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17. Number of paraaortic lymph node dissections as a prognostic factor in locally advanced cervical cancer

Author

Nicolas I, Gilabert-Estelles J, Gilabert-Aguilar J, Fuste P, Aghababyan K, Pahisa J, Gil-Ibanez B, Diaz-Feijoo B, Carmona F, Calpe F, Saco A, Ordi J, and Torne A

Abstract

BACKGROUND: Lymph node (LN) metastases are the most important prognostic factor in locally advanced cervical cancer. Paraaortic lymphadenectomy is the only method able to confirm the presence of metastasis and thereby help to determine the most adequate treatment approach. There is no standard regarding the minimal number of LNs that should be removed in paraaortic lymphadenectomy. Women with undiagnosed positive paraaortic LNs (false negatives) due to a low LN count do not receive extended-field radiation therapy, which may lead to worse survival outcomes. The aim of this study is to confirm LN metastases as poor prognosis and to assess whether in cases of locally advanced CC with negative paraaortic LN status, the number of paraaortic LN laparoscopically removed carries a prognostic value. METHODS: We analyzed 78 patients with locally advanced cervical cancer that underwent complete paraaortic lymphadenectomy. RESULTS: Fifteen (19.2%) women had paraaortic LN metastases. The mean number of LN extracted was 11.1 (SD 7.5). Patients with paraaortic LN metastases presented a worse overall survival (127.1 months [95% CI 111.7-142.4] vs. 59.6 months [95% CI 31.2-87.9]; p

Published
2020

29. GROWING TERATOMA SYNDROME IN AN UNUSUAL CASE OF AGGRESSIVE STAGE IA IMMATURE TERATOMA OF THE OVARY

Author

Gil Ibáñez, Blanca, Glickman, A., Pahisa, J., Fusté, P., Del Pino, M., Nicolás, I., Agustí, N., and Carreras, N.

Abstract

INTRODUCTIONGerm cell tumors (GCT) represent less than 3% of all ovarian malignancies. They occur predominantly at young ages. The immature ovarian teratoma is the third commonest of the GCT, accounting for less than 1% of ovarian cancer cases worldwide. Growing teratoma syndrome (GTS) is a clinical entity characterized by a rapidly enlarging benign tumor mass, that arises during or after adjuvant chemotherapy for malignant ovarian GCT in presence of normal tumor markers. Its incidence has been reported to be from 2.5% to 19% of immature teratomas. We report an unusual case of GTS in a patient previously treated for recurrent stage IA immature teratoma of the ovary.PATIENTS AND RESULTSA 32-year-old nulligravida woman underwent right laparoscopic salpingo-oophorectomy because of suspected teratoma. Preoperative transvaginal ultrasound had identified a 12 cm complex cystic ovarian mass, with thin wall, a central solid component of 7 cm in size and two septa. Computed tomography (CT) did not show carcinomatosis nor other signs of disseminated disease. Serum tumor markers were normal except from u03b1-fetoprotein (AFP)=156ng/ml. Removal of specimen was performed within an endobag. Intraoperatory histological examination informed benign teratoma. Final pathology revealed the presence of isolated foci of neuroepithelial immature tissue in one low magnification field of only one histological preparation, prompting the diagnosis of grade-1 stage IA immature teratoma. The cytologic examination of peritoneal washing did not detect malignant cells. Tumor board decided to perform follow-up and this was agreed with the patient. Three months after surgery the patient consulted again for abdominal pain. Transvaginal ultrasound revealed the presence of a 15 cm complex solid mass in the right adnexal fossa. CT described a vast 20cm pelvic mass, a 7 cm left iliac fossa tumor, two Douglas pouch implants (2 and 2.5 cm), one 1.5 cm subhepatic implant and a 2 cm right iliac fossa implant. Elevated serum tumor markers were: CA-125=250U/ml, CA-19.9=97U/ml, TAG-72=19.8U/ml and AFP=3054ng/ml. Optimal citorreductive open surgery was performed, removing the pelvic tumor, cecal appendix, greater omentum and implants in Douglas pouch, uterine serosa, left ovarian surface, pelvic peritoneum and sigmoid colon serosa. Final pathology revealed a grade-3 immature teratoma in all resected lesions. The patient underwent adjuvant chemotherapy postoperatively with cisplatin, etoposide, and bleomycin (BEP x 4 cycles).Five months after surgery, a control CT scan was performed showing multiple 3 to 5 cm implants in the abdominal cavity. All tumor markers were normal. Another complete citorreduction that required a right hemicolectomy was achieved. Final pathology informed 39 implants, all of them presenting mature teratoma histology. Close follow-up was agreed. CONCLUSIONImmature teratoma is an aggressive tumor that usually shows a good response to chemotherapy. Its aggressiveness remains on the proportion of tissue containing immature neural elements found. The occurrence of GTS should be bared in mind when dealing with immature teratoma. Surgical treatment with no residual disease is fundamental and should be always attempted. Long-term close follow-up is always needed.

