Gynecology Oncology
Aida Uzaya; Syahrul Rauf; Trika Irianta; Firdaus Hamid; John Rambulangi; Abdul Rahman
Articles in Press, Accepted Manuscript, Available Online from 12 February 2024
Abstract
Background and Aim: Ovarian cancer affects women worldwide. Immunoregulatory cytokines, particularly interleukin (IL)-6, can enhance tumorigenicity and are persistently secreted by ovarian cancer cells. This study aims to examine IL-6 as a marker of preoperative epithelial ovarian malignancy.
Methods: ...
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Background and Aim: Ovarian cancer affects women worldwide. Immunoregulatory cytokines, particularly interleukin (IL)-6, can enhance tumorigenicity and are persistently secreted by ovarian cancer cells. This study aims to examine IL-6 as a marker of preoperative epithelial ovarian malignancy.
Methods: This study used a cross-sectional design on 81 eligible patients with ovarian neoplasms who were undergoing surgery at the Dr. Wahidin Sudirohusodo Hospital and its networking hospital from October 2021 to June 2022. The ELISA technique was used to measure serum IL-6 from the peripheral vein. In addition, the CA-125 levels, risk of malignancy (RMI) index, and proportion of blood cells were analyzed. Chi-square analysis of the data had been used.
Results: Most of the subjects were presented as malignant ovarian neoplasms (66.7%), followed by benign ovarian neoplasms (33.3%). IL-6 level ≥ 3.75 pg/mL was found in 72.8% of patients. In individuals with epithelial ovarian neoplasms, IL-6 levels did not significantly differ between malignant and benign types (p > 0.05). CA-125 levels, RMI, ascites, and tumor size differed significantly in patients with ovarian epithelial neoplasms between malignant and benign types (p <0.05). Leukocyte levels, hemoglobin levels, platelet levels, age, parity, and age of menarche were not significantly different in epithelial ovarian neoplasm patients between malignant and benign types (p > 0.05).
Conclusion: The preoperative serum IL-6 level cannot be used as a marker of ovarian malignancy. However, this study confirms the relationship between the CA-125 level, RMI, ascites, and tumor size with the malignancy of ovarian tumors.
Obstetrics and Gynecology
Salma Samy Abdellateef; Safaa Kamal Marei; Nagwa Mahmoud Elghorab; Hesham Gaber Al-Anany
Articles in Press, Accepted Manuscript, Available Online from 21 February 2024
Abstract
Background and Objective: Intrauterine infusion of autologous platelet-rich plasma (PRP) is a novel modality that has a role in the treatment of thin endometrial layer. This study aimed to assess the efficacy of intrauterine infusion of autologous PRP on success rate of intracytoplasmic sperm injection ...
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Background and Objective: Intrauterine infusion of autologous platelet-rich plasma (PRP) is a novel modality that has a role in the treatment of thin endometrial layer. This study aimed to assess the efficacy of intrauterine infusion of autologous PRP on success rate of intracytoplasmic sperm injection (ICSI) and clinical pregnancy rates in females with history of implantation failure.
Methods: This prospective study was carried out on 109 females aged ˂ 40 y, with FSH level < 10mIU /ML, AMH > 1ng/mL, presented with either primary or secondary infertility and advised for IVF or ICSI after IVF/ICSI failure. Cases was divided in to two groups with history of implantation or previously unsuccessful IVF cycles: 1st group (n=50) did ICSI without PRP injection and 2nd group (n=50) did ICSI with PRP injection.
Results: Endometrial thickness at OR day was insignificantly different between both groups, but at ET day it was significantly elevated in PRP group in comparison with non-PRP group (P<0.001). The two groups were comparable regarding numbers of retrieved oocytes, mature oocytes, and numbers of fertilized ova but without significant differences. The numbers of good quality embryos showed no significant differences in PRP group in comparison with non-PRP group. There was no significant difference regarding numbers of embryos transferred at day of ET in both groups.
Conclusions: PRP is a new procedure of treatment in the field of reproductive medicine with high safety. Although it significantly increased endometrial thickness at day of ET day and consequently it increased the chemical pregnancy rate
Pathology
maryam deldar; Robab Anbiaee; Masoumeh Keshvari
Articles in Press, Accepted Manuscript, Available Online from 28 February 2024
Abstract
Background: Neoadjuvant chemotherapy (NACT) is used to treat advanced or irreversible breast cancer tumors and increases the possibility of Breast-conserving surgery. There is evidence that pathological complete response (pCR) after NACT reduces the risk of recurrence and increases survival.
