BackgroundDysgerminomas are malignant ovarian germ-cell tumors that typically affect young women. Although these tumors have an excellent response to chemotherapy, surgery is an integral part of primary treatment.ObjectiveTo evaluate outcomes of initial cytoreduction in patients diagnosed with dysgerminomas.MethodsPatients who underwent primary cytoreductive surgery for ovarian dysgerminoma between January 1985 and December 2013 were identified and included in the study. A comparison was made between patients who underwent optimal versus sub-optimal cytoreduction. Descriptive, comparative statistics and odds ratios were used to establish an association. Survival curves were performed with the Kaplan-Meier method and compared using a log-rank test. A value of p<0.05 was used to establish a statistical difference.ResultsA total of 180 patients with a histologically confirmed dysgerminoma were included in the analysis. A subsection of 37 patients in stages III/IV were analyzed. The median age at diagnosis was 21 years (IQR 18–26). Histologically, 166 (92.2%) patients had pure dysgerminomas, whereas the rest had mixed histologies. The median tumor size was 18 (IQR 12–22) cm. In all stages, factors associated with optimal cytoreduction, were higher lactate dehydrogenase levels (OR=1.01; p=0.03), higher CA125 levels (OR=1.01; p=0.04), receiving adjuvant chemotherapy (OR=0.22; p<0.01), or undergoing treatment in a specialized institution (OR=12.68; p<0.01). Patients in stages III/IV, initially managed outside our institution were less likely to be taken for cytoreduction (OR=16.88; p=0.013). Other factors, including age (OR=1.02; p=0.39), pelvic lymph-node positivity (OR=2.24; p=0.36), pregnancy during follow-up (OR=0.91: p=0.80), or recurrence of disease (OR=1.93; p=0.23) were found to be similar in both groups. Overall survival was higher in optimally cytoreducted patients (100% vs 95.7%; p=0.032) including all stages, but not if considering only stages III/IV (100% vs 90%, p=0.186); disease-free survival was the same for both groups regardless of stage (94.3% vs 91.1%; p=0.36).ConclusionPatients with optimal surgeries were most likely to be treated in referral centers. Initial residual disease did not significantly alter recurrence, progression, disease-free survival, or overall survival.

Background: Open radical hysterectomy with bilateral pelvic lymphadenectomy is the standard treatment in early stages (1A2-1B1) of uterine cervical cancer (UCC); laparoscopic radical hysterectomy (LRH) is a safe and viable option. Objective: To evaluate the safety and feasibility of LRH in a hospital cancer care center. Method: Retrospective study that included the first 17 patients with UCC in an early stage operated with LRH in the period from April 2013 to November 2016 at the National Cancer Institute of Mexico. Results: The 17 patients were stage IB1 clinical, of which 10 (58.8%) was epidermoid subtype, 4 (23.5%) adenocarcinoma and 3 (17.6%) adenoescamoso. The mean age was 42 ± 8 years. The tumor size was 2.3 ± 0.9 cm, and in 94.1% the surgical margins were free of disease. The average operative time was 341 ± 65 minutes and blood loss of 107 ± 64 ml, no patient required blood transfusion and there was no case of conversion to open surgery. The average length of hospital stay was 2.7 days (range: 2-7 days). There were no intraoperative or postoperative complications. Conclusions: LRH is a safe and reliable alternative for the treatment of early stage UCC.

LRH is a safe and reliable alternative for the treatment of early stage UCC.