Gynecologic oncology
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Gynecologic oncology · Nov 2006
Risk factors for anastomotic leak after recto-sigmoid resection for ovarian cancer.
Anastomotic leak after recto-sigmoid (RS) resection for ovarian cancer (OC) is a life-threatening complication. Selection of patients for protective diverting stomas has been based on observations from the colorectal literature. Our objective was to identify primary risk factors for anastomotic leak in OC patients undergoing RS resection to better determine who would most benefit from protective diversion. ⋯ Low serum albumin is associated with an increased risk of anastomotic leak after RS resection for OC. Patients with a low albumin level may benefit from a protective diverting colostomy/ileostomy.
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Gynecologic oncology · Nov 2006
Cystoscopic temporary ureteral catheterization during radical vaginal and abdominal trachelectomy.
To describe the role of temporary retrograde ureteral catheterization at the time of fertility-sparing radical vaginal or abdominal trachelectomy in women with early-stage cervical cancer. ⋯ Cystourethroscopy and bilateral retrograde ureteral catheterization by gynecologic oncologists is a simple and quick procedure that may facilitate identifying the distal ureter during radical vaginal or abdominal trachelectomy. We favor using 5Fr whistle-tip catheters as they may be associated with less ureteral mucosal trauma and subsequent postoperative edema. The skills needed for this procedure should be available to fellows in gynecologic oncology training.
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Gynecologic oncology · Nov 2006
Prospective endometrial assessment of breast cancer patients treated with third generation aromatase inhibitors.
A prospective evaluation of the effects on endometrium of third generation aromatase inhibitors (AIs), administered as adjuvant up-front therapy or switched therapy in menopausal patients suffering from breast cancer. ⋯ AIs delivered as up-front therapy for breast cancer have no effects on unspecific endometrial thickening. When administered as switched therapy after tamoxifen withdrawal, AIs may reverse tamoxifen-associated endometrial thickening. As a consequence, we reduced unnecessary second-line endometrial investigations. A low rate of emerging endometrial pathology was found during AIs therapy.
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Gynecologic oncology · Oct 2006
The impact of age on long-term outcome in patients with endometrial cancer treated with postoperative radiation.
Endometrial cancer is the most commonly diagnosed gynecologic malignancy in the United States. Age has been associated with worse outcome in univariate analysis. However, the patterns of failure and associated risk factors in older patients remain unclear. We reviewed our institution's experience to assess the effect of age in a population of endometrial cancer patients treated with surgery and adjuvant radiation therapy. ⋯ Older endometrial cancer (age >63 years) patients have a significantly decreased overall survival, cause-specific survival, and greater risk of recurrence following postoperative RT independent of other prognostic factors and/or treatment technique. The impact of treatment-related variables did not alter the age-related outcome.