154 results found
Raglan O, Kalliala I, Markozannes G, et al., 2019, Risk factors for endometrial cancer: An umbrella review of the literature, International Journal of Cancer, Vol: 145, Pages: 1719-1730, ISSN: 0020-7136
Although many risk factors could have causal association with endometrial cancer, they are also prone to residual confounding or other biases which could lead to over‐ or underestimation. This umbrella review evaluates the strength and validity of evidence pertaining risk factors for endometrial cancer.Systematic reviews or meta‐analyses of observational studies evaluating the association between non‐genetic risk factors and risk of developing or dying from endometrial cancer were identified from inception to April 2018 using PubMed, the Cochrane database and manual reference screening. Evidence was graded strong, highly suggestive, suggestive or weak based on statistical significance of random‐effects summary estimate, largest study included, number of cases, between‐study heterogeneity, 95% prediction intervals, small study effects, excess significance bias and sensitivity analysis with credibility ceilings.We identified 171 meta‐analyses investigating associations between 53 risk factors and endometrial cancer incidence and mortality. Risk factors were categorised: anthropometric indices, dietary intake, physical activity, medical conditions, hormonal therapy use, biochemical markers, gynaecological history and smoking. Of 127 meta‐analyses including cohort studies, three associations were graded with strong evidence. Body mass index and waist‐to‐hip ratio were associated with increased cancer risk in premenopausal women (RR per 5 kg/m2 1.49; CI 1.39–1.61) and for total endometrial cancer (RR per 0.1unit 1.21; CI 1.13–1.29), respectively. Parity reduced risk of disease (RR 0.66, CI 0.60–0.74).Of many proposed risk factors, only three had strong association without hints of bias. Identification of genuine risk factors associated with endometrial cancer may assist in developing targeted prevention strategies for women at high risk.
Athanasiou A, Veroniki AA, Efthimiou O, et al., Comparative fertility and pregnancy outcomes after local treatment for cervical intra-epithelial neoplasia and stage 1a1 cervical cancer: protocol for a systematic review and network meta-analysis from the CIRCLE Group, BMJ Open, ISSN: 2044-6055
Introduction: There are several local treatment methods for cervical intra-epithelial neoplasia that remove or ablate a cone-shaped part of the uterine cervix. There is evidence to suggest that these increase the risk of preterm birth and that this is higher for techniques that remove larger parts of the cervix, although the data is conflicting. We present a protocol for a systematic review and network meta-analysis that will update the evidence and compare all treatments in terms of fertility and pregnancy complications. Methods and Analysis: We will search electronic databases (CENTRAL, MEDLINE, EMBASE) from inception till October 2019, in order to identify randomised controlled trials (RCTs) and cohort studies comparing the fertility and pregnancy outcomes amongst different excisional and ablative treatment techniques and/or to untreated controls. The primary outcome will be preterm birth (PTB; <37weeks). Secondary outcomes will include severe or extreme PTB, prelabour rupture of membranes, low birth weight (<2500gr), neonatal intensive care unit admission, perinatal mortality, total pregnancy rates, 1st and 2nd trimester miscarriage. We will search for published and unpublished studies in electronic databases, trial registries and we will hand-search references of published papers. We will assess the risk of bias in RCTs and cohort studies using tools developed by the Cochrane Collaboration. Two investigators will independently assess the eligibility, abstract the data and assess the risk of bias of the identified studies. For each outcome, we will perform a meta-analysis for each treatment comparison and a network meta-analysis once the transitivity assumption holds, using the odds ratio for dichotomous data. We will use CINEMA to assess the quality of the evidence for the primary outcome.Ethics and dissemination: Ethical approval is not required. Results will be disseminated to academic beneficiaries, medical practitioners, patients and the public.PROSPE
