJECTIVE: : The purpose of this study is to determine whether the age of a patient undergoing pelvic reconstructive and/or anti-incontinence pelvic surgery is a risk factor for perioperative complications. STUDY DESIGN: : A retrospective chart review was conducted of women who underwent pelvic reconstructive and anti-incontinence pelvic surgery between the years 2000 and 2006. The women underwent surgery by 1 urogynecologist, at 2 city hospitals. Patients with incomplete medical documentation were excluded from the study. The variables investigated included demographics, smoking history, pri

Surgical treatment for chronic pelvic pain.

The source of chronic pelvic pain may be reproductive organ, urological, musculoskeletal-neurological, gastrointestinal, or myofascial. A ps … areas of pain as well as thin ahesions affecting critical structures such as ovaries and tubes; 6) salpingectomy or neosalpingostomy for symptomatic hydrosalpinx; 7) ovarian treatment for symptomatic ovarian pain; 8) uterosacral nerve vaporization for dysmenorrhea; 9) presacral neurectomy for disabling central pain primarily of uterine but also of bladder orig …

International trends in concurrent hysterectomy at risk-reducing surgery in BRCA1/2 pathogenic variant carriers: a mixed-methods study.

BACKGROUND: BRCA1/2 pathogenic variant carriers are advised to undergo a risk-reducing salpingo-oophorectomy between the ages of 35 and 45 d … 2% in Australia, and 2.8% in Europe (P<.001). Execution of concurrent hysterectomy at risk-reducing salpingectomy in women from North- and South America occurred more often in women with a BRCA1 pathogenic variant compared to a BRCA2 pathogenic variant (adjusted odds ratio 0.4 [95% confidence interval, 0.2-0.7]). In the qualitative analysis, we interviewed 23 h …

Association of Hysteroscopic vs Laparoscopic Sterilization With Procedural, Gynecological, and Medical Outcomes.

IMPORTANCE: Safety of hysteroscopic sterilization has been recently questioned following reports of general symptoms such as allergy, tiredn … ural complications (surgical and medical) and of gynecological (sterilization failure that includes salpingectomy, second sterilization procedure, or pregnancy; pregnancy; reoperation) and medical outcomes (all types of allergy; autoimmune diseases; thyroid disorder; use of analgesics, antimigraines, antidepressants, benzodiazepines; outpatient visits; sickness …

Substantial lymph-vascular space invasion (LVSI) is a significant risk factor for recurrence in endometrial cancer--A pooled analysis of PORTEC 1 and 2 trials.

BACKGROUND: Lymph-vascular space invasion (LVSI) is an important adverse prognostic factor in endometrial cancer (EC). However, its role in relation to type of recurrence and adjuvant treatment is not well defined, and there is significant interobserver variation. This study aimed to quantify LVSI and correlate this to risk and type of recurrence. METHODS: In the post operative radiation therapy in endometrial carcinoma (PORTEC)-trials stage I EC patients were randomised to receive external beam radiotherapy (EBRT) versus no additional treatment after surgery (PORTEC-1, n=714), or to EBRT ver

Chemotherapy Response Score: Development and Validation of a System to Quantify Histopathologic Response to Neoadjuvant Chemotherapy in Tubo-Ovarian High-Grade Serous Carcinoma.

PURPOSE: To develop and validate a histopathologic scoring system for measuring response to neoadjuvant chemotherapy in interval debulking surgery specimens of stage IIIC to IV tubo-ovarian high-grade serous carcinoma. PATIENTS AND METHODS: A six-tier histopathologic scoring system was proposed and applied to a test cohort (TC) of 62 patients treated with neoadjuvant chemotherapy and interval debulking surgery. Adnexal and omental sections were independently scored by three pathologists. On the basis of TC results, a three-tier chemotherapy response score (CRS) system was developed and applie

Flutamide and biomarkers in women at high risk for ovarian cancer: preclinical and clinical evidence.

We hypothesized that (i) preclinical biologic evidence exists for the role of androgens in ovarian cancer development and (ii) flutamide treatment of women at high risk for ovarian cancer may identify meaningful tissue biomarkers of androgen action and of ovarian cancer initiation. We showed that androgen ablation of male mice led to a 24-fold decrease in tumor burden from serous ovarian cells. In a phase II study, we studied the effect of preoperative flutamide treatment (125 mg/day × 6 weeks) in 12 women versus 47 controls, 47% with BRCA mutation. We analyzed immunohistochemical scores of ca

Evidence-based cesarean delivery: postoperative care (part 10).