Objectives: ...
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Background: Neoadjuvant chemotherapy (NACT) is used to treat advanced or irreversible breast cancer tumors and increases the possibility of Breast-conserving surgery. There is evidence that pathological complete response (pCR) after NACT reduces the risk of recurrence and increases survival.
Objectives: This study aimed to investigate the factors affecting the pathological complete response in breast cancer patients treated with NACT.
Methods: We identified non-metastatic breast cancer patients receiving NACT during 2010–2020. Patients’ and disease characteristics, rates of pCR based on these characteristics were recorded in different subgroups. Analyzes were performed by descriptive and analytical statistics using SPSS.ver26.
Results: 204 patients had mean age of 45.3 years, 32.4% had grade 3, and 89.7% had ductal histology. Overall pCR rate was 33.3% and differed according to disease subtype (p<0.001), receptor status (p<0.001), grade (p=0.015), ki-67 (p=0.004), but not according to age, BMI, menopausal status, tumor size, surgery type after NACT.
Conclusion: In our study, pCR rates are conformed with other studies. Many patients have residual disease following NACT that suggests lower survival or higher risk of recurrence, therefore determining the factors affecting the pathological complete response can help physicians in treatment decisions.
Gynecology Oncology
Fatemeh Sedaghat; zahra Shiravani; Ali Mohammad Karimi; Mohammad Reza Haghshenas; Abbas Ghaderi; Mohammad Javad Fattahi
Articles in Press, Accepted Manuscript, Available Online from 02 March 2024
Abstract
Objective: Endometrial cancer (EC) is the most prevalent gynecological malignancy in more developed countries. Multiple researches have been done about the role of IL-27 in different cancers that suggest a dual role for this cytokine. In the present study, we evaluated the serum level of IL-27 in endometrial ...
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Objective: Endometrial cancer (EC) is the most prevalent gynecological malignancy in more developed countries. Multiple researches have been done about the role of IL-27 in different cancers that suggest a dual role for this cytokine. In the present study, we evaluated the serum level of IL-27 in endometrial cancer patients. We also investigated the correlations between serum levels of IL-27 and the demographic and clinicopathologic features of the patients.
Material and Method: In this case-control study 65 endometrial cancer patients and 58 sex-age-match healthy controls were investigated. Serum levels of IL-27 in both cases and the control group were assessed by a reliable and specific sandwich enzyme-linked immunosorbent assay (ELISA) kit and results were analyzed with SPSS.
Results: We observed that the serum level of IL-27 in EC patients was dramatically higher than in the control group (P=0.003). Additionally, Higher grades of EC (grade II and III) showed higher IL-27 serum levels compared to the control (P=0.006 and P=0.01 respectively). No significant correlations between serum levels of IL-27 and lymph node involvement, tumor stage, tumor size, and demographic features of the patients were detected.
Conclusion: Our results showed that there is a statistically significant difference between serum levels of IL-27 in EC patients and controls. Therefore, the serum level of IL-27 may exert a role in the pathogenesis of endometrial carcinoma although further studies are needed.
Gynecology Oncology
Maha Saad Maki; Mohammed S. Ali; Hala Rawi
Articles in Press, Accepted Manuscript, Available Online from 03 March 2024
Abstract
Background: assess the level of serum Macrophage inhibitory cytokine-1 and high sensitive C - reactive protein level in the first trimester threatened miscarriage.
Method: We conducted a case-control study on 91 pregnant women who were in their first trimester and had a positive fetal heart confirmed ...
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Background: assess the level of serum Macrophage inhibitory cytokine-1 and high sensitive C - reactive protein level in the first trimester threatened miscarriage.
Method: We conducted a case-control study on 91 pregnant women who were in their first trimester and had a positive fetal heart confirmed by ultrasound. On the same day, a serum sample was taken to measure the levels of macrophage inhibitory cytokine-1 and high-sensitivity C-reactive protein using an enzyme-linked immunosorbent assay and particle-enhanced immunoturbidimetric assay, respectively. The study grouped the participants into two categories: control and patient.
