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1. Computer Tomography-Guided Percutaneous Indocyanine Green Injection for Intraoperative Mapping of Metastatic Suspected Lesions

Author

Anne Kreklau, Ruben Lopez Benitez, Jürgen Fornaro, Gesine Meili, and Andreas Günthert

Subjects
Indocyanine Green, ICG, mapping metastatic suspected lesions, gynecological metastatic suspected lesions, gynecological oncology, Medicine (General), R5-920
Abstract

Introduction: Surgical treatment in oncology is one of the main part concerning the surveillance rate of the patient in case of tumor recurrence. Metastatic suspected lesions are mostly located in the abdomen or pelvis and are diagnosed by PET, MRI, or CT scan. Especially surgery of small lesions in recurrent disease for diagnostic or therapeutic purpose is often challenging.Material and Methods: We report a case series of 3 patients who were treated in our department due to a metastatic suspected lesion in PET-CT in follow up. For histological confirmation we performed a laparoscopy using a near infrared camera (NIR) for an improved visualization of the metastatic suspected lesion during surgical treatment. Previously the lesion was marked with an amount of Indocyanine Green (ICG) via computer tomography-guided percutaneous injection. The lesion was identified via NIR camera. While changing the camera in NIR mode, it show up as a blue spot due to the fluorescent signal. After correct identification it was removed and send to pathology.Results: In all 3 cases they confirmed the diagnosis of a metastatic lesion. Complication occur in just one case, where the metastatic lymph node infiltrated the external iliac vein, which led to a high blood loss. In this case a vascular interposition had to be done.Conclusions: Because of separate wavelengths, which are used for illumination and recording, only the marked area is visible, not the background.Due to correct identification, resection of the lesion was improved and healthy surrounding tissue could have been spared.

Published
2018
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2. SUCCOR Nodes: May Sentinel Node Biopsy Determine the Need for Adjuvant Treatment?

Author

Arantxa Berasaluce Gómez MD, Nerea Martín-Calvo MD, Félix Boria MD, Nabil Manzour MD, Enrique Chacón MD, Nicolò Bizzarri MD, Luis Chiva MD, Alejandra, Martinez, Alfonso, Quesada, Ali, Kucukmetin, Alicia, Vázquez, Aljosa, Mandic, Andrea, Casajuana, Andreas, Kavallaris, Anna, Fagotti, Anna, Perrone, Annamaria, Ferrero, Arantxa, Lekuona, Arno, Uppin, Artem, Stepanyan, Benito, Chiofalo, Bibiana, Morillas, Carmen, Tauste, Claudia, Andrade, Constantijne, Mom, Cosima, Brucker, Cosmin-Paul, Sarac, Daniel, Vázquez-Vicente, David, Cibula, Denis, Querleu, Diego, Erasun, Dilyara, Kaidarova, Dimitrios, Tsolakidis, Dimitros, Haidopoulos, Dmytro, Golub, Eduard-Aexandru, Bonci, Elif, Aksahin, Elisabete, Gonçalves, Enrique, Moratalla, Erbil, Karaman, Eva, Myriokefalitaki, Fabio, Ghezzi, Fabrice, Narducci, Fernando, Roldan, Francesco, Raspagliesi, Frédéric, Goffin, Frederic, Grandjean, Frédéric, Guyon, Fuat, Demirkiran, Gabriel, Fiol, Galina, Chakalova, Gemma, Mancebo, George, Vorgias, Gerhard, Gebauer, Gesine, Meili, Gines, Hernandez-Cortes, Giorgio, Bogani, Gloria, Cordeiro, Goran, Vujić, Gustavo, Mendinhos, Hans, Trum, Hélène, Bonsang-Kitzis, Herman, Haller, Ignace, Vergote, Ignacio, Zapardiel, Igor, Aluloski, Igor, Berlev, Imre, Pete, Ioannis, Kalogiannidis, Ioannis, Kotsopoulos, Iryna, Yezhova, Javier, Díez, Feron, Jean G., Jens-Peter, Scharf, Jogchum, Beltman, Jolien, Haesen, Jordi, Ponce, Jorge, Cea, Jose Ángel Mínguez, José, García, Juan, Arévalo-Serrano, Juan, Gilabert, Juan Luis Alcazar, Kersti, Kukk, Khadra, Galaal, Laura, Cárdenas, Laurentiu, Pirtea, Mereu, Liliana, Luigi Pedone Anchora, Lukas, Dostalek, Lukasz, Klasa, Maja, Pakižimre, Manuela, Undurraga, Marcin, Jedryka, Margarida, Bernardino, Maria, Alonso-Espias, María Belén Martín-Salamanca, Maria, Cuadra, Mariana, Tavares, Mario, Malzoni, Mathias, Fehr, Mathieu, Luyckx, Maximilian, Lanner, Meelis, Leht, Mehmet, Meydanli, Michael, Mallmann, Mihai, Căpîlna, Mikulás, Redecha, Milena, Mitrovic, Maenpaa, Minna M., Miriam, Guijarro, Nabil, Abdalla, Nana, Gomes, Natalia, Povolotskaya, Nikola, Badzakov, Octavio, Arencibia, Özgür, Akbayir, Pere, Cavalle, Petra, Zusterzeel, Philip, Rolland, Pluvio, Coronado, Rasiah, Bharathan, Reeli, Saaron, Rita, Sousa, Robert, Fruscio, Robert, Jach, Robert, Poka, Rosa, Barrachina, Santiago, Domingo, Sara, Morales, Sedat, Akgöl, Sergi, Fernandez-Gonzalez, Shamistan, Aliyev, Sofía, Herrero, Soledad, Fidalgo, Sonia, Prader, Špela, Smrkolj, Stamatios, Petousis, Stefan, Kovachev, Taner, Turan, Tayfun, Toptas, Teresa, Castellanos, Teresa Diniz da Costa, Tiermes, Marina, Vanna, Zanagnolo, Victor, Martin, Virginia, Gonzalez, Vladimír Študent &amp, and Vladyslav, Sukhin

