• MeSH
• lidé MeSH
• nádory dělohy * diagnóza   patofyziologie   terapie   MeSH
• sarkom * diagnóza   patofyziologie   terapie   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• přehledy MeSH

An international joint statement about the use of hyperthermic intraperitoneal chemotherapy (HIPEC) in ovarian cancer was published in 2016, warning about the uncritical use of HIPEC outside controlled studies. This statement has now been updated after the most recent literature was reviewed by the participating study groups and societies. HIPEC became a treatment option in patients with advanced colon cancer after positive results of a randomized trial comparing surgery and HIPEC versus palliative treatment alone. Although this trial did not compare the added value of HIPEC to surgery alone, HIPEC for the treatment of peritoneal metastases was in the subsequent years generalized to many other cancer types associated with peritoneal carcinomatosis including epithelial ovarian cancer (EOC). In the meantime, new evidence from prospective randomized trials specifically for EOC-patients emerged, with however contradicting results and several quality aspects that made the interpretation of their findings critical. Moreover, three additional trials in colorectal cancer failed to confirm the previously presumed survival benefit through the implementation of HIPEC in peritoneally disseminated colorectal cancers. Based on a still unclear and inconsistent landscape, the authors conclude that HIPEC should remain within the remit of clinical trials for EOC-patients. Available evidence is not yet sufficient to justify its broad endorsement into the routine clinical practice.

• MeSH
• epiteliální ovariální karcinom patologie   MeSH
• hypertermická intraperitoneální peroperační chemoterapie MeSH
• indukovaná hypertermie * metody   MeSH
• kombinovaná terapie MeSH
• lidé MeSH
• nádory vaječníků * farmakoterapie   patologie   MeSH
• prospektivní studie MeSH
• protokoly protinádorové kombinované chemoterapie terapeutické užití   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• Rakousko MeSH
• Švýcarsko MeSH

• MeSH
• lidé MeSH
• nádory děložního čípku * diagnostické zobrazování   MeSH
• ultrasonografie MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• přehledy MeSH

• MeSH
• adenomyóza chirurgie   MeSH
• endometrióza * chirurgie   diagnostické zobrazování   klasifikace   MeSH
• laparoskopie metody   MeSH
• močový měchýř chirurgie   MeSH
• peritoneum chirurgie   MeSH
• předoperační vyšetření normy   MeSH
• tlusté střevo chirurgie   patologie   MeSH
• ureter chirurgie   MeSH
• ženská infertilita chirurgie   etiologie   klasifikace   MeSH

BACKGROUND: To prospectively assess LLL incidence among cervical cancer patients treated by uterine surgery complemented by SLN biopsy, without PLND. METHODS: A prospective study in 150 patients with stage IA1-IB2 cervical cancer treated by uterine surgery with bilateral SLN biopsy. Objective LLL assessments, based on limb volume increase (LVI) between pre- and postoperative measurements, and subjective patient-perceived swelling were conducted in six-month periods over 24-months post-surgery. RESULTS: The cumulative incidence of LLL at 24 months was 17.3% for mild LLL (LVI 10-19%), 9.2% for moderate LLL (LVI 20-39%), while only one patient (0.7%) developed severe LLL (LVI > 40%). The median interval to LLL onset was nine months. Transient edema resolving without intervention within six months was reported in an additional 22% of patients. Subjective LLL was reported by 10.7% of patients, though only a weak and partial correlation between subjective-report and objective-LVI was found. No risk factor directly related to LLL development was identified. CONCLUSIONS: The replacement of standard PLND by bilateral SLN biopsy in the surgical treatment of cervical cancer does not eliminate the risk of mild to moderate LLL, which develops irrespective of the number of SLN removed.

