Oncological outcomes of intraperitoneal chemotherapy in advanced ovarian cancer: BRCA mutation role.

INTRODUCTION: The knowledge of BRCA status offers a chance to evaluate the role of the intraperitoneal route in patients selected by biomolecular profiles after primary cytoreduction surgery in advanced ovarian cancer. MATERIALS AND METHODS: We performed a retrospective, multicenter study to assess oncological outcomes depending on adjuvant treatment (intraperitoneal [IP] vs intravenous [IV]) and BRCA status (BRCA1/2 mutated vs. BRCA wild type [WT]). The primary endpoint was to determine progression-free survival. The secondary objectives were overall survival and toxicity. RESULTS: A total of 288 women from eight centers were included: 177 in the IP arm and 111 in the IV arm, grouped into four arms according to BRCA1/2 status. Significantly better PFS was observed in BRCA1/2-mutated patients with IP chemotherapy (HR: 0.35; 95% CI, 0.16-0.75, p = 0.007), which was not present in BRCA1/2-mutated patients with IV chemotherapy (HR: 0.65; 95% CI, 0.37-1.12, p = 0.14). Significantly better OS was also observed in IP chemotherapy (HR: 0.17; 95% CI, 0.06-043, p < 0.0001), but was not present in IV chemotherapy in relation with BRCA mutation (HR: 0.52; 95% CI, 0.22-1.27, p = 0.15). For BRCA WT patients, worse survival was observed regardless of the adjuvant route used. The IP route was more toxic compared to the IV route, but toxicity was equivalent at the long-term follow-up. CONCLUSION: This retrospective study suggests that BRCA status can help to offer an individualized, systematic treatment after optimal primary surgery for advanced ovarian cancer, but is limited by the small sample size. Prospective trials are essential to confirm these results.

Colposacropexia laparoscópica y cistocele / No disponible

No disponible

La colposacropexia laparoscópica en el tratamiento del cistocele / Laparoscopic sacrocolpopexy for the treatment of cystoceles

Objetivo: Estudiar los resultados de la colposacropexia sobre el cistocele. Material y métodos: Setenta y siete pacientes con cistocele sometidas a colposacropexia. Con seguimiento mínimo de 6 meses, se practicó la exploración y la detección de síntomas de prolapso, urinarios rectales y sexuales. La curación objetivo se definió como un grado < II en la clasificación de Baden-Walker. Resultados: La edad media ± desviación estándar era de 53,8 ± 8,9 años. El tiempo medio operatorio de 193,6 ± 44 min. Las complicaciones intraoperatorias existieron en el 11,6% y las postoperatorias en el 19,4%. La estancia media fue de 2,7 días (1-8). Con un seguimiento medio de 15,5 ± 12,8 meses, la curación subjetiva se alcanzó en el 89,6% y la mejoría en el 6,4%. Hubo en el seguimiento un 11,6% de pacientes con cistoceles con criterios de recidiva anatómica. Setenta y cinco pacientes se declararon satisfechas o moderadamente satisfechas (97,7%). Conclusión: La colposacropexia es también efectiva para corregir el compartimento anterior (AU)

Objective: To study the results of sacrocolpopexy in our hospital for the treatment of cystoceles. Material and methods: A total of 77 patients were treated by laparoscopic sacrocolpopexy. With a minimum mean follow-up of 6 moths, a clinical examination was performed to detect symptoms of prolapse or urinary, sexual and rectal symptoms. Objective cure was defined as < grade 2 prolapse in the Baden-Walker classification. Results: The mean age was 53.8 ± 8.9 years. The mean operating time was 193.6 ± 44 minutes. Intra-operative and post-operative complications rates were 11.6% and 19.4%, respectively. The mean length of hospital stay was 2.7 (1-8) days. With a mean follow-up of 15.3 ± 12.8 months, the subjective cure rate was 89.6% and the improvement rate was 6.4%. The rate of anatomical recurrence of cystocele was 11.6%. Seventy-five patients reported they were satisfied or moderately satisfied (97.7%). Conclusion: Laparoscopy sacrocolpopexy appears to be an effective method for the treatment of cystocele (AU)