Published
2023

3. Incidence Trends of Cervical Cancer and Its Precancerous Lesions in Women of Central Switzerland from 2000 until 2014

Author

Katrin Ochs, Gesine Meili, Joachim Diebold, Volker Arndt, and Andreas Günthert

Subjects
cervical cancer, cervical intraepithelial neoplasia, conizations, Switzerland, incidence, screening, Medicine (General), R5-920
Abstract

ObjectiveCervical cancer (CC) screening by Pap smears has led to a decrease in the incidence of CC worldwide. Indeed, the incidence of CC in Switzerland is very low; however, there is a lack of data to evaluate the efficiency of the Pap smear as a screening tool. Until now, only Pap smears have been used and other methods such as the presence of an infection with HPV have not been integrated into the routine screening. The aim of this study is to evaluate trends in the incidence of CC and its precancerous lesions in Central Switzerland, which represents a rural region, with those in urban regions and the entire country of Switzerland.MethodsAll conizations and CC registered between 2000 and 2014 at the Institute of Pathology at the Cantonal Hospital of Lucerne have been included in our study. The incidence of CC and its precancerous lesions have been categorized according to age, stage, morphology, and study period. Age-standardized incidence in the Canton of Zurich and the entire country served as reference for the assessment of trends in CC incidence in the study region.ResultsIn Central Switzerland, the number of conizations performed annually has more than doubled over the observed 15 years. There has been a significant increase in precancerous lesions, which were found in approximately 50% of conizations. The total number of CC diagnosed by conization increased by 37.5% and the total of CIN3 increased by 130%. Age-standardized incidence of CC and CIN3 increased from 2.4 to 3.3/100,000 and from 11.6 to 26.9/100,000, respectively. The incidence of CC was lower in Central Switzerland compared to incidence in the Canton of Zurich and in Switzerland generally.ConclusionApproximately 50% of all conizations were performed on women without serious precancerous lesions. For this reason, we recommend the adaptation of screening modalities and the use of risk stratification to avoid overtreatment. In light of the forthcoming implementation of an HPV vaccination program, our data provides important baseline information.

Published
2018
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4. SUCCOR Risk: Design and Validation of a Recurrence Prediction Index for Early-Stage Cervical Cancer