Published
2017

33. EP-1320: Postoperative radiotherapy results of serous endometrial carcinoma: 34 cases during 2003-2014

Author

Holub, K., primary, Rovirosa, A., additional, Oses, G., additional, Castilla, L., additional, Mansilla, J., additional, Llorente, R., additional, Cortes, K., additional, Garcia, J., additional, Garrido, S., additional, Huguet, A., additional, Castro, C., additional, Sola, J., additional, Ordi, J., additional, Pahisa, J., additional, and Biete, A., additional

Published
2016
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34. EP-1967: Preliminary results of a new brachytherapy schedule in postoperative endometrial carcinoma

Author

Rovirosa, A., primary, Holub, K., additional, Herreros, A., additional, Ascaso, C., additional, Sánchez, J., additional, Oses, G., additional, Mansilla, J., additional, Sola, J., additional, Huguet, A., additional, Garrida, S., additional, Saez, J., additional, Camacho, C., additional, Camarasa, A., additional, Quilis, C., additional, Arenas, M., additional, Sabater, S., additional, Del Pino, M., additional, Pahisa, J., additional, and Biete, A., additional

Published
2016
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36. The EANM clinical and technical guidelines for lymphoscintigraphy and sentinel node localization in gynaecological cancers

Author

Giammarile, F., Bozkurt, M.F., Cibula, D., Pahisa, J., Oyen, W.J.G., Paredes, P., Olmos, R.V., Sicart, S.V., Giammarile, F., Bozkurt, M.F., Cibula, D., Pahisa, J., Oyen, W.J.G., Paredes, P., Olmos, R.V., and Sicart, S.V.

Abstract

Item does not contain fulltext, The accurate harvesting of a sentinel node in gynaecological cancer (i.e. vaginal, vulvar, cervical, endometrial or ovarian cancer) includes a sequence of procedures with components from different medical specialities (nuclear medicine, radiology, surgical oncology and pathology). These guidelines are divided into sectione entitled: Purpose, Background information and definitions, Clinical indications and contraindications for SLN detection, Procedures (in the nuclear medicine department, in the surgical suite, and for radiation dosimetry), and Issues requiring further clarification. The guidelines were prepared for nuclear medicine physicians. The intention is to offer assistance in optimizing the diagnostic information that can currently be obtained from sentinel lymph node procedures. If specific recommendations given cannot be based on evidence from original scientific studies, referral is made to "general consensus" and similar expressions. The recommendations are designed to assist in the practice of referral to, and the performance, interpretation and reporting of all steps of the sentinel node procedure in the hope of setting state-of-the-art standards for high-quality evaluation of possible metastatic spread to the lymphatic system in gynaecological cancer. The final result has been discussed by a group of distinguished experts from the EANM Oncology Committee and the European Society of Gynaecological Oncology (ESGO). The document has been endorsed by the SNMMI Board.

Published
2014

46. Intraoperative post-conisation human papillomavirus testing for early detection of treatment failure in patients with cervical intraepithelial neoplasia: a pilot study

Author

Torné, A, primary, Fusté, P, additional, Rodríguez-Carunchio, L, additional, Alonso, I, additional, del Pino, M, additional, Nonell, R, additional, Cardona, M, additional, Rodríguez, A, additional, Castillo, P, additional, Pahisa, J, additional, Balasch, J, additional, Ramírez, J, additional, and Ordi, J, additional

Published
2012
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