67 results on '"Poka, R."'
Search Results
2. THE ROLE OF SENTINEL NODE ASSESSMENT AND LAPAROSCOPIC APPROACH IN DECREASING MORBIDITY OF STAGING SURGERY FOR ENDOMETRIAL CANCER: EP602
- Author
-
Poka, R, Baradács, I, Molnár, S, and Krasznai, Z
- Published
- 2019
- Full Text
- View/download PDF
3. SENTIX - Sentinel lymph node in patients with cervical cancer: time to voiding recovery after surgery (CEEGOG-CX01; ENGOT-CX2; NCT02494063)
- Author
-
Zapardiel, I, Kocian, R, Köhler, C, Klat, J, Germanova, A, Jacob, A, Bajsova, S, Böhmer, G, Lay, L, Torne, A, Havelka, P, Kipp, B, Szewczyk, G, Toth, R, Staringer, J, De Santiago, F J, Coronado, P J, Poka, R, Laky, R, Luyckx, M, Fastrez, M, Dusek, L, Hernandez, A, and Cibula, D
- Published
- 2019
- Full Text
- View/download PDF
4. The Cost Implications in Ontario, Alberta, and British Columbia of Early Versus Delayed External Cephalic Version in the Early External Cephalic Version 2 (EECV2) Trial
- Author
-
Hutton, E.K., Barrett, J., Carson, G.D., Delisle, M.F., Dunn, M., Edwards, S., Fernandez, A., Gafni, A., Hannah, M.E., Hewson, S., Natale, R., Ohlsson, A., Ross, S.J., Willan, A.R., Windrim, R., Pollard, J.K., Schweitzer, Sylvestre, G., Turtle, P., Bracken, M., Crowley, P., Donner, A., Duley, L., Ehrenkranz, R., Curioni, M., Abalos Gorostiaga, R., Becker, C., Elizabeth, P.A., Errandonea, L., Palermo, M., Ramos, C.A., Trabucco, M., Montes Varela, D., Bertin, M.S., Castaldi, J.L., Mohedano de Duhalde, M., Messina, A., Baumgartner, J., Kovacs, G., Malcolm, B., Neil, J.R., Mahomed, K., Green, A., Child, A., DeVries, B., Phipps, H., Welsh, A., Davis, G.K., Roberts, L., Watts, N.P., Cybulski, M., Gibson, D., Tucker, S., McCahon, I., Sheehan, P., Umstad, M., Milligan, J., Morris, J., Rickard, K., Gardener, G., Jenkins-Manning, S., Boniface, C., Edmondson, M., Watson, D., Ayub, A., Soanes, S., Jordan, A., Fanning, C., Parish, B., Watson, M.A., Reid, D., Scheufler, P., Malott, A.M., Reitsma, A., Haslauer, K.A., Lipp, M., Farquharson, D., Gray, K., Demianczuk, N., Penttinen, E., Herer, E., McLean, K., Aghajafari, F., Williams, S., Moravac, C., Yudin, M., Pollard, J., Miller, L., Anderson, R.B., Good, M., Walker, M.C., Kulkarni, R., Scarfone, R., Cameron, C., Peel, T., Carrillo, J., Cruces, A., Gonzalez, Y., Figueroa Poblete, J., Lama Hormazabal, L., Saez, J., Oyarzun, E., Rioseco, A., Illanes, S., Kottmann, C., Parra, M., Quezada, S., Quiroz, L., Hvidman, L., Mogensen, I.M., Mouritzen, A., Ostberg, B., Abdel-Samad, S.N.M., Al-Hussaini, T., El-Nashar, I., Kirss, F., Rull, K., Ustav, E., Vaas, P., Brink-Spalink, V., Weizsaecker, K., Major, T., Poka, R., Daly, S., Kaneti, H., Rosen, D., Schachter, B., Chayen, B., Harel, L., Hiaeb, Z., Malinger, G., Dukler, D., Lunenfeld, E., AlFaris, L., El-Zibdeh, M., Domzalska-Popadiuk, I., Kobiela, P., Pankrac, Z., Preis, J., Preis, K., Swiatkowska-Freund, M., Cravo, J., Theron, A.M., Theron, G.B., Cronje, H.S., du Plessis, J.M., Munoz, M., Khan, G., Khan, S., Goossens, S., Pieters, M., Roumen, F.J.M.E., ten Cate, F., Smits, F., Heres, M., Krabbendam, E., Airey, R., Farrar, D., Tuffnell, D.J., Heyes, V., Melvin, C., Schram, C., Galimberti, A., Stewart, P., Cresswell, J., McCormick, C., Andrews, J., Fleener, D., Coonrod, D., Jimenez, B.F., Brown, S., Gregg, A., Pitchford, C., Seubert, D., Ahmed, Rashid J., Gafni, Amiram, and Hutton, Eileen K.
- Published
- 2016
- Full Text
- View/download PDF
5. SUCCOR cone study
- Author
-
Chacon, E, Manzour, N, Zanagnolo, V, Querleu, D, Núñez-Córdoba, Jm, Martin-Calvo, N, Căpîlna, Me, Fagotti, A, Kucukmetin, A, Mom, C, Chakalova, G, Shamistan, A, Gil Moreno, A, Malzoni, M, Narducci, F, Arencibia, O, Raspagliesi, F, Toptas, T, Cibula, D, Kaidarova, D, Meydanli, Mm, Tavares, M, Golub, D, Perrone, Am, Poka, R, Tsolakidis, D, Vujić, G, Jedryka, Ma, Zusterzeel, Plm, Beltman, Jj, Goffin, F, Haidopoulos, D, Haller, H, Jach, R, Yezhova, I, Berlev, I, Bernardino, M, Bharathan, R, Lanner, M, Maenpaa, Mm, Sukhin, V, Feron, Jg, Fruscio, R, Kukk, K, Ponce, J, Minguez, Ja, Vázquez-Vicente, D, Castellanos, T, Boria, F, Alcazar, Jl, Chiva, L, SUCCOR study group, SUCCOR study Group: Abdalla, N, Akgöl, S, Aksahin, D, Aliyev, S, Alonso-Espias, M, Aluloski, I, Andrade, C, Badzakov, N, Barrachina, R, Bogani, G, Bonci, E-A, Bonsang-Kitzis, H, Brucker, C, Cárdenas, L, Casajuana, A, Cavalle, P, Cea, J, Chiofalo, B, Cordeiro, G, Coronado, P, Cuadra, M, Díez, J, Diniz da Costa, T, Domingo, S, Dostalek, L, Elif, F, Erasun, D, Fehr, M, Fernandez-Gonzalez, S, Ferrero, A, Fidalgo, S, Fiol, G, Galaal, K, García, J, Gebauer, G, Ghezzi, F, Gilabert, J, Gomes, N, Gonçalves, E, Gonzalez, V, Grandjean, F, Guijarro, M, Guyon, F, Haesen, J, Hernandez-Cortes, G, Herrero, S, Pete, I, Kalogiannidis, I, Karaman, E, Kavallaris, A, Klasa, L, Kotsopoulos, I, Stefan Kovachev, S, U A, Leht, Lekuona, A, Luyckx, M, Mallmann, M, Mancebo, G, Mandic, A, Marina, T, Martin, V, M B, Martín-Salamanca, Lago, V, Martinez, A, Meili, G, Mendinhos, G, Mereu, L, Mitrovic, M, Morales, S, Moratalla, E, N R, Gómez-Hidalgo, Morillas, B, Myriokefalitaki, E, Pakižimre, M, Petousis, S, Pirtea, L, Povolotskaya, N, Prader, S, Quesada, A, Redecha, M, Roldan, F, Rolland, P, Saaron, R, Sarac, C-P, Scharf, J-P, Smrkolj, S, Sousa, R, Stepanyan, A, Študent, V, Tauste, C, Trum, H, Turan, T, Undurraga, M, Vázquez, A, Vergote, I, Vorgias, G, and Zapardiel, I, Obstetrics and gynaecology, CCA - Cancer Treatment and quality of life, Amsterdam Reproduction & Development (AR&D), Chacon, E, Manzour, N, Zanagnolo, V, Querleu, D, Núñez-Córdoba, J, Martin-Calvo, N, Căpîlna, M, Fagotti, A, Kucukmetin, A, Mom, C, Chakalova, G, Shamistan, A, Gil Moreno, A, Malzoni, M, Narducci, F, Arencibia, O, Raspagliesi, F, Toptas, T, Cibula, D, Kaidarova, D, Meydanli, M, Tavares, M, Golub, D, Perrone, A, Poka, R, Tsolakidis, D, Vujić, G, Jedryka, M, Zusterzeel, P, Beltman, J, Goffin, F, Haidopoulos, D, Haller, H, Jach, R, Yezhova, I, Berlev, I, Bernardino, M, Bharathan, R, Lanner, M, Maenpaa, M, Sukhin, V, Feron, J, Fruscio, R, Kukk, K, Ponce, J, Minguez, J, Vázquez-Vicente, D, Castellanos, T, Boria, F, Alcazar, J, and Chiva, L
- Subjects
Adult ,Databases, Factual ,cervical cancer ,Conization ,Obstetrics and Gynecology ,Uterine Cervical Neoplasms ,Middle Aged ,Disease-Free Survival ,Women's cancers Radboud Institute for Health Sciences [Radboudumc 17] ,surgery ,Settore MED/40 - GINECOLOGIA E OSTETRICIA ,laparoscopes ,laparoscope ,Oncology ,laparotomy ,Humans ,Minimally Invasive Surgical Procedures ,Female ,Neoplasm Recurrence, Local ,hysterectomy ,Propensity Score ,Retrospective Studies - Abstract
ObjectiveTo evaluate disease-free survival of cervical conization prior to radical hysterectomy in patients with stage IB1 cervical cancer (International Federation of Gynecology and Obstetrics (FIGO) 2009).MethodsA multicenter retrospective observational cohort study was conducted including patients from the Surgery in Cervical Cancer Comparing Different Surgical Aproaches in Stage IB1 Cervical Cancer (SUCCOR) database with FIGO 2009 IB1 cervical carcinoma treated with radical hysterectomy between January 1, 2013, and December 31, 2014. We used propensity score matching to minimize the potential allocation biases arising from the retrospective design. Patients who underwent conization but were similar for other measured characteristics were matched 1:1 to patients from the non-cone group using a caliper width ≤0.2 standard deviations of the logit odds of the estimated propensity score.ResultsWe obtained a weighted cohort of 374 patients (187 patients with prior conization and 187 non-conization patients). We found a 65% reduction in the risk of relapse for patients who had cervical conization prior to radical hysterectomy (hazard ratio (HR) 0.35, 95% confidence interval (CI) 0.16 to 0.75, p=0.007) and a 75% reduction in the risk of death for the same sample (HR 0.25, 95% CI 0.07 to 0.90, p=0.033). In addition, patients who underwent minimally invasive surgery without prior conization had a 5.63 times higher chance of relapse compared with those who had an open approach and previous conization (HR 5.63, 95% CI 1.64 to 19.3, p=0.006). Patients who underwent minimally invasive surgery with prior conization and those who underwent open surgery without prior conization showed no differences in relapse rates compared with those who underwent open surgery with prior cone biopsy (reference) (HR 1.94, 95% CI 0.49 to 7.76, p=0.349 and HR 2.94, 95% CI 0.80 to 10.86, p=0.106 respectively).ConclusionsIn this retrospective study, patients undergoing cervical conization before radical hysterectomy had a significantly lower risk of relapse and death.