Author

Manzour, Nabil, Chiva, Luis, Chacón, Enrique, Martin-Calvo, Nerea, Boria, Felix, Minguez, José A, Alcazar, Juan, L, Vanna, Zanagnolo, Denis, Querleu, Mihai, Căpîlna, Anna, Fagotti, Ali, Kucukmetin, Constantijne, Mom, Galina, Chakalova, Shamistan, Aliyev, Mario, Malzoni, Fabrice, Narducci, Octavio, Arencibia, Francesci, Raspagliesi, Tayfun, Toptas, David, Cibula, Dilyara, Kaidarova, Mehmet, Meydanli, Mariana, Tavares, Dmytro, Golub, Anna, Perrone, Robert, Poka, Dimitrios, Tsolakidis, Goran, Vujić, Marcin, Jedryka, Petra, Zusterzeel, Jogchum, Beltman, Frédéric, Goffin, Dimitros, Haidopoulos, Herman, Haller, Robert, Jach, Iryna, Yezhova, Igor, Berlev, Margarida, Bernardino, Rasiah, Bharathan, Maximilian, Lanner, Vladyslav, Sukhin, Jean, G Feron, Robert, Fruscio, Kersti, Kukk, Jordi, Ponce, Nabil, Abdalla, Özgür, Akbayir, Sedat, Akgöl, Elif, Aksahin, Maria, Alonso-Espias, Igor, Aluloski, Claudia, Andrade, Nikola, Badzakov, Rosa, Barrachina, Giorgio, Bogani, Eduard-Aexandru, Bonci, Hélène, Bonsang-Kitzis, Cosima, Brucker, Laura, Cárdenas, Andrea, Casajuana, Pere, Cavalle, Jorge, Cea, Benito, Chiofalo, Gloria, Cordeiro, Pluvio, Coronado, Maria, Cuadra, Javier, Díez, Teresa Diniz da Costa, Santiago, Domingo, Lukas, Dostalek, Fuat, Demirkiran, Diego, Erasun, Mathias, Fehr, Sergi, Fernandez-Gonzalez, Soledad, Fidalgo, Gabriel, Fiol, Khadra, Galaal, José, García, Gerhard, Gebauer, Fabio, Ghezzi, Juan, Gilabert, Nana, Gomes, Elisabete, Gonçalves, Virginia, Gonzalez, Frederic, Grandjean, Miriam, Guijarro, Frédéric, Guyon, Jolien, Haesen, Gines, Hernandez-Cortes, Sofía, Herrero, Imre, Pete, Ioannis, Kalogiannidis, Erbil, Karaman, Andreas, Kavallaris, Lukasz, Klasa, Ioannis, Kotsopoulos, Stefan, Kovachev, Meelis, Leht, Arantxa, Lekuona, Mathieu, Luyckx, Michael, Mallmann, Gemma, Mancebo, Aljosa, Mandic, Tiermes, Marina, Victor, Martin, María Belén Martín-Salamanca, Alejandra, Martinez, Gesine, Meili, Gustavo, Mendinhos, Mereu, Liliana, Milena, Mitrovic, Sara, Morales, Enrique, Moratalla, Bibiana, Morillas, Eva, Myriokefalitaki, Maja, Pakižimre, Stamatios, Petousis, Laurentiu, Pirtea, Natalia, Povolotskaya, Sonia, Prader, Alfonso, Quesada, Mikuláš, Redecha, Fernando, Roldan, Philip, Rolland, Reeli, Saaron, Cosmin-Paul, Sarac, Jens-Peter, Scharf, Špela, Smrkolj, Rita, Sousa, Artem, Stepanyan, Vladimír, Študent, Carmen, Tauste, Hans, Trum, Taner, Turan, Manuela, Undurraga, Arno, Uppin, Alicia, Vázquez, Ignace, Vergote, George, Vorgias, Ignacio, Zapardiel, Amsterdam Reproduction & Development (AR&D), Obstetrics and gynaecology, CCA - Imaging and biomarkers, Manzour, N, Chiva, L, Chacon, E, Martin-Calvo, N, Boria, F, Minguez, J, Alcazar, J, Zanagnolo, V, Querleu, D, Capilna, M, Fagotti, A, Kucukmetin, A, Mom, C, Chakalova, G, Aliyev, S, Malzoni, M, Narducci, F, Arencibia, O, Raspagliesi, F, Toptas, T, Cibula, D, Kaidarova, D, Meydanli, M, Tavares, M, Golub, D, Perrone, A, Poka, R, Tsolakidis, D, Vujic, G, Jedryka, M, Zusterzeel, P, Beltman, J, Goffin, F, Haidopoulos, D, Haller, H, Jach, R, Yezhova, I, Berlev, I, Bernardino, M, Bharathan, R, Lanner, M, Sukhin, V, Feron, J, Fruscio, R, Kukk, K, Ponce, J, Abdalla, N, Akbayir, O, Akgol, S, Aksahin, E, Alonso-Espias, M, Aluloski, I, Andrade, C, Badzakov, N, Barrachina, R, Bogani, G, Bonci, E, Bonsang-Kitzis, H, Brucker, C, Cardenas, L, Casajuana, A, Cavalle, P, Cea, J, Chiofalo, B, Cordeiro, G, Coronado, P, Cuadra, M, Diez, J, da Costa, T, Domingo, S, Dostalek, L, Demirkiran, F, Erasun, D, Fehr, M, Fernandez-Gonzalez, S, Fidalgo, S, Fiol, G, Galaal, K, Garcia, J, Gebauer, G, Ghezzi, F, Gilabert, J, Gomes, N, Goncalves, E, Gonzalez, V, Grandjean, F, Guijarro, M, Guyon, F, Haesen, J, Hernandez-Cortes, G, Herrero, S, Pete, I, Kalogiannidis, I, Karaman, E, Kavallaris, A, Klasa, L, Kotsopoulos, I, Kovachev, S, Leht, M, Lekuona, A, Luyckx, M, Mallmann, M, Mancebo, G, Mandic, A, Marina, T, Martin, V, Martin-Salamanca, M, Martinez, A, Meili, G, Mendinhos, G, Mereu, L, Mitrovic, M, Morales, S, Moratalla, E, Morillas, B, Myriokefalitaki, E, Pakizimre, M, Petousis, S, Pirtea, L, Povolotskaya, N, Prader, S, Quesada, A, Redecha, M, Roldan, F, Rolland, P, Saaron, R, Sarac, C, Scharf, J, Smrkolj, S, Sousa, R, Stepanyan, A, Student, V, Tauste, C, Trum, H, Turan, T, Undurraga, M, Uppin, A, Vazquez, A, Vergote, I, Vorgias, G, and Zapardiel, I

