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State of the Art: Surgery for Gynecologic Oncology
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State of the Art: Surgery for Gynecologic Oncology

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Obstetrics & Gynecology".

Deadline for manuscript submissions: closed (25 April 2024) | Viewed by 1356

Special Issue Editors

Dr. Maxime Fastrez

E-Mail Website
Guest Editor
OB GYN Departement, ULB-Université Libre de Bruxelles, H.U.B.-Hôpital Universitaire de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium
Interests: gynecological cancers surgery; minimal invasive surgery; endometriosis
Dr. Mathieu Luyckx

E-Mail Website
Guest Editor
Department of Gynecology-Andrology and Institut Roi Ablert II, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, 10 avenue Hippocrate, 1200 Brussels, Belgium
Interests: gynecological cancer surgery; immunology and genetic of tumor; ultraradical surgery for ovarian cancer; inflamma-tion and tumor; endometriosis

Special Issue Information

Dear Colleagues, 

Surgery for gynecological cancers has been challenged in recent years by the intensification of treatment for ovarian cancer and, on the other hand, de-escalation for endometrial and cervical cancer surgery. HIPEC (hyperthermic intra peritoneal chemotherapy) has emerged as an option in the management of recurrent ovarian cancer and is under investigation as a first-line treatment. Sentinel lymph node biopsy has become a standard of care in early endometrial cancer, while the decision for adjuvant treatment is more and more guided by the risk profile of the endometrial cancer determined by both the histopathologic and the molecular classification of the tumor. The surgical approach (open surgery versus minimal invasive surgery) and the type of hysterectomy for cervical cancer have been questioned in both the LACC and the SHAPE trials.

The quality of life of the patients surviving cancer is as important as the efficacy of treatments and needs to be discussed when proposing therapeutic options to women diagnosed with a gynecological cancer.

Survival after the standard first-line treatment is often very variable and difficult to predict. Variables with an impact on survival during the treatment are more and more considered.

We propose, in this Special Issue, to address most of the novel medico-surgical strategies in the treatment of gynecological cancer. We also propose presenting original results such as the impact of inflammation during debulking surgery for ovarian cancer on patients’ survival.

Dr. Maxime Fastrez
Dr. Mathieu Luyckx
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • gynecological cancer
  • surgery
  • minimally invasive surgery
  • novel strategy
  • quality of life
  • fertility

Published Papers (2 papers)

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17 pages, 3929 KiB  
Article
Intraoperative Ketorolac and Outcomes after Ovarian Cancer Surgery
by Mathieu Luyckx, Céline Verougstraete, Mathieu Jouret, Kiswendsida Sawadogo, Marc Waterkeyn, Frédéric Grandjean, Jean-Paul Van Gossum, Nathanael Dubois, Vincent Malvaux, Lucie Verreth, Pascale Grandjean, Pascale Jadoul, Charlotte Maillard, Amandine Gerday, Audrey Dieu, Patrice Forget, Jean-François Baurain and Jean-Luc Squifflet
J. Clin. Med. 2024, 13(6), 1546; https://doi.org/10.3390/jcm13061546 - 07 Mar 2024
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Abstract
Introduction: Surgery is the cornerstone of ovarian cancer treatment. However, surgery and perioperative inflammation have been described as potentially pro-metastagenic. In various animal models and other human cancers, intraoperative administration of non-steroidal anti-inflammatory drugs (NSAIDs) appears to have a positive impact on patient [...] Read more.
Introduction: Surgery is the cornerstone of ovarian cancer treatment. However, surgery and perioperative inflammation have been described as potentially pro-metastagenic. In various animal models and other human cancers, intraoperative administration of non-steroidal anti-inflammatory drugs (NSAIDs) appears to have a positive impact on patient outcomes. Materials and methods: In this unicentric retrospective study, we provide an exploratory analysis of the safety and potential benefit of intraoperative administration of ketorolac on the outcome of patients undergoing surgery for ovarian cancer. The study population included all patients who were given a diagnosis of ovarian, fallopian tube or peritoneal cancer by the multidisciplinary oncology committee (MOC) of the Cliniques universitaires Saint-Luc between 2015 and 2020. Results: We included 166 patients in our analyses, with a median follow-up of 21.8 months. Both progression-free survival and overall survival were superior in patients who received an intraoperative injection of ketorolac (34.4 months of progression-free survival in the ketorolac group versus 21.5 months in the non-ketorolac group (p = 0.002), and median overall survival was not reached in either group but there was significantly higher survival in the ketorolac group (p = 0.004)). We also performed subgroup analyses to minimise bias due to imbalance between groups on factors that could influence patient survival, and the group of patients receiving ketorolac systematically showed a better outcome. Uni- and multivariate analyses confirmed that administration of ketorolac intraoperatively was associated with better progression-free survival (HR = 0.47 on univariate analysis and 0.43 on multivariate analysis, p = 0.003 and 0.023, respectively). In terms of complications, there were no differences between the two groups, either intraoperatively or postoperatively. Conclusion: Our study has shown a favourable association between the use of ketorolac during surgery and the postoperative progression of ovarian cancer in a group of 166 patients, without any rise in intra- or postoperative complications. These encouraging results point to the need for a prospective study to confirm the benefit of intraoperative administration of ketorolac in ovarian cancer surgery. Full article
(This article belongs to the Special Issue State of the Art: Surgery for Gynecologic Oncology)
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17 pages, 653 KiB  
Systematic Review
Malignancy in Abdominal Wall Endometriosis: Is There a Way to Avoid It? A Systematic Review
by Julie Alaert, Mathilde Lancelle, Marie Timmermans, Panayiotis Tanos, Michelle Nisolle and Stavros Karampelas
J. Clin. Med. 2024, 13(8), 2282; https://doi.org/10.3390/jcm13082282 - 15 Apr 2024
Viewed by 466
Abstract
Background: Malignant-associated abdominal wall endometriosis (AWE) is a rare pathology, likely to occur in 1% of scar endometriosis. The objectives of this study were to update the evidence on tumor degeneration arising from AWE to notify about the clinical characteristics, the different treatments [...] Read more.
Background: Malignant-associated abdominal wall endometriosis (AWE) is a rare pathology, likely to occur in 1% of scar endometriosis. The objectives of this study were to update the evidence on tumor degeneration arising from AWE to notify about the clinical characteristics, the different treatments offered to patients and their outcomes. Methods: A comprehensive systematic review of the literature was conducted. PubMed, Embase and Cochrane Library databases were used. Prospero (ID number: CRD42024505274). Results: Out of the 152 studies identified, 63 were included, which involved 73 patients. The main signs and symptoms were a palpable abdominal mass (85.2%) and cyclic pelvic pain (60.6%). The size of the mass varied between 3 and 25 cm. Mean time interval from the first operation to onset of malignant transformation was 20 years. Most common cancerous histological types were clear cell and endometrioid subtypes. Most widely accepted treatment is the surgical resection of local lesions with wide margins combined with adjuvant chemotherapy. The prognosis for endometriosis-associated malignancy in abdominal wall scars is poor, with a five-year survival rate of around 40%. High rates of relapse have been reported. Conclusions: Endometrial implants in the abdominal wall should be considered as preventable complications of gynecological surgeries. Special attention should be paid to women with a history of cesarean section or uterine surgery. Full article
(This article belongs to the Special Issue State of the Art: Surgery for Gynecologic Oncology)
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