- Published
- 2022
6. SUCCOR study: An international European cohort observational study comparing minimally invasive surgery versus open abdominal radical hysterectomy in patients with stage IB1 cervical cancer
- Author
-
Chiva, L. Zanagnolo, V. Querleu, D. Martin-Calvo, N. Arévalo-Serrano, J. Cǎpîlna, M.E. Fagotti, A. Kucukmetin, A. Mom, C. Chakalova, G. Aliyev, S. Malzoni, M. Narducci, F. Arencibia, O. Raspagliesi, F. Toptas, T. Cibula, D. Kaidarova, D. Meydanli, M.M. Tavares, M. Golub, D. Perrone, A.M. Poka, R. Tsolakidis, D. Vujić, G. Jedryka, M.A. Zusterzeel, P.L.M. Beltman, J.J. Goffin, F. Haidopoulos, D. Haller, H. Jach, R. Yezhova, I. Berlev, I. Bernardino, M. Bharathan, R. Lanner, M. Maenpaa, M.M. Sukhin, V. Feron, J.-G. Fruscio, R. Kukk, K. Ponce, J. Minguez, J.A. Vázquez-Vicente, D. Castellanos, T. Chacon, E. Alcazar, J.L. On behalf of the SUCCOR study Group
- Abstract
Background Minimally invasive surgery in cervical cancer has demonstrated in recent publications worse outcomes than open surgery. The primary objective of the SUCCOR study, a European, multicenter, retrospective, observational cohort study was to evaluate disease-free survival in patients with stage IB1 (FIGO 2009) cervical cancer undergoing open vs minimally invasive radical hysterectomy. As a secondary objective, we aimed to investigate the association between protective surgical maneuvers and the risk of relapse. Methods We obtained data from 1272 patients that underwent a radical hysterectomy by open or minimally invasive surgery for stage IB1 cervical cancer (FIGO 2009) from January 2013 to December 2014. After applying all the inclusion-exclusion criteria, we used an inverse probability weighting to construct a weighted cohort of 693 patients to compare outcomes (minimally invasive surgery vs open). The first endpoint compared disease-free survival at 4.5 years in both groups. Secondary endpoints compared overall survival among groups and the impact of the use of a uterine manipulator and protective closure of the colpotomy over the tumor in the minimally invasive surgery group. Results Mean age was 48.3 years (range; 23-83) while the mean BMI was 25.7 kg/m 2 (range; 15-49). The risk of recurrence for patients who underwent minimally invasive surgery was twice as high as that in the open surgery group (HR, 2.07; 95% CI, 1.35 to 3.15; P=0.001). Similarly, the risk of death was 2.42-times higher than in the open surgery group (HR, 2.45; 95% CI, 1.30 to 4.60, P=0.005). Patients that underwent minimally invasive surgery using a uterine manipulator had a 2.76-times higher hazard of relapse (HR, 2.76; 95% CI, 1.75 to 4.33; P
- Published
- 2020
7. EP602 The role of sentinel node assessment and laparoscopic approach in decreasing morbidity of staging surgery for endometrial cancer
- Author
-
Poka, R, primary, Baradács, I, additional, Molnár, S, additional, and Krasznai, Z, additional
- Published
- 2019
- Full Text
- View/download PDF
8. EP908 Expression of CD24 in ovarian cancer
- Author
-
Lukacs, J, primary, Soltesz, B, additional, Nagy, B, additional, and Poka, R, additional
- Published
- 2019
- Full Text
- View/download PDF
9. SENTIX – Sentinel lymph node in patients with cervical cancer: time to voiding recovery after surgery (CEEGOG-CX01; ENGOT-CX2; NCT02494063)
- Author
-
Zapardiel, I, primary, Kocian, R, additional, Köhler, C, additional, Klat, J, additional, Germanova, A, additional, Jacob, A, additional, Bajsova, S, additional, Böhmer, G, additional, Lay, L, additional, Torne, A, additional, Havelka, P, additional, Kipp, B, additional, Szewczyk, G, additional, Toth, R, additional, Staringer, J, additional, De Santiago, FJ, additional, Coronado, PJ, additional, Poka, R, additional, Laky, R, additional, Luyckx, M, additional, Fastrez, M, additional, Dusek, L, additional, Hernandez, A, additional, and Cibula, D, additional
- Published
- 2019
- Full Text
- View/download PDF
10. P14.12: Maternal characteristics, ultrasound- and serum-markers at 11-13 + 6 weeks in pregnancies without pre-eclampsia resulting small for gestational age neonates
- Author
-
Orosz, L., primary, Orosz, G., additional, Arany, I., additional, Fabian, A., additional, Pap, K., additional, Medve, L., additional, Tóth, Z., additional, Poka, R., additional, and Torok, O., additional
- Published
- 2014
- Full Text
- View/download PDF
11. P14.32: The contribution of PLGF to the performance of screening for severe pre‐eclampsia in the first trimester of pregnancy in routine clinical practice
- Author
-
Orosz, L., primary, Orosz, G., additional, Arany, I., additional, Fabian, A., additional, Pap, K., additional, Medve, L., additional, Tóth, Z., additional, Poka, R., additional, and Torok, O., additional
- Published
- 2014
- Full Text
- View/download PDF
12. Radiation damage measurement in physiological environment in cervical cancer
- Author
-
Szluha, K. L., primary, Lazányi, K., additional, Pintye, É., additional, Kovács, A., additional, Opauszki, A., additional, Poka, R., additional, Benkő, K., additional, Toth, J., additional, András, Cs., additional, Horváth, A., additional, Tokési, Károly, additional, and Sulik, Béla, additional
- Published
- 2008
- Full Text
- View/download PDF
13. THE ROLE OF DYNAMIC MAGNETIC RESONANCE MAMMOGRAPHY IN TREATMENT PLANNING OF BREAST CANCER
- Author
-
Szluha, K. L., primary, Bodgal, Z., additional, Andras, C., additional, Poka, R., additional, Fülöp, B., additional, Kósa, C., additional, and Varga, I., additional
- Published
- 2003
- Full Text
- View/download PDF
14. Invasive cervical carcinoma associated with pregnancy
- Author
-
Poka, R., primary, Hernadi, Z., additional, and Lampe, L., additional
- Published
- 1993
- Full Text
- View/download PDF
15. O382 THE POSSIBLE ROLE OF NEUTROPHIL GRANULOCYTES IN HEALTHY AND PREECLAMPTIC PREGNANCY
- Author
-
Lampé, R., Szucs, S., Ádány, R., and Póka, R.
- Published
- 2012
- Full Text
- View/download PDF
16. Stage related detection rate of human papillomavirus DNA in invasive cervical cancer
- Author
-
Poka, R., primary, Czegledy, J., additional, Hernadi, Z., additional, Gergely, L., additional, and Lampe, L., additional
- Published
- 1991
- Full Text
- View/download PDF
17. The role of preoperative brachytherapy as an adjunct to surgery and postoperative radiotherapy in the treatment of stage I endometrial carcinoma
- Author
-
Poka, R., Szluha, K., Lampe, L., Urbancsek, H., and Borsos, A.
- Published
- 2000
- Full Text
- View/download PDF
18. HPV- and node status in cervical cancer Long-term results
- Author
-
Poka, R. and Czegledy, J.
- Published
- 1997
- Full Text
- View/download PDF
19. Are pre-operative lymphographic results reflected in the survival of stage Ib and IIa cervical...
- Author
-
Poka, R. and Szluha, K.
- Subjects
- *
LYMPHANGIOGRAPHY , *CERVICAL cancer diagnosis - Abstract
Evaluates the role of lymphography in the management of patients with stage Ib and IIa cervix carcinoma. Analysis of stage-respective survival curves; Comparison of survival curves of patients with positive pre-operative lymphography with those with negative findings.
- Published
- 1994
20. Stage-related superoxide anion production of granulocytes of gynecologic cancer patients
- Author
-
Poka, R., Szucs, S., Adany, R., and Szikszay, E.
- Published
- 2000
- Full Text
- View/download PDF
21. The Cost Implications in Ontario, Alberta, and British Columbia of Early Versus Delayed External Cephalic Version in the Early External Cephalic Version 2 (EECV2) Trial
- Author
-
Ahmed, Rashid J., Gafni, Amiram, Hutton, Eileen K., Hutton, E.K., Barrett, J., Carson, G.D., Delisle, M.F., Dunn, M., Edwards, S., Fernandez, A., Gafni, A., Hannah, M.E., Hewson, S., Natale, R., Ohlsson, A., Ross, S.J., Willan, A.R., Windrim, R., Pollard, J.K., Schweitzer, Sylvestre, G., Turtle, P., Bracken, M., Crowley, P., Donner, A., Duley, L., Ehrenkranz, R., Curioni, M., Abalos Gorostiaga, R., Becker, C., Elizabeth, P.A., Errandonea, L., Palermo, M., Ramos, C.A., Trabucco, M., Montes Varela, D., Bertin, M.S., Castaldi, J.L., Mohedano de Duhalde, M., Becker, C., Messina, A., Baumgartner, J., Kovacs, G., Malcolm, B., Neil, J.R., Mahomed, K., Green, A., Child, A., DeVries, B., Phipps, H., Welsh, A., Davis, G.K., Roberts, L., Watts, N.P., Cybulski, M., Gibson, D., Tucker, S., McCahon, I., Sheehan, P., Umstad, M., Milligan, J., Morris, J., Rickard, K., Gardener, G., Jenkins-Manning, S., Boniface, C., Edmondson, M., Watson, D., Ayub, A., Delisle, M.F., Soanes, S., Jordan, A., Windrim, R., Fanning, C., Parish, B., Natale, R., Watson, M.A., Reid, D., Scheufler, P., Malott, A.M., Reitsma, A., Haslauer, K.A., Lipp, M., Farquharson, D., Gray, K., Demianczuk, N., Penttinen, E., Herer, E., McLean, K., Aghajafari, F., Williams, S., Moravac, C., Yudin, M., Pollard, J., Miller, L., Anderson, R.B., Good, M., Walker, M.C., Kulkarni, R., Scarfone, R., Cameron, C., Peel, T., Carrillo, J., Cruces, A., Gonzalez, Y., Figueroa Poblete, J., Lama Hormazabal, L., Saez, J., Oyarzun, E., Rioseco, A., Illanes, S., Kottmann, C., Parra, M., Quezada, S., Quiroz, L., Hvidman, L., Mogensen, I.M., Mouritzen, A., Ostberg, B., Abdel-Samad, S.N.M., Al-Hussaini, T., El-Nashar, I., Kirss, F., Rull, K., Ustav, E., Vaas, P., Brink-Spalink, V., Weizsaecker, K., Major, T., Poka, R., Daly, S., Kaneti, H., Rosen, D., Schachter, B., Chayen, B., Harel, L., Hiaeb, Z., Malinger, G., Dukler, D., Lunenfeld, E., AlFaris, L., El-Zibdeh, M., Domzalska-Popadiuk, I., Kobiela, P., Pankrac, Z., Preis, J., Preis, K., Swiatkowska-Freund, M., Cravo, J., Theron, A.M., Theron, G.B., Cronje, H.S., du Plessis, J.M., Munoz, M., Khan, G., Khan, S., Goossens, S., Pieters, M., Roumen, F.J.M.E., ten Cate, F., Pieters, M., Smits, F., Heres, M., Krabbendam, E., Airey, R., Farrar, D., Tuffnell, D.J., Heyes, V., Melvin, C., Schram, C., Galimberti, A., Stewart, P., Cresswell, J., McCormick, C., Andrews, J., Fleener, D., Coonrod, D., Jimenez, B.F., Brown, S., Gregg, A., Pitchford, C., and Seubert, D.
- Abstract
According to the Early External Cephalic Version (EECV2) Trial, planning external cephalic version (ECV) early in pregnancy results in fewer breech presentations at delivery compared with delayed external cephalic version. A Cochrane review conducted after the EECV2 Trial identified an increase in preterm birth associated with early ECV. We examined whether a policy of routine early ECV (i.e., before 37 weeks' gestation) is more or less costly than a policy of delayed ECV.
- Published
- 2016
- Full Text
- View/download PDF
22. Severe fetal thrombocytopenia diagnosed during labor
- Author
-
Poka, R., Katona, N., and Juhasz, B.
- Published
- 1997
- Full Text
- View/download PDF
23. Cervical cancer in young women: A poorer prognosis?
- Author
-
Póká, R., Juhász, B., and Lampé, L.
- Published
- 1994
- Full Text
- View/download PDF
24. CHALLENGES IN CHILD SEXUAL ABUSE HUNGARY
- Author
-
Csorba, R., Lampe, R., and Poka, R.
- Published
- 2010
25. 186 Challenges in Child Sexual Abuse Hungary
- Author
-
Csorba, R, Lampe, R, and Poka, R
- Abstract
Objective: Between 1986 and 2005, 266 girls under the age of 18 had been exposed to sexual abuse. We summarize the characteristics of child sexual abuse cases and explore common features.Methods: We prospectively collected data according to characteristics of all cases. Legal procedures were also evaluated. We describe the medical and legal approaches to handling child neglect.Results: Seventy-eight percent of the victims were students, and 45% of them were between 11 and 14 years of age. Perpetrator was familiar to the victim in 67% of the cases, and a stranger in 33%. Seventy-five (28%) perpetrators were members of the victims' families. In 14% of cases, the perpetrator was the victim's father and in 9%, her stepfather. The abuse had occurred on multiple occasions in 29%. The occurrence rate of assault was highest in the summer season (54%). Vaginal penetration was the type of abuse in 63%, and sexual perversion in 37%. Eighty-five victims were physically injured, and in 40 cases the presence of sperm was confirmed. Two pregnancy occurred. 167 cases were reported to the police; 68 of the perpetrators were sentenced as a result of legal proceedings.Conclusion: Majority of sexual abuse takes place within the family and is revealed after multiple episodes. The underestimated prevalence of sexual assault is the consequence of the lack of cooperation between the emergency services and the Hungarian criminal law. Prevention requires vigilance in out-of-school times, child education, early involvement of healthcare professionals, and adjustment of the administration of justice.