Subjects
cervical cancer, Cevical cancer, Uterine Cervical Neoplasms, Hysterectomy, Prognosis, Risk Assessment, Women's cancers Radboud Institute for Health Sciences [Radboudumc 17], conization, Settore MED/40 - GINECOLOGIA E OSTETRICIA, Oncology, Recurrence, radical hysterectomy, Humans, Female, Surgery, Neoplasm Recurrence, Local, Neoplasm Staging, Retrospective Studies
Abstract

Objective Based on the SUCCOR study database, our primary objective was to identify the independent clinical pathological variables associated with the risk of relapse in patients with stage IB1 cervical cancer who underwent a radical hysterectomy. Our secondary goal was to design and validate a risk predictive index (RPI) for classifying patients depending on the risk of recurrence. Methods Overall, 1116 women were included from January 2013 to December 2014. We randomly divided our sample into two cohorts: discovery and validation cohorts. The test group was used to identify the independent variables associated with relapse, and with these variables, we designed our RPI. The index was applied to calculate a relapse risk score for each participant in the validation group. Results A previous cone biopsy was the most significant independent variable that lowered the rate of relapse (odds ratio [OR] 0.31, 95% confidence interval [CI] 0.17–0.60). Additionally, patients with a tumor diameter >2 cm on preoperative imaging assessment (OR 2.15, 95% CI 1.33–3.5) and operated by the minimally invasive approach (OR 1.61, 95% CI 1.00–2.57) were more likely to have a recurrence. Based on these findings, patients in the validation cohort were classified according to the RPI of low, medium, or high risk of relapse, with rates of 3.4%, 9.8%, and 21.3% observed in each group, respectively. With a median follow-up of 58 months, the 5-year disease-free survival rates were 97.2% for the low-risk group, 88.0% for the medium-risk group, and 80.5% for the high-risk group (p < 0.001). Conclusion Previous conization to radical hysterectomy was the most powerful protective variable of relapse. Our risk predictor index was validated to identify patients at risk of recurrence.

Published
2022
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5. Surgical uterus-preserving therapy after uterine rupture and haemorrhage due to placenta percreta in the first trimester following embolisation of the uterine arteries and B-Lynch suture in a previous pregnancy

Author

Laura Gabriel, Louisa Ederhof, Ursula Fellmann, and Gesine Meili

Subjects
Rupture, Spontaneous, Sutures, Uterus, Placenta Accreta, General Medicine, Hysterectomy, Abdominal Pain, Pregnancy Trimester, First, Uterine Artery, Uterine Rupture, Pregnancy, Hemoperitoneum, Humans, Female
Abstract

A woman in her early 30s in the 11 2/7 week of pregnancy was admitted with severe abdominal pain and emesis. One year prior, the patient had undergone hysteroscopic adhesiolysis to treat Asherman syndrome resulting from a prior pregnancy. Examination of the patient revealed a haemoperitoneum and an intact intrauterine pregnancy. Laparoscopic adhesiolysis and haemostasis was performed and the patient was transferred to the intensive care unit. Subsequent examination due to persistent abdominal pain revealed an occult iatrogenic perforation of the uterus and placenta percreta with spontaneous uterine rupture. Although treatment for placenta percreta has generally been hysterectomy, in this case, the rupture and perforation sites were resected, representing successful fertility preserving management for this oft-overlooked pregnancy complication.

Published
2022
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6. Spondylodiszitis nach Sakropexie

Author

Corina Christmann, Gesine Meili, Marianne Sigg, and Jürg Schneider

Subjects
Gynecology, 03 medical and health sciences, medicine.medical_specialty, 030219 obstetrics & reproductive medicine, 0302 clinical medicine, business.industry, medicine, Obstetrics and Gynecology, 030212 general & internal medicine, business
Abstract

Osteomyelitiden nach Sakrokolpopexien stellen eine seltene Komplikation dar, die fur die Betroffenen meist umfangreiche Therapien nach sich ziehen: Nachoperationen mit oft persistierenden Beschwerden, Schmerzen oder gar Invaliditat konnen Folgen sein. Wir diskutieren diese Komplikation anhand eines eigenen Falles und geben einen Uberblick zur Literatur. Goldstandard in der Therapie ist eine Langzeitantibiose nach Antibiogramm. Manchmal ist jedoch auch eine operative Therapie mit Mesh-Entfernung indiziert. Wir beschreiben einen Fall einer konservativ behandelten Osteomyelitis nach laparoskopischer Sakrokolpopexie.

