Search

We compare outcomes in two large‐scale contemporaneously treated HPV‐positive (HPV+) oropharynx cancer (OPC) cohorts treated with definitive radiotherapy/chemoradiotherapy (RT/CRT). p16‐confirmed HPV+ OPC treated between 2007 and 2015 at PMH and DAHANCA were identified. Locoregional failure (LRF), distant metastasis (DM), and overall survival (OS) were compared. Multivariable analysis (MVA) calculated adjusted‐hazard‐ratio (aHR) with 95% confidence interval (95% CI), adjusting for cohort, age, gender, performance status, smoking pack‐years, T‐category and N‐category and chemotherapy. Compared to PMH (n = 701), DAHANCA (n = 1174) contained lower TNM‐8T‐categories (T1‐T2: 77% vs 56%), N‐categories (N0‐N1: 77% vs 67%) and stages (stage I: 63% vs 44% (all P <.001). PMH used standard‐fractionation CRT in 69% (481) while 31% (220) received hypofractionated or moderately accelerated RT‐alone. All DAHANCA patients were treated with moderately accelerated RT; 96% (1129) received nimorazole (NIM) and 73% (856) concurrent weekly cisplatin. DAHANCA had shorter overall‐treatment‐time (P <.001), lower gross tumor (66‐68 vs 70 Gy) and elective neck (50 vs 56 Gy) doses. Median follow‐up was 4.8 years. DAHANCA had higher 5‐year LRF (13% vs 7%, aHR = 0.47 [0.34‐0.67]), comparable DM (7% vs 12%, aHR = 1.32 [0.95‐1.82]), but better OS (85% vs 80%, aHR = 1.30 [1.01‐1.68]). CRT patients had a lower risk of LRF (aHR 0.56 [0.39‐0.82]), DM (aHR 0.70 [0.50‐1.00]) and death (aHR 0.39 [0.29‐0.52]) vs RT‐alone. We observed exemplary outcomes for two large‐scale trans‐Atlantic HPV+ OPC cohorts treated in a similar manner. Concurrent chemotherapy was a strong, independent prognostic factor for all endpoints. Our findings underscore the need for a very careful approach to de‐intensification of treatment for this disease. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of the present study was to evaluate learning curves and short-term outcomes following laparoscopic surgery for early endometrial cancer in women of different body mass index (BMI) classes.Material and Methods: Data from 227 women planned for laparoscopic surgery for presumed stage I endometrial cancer were collected retrospectively from a Danish gynecologic oncology unit. Surgery included laparoscopic hysterectomy and bilateral salpingo-oophorectomy with or without pelvic lymphadenectomy (PLA).Results: Median length of operations was 60 min (range, 30-197) and 120 min (range, 60-230), depending on whether PLA was included. The median pelvic lymph node yield was 18 (range, 7-42). For staging with PLA there was a learning curve when measured as operative time as well as lymph node yield, and a level of proficiency was not reached after 40 operations. The women had a perioperative complication rate of 4.5% and a median hospital stay of one night. Postoperative complication rate was 12%, comprising vaginal cuff hematoma (3.1%), vaginal cuff rupture (0.9%), trocar hernia (1.3%), ureter lesion (0.4%), bowel lesion (0.4%), reoperation (0.9%) and other complications (4.5%). All peri- and postoperative outcomes were independent of BMI classes.Conclusions: Our data suggest that laparoscopic surgery for early endometrial cancer is feasible and safe. With increasing surgeon's experience there is a significant decrease in operative time and increase in the number of lymph nodes harvested. In experienced hands, either operative time, complications or length of stay are not affected by increasing BMI, even when women are morbidly obese. [ABSTRACT FROM AUTHOR]

The benefits of laparoscopic hysterectomy are well documented and include less postoperative pain, shorter hospital stay and faster recovery. The objective of this study was to assess the feasibility of laparoscopic hysterectomy as an outpatient procedure. A total of 26 women regarded eligible for an accelerated approach were included. The mean duration of the operation was 40 min (range 23-60 min), with a blood loss of 50 mL (range 10-200 mL). Twenty-three left the hospital the same day (88%). One woman required overnight hospitalization because of a port hematoma, while two stayed for reasons unrelated to the surgery. Three other women were referred with minor problems to an urgent clinic appointment within the first month. Overall, the women were satisfied with the procedure, with a mean rating of 9 of 10 possible points. Thus, outpatient laparoscopic hysterectomy appeared to be safe and well accepted by selected patients. [ABSTRACT FROM AUTHOR]