- Published
- 2010
- Full Text
- View/download PDF
26. Radical hysterectomy in early cervical cancer in Europe: Characteristics, outcomes and evaluation of ESGO quality indicators
- Author
-
Aliyev Shamistan, Jogchum Jan Beltman, Fabrice Narducci, Juan Luis Alcázar, Iryna Yezhova, Mehmet Mutlu Meydanli, Frédéric Goffin, José Ángel Mínguez, Robert Fruscio, Dmytro Golub, Nerea Martín-Calvo, Mariana Tavares, Anna Fagotti, Robert Jach, Dimitrios Haidopoulos, N Manzour, Margarida Bernardino, E Chacon, Marcin Jędryka, Kersti Kukk, Dimitrios Tsolakidis, Ali Kucukmetin, Denis Querleu, Mihai Emil Căpîlna, Herman Haller, Jordi Ponce, Mario Malzoni, Constantijne H. Mom, Teresa Castellanos, Goran Vujić, Dilyara Kaidarova, Tayfun Toptas, Daniel Vázquez-Vicente, María Alonso-Espías, Luis Chiva, David Cibula, Jean Guillaume Feron, Galina Chakalova, Vladyslav Sukhin, Matías Jurado, Rasiah Bharathan, Vanna Zanagnolo, Igor Berlev, Minna M. Mäenpää, F Boria, Maximilian Lanner, Francesco Raspagliesi, Anna Myriam Perrone, Octavio Arencibia, Petra L.M. Zusterzeel, Róbert Póka, Boria, F, Chiva, L, Zanagnolo, V, Querleu, D, Martin-Calvo, N, CA Pilna, M, Fagotti, A, Kucukmetin, A, Mom, C, Chakalova, G, Shamistan, A, Malzoni, M, Narducci, F, Arencibia, O, Raspagliesi, F, Toptas, T, Cibula, D, Kaidarova, D, Meydanli, M, Tavares, M, Golub, D, Perrone, A, Poka, R, Tsolakidis, D, Vujic, G, Jedryka, M, Zusterzeel, P, Beltman, J, Goffin, F, Haidopoulos, D, Haller, H, Jach, R, Yezhova, I, Berlev, I, Bernardino, M, Bharathan, R, Lanner, M, Maenpaa, M, Sukhin, V, Feron J.,, Fruscio, R, Kukk, K, Ponce, J, Alonso-Espias, M, Minguez, J, Vazquez-Vicente, D, Manzour, N, Jurado, M, Castellanos, T, Chacon, E, Alcazar, J, Boria F., Chiva L., Zanagnolo V., Querleu D., Martin-Calvo N., CA Pilna M.E., Fagotti A., Kucukmetin A., Mom C., Chakalova, G., Shamistan A., Malzoni M., Narducci F., Arencibia O., Raspagliesi F., Toptas T., Cibula D., Kaidarova D., Meydanli M.M., Tavares M., Golub D., Perrone A.M., Poka R., Tsolakidis D., Vujic G., Jedryka M.A., Zusterzeel P.L.M., Beltman J.J., Goffin F., Haidopoulos D., Haller H., Jach R., Yezhova I., Berlev I., Bernardino M., Bharathan R., Lanner M., Maenpaa M.M., Sukhin V., Feron J.-G., Fruscio R., Kukk K., Ponce J., Alonso-Espias M., Minguez J.A., Vazquez-Vicente D., Manzour N., Jurado M., Castellanos T., Chacon E., Alcazar J.L., Obstetrics and gynaecology, CCA - Cancer Treatment and quality of life, and Amsterdam Reproduction & Development (AR&D)
- Subjects
0301 basic medicine ,medicine.medical_specialty ,SLN and lympadenectomy ,cervical cancer ,hysterectomy ,postoperative complications ,radiation ,medicine.medical_treatment ,Population ,Uterine Cervical Neoplasms ,Physical examination ,03 medical and health sciences ,0302 clinical medicine ,Adjuvant therapy ,medicine ,Humans ,postoperative complication ,Stage (cooking) ,Radical Hysterectomy ,education ,Quality Indicators, Health Care ,Cervical cancer ,education.field_of_study ,Hysterectomy ,medicine.diagnostic_test ,business.industry ,BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Ginekologija i opstetricija ,General surgery ,BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Gynecology and Obstetrics ,Obstetrics and Gynecology ,Middle Aged ,medicine.disease ,Women's cancers Radboud Institute for Health Sciences [Radboudumc 17] ,Europe ,030104 developmental biology ,Settore MED/40 - GINECOLOGIA E OSTETRICIA ,Treatment Outcome ,Oncology ,030220 oncology & carcinogenesis ,Cohort ,Female ,business ,Human - Abstract
IntroductionComprehensive updated information on cervical cancer surgical treatment in Europe is scarce.ObjectiveTo evaluate baseline characteristics of women with early cervical cancer and to analyze the outcomes of the ESGO quality indicators after radical hysterectomy in the SUCCOR database.MethodsThe SUCCOR database consisted of 1272 patients who underwent radical hysterectomy for stage IB1 cervical cancer (FIGO 2009) between January 2013 and December 2014. After exclusion criteria, the final sample included 1156 patients. This study first described the clinical, surgical, pathological, and follow-up variables of this population and then analyzed the outcomes (disease-free survival and overall survival) after radical hysterectomy. Surgical-related ESGO quality indicators were assessed and the accomplishment of the stated recommendations was verified.ResultsThe mean age of the patients was 47.1 years (SD 10.8), with a mean body mass index of 25.4 kg/m2 (SD 4.9). A total of 423 (36.6%) patients had a previous cone biopsy. Tumor size (clinical examination) ConclusionsIn this European cohort, the rate of adjuvant therapy after radical hysterectomy is higher than for most similar patients reported in the literature. The majority of centers were already following the European recommendations even 5 years prior to the ESGO quality indicator implementations.
- Published
- 2021
27. SUCCOR study: an international European cohort observational study comparing minimally invasive surgery versus open abdominal radical hysterectomy in patients with stage IB1 cervical cancer
- Author
-
Chiva, Luis, Zanagnolo, Vanna, Querleu, Denis, Martin-Calvo, Nerea, Arévalo-Serrano, Juan, Căpîlna, Mihai Emil, Fagotti, Anna, Kucukmetin, Ali, Mom, Constantijne, Chakalova, Galina, Aliyev, Shamistan, Malzoni, Mario, Narducci, Fabrice, Arencibia, Octavio, Raspagliesi, Francesco, Toptas, Tayfun, Cibula, David, Kaidarova, Dilyara, Meydanli, Mehmet Mutlu, Tavares, Mariana, Golub, Dmytro, Perrone, Anna Myriam, Poka, Robert, Tsolakidis, Dimitrios, Vujić, Goran, Jedryka, Marcin A, Zusterzeel, Petra L M, Beltman, Jogchum Jan, Goffin, Frederic, Haidopoulos, Dimitrios, Haller, Herman, Jach, Robert, Yezhova, Iryna, Berlev, Igor, Bernardino, Margarida, Bharathan, Rasiah, Lanner, Maximilian, Maenpaa, Minna M, Sukhin, Vladyslav, Feron, Jean-Guillaume, Fruscio, Robert, Kukk, Kersti, Ponce, Jordi, Minguez, Jose Angel, Vázquez-Vicente, Daniel, Castellanos, Teresa, Chacon, Enrique, Alcazar, Juan, Luis, Nabil, Abdalla, Özgür, Akbayir, Sedat, Akgöl, Elif, Aksahin, Shamistan, Aliyev, Maria, Alonso-Espias, Igor, Aluloski, Claudia, Andrade, Nikola, Badzakov, Rosa, Barrachina, Giorgio, Bogani, Eduard-Aexandru, Bonci, Hélène, Bonsang-Kitzis, Felix, Boria, Cosima, Brucker, Laura, Cárdenas, Andrea, Casajuana, Pere, Cavalle, Jorge, Cea, Benito, Chiofalo, Gloria, Cordeiro, Pluvio, Coronado, Maria, Cuadra, Javier, Díez, Teresa Diniz da Costa, Santiago, Domingo, Lukas, Dostalek, Fuat, Demirkiran, Diego, Erasun, Mathias, Fehr, Sergi, Fernandez-Gonzalez, Annamaria, Ferrero, Soledad, Fidalgo, Gabriel, Fiol, Khadra, Galaal, José, García, Gerhard, Gebauer, Fabio, Ghezzi, Juan, Gilabert, Nana, Gomes, Elisabete, Gonçalves, Virginia, Gonzalez, Frederic, Grandjean, Miriam, Guijarro, Frédéric, Guyon, Jolien, Haesen, Gines, Hernandez-Cortes, Sofía, Herrero, Imre, Pete, Ioannis, Kalogiannidis, Erbil, Karaman, Andreas, Kavallaris, Lukasz, Klasa, Ioannis, Kotsopoulos, Stefan, Kovachev, Meelis, Leht, Arantxa, Lekuona, Mathieu, Luyckx, Michael, Mallmann, Gemma, Mancebo, Aljosa, Mandic, Nabil, Manzour, Tiermes, Marina, Victor, Martin, María Belén Martín-Salamanca, Alejandra, Martinez, Gesine, Meili, Gustavo, Mendinhos, Mereu, Liliana, Milena, Mitrovic, Sara, Morales, Enrique, Moratalla, Bibiana, Morillas, Eva, Myriokefalitaki, Maja, Pakižimre, Stamatios, Petousis, Laurentiu, Pirtea, Natalia, Povolotskaya, Sonia, Prader, Alfonso, Quesada, Mikuláš, Redecha, Fernando, Roldan, Philip, Rolland, Reeli, Saaron, Cosmin-Paul, Sarac, Jens-Peter, Scharf, Špela, Smrkolj, Rita, Sousa, Artem, Stepanyan, Vladimír, Študent, Carmen, Tauste, Hans, Trum, Taner, Turan, Manuela, Undurraga, Arno, Uppin, Alicia, Vázquez, Ignace, Vergote, George, Vorgias, Ignacio, Zapardiel, Obstetrics and gynaecology, CCA - Cancer biology and immunology, CCA - Cancer Treatment and quality of life, Amsterdam Reproduction & Development (AR&D), Ethics, Law & Medical humanities, Chiva L., Zanagnolo V., Querleu D., Martin-Calvo N., Arevalo-Serrano J., Capilna M.E., Fagotti A., Kucukmetin A., Mom C., Chakalova G., Aliyev S., Malzoni M., Narducci F., Arencibia O., Raspagliesi F., Toptas T., Cibula D., Kaidarova D., Meydanli M.M., Tavares M., Golub D., Perrone A.M., Poka R., Tsolakidis D., Vujic G., Jedryka M.A., Zusterzeel P.L.M., Beltman J.J., Goffin F., Haidopoulos D., Haller H., Jach R., Yezhova I., Berlev I., Bernardino M., Bharathan R., Lanner M., Maenpaa M.M., Sukhin V., Feron J.-G., Fruscio R., Kukk K., Ponce J., Minguez J.A., Vazquez-Vicente D., Castellanos T., Chacon E., Alcazar J.L., Chiva, L, Zanagnolo, V, Querleu, D, Martin-Calvo, N, Arévalo-Serrano, J, Căpîlna, M, Fagotti, A, Kucukmetin, A, Mom, C, Chakalova, G, Aliyev, S, Malzoni, M, Narducci, F, Arencibia, O, Raspagliesi, F, Toptas, T, Cibula, D, Kaidarova, D, Meydanli, M, Tavares, M, Golub, D, Perrone, A, Poka, R, Tsolakidis, D, Vujić, G, Jedryka, M, Zusterzeel, P, Beltman, J, Goffin, F, Haidopoulos, D, Haller, H, Jach, R, Yezhova, I, Berlev, I, Bernardino, M, Bharathan, R, Lanner, M, Maenpaa, M, Sukhin, V, Feron, J, Fruscio, R, Kukk, K, Ponce, J, Minguez, J, Vázquez-Vicente, D, Castellanos, T, Chacon, E, Alcazar, J, INSERM, Université de Lille, Protéomique, Réponse Inflammatoire, Spectrométrie de Masse (PRISM) - U1192, Clínica Universidad de Navarra [Pamplona], Istituto Europeo di Oncologia [Milano] [IEO], Institut Bergonié [Bordeaux], Universidad de Navarra [Pamplona] [UNAV], Istituto Europeo di Oncologia [Milano] (IEO), UNICANCER, Universidad de Navarra [Pamplona] (UNAV), Protéomique, Réponse Inflammatoire, Spectrométrie de Masse (PRISM) - U 1192 (PRISM), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)
- Subjects
Adult ,BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences ,medicine.medical_specialty ,Uterine Cervical Neoplasm ,cervical cancer ,[SDV]Life Sciences [q-bio] ,03 medical and health sciences ,Young Adult ,surgical oncology ,0302 clinical medicine ,hysterectomy ,laparoscope ,cervix uteri ,laparotomy ,Surgical oncology ,local ,medicine ,Radical Hysterectomy ,Prospective cohort study ,Cancer staging ,Aged ,Neoplasm Staging ,Cervical cancer ,Aged, 80 and over ,030219 obstetrics & reproductive medicine ,neoplasm recurrence, local ,business.industry ,BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti ,Obstetrics and Gynecology ,Retrospective cohort study ,Minimally Invasive Surgical Procedure ,Middle Aged ,medicine.disease ,neoplasm recurrence ,Surgery ,Women's cancers Radboud Institute for Health Sciences [Radboudumc 17] ,Europe ,Settore MED/40 - GINECOLOGIA E OSTETRICIA ,laparoscopes ,Oncology ,030220 oncology & carcinogenesis ,Cohort ,Female ,Cohort Studie ,business ,Cohort study ,Human - Abstract