Result: We conducted a study with 91 pregnant women, out of which 30 had symptoms of threatened miscarriage such as vaginal spotting or bleeding, while the remaining 61 were healthy. In our study, we found that the concentration levels of serum Macrophage inhibitory cytokine-1 varied significantly between the two groups (control and patient groups) with a P-value of 0.005. The mean concentration for the control group was 622.77 ± 15.10, while for the patient group, it was 1860.13 ± 33.60. Additionally, we observed that high-sensitivity c-reactive protein (HS CRP) had a significant correlation with threatened miscarriage, with a P-value of 0.001. The mean concentration for the control group was 7.49 ± 0.89, while for the patient group, it was 16.02 ± 2.11.
Conclusion: The results of this study provide valuable insights into the pathophysiology of miscarriage and may pave the way for the development of novel therapeutic interventions to prevent this adverse pregnancy outcome.
Obstetrics and Gynecology
Yuni Nurwati; Hardinsyah Hardinsyah; Sri Anna Marliyati; Budi Iman Santoso; Dewi Anggraini
Articles in Press, Accepted Manuscript, Available Online from 04 March 2024
Abstract
Abstract Background and Objective: Nowadays, a simple and reliable screening tool to identify the risk of low birth weight (LBW) infant remains limited, particularly in rural areas where advanced technology is not available. Hence, this study has developed a reliable tool to be simply used by midwives ...
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Abstract Background and Objective: Nowadays, a simple and reliable screening tool to identify the risk of low birth weight (LBW) infant remains limited, particularly in rural areas where advanced technology is not available. Hence, this study has developed a reliable tool to be simply used by midwives and cadres in detecting risk of LBW. Methods: This study used an analytic quantitative study based on retrospective data of 165 eligible pregnant women collected from a public hospital in Ternate City (2018-2023). Body height, body weight, body mass index (BMI), mid-upper arm circumference (MUAC), nausea and vomiting, gestational age of ANC visit (AV) of the first trimester of pregnancy, as well as marital age, age, occupation, education, parity, and abortion history of pregnant women were used as research variables. Binary logistic regression was applied to develop the model. Results: Body weight, marital age, education, and AV are statistically significant as screening indicators for detecting the risk of LBW infant with Area Under Curve (AUC) is 79.6%.Conclusion: Therefore, the model can be developed as a basis for developing a simple and reliable screening tool in the first trimester to detect the risk of LBW infant that can be implemented by midwives and cadres in rural area
Obstetrics and Gynecology
Zainab Muayad Essa; Alia Kareem Mohamad AL-Qarawy; Ashwaq Kadhim Mohammed
Articles in Press, Accepted Manuscript, Available Online from 09 March 2024
Abstract
Background: Endocrine disorders like polycystic ovarian syndrome affect reproductive-age women. It causes infertility and has several clinical symptoms. Clomiphene citrate ovulation induction is a first-line treatment. Serum anti-mullerian hormone can indicate positive pregnancy outcomes in women with ...
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Background: Endocrine disorders like polycystic ovarian syndrome affect reproductive-age women. It causes infertility and has several clinical symptoms. Clomiphene citrate ovulation induction is a first-line treatment. Serum anti-mullerian hormone can indicate positive pregnancy outcomes in women with this disease, however this is controversial. Aim of the study:to assess the value of anti-mullerian hormone (AMH) as an anticipator of ovary response to clomiphene citrate in patients with “polycystic ovary syndrome (PCOS). Patients and methods: A cross-sectional study of 50 women diagnosed with Rotterdam-based polycystic ovarian syndrome by two gynaecologists was conducted. The Maternity and Paediatric Teaching Hospital in Diwaniyah Province, Iraq, conducted the study from August 1, 2022, to May 15, 2023, at the obstetrics and gynaecology department. Women with diabetes or hypertension were excluded from the trial. These women sought medical treatment for infertility and received clomiphene citrate to induce ovulation. The findings of hCG urine and blood testing divided women into positive and negative biochemical pregnancy groups. Results: The mean FSH of all recruited women was 5.19±1.14 IU/L, with no significant difference between pregnant and non-pregnant women (p = 0.849). AMH levels were significantly lower in pregnant women compared to non-pregnant women (p< 0.001). The mean AMH was 6.97±2.88 ng/ml for all enrolled women. ROC curve research determined the optimal AMH cutoff value for predicting positive biochemical pregnancy: ≤6.5 ng/ml with 100% sensitivity, 67.7% specificity, and 80.9 % accuracy. Conclusion: Serum anti-mullerian hormone accurately predicts pregnancy success in PCOS women taking clomiphene citrate to induce ovulation.
