Aim: 18 F-Fluorodeoxyglucose positron-emission tomography integrated with computed tomography ( 18 FDG PET-CT) is a non-invasive examination that could be helpful for the management of endometrial cancer. This study investigated the performance of 18 FDG PET-CT in assessing para-aortic (PA) lymph-node involvement in high-risk endometrial cancer. Materials and Methods: This was a retrospective, single-center study carried out between 2009 and 2018. The inclusion criteria were high-risk and locally advanced type 1 or 2 endometrial cancer with 18 FDG PET-CT before PA lymphadenectomy. Results: During the study period, among 142 patients with high-risk endometrial cancer, 35 patients (24.6%) underwent 18 FDG PET-CT followed by PA lymphadenectomy. In 25% of cases, PA lymphadenectomy was not performed due to the discovery of metastasis. 18 FDG PET-CT had a sensitivity of 50%, a specificity of 100%, a positive predictive value of 100%, a negative predictive value of 75%, accuracy of 80% and an area under the curve of 0.75 for the evaluation of PA involvement. Conclusion: According to its high specificity in PA lymph-node evaluation, a positive PET scan might allow PA lymphadenectomy to be avoided.Endometrial cancer is the fourth most frequent cancer in women, with more than 8,000 cases per year in France (1). A knowledge of lymph-node status and International Federation of Gynecology and Obstetrics (FIGO) stage is necessary to establish the most appropriate treatment strategy. The risk of lymph-node involvement is strongly correlated with the characteristics of the tumor, and depends on its histological type, grade, the degree of local extension (myometrium and cervical stroma), and the presence of lymphovascular space invasion (2). Since the European Society for Medical Oncology (ESMO) congress of 2009 (3) and the publication of the French National Institute of Cancer (INCA) recommendations in 2010 (4), para-aortic lymphadenectomy (PAL) has been recommended for stage I tumors of histological type 1 (endometrioid adenocarcinoma) with a high risk of recurrence (stage IB and grade 3, or with the presence of lymphovascular space invasion, regardless of grade), for tumors of stage II and above, and for histological type 2 tumors (clear-cell carcinoma, papillary serous carcinoma, and carcinosarcoma) of all stages.PAL is a surgical procedure associated with non-negligible morbidity, particularly in elderly patients with associated comorbid conditions (5). Its therapeutic impact on survival is a matter of debate (6). Knowledge of pelvic and paraaortic (PA) lymph-node status guides therapeutic decisions, determining whether there are indications for more or less extensive radiotherapy and systemic treatment (7). The PORTEC-3 study showed that adjuvant chemotherapy, in addition to radiotherapy, was beneficial in stage III high-risk endometrial cancer (8).18 F-Fluorodeoxyglucose positron-emission tomography integrated with computed tomography ( 18 FDG PET-CT) is a non-invasive examination that can modify the management of endometr...

Introduction The coronavirus SARS-CoV-2 (COVID-19) pandemic has put tremendous pressure on the French healthcare system. Almost all hospital departments have had to profoundly modify their activity to cope with the crisis. In this context, the surgical management of cancers has been a topic of debate as care strategies were tailored to avoid any delay in treatment that could be detrimental to patient wellbeing while being careful not to overload intensive care units. The primary objective of this study was to observe changes in the surgical management of pelvic cancers during the COVID-19 pandemic in France. Material and Methods This study analyzed data from the prospective multi-center cohort study conducted by the French Society for Pelvic and Gynecological Surgery (SCGP) with methodological support from the French (FRANCOGYN) Group. All members of the SCGP received by e-mail a link allowing them to include patients who were scheduled to undergo gynecological carcinologic surgery between March 16th 2020 and May 11th 2020. Demographic data, the characteristics of cancers and the impact of the crisis in terms of changes to the usual recommended coarse of care were collected. Results A total of 181 patients with a median age 63 years were included in the cohort. In total, 31 patients had cervical cancer, 76 patients had endometrial cancer, 52 patients had ovarian or tubal cancer, 5 patients had a borderline tumor of the ovary, and 17 patients had vulvar cancer. During the study period, the care strategy was changed for 49 (27%) patients with postponed for 35 (19.3%) patients, and cancelled for 7 (3.9%) patients. Surgical treatment was maintained for 139 (76.8%) patients. Management with neo-adjuvant chemotherapy was offered to 19 (10,5%) patients and a change in surgical choice was made for 5 (2,8%) patients. In total, 8 (4,4%) patients tested positive for COVID-19. Data also shows a greater number of therapeutic changes in cases of ovarian cancer as well as a cancellation of a lumbo-aortic lymphadenectomy in one patient with cervical cancer. Hospital consultants estimated a direct detrimental impact of the COVID-19 pandemic for 39 patients, representing 22% of gynecological cancers. Conclusion This study provided observational data of the impact of the COVID-19 health crisis on the surgical management of gynecological cancers.

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Q fever during pregnancy is responsible for severe obstetric complications. It must be diagnosed early and its clinical forms known in order to start appropriate antibiotic therapy.