SUCCOR study: an international European cohort observational study comparing minimally invasive surgery versus open abdominal radical hysterectomy in patients with stage IB1 cervical cancer FREE http://orcid.org/0000-0002-1908-3251Luis Chiva1, Vanna Zanagnolo2, Denis Querleu3, Nerea Martin- Calvo4, Juan Arévalo-Serrano5, Mihai Emil Căpîlna6, Anna Fagotti7, Ali Kucukmetin8, Constantijne Mom9, Galina Chakalova10, Shamistan Aliyev11, Mario Malzoni12, http://orcid.org/0000- 0001-5809-3535Fabrice Narducci13, Octavio Arencibia14, Francesco Raspagliesi15, Tayfun Toptas16, David Cibula17, Dilyara Kaidarova18, http://orcid.org/0000-0001-6763-9720Mehmet Mutlu Meydanli19, Mariana Tavares20, Dmytro Golub21, http://orcid.org/0000-0003-3140-4772Anna Myriam Perrone22, Robert Poka23, Dimitrios Tsolakidis24, Goran Vujić25, http://orcid.org/0000-0001-8935- 0311Marcin A Jedryka26, Petra L M Zusterzeel27, Jogchum Jan Beltman28, Frederic Goffin29, Dimitrios Haidopoulos30, Herman Haller31, Robert Jach32, Iryna Yezhova33, Igor Berlev34, Margarida Bernardino35, Rasiah Bharathan36, Maximilian Lanner37, Minna M Maenpaa38, http://orcid.org/0000-0002-4403-3707Vladyslav Sukhin39, Jean-Guillaume Feron40, Robert Fruscio41, 42, Kersti Kukk43, Jordi Ponce44, Jose Angel Minguez45, http://orcid.org/0000-0002-9618- 5606Daniel Vázquez-Vicente45, Teresa Castellanos45, Enrique Chacon46 and http://orcid.org/0000-0002-9700-0853Juan Luis Alcazar47 On behalf of the SUCCOR study Group Author affiliations Abstract Background Minimally invasive surgery in cervical cancer has demonstrated in recent publications worse outcomes than open surgery. The primary objective of the SUCCOR study, a European, multicenter, retrospective, observational cohort study was to evaluate disease-free survival in patients with stage IB1 (FIGO 2009) cervical cancer undergoing open vs minimally invasive radical hysterectomy. As a secondary objective, we aimed to investigate the association between protective surgical maneuvers and the risk of relapse. Methods We obtained data from 1272 patients that underwent a radical hysterectomy by open or minimally invasive surgery for stage IB1 cervical cancer (FIGO 2009) from January 2013 to December 2014. After applying all the inclusion-exclusion criteria, we used an inverse probability weighting to construct a weighted cohort of 693 patients to compare outcomes (minimally invasive surgery vs open). The first endpoint compared disease-free survival at 4.5 years in both groups. Secondary endpoints compared overall survival among groups and the impact of the use of a uterine manipulator and protective closure of the colpotomy over the tumor in the minimally invasive surgery group. Results Mean age was 48.3 years (range ; 23–83) while the mean BMI was 25.7 kg/m2 (range ; 15–49). The risk of recurrence for patients who underwent minimally invasive surgery was twice as high as that in the open surgery group (HR, 2.07 ; 95% CI, 1.35 to 3.15 ; P=0.001). Similarly, the risk of death was 2.42-times higher than in the open surgery group (HR, 2.45 ; 95% CI, 1.30 to 4.60, P=0.005). Patients that underwent minimally invasive surgery using a uterine manipulator had a 2.76-times higher hazard of relapse (HR, 2.76 ; 95% CI, 1.75 to 4.33 ; P
- Published
- 2020
28. Clear cell carcinoma of the endometrium
- Author
-
Giorgio Bogani, Isabelle Ray-Coquard, Nicole Concin, Natalie Y.L. Ngoi, Philippe Morice, Takayuki Enomoto, Kazuhiro Takehara, Hannelore Denys, Domenica Lorusso, Robert Coleman, Michelle M. Vaughan, Masashi Takano, Diane Provencher, Satoru Sagae, Pauline Wimberger, Robert Póka, Yakir Segev, Se Ik Kim, Jae-Weon Kim, Francisco J. Candido dos Reis, Andrea Mariani, Mario M. Leitao, Viky Makker, Nadeem Abu Rustum, Ignace Vergote, Gian Franco Zannoni, David S.P. Tan, Mary McCormack, Marta Bini, Salvatore Lopez, Francesco Raspagliesi, Pierluigi Benedetti Panici, Violante di Donato, Ludovico Muzii, Nicoletta Colombo, Giovanni Scambia, Sandro Pignata, Bradley J. Monk, Bogani, G, Ray-Coquard, I, Concin, N, Ngoi, N, Morice, P, Enomoto, T, Takehara, K, Denys, H, Lorusso, D, Coleman, R, Vaughan, M, Takano, M, Provencher, D, Sagae, S, Wimberger, P, Poka, R, Segev, Y, Kim, S, Kim, J, Candido dos Reis, F, Mariani, A, Leitao, M, Makker, V, Rustum, N, Vergote, I, Zannoni, G, Tan, D, Mccormack, M, Bini, M, Lopez, S, Raspagliesi, F, Panici, P, di Donato, V, Muzii, L, Colombo, N, Scambia, G, Pignata, S, and Monk, B
- Subjects
Clear cell endometrial cancer ,Immunotherapy ,Target therapy ,Uterine cancer ,Obstetrics and Gynecology ,Prognosis ,Endometrial Neoplasms ,Endometrium ,Settore MED/40 - GINECOLOGIA E OSTETRICIA ,Oncology ,Uterine Neoplasms ,Humans ,Female ,Tumor Suppressor Protein p53 ,Adenocarcinoma, Clear Cell - Abstract
Clear cell endometrial carcinoma represents an uncommon and poorly understood entity. Data from molecular/genomic profiling highlighted the importance of various signatures in assessing the prognosis of endometrial cancer according to four classes of risk (POLE mutated, MMRd, NSMP, and p53 abnormal). Unfortunately, data specific to clear cell histological subtype endometrial cancer are lacking. More recently, data has emerged to suggest that most of the patients (more than 80%) with clear cell endometrial carcinoma are characterized by p53 abnormality or NSMP type. This classification has important therapeutic implications. Although it is an uncommon entity, clear cell endometrial cancer patients with POLE mutation seem characterized by a good prognosis. Chemotherapy is effective in patients with NSMP (especially in stage III and IV) and patients with p53 abnormal disease (all stages). While, preliminary data suggested that patients with MMRd are less likely to benefit from chemotherapy. The latter group appears to benefit much more from immune checkpoint inhibitors: recent data from clinical trials on pembrolizumab plus lenvatinib and nivolumab plus cabozantinib supported that immunotherapy plus tyrosine kinase inhibitors (TKI) would be the most appropriate treatment for recurrent non-endometrioid endometrial cancer (including clear cell carcinoma) after the failure of platinum-based chemotherapy. Moreover, ongoing clinical trials testing the anti-tumor activity of innovative products will clarify the better strategies for advanced/recurrent clear cell endometrial carcinoma. Further prospective evidence is urgently needed to better characterize clear cell endometrial carcinoma.
- Published
- 2022
29. SUCCOR quality: validation of ESGO quality indicators for surgical treatment of cervical cancer
- Author
-
Felix Boria, Luis Chiva, Enrique Chacon, Vanna Zanagnolo, Anna Fagotti, Ali Kucukmetin, Constantijne Mom, Galina Chakalova, Aliyev Shamistan, Mario Malzoni, Fabrice Narducci, Octavio Arencibia, Francesco Raspagliesi, Tayfun Toptas, David Cibula, Dilyara Kaidarova, Mehmet Mutlu Meydanli, Mariana Tavares, Dmytro Golub, Anna Myriam Perrone, Robert Poka, Petra L M Zusterzeel, Igor Aluloski, Frederic Goffin, Dimitrios Haidopoulos, Herman Haller, Robert Jach, Iryna Yezhova, Margarida Bernardino, Rasiah Bharathan, Minna M Maenpaa, Vladyslav Sukhin, Jean-Guillaume Feron, Robert Fruscio, Kersti Kukk, Jordi Ponce, Fuat Demirkiran, George Vorgias, Natalia Povolotskaya, Pluvio J Coronado Martín, Tiermes Marina, Ignacio Zapardiel, Nicolò Bizzarri, Mikel Gorostidi, Monica Gutierrez, Nabil Manzour, Arantxa Berasaluce, Nerea Martin-Calvo, Boria, F, Chiva, L, Chacon, E, Zanagnolo, V, Fagotti, A, Kucukmetin, A, Mom, C, Chakalova, G, Shamistan, A, Malzoni, M, Narducci, F, Arencibia, O, Raspagliesi, F, Toptas, T, Cibula, D, Kaidarova, D, Meydanli, M, Tavares, M, Golub, D, Perrone, A, Poka, R, Zusterzeel, P, Aluloski, I, Goffin, F, Haidopoulos, D, Haller, H, Jach, R, Yezhova, I, Bernardino, M, Bharathan, R, Maenpaa, M, Sukhin, V, Feron, J, Fruscio, R, Kukk, K, Ponce, J, Demirkiran, F, Vorgias, G, Povolotskaya, N, Coronado Martin, P, Marina, T, Zapardiel, I, Bizzarri, N, Gorostidi, M, Gutierrez, M, Manzour, N, Berasaluce, A, Obstetrics and gynaecology, CCA - Cancer Treatment and quality of life, and Amsterdam Reproduction & Development (AR&D)
- Subjects
Settore MED/40 - GINECOLOGIA E OSTETRICIA ,Oncology ,cervical cancer ,gynecologic surgical procedure ,Obstetrics and Gynecology ,hysterectomy ,gynecologic surgical procedures ,Women's cancers Radboud Institute for Health Sciences [Radboudumc 17] - Abstract
ObjectiveTo evaluate whether compliance with European Society of Gynaecological Oncology (ESGO) surgery quality indicators impacts disease-free survival in patients undergoing radical hysterectomy for cervical cancer.MethodsIn this retrospective cohort study, 15 ESGO quality indicators were assessed in the SUCCOR database (patients who underwent radical hysterectomy for International Federation of Gynecology and Obstetrics (FIGO) stage 2009 IB1, FIGO 2018 IB1, and IB2 cervical cancer between January 2013 and December 2014), and the final score ranged between 0 and 16 points. Centers with more than 13 points were classified as high-quality indicator compliance centers. We constructed a weighted cohort using inverse probability weighting to adjust for the variables. We compared disease-free survival and overall survival using Cox proportional hazards regression analysis in the weighted cohort.ResultsA total of 838 patients were included in the study. The mean number of quality indicators compliance in this cohort was 13.6 (SD 1.45). A total of 479 (57.2%) patients were operated on at high compliance centers and 359 (42.8%) patients at low compliance centers. High compliance centers performed more open surgeries (58.4% vs 36.7%, pConclusionsPatients with early cervical cancer who underwent radical hysterectomy in centers with high compliance with ESGO quality indicators had a lower risk of recurrence and death.