• Publikační typ
• časopisecké články MeSH

BACKGROUND: SENTIX (ENGOT-CX2/CEEGOG-CX1) is an international, multicentre, prospective observational trial evaluating sentinel lymph node (SLN) biopsy without pelvic lymph node dissection in patients with early-stage cervical cancer. We report the final preplanned analysis of the secondary end-points: SLN mapping and outcomes of intraoperative SLN pathology. METHODS: Forty-seven sites (18 countries) with experience of SLN biopsy participated in SENTIX. We preregistered patients with stage IA1/lymphovascular space invasion-positive to IB2 (4 cm or smaller or 2 cm or smaller for fertility-sparing treatment) cervical cancer without suspicious lymph nodes on imaging before surgery. SLN frozen section assessment and pathological ultrastaging were mandatory. Patients were registered postoperatively if SLN were bilaterally detected in the pelvis, and frozen sections were negative. TRIAL REGISTRATION: ClinicalTrials.gov (NCT02494063). RESULTS: We analysed data for 395 preregistered patients. Bilateral detection was achieved in 91% (355/395), and it was unaffected by tumour size, tumour stage or body mass index, but it was lower in older patients, in patients who underwent open surgery, and in sites with fewer cases. No SLN were found outside the seven anatomical pelvic regions. Most SLN and positive SLN were localised below the common iliac artery bifurcation. Single positive SLN above the iliac bifurcation were found in 2% of cases. Frozen sections failed to detect 54% of positive lymph nodes (pN1), including 28% of cases with macrometastases and 90% with micrometastases. INTERPRETATION: SLN biopsy can achieve high bilateral SLN detection in patients with tumours of 4 cm or smaller. At experienced centres, all SLN were found in the pelvis, and most were located below the iliac vessel bifurcation. SLN frozen section assessment is an unreliable tool for intraoperative triage because it only detects about half of N1 cases.

• MeSH
• biopsie sentinelové lymfatické uzliny metody   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory děložního čípku patologie   chirurgie   MeSH
• prospektivní studie MeSH
• senioři MeSH
• sentinelová uzlina patologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH

• MeSH
• adenosarkom patologie   terapie   MeSH
• endometriální stromální sarkom diagnóza   klasifikace   patologie   terapie   MeSH
• leiomyosarkom chirurgie   diagnóza   patofyziologie   terapie   MeSH
• lidé MeSH
• nádory dělohy * chirurgie   diagnóza   klasifikace   patofyziologie   patologie   terapie   MeSH
• prognóza MeSH
• staging nádorů MeSH
• stupeň závažnosti nemoci MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• přehledy MeSH

The quality of pathological assessment is crucial for the safety of patients with cervical cancer if pelvic lymph node dissection is to be replaced by sentinel lymph node (SLN) biopsy. Central pathology review of SLN pathological ultrastaging was conducted in the prospective SENTIX/European Network of Gynaecological Oncological Trial (ENGOT)-CX2 study. All specimens from at least two patients per site were submitted for the central review. For cases with major or critical deviations, the sites were requested to submit all samples from all additional patients for second-round assessment. From the group of 300 patients, samples from 83 cases from 37 sites were reviewed in the first round. Minor, major, critical, and no deviations were identified in 28%, 19%, 14%, and 39% of cases, respectively. Samples from 26 patients were submitted for the second-round review, with only two major deviations found. In conclusion, a high rate of major or critical deviations was identified in the first round of the central pathology review (28% of samples). This reflects a substantial heterogeneity in current practice, despite trial protocol requirements. The importance of the central review conducted prospectively at the early phase of the trial is demonstrated by a substantial improvement of SLN ultrastaging quality in the second-round review.