Hall M, Savvatis K, Nixon K, et al., 2019, Maximal-effort cytoreductive surgery for ovarian cancer patients with a high tumor burden: variations in practice and impact on outcome, Annals of Surgical Oncology, Vol: 26, Pages: 2943-2951, ISSN: 1068-9265
BackgroundThis study aimed to compare the outcomes of two distinct patient populations treated within two neighboring UK cancer centers (A and B) for advanced epithelial ovarian cancer (EOC).MethodsA retrospective analysis of all new stages 3 and 4 EOC patients treated between January 2013 and December 2014 was performed. The Mayo Clinic surgical complexity score (SCS) was applied. Cox regression analysis identified the impact of treatment methods on survival.ResultsThe study identified 249 patients (127 at center A and 122 in centre B) without significant differences in International Federation of Gynecology and Obstetrics (FIGO) stage (FIGO 4, 29.7% at centers A and B), Eastern Cooperative Oncology Group (ECOG) performance status (ECOG < 2, 89.9% at centers A and B), or histology (serous type in 84.1% at centers A and B). The patients at center A were more likely to undergo surgery (87% vs 59.8%; p < 0.001). The types of chemotherapy and the patients receiving palliative treatment alone were equivalent between the two centers (3.6%). The median SCS was significantly higher at center A (9 vs 2; p < 0.001) with greater tumor burden (9 vs 6 abdominal fields involved; p < 0.001), longer median operation times (285 vs 155 min; p < 0.001), and longer hospital stays (9 vs 6 days; p < 0.001), but surgical morbidity and mortality were equivalent. The independent predictors of reduced overall survival (OS) were non-serous histology (hazard ratio [HR], 1.6; 95% confidence interval [CI] 1.04–2.61), ECOG higher than 2 (HR, 1.9; 95% CI 1.15–3.13), and palliation alone (HR, 3.43; 95% CI 1.51–7.81). Cytoreduction, of any timing, had an independent protective impact on OS compared with chemotherapy alone (HR, 0.31 for interval surgery and 0.39 for primary surgery), even after adjustment for other prognostic factors.ConclusionsIncorporating surgery into the initia
Athanasiou A, Veroniki A, Efthimiou O, et al., Comparative efficacy and complication rates after local treatment for cervical intra-epithelial neoplasia and stage 1a1 cervical cancer: protocol for a systematic review and network meta-analysis from the CIRCLE Group, BMJ Open, ISSN: 2044-6055
Introduction: Local treatments for cervical intra-epithelial neoplasia (CIN) and microinvasive disease remove or ablate a cone-shaped part of the uterine cervix containing theabnormal cells. A trend towards less radical techniques has raised concerns that this mayadversely impact the rates of precancerous and cancerous recurrence. However, there hasbeen no strong evidence to support such claims. We hereby describe a protocol of asystematic review and network meta-analysis that will update the evidence and compare allrelevant treatments in terms of efficacy and complications.Methods and Analysis: Literature searches in electronic databases (CENTRAL, MEDLINE,EMBASE) or trial registries will identify published and unpublished randomised controlledtrials (RCTs) and cohort studies comparing the efficacy and complications amongst differentexcisional and ablative techniques. The excisional techniques include cold knife, laser orfischer cone, large loop or needle excision of the transformation zone and the ablative radicalpoint diathermy, cryotherapy, cold coagulation or laser ablation. The primary outcome willbe residual/recurrent disease defined as abnormal histology or cytology of any grade, whilesecondary outcomes will include treatment failure rates defined as high-grade histology orcytology, histologically-confirmed CIN1+ or histologically-confirmed CIN2+, HPVpositivity rates, involved margins rates, bleeding and cervical stenosis rates. We will assessthe risk of bias in RCTs and observational studies using tools developed by the CochraneCollaboration. Two authors will independently assess study eligibility, abstract the data, andassess the risk of bias. Random-effects meta-analyses and network meta-analyses will beconducted using the odds ratio for dichotomous outcomes and the mean difference forcontinuous outcomes. The quality of the evidence for the primary outcome will be assessedusing the CINEMA tool.