- Published
- 2022
30. SUCCOR Risk: Design and Validation of a Recurrence Prediction Index for Early-Stage Cervical Cancer
- Author
-
Manzour, Nabil, Chiva, Luis, Chacón, Enrique, Martin-Calvo, Nerea, Boria, Felix, Minguez, José A, Alcazar, Juan, L, Vanna, Zanagnolo, Denis, Querleu, Mihai, Căpîlna, Anna, Fagotti, Ali, Kucukmetin, Constantijne, Mom, Galina, Chakalova, Shamistan, Aliyev, Mario, Malzoni, Fabrice, Narducci, Octavio, Arencibia, Francesci, Raspagliesi, Tayfun, Toptas, David, Cibula, Dilyara, Kaidarova, Mehmet, Meydanli, Mariana, Tavares, Dmytro, Golub, Anna, Perrone, Robert, Poka, Dimitrios, Tsolakidis, Goran, Vujić, Marcin, Jedryka, Petra, Zusterzeel, Jogchum, Beltman, Frédéric, Goffin, Dimitros, Haidopoulos, Herman, Haller, Robert, Jach, Iryna, Yezhova, Igor, Berlev, Margarida, Bernardino, Rasiah, Bharathan, Maximilian, Lanner, Vladyslav, Sukhin, Jean, G Feron, Robert, Fruscio, Kersti, Kukk, Jordi, Ponce, Nabil, Abdalla, Özgür, Akbayir, Sedat, Akgöl, Elif, Aksahin, Maria, Alonso-Espias, Igor, Aluloski, Claudia, Andrade, Nikola, Badzakov, Rosa, Barrachina, Giorgio, Bogani, Eduard-Aexandru, Bonci, Hélène, Bonsang-Kitzis, Cosima, Brucker, Laura, Cárdenas, Andrea, Casajuana, Pere, Cavalle, Jorge, Cea, Benito, Chiofalo, Gloria, Cordeiro, Pluvio, Coronado, Maria, Cuadra, Javier, Díez, Teresa Diniz da Costa, Santiago, Domingo, Lukas, Dostalek, Fuat, Demirkiran, Diego, Erasun, Mathias, Fehr, Sergi, Fernandez-Gonzalez, Soledad, Fidalgo, Gabriel, Fiol, Khadra, Galaal, José, García, Gerhard, Gebauer, Fabio, Ghezzi, Juan, Gilabert, Nana, Gomes, Elisabete, Gonçalves, Virginia, Gonzalez, Frederic, Grandjean, Miriam, Guijarro, Frédéric, Guyon, Jolien, Haesen, Gines, Hernandez-Cortes, Sofía, Herrero, Imre, Pete, Ioannis, Kalogiannidis, Erbil, Karaman, Andreas, Kavallaris, Lukasz, Klasa, Ioannis, Kotsopoulos, Stefan, Kovachev, Meelis, Leht, Arantxa, Lekuona, Mathieu, Luyckx, Michael, Mallmann, Gemma, Mancebo, Aljosa, Mandic, Tiermes, Marina, Victor, Martin, María Belén Martín-Salamanca, Alejandra, Martinez, Gesine, Meili, Gustavo, Mendinhos, Mereu, Liliana, Milena, Mitrovic, Sara, Morales, Enrique, Moratalla, Bibiana, Morillas, Eva, Myriokefalitaki, Maja, Pakižimre, Stamatios, Petousis, Laurentiu, Pirtea, Natalia, Povolotskaya, Sonia, Prader, Alfonso, Quesada, Mikuláš, Redecha, Fernando, Roldan, Philip, Rolland, Reeli, Saaron, Cosmin-Paul, Sarac, Jens-Peter, Scharf, Špela, Smrkolj, Rita, Sousa, Artem, Stepanyan, Vladimír, Študent, Carmen, Tauste, Hans, Trum, Taner, Turan, Manuela, Undurraga, Arno, Uppin, Alicia, Vázquez, Ignace, Vergote, George, Vorgias, Ignacio, Zapardiel, Amsterdam Reproduction & Development (AR&D), Obstetrics and gynaecology, CCA - Imaging and biomarkers, Manzour, N, Chiva, L, Chacon, E, Martin-Calvo, N, Boria, F, Minguez, J, Alcazar, J, Zanagnolo, V, Querleu, D, Capilna, M, Fagotti, A, Kucukmetin, A, Mom, C, Chakalova, G, Aliyev, S, Malzoni, M, Narducci, F, Arencibia, O, Raspagliesi, F, Toptas, T, Cibula, D, Kaidarova, D, Meydanli, M, Tavares, M, Golub, D, Perrone, A, Poka, R, Tsolakidis, D, Vujic, G, Jedryka, M, Zusterzeel, P, Beltman, J, Goffin, F, Haidopoulos, D, Haller, H, Jach, R, Yezhova, I, Berlev, I, Bernardino, M, Bharathan, R, Lanner, M, Sukhin, V, Feron, J, Fruscio, R, Kukk, K, Ponce, J, Abdalla, N, Akbayir, O, Akgol, S, Aksahin, E, Alonso-Espias, M, Aluloski, I, Andrade, C, Badzakov, N, Barrachina, R, Bogani, G, Bonci, E, Bonsang-Kitzis, H, Brucker, C, Cardenas, L, Casajuana, A, Cavalle, P, Cea, J, Chiofalo, B, Cordeiro, G, Coronado, P, Cuadra, M, Diez, J, da Costa, T, Domingo, S, Dostalek, L, Demirkiran, F, Erasun, D, Fehr, M, Fernandez-Gonzalez, S, Fidalgo, S, Fiol, G, Galaal, K, Garcia, J, Gebauer, G, Ghezzi, F, Gilabert, J, Gomes, N, Goncalves, E, Gonzalez, V, Grandjean, F, Guijarro, M, Guyon, F, Haesen, J, Hernandez-Cortes, G, Herrero, S, Pete, I, Kalogiannidis, I, Karaman, E, Kavallaris, A, Klasa, L, Kotsopoulos, I, Kovachev, S, Leht, M, Lekuona, A, Luyckx, M, Mallmann, M, Mancebo, G, Mandic, A, Marina, T, Martin, V, Martin-Salamanca, M, Martinez, A, Meili, G, Mendinhos, G, Mereu, L, Mitrovic, M, Morales, S, Moratalla, E, Morillas, B, Myriokefalitaki, E, Pakizimre, M, Petousis, S, Pirtea, L, Povolotskaya, N, Prader, S, Quesada, A, Redecha, M, Roldan, F, Rolland, P, Saaron, R, Sarac, C, Scharf, J, Smrkolj, S, Sousa, R, Stepanyan, A, Student, V, Tauste, C, Trum, H, Turan, T, Undurraga, M, Uppin, A, Vazquez, A, Vergote, I, Vorgias, G, and Zapardiel, I
- Subjects
cervical cancer ,Cevical cancer ,Uterine Cervical Neoplasms ,Hysterectomy ,Prognosis ,Risk Assessment ,Women's cancers Radboud Institute for Health Sciences [Radboudumc 17] ,conization ,Settore MED/40 - GINECOLOGIA E OSTETRICIA ,Oncology ,Recurrence ,radical hysterectomy ,Humans ,Female ,Surgery ,Neoplasm Recurrence, Local ,Neoplasm Staging ,Retrospective Studies - Abstract
Objective Based on the SUCCOR study database, our primary objective was to identify the independent clinical pathological variables associated with the risk of relapse in patients with stage IB1 cervical cancer who underwent a radical hysterectomy. Our secondary goal was to design and validate a risk predictive index (RPI) for classifying patients depending on the risk of recurrence. Methods Overall, 1116 women were included from January 2013 to December 2014. We randomly divided our sample into two cohorts: discovery and validation cohorts. The test group was used to identify the independent variables associated with relapse, and with these variables, we designed our RPI. The index was applied to calculate a relapse risk score for each participant in the validation group. Results A previous cone biopsy was the most significant independent variable that lowered the rate of relapse (odds ratio [OR] 0.31, 95% confidence interval [CI] 0.17–0.60). Additionally, patients with a tumor diameter >2 cm on preoperative imaging assessment (OR 2.15, 95% CI 1.33–3.5) and operated by the minimally invasive approach (OR 1.61, 95% CI 1.00–2.57) were more likely to have a recurrence. Based on these findings, patients in the validation cohort were classified according to the RPI of low, medium, or high risk of relapse, with rates of 3.4%, 9.8%, and 21.3% observed in each group, respectively. With a median follow-up of 58 months, the 5-year disease-free survival rates were 97.2% for the low-risk group, 88.0% for the medium-risk group, and 80.5% for the high-risk group (p < 0.001). Conclusion Previous conization to radical hysterectomy was the most powerful protective variable of relapse. Our risk predictor index was validated to identify patients at risk of recurrence.
- Published
- 2022
31. Uterine serous carcinoma
- Author
-
Diane Provencher, Michelle M. Vaughan, Kazuhiro Takehara, Violante Di Donato, Takayuki Enomoto, Se Ik Kim, Nicoletta Colombo, Domenica Lorusso, Nicole Concin, Natalie Ngoi, Giovanni Scambia, Francesco Raspagliesi, Isabelle Ray-Coquard, Bradley J. Monk, Róbert Póka, Ludovico Muzii, Remi A. Nout, Satoru Sagae, Andrea Mariani, Sandro Pignata, Philippe Morice, Hannelore Denys, Mario M. Leitao, Pauline Wimberger, Yakir Segev, Salvatore Lopez, Alice Indini, Francisco José Candido dos Reis, Pieluigi Benedetti Panici, Marta Bini, Giorgio Bogani, Masashi Takano, Bogani, G, Ray-Coquard, I, Concin, N, Ngoi, N, Morice, P, Enomoto, T, Takehara, K, Denys, H, Nout, R, Lorusso, D, Vaughan, M, Bini, M, Takano, M, Provencher, D, Indini, A, Sagae, S, Wimberger, P, Poka, R, Segev, Y, Kim, S, Candido dos Reis, F, Lopez, S, Mariani, A, Leitao, M, Raspagliesi, F, Panici, P, Di Donato, V, Muzii, L, Colombo, N, Scambia, G, Pignata, S, and Monk, B
- Subjects
0301 basic medicine ,Oncology ,medicine.medical_specialty ,Serous uterine cancer ,medicine.medical_treatment ,Gynecologic oncology ,Pembrolizumab ,Article ,Uterine serous carcinoma ,Targeted therapy ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Endometrial cancer ,SDG 3 - Good Health and Well-being ,Internal medicine ,Medicine ,Humans ,Randomized Controlled Trials as Topic ,business.industry ,Obstetrics and Gynecology ,medicine.disease ,Cystadenocarcinoma, Serous ,Radiation therapy ,Serous fluid ,030104 developmental biology ,chemistry ,Clinical Trials, Phase III as Topic ,030220 oncology & carcinogenesis ,IMUNOTERAPIA ,Uterine Neoplasms ,Female ,Immunotherapy ,business ,Lenvatinib - Abstract
Serous endometrial cancer represents a relative rare entity accounting for about 10% of all diagnosed endometrial cancer, but it is responsible for 40% of endometrial cancer-related deaths. Patients with serous endometrial cancer are often diagnosed at earlier disease stage, but remain at higher risk of recurrence and poorer prognosis when compared stage-for-stage with endometrioid subtype endometrial cancer. Serous endometrial cancers are characterized by marked nuclear atypia and abnormal p53 staining in immunohistochemistry. The mainstay of treatment for newly diagnosed serous endometrial cancer includes a multi-modal therapy with surgery, chemotherapy and/or radiotherapy. Unfortunately, despite these efforts, survival outcomes still remain poor. Recently, The Cancer Genome Atlas (TCGA) Research Network classified all endometrial cancer types into four categories, of which, serous endometrial cancer mostly is found within the "copy number high" group. This group is characterized by the increased cell cycle deregulation (e.g., CCNE1, MYC, PPP2R1A, PIKCA, ERBB2 and CDKN2A) and TP53 mutations (90%). To date, the combination of pembrolizumab and lenvatinib is an effective treatment modality in second-line therapy, with a response rate of 50% in advanced/recurrent serous endometrial cancer. Owing to the unfavorable outcomes of serous endometrial cancer, clinical trials are a priority. At present, ongoing studies are testing novel combinations of various targeted and immunotherapeutic agents in newly diagnosed and advanced/recurrent endometrial cancer - an important strategy for serous endometrial cancer, whereby tumors are usually p53+ and pMMR, making response to PD-1 inhibitor monotherapy unlikely. Here, the rare tumor working group (including members from the European Society of Gynecologic Oncology (ESGO), Gynecologic Cancer Intergroup (GCIG), and Japanese Gynecologic Oncology Group (JGOG)), performed a narrative review reporting on the current landscape of serous endometrial cancer and focusing on standard and emerging therapeutic options for patients affected by this difficult disease.
