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Objective: The aim of our study was to evaluate clinical and pathological data in order to draweligibility criteria for oncologically sufficient radical trachelectomy (RT) in early-stage cervical cancer. Reviewing all cases of attempted RT performed at our unit, we focused attention on prognostic indicators of the need for additional oncologic treatment following RT. The analysiswas extended by extensive literature review to include previously published cases of oncologic failures. Methods: The authors retrospectively analyzed data of patients who underwent RT at the Department of Obstetrics and Gynecology, University of Debrecen. Electronic records and case notes of RT cases were reviewed to determine the incidence of abdominal and vaginal route, distribution of clinicopathologic data, and follow-up results of individual cases. Individual procedures were categorized as oncologically insufficient if additional oncologic treatment was necessary following RT. Theoretical eligibility criteria for RT in early-stage cervical cancer were determined retrospectively by selecting prognostic features that were associated with oncologic insufficiency from clinicopathologic indicators of the complete series. Results: Twenty-four cases of RT were performed by the authors, 15 vaginal RTs with laparoscopic pelvic lymphadenectomy and 9 abdominal RTs with open pelvic lymphadenectomy. Fifteen of 24 cases proved oncologically sufficient. Three cases required immediate conversion to radical hysterectomy because of positive sentinel nodes and/or positive isthmic disc on frozen section. In further 5 cases, final pathology results indicated additional oncologic treatment, that is, radical hysterectomy (n = 2), chemoradiotherapy (n = 2), or chemotherapy (n = 1). One patient among immediately converted cases and another 3 among those who required additional oncologic treatment died of their disease later. There were no other cases of recurrences over a median follow-up of 34 months (range, 12-188 months). Factors that may predict oncologic insufficiency of RT were stage IB1 or greater, tumor size of greater than 2 cm in 1 dimension or greater than 15 mm in 3 dimensions, G3, nonsquamous/adeno histological type, stromal invasion of greater than 9 mm, and lymphovascular space involvement in the primary tumor. Conclusions: Most cases of oncologically insufficient RTs have significant risk features that can be identified preoperatively. There is a need for more clinicopathologic data on oncologic failure of RT cases in order to improve patient selection. [ABSTRACT FROM AUTHOR]

Introduction Phagocytic function of neutrophil granulocytes and monocytes is poorly examined in healthy and preeclamptic pregnancies. Phagocytosis in an important function of innate immune system which protects the mother and the fetus with elimination of microbes and probably microparticles. Objectives We examined the phagocytic index of non-pregnant, healthy pregnant and preeclamptic women. We also described the effect of different plasma samples on phagocytic function of neutrophil granulocytes and monocytes of the three groups. Methods Five healthy pregnant, preeclamptic pregnant and non-pregnant women were enrolled into our study. Cells and plasma samples were isolated from peripherial blood samples. Cells of the three groups were incubated in autologous and different plasma samples and evaluated by their phagocytic index with an immunofluorescent microscope after internalization of zymosan molecules. Results Phagocytic index of monocytes and granulocytes was decreased in healthy pregnancy and further decreased in preeclampsia. Phagocytic index of cells from non pregnant women was inhibited by plasma from healthy pregnant women and further decreased by plasma from preeclamptic women. Phagocytosis of cells from healthy pregnant women was increased by plasma from non-pregnant women and decreased by plasma from preeclamptic women. Phagocytic index of cells from preeclamptic women was increased by plasma from healthy pregnant women and further increased by plasma from non-pregnant women. Conclusions Phagocytic function of granulocytes and monocytes decreased significantly in healthy pregnancy and further decreased in preeclampsia compared with non-pregnant controls. The reduced phagocytic index of neutrophils and monocytes in healthy pregnancy may be caused by immunosuppressive factors present in maternal plasma. This mechanism can be part of the maternal immunosuppression for the protection of the fetus. Failure of this mechanism and further inhibition of phagocytosis in preeclampsia may take part in the pathogenesis of preeclampsia. [ABSTRACT FROM AUTHOR]