Obstetrics and Gynecology
Ashwaq Kadhim Mohammed; Zainab Muayad Essa
Articles in Press, Accepted Manuscript, Available Online from 09 March 2024
Abstract
Background: An unusual manifestation of prenatal trophoblastic illness is a twin molar pregnancy with a live foetus and a hydatidiform mole. Due to increased ovulation stimulation, this unusual scenario is rising. Most hydatidiform moles are complete with a foetus, while 0.005 to 0.01% of gestations ...
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Background: An unusual manifestation of prenatal trophoblastic illness is a twin molar pregnancy with a live foetus and a hydatidiform mole. Due to increased ovulation stimulation, this unusual scenario is rising. Most hydatidiform moles are complete with a foetus, while 0.005 to 0.01% of gestations have a partial mole. This report examined the clinical appearance and outcome of live foetuses with molar pregnancies. Methods: This study was done at Adiwaniyah, where the Maternity and Pediatrics Teaching Hospital has one obstetrics centre. The researcher reviewed 20 years of obstetric reports and found 12 cases of hydatiform mole pregnancies with ultrasound reports and/or post-partum examination of the product of gestation indicating twin pregnancy with a single viable foetus. Results: The average age was 27.00 ±6.87 years, with a range of 18-37 years. The parity breakdown was 8 (66.7%) primiparous and 4 (33.3%) multiparous. The average gestational age upon diagnosis was 19.50 ±3.09 weeks, ranging from 15 to 25 weeks. The average gestational age at delivery commencement was 26.67 ±7.09 weeks, with a range of 17-35 weeks. Seven (58.3%) amniocentesis were normal. Maternal complications included bleeding, anemia, blood transfusion, threatening miscarriage, and pre-eclampsia. End-of-gestation outcomes comprised 5 (41.7%) living and healthy newborns and 3 (25.0%) dead babies. There were 5 (41.7%) men and 2 (16.7%) women. Also reported: miscarriage, premature labour, and caesarean sections. Conclusion: Twin pregnancy with a live viable foetus and a molar pregnancy is rare, hence early detection and care are crucial to prevent difficulties for the mother and foetus.
Gynecology Oncology
elham sharafkhani
Articles in Press, Accepted Manuscript, Available Online from 13 March 2024
Abstract
Ovarian Low-grade serous carcinoma (LGSC), a type of epithelial ovarian tumor, is often diagnosed in the advanced stage, arising from fallopian tube cells or borderline tumors that cause symptoms like abdominal or pelvic pain, bloating, and unexplained weight loss. Treatment involves surgery and chemotherapy. ...
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Ovarian Low-grade serous carcinoma (LGSC), a type of epithelial ovarian tumor, is often diagnosed in the advanced stage, arising from fallopian tube cells or borderline tumors that cause symptoms like abdominal or pelvic pain, bloating, and unexplained weight loss. Treatment involves surgery and chemotherapy. Fertility may be affected depending on the cancer stage. In advanced stages (3 and 4), removing all tumoral implants with both the uterus and ovaries (debulking surgery) may be the first surgical goal, and it can be anticipated that the possibility of pregnancy will be diminished. We presented a case of a 38-year-old woman who became pregnant three years after being diagnosed with LGSOC at stage 3c. Although the standard surgery at a higher stage is debulking surgery and we resected all tumoral implants, the decision was made to preserve the uterus for her since there were no signs of tumor metastasis to the uterus, and the patient wanted to be pregnant. The patient underwent surgery then followed by a standard chemotherapy regimen with carboplatin (AUC 6) and paclitaxel (175 mg/m2) every three weeks for four cycles. During the three years of follow-up, there were no signs of tumor return; she decided to get pregnant by egg donation through an in vitro fertilization (IVF) procedure. She received routine supplements during her pregnancy with the incidence of gestational diabetes and HTN. A cesarean section was done in the week 35th, and the twin infants were born in good condition and with good APGAR scores.
Gynecology Oncology
Kavitha Nagadla; Khine Khine Lwin; Phyu Synn Oo; Thin Thin Win; Afshan Sumera
Articles in Press, Accepted Manuscript, Available Online from 13 March 2024
Abstract
Background and Objective: The management of cervical cancer during pregnancy is significantly challenging. This systematic review summarises the current data on chemotherapy agents (platinum and taxanes) in the management of cervical cancer during pregnancy.