- Published
- 2021
32. 91 Early results of DTC enhancement and dmr postirradiational tumour activity change measurements
- Author
-
Szluha, K., Tóth, J., Péter, M., Lipták, Zs., and Póka, R.
- Published
- 1998
- Full Text
- View/download PDF
33. SUCCOR quality: validation of ESGO quality indicators for surgical treatment of cervical cancer.
- Author
-
Boria F, Chiva L, Chacon E, Zanagnolo V, Fagotti A, Kucukmetin A, Mom C, Chakalova G, Shamistan A, Malzoni M, Narducci F, Arencibia O, Raspagliesi F, Toptas T, Cibula D, Kaidarova D, Meydanli MM, Tavares M, Golub D, Perrone AM, Poka R, Zusterzeel PLM, Aluloski I, Goffin F, Haidopoulos D, Haller H, Jach R, Yezhova I, Bernardino M, Bharathan R, Maenpaa MM, Sukhin V, Feron JG, Fruscio R, Kukk K, Ponce J, Demirkiran F, Vorgias G, Povolotskaya N, Coronado Martín PJ, Marina T, Zapardiel I, Bizzarri N, Gorostidi M, Gutierrez M, Manzour N, Berasaluce A, and Martin-Calvo N
- Subjects
- Humans, Female, Quality Indicators, Health Care, Retrospective Studies, Neoplasm Staging, Neoplasm Recurrence, Local surgery, Hysterectomy, Uterine Cervical Neoplasms pathology
- Abstract
Objective: To evaluate whether compliance with European Society of Gynaecological Oncology (ESGO) surgery quality indicators impacts disease-free survival in patients undergoing radical hysterectomy for cervical cancer., Methods: In this retrospective cohort study, 15 ESGO quality indicators were assessed in the SUCCOR database (patients who underwent radical hysterectomy for International Federation of Gynecology and Obstetrics (FIGO) stage 2009 IB1, FIGO 2018 IB1, and IB2 cervical cancer between January 2013 and December 2014), and the final score ranged between 0 and 16 points. Centers with more than 13 points were classified as high-quality indicator compliance centers. We constructed a weighted cohort using inverse probability weighting to adjust for the variables. We compared disease-free survival and overall survival using Cox proportional hazards regression analysis in the weighted cohort., Results: A total of 838 patients were included in the study. The mean number of quality indicators compliance in this cohort was 13.6 (SD 1.45). A total of 479 (57.2%) patients were operated on at high compliance centers and 359 (42.8%) patients at low compliance centers. High compliance centers performed more open surgeries (58.4% vs 36.7%, p<0.01). Women who were operated on at centers with high compliance with quality indicators had a significantly lower risk of relapse (HR=0.39; 95% CI 0.25 to 0.61; p<0.001). The association was reduced, but remained significant, after further adjustment for conization, surgical approach, and use of manipulator surgery (HR=0.48; 95% CI 0.30 to 0.75; p=0.001) and adjustment for adjuvant therapy (HR=0.47; 95% CI 0.30 to 0.74; p=0.001). Risk of death from disease was significantly lower in women operated on at centers with high adherence to quality indicators (HR=0.43; 95% CI 0.19 to 0.97; p=0.041). However, the association was not significant after adjustment for conization, surgical approach, use of manipulator surgery, and adjuvant therapy., Conclusions: Patients with early cervical cancer who underwent radical hysterectomy in centers with high compliance with ESGO quality indicators had a lower risk of recurrence and death., Competing Interests: Competing interests: None declared., (© IGCS and ESGO 2022. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2022
- Full Text
- View/download PDF
34. SUCCOR cone study: conization before radical hysterectomy.
- Author
-
Chacon E, Manzour N, Zanagnolo V, Querleu D, Núñez-Córdoba JM, Martin-Calvo N, Căpîlna ME, Fagotti A, Kucukmetin A, Mom C, Chakalova G, Shamistan A, Gil Moreno A, Malzoni M, Narducci F, Arencibia O, Raspagliesi F, Toptas T, Cibula D, Kaidarova D, Meydanli MM, Tavares M, Golub D, Perrone AM, Poka R, Tsolakidis D, Vujić G, Jedryka MA, Zusterzeel PLM, Beltman JJ, Goffin F, Haidopoulos D, Haller H, Jach R, Yezhova I, Berlev I, Bernardino M, Bharathan R, Lanner M, Maenpaa MM, Sukhin V, Feron JG, Fruscio R, Kukk K, Ponce J, Minguez JA, Vázquez-Vicente D, Castellanos T, Boria F, Alcazar JL, and Chiva L
- Subjects
- Adult, Databases, Factual, Disease-Free Survival, Female, Humans, Middle Aged, Minimally Invasive Surgical Procedures, Propensity Score, Retrospective Studies, Uterine Cervical Neoplasms pathology, Conization statistics & numerical data, Hysterectomy statistics & numerical data, Neoplasm Recurrence, Local prevention & control, Uterine Cervical Neoplasms surgery
- Abstract
Objective: To evaluate disease-free survival of cervical conization prior to radical hysterectomy in patients with stage IB1 cervical cancer (International Federation of Gynecology and Obstetrics (FIGO) 2009)., Methods: A multicenter retrospective observational cohort study was conducted including patients from the Surgery in Cervical Cancer Comparing Different Surgical Aproaches in Stage IB1 Cervical Cancer (SUCCOR) database with FIGO 2009 IB1 cervical carcinoma treated with radical hysterectomy between January 1, 2013, and December 31, 2014. We used propensity score matching to minimize the potential allocation biases arising from the retrospective design. Patients who underwent conization but were similar for other measured characteristics were matched 1:1 to patients from the non-cone group using a caliper width ≤0.2 standard deviations of the logit odds of the estimated propensity score., Results: We obtained a weighted cohort of 374 patients (187 patients with prior conization and 187 non-conization patients). We found a 65% reduction in the risk of relapse for patients who had cervical conization prior to radical hysterectomy (hazard ratio (HR) 0.35, 95% confidence interval (CI) 0.16 to 0.75, p=0.007) and a 75% reduction in the risk of death for the same sample (HR 0.25, 95% CI 0.07 to 0.90, p=0.033). In addition, patients who underwent minimally invasive surgery without prior conization had a 5.63 times higher chance of relapse compared with those who had an open approach and previous conization (HR 5.63, 95% CI 1.64 to 19.3, p=0.006). Patients who underwent minimally invasive surgery with prior conization and those who underwent open surgery without prior conization showed no differences in relapse rates compared with those who underwent open surgery with prior cone biopsy (reference) (HR 1.94, 95% CI 0.49 to 7.76, p=0.349 and HR 2.94, 95% CI 0.80 to 10.86, p=0.106 respectively)., Conclusions: In this retrospective study, patients undergoing cervical conization before radical hysterectomy had a significantly lower risk of relapse and death., Competing Interests: Competing interests: None declared., (© IGCS and ESGO 2022. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2022
- Full Text
- View/download PDF
35. Challenges in lower limb lymphoedema assessment based on limb volume change: Lessons learnt from the SENTIX prospective multicentre study.
- Author
-
Borčinová M, Ragosch V, Jarkovský J, Bajsová S, Pilka R, Glickman A, Garrido-Mallach S, Raspagliesi F, Szatkowski W, Pakiz M, Snyman LC, Kocián R, Tamussino K, Kalist V, Michal M, Segovia MG, Poka R, Kipp B, Szewczyk G, Wydra D, Tóth R, Vinnytska A, Fischerová D, Siegler K, and Cibula D
- Subjects
- Adult, Europe, Female, Humans, Lower Extremity, Prospective Studies, Sentinel Lymph Node Biopsy, South Africa, Decision Making, Lymphedema pathology, Neoplasm Staging, Uterine Cervical Neoplasms pathology
- Abstract
Background: Lower limb lymphoedema (LLL) is the most disabling adverse effect of surgical staging of pelvic lymph nodes. However, the lack of standardisation of volumetric LLL assessment hinders direct comparison between the studies and makes LLL reporting unreliable. The aim of our study is to report outcomes from a prospective trial that have implications for LLL assessment standardisation., Methods: In the prospective international multicentre trial SENTIX, a group of 150 patients with stage IA1-IB2 cervical cancer treated by uterine surgery with bilateral sentinel lymph node biopsy was prospectively evaluated by objective LLL assessment, based on limb volume change (LVC) using circumferrential limb measurements and subjective patient-reported swelling. The assessments were conducted in six-month periods over 24 months post-surgery., Results: Patient LVC substantially fluctuated in both positive and negative directions, which were comparable in frequency up to ±14% change. Thirty-eight patients experienced persistent LVC increase >10% classified as LLL, with nine months median time to onset. Some 34.2% of cases experienced onset later than one year after the surgery. Thirty-three patients (22%) experienced transient oedema characterised as LVC >10%, which resolved without intervention between two consequent follow-up visits. No significant correlation between LVC >10% and a patient-reported swelling was observed., Conclusions: Given that we observed comparable fluctuations of the the lower-limb volumes after surgical treatment of cervical cancer in both positive and negative direction up to ±14%, the diagnostic threshold for LLL diagnosis based on LVC should be increased to >15% LVC. The distinction of transient oedema from persistent LLL requires repeated measurements. Also, as one-third of LLL cases are diagnosed >1-year post-surgery, a sufficient follow-up duration needs to be ensured. Patient-reported swelling correlated poorly with LVC and should only be used as an adjunct to objective LLL assessment., Trial Registration: ClinicalTrials.gov: NCT02494063., Competing Interests: Declaration of Competing Interest None declared., (Copyright © 2021 Elsevier Inc. All rights reserved.)
- Published
- 2022
- Full Text
- View/download PDF
36. Radical hysterectomy in early cervical cancer in Europe: characteristics, outcomes and evaluation of ESGO quality indicators.
- Author
-
Boria F, Chiva L, Zanagnolo V, Querleu D, Martin-Calvo N, Căpîlna ME, Fagotti A, Kucukmetin A, Mom C, Chakalova G, Shamistan A, Malzoni M, Narducci F, Arencibia O, Raspagliesi F, Toptas T, Cibula D, Kaidarova D, Meydanli MM, Tavares M, Golub D, Perrone AM, Poka R, Tsolakidis D, Vujić G, Jedryka MA, Zusterzeel PLM, Beltman JJ, Goffin F, Haidopoulos D, Haller H, Jach R, Yezhova I, Berlev I, Bernardino M, Bharathan R, Lanner M, Maenpaa MM, Sukhin V, Feron JG, Fruscio R, Kukk K, Ponce J, Alonso-Espías M, Minguez JA, Vázquez-Vicente D, Manzour N, Jurado M, Castellanos T, Chacon E, and Alcazar JL
- Subjects
- Europe, Female, Humans, Middle Aged, Treatment Outcome, Hysterectomy methods, Quality Indicators, Health Care standards, Uterine Cervical Neoplasms surgery
- Abstract
Introduction: Comprehensive updated information on cervical cancer surgical treatment in Europe is scarce., Objective: To evaluate baseline characteristics of women with early cervical cancer and to analyze the outcomes of the ESGO quality indicators after radical hysterectomy in the SUCCOR database., Methods: The SUCCOR database consisted of 1272 patients who underwent radical hysterectomy for stage IB1 cervical cancer (FIGO 2009) between January 2013 and December 2014. After exclusion criteria, the final sample included 1156 patients. This study first described the clinical, surgical, pathological, and follow-up variables of this population and then analyzed the outcomes (disease-free survival and overall survival) after radical hysterectomy. Surgical-related ESGO quality indicators were assessed and the accomplishment of the stated recommendations was verified., Results: The mean age of the patients was 47.1 years (SD 10.8), with a mean body mass index of 25.4 kg/m
2 (SD 4.9). A total of 423 (36.6%) patients had a previous cone biopsy. Tumor size (clinical examination) <2 cm was observed in 667 (57.7%) patients. The most frequent histology type was squamous carcinoma (794 (68.7%) patients), and positive lymph nodes were found in 143 (12.4%) patients. A total of 633 (54.8%) patients were operated by open abdominal surgery. Intra-operative complications occurred in 108 (9.3%) patients, and post-operative complications during the first month occurred in 249 (21.5%) patients, with bladder dysfunction as the most frequent event (119 (10.3%) patients). Clavien-Dindo grade III or higher complication occurred in 56 (4.8%) patients. A total of 510 (44.1%) patients received adjuvant therapy. After a median follow-up of 58 months (range 0-84), the 5-year disease-free survival was 88.3%, and the overall survival was 94.9%. In our population, 10 of the 11 surgical-related quality indicators currently recommended by ESGO were fully fulfilled 5 years before its implementation., Conclusions: In this European cohort, the rate of adjuvant therapy after radical hysterectomy is higher than for most similar patients reported in the literature. The majority of centers were already following the European recommendations even 5 years prior to the ESGO quality indicator implementations., Competing Interests: Competing interests: None declared., (© IGCS and ESGO 2021. No commercial re-use. See rights and permissions. Published by BMJ.)- Published
- 2021
- Full Text
- View/download PDF
37. Voiding recovery after radical parametrectomy in cervical cancer patients: An international prospective multicentre trial - SENTIX.
