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Several techniques can be proposed as fertility sparing surgery in young patients treated for cervical cancer but uncertaincies remain concerning their outcomes. Analysis of oncological issues is then the first aim of this review in order to evaluate the best strategy.Data were identified from searches of MEDLINE, Current Contents, PubMed and from references in relevant articles from January 1987 to 15th of September 2021. We carry out an updated systematic review involving 5862 patients initially selected for fertility-sparing surgery in 275 series.In patients having a stage IB1 disease, recurrence rate/RR in patients undergoing simple conisation/trachelectomy, radical trachelectomy/RT by laparoscopico-vaginal approach, laparotomic or laparoscopic approaches are respectively: 4.1%, 4.7%, 2.4% and 5.2%. In patients having a stage IB2 disease, RR after neoadjuvant chemotherapy or RT by laparotomy are respectively 13.2% and 4.8% (p = .0035). After neoadjuvant treatment a simple cone/trachelectomy was carried out in 91 (30%) patients and a radical one in 210 (70%) cases. But the lowest pregnancy rate is observed in patients undergoing RT by laparotomy (36%).The choice between these treatments should be based above all, on objective oncological data that strike a balance for each procedure between the best chances for cure and the fertility results. In patients having a stage IB1 disease, oncological results are quite similar according to the procedure used. In patients having a stage IB2 disease, RT by open approach has the lowest RR. Anyway the lowest pregnancy rate is observed in patients undergoing RT by laparotomy.

Introduction/Background Ovarian serous borderline tumors with invasive peritoneal implants (SBOT-IPI) are associated with serous low grade carcinomas (SLGC) in the 2016 WHO classification of ovarian neoplasms. Even if SBOT-IPI can relapse as SLGC in 30% of cases, long term survival is not well known. The aim of this study was to describe the frequency and the characteristics of the recurrences of OSBT-IPI. Methodology Retrospective study of patients referred to our institution, from 1971 to 2018, for a SBOT-IPI with a minimal follow-up of 12 months. Results 30 patients were identified; the median age at diagnosis was 36,5 [19–72] year. FIGO stage was up to IIIA for 26 patients and the average number of peritoneal areas involved was 4,5 [1–12]. The median follow-up was 106,6 [12–366] months. Twelve patients (40%) developed an invasive relapse (4 as SBOT-IPI and 7 as SLGC) with an average time of 53,6 [10,1–175,8] months. In this group, the mean age was 45,3 [23–72] year old at first diagnosis. The initial stage was up to IIIB in 75% of the cases and the average number of peritoneal areas involved was 5,2 [1–12]. Two patients died due to recurrence, one had a recurrence as SBOT-IPI 6 years after and one as SLGC 10 years after. Conclusion Relapsing as an invasive disease were more frequent than reported in other series and seems to be associated with the initial FIGO stage and with the number of peritoneal areas involved in the initial diagnosis. However, in this long term follow-up study, overall mortality of SBOT-IPI seems lower than mobility rate of SLGC. This study highlights that SBOT-IPI long term survival is poorly known. Finally, the prognosis of the SBOT-IPI should not be associated with the SLGC. Disclosure Nothing to disclose.

Introduction/Background Granulosa cell tumors account for approximatively 3% of ovarian tumors. The juvenile histological type (JGCT) represents 5% of them, and remains relatively unknown. Our aim was to describe clinicopathologic characteristics and to evaluate prognostic factors. Methodology We retrospectively studied medical records of 40 patients referred to our center for JGCT between November 2010 and 2018. Results Thirty-six patients had confirmed JGCT. The mean age was 19,9 years (range 2,5 months - 47,4 years). Abdominal pain (53%), vaginal bleeding (31%), palpable mass (28%), were the most common presenting symptoms. The distribution of FIGO stage was: 16 patients at stage Ia, 17 Ic, 1 IIa, 1 IIIb, 1 IIIc. Thirty-two patients (89%) had conservative surgery. Sixteen (44%) received adjuvant chemotherapy (Ic=13, IIa=1, IIIb=1, IIIc=1), mostly bleomycine/etoposide/cisplatine regimen. The mean follow up was 35 months (range 1 to 204 months). Nine patients recurred (Ia=1, Ic=6, IIa=1, IIIc=1) with a mean time of 12,1 months (range 1–47). Among them, 4 had a cystectomy at the initial surgery: 3 without adjuvant chemotherapy, 2 died of disease; 4 stage Ic did not received adjuvant chemotherapy neither. Three patients died after a mean of 21,2 months (range 9,5–32,4). At 36 months: progression free survival was 70,4% [54,9–90,2], overall survival was 85,6% [71,4–100]. The main prognosis factor of recurrence was advanced FIGO stage (p 15 years (p=0,09)and cytonuclear atypia (p=0,08)tended to be associated to relapse too. Intra operative tumor rupture (p=0,03) was a significant risk factor of death.We observed 5 pregnancies with term deliveries. Conclusion The main prognostic factors are: FIGO stage and intra operative tumor rupture. Fertility sparing surgery is safe for stage Ia, reasonable for stage Ic combined with adjuvant chemotherapy. Patients with cystectomy had poor outcome; unilateral salpingo-oophorectomy must be done sytematically. Disclosure Nothing to disclose.