Kyrgiou M, Valasoulis G, Stasinou S-M, et al., 2019, Proportion of cervical excision for cervical intraepithelial neoplasia as a predictor of pregnancy outcomes (vol 128, pg 141, 2015), INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS, Vol: 146, Pages: 392-392, ISSN: 0020-7292
Joura EA, Kyrgiou M, Bosch FX, et al., 2019, Human papillomavirus vaccination: The ESGO-EFC position paper of the European society of Gynaecologic Oncology and the European Federation for colposcopy, EUROPEAN JOURNAL OF CANCER, Vol: 116, Pages: 21-26, ISSN: 0959-8049
Raglan O, Assi N, Nautiyal J, et al., 2019, Proteomic analysis of malignant and benign endometrium according to obesity and insulin resistance status using reverse phase protein array, Publisher: WILEY, Pages: 81-81, ISSN: 1470-0328
Wiik J, Sengpiel V, Kyrgiou M, et al., 2019, Cervical microbiota in women with cervical intra-epithelial neoplasia, prior to and after local excisional treatment, a Norwegian cohort study, BMC Women's Health, Vol: 19, ISSN: 1472-6874
BackgroundLocal treatment for cervical intraepithelial neoplasia (CIN) by Loop Electrosurgical Excision Procedure (LEEP) has been correlated with reproductive morbidity, while the cervicovaginal microbiota is also known to affect the risk of preterm delivery. CIN and treatment by LEEP might change the cervical microbiota. The main aim of this study was to describe the cervical microbiota before and after LEEP and assess its associaton with cone depth and HPV persistence. Further, we aimed to compare the microbiota to references with normal cervical cytology.MethodsBetween 2005 and 2007, we prospectively identified 89 women planned for LEEP in a Norwegian hospital and recruited 100 references with a normal cervical cytology. Endocervical swabs were collected prior to treatment and at six (n = 77) and 12 months (n = 72) post LEEP for bacterial culture and PCR, and post LEEP for DNA testing for human papillomavirus (HPV). We compared the cervical microbiota composition before and after treatment and between women planned for LEEP vs references.ResultsThere was a reduction in the number of non-Lactobacillus bacterial species six and 12 months after LEEP compared to before treatment and a tendency towards a concomitant increase in Lactobacillus. No association between the detection of cervical bacteria, HPV persistence or cone depth was found.Women planned for LEEP carried significantly more Bacteroides spp., Gardnerella vaginalis, Mycoplasma hominis and Ureaplasma parvum as well as a greater number of bacterial species than the references.ConclusionsLocal excisional treatment appears to alter the cervical microbiota towards a less diverse microbiota. Women with CIN have a more diverse cervical microbiota compared to women with normal cervical cytology.
Tsagkas N, Siafaka V, Tzallas A, et al., 2019, Knowledge and beliefs about HPV infection and the relevant vaccination in Greek young population, EUROPEAN JOURNAL OF GYNAECOLOGICAL ONCOLOGY, Vol: 40, Pages: 557-562, ISSN: 0392-2936
Dilley J, Pratt P, Kyrgiou M, et al., 2018, Current and future use of radiological images in the management of gynecological malignancies - a survey of practice in the UK, Anticancer Research, Vol: 38, Pages: 5867-5876, ISSN: 0250-7005
Background/Aim: Radiology provides increasingly accurate and complex information. Understanding the clinicians' interpretation of scans could improve surgical planning, decision-making; informed training and development of augmented imaging. This was a survey exploring the interpretation of imaging by clinicians and its use in operative preparation and prediction. Materials and Methods: The survey was open for two-months and circulated online to British Gynaecological Cancer society members. Results: Seventy-three (19%) members completed the survey. Respondents had a confidence level of 51% in their ability to interpret computed tomography (CT) and/or magnetic resonance imaging (MRI) images independently. Preoperative imaging was commonly used to plan operations, predict complications and complete resection. Images were reviewed for primary (96.3%)/interval (92.6%) ovarian debulking, but less so for vulvectomy (45%). Scan (79.6%) and multidisciplinary team meeting (MDT) (66.6%) reports were used more often than scan images (50%) for operative planning. Amount and pattern of disease on scan were the most important factors predicting operating time. Conclusion: Imaging influences the surgeon's planning, however respondents lack confidence. Training of clinicians in radiological interpretation needs to improve. Augmented image interfaces could facilitate this.