- Author
-
Zapardiel I, Kocian R, Köhler C, Klat J, Germanova A, Jacob A, Bajsova S, Böhmer G, Lay L, Gil-Ibañez B, Havelka P, Kipp B, Szewczyk G, Toth R, Staringer JC, De Santiago J, Coronado PJ, Poka R, Laky R, Luyckx M, Fastrez M, Dusek L, Hernandez A, and Cibula D
- Subjects
- Adult, Aged, Female, Humans, Middle Aged, Prospective Studies, Hysterectomy adverse effects, Uterine Cervical Neoplasms surgery
- Abstract
Objective: Voiding dysfunctions represent a leading morbidity after radical hysterectomy performed in patients with early-stage cervical cancer. The aim of this study was to perform ad hoc analysis of factors influencing voiding recovery in SENTIX (SENTinel lymph node biopsy in cervIX cancer) trial., Methods: The SENTIX trial (47 sites, 18 countries) is a prospective study on sentinel lymph node biopsy without pelvic lymphadenectomy in patients with early-stage cervical cancer. Overall, the data of 300 patients were analysed. Voiding recovery was defined as the number of days from surgery to bladder catheter/epicystostomy removal or to post-voiding urine residuum ≤50 mL., Results: The median voiding recovery time was three days (5th-95th percentile: 0-21): 235 (78.3%) patients recovered in <7 days and 293 (97.7%) in <30 days. Only seven (2.3%) patients recovered after >30 days. In the multivariate analysis, only previous pregnancy (p = 0.033) and type of parametrectomy (p < 0.001) significantly influenced voiding recovery >7 days post-surgery. Type-B parametrectomy was associated with a higher risk of delayed voiding recovery than type-C1 (OR = 4.69; p = 0.023 vs. OR = 3.62; p = 0.052, respectively), followed by type-C2 (OR = 5.84; p = 0.011). Both previous pregnancy and type C2 parametrectomy independently prolonged time to voiding recovery by two days., Conclusions: Time to voiding recovery is significantly related to previous pregnancy and type of parametrectomy but it is not influenced by surgical approach (open vs minimally invasive), age, or BMI. Type B parametrectomy, without direct visualisation of nerves, was associated with longer recovery than nerve-sparing type C1. Importantly, voiding dysfunctions after radical surgery are temporary, and the majority of the patients recover in less than 30 days, including patients after C2 parametrectomy., Competing Interests: Conflict of interest statement Authors do not have any conflicts of interest., (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Published
- 2021
- Full Text
- View/download PDF
38. GYNOCARE Update: Modern Strategies to Improve Diagnosis and Treatment of Rare Gynecologic Tumors—Current Challenges and Future Directions
- Author
-
Di Fiore R, Suleiman S, Ellul B, O'Toole SA, Savona-Ventura C, Felix A, Napolioni V, Conlon NT, Kahramanoglu I, Azzopardi MJ, Dalmas M, Calleja N, Brincat MR, Muscat-Baron Y, Sabol M, Dimitrievska V, Yordanov A, Vasileva-Slaveva M, von Brockdorff K, Micallef RA, Kubelac P, Achimaș-Cadariu P, Vlad C, Tzortzatou O, Poka R, Giordano A, Felice A, Reed N, Herrington CS, Faraggi D, and Calleja-Agius J
- Abstract
More than 50% of all gynecologic tumors can be classified as rare (defined as an incidence of ≤6 per 100,000 women) and usually have a poor prognosis owing to delayed diagnosis and treatment. In contrast to almost all other common solid tumors, the treatment of rare gynecologic tumors (RGT) is often based on expert opinion, retrospective studies, or extrapolation from other tumor sites with similar histology, leading to difficulty in developing guidelines for clinical practice. Currently, gynecologic cancer research, due to distinct scientific and technological challenges, is lagging behind. Moreover, the overall efforts for addressing these challenges are fragmented across different European countries and indeed, worldwide. The GYNOCARE, COST Action CA18117 (European Network for Gynecological Rare Cancer Research) programme aims to address these challenges through the creation of a unique network between key stakeholders covering distinct domains from concept to cure: basic research on RGT, biobanking, bridging with industry, and setting up the legal and regulatory requirements for international innovative clinical trials. On this basis, members of this COST Action, (Working Group 1, “Basic and Translational Research on Rare Gynecological Cancer”) have decided to focus their future efforts on the development of new approaches to improve the diagnosis and treatment of RGT. Here, we provide a brief overview of the current state-of-the-art and describe the goals of this COST Action and its future challenges with the aim to stimulate discussion and promote synergy across scientists engaged in the fight against this rare cancer worldwide.
- Published
- 2021
- Full Text
- View/download PDF
39. The Effect of Vaginal Microablative Fractional CO 2 Laser Treatment on Vaginal Cytology.
- Author
-
Takacs P, Sipos AG, Kozma B, Cunningham TD, Larson K, Lampé R, and Poka R
- Subjects
- Atrophy pathology, Carbon Dioxide, Female, Humans, Treatment Outcome, Vagina pathology, Vagina surgery, Lasers, Gas therapeutic use, Vaginal Diseases surgery
- Abstract
Background and Objectives: Most recently vaginal laser treatment was introduced as a new option for women with genitourinary syndrome of menopause, vaginal dryness. Our objective was to assess the effects of intravaginal CO
2 laser treatment on vaginal cytology., Study Design/materials and Methods: Fifty-two women with symptoms of vaginal dryness were enrolled and underwent vaginal laser treatment using a fractional CO2 laser. Patients received three vaginal laser treatments 4 weeks apart. Vaginal cytology was obtained before the first treatment and 4 weeks after each additional treatment. Vaginal dryness was assessed by using a Visual Analog Scale (VAS)., Results: Out of the 52 women enrolled, 34 were in menopause. Postmenopausal women had significantly lower vaginal maturation values (VMV) compared with premenopausal women at the baseline visit (mean ± standard deviation [SD], 42 ± 23 vs. 68 ± 13, P < 0.01). The vaginal dryness VAS was higher (worse) in postmenopausal women compared with premenopausal cases (mean ± SD, 5.7 ± 4 vs. 2.4 ± 3, P < 0.01). The VMV did not change significantly over time after vaginal laser treatment. However vaginal dryness VAS improved significantly after each treatment. Both in the premenopausal and postmenopausal groups, vaginal dryness scores improved significantly from baseline after the three treatments (postmenopausal 5.7 ± 4 vs. 1.6 ± 2.5, P < 0.01 and premenopausal 2.4 ± 3 vs. 0.2 ± 0.5, P < 0.01). Those patients who had improvement in VMV had significantly better (lower) dryness VAS compared with those women without an improvement in VMV after the three treatments (mean ± SD, 0.3 ± 0.8 vs. 1.6 ± 2.6, P = 0.04)., Conclusions: Vaginal dryness VAS improved significantly in a cohort of premenopausal and postmenopausal women undergoing vaginal CO2 laser treatment despite no significant change in vaginal cytology. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc., (© 2020 Wiley Periodicals, Inc.)- Published
- 2020
- Full Text
- View/download PDF
40. SUCCOR study: an international European cohort observational study comparing minimally invasive surgery versus open abdominal radical hysterectomy in patients with stage IB1 cervical cancer.
- Author
-
Chiva L, Zanagnolo V, Querleu D, Martin-Calvo N, Arévalo-Serrano J, Căpîlna ME, Fagotti A, Kucukmetin A, Mom C, Chakalova G, Aliyev S, Malzoni M, Narducci F, Arencibia O, Raspagliesi F, Toptas T, Cibula D, Kaidarova D, Meydanli MM, Tavares M, Golub D, Perrone AM, Poka R, Tsolakidis D, Vujić G, Jedryka MA, Zusterzeel PLM, Beltman JJ, Goffin F, Haidopoulos D, Haller H, Jach R, Yezhova I, Berlev I, Bernardino M, Bharathan R, Lanner M, Maenpaa MM, Sukhin V, Feron JG, Fruscio R, Kukk K, Ponce J, Minguez JA, Vázquez-Vicente D, Castellanos T, Chacon E, and Alcazar JL
- Subjects
- Adult, Aged, Aged, 80 and over, Cohort Studies, Europe, Female, Humans, Middle Aged, Neoplasm Staging, Young Adult, Hysterectomy methods, Minimally Invasive Surgical Procedures methods, Uterine Cervical Neoplasms surgery
- Abstract
Background: Minimally invasive surgery in cervical cancer has demonstrated in recent publications worse outcomes than open surgery. The primary objective of the SUCCOR study, a European, multicenter, retrospective, observational cohort study was to evaluate disease-free survival in patients with stage IB1 (FIGO 2009) cervical cancer undergoing open vs minimally invasive radical hysterectomy. As a secondary objective, we aimed to investigate the association between protective surgical maneuvers and the risk of relapse., Methods: We obtained data from 1272 patients that underwent a radical hysterectomy by open or minimally invasive surgery for stage IB1 cervical cancer (FIGO 2009) from January 2013 to December 2014. After applying all the inclusion-exclusion criteria, we used an inverse probability weighting to construct a weighted cohort of 693 patients to compare outcomes (minimally invasive surgery vs open). The first endpoint compared disease-free survival at 4.5 years in both groups. Secondary endpoints compared overall survival among groups and the impact of the use of a uterine manipulator and protective closure of the colpotomy over the tumor in the minimally invasive surgery group., Results: Mean age was 48.3 years (range; 23-83) while the mean BMI was 25.7 kg/m
2 (range; 15-49). The risk of recurrence for patients who underwent minimally invasive surgery was twice as high as that in the open surgery group (HR, 2.07; 95% CI, 1.35 to 3.15; P=0.001). Similarly, the risk of death was 2.42-times higher than in the open surgery group (HR, 2.45; 95% CI, 1.30 to 4.60, P=0.005). Patients that underwent minimally invasive surgery using a uterine manipulator had a 2.76-times higher hazard of relapse (HR, 2.76; 95% CI, 1.75 to 4.33; P<0.001) and those without the use of a uterine manipulator had similar disease-free-survival to the open surgery group (HR, 1.58; 95% CI, 0.79 to 3.15; P=0.20). Moreover, patients that underwent minimally invasive surgery with protective vaginal closure had similar rates of relapse to those who underwent open surgery (HR, 0.63; 95% CI, 0.15 to 2.59; P<0.52)., Conclusions: Minimally invasive surgery in cervical cancer increased the risk of relapse and death compared with open surgery. In this study, avoiding the uterine manipulator and using maneuvers to avoid tumor spread at the time of colpotomy in minimally invasive surgery was associated with similar outcomes to open surgery. Further prospective studies are warranted., Competing Interests: Competing interests: None declared., (© IGCS and ESGO 2020. No commercial re-use. See rights and permissions. Published by BMJ.)- Published
- 2020
- Full Text
- View/download PDF
41. Efficacy and safety of vilaprisan in women with uterine fibroids: Data from the phase 2b randomized controlled trial ASTEROID 2.
