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Background: to prove the effectivity of fertility-sparing procedures in early-stage ovarian cancer by assessing pregnancy rates and obstetrical outcomes. Methods: we performed a retrospective multicenter study among 55 Spanish hospitals, collecting patients from 18 to 40 years old with diagnosis of early-stage ovarian cancer, epithelial (EOC) or non-epithelial (non-EOC), from January 2010 to December 2019. Data on the use of assisted reproductive techniques, pregnancy attempts and obstetrical outcomes were collected. Results: a total of 150 patients met inclusion criteria, 70 (46.6%) EOC and 80 (53.4%) non-EOC. Pregnancy attempts were reported in 51 (34%) patients, with 42 (28%) patients carrying the pregnancy to term. Among them, 30 (71.4%) underwent surgery alone and 12 (28.6%) had additional postoperative chemotherapy. A total of 32 (76.1% patients) had spontaneous pregnancies and 10 (23.9%) required in vitro fertilization. There was only one (2.4%) complication reported. Vaginal delivery was reported in twenty-nine (69%) patients and cesarean section in five (11.9%) patients. Conclusions: fertility-sparing management for ovarian cancer seems to be an option with proven good pregnancy rates and low complications. The selection of patients must consider strict criteria in order to maintain a good prognosis. [ABSTRACT FROM AUTHOR]

Simple Summary: Uterine carcinosarcoma is a rare disease that represents less than 5% of uterine malignancies, although approximately 16% of the uterine cancer-related deaths are caused by this disease. Nowadays, there seems to be a lack of prognostic stratifying studies that could lead to tailor the management of uterine carcinosarcoma. The aim of our study was to assess the impact of possible different prognostic factors on the survival of patients diagnosed with uterine carcinosarcoma. We observed that incomplete cytoreduction, presence of tumor residual after treatment, advanced FIGO stage, extrauterine disease, and tumor size were significant prognostic factors decreasing disease-free survival and overall survival. Background: The aim of this study was to assess the impact of prognostic factors on the survival of patients diagnosed with uterine carcinosarcoma. Methods: A sub-analysis of the SARCUT study, a multicentric retrospective European study, was carried out. We selected 283 cases of diagnosed uterine carcinosarcoma for the present study. Prognosis factors influencing survival were analyzed. Results: Significant prognostic factors for overall survival were: incomplete cytoreduction (HR = 4.02; 95%CI = 2.68–6.18), FIGO stages III and IV (HR = 3.21; 95%CI = 1.83–5.61), tumor persistence after any treatment (HR = 2.90; 95%CI = 1.97–4.27), presence of extrauterine disease (HR = 2.62; 95%CI = 1.75–3.92), a positive resection margin (HR = 1.56; 95%CI = 1.05–2.34), age (HR = 1.02; 95%CI = 1.00–1.05), and tumor size (HR = 1.01; 95%CI = 1.00–1.01). Significant prognostic factors for disease-free survival were: incomplete cytoreduction (HR = 3.00; 95%CI = 1.67–5.37), tumor persistence after any treatment (HR = 2.64; 95%CI = 1.81–3.86), FIGO stages III and IV (HR = 2.33; 95%CI = 1.59–3.41), presence of extrauterine disease (HR = 2.13; 95%CI = 1.44–3.17), administration of adjuvant chemotherapy (HR = 1.84; 95%CI = 1.27–2.67), a positive resection margin (HR = 1.65; 95%CI = 1.11–2.44), presence of LVSI (HR = 1.61; 95%CI = 1.02–2.55), and tumor size (HR = 1.00; 95%CI = 1.00–1.01). Conclusions: Incomplete cytoreduction, presence of tumor residual after treatment, advanced FIGO stage, extrauterine disease, and tumor size are significant prognostic factors decreasing disease-free survival and overall survival of patients with uterine carcinosarcoma. [ABSTRACT FROM AUTHOR]

