Clinical Advances in Gynaecological Cancer Management

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 (20 November 2022) | Viewed by 4190

Special Issue Editor


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Guest Editor
Unit of Obstetrics and Gynaecology, Maternal and Child Department, Giovanni Paolo II Hospital, 88046 Lamezia Terme, Catanzaro, Italy
Interests: gynecology; gynecologic oncology; endometriosi; uterine fibroid; fertility preservation

Special Issue Information

Dear Colleagues,

Gynecological cancer research activity is continuously increasing. Results from both clinical and translational research studies represent the primum movens to hugely accelerate the discovery of new strategies for the prevention, early diagnosis, and treatment of cancers. In this Special Issue, we would like to underline how discoveries that have occurred over the last 10 years are improving the knowledge about the intrinsic biological behavior of gynecological cancer, consequently improving the property in patient care. Let us think, for example, of the impact that research has had in improving the personalized treatment of patients with endometrial cancer, a cancer that was previously poorly studied by translational research. Moreover, there is an improvement about the new therapeutic approaches for ovarian cancer and the news about the role of a more or less radical surgery. In addition, new cancer risk stratification strategies have been obtained for women with uterine masses. These strategies are helping to improve the clinician’s ability to discriminate between patients with uterine sarcoma and women with benign diseases, in order to guide the clinician’s choice towards the most appropriate treatment.

Dr. Annalisa Di Cello
Guest Editor

Manuscript Submission Information

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Keywords

  • gynecological cancer
  • biological cancer behavior
  • translational research
  • cancer risk stratification
  • cancer prevention
  • cancer treatment

Published Papers (2 papers)

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Research

25 pages, 2013 KiB  
Article
The Utility of Pre-Treatment Inflammation Markers as Associative Factors to the Adverse Outcomes of Vulvar Cancer: A Study on Staging, Nodal Involvement, and Metastasis Models
by Hariyono Winarto, Muhammad Habiburrahman, Tricia Dewi Anggraeni, Kartiwa Hadi Nuryanto, Renny Anggia Julianti, Gatot Purwoto and Andrijono Andrijono
J. Clin. Med. 2023, 12(1), 96; https://doi.org/10.3390/jcm12010096 - 22 Dec 2022
Cited by 2 | Viewed by 1935
Abstract
Background: Given the role of inflammation in carcinogenesis, this study investigated the utility of pre-treatment inflammatory markers as associative indicators for advanced-stage disease, lymph node metastasis (LNM), and distant metastasis (DM) in vulvar cancer (VC). Methods: A cross-sectional study was conducted on 86 [...] Read more.
Background: Given the role of inflammation in carcinogenesis, this study investigated the utility of pre-treatment inflammatory markers as associative indicators for advanced-stage disease, lymph node metastasis (LNM), and distant metastasis (DM) in vulvar cancer (VC). Methods: A cross-sectional study was conducted on 86 women with VC in a single centre in Jakarta, Indonesia. The laboratory data was based on C-reactive protein (CRP), procalcitonin, the erythrocyte sedimentation rate (ESR) and fourteen derived, recorded and calculated ratios: leukocyte-to-platelet (LPR), neutrophil-to-lymphocyte (NLR), derived neutrophil-to-lymphocyte (dNLR), neutrophil-to-monocyte (NMR), platelet-to-monocyte (PLR), lymphocyte-to-monocyte (LMR), basophil-to-monocyte (BLR), systemic immune-inflammation index (SII), body mass index, albumin, and NLR (BAN) score, haemoglobin-to-platelet (HPR), prognostic nutritional index (PNI), modified Glasgow Prognostic Score (mGPS), CRP-to-albumin, and CRP-to-procalcitonin. The optimal cut-off for each marker was determined using receiver operating characteristic (ROC) curve analysis, and their diagnostic indicator performances were assessed. The utility of these ratios as associative factors for three endpoints was further evaluated in multivariate regression models. Results: Investigated inflammatory markers exhibited specific performances for individual adverse outcomes, proving a fair to excellent ability in case finding and screening. After adjustment, the BAN score ≤ 334.89 (OR 9.20, p = 0.001) and ESR ≥ 104 (OR 4.18, p = 0.048) become two advanced-stage associative factors with AUC: 0.769. LNM was solely determined by higher NLR ≥ 2.83 (OR 4.15, p = 0.014) with AUC: 0.615. Meanwhile, BLR ≥ 0.035 (OR 5.67, p = 0.001) and ESR ≥ 84 (OR 6.01, p = 0.003) were contributing factors for DM, with AUC: 0.765. Conclusions: Inflammatory markers are crucial for identifying the deleterious outcomes of VC. Accordingly, yielded models require external validation. Full article
(This article belongs to the Special Issue Clinical Advances in Gynaecological Cancer Management)
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9 pages, 2352 KiB  
Article
Patient-Derived Training Simulator for Image-Guided Adaptive Brachytherapy of Locally Advanced Cervical Cancers: Development and Initial Use
by Kento Tomizawa, Takahiro Oike, Ken Ando, Daisuke Irie, Makoto Sakai, Hirofumi Shimada and Tatsuya Ohno
J. Clin. Med. 2022, 11(11), 3103; https://doi.org/10.3390/jcm11113103 - 30 May 2022
Cited by 2 | Viewed by 1736
Abstract
Image-guided adaptive brachytherapy (IGABT) using intracavitary and interstitial (IC/IS) techniques plays a pivotal role in definitive radiotherapy for locally advanced cervical cancers. However, the training opportunities for interstitial needle application are limited, preventing this technique from becoming widespread. This study aimed to develop [...] Read more.
Image-guided adaptive brachytherapy (IGABT) using intracavitary and interstitial (IC/IS) techniques plays a pivotal role in definitive radiotherapy for locally advanced cervical cancers. However, the training opportunities for interstitial needle application are limited, preventing this technique from becoming widespread. This study aimed to develop a training simulator for IC/IS brachytherapy. The simulator consists of a soft silicone tumor phantom and acrylic tube mimicking the vagina; it has high visibility because of translucent materials and is compatible with computed tomography (CT) and magnetic resonance imaging (MRI). A patient harboring a typical bulky and irregular-shaped cervical tumor was selected from 495 in-house IGABT-treated candidates, and a tumor phantom (68 × 49 × 45 mm) modeled on this patient was produced from three-dimensional real-scale measurements of the MRI-based high-risk clinical target volume at first brachytherapy. In trial use by two physicians with different levels of IGABT skills, a Fletcher-Suit Asian Pacific applicator, and a Venezia applicator with interstitial needles were nicely applied to the simulator, facilitating successful creation of CT-based treatment plans consistent with clinical practice. Thus, the training simulator can be useful for the training of IC/IS brachytherapy, and warrants further research employing a greater number of phantoms and practitioners to verify its educational value. Full article
(This article belongs to the Special Issue Clinical Advances in Gynaecological Cancer Management)
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