Published
2018
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7. Patientinnenzufriedenheit und Outcome nach Prolapsoperationen in einem ländlichen Spital

Author

Gesine Meili, Jürg Schneider, and Corina Christmann

Subjects
03 medical and health sciences, 030219 obstetrics & reproductive medicine, 0302 clinical medicine, 030212 general & internal medicine, General Medicine
Abstract

Zusammenfassung. Untersucht wurden objektive und subjektive Langzeitergebnisse vaginaler und laparoskopischer Prolapsoperationen in einem allgemeinen gynäkologischen Lehrkrankenhaus. Es handelt sich um eine retrospektive Studie mit 269 Frauen. Das subjektive Ergebnis wurde anhand des P-QOL-Fragebogens und Befragungen beurteilt, die objektiven Ergebnisdaten wurden prä- und postoperativ nach drei bis neun Monaten beurteilt. Die Krankengeschichte wurde bezüglich Anamnese sowie intra- und postoperativen Komplikationen analysiert. Wir führten 87 laparoskopische Sakrokolpopexien, 100 Kolpofixationen nach Richter, 164 anteriore oder/und posteriore vaginale Plastiken, oft in Kombination mit anderen Eingriffen, sowie weitere Eingriffe durch. 80 % (185/206) der behandelten Frauen waren mit dem postoperativen Ergebnis zufrieden. Kenntnisse der Anamnese und der Symptome der Patientin sind sehr wichtig, um die Frauen über chirurgische Optionen und Erwartungen hinsichtlich des objektiven postoperativen Ergebnisses orientieren zu können.

Published
2018
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8. SUCCOR study: an international European cohort observational study comparing minimally invasive surgery versus open abdominal radical hysterectomy in patients with stage IB1 cervical cancer