Lathouras K, Saso S, Tzafetas M, et al., 2018, Genetic polymorphisms of matrix metalloproteinases 1-3 and their inhibitor are not associated with premature labor, FUTURE SCIENCE OA, Vol: 4, ISSN: 2056-5623
Dardiotis E, Siokas V, Garas A, et al., 2018, Genetic variations in the SULF1 gene alter the risk of cervical cancer and precancerous lesions, ONCOLOGY LETTERS, Vol: 16, Pages: 3833-3841, ISSN: 1792-1074
Paraskevaidi M, Morais CLM, Raglan O, et al., 2018, Aluminium foil as an alternative substrate for the spectroscopic interrogation of endometrial cancer, JOURNAL OF BIOPHOTONICS, Vol: 11, ISSN: 1864-063X
Tzafetas M, Mitra A, Kalliala I, et al., 2018, Fertility-sparing surgery for presumed early-stage invasive cervical cancer: a survey of practice in the United Kingdom., Anticancer Research, Vol: 38, Pages: 3641-3646, ISSN: 0250-7005
AIM: To explore current practice in fertility-sparing surgery for cervical cancer in the UK. MATERIALS AND METHODS: A web-based structured questionnaire was designed and circulated to all members of the British Gynaecological Cancer Society. RESULTS: From 111 recipients, a total of 49 responses were collected. The majority of centres treated between 20-29 cases of invasive cervical cancer surgically (21/49, 42.9%) and performed between 0-5 cases of radical trachelectomy annually (29/49, 59.2%). The vaginal approach was the one most commonly used and was offered by almost half of the centres (21/49, 42.9%); laparoscopic techniques were offered in 13 (13/49, 26.6%). The responses were divided as to whether these cases should have been referred to supra-regional centres (25/49, 51.0%). CONCLUSION: With the use of Human Papillomavirus vaccination leading to a projected decrease in the number of cervical cancer incidence, patients may need to be referred to supraregional centres in the future.
Markozannes G, Kalliala I, Kyrgiou M, et al., 2018, Letter to the editor on "Body mass index and 20-specific cancers - re-analyses of dose-response meta-analyses of observational studies", Annals of Oncology, Vol: 29, Pages: 1490-1491, ISSN: 0923-7534
Tzafetas M, Mitra A, Kalliala I, et al., 2018, iKnife - improving surgical outcomes in pre-invasive and invasive cervical disease, RCOG World Congress 2018, Publisher: Wiley, Pages: 17-17, ISSN: 1470-0328
Tainio K, Athanasiou A, Tikkinen KAO, et al., 2018, Clinical course of untreated cervical intraepithelial neoplasia grade 2 under active surveillance: systematic review and meta-analysis, BMJ, Vol: 360, Pages: k499-k499, ISSN: 0959-8138
OBJECTIVE: To estimate the regression, persistence, and progression of untreated cervical intraepithelial neoplasia grade 2 (CIN2) lesions managed conservatively as well as compliance with follow-up protocols. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Medline, Embase, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) from 1 January 1973 to 20 August 2016. ELIGIBILITY CRITERIA: Studies reporting on outcomes of histologically confirmed CIN2 in non-pregnant women, managed conservatively for three or more months. DATA SYNTHESIS: Two reviewers extracted data and assessed risk of bias. Random effects model was used to calculate pooled proportions for each outcome, and heterogeneity was assessed using I2statistics. MAIN OUTCOME MEASURES: Rates of regression, persistence, or progression of CIN2 and default rates at different follow-up time points (3, 6, 12, 24, 36, and 60 months). RESULTS: 36 studies that included 3160 women were identified (seven randomised trials, 16 prospective cohorts, and 13 retrospective cohorts; 50% of the studies were at low risk of bias). At 24 months, the pooled rates were 50% (11 studies, 819/1470 women, 95% confidence interval 43% to 57%; I2=77%) for regression, 32% (eight studies, 334/1257 women, 23% to 42%; I2=82%) for persistence, and 18% (nine studies, 282/1445 women, 11% to 27%; I2=90%) for progression. In a subgroup analysis including 1069 women aged less than 30 years, the rates were 60% (four studies, 638/1069 women, 57% to 63%; I2=0%), 23% (two studies, 226/938 women, 20% to 26%; I2=97%), and 11% (three studies, 163/1033 women, 5% to 19%; I2=67%), respectively. The rate of non-compliance (at six to 24 months of follow-up) in prospective studies was around 10%. CONCLUSIONS: Most CIN2 lesions, particularly in young women (<30 years), regress spontaneously. Active surveillance, rather than immediate intervention, is therefore justified, especially among young women who are likely to adhere to mon
Arbyn M, Redman CWE, Verdoodt F, et al., 2017, Incomplete excision of cervical precancer as a predictor of treatment failure: a systematic review and meta-analysis., Lancet Oncology, Vol: 18, Pages: 1665-1679, ISSN: 1470-2045
