New Developments in Minimally Invasive Gynecologic Oncology Surgery

Stewart, K.I.; Fader, Amanda N.

doi:10.1097/grf.0000000000000286

Cited by 25 publications

(18 citation statements)

References 75 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…nationally, as the number of EC patients who underwent minimally invasive hysterectomy increased from 22% to 50% between 2007 and 2011 [18]. A landmark randomized controlled trial by the Gynecologic Oncology Group (GOG) comparing laparoscopic and open hysterectomies found that minimally invasive hysterectomies result in improved shortterm surgical outcomes [19,20].…”

Section: Discussionmentioning

confidence: 99%

Stage III uterine serous carcinoma: modern trends in multimodality treatment

Young

Huang

et al. 2020

J Gynecol Oncol

View full text Add to dashboard Cite

Objective: To examine outcomes in a modern treatment era for stage III uterine serous carcinoma (USC). Methods: Fifty women were retrospectively identified as 2009 International Federation of Gynecology and Obstetrics stage III USC patients who received radiotherapy (RT) at our institution between 1/2003-5/2018. The patients were divided into 2 cohorts: 20 in the early era (2003-2010) and 30 in the modern era (2011-2018). Patient characteristics were compared using χ 2 tests for categorical variables and t-tests for continuous variables. Recurrence free survival (RFS) and overall survival (OS) were analyzed with Kaplan-Meier estimates, the logrank test, and Cox proportional hazards. Results: The modern era differed from the early era in the increased use of volume-directed external beam RT (EBRT) as opposed to vaginal brachytherapy (VB) alone (33.3% vs 5.0%, p=0.048), minimally invasive surgery (56.7% vs. 25%, p=0.027), sentinel node sampling (26.7% vs. 0%, p=0.012), computed tomography imaging in the perioperative period (63.3% vs. 30%, p=0.044), and human epidermal growth factor receptor 2/neu testing (96.7% vs. 55%, p=0.001). Median follow-up for early and modern eras was 37.27 and 33.23 months, respectively. The early vs. modern 3-year RFS was 33% and 64% (p=0.039), respectively, while the 3-year OS was 55% and 90% (p=0.034). Regional nodal recurrence more common among the patients who received VB only (p=0.048). Conclusion: Modern era treatment was associated with improved RFS and OS in patients with stage III USC. Regional nodal recurrences were significantly reduced in patients who received EBRT.

show abstract

Section: Discussionmentioning

confidence: 99%

Stage III uterine serous carcinoma: modern trends in multimodality treatment

Young

Huang

et al. 2020

J Gynecol Oncol

View full text Add to dashboard Cite

show abstract

“…First, we selected laparoscopic surgery for a huge solid ovarian tumor that was expected to be an early-stage sex cordstromal tumor, such as GCT or thecoma. Minimally invasive laparoscopic approaches in gynecological oncology have become increasingly more common and convenient because of reduced bleeding and morbidity, and shorted recovery time and length of hospitalization [6]. Followed by the ESMO Clinical Practice Guidelines published in 2018 [3], a recent retrospective study showed that the oncologic outcome showed no difference between laparoscopic and open surgery in stage I AGCT adult granulosa cell tumors treated within the Multicenter Italian Trials in Ovarian cancer (MITO-9) Group.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Surgery for a 91-year-old Woman with a Huge Solid Adult Granulosa Cell Tumor: A Case Report

Otake¹,

Horai²,

Suzuki³

et al. 2019

COGO

View full text Add to dashboard Cite

Adult granulosa cell tumors are rare ovarian malignancies. They are usually stage I tumors and have a relatively good prognosis. Surgery is the mainstay of primary therapy. Recent studies showed that a minimally invasive laparoscopic approach is an option for selected patients with adult granulosa cell tumors. We report the case of a 91-year-old woman with an 18 cm solid adult granulosa cell tumor treated with laparoscopic surgery. The patient complained of pelvic discomfort and was found to have a solid ovarian tumor. The tumor was expected to be an early-stage sex cord-stromal tumor such as a granulosa cell tumor or thecoma because of the pelvic magnetic resonance imaging findings and abnormal hormonal blood test results. She underwent laparoscopic bilateral salpingo-oophorectomy. We successfully performed laparoscopic surgery in an elderly woman with an 18-cm solid adult granulosa cell tumor without scattering and spillage of the tumor, using a Vagi-Bag. She had no perioperative complications and recovery was rapid. She was doing well and disease-free at 8 months of follow-up.

show abstract

“…The current data available in the literature demonstrate many direct benefits of laparoscopic surgery for gynecologic pathologies when compared to open surgery [1][2][3]. The known rate of intraoperative and postoperative major complications during gynecologic laparoscopic surgery was 0.7-4% after surgery for benign pathologies [4][5][6] and 4-21% after surgery for malignant diseases [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

The utility of fibrinogen level as a predictor of complications after laparoscopic gynecologic surgery: a prospective observational study

et al. 2019

View full text Add to dashboard Cite

Background: Complications after laparoscopic gynecological surgery may increase patients' morbidity and mortality; therefore, their timely diagnosis and early treatment would help clinicians to avoid life-threatening situations. We aimed to evaluate the predictive role of fibrinogen for diagnosing complications after laparoscopic gynecologic surgery for benign and malignant conditions. Patients and methods: All patients who underwent elective laparoscopic gynecologic surgery between June 2013 and December 2017 at the Department of Gynecologic Oncology, Azienda Ospedaliera Brotzu, Cagliari, were prospectively included. Post-operative complications were assessed and graded according to the Clavien-Dindo classification. Fibrinogen and white blood cell level were determined preoperatively, on the first post-operative day and at the appearance of symptoms indicative of an irregular post-operative course or at the time of rehospitalization for persistent symptoms. The postoperative changes (calculated from the first postoperative day) were correlated with the occurrence and severity of complications and their predictive role was assessed. Results: We enrolled 1016 patients: 36% underwent surgery for benign pathologies (mainly voluminous fibromatous uteri and severe deep endometriosis) and 64% for gynecologic malignancies. The overall complication rate was of 3.45%, the rate of major postoperative complications was 2.85%. A postoperative fibrinogen increase ≥ 20% had a high diagnostic accuracy to identify postoperative complications early (AUC 0.931, sensitivity 89%, and specificity 99%). The magnitude of postoperative fibrinogen change was associated with complication severity. Conclusions: Our findings demonstrated that fibrinogen increase can enable the early detection of postoperative complications after laparoscopic gynecological surgery. Further prospective and multi-center studies are warranted to confirm these results.

show abstract

New Developments in Minimally Invasive Gynecologic Oncology Surgery

Cited by 25 publications

References 75 publications

Stage III uterine serous carcinoma: modern trends in multimodality treatment

Stage III uterine serous carcinoma: modern trends in multimodality treatment

Laparoscopic Surgery for a 91-year-old Woman with a Huge Solid Adult Granulosa Cell Tumor: A Case Report

The utility of fibrinogen level as a predictor of complications after laparoscopic gynecologic surgery: a prospective observational study

Contact Info

Product

Resources

About