Author

Chiva, Luis, Zanagnolo, Vanna, Querleu, Denis, Martin-Calvo, Nerea, Arévalo-Serrano, Juan, Căpîlna, Mihai Emil, Fagotti, Anna, Kucukmetin, Ali, Mom, Constantijne, Chakalova, Galina, Aliyev, Shamistan, Malzoni, Mario, Narducci, Fabrice, Arencibia, Octavio, Raspagliesi, Francesco, Toptas, Tayfun, Cibula, David, Kaidarova, Dilyara, Meydanli, Mehmet Mutlu, Tavares, Mariana, Golub, Dmytro, Perrone, Anna Myriam, Poka, Robert, Tsolakidis, Dimitrios, Vujić, Goran, Jedryka, Marcin A, Zusterzeel, Petra L M, Beltman, Jogchum Jan, Goffin, Frederic, Haidopoulos, Dimitrios, Haller, Herman, Jach, Robert, Yezhova, Iryna, Berlev, Igor, Bernardino, Margarida, Bharathan, Rasiah, Lanner, Maximilian, Maenpaa, Minna M, Sukhin, Vladyslav, Feron, Jean-Guillaume, Fruscio, Robert, Kukk, Kersti, Ponce, Jordi, Minguez, Jose Angel, Vázquez-Vicente, Daniel, Castellanos, Teresa, Chacon, Enrique, Alcazar, Juan, Luis, Nabil, Abdalla, Özgür, Akbayir, Sedat, Akgöl, Elif, Aksahin, Shamistan, Aliyev, Maria, Alonso-Espias, Igor, Aluloski, Claudia, Andrade, Nikola, Badzakov, Rosa, Barrachina, Giorgio, Bogani, Eduard-Aexandru, Bonci, Hélène, Bonsang-Kitzis, Felix, Boria, Cosima, Brucker, Laura, Cárdenas, Andrea, Casajuana, Pere, Cavalle, Jorge, Cea, Benito, Chiofalo, Gloria, Cordeiro, Pluvio, Coronado, Maria, Cuadra, Javier, Díez, Teresa Diniz da Costa, Santiago, Domingo, Lukas, Dostalek, Fuat, Demirkiran, Diego, Erasun, Mathias, Fehr, Sergi, Fernandez-Gonzalez, Annamaria, Ferrero, Soledad, Fidalgo, Gabriel, Fiol, Khadra, Galaal, José, García, Gerhard, Gebauer, Fabio, Ghezzi, Juan, Gilabert, Nana, Gomes, Elisabete, Gonçalves, Virginia, Gonzalez, Frederic, Grandjean, Miriam, Guijarro, Frédéric, Guyon, Jolien, Haesen, Gines, Hernandez-Cortes, Sofía, Herrero, Imre, Pete, Ioannis, Kalogiannidis, Erbil, Karaman, Andreas, Kavallaris, Lukasz, Klasa, Ioannis, Kotsopoulos, Stefan, Kovachev, Meelis, Leht, Arantxa, Lekuona, Mathieu, Luyckx, Michael, Mallmann, Gemma, Mancebo, Aljosa, Mandic, Nabil, Manzour, Tiermes, Marina, Victor, Martin, María Belén Martín-Salamanca, Alejandra, Martinez, Gesine, Meili, Gustavo, Mendinhos, Mereu, Liliana, Milena, Mitrovic, Sara, Morales, Enrique, Moratalla, Bibiana, Morillas, Eva, Myriokefalitaki, Maja, Pakižimre, Stamatios, Petousis, Laurentiu, Pirtea, Natalia, Povolotskaya, Sonia, Prader, Alfonso, Quesada, Mikuláš, Redecha, Fernando, Roldan, Philip, Rolland, Reeli, Saaron, Cosmin-Paul, Sarac, Jens-Peter, Scharf, Špela, Smrkolj, Rita, Sousa, Artem, Stepanyan, Vladimír, Študent, Carmen, Tauste, Hans, Trum, Taner, Turan, Manuela, Undurraga, Arno, Uppin, Alicia, Vázquez, Ignace, Vergote, George, Vorgias, Ignacio, Zapardiel, Obstetrics and gynaecology, CCA - Cancer biology and immunology, CCA - Cancer Treatment and quality of life, Amsterdam Reproduction & Development (AR&D), Ethics, Law & Medical humanities, Chiva L., Zanagnolo V., Querleu D., Martin-Calvo N., Arevalo-Serrano J., Capilna M.E., Fagotti A., Kucukmetin A., Mom C., Chakalova G., Aliyev S., Malzoni M., Narducci F., Arencibia O., Raspagliesi F., Toptas T., Cibula D., Kaidarova D., Meydanli M.M., Tavares M., Golub D., Perrone A.M., Poka R., Tsolakidis D., Vujic G., Jedryka M.A., Zusterzeel P.L.M., Beltman J.J., Goffin F., Haidopoulos D., Haller H., Jach R., Yezhova I., Berlev I., Bernardino M., Bharathan R., Lanner M., Maenpaa M.M., Sukhin V., Feron J.-G., Fruscio R., Kukk K., Ponce J., Minguez J.A., Vazquez-Vicente D., Castellanos T., Chacon E., Alcazar J.L., Chiva, L, Zanagnolo, V, Querleu, D, Martin-Calvo, N, Arévalo-Serrano, J, Căpîlna, M, Fagotti, A, Kucukmetin, A, Mom, C, Chakalova, G, Aliyev, S, Malzoni, M, Narducci, F, Arencibia, O, Raspagliesi, F, Toptas, T, Cibula, D, Kaidarova, D, Meydanli, M, Tavares, M, Golub, D, Perrone, A, Poka, R, Tsolakidis, D, Vujić, G, Jedryka, M, Zusterzeel, P, Beltman, J, Goffin, F, Haidopoulos, D, Haller, H, Jach, R, Yezhova, I, Berlev, I, Bernardino, M, Bharathan, R, Lanner, M, Maenpaa, M, Sukhin, V, Feron, J, Fruscio, R, Kukk, K, Ponce, J, Minguez, J, Vázquez-Vicente, D, Castellanos, T, Chacon, E, Alcazar, J, INSERM, Université de Lille, Protéomique, Réponse Inflammatoire, Spectrométrie de Masse (PRISM) - U1192, Clínica Universidad de Navarra [Pamplona], Istituto Europeo di Oncologia [Milano] [IEO], Institut Bergonié [Bordeaux], Universidad de Navarra [Pamplona] [UNAV], Istituto Europeo di Oncologia [Milano] (IEO), UNICANCER, Universidad de Navarra [Pamplona] (UNAV), Protéomique, Réponse Inflammatoire, Spectrométrie de Masse (PRISM) - U 1192 (PRISM), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)

Subjects
Adult, BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences, medicine.medical_specialty, Uterine Cervical Neoplasm, cervical cancer, [SDV]Life Sciences [q-bio], 03 medical and health sciences, Young Adult, surgical oncology, 0302 clinical medicine, hysterectomy, laparoscope, cervix uteri, laparotomy, Surgical oncology, local, medicine, Radical Hysterectomy, Prospective cohort study, Cancer staging, Aged, Neoplasm Staging, Cervical cancer, Aged, 80 and over, 030219 obstetrics & reproductive medicine, neoplasm recurrence, local, business.industry, BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti, Obstetrics and Gynecology, Retrospective cohort study, Minimally Invasive Surgical Procedure, Middle Aged, medicine.disease, neoplasm recurrence, Surgery, Women's cancers Radboud Institute for Health Sciences [Radboudumc 17], Europe, Settore MED/40 - GINECOLOGIA E OSTETRICIA, laparoscopes, Oncology, 030220 oncology & carcinogenesis, Cohort, Female, Cohort Studie, business, Cohort study, Human
Abstract