BACKGROUND: Incomplete excision of cervical precancer is associated with therapeutic failure and is therefore considered as a quality indicator of clinical practice. Conversely, the risk of preterm birth is reported to correlate with size of cervical excision and therefore balancing the risk of adequate treatment with iatrogenic harm is challenging. We reviewed the literature with an aim to reveal whether incomplete excision, reflected by presence of precancerous tissue at the section margins, or post-treatment HPV testing are accurate predictors of treatment failure. METHODS: We did a systematic review and meta-analysis to assess the risk of therapeutic failure associated with the histological status of the margins of the tissue excised to treat cervical precancer. We estimated the accuracy of the margin status to predict occurrence of residual or recurrent high-grade cervical intraepithelial neoplasia of grade two or worse (CIN2+) and compared it with post-treatment high-risk human papillomavirus (HPV) testing. We searched for published systematic reviews and new references from PubMed-MEDLINE, Embase, and CENTRAL and did also a new search spanning the period Jan 1, 1975, until Feb 1, 2016. Studies were eligible if women underwent treatment by excision of a histologically confirmed CIN2+ lesion, with verification of presence or absence of CIN at the resection margins; were tested by cytology or HPV assay between 3 months and 9 months after treatment; and had subsequent follow-up of at least 18 months post-treatment including histological confirmation of the occurrence of CIN2+. Primary endpoints were the proportion of positive section margins and the occurrence of treatment failure associated with the marginal status, in which treatment failure was defined as occurrence of residual or recurrent CIN2+. Information about positive resection margins and subsequent treatment failure was pooled using procedures for meta-analysis of binomial data and analysed using rando
Kyrgiou M, Athanasiou A, Kalliala IEJ, et al., 2017, Obstetric outcomes after conservative treatment for cervical intraepithelial lesions and early invasive disease., Cochrane Database of Systematic Reviews, Vol: 11, ISSN: 1469-493X
BACKGROUND: The mean age of women undergoing local treatment for pre-invasive cervical disease (cervical intra-epithelial neoplasia; CIN) or early cervical cancer (stage IA1) is around their 30s and similar to the age of women having their first child. Local cervical treatment has been correlated to adverse reproductive morbidity in a subsequent pregnancy, however, published studies and meta-analyses have reached contradictory conclusions. OBJECTIVES: To assess the effect of local cervical treatment for CIN and early cervical cancer on obstetric outcomes (after 24 weeks of gestation) and to correlate these to the cone depth and comparison group used. SEARCH METHODS: We searched the following databases: Cochrane Central Register of Controlled Trials (CENTRAL; the Cochrane Library, 2017, Issue 5), MEDLINE (up to June week 4, 2017) and Embase (up to week 26, 2017). In an attempt to identify articles missed by the search or unpublished data, we contacted experts in the field and we handsearched the references of the retrieved articles and conference proceedings. SELECTION CRITERIA: We included all studies reporting on obstetric outcomes (more than 24 weeks of gestation) in women with or without a previous local cervical treatment for any grade of CIN or early cervical cancer (stage IA1). Treatment included both excisional and ablative methods. We excluded studies that had no untreated reference population, reported outcomes in women who had undergone treatment during pregnancy or had a high-risk treated or comparison group, or both DATA COLLECTION AND ANALYSIS: We classified studies according to the type of treatment and the obstetric endpoint. Studies were classified according to method and obstetric endpoint. Pooled risk ratios (RR) and 95% confidence intervals (CIs) were calculated using a random-effects model and inverse variance. Inter-study heterogeneity was assessed with I2 statistics. We assessed maternal outcomes that included preterm birth (PTB) (spontaneous a
Arbyn M, Charles R, Verdoodt F, et al., 2017, PREDICTION OF THE OUTCOME AFTER EXCISION OF CERVICAL PRECANCER BY THE RESECTION MARGINS OR BY POST-TREATMENT HPV TESTING: A SYSTEMATIC REVIEW AND META-ANALYSIS, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: 1910-1910, ISSN: 1048-891X
Tainio K, Athanasiou A, Tikkinen K, et al., 2017, NATURAL HISTORY OF CERVICAL INTRAEPITHELIAL NEOPLASIA GRADE 2 UNDER ACTIVE SURVEILLANCE - A SYSTEMATIC REVIEW AND META-ANALYSIS, Publisher: BMJ PUBLISHING GROUP, Pages: 893-893, ISSN: 1048-891X
Raglan O, Doria L, Soares R, et al., 2017, ENDOMETRIAL CANCER TISSUE HAS A UNIQUE PHOSPHOLIPID SIGNATURE IDENTIFIABLE USING DESORPTION ELECTROSPRAY IONISATION (DESI) IMAGING, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: 454-454, ISSN: 1048-891X