• Publikační typ
• časopisecké články MeSH

Publikácia sa zaoberá myómy maternice a najmä spôsoby ich liečby. Určené odbornej verejnosti.; Kniha Myómy maternice komplexne opisuje aktuálny pohľad na problematiku myómov u žien. Ide síce o benígne, no kvalitu života výrazne zhoršujúce ochorenie, ktoré postihuje takmer 40 % žien. Kniha podáva ucelený prehľad a najnovšie poznatky o epidemiológii, etiopatogenéze, symptómoch týchto benígnych nádorov, ako aj o ich diagnostike. Do detailov sú rozoberané možnosti liečby myómov maternice, od konzervatívnych možností, akými sú farmakologická liečba alebo miniinvazívne uterus zachovávajúce prístupy, ktoré si vyžadujú spoluprácu intervenčného rádiológa. Samostatné kapitoly sú venované chirurgickej liečbe myómov maternice s detailným opisom jednotlivých chirurgických techník. Záverečná kapitola opisuje zriedkavú, no o to závažnejšiu diagnózu leiomyosarkómu a jej možnú zámenu za benígny myóm maternice. Kniha je teoretickým ale aj praktickým návodom pre gynekológov na ambulanciách a v nemocničných zariadeniach. Hlavným mottom celej monografie je pritom individuálny prístup ku každej pacientke aj v prípadoch tak častého ochorenia, ako sú myómy maternice.

• MeSH
• farmakoterapie MeSH
• gynekologické chirurgické výkony MeSH
• myom terapie   MeSH
• nádory dělohy terapie   MeSH
• radioterapie MeSH
• Check Tag
• ženské pohlaví MeSH
• Publikační typ
• monografie MeSH

• Konspekt
• Gynekologie. Porodnictví
• NLK Obory
• gynekologie a porodnictví
• onkologie

Cieľ štúdie: Autori vo svojej práci sledovali vplyv zisteného oligohydramnia v poslednom mesiaci tehotnosti na perinatálne výsledky. Typ štúdie: Retrospektívna porovnávacia štúdia. Názov a sídlo pracoviska: II. gynekologicko-pôrodnícka klinika LF UK a UNB. Metodika: Autori vo svojej práci analyzovali súbor 372 pacientok s jednoplodovou graviditiou po ukončenom 37. týždni tehotnosti za obdobie rokov 2011 až 2015, u ktorých bol ultrazvukovo potvrdený nález izolovaného oligohydramnia. Kontrolný súbor tvorili pacientky s normálnym množstvom plodovej vody vybrané na základe veku a parity. Výsledky: Autori zistili rozdiel v počte pôrodníckych intervencií: pacientky s oligohydramniom rodili výrazne častejšie cisárskym rezom (71,0 % oproti 33,9 %) a v tejto skupine bolo podstatne viac pôrodov indukovaných (27,4 % oproti 18,8 %). Najčastejšou indikáciou k cisárskemu rezu bola hroziaca intrauterinná asfyxia plodu. Nebol zaznamenaný rozdiel vo výskyte nízkeho pupočníkového pH či nízkeho Apgar skóre v 5. minúte ani v počte novorodencov prijatých na JIS. Záver: Nález izolovaného oligohydramnia po 37. týždni tehotnosti zvyšuje riziko pôrodníckej intervencie bez vplyvu na perinatálny výsledok.

Objective: The objective of this study is to determinate the influence of oligohydramnios on perinatal outcome in term pregnancies. Design: Retrospective case-control study. Setting: II. Gynecologic Obstetrics Department, Comenius University, Bratislava. Methods: Authors analysed a group of 372 single pregnancies after completed 37th week of gestation in years 2011 to 2015 with sonographic diagnosis of isolated oligohydramnios. A control group was created with matched patients by age and parity with normal amniotic fluid volume. Results: We found significant differences in number of obstetric intervention between the two groups: patients with oligohydramnios had higher number of cesarean sections (71% compared to 33.9% in control group) and also the number of inductions was significantely higher (27.4% compared to 18.8%). The most common indication for cesarean delivery was presumed fetal hypoxia. We did not find any differences in numbers of neonates with low Apgar score, low umbilical cord pH and admission to neonatal intensive care unit. Conclusion: The finding of isolated oligohydramnios after 37th week of gestations is associated with higher risk of obstetric intervention without any association with adverse perinatal outcome.

• MeSH
• císařský řez MeSH
• komplikace těhotenství * MeSH
• lidé MeSH
• oligohydramnion * MeSH
• plodová voda diagnostické zobrazování   MeSH
• retrospektivní studie MeSH
• těhotenství MeSH
• ultrasonografie prenatální využití   MeSH
• vedení porodu MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH