Cíl studie: Převod dotazníku kvality života EORTC QLQ - CX24 do českého jazyka a jeho ověření. Typ studie: Prospektivní studie. Název a sídlo pracoviště: Gynekologicko-porodnická klinika UK 2. LF a FN v Motole, Praha. Metodika: V souladu s doporučením EORTC byl přeložen a validován dotazník kvality života pro pacientky s karcinomem děložního hrdla. Skupina 14 pacientek, které prodělaly léčbu pro karcinom děložního hrdla, vyplnily dotazník. Pro vyhodnocení charakteristik pacientek a pro vyhodnocení rozdílů v kvalitě života podle terapeutických modalit byl použit t-test. Výsledky: Je prezentován dotazník EORTC QLQ-CX24 a způsob vyhodnocení. Při porovnání jednotlivých léčebných modalit pomocí testu nebyl nalezen statisticky signifikantní rozdíl. Závěr: EORTC QLQ-CX24 je mezinárodně uznávaný a srozumitelný dotazník zaměřený na pacientky s karcinomem děložního hrdla, který by měl být součástí projektů týkajících se žen podstupujících léčbu tohoto onemocnění.
Objective: Translation and validation of the EORTC QLQ - CX24 questionnaire on quality of life into the Czech language and literature. Type of study: Prospective study. Setting: Dept. of Obstetrics and Gynaecology, 2nd Medical Faculty, Charles University and Faculty Hospital Motol, Prague. Methods: In concordance with the EORTC guidelines a questionaire for patients with cervical cancer was translated and validated. A group of 14 women who underwent the treatment for cervical cancer filled in the questionaire. T-test was used for the evaluation of the patient’s characteristics and the differences in quality of life. Results: We present a Czech version of the questionaire EORTC QLQ-CX24 and the description how to evaulate it. In comparison of the two treatment groups no statistically significant differences have been found. Conclusion: EORTC QLQ-CX24 is an internationally accepted questionnaire focused on patients with cervical cancer which should be incorporated into the projects dealing with women undergoing treatment for this disease.
INTRODUCTION: Endometrial cancer incidence increases over the age of 65 and lymphadenectomy in these women is a morbid procedure. Sentinel lymph node (SLN) should avoid extensive lymphadenectomy in node negative patients. The aim of this prospective study is to determine the feasibility and usefulness of lymphatic mapping and SLN identification in the management of endometrial cancer. METHODS: From January 2004 to December 2007 101 women with endometrial cancer participated in the study. We injected Tc hysteroscopically, peritumorally 2 hours before laparotomy in 24 women. We applied Tc and blue dye subserously after laparotomy and before adhesiolysis in 67 women. Ten patients with metastatic disease in ovary, omentum, peritoneum, and bulky nodes were excluded from analysis. RESULTS: We detected SLN in 12 women (50%) in hysteroscopic group and in 49 women (73.1%) in subserous group. We identified 133 SLNs in 61 women. We found 20 SLNs (15.0%) in supraobturator region, 78 (58.6%) in external iliac area, 11 (8.3%) in paraaortal area, 13 (9.8%) on common iliac artery, 8 (6.0%) in medial part of lateral parametrium, and 3 (2.3%) in presacral area. CONCLUSIONS: Sentinel lymph node identification is a new strategy that can be used to examine nodal status with a high successful rate in breast, cervical, and vulvar cancer. Results in endometrial cancer are not as successful, however. In the future, it will be necessary to find optimal timing, the best route of application, and the "right" size of the Tc particles. Subserous application seems to be superior to hysteroscopic application.
- MeSH
- adenoskvamózní karcinom patologie MeSH
- biopsie sentinelové lymfatické uzliny MeSH
- dospělí MeSH
- endometroidní karcinom patologie MeSH
- hysteroskopie MeSH
- injekce do léze MeSH
- lidé středního věku MeSH
- lidé MeSH
- lymfadenektomie MeSH
- lymfatické metastázy MeSH
- lymfatické uzliny MeSH
- nádory endometria patologie MeSH
- prospektivní studie MeSH
- senioři MeSH
- studie proveditelnosti MeSH
- technecium 99mTc-agregovaný albumin diagnostické užití MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH
- srovnávací studie MeSH
Zhodnocení nové metodiky analýzy multifrekvenční bioelektrické impedance (MFBIA) u pacientek s kontrolovanou ovariální hyperstimulací a posouzení jejího významu v predikci a včasné diagnostice ovariálního hyperstimulačního syndromu (OHSS). Typ studie: Prospektivní kontrolovaná studie. Název a sídlo pracoviště: Gynekologicko–porodnická klinika 2. LF UK a FN Motol, Praha. Metodika: Do studie jsme zařadili 53 žen s kontrolovanou ovariální hyperstimulací. Impedance jsme měřili při frekvenci proudu 1, 5, 50 a 100 kHz. U 13 pacientek se rozvinul OHSS III.–V. stupně podle Golanové klasifikace. Do kontrolního souboru bylo zařazeno 40 stimulovaných pacientek bez následného rozvoje OHSS. Hodnoty impedance jsme měřili přístrojem MFBIA. Výsledky: Pokles hodnot impedancí mezi dnem odběru oocytů a dnem embryotransferu představuje statisticky signifikantní zvýšení relativního rizika (RR) rozvoje OHSS III.–V. stupně. Nejvýznamnější korelace byla nalezena pro frekvenci 5kHz (RR 9,08 p<0,0001). Korelace při použití MFBIA je silnější než prediktivní hodnota počtu získaných oocytů (>20 oocytů – RR 5,71). Závěr: Pacientky s poklesem hodnot impedancí mají vyšší riziko rozvoje OHSS. Prediktivní hodnota je nejvyšší pro frekvenci 5 kHz. Pro potvrzení našich předběžných výsledků je vhodné provést větší, nejlépe multicentrickou studii.