Methods: Two independent investigators searched ...
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Background and Objective: The management of cervical cancer during pregnancy is significantly challenging. This systematic review summarises the current data on chemotherapy agents (platinum and taxanes) in the management of cervical cancer during pregnancy.
Methods: Two independent investigators searched the literature and extracted data from all studies that examined the efficacy and safety of platinum and taxanes in managing cervical cancer during pregnancy. A quantitative synthesis of the published articles was performed and Kaplan–Meier survival curves were estimated to determine the overall and progression-free survival.
Results: Overall, 43 studies with 114 patients were included in this systematic review. All patients received neoadjuvant chemotherapy during pregnancy; the majority received platinum-based chemotherapy. Cisplatin was the main platinum-based chemotherapy agent in 49% (n = 56) of patients, followed by combined platinum and paclitaxel therapy in 36% (n = 41) of patients. A few and two patients were treated with single-agent vincristine and platinum with external beam radiation therapy, respectively. Bleomycin and 5-fluorouracil were administered to two patients. The most frequent complications were grade 2 thrombocytopenia and grade 3 hepatotoxicity in 32 (28%) and 18(20.5%) cases, respectively. The common fetal complications were low birth weight and growth restriction. Chemotherapy was well tolerated by most women in the case group. The progression-free survival was 35% (n = 22).
Conclusion: Platinum and taxane neoadjuvant chemotherapy has proven to be safe and effective in preventing cervical cancer disease progression until definitive surgical treatment.
Maternal Fetal Medicine
Nematullah Shomoossi; Mostafa Rad
Volume 8, Issue 3 , May and June 2023, , Pages 306-307
Abstract
This letter comes to you in the hope of stressing the need to understand age differences and relevant requirements in delivering bad news to end-stage children. Among variables affecting the way healthcare providers communicate bad news, the age of the recipient is a critical factor requiring caregivers’ ...
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This letter comes to you in the hope of stressing the need to understand age differences and relevant requirements in delivering bad news to end-stage children. Among variables affecting the way healthcare providers communicate bad news, the age of the recipient is a critical factor requiring caregivers’ meticulous tactfulness. For practical purposes, various strategies are already suggested in communicating unexpectedly bad news to patients abruptly taken to face their end of life (1). However, patients of different ages may require different strategies. For some healthcare providers and physicians, breaking bad news to an elderly end-stage client may be taken for granted because public mindset is wired to assent to end-of-life deaths. While this tendency appears controversial by itself, communicating bad news to younger patients with life-threatening irremediable diseases appears more perplexing which should be given due attention in practice and special priority in training.Young frivolous patients hope for life rather than death because children conceive of disease as a temporary stage of abnormal functioning of body systems; never do they expect dying if they become ill. The concept gradually transforms; for instance, school-age children may tend to blame themselves by attributing illness to their own actions but as they grow up, illness becomes increasingly attributed to external causes. Therefore, such conceptualizations should guide healthcare providers’ behavior toward their patients.
Obstetrics and Gynecology
Francesco Fedele; Giovanna Esposito; Fabio Parazzini
Articles in Press, Accepted Manuscript, Available Online from 24 March 2024
Abstract
We report the association between situs viscerum inversus and complete cervicovaginal agenesis. Situs viscerum inversus, a rare anomaly, is characterized by a mirror-image of the visceral organs. Cervicovaginal atresia is a rare variety of Müllerian duct aplasia, characterized by a functioning uterine ...
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We report the association between situs viscerum inversus and complete cervicovaginal agenesis. Situs viscerum inversus, a rare anomaly, is characterized by a mirror-image of the visceral organs. Cervicovaginal atresia is a rare variety of Müllerian duct aplasia, characterized by a functioning uterine body (normal or malformed) with the constant absence of the cervix and the total or partial absence of the vagina.
We describe a case of a 17-year-old female patient. During hospitalization at out gynecologycal department, a complete digestive tract x-ray resulted in a depiction of severe congenital intestinal malrotation. An initial gynecological misdiagnosis led to two an inadequate and unsuccessful attempts of conservative surgery before reaching our academic center. Despite a finally complete diagnosis and adequate conservative surgery, the results of previous surgeries have resulted in a failure of conservative therapy and the need for demolitive surgery. Knowledge of this malformative association is crucial for planning interventional procedures.