SUCCOR study: an international European cohort observational study comparing minimally invasive surgery versus open abdominal radical hysterectomy in patients with stage IB1 cervical cancer FREE http://orcid.org/0000-0002-1908-3251Luis Chiva1, Vanna Zanagnolo2, Denis Querleu3, Nerea Martin- Calvo4, Juan Arévalo-Serrano5, Mihai Emil Căpîlna6, Anna Fagotti7, Ali Kucukmetin8, Constantijne Mom9, Galina Chakalova10, Shamistan Aliyev11, Mario Malzoni12, http://orcid.org/0000- 0001-5809-3535Fabrice Narducci13, Octavio Arencibia14, Francesco Raspagliesi15, Tayfun Toptas16, David Cibula17, Dilyara Kaidarova18, http://orcid.org/0000-0001-6763-9720Mehmet Mutlu Meydanli19, Mariana Tavares20, Dmytro Golub21, http://orcid.org/0000-0003-3140-4772Anna Myriam Perrone22, Robert Poka23, Dimitrios Tsolakidis24, Goran Vujić25, http://orcid.org/0000-0001-8935- 0311Marcin A Jedryka26, Petra L M Zusterzeel27, Jogchum Jan Beltman28, Frederic Goffin29, Dimitrios Haidopoulos30, Herman Haller31, Robert Jach32, Iryna Yezhova33, Igor Berlev34, Margarida Bernardino35, Rasiah Bharathan36, Maximilian Lanner37, Minna M Maenpaa38, http://orcid.org/0000-0002-4403-3707Vladyslav Sukhin39, Jean-Guillaume Feron40, Robert Fruscio41, 42, Kersti Kukk43, Jordi Ponce44, Jose Angel Minguez45, http://orcid.org/0000-0002-9618- 5606Daniel Vázquez-Vicente45, Teresa Castellanos45, Enrique Chacon46 and http://orcid.org/0000-0002-9700-0853Juan Luis Alcazar47 On behalf of the SUCCOR study Group Author affiliations Abstract Background Minimally invasive surgery in cervical cancer has demonstrated in recent publications worse outcomes than open surgery. The primary objective of the SUCCOR study, a European, multicenter, retrospective, observational cohort study was to evaluate disease-free survival in patients with stage IB1 (FIGO 2009) cervical cancer undergoing open vs minimally invasive radical hysterectomy. As a secondary objective, we aimed to investigate the association between protective surgical maneuvers and the risk of relapse. Methods We obtained data from 1272 patients that underwent a radical hysterectomy by open or minimally invasive surgery for stage IB1 cervical cancer (FIGO 2009) from January 2013 to December 2014. After applying all the inclusion-exclusion criteria, we used an inverse probability weighting to construct a weighted cohort of 693 patients to compare outcomes (minimally invasive surgery vs open). The first endpoint compared disease-free survival at 4.5 years in both groups. Secondary endpoints compared overall survival among groups and the impact of the use of a uterine manipulator and protective closure of the colpotomy over the tumor in the minimally invasive surgery group. Results Mean age was 48.3 years (range ; 23–83) while the mean BMI was 25.7 kg/m2 (range ; 15–49). The risk of recurrence for patients who underwent minimally invasive surgery was twice as high as that in the open surgery group (HR, 2.07 ; 95% CI, 1.35 to 3.15 ; P=0.001). Similarly, the risk of death was 2.42-times higher than in the open surgery group (HR, 2.45 ; 95% CI, 1.30 to 4.60, P=0.005). Patients that underwent minimally invasive surgery using a uterine manipulator had a 2.76-times higher hazard of relapse (HR, 2.76 ; 95% CI, 1.75 to 4.33 ; P

Published
2020
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10. Incidence Trends of Cervical Cancer and Its Precancerous Lesions in Women of Central Switzerland from 2000 until 2014

Author

Andreas R. Günthert, Volker Arndt, Katrin Ochs, Gesine Meili, Joachim Diebold, University of Zurich, and Günthert, Andreas

Subjects
medicine.medical_specialty, cervical cancer, 610 Medicine & health, 2700 General Medicine, cervical intraepithelial neoplasia, Cervical cancer screening, Cervical intraepithelial neoplasia, 03 medical and health sciences, 0302 clinical medicine, Incidence trends, medicine, 030212 general & internal medicine, Stage (cooking), Original Research, Cervical cancer, lcsh:R5-920, Pap smears, Routine screening, Obstetrics, business.industry, Incidence (epidemiology), screening, 10060 Epidemiology, Biostatistics and Prevention Institute (EBPI), General Medicine, medicine.disease, female genital diseases and pregnancy complications, 030220 oncology & carcinogenesis, incidence, Medicine, lcsh:Medicine (General), business, conizations, Switzerland
Abstract