Resume Une patiente âgee de 40 ans a ete prise en charge pour une tumeur desmoide initialement developpee sur la paroi thoracique anterieure. Son evolution a ete marquee par une extension intrathoracique pour laquelle ni une hormonotherapie, ni une chimiotherapie, ni une chirurgie n'ont ete efficaces. Compte tenu de la taille de la tumeur et de son retentissement hemodynamique, la patiente a ete finalement consideree, apres plusieurs annees d'evolution, comme incurable et traitee de facon symptomatique. Un an apres, la tumeur desmoide avait completement disparue. Bien que la resection chirurgicale constitue un element essentiel des tumeurs desmoides, certaines tumeurs meme tres evoluees peuvent regresser spontanement.

Ureteral injury is a rare but potential serious complication that can occur during a variety of general surgical procedures. Knowledge of the course of the ureter is the first step toward preventing ureteral injuries. While some injuries are noticed intraoperatively, most are missed and present later with pain, sepsis, urinary drainage or renal loss. The choice of treatment is based on the location, type and extend of ureteral injury. For injuries recognized during open surgery, when involving the distal 5 cm of the ureter, an antireflux ureterocystostomy such as the Politano-Leadbetter procedure or a vesicopsoas hitch can be performed. For the middle ureter, an ureteroureterostomy is satisfactory and for the proximal ureter, most injuries can be managed by transureteroureterostomy. In complex situations intestinal interposition, autotransplantation or even nephrectomy can be considered. The majority of patients with delayed diagnosed ureteral injuries should be managed by an initial endo-urologic approach.

615 Background: International guidelines recommend rapid diagnostic and therapeutic procedures for suspect breast lesions. However, the impact of the interval between screening and treatment (trt) (STI) on the severity of the disease remains unclear. We explored the potential impact of STI on a surrogate of survival, axillary nodal involvement (N+), among 1,000 recently diagnosed BC pts, as well as the causes of potential delays. Methods: We collected complete data of prospectively recorded community BC cases in a single regional cancer center between January 1, 2005, and October 10, 2007. Pts were eligible if they i. had a final diagnosis of invasive BC ii. were operated as first trt for BC, iii. had no history of other previous malignancy within the past 5 year period. Logistic regression analyses (SAS) were used to determine factors predictive of N+ and those influencing intervals between first description of the lesion and first therapeutic surgery (STI). Candidate factors included socio-economic variables (marital status, occupation, county of living, country of birth), personal and familial medical history parameters, as well as BC characteristics. Results: 990 pts met the inclusion criteria and had full data available. Med age: 59 years, BI-RAD ACR3/4/5: 2/41/55%, med pathological tumor size (pT): 16 mm (2–100), N+: 41%, med delay between first description of the lesion and surgery: 67 days. Factors predicting longer STI were: Birad ACR No significant financial relationships to disclose.

Abstract #1021 Background: The Minicam* is a high-resolution 1.6 inches field-of-view hand-held gamma camera. We used it to detect breast cancer sentinel nodes (SN). Material and Methods : This is a prospective, non-randomized, blind study comparing the minicam (MC) and classic scintigraphy (CS) in 50 cases. All patients underwent CS, and the surgeon used the MC in the operating room blinded to the CS results. Then CS images were visualized and the operation was performed as usual with a probe. At the end of the procedure, control MC images were obtained and displayed. Results : Isotopic detection failed in a single case (1/50). Concordance between the MC and CS was very good in 33 cases (67.5%). In 6 cases (12%), the MC was better and in 10 cases (20.5%) CS was better, in terms of the number of detected nodes. The post-procedure control images were always negative. The surgeon found that the MC was better than the probe for node localization in 2 difficult cases. It took 4 to 10 minutes using the MC in the first 8 cases, and a mean of 2 minutes (range 1-3 min) thereafter. The small screen size (1.6x1.6 inches) was noted as the cause of difficulties in 12 cases and was associated with 4/10 failures. Discussion : This minicam device is easy to use for the surgeon, with a user-friendly software, a short learning curve and good accuracy. The small screen size is really the only drawback. On the basis of this first blind comparison with CS, a larger multicentric study will be initiated. * Euromedical, France. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1021.