Obstetrics and Gynecology
Anak Agung Ngurah Jaya Kusuma; Endang Sri Widiyanti; I Gede Mega Putra; Kadek Ary Widayana; William Alexander Setiawan
Articles in Press, Accepted Manuscript, Available Online from 26 March 2024
Abstract
Background and Objective: Pre-eclampsia is one of the pregnancy complications that can result in maternal and neonatal morbidity and mortality. Magnesium sulfate (MgSO4) is one of the effective drugs to prevent and stop seizures in pre-eclampsia and eclampsia. This study aimed to investigate the characteristics ...
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Background and Objective: Pre-eclampsia is one of the pregnancy complications that can result in maternal and neonatal morbidity and mortality. Magnesium sulfate (MgSO4) is one of the effective drugs to prevent and stop seizures in pre-eclampsia and eclampsia. This study aimed to investigate the characteristics of patients with pre-eclampsia and eclampsia and serum magnesium levels during MgSO4 therapy.
Methods: A cross-sectional study design used secondary data from the Emergency Maternity Room of Prof. Dr. I.G.N.G. Ngoerah Hospital. The samples were all superimposed pre-eclampsia, severe pre-eclampsia, and eclampsia cases in 2019. We collected and analyzed characteristic and laboratory data, including the MgSO4 serum levels of the patients. Participants' baseline characteristics (CBC, blood chemistry, and MgSO4) and their diagnosis were compared using the chi-square test for categorical data and the independent t-test for numerical data.
Results: The patients with severe pre-eclampsia were 183 patients, superimposed pre-eclampsia were 41 patients, and eclampsia 15 patients. Age <35 years old was the most influential characteristic variable in superimposed pre-eclampsia (adjusted odds ratio (aOR)=0.166, p<0,001, 95%CI=0.082-0.336) and severe pre-eclampsia (aOR=3.011, p<0,001, 95%CI=1.662-5.455). Hospital referrals were the most influential characteristic variable in eclampsia (aOR=3.653, p=0.016, 95%CI=1.273-10.486). The administration of MgSO4 was significant with severe pre-eclampsia (p<0.001). The highest serum magnesium occurred 6 hours before MgSO4 administration (3.97 ± 1.28 mg/dL).
Conclusion: Patients with superimposed pre-eclampsia, severe pre-eclampsia, and eclampsia conditions have various characteristics associated with each state. During the use of MgSO4, there was a significant association between serum magnesium levels and the therapeutic target levels.
Gynecology Oncology
Ganesalingam Murali; CheeMeng Yong; Nagandla Kavitha; Chew Hua Yeoh
Articles in Press, Accepted Manuscript, Available Online from 26 March 2024
Abstract
Pelvic exenteration (PE) is a surgical procedure that requires an en-bloc excision of lower abdominopelvic structures. Despite its high morbidity, PE is most indicated for treatment of advanced primary or locally recurrent pelvic cancers. We aim to evaluate our experience with PE for patients with gynaecological ...
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Pelvic exenteration (PE) is a surgical procedure that requires an en-bloc excision of lower abdominopelvic structures. Despite its high morbidity, PE is most indicated for treatment of advanced primary or locally recurrent pelvic cancers. We aim to evaluate our experience with PE for patients with gynaecological cancers over 8 years from January 2011 to 31 December 2019 that were identified through hospital databases. Patient demographic characteristics, indications, surgical characteristics and outcomes were retrospectively assessed. Overall survival (OS) was analysed with Kaplan-Meier method and log rank test. Cox proportional hazards regression was used to model survival outcomes. Twenty- one patients were identified with recurrent cervical, endometrial, ovarian and, or vaginal cancer underwent PE. Local disease recurrence was the most common indication in 80.9%. The primary tumor origin was the cervix in 80.9%, followed by endometrial origin 9.5%. PE was performed as curative intent in 62% and in 38% as palliative intent. The most common early complication was wound infections and late complications included deep vein thrombosis, lymphocyst and recurrent urinary tract infections. The median survival at 6 months is 85.7% and 12 months is 57.1 %. Our five-year OS was 54.3 % (95% CI 34.2, 74.6). Our case series illustrates pelvic exenteration provides about 54.3% of 5-year survival chance in a selected group of patients. The early-and late complications rate are similar to those described historically. Pelvic exenteration results in sustained survival in selected patients and continued efforts must focus on identifying those patients who could potentially benefit most from PE.