Objective Cervical cancer screening by Pap smears has led to a decrease in the incidence of cervical cancer (CC) worldwide. Indeed, the incidence of CC in Switzerland is very low, however there is a lack of data to evaluate the efficiency of the Pap smear as a screening tool. Until now only Pap smears have been used and other methods such as the presence of an infection with HPV have not been integrated into the routine screening. The aim of this study is to evaluate trends in the incidence of CC and its precancerous lesions in Central Switzerland, which represents a rural region, with those in urban regions and the entire country of Switzerland. Methods All conizations and CC registered between 2000 and 2014 at the Institute of Pathology at the Cantonal Hospital of Lucerne have been included in our study. The incidence of CC and its precancerous lesions have been categorized according to age, stage, morphology and study period. Age-standardized incidence in the Canton of Zurich and the entire country served as reference for the assessment of trends in CC incidence in the study region. Results In Central Switzerland, the number of conizations performed annually have more than doubled over the observed 15 years. There has been a significant increase in precancerous lesions, which were found in approximately 50% of conizations. The total number of CC diagnosed by conization increased by 37.5%, and the total of CIN3 increased by 130%. Age-standardized incidence of CC and CIN3 increased from 2.4 to 3.3 /100 000 and from 11.6 to 26.9 /100 000, respectively. The incidence of CC was lower in Central Switzerland compared to incidence in the Canton of Zurich and in Switzerland generally. Conclusions Approximately 50% of all conizations were performed on women without serious precancerous lesions. For this reason we recommend the adaptation of screening modalities and the use of risk stratification in order to avoid overtreatment. In light of the forthcoming implementation of an HPV vaccination program our data provides important baseline information.

Published
2018
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11. Mütterliche Mortalität in der Schweiz 1985–1994

Author

Gesine Meili, Renate Huch, Roland Zimmermann, and Albert Huch

Subjects
Gynecology, medicine.medical_specialty, Political science, medicine, Obstetrics and Gynecology, General Medicine
Abstract

In den letzten 100 Jahren ist die mütterliche Mortalität in den westlichen Ländern massiv gesunken. Aktuelle und detaillierte Zahlen über die Ursachen in der Schweiz existieren jedoch nicht. Ausgehend von den damals mit ICD-8 kodierten öffentlich erfassten Müttersterbefällen der Jahre 1985–1994 haben wir mit einer direkten Einsicht in die anonymisierten Krankenakten die Fälle präziser klassieren können. Wir teilten sie in direkte und indirekte Müttersterbefälle ein. Von primär 76 registrierten Fällen blieben 45 direkte Todesfälle auf 812825 Geburten, was einer direkten Müttersterblichkeit von 5,4/100000 Lebendgeburten entspricht. Die übrigen Fälle mussten umklassiert werden (indirekte, nicht schwangerschaftsbedingte und späte Müttersterbefälle). Am häufigsten starben Mütter an einer Thromboembolie (15%). Die Sektioletalität betrug 0,09‰. Die grosse Zahl von umklassierten Fällen zeigt, dass eine Unterweisung im Ausfüllen der Todeszertifikate nötig wäre. Beim Bestreben, die Müttersterblichkeit weiter zu senken, muss das Augenmerk auf eine konsequente Thromboembolieprophylaxe und eine frühe Entbindung bei HELLP-Syndrom gerichtet werden.

Published
2003
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12. [Maternal mortality in Switzerland 1985-1994]

Author

Gesine, Meili, Renate, Huch, Albert, Huch, and Roland, Zimmermann

Subjects
Adult, HELLP Syndrome, Adolescent, Cesarean Section, Pregnancy Complications, Cardiovascular, Age Factors, Death Certificates, Maternal Mortality, Obstetric Labor, Premature, Pregnancy, Risk Factors, Thromboembolism, Humans, Female, Labor, Induced, Switzerland
Abstract

The maternal mortality rate in the west has dropped drastically in the last 100 years. As yet there are no detailed numbers of the actual causes of death for Switzerland. We re-evaluated the anonymous patient documentation for the years 1985-1994 using the officially registered (ICD-8) cases of maternal mortality. 45 deaths out of 812,825 births remained from the original 76 registered cases, which corresponds to a direct maternal mortality of 5.4/100,000 live births. The other cases had to be reclassified (indirect, late or pregnancy-related obstetric deaths). The majority of the deaths were caused by thromboembolism (15%). The mortality rate for cesarean section was 0.09 per thousand. The large number of reclassified cases shows that further teaching is necessary in the completion of the death certificate. In the attempt to reduce maternal mortality, one has to direct attention to the consequent prophylaxis of thromboembolism and induce a premature birth in cases of HELLP syndrome.

Published
2003

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