PURPOSE OF REVIEW: This paper aims to review recent findings related to uterine morcellation. RECENT FINDINGS: In 2014, the US Food and Drug Administration (FDA) issued a safety communication warning against the use of laparoscopic power morcellators. A risk of occult uterine sarcoma in women is 1/770 to 1/10,000. Our goal is to minimize the risk of spillage due to morcellation and balance it with other risks due to different surgical approaches. In case of a presence of sarcoma risk factors, any form of morcellation should be contraindicated. Power morcellation should be limited to myomectomies. In peri- and postmenopausal age, an endometrial biopsy is highly recommended before surgery with expected morcellation. It is important to explain to the patient the risks of morcellation and the risks and benefits of different surgical approaches. Finally, women should be informed that the prognosis of leiomyosarcoma is poor regardless of the method of removal.

• Klíčová slova
• Containment bags, Laparoscopic hysterectomy, Morcellation, Myomectomy, Oncological risk, Uterine sarcoma,
• MeSH
• laparoskopie MeSH
• lidé MeSH
• morcelace škodlivé účinky   metody   MeSH
• myomektomie škodlivé účinky   MeSH
• nádory dělohy etiologie   MeSH
• sarkom etiologie   MeSH
• uterus chirurgie   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

PURPOSE OF REVIEW: Cancer diagnosis in young pregnant women challenges oncological decision-making. The International Network on Cancer, Infertility and Pregnancy (INCIP) aims to build on clinical recommendations based on worldwide collaborative research. RECENT FINDINGS: A pregnancy may complicate diagnostic and therapeutic oncological options, as the unborn child must be protected from potentially hazardous exposures. Pregnant patients should as much as possible be treated as non-pregnant patients, in order to preserve maternal prognosis. Some approaches need adaptations when compared with standard treatment for fetal reasons. Depending on the gestational age, surgery, radiotherapy, and chemotherapy are possible during pregnancy. A multidisciplinary approach is the best guarantee for experience-driven decisions. A setting with a high-risk obstetrical unit is strongly advised to safeguard fetal growth and health. Research wise, the INCIP invests in clinical follow-up of children, as cardiac function, neurodevelopment, cancer occurrence, and fertility theoretically may be affected. Furthermore, parental psychological coping strategies, (epi)genetic alterations, and pathophysiological placental changes secondary to cancer (treatment) are topics of ongoing research. Further international research is needed to provide patients diagnosed with cancer during pregnancy with the best individualized management plan to optimize obstetrical and oncological care.

• Klíčová slova
• Cancer, Fertility, INCIP, Pregnancy, Research,
• MeSH
• adaptace psychologická MeSH
• internacionalita MeSH
• lidé MeSH
• nádorové komplikace v těhotenství * diagnóza   epidemiologie   psychologie   terapie   MeSH
• nádory diagnóza   epidemiologie   psychologie   terapie   MeSH
• nemoci placenty diagnóza   etiologie   terapie   MeSH
• novorozenec MeSH
• registrace statistika a číselné údaje   MeSH
• těhotenství MeSH
• týmová péče o pacienty MeSH
• výsledek těhotenství epidemiologie   MeSH
• ženská infertilita epidemiologie   prevence a kontrola   MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

PURPOSE OF REVIEW: For uterine cervical cancer, the recently revised International Federation of Gynecology and Obstetrics (FIGO) staging system (2018) incorporates imaging and pathology assessments in its staging. In this review we summarize the reported staging performances of conventional and novel imaging methods and provide an overview of promising novel imaging methods relevant for cervical cancer patient care. RECENT FINDINGS: Diagnostic imaging during the primary diagnostic work-up is recommended to better assess tumor extent and metastatic disease and is now reflected in the 2018 FIGO stages 3C1 and 3C2 (positive pelvic and/or paraaortic lymph nodes). For pretreatment local staging, imaging by transvaginal or transrectal ultrasound (TVS, TRS) and/or magnetic resonance imaging (MRI) is instrumental to define pelvic tumor extent, including a more accurate assessment of tumor size, stromal invasion depth, and parametrial invasion. In locally advanced cervical cancer, positron emission tomography-computed tomography (PET-CT) or computed tomography (CT) is recommended, since the identification of metastatic lymph nodes and distant metastases has therapeutic consequences. Furthermore, novel imaging techniques offer visualization of microstructural and functional tumor characteristics, reportedly linked to clinical phenotype, thus with a potential for further improving risk stratification and individualization of treatment. Diagnostic imaging by MRI/TVS/TRS and PET-CT/CT is instrumental for pretreatment staging in uterine cervical cancer and guides optimal treatment strategy. Novel imaging techniques may also provide functional biomarkers with potential relevance for developing more targeted treatment strategies in cervical cancer.

• Klíčová slova
• Cervical cancer, Diffusion-weighted imaging, Imaging biomarkers, Magnetic resonance imaging, Positron emission tomography, Transvaginal ultrasound,
• MeSH
• lidé MeSH
• lymfatické metastázy MeSH
• magnetická rezonanční tomografie metody   MeSH
• nádory děložního čípku diagnostické zobrazování   patologie   terapie   MeSH
• PET/CT metody   MeSH
• počítačová rentgenová tomografie metody   MeSH
• staging nádorů MeSH
• ultrasonografie metody   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

The number of patients given neoadjuvant chemotherapy (NAC) followed by fertility-sparing surgery in cervical cancer is still scarce. Only a few centres perform these procedures, and thus, such procedures remain largely in the experimental stage. Patients that do not fulfil the criteria for standard fertility-sparing procedure can be included in studies with NAC followed by fertility-sparing procedure. We must consider that both oncological and pregnancy outcomes are important. Patients with only microscopic disease after NAC are apparently the best candidates for fertility-sparing surgery. Current data are not sufficient to identify the optimal procedure after NAC [abdominal radical trachelectomy (ART) or vaginal radical trachelectomy (VRT) or simple trachelectomy]. Some evidence suggests that pregnancy outcome is better after simple trachelectomy as compared with VRT or ART. Long-term results regarding oncological outcome for this concept are still lacking. Adjuvant chemotherapy in patients with histopathological risk factors (lymphovascular space involvement (LVSI), macroscopic residual disease) would decrease a risk of recurrence.

• MeSH
• biopsie sentinelové lymfatické uzliny MeSH
• dospělí MeSH
• gynekologické chirurgické výkony metody   MeSH
• kombinovaná terapie MeSH
• lidé MeSH
• lokální recidiva nádoru prevence a kontrola   MeSH
• magnetická rezonanční tomografie MeSH
• nádory děložního čípku patologie   chirurgie   MeSH
• neoadjuvantní terapie metody   MeSH
• protokoly antitumorózní kombinované chemoterapie terapeutické užití   MeSH
• spinocelulární karcinom patologie   chirurgie   MeSH
• těhotenství MeSH
• výsledek těhotenství MeSH
• výsledek terapie MeSH
• zachování plodnosti metody   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

Ultrasound is the primary imaging modality in gynecological oncology. Over the last decade, there has been a massive technology development which led to a dramatic improvement in the quality ultrasound imaging. If performed by an experienced sonographer, ultrasound has an invaluable role in the primary diagnosis of gynecological cancer, in the assessment of tumor extent in the pelvis and abdominal cavity, in the evaluation of the treatment response, and in follow-up. Ultrasound is also a valuable procedure for monitoring patients treated with fertility-sparing surgery. Furthermore, it is an ideal technique to guide tru-cut biopsy for the collection of material for histology. Taking into consideration that besides its accuracy, the ultrasound is a commonly available, non-invasive, and inexpensive imaging method that can be carried out without any risk or discomfort to the patient; it is time to reconsider its role in gynecologic oncology and to allocate resources for a specialized education of future experts in ultrasound imaging in gynecology.

• MeSH
• břicho diagnostické zobrazování   MeSH
• intervenční ultrasonografie metody   MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• nádory děložního čípku diagnóza   diagnostické zobrazování   MeSH
• nádory endometria diagnóza   diagnostické zobrazování   MeSH
• nádory vaječníků diagnóza   diagnostické zobrazování   MeSH
• pánev diagnostické zobrazování   MeSH
• počítačová rentgenová tomografie MeSH
• pozitronová emisní tomografie MeSH
• staging nádorů metody   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH