Abstract:
OBJECTIVE:Benefits of laparoscopy over laparotomy in patients with endometrial cancer (EC) are well known. As many patients with EC carry co-morbid conditions, surgery is exposing them to increased risk of complications. A review of the patients with EC recruited so far in a clinical trial comparing laparoscopy to laparotomy was performed. The goal was to identify patients carrying specific risk factors for complications, who would most benefit of laparoscopy and be the ideal candidates for this surgical approach. PATIENTS AND METHODS:Between July 1995 and December 2002, 122 patients with uterine cancer entered the study. Sixty-three patients were allocated to the laparoscopy (LPS) arm (group A), while 59 were allocated to the laparotomy (LPT) arm (group B). Rate and type of intra-, early and late post-operative complications were prospectively recorded. Risk factors for complications are analyzed to define a group of patients truly benefiting from laparoscopy. RESULTS:Overall, 12 patients out of 122 (9.8%) have experienced intra-operative, 43 patients out of 122 (35.2%) early post-operative and 25 patients out of 122 (20.4%) late post-operative complications. Rate of intra-operative complications was 4.7% in group A (3 patients out of 63) vs. 15.2% in group B (9 patients out of 59), P = 0.082. Early post-operative complications rate was 23.8% in group A (15 out of 63) and 47.4% in group B (28 out of 59), P = 0.011. Rate of late post-operative complications was 7.9% (5 out of 63) in group A vs. 35.5% (21 out of 59), P = 0.001. Univariate analysis shows co-morbid medical conditions, weight >80 kg, Quetelet index >30 and age >65 years to be predictive of complications and, in fact, a subgroup of patients presenting with these characteristics (n = 57, 30 in group A and 27 in group B) has been recognized to accumulate 60% of the overall complications. In these patients, multivariate analysis identifies the surgical technique (LPS vs. LPT) to be the only significant risk factor for complications. CONCLUSION:At least one third of the patients with EC carry serious co-morbidities with an increased surgical risk for complications. For this subgroup of patients, a laparoscopic-vaginal approach significantly reduces the rate of complications and should be the standard of surgical treatment.
journal_name
Gynecol Oncoljournal_title
Gynecologic oncologyauthors
Tozzi R,Malur S,Koehler C,Schneider Adoi
10.1016/j.ygyno.2004.12.048subject
Has Abstractpub_date
2005-04-01 00:00:00pages
4-9issue
1eissn
0090-8258issn
1095-6859pii
S0090-8258(04)01049-2journal_volume
97pub_type
临床试验,杂志文章,随机对照试验abstract:OBJECTIVE:Primary objective of this study was to determine prognostic significance of Bohm's histopathological regression score in patients who received neoadjuvant chemotherapy (NACT) for treatment of high grade serous (HGS) tubal & ovarian carcinoma. METHODS:This was a retrospective cohort study of patients who rece...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2018.08.042
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVE:Mismatch repair (MMR) deficiency and Bethesda panel microsatellite instability (MSI) are increasingly analyzed to identify tumors that might benefit from immune checkpoint inhibitors, but tumor heterogeneity is a potential obstacle for such analyses. In ovarian cancer, data on intratumoral heterogeneity of MM...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2019.12.031
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVES:MDM2 is an important negative regulator of the p53 tumor suppressor protein. A naturally occurring T/G single nucleotide polymorphism (SNP) in the MDM2 gene promoter, SNP309, causes an increase in MDM2 protein levels and impairment of p53 tumor suppressor activity. SNP309 occurs at a relatively high frequenc...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2006.10.008
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:High tumor dissemination (HTD) is a major risk factor for serious morbidity after primary ovarian cancer (OC) surgery, particularly in medically compromised patients. We performed a pilot study of whether CT findings could predict extent of disease and surgical complexity necessary in advanced OC. METHODS:P...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2013.05.007
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVE:To review and summarize evidence from clinical, translational and epidemiologic studies which have examined the clinically relevant aspects of HPV type prevalence and cervical dysplasia in HIV-infected women. METHODS:Relevant studies were identified through a MEDLINE search. References of identified reports ...
journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1016/j.ygyno.2009.10.058
更新日期:2010-03-01 00:00:00
abstract:OBJECTIVE:The expression of homologous recombination (HR) genes in high grade ovarian cancer (HGOC) samples from debulking surgeries were correlated to outcomes in patients selected for chemotherapy treatment regimens. STUDY DESIGN:RNA was extracted from 96 fresh frozen tumor samples from debulking surgeries from chem...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2018.01.017
更新日期:2018-03-01 00:00:00
abstract:PURPOSE:To evaluate the long-term disease control, survival and complication rates using high-dose-rate intracavitary brachytherapy (HDRB) and external beam radiotherapy (EBRT) for patients found to have isolated vaginal recurrences from early-stage endometrial adenocarcinoma following total abdominal hysterectomy and ...
journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1006/gyno.1997.4752
更新日期:1997-08-01 00:00:00
abstract:OBJECTIVE:To determine the impact of geographic location on advanced-stage ovarian cancer care adherence to the National Comprehensive Cancer Network (NCCN) guidelines in relation to race and socioeconomic status (SES). METHODS:Patients diagnosed with stage IIIC/IV epithelial ovarian cancer (1/1/96-12/31/06) were iden...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2014.03.561
更新日期:2014-07-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1993.1064
更新日期:1993-03-01 00:00:00
abstract:BACKGROUND:Ovarian cancer is the deadliest gynecologic malignancy, yet the effects on survival of modifiable pre-diagnosis lifestyle factors, such as obesity and physical activity, remain largely unexplored. Our objective was to evaluate the effect of pre-diagnosis BMI and physical activity on ovarian cancer mortality ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2019.07.025
更新日期:2019-10-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2018.05.001
更新日期:2018-07-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2013.04.001
更新日期:2013-07-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(90)90135-8
更新日期:1990-03-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2011.08.012
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:Obesity confers an overall increased risk for development of endometrial cancer. However there are conflicting reports regarding the effect of obesity on patients' overall and disease specific survival. The purpose of this study was to evaluate the effect of obesity on survival in women with endometrial canc...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2019.03.258
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVE:Metformin is one of the most widely used drugs for the treatment of type 2 diabetes. Recent investigations demonstrated that application of metformin reduces cancer risk. The present study aimed to determine the role of liver kinase B1 (LKB1) in the response of cervical cancer cells to metformin. METHODS:LKB...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2012.06.032
更新日期:2012-10-01 00:00:00
abstract::The existing means of detecting recurrent ovarian carcinoma are notoriously poor. Positron emission tomography (PET) is a form of computer-assisted imaging which produces images reflective of the biochemistry of the tissues rather than their physical characteristics. PET imaging with the positron emitting glucose anal...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1993.1268
更新日期:1993-11-01 00:00:00
abstract:BACKGROUND:Treatment with weekly cisplatin (CDDP) plus radiotherapy (RT) is the standard regimen for stage IB to stage IVA cervical carcinoma (CC). We performed a systematic review and meta-analysis of published studies to evaluate whether CDDP-based doublet therapy improves survival compared to weekly CDDP plus RT in ...
journal_title:Gynecologic oncology
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.ygyno.2014.04.049
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to investigate the clinical and pathological characteristics of uterine clear cell carcinoma (UCCC) and the treatment of this disease in relation to patient outcomes. METHODS:The clinicopathological data for and the management of all patients with UCCC who presented between 1991 and...
journal_title:Gynecologic oncology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ygyno.2014.07.005
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVE:The purpose was to examine the outcomes of patients with advanced ovarian cancer treated with neoadjuvant chemotherapy, with a special emphasis on the patients' quality of life (QOL). METHODS:Seventeen patients with advanced ovarian cancer were treated with neoadjuvant chemotherapy based on the extent of dis...
journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章
doi:10.1006/gyno.2002.6849
更新日期:2003-01-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2012.05.004
更新日期:2012-08-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2009.08.004
更新日期:2009-12-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1016/j.ygyno.2010.02.007
更新日期:2010-05-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2011.10.030
更新日期:2012-03-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2015.12.014
更新日期:2016-02-01 00:00:00
abstract::An estimated 2-5% of endometrial cancers and 15-20% of high-grade, non-mucinous epithelial ovarian cancers have an underlying hereditary cause. Appropriate risk assessment, genetic counseling, and germline genetic testing for cancer predisposition genes in both gynecologic cancer patients and their at-risk relatives i...
journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1016/j.ygyno.2019.01.024
更新日期:2019-04-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2004.08.024
更新日期:2004-12-01 00:00:00
abstract:BACKGROUND:Positron emission tomography (PET) is commonly used to detect occult or recurrent malignancy, including tumors of the female genital tract. Recently, there have been reports of PET scans used in patients with Gestational Trophoblastic Disease (GTD). CASE:A 22-year-old female presented with vaginal bleeding ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2005.01.049
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine prognostic factors of metachronous Krukenberg's tumors of gastric origin, thereby helping to establish a therapeutic plan for this rare entity. METHODS:Thirty-four female patients who underwent curative resection of gastric carcinoma from 1987 through 1996 and subsequen...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.2001.6210
更新日期:2001-07-01 00:00:00
abstract::Human papillomavirus (HPV) types 16 and 18 are associated with cervical dysplasia and carcinoma. In vitro integration of HPV-16 or HPV-18 DNA into cultured human cervical cells results in their immortalization. In this study, in vivo differentiation of human cervical cells immortalized with recombinant HPV-16 or HPV-1...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(90)90082-v
更新日期:1990-09-01 00:00:00