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Abstract: Objective: Fertility-sparing surgery has been proposed for the treatment of borderline ovarian tumors. The aim of this study was to evaluate the outcome of patients submitted to cystectomy (CYS) compared with patients treated by unilateral salpingo-oophorectomy (USO) or bilateral salpingo-oophorectomy with/without total hysterectomy (radical surgery, RS). Methods: We reviewed retrospectively the data of patients treated in 3 institutions for borderline ovarian tumors. One hundred and sixty-eight patients underwent laparoscopic or laparotomic surgical treatment from 1985 to 2006. Tumor recurrence rate, disease-free survival and site of recurrences were evaluated. Specific prognostic factors, such as stage, histology, micropapillary subtype, exophytic tumor growth, intraoperative spillage, endosalpingiosis, staging procedures, and route of surgery were analysed. Results: Thirty-five patients underwent cystectomy, 50 unilateral salpingo-oopohorectomy, and 83 radical surgery. Twelve patients in the CYS group (34.3%), 10 in the USO group (20.0%), and 5 (6.0%) in RS group relapsed. Five-year progression-free survival (PFS) was 59.6%, 78.4%, and 93.5% in CYS, USO and RS groups, respectively. None of the relapsed patients died of disease. Conclusions: Cystectomy is an effective surgical strategy for patients with borderline ovarian tumor. The higher risk of local relapses is not associated with a reduction in the overall survival. The procedure should be offered to young patients with bilateral tumors and to very young ones, considering the higher risk of local relapse. [Copyright &y& Elsevier]

Objective To evaluate the effects of transdermal hormone replacement therapy (HRT) on plasma viscosity, serum levels of thromboxane B2 (TXB2) and vascular impedance in the uterine, bladder wall, internal carotid and ophthalmic arteries in normotensive and hypertensive postmenopausal patients. Methods Thirty postmenopausal patients underwent continuous estradiol transdermal supplementation at a dose of 50 μg/day and 12-day courses of medroxyprogesterone acetate 10 mg/day every 2 months. The women were divided into two groups according to their blood pressure: normotensive women (Group 1, n = 14) and hypertensive subjects (Group 2, n = 16). Before starting HRT and after 6 months of therapy, the patients underwent: transvaginal ultrasonographic examination of the pelvic organs; Doppler examination of the blood flow velocities in the uterine, bladder wall, internal carotid and ophthalmic arteries; and analysis of plasma viscosity and plasma TXB2. Results After 6 months of HRT plasma viscosity had decreased in both groups (mean reduction in Group 1, (14 ± 1)%, P = 0.005; mean reduction in Group 2, (10 ± 1)%, P = 0.005) as had the TXB2 levels (mean reduction in Group 1, (93 ± 2)%, P < 0.001; mean reduction in Group 2, (92 ± 3)%, P < 0.001). The mean percentage reduction in plasma viscosity was smaller in hypertensive women than in normotensive women (P < 0.05). There was also a significant reduction in vascular impedance in the uterine artery (mean reduction in Group 1, (16 ± 1)%, P = 0.005; mean reduction in Group 2, (19 ± 1)%, P = 0.005), the bladder wall arteries (mean reduction in Group 1, (23 ± 2)%, P = 0.005; mean reduction in Group 2, (18 ± 1)%, P = 0.005), the internal carotid artery (mean reduction in Group 1, (25 ± 1)%, P = 0.005; mean reduction in Group 2, (26 ± 1)%, P = 0.005) and the ophthalmic artery (mean reduction in Group 1, (24 ± 2)%, P = 0.005; mean reduction in Group 2, (16 ± 1)%, P = 0.005). The percentage reduction in vascular impedance did not differ significantly between the two groups. Conclusions Our results show that transdermal HRT is effective in reducing plasma viscosity, TXB2 levels and vascular impedance in the peripheral and central vessels both in normotensive and hypertensive postmenopausal patients. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this cross-sectional study was to describe QoL in a large sample of women attending menopause centres and compare untreated postmenopausal women and matched HRT users by employing the Women's Health Questionnaire (WHQ) and two generic instruments, the SF-36 and the EQ-5D.Methods: Overall, 2906 women were recruited by 64 menopause centres throughout Italy, of whom 2160 filled in the questionnaire (1093 on HRT and 1067 not on HRT; response rate: 74%).Results: HRT users tended to be younger, healthier and with shorter menopause duration as opposed to non users, while no major socio-economic differences were present. At multivariate analysis, the presence of chronic diseases, low socio-economic status and living in Southern Italy represented the most important predictors of poor QoL. Furthermore, HRT users showed a lower probability of reporting problems in usual activities and pain/discomfort (EQ-5D), role limitations due to emotional problems (SF-36) and anxiety/fears (WHQ). HRT users also showed highly significant better outcomes in those areas that are more directly attributable to hormonal changes of mid age, namely vasomotor symptoms and sexual problems.Conclusions: Although QoL is mainly influenced by socio-economic and cultural factors, HRT has the potential for improving not only symptoms, but also more general aspects of physical and psychological well-being of symptomatic postmenopausal women. [ABSTRACT FROM AUTHOR]