ABSTRACT
PURPOSE OF INVESTIGATION: The purpose of this study was to evaluate the feasibility of laparoscopic hysterectomy versus the transabdominal approach with systemic pelvic lymphadenectomy in early stage endometrial cancer. METHODS: From January 1996 to April 2002, 59 women were treated for endometrial cancer at the Department of Gynecology in Padova, Italy (29 by the laparoscopic technique and 30 by laparotomy). Every patient underwent hysterosalpingo-oophorectomy with systemic pelvic lymphadenectomy. RESULTS: Comparing the two techniques, operating time was longer and hospital stay was significantly shorter for laparoscopy; no differences were observed about the number of removed lymph nodes (range 5-33) or intra-postoperatory complications. CONCLUSION: The laparoscopic approach to endometrial cancer is certainly to be considered appropriate and efficacious, even if it requires skilled surgeons and adequate oncologic training. It is important to perform pelvic lymphadenectomy in all cases of early stage cancer.
Subject(s)
Endometrial Neoplasms/pathology , Endometrial Neoplasms/surgery , Hysterectomy/methods , Laparoscopy/methods , Adult , Aged , Biopsy, Needle , Cohort Studies , Female , Follow-Up Studies , Humans , Laparotomy/methods , Lymph Node Excision/methods , Middle Aged , Neoplasm Staging , Postoperative Complications , Probability , Retrospective Studies , Sensitivity and Specificity , Treatment OutcomeABSTRACT
Better knowledge and adequate treatment of malignant ovarian tumors have improved the quality of life of young women--especially of child-bearing age. Nowadays preservation of ovarian function in women with tumors in early stage (I) or, in selected cases even in advanced stage (II-III), must be evaluated for conservative surgery (sometimes expressly requested by the patient herself). In our Institute we have followed this philosophy for many years and our experience confirms its value: 42 patients under age 40 (36 in stage I and 6 in advanced stage) underwent conservative surgery: 12 subsequently became pregnant and another 12 are able to conceive. Five- and ten-year survival rates are very good with 89.2% and 83.3% for all stages and 96.9% and 95% for early stages.
Subject(s)
Ovarian Neoplasms/surgery , Quality of Life , Adult , Antineoplastic Agents/therapeutic use , Combined Modality Therapy , Female , Humans , Ovarian Neoplasms/drug therapy , Survival RateABSTRACT
The malignant potential of granulosa cell tumors (GCT) of the ovary is much debated. This study includes 18 patients with a diagnosis of GCT of the ovary. Clinical and pathologic data from patients were compared with flow cytometry ploidy, Ki-67 reactivity and p53 overexpression in order to determine their prognostic usefulness. There was no correlation between ploidy and stages or between ploidy and biological behavior. On the other hand, mitotic count, Ki-67 reactivity and p53 overexpression were associated with stages of disease, recurrent onset and survival. We believe that ploidy, Ki-67 and p53 should be considered important prognostic factors for GCT in association with the other more studied prognostic factors, even if no conclusions can be reached.
Subject(s)
Biomarkers, Tumor/analysis , Granulosa Cell Tumor/chemistry , Granulosa Cell Tumor/diagnosis , Ovarian Neoplasms/chemistry , Ovarian Neoplasms/diagnosis , Adult , DNA, Neoplasm , Female , Flow Cytometry , Humans , Ki-67 Antigen/analysis , Middle Aged , Neoplasm Staging , Ploidies , Prognosis , Risk Factors , Tumor Suppressor Protein p53/analysisABSTRACT
A 38-week pregnant patient, weighing 70 Kgs, with poisoning by petrol ingestion, showing mixed acidosis and with a fetus with cardiotocographic alterations and oligohydramnios, underwent an urgent caesarean section under general anaesthesia. After 15 days from ingestion no complications were observed, the mother's vital parameters were normal and no severe complications were seen in the newborn (2900 g; 49 cm). There are no similar cases of intense hydrocarbon ingestion in pregnant women as far as we know. Thus, in order to evaluate the toxicity of such chemical agents on pregnant patients and fetuses, we must consider the quantity of ingested hydrocarbons, gestation time and metabolism modifications which physiologically occur during pregnancy.