The following review focuses on routine postoperative care after cesarean delivery (CD), including specific Enhanced Recovery After Cesarean … unseled pre-CD on the option of immediate postpartum intrauterine devices insertion, intraoperative salpingectomy, or placement of long-acting reversible contraception in the postpartum period. Implementation of such evidence-based postoperative care protocols decrease length of stay, surgical site infection rates, and improve patient satisfaction and breastfee …

[Outcome and relevant factors of tubal pregnancy treated with laparoscopic conservative surgery].

OBJECTIVE: To investigate the therapeutic outcome and its influencing factors after laparoscopic conservative surgery in treatment of tubal … p A. Nineteen cases who were failed in their first laparoscopic conservative surgery and treated by salpingectomy and 63 cases with tubal obstruction were enrolled in group B. The rate of tubal patency was calculated on patients with characteristics of gestational sac less or more than 5 cm, the level serum human chorionic gonadotropin (hCG) less than 2000 IU/L …

Гистологическая оценка образцов гистерэктомии после эндометрической абляции в Новосере у пациентов с нетипичной эндомией гиперплазии или эндометрической карциномой.

ОКРУЖАЮЩАЯ СРЕДА: Для пациентов с тяжелым менструальным кровотечением (HMB) разрешается лечение с помощью эндомеальной абляции &quot; Новасуре &quot; без признаков злокачественных или предмалярных повреждений. В этом анализе рассматривается редкая, но клинически значимая ситуация, в которой эндометричная карцинома (ЭК) или атипичная гиперплазия (АЭГ) выявляется гистологически после эндомеальной абляции у доменопаузальных пациентов. ЦЕЛЬ: гистологическая оценка образцов гистерэктомии с корреляцией с клиническими параметрами у пациентов, страдающих гистерэктомией после случайного гистологическог

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… All eight patients with AEH underwent hysterectomy with bilateral salpingectomy. Histopathological examination of the hysterectomy specimens revealed that 6 of the 8 patients with a preoperative diagnosis of AEH showed no residual atypia. …

Case Report: Erythema gyratum repens associated with adenomyosis and endometriosis: an immunological twist?

A 37-year-old non-Caucasian woman presented with a 2-year history of pruritic, concentric erythematous plaques refractory to multiple topical and systemic therapies. The clinical findings were highly suggestive of erythema gyratum repens (EGR), a rare figurate dermatosis classically associated with paraneoplastic syndromes. Routine laboratory investigations and an autoantibody panel were unremarkable, except for a significantly elevated CA-125 level. A targeted gynecological assessment, prompted by a chronic history of pelvic pain and menorrhagia, identified severe adenomyosis with concomitant

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… Crucially, the decision to proceed with a total abdominal hysterectomy with bilateral salpingectomy was purely therapeutic—aimed at treating her severe, symptomatic adenomyosis and endometriosis—rather than diagnostic, as comprehensive cross-sectional imaging had already ruled out pelvic malignancy. …

Focused Training in Pelvic Floor Surgery: A CUSUM Analysis of the Learning Curve in Uterosacral Ligament Suspension.

INTRODUCTION: Pelvic organ prolapse (POP) involves the descent of pelvic organs into the vaginal cavity due to weakened pelvic support struc … a, Italy, between November 2021 and February 2023. Patients underwent transvaginal hysterectomy and salpingectomy, with additional procedures as necessary, followed by high uterosacral ligament suspension. Follow-up assessments were performed periodically to evaluate symptoms and determine objective recurrence. Comparative analyses were conducted on preoperativ …

Undetected, natural conception pregnancies in luteal phase stimulations-case series and review of literature.

STUDY QUESTION: What is the risk of an undetected natural conception pregnancy during luteal phase ovarian stimulation, and how does it impa … gnancies (patient age: 30, 39, and 42 years), one patient had an ectopic pregnancy which required a salpingectomy, and one patient (age: 34 years) had an early pregnancy loss. LIMITATIONS, REASONS FOR CAUTION: The retrospective study design and the small sample size can limit the accuracy of the estimates. WIDER IMPLICATIONS OF THE FINDINGS: Overall, there is …

A case of neovagina surgical creation using the uterine cervix remnant in a patient with Mayer-Rokitansky-Küster-Hauser syndrome.

OBJECTIVE: To study the efficacy of a novel approach to vaginoplasty in a patient with vaginal aplasia and a preserved cervix. DESIGN: We present the case of a 28-year-old patient who was referred with a history of absent menstruation and vaginal intercourse was absent as well as abnormal development of the internal genitals. The patient underwent a laparoscopic cystectomy in 2012 because of an ovarian cyst and later that year underwent laparotomic supracervical hysterectomy with bilateral salpingectomy because of severe pain caused by a hematometra in their uterine remnant. In the period fro…