The aim of the study was to establish a new method of the multiple-frequency bioimpedance analysis (MFBIA) for patients with controlled ovarian hyperstimulation (COH) and to determine the significance of this method in prediction and early diagnosis of severe forms of ovarian hyperstimulation syndrome (OHSS). Design: Prospective case control study. Setting: Department of Obstetrics and Gynecology, 2nd Medical Faculty, Charles University and University Hospital Motol, Prague. Methods: 53 patients were recruited into the case control study. The surface body impedances for the frequencies of the current 1, 5, 50 and 100 kHz were measured. Study group included 13 patients with developed OHSS grade III. -V. according Golans classification. The control group included 40 women undergoing COH without developed OHSS. Measurements of impedances were performed by MFBIA device. Results: The decrease of the values of impedance between the day of oocyte retrieval and the day of embryotransfer significantly increases relative risk of OHSS grade III.-V. development. The best correlation was found for the frequency of 5 kHz (9.08 p<0.0001). The study suggests, the predictive value of MFBIA in OHSS development might be higher than the number of retrieved oocytes (>20 oocytes – RR 5,71). Conclusion: Patients in risk of OHSS development are those with decreasing impedances. The highest predictive value of OHSS development is for the impedances at frequency of 5 kHz. Greater multicenter studies should be done to confirm our preliminary results.
Objective: The purpose of this study was to determine the feasibility and safety of a novel and less radical fertility preserving surgery; laparoscopic lymphadenectomy with sentinel lymph node identification (SLNI) followed by large cone or simple trachelectomy. Obstetrical and oncological outcomes were evaluated. Material and Methods: Forty patients (3-IA1, 10-IA2, 27-IB1), selected on the basis of favourable cervical tumour characteristics and the desire to maintain fertility underwent laparoscopic SLNI, frozen section (FS) and a complete pelvic lymphadenectomy as the first step of treatment. All of the nodes were submitted for microscopic evaluation (sentinel nodes for ultramicrostaging). After a seven-day interval, large cone or simple vaginal trachelectomy was performed in patients with negative nodes. Results: Finally we saved fertility in 32 women. The average of the sentinel nodes per side was 1.50 and the average of the total nodes was 27.8. Six FS were positive (15.0%). In these cases Wertheim radical hysterectomy type III was immediately performed. There were no false negative SLN results. Median follow-up was 46 months (12–102). One central recurrence (isthmic part of the uterus) was observed 14 months after surgery. This patient was treated with radical chemoradiotherapy and there was no evidence of the disease 36 months after treatment. One patient in follow up had HG SIL/HPV HR positive – patient decided for hysterectomy. 24 women planed pregnancy, we had 23 pregnancies in 17 women; we had 12 children (1 in 24 weeks, 1 in 34 weeks, 1 in 36 weeks and 9 between 37 to 39 weeks). Conclusions: Lymphatic mapping and SLNI improves safety in this fertility sparing surgery. Large cone or simple trachelectomy combined with laparoscopic pelvic lymphadenectomy can be a feasible method with a high successful pregnancy rate. Key words: simple trachelectomy, sentinel lymph node, cervical cancer, fertility sparing surgery.
- MeSH
- biopsie sentinelové lymfatické uzliny MeSH
- fertilita MeSH
- financování organizované MeSH
- hysterektomie metody využití MeSH
- laparoskopie metody využití MeSH
- lidé MeSH
- lymfadenektomie metody využití MeSH
- nádory děložního čípku diagnóza chirurgie prevence a kontrola MeSH
- výsledky a postupy - zhodnocení (zdravotní péče) MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- abstrakty MeSH
We report five patients with early-stage cervical cancer who do not fulfill criteria of fertility-sparing surgery (tumor more than 2 cm in the biggest diameter or infiltrating more than half of stroma). Five patients received three cycles of dose density neoadjuvant chemotherapy (NAC) at a 10-day interval: cisplatin plus ifosfamide in squamous cell cancer or plus doxorubicin in adenocarcinoma with good tolerance. After NAC, they underwent laparoscopic pelvic lymphadenectomy and vaginal simple trachelectomy. Two patients had no residual tumor, two had only microscopic residual disease, and one had macroscopic residual disease. Two women became pregnant 5 and 8 months after surgery, one delivered in term healthy baby and one is now in the second trimester of pregnancy without any complications. NAC followed by fertility-sparing surgery seems to be feasible treatment for women with tumor bigger than 2 cm or infiltrated more than half of the stroma.