Objective: The primary objective was to evaluate the response rate of conservative treatment for endometrial cancer, and the secondary objective was to assess oncological, fertility and obstetric outcomes in patients who underwent fertility preservation treatment. Material and methods: This multicentre, observational, retrospective study evaluated endometrial cancer patients who underwent fertility-sparing treatment in Spanish centres between January 2010 and January 2020. Seventy-three patients with stage IA endometrioid adenocarcinoma of the uterus were included in the study. Results: The levonorgestrel intrauterine device (LNG-IUD) was the most common fertility-sparing treatment (53.4%), followed by megestrol acetate (20.5%) and medroxyprogesterone acetate (16.4%). During the 24-month follow-up period, the rate of complete response to fertility-sparing management was 74% (n = 54), and 8.2% (n = 6) of patients presented a partial response. Additionally, 13 (17.8%) patients presented with persistent disease and six (8.2%) relapsed after response. The LNG-IUD was associated with a higher complete response rate than the other methods (87.2 vs. 58.8%; p = 0.01). Surgical treatment (at least hysterectomy) was performed in 44 (60.3%) patients as the end of fertility-sparing treatment. Four (5.5%) patients presented relapse after surgery, associated with final FIGO stage III (p = 0.036), myometrial invasion > 50% (p = 0.018) and final tumour grade 2–3 (p = 0.018). The mean follow-up period was 57.8 (range 6–159) months. The 5-year relapse-free survival and overall survival rates were 92.6% [95% CI (81.3, 97.2)] and 93.5% [95% CI (80.7, 97.9)], respectively. During follow-up, three patients (4.1%) died of the disease after completion of surgical treatment. Up to 50.7% of patients included in the study attempted to get pregnant. Of these, the rate of pregnancy was 81.1% (n = 30/37), and reproductive techniques were used for this purpose in 78.4% of cases. Conclusions: Fertility-sparing management presented a high response rate in patients with endometrial cancer. LNG-IUD was associated with a better response rate compared to the other treatment options. Moreover, in patients using this management method, pregnancy could be achieved using reproductive techniques. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the prognostic factors of recurrence and overall survival in rare histotypes of vulvar cancer. Methods: An international multicenter retrospective study including patients diagnosed with vulvar cancer was performed. One hundred centers participated in the study and 2453 vulvar cancer cases were enrolled from January 2001 until December 2005. After exclusion of squamous vulvar cancer, Paget´s disease and vulvar melanoma 112 tumors were analyzed for the present study. Results: The mean age at diagnosis was 64.9 ± 17.2 years. 99 (88.4%) patients had a single lesion, in 25 (22.3%) cases the vulvar tumor involved the midline, and only 13 (11.5%) patients had clinically positive inguinal lymph nodes. The mean size of the lesion was 33.8 ± 33.9 mm. Regarding the surgical treatment, 2 (1.8%) patients underwent skinning vulvectomy, 63 (56.3%) local excision, 41 (36.6%) vulvectomy, 3 (2.7%) exenteration and 3 (2.7%) did not receive any surgical treatment. The mean free surgical margin was 8.2 ± 9 mm and 7 (6.2%) patients presented positive inguinal nodes. Radiotherapy was administered in 22 (19.6%) patients and it was performed postoperatively in all cases; 14 (12.5%) patients received adjuvant chemotherapy. The mean overall follow-up time was 44.1 ± 35.7 months. The risk factors associated with overall survival were chemotherapy and radiotherapy, tumor size and stromal invasion (p < 0.05). The only independent factor significantly associated with global recurrence and absence of metastasis was radiotherapy (p = 0.02 and p = 0.002, respectively). Conclusion: Postoperative radiotherapy seems to be the only independent factor associated with recurrence and overall survival in uncommon types of vulvar cancer. [ABSTRACT FROM AUTHOR]

Aims: Vulvar cancer is a rare disease. In western European countries, the incidence is 1.2 cases per 100,000 women/year. The aim of this study was to analyze the management and disease-free survival (DFS) of vulvar cancer among European countries.Methods: An international multicenter retrospective study including patients diagnosed of squamous cell vulvar cancer was performed. Countries analyzed included Austria, Germany, Greece, Italy, Latvia, Lithuania, Poland, Portugal, Spain and Turkey. One hundred different centers were enrolled including 1,505 squamous cell tumors treated from January 2001 until December 2005.Results: The mean free surgical margin was 9.93 mm, which was different between countries (p = 0.076); it ranged from 5.79 mm (95% CI 4.44-7.13) in Germany to 33.39 mm (95% CI 22.21-44.58) in Lithuania. The global 5-year overall survival rate was 61.4%, and the global 5-year DFS rate was 32%. DFS times were different between countries as well as the treatments carried out. The country with the shortest DFS time had 15.9 ± 3.1 months compared to the one with the longest time with 66.0 ± 17.4 months.Conclusion: Wide differences in treatments and DFS times have been observed between countries. Homogeneous management for squamous cell vulvar cancer is needed to obtain the best survival rates for all patients. [ABSTRACT FROM AUTHOR]

Objective: To analyze the prognostic factors related to the recurrence rate of vulvar cancer. Methods: Retrospective study of 87 patients diagnosed of vulvar squamous cell carcinoma diagnosed at a tertiary hospital in Madrid between January 2000 and December 2010. Results: The pathological mean tumor size was 35.1±22.8 mm, with stromal invasion of 7.7±6.6 mm. The mean free margin after surgery was 16.8±10.5 mm. Among all patients, 31 (35.6%) presented local recurrence (mean time 10 months; range, 1 to 114 months) and 7 (8%) had distant metastases (mean time, 5 months; range, 1 to 114 months). We found significant differences in the mean tumor size between patients who presented a relapse and those who did not (37.6±21.3 mm vs. 28.9±12.1 mm; p=0.05). Patients with free margins equal or less than 8 mm presented a relapse rate of 52.6% vs. 43.5% of those with free margin greater than 8 mm (p=0.50). However, with a cut-off of 15 mm, we observed a local recurrence rate of 55.6% vs. 34.5%, respectively (p=0.09). When the stromal invasion cut-off was >4 mm, local recurrence rate increased up to 52.9% compared to 37.5% when the stromal invasion was ⩽4 mm (p=0.20). Conclusion: Tumor size, pathologic margin distance and stromal invasion seem to be the most important predictors of local vulvar recurrence. We consider the cut-off of 35 mm of tumor size, 15 mm tumor-free surgical margin and stromal invasion >4 mm, high risk predictors of local recurrence rate. [ABSTRACT FROM AUTHOR]

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Copyright of Ginecología y Obstetricia de México is the property of Federacion Mexicana de Ginecologia y Obstetricia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)