Raglan O, Doria L, Soares R, et al., 2017, ENDOMETRIAL CANCER TISSUE HAS A UNIQUE PHOSPHOLIPID SIGNATURE IDENTIFIABLE USING DESORPTION ELECTROSPRAY IONISATION (DESI) IMAGING, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: 1195-1195, ISSN: 1048-891X
Mitra A, MacIntyre D, Lee Y, et al., 2017, THE VAGINAL MICROBIOTA AFTER EXCISIONAL TREATMENT FOR CERVICAL INTRAEPITHELIAL NEOPLASIA, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: 979-979, ISSN: 1048-891X
Tainio K, Athanasiou A, Tikkinen K, et al., 2017, NATURAL HISTORY OF CERVICAL INTRAEPITHELIAL NEOPLASIA GRADE 2 UNDER ACTIVE SURVEILLANCE - A SYSTEMATIC REVIEW AND META-ANALYSIS, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: 25-25, ISSN: 1048-891X
kalliala I, Markozannes G, Gunter M, et al., 2017, Obesity and gynaecological and obstetrical conditions: an umbrella review of the literature, British Medical Journal, Vol: 7, ISSN: 0959-8138
Objective To study the strength and validity of associations between adiposity and risk of any type of obstetric or gynaecological conditions.Design An umbrella review of meta-analyses.Data sources PubMed, Cochrane database of systematic reviews, manual screening of references for systematic reviews or meta-analyses of observational and interventional studies evaluating the association between adiposity and risk of any obstetrical or gynaecological outcome.Main outcomes Meta-analyses of cohort studies on associations between indices of adiposity and obstetric and gynaecological outcomes.Data synthesis Evidence from observational studies was graded into strong, highly suggestive, suggestive, or weak based on the significance of the random effects summary estimate and the largest study in the included meta-analysis, the number of cases, heterogeneity between studies, 95% prediction intervals, small study effects, excess significance bias, and sensitivity analysis with credibility ceilings. Interventional meta-analyses were assessed separately.Results 156 meta-analyses of observational studies were included, investigating associations between adiposity and risk of 84 obstetric or gynaecological outcomes. Of the 144 meta-analyses that included cohort studies, only 11 (8%) had strong evidence for eight outcomes: adiposity was associated with a higher risk of endometrial cancer, ovarian cancer, antenatal depression, total and emergency caesarean section, pre-eclampsia, fetal macrosomia, and low Apgar score. The summary effect estimates ranged from 1.21 (95% confidence interval 1.13 to 1.29) for an association between a 0.1 unit increase in waist to hip ratio and risk endometrial cancer up to 4.14 (3.61 to 4.75) for risk of pre-eclampsia for BMI >35 compared with <25. Only three out of these eight outcomes were also assessed in meta-analyses of trials evaluating weight loss interventions. These interventions significantly reduced the risk of caesarean section and pre
Nasser S, Kyrgiou M, Krell J, et al., 2017, A Review of Thoracic and Mediastinal Cytoreductive Techniques in Advanced Ovarian Cancer: Extending the Boundaries, Annals of Surgical Oncology, Vol: 24, Pages: 3700-3705, ISSN: 1068-9265
The aim of this study was to review the surgical and clinical outcomes of intrathoracic and mediastinal surgical cytoreduction in stage IV epithelial ovarian cancer (EOC). Relevant articles were identified from MEDLINE and EMBASE. Only analyses or reports that described actual intrathoracic cytoreduction via pleurectomy and/or resection of cardiophrenic/mediastinal lymph nodes were included. Imaging articles that merely described thoracic tumor patterns were excluded. A total of nine studies were identified, the oldest originating in 2007. Procedures described were transdiaphragmatic resection of cardiophrenic lymph nodes and pleural disease (n = 5) and video-assisted thoracoscopic and mediastinal tumorectomies including pleurectomy (n = 4). The number of operated patients ranged between 1 and 30 with complete cytoreduction rates ranging between 68 and 100%. No surgical deaths directly related to the thoracic cytoreduction were reported and only one patient (1/30) experienced a postoperative complication in terms of a pneumothorax. None of the studies presented a direct comparison of survival to patients with thoracic disease who did not undergo thoracic cytoreduction, and therefore the survival benefit of thoracic cytoreduction could not be quantified. In conclusion, thoracic cytoreduction in advanced EOC seems feasible and with acceptable morbidity while offering a better understanding of the extent of disease and hence allowing the tailoring of intraabdominal resections. Nevertheless, its direct impact on patients’ survival by a potential overruling of a more adverse tumor biology remains to be established in larger-scale prospective and ideally randomized trials.
Mitra A, Mahajan V, Macintyre D, et al., 2017, Comparison of vaginal microbiota sampling techniques: cytobrush versus swab, Scientific Reports, Vol: 7, ISSN: 2045-2322
Evidence suggests the vaginal microbiota (VM) may influence risk of persistent Human Papillomavirus (HPV) infection and cervical carcinogenesis. Established cytology biobanks, typically collected with a cytobrush, constitute a unique resource to study such associations longitudinally. It is plausible that compared to rayon swabs; the most commonly used sampling devices, cytobrushes may disrupt biofilms leading to variation in VM composition. Cervico-vaginal samples were collected with cytobrush and rayon swabs from 30 women with high-grade cervical precancer. Quantitative PCR was used to compare bacterial load and Illumina MiSeq sequencing of the V1-V3 regions of the 16S rRNA gene used to compare VM composition. Cytobrushes collected a higher total bacterial load. Relative abundance of bacterial species was highly comparable between sampling devices (R2 = 0.993). However, in women with a Lactobacillus-depleted, high-diversity VM, significantly less correlation in relative species abundance was observed between devices when compared to those with a Lactobacillus species-dominant VM (p = 0.0049). Cytobrush and swab sampling provide a comparable VM composition. In a small proportion of cases the cytobrush was able to detect underlying high-diversity community structure, not realized with swab sampling. This study highlights the need to consider sampling devices as potential confounders when comparing multiple studies and datasets.
Halliwell DE, Morais CLM, Lima KMG, et al., 2017, An imaging dataset of cervical cells using scanning near-field optical microscopy coupled to an infrared free electron laser, SCIENTIFIC DATA, Vol: 4, ISSN: 2052-4463
Using a scanning near-field optical microscope coupled to an infrared free electron laser (SNOM-IR-FEL) in low-resolution transmission mode, we collected chemical data from whole cervical cells obtained from 5 pre-menopausal, non-pregnant women of reproductive age, and cytologically classified as normal or with different grades of cervical cell dyskaryosis. Imaging data are complemented by demography. All samples were collected before any treatment. Spectra were also collected using attenuated total reflection, Fourier-transform (ATR-FTIR) spectroscopy, to investigate the differences between the two techniques. Results of this pilot study suggests SNOM-IR-FEL may be able to distinguish cervical abnormalities based upon changes in the chemical profiles for each grade of dyskaryosis at designated wavelengths associated with DNA, Amide I/II, and lipids. The novel data sets are the first collected using SNOM-IR-FEL in transmission mode at the ALICE facility (UK), and obtained using whole cells as opposed to tissue sections, thus providing an ‘intact’ chemical profile. These data sets are suited to complementing future work on image analysis, and/or applying the newly developed algorithm to other datasets collected using the SNOM-IR-FEL approach.
Kyrgiou M, Bennett P, 2017, Can we prevent preterm birth after radical trachelectomy?, British Journal of Obstetrics and Gynaecology, Vol: 124, Pages: 1737-1737, ISSN: 0306-5456
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