- Author
-
Gemzell-Danielsson K, Heikinheimo O, Zatik J, Poka R, Rechberger T, Hudecek R, Petersdorf K, Ramirez F, Faustmann T, Groettrup-Wolfers E, and Seitz C
- Subjects
- Adult, Female, Humans, Leiomyoma drug therapy, Menorrhagia drug therapy, Norpregnadienes adverse effects, Steroids therapeutic use, Uterine Neoplasms drug therapy
- Abstract
Objective: To assess the efficacy of vilaprisan compared with placebo in the management of the symptoms of uterine fibroids (UF), with a secondary objective to provide a descriptive comparison with ulipristal acetate., Study Design: The randomized, parallel-group, double-blind, placebo- and active-controlled, multicenter ASTEROID 2 trial assessed the efficacy and safety of vilaprisan versus placebo and ulipristal acetate for two 12-week treatment periods in women with ≥1 UF experiencing heavy menstrual bleeding (HMB). The primary endpoint compared the efficacy of vilaprisan with placebo at 12 weeks, assessed as the absence of bleeding/spotting by bleeding diary. Secondary endpoints compared the efficacy of vilaprisan with ulipristal acetate. Results of the first 12-week treatment period are reported here., Results: Women (mean age 42.5 years) were enrolled from 1 June 2015. At baseline, mean menstrual blood loss per 28 days was 214.1 mL and the volume of the three largest UF was 106.2 mL. In total, 155 women completed the initial 12-week treatment period. Complete absence of bleeding/spotting until the end of the 12-week treatment period was achieved by 62.9 % of women receiving vilaprisan versus 0.0 % with placebo (p < .001); 55.4 % of women treated with ulipristal acetate reported absence of bleeding/spotting. The predefined HMB response (<80 mL and >50 % reduction from baseline during the last 28 days of treatment) was observed in 95.7 % of subjects treated with vilaprisan and 86.5 % of subjects treated with ulipristal acetate. Vilaprisan and ulipristal acetate treatment reduced the sum of the volume of the three largest UF by 29.9 % and 23.8 %, respectively, whereas an increase of 6.3 % was observed in the placebo group. No safety concerns, including multiple laboratory parameters, were identified., Conclusion: Daily administration of vilaprisan 2 mg induced amenorrhea, controlled bleeding, decreased UF size, and was well tolerated in women with HMB associated with UF., Clinical Trial Registration: ClinicalTrials.gov number: NCT02465814 https://clinicaltrials.gov/ct2/show/NCT02465814., (Copyright © 2020. Published by Elsevier B.V.)
- Published
- 2020
- Full Text
- View/download PDF
42. Randomized controlled trial for improved recovery of the pelvic floor after vaginal delivery with a specially formulated postpartum supplement.
- Author
-
Takacs P, Kozma B, Lampé R, Sipos A, and Poka R
- Abstract
Objective: To improve pelvic floor recovery after vaginal delivery with daily supplementation of a specially formulated postpartum recovery supplement., Methods: Within 48 hours of vaginal delivery, primipara women were randomized in a 1:1 ratio to receive daily oral supplementation for 6 weeks with either a combination of regular prenatal vitamin (PNV), leucine (4 g/day), zinc (30 mg/day) and omega-3 fatty acid (900 mg/day) (treatment group), or only a PNV daily (control group). Co-primary outcomes were vaginal squeeze pressure as measured by perineometer and levator muscle injury as measured by transperineal 3-dimensional tomographic ultrasound at 6 weeks postpartum., Results: Twenty-six women in the control group and 27 in the treatment group completed the trial. Weak pelvic floor muscle strength was significantly less frequent in the treatment group compared to the control group at 6 weeks after delivery (28% vs. 58%, P =0.03). Both right and left-sided levator-urethra gap was significantly larger in the control group compared to the treatment group indicating more levator injury being present in the control group at 6 weeks after delivery. Anterior vaginal wall prolapse at or beyond the hymenal ring was significantly more common in the control group compared to the treatment group (19% vs. 0%, P =0.02). Significantly more women reported bothersome bulge symptoms in the control group compared to the treatment group at 6 weeks postpartum (19% vs. 0%, P =0.02)., Conclusion: Postpartum women who received a specially formulated postpartum recovery supplement had improved recovery of the pelvic floor after vaginal delivery., Competing Interests: Conflict of interest: Peter Takacs is a paid consultant for Fempharma LLC. The other authors have no potential conflict of interest relevant to this article was reported., (Copyright © 2020 Korean Society of Obstetrics and Gynecology.)
- Published
- 2020
- Full Text
- View/download PDF
43. Central Pathology Review in SENTIX, A Prospective Observational International Study on Sentinel Lymph Node Biopsy in Patients with Early-Stage Cervical Cancer (ENGOT-CX2).
- Author
-
Nemejcova K, Kocian R, Kohler C, Jarkovsky J, Klat J, Berjon A, Pilka R, Sehnal B, Gil-Ibanez B, Lupo E, Petiz A, Sanchez OA, Kascak P, Martinelli F, Buda A, Presl J, Barahona M, Lonkhuijzen LV, Szatkowski W, Minar L, Pakiz M, Havelka P, Zorrero C, Misiek M, Snyman LC, Wydra D, Vergote I, Vinnytska A, Redecha M, Michal M, Tingulstad S, Kipp B, Szewczyk G, Toth R, Garcia FJS, Martin PJC, Poka R, Tamussino K, Luyckx M, Fastrez M, Staringer JC, Germanova A, Plaikner A, Bajsova S, Dundr P, Mallmann-Gottschalk N, and Cibula D
- Abstract
The quality of pathological assessment is crucial for the safety of patients with cervical cancer if pelvic lymph node dissection is to be replaced by sentinel lymph node (SLN) biopsy. Central pathology review of SLN pathological ultrastaging was conducted in the prospective SENTIX/European Network of Gynaecological Oncological Trial (ENGOT)-CX2 study. All specimens from at least two patients per site were submitted for the central review. For cases with major or critical deviations, the sites were requested to submit all samples from all additional patients for second-round assessment. From the group of 300 patients, samples from 83 cases from 37 sites were reviewed in the first round. Minor, major, critical, and no deviations were identified in 28%, 19%, 14%, and 39% of cases, respectively. Samples from 26 patients were submitted for the second-round review, with only two major deviations found. In conclusion, a high rate of major or critical deviations was identified in the first round of the central pathology review (28% of samples). This reflects a substantial heterogeneity in current practice, despite trial protocol requirements. The importance of the central review conducted prospectively at the early phase of the trial is demonstrated by a substantial improvement of SLN ultrastaging quality in the second-round review., Competing Interests: The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.
- Published
- 2020
- Full Text
- View/download PDF
44. The Effect of Fractional CO 2 Laser Treatment on the Symptoms of Pelvic Floor Dysfunctions: Pelvic Floor Distress Inventory-20 Questionnaire.
- Author
-
Sipos AG, Kozma B, Poka R, Larson K, and Takacs P
- Subjects
- Aged, Female, Follow-Up Studies, Humans, Middle Aged, Pelvic Floor Disorders diagnosis, Prospective Studies, Severity of Illness Index, Treatment Outcome, Lasers, Gas therapeutic use, Pelvic Floor Disorders surgery, Vagina surgery
- Abstract
Background and Objectives: To assess the improvement on pelvic floor distress (PFD)-related urogenital symptoms using validated questionnaires after intravaginal CO
2 laser treatment., Study Design/materials and Methods: Forty postmenopausal women with genitourinary symptoms of menopause (GSM) were enrolled into this prospective cohort study and underwent vaginal laser treatment using MonaLisa Touch® fractional CO2 laser system. Patients received three vaginal laser treatments with 360° probe 4 weeks apart. A three-component Pelvic Floor Distress Inventory (PFDI-20) validated questionnaire was filled out by each patient before each session and 4 weeks after the final treatment. Wilcoxon rank sum test was used to compare the before and after treatment scores., Results: Pelvic Organ Prolapse Distress Inventory (POPDI-6) scores were not significantly different after the first treatment compared with baseline (mean ± standard deviation [SD], 21 ± 18 vs. 17 ± 15, P = 0.44). However, each subsequent treatment resulted in further, statistically significant improvement in symptom scores (14 ± 15, P = 0.03 and 13 ± 13, P = 0.01, after the second and third treatments, respectively). Similarly, Urinary Distress Inventory (UDI-6) scores were not significantly different after the first laser treatment (mean ± SD, 36 ± 25 vs. 29 ± 23, P = 0.36). After the second and third treatments there were significant improvement in the standardized scores (24 ± 20, P = 0.03 and 22 ± 21, P = 0.01). Colorectal-Anal Distress Inventory (CRADI-8) scores did not change significantly after three laser treatments., Conclusions: Three sessions of microablative fractional CO2 vaginal laser treatment significantly improves patient reported urinary and pelvic organ prolapse symptoms. Lasers Surg. Med. © 2019 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc., (© 2019 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.)- Published
- 2019
- Full Text
- View/download PDF
45. Aberrant Methylation Status of Tumour Suppressor Genes in Ovarian Cancer Tissue and Paired Plasma Samples.
- Author
-
Dvorská D, Braný D, Nagy B, Grendár M, Poka R, Soltész B, Jagelková M, Zelinová K, Lasabová Z, Zubor P, and Danková Z
- Subjects
- Aged, Aged, 80 and over, CpG Islands, Female, Gene Expression Regulation, Neoplastic, High-Throughput Nucleotide Sequencing, Humans, Liquid Biopsy, Middle Aged, Neoplasm Staging, Ovarian Neoplasms blood, Ovarian Neoplasms diagnosis, Promoter Regions, Genetic, ROC Curve, Biomarkers, Tumor, DNA Methylation, Genes, Tumor Suppressor, Ovarian Neoplasms genetics
- Abstract
Ovarian cancer is a highly heterogeneous disease and its formation is affected by many epidemiological factors. It has typical lack of early signs and symptoms, and almost 70% of ovarian cancers are diagnosed in advanced stages. Robust, early and non-invasive ovarian cancer diagnosis will certainly be beneficial. Herein we analysed the regulatory sequence methylation profiles of the RASSF1 , PTEN , CDH1 and PAX1 tumour suppressor genes by pyrosequencing in healthy, benign and malignant ovarian tissues, and corresponding plasma samples. We recorded statistically significant higher methylation levels ( p < 0.05) in the CDH1 and PAX1 genes in malignant tissues than in controls (39.06 ± 18.78 versus 24.22 ± 6.93; 13.55 ± 10.65 versus 5.73 ± 2.19). Higher values in the CDH1 gene were also found in plasma samples (22.25 ± 14.13 versus 46.42 ± 20.91). A similar methylation pattern with positive correlation between plasma and benign lesions was noted in the CDH1 gene ( r = 0.886, p = 0.019) and malignant lesions in the PAX1 gene ( r = 0.771, p < 0.001). The random forest algorithm combining methylation indices of all four genes and age determined 0.932 AUC (area under the receiver operating characteristic (ROC) curve) prediction power in the model classifying malignant lesions and controls. Our study results indicate the effects of methylation changes in ovarian cancer development and suggest that the CDH1 gene is a potential candidate for non-invasive diagnosis of ovarian cancer.
- Published
- 2019
- Full Text
- View/download PDF
46. Screening for preeclampsia in the first trimester of pregnancy in routine clinical practice in Hungary.
- Author
-
Orosz L, Orosz G, Veress L, Dosa D, Orosz L Sr, Arany I, Fabian A, Medve L, Pap K, Karanyi Z, Toth Z, Poka R, Than NG, and Torok O
- Subjects
- Biomarkers metabolism, Case-Control Studies, Female, Humans, Hungary epidemiology, Pre-Eclampsia epidemiology, Pregnancy, Pregnancy-Associated Plasma Protein-A metabolism, Prenatal Diagnosis standards, Prospective Studies, Software, Pre-Eclampsia diagnosis, Pregnancy Trimester, First, Prenatal Diagnosis methods
- Abstract
We aimed to evaluate the contribution of different factors in the Fetal Medicine Foundation algorithms for preeclampsia (PE) risk calculation during first-trimester screening in Hungary. We selected subjects for the nested case-control study from a prospective cohort of 2545 low-risk pregnancies. Eighty-two patients with PE and 82 gestational age-matched controls were included. Individual PE risk was calculated using two risk-assessing softwares. Using Astraia 2.3.1, considering maternal characteristics and biophysical parameters only, detection rates (DR) were 63.6% for early-PE and 67.6% for late-PE. When we added placenta associated plasma protein A (PAPP-A) to the risk calculation, DRs decreased to 54.5% and 64.8% respectively. Using Astraia 2.8.2 with maternal characteristics and biophysical parameters resulted in the DRs of 63.6% (early-PE) and 56.3% (late-PE). If we added PAPP-A to the risk calculation, DRs improved to 72.7% and 54.9%. The addition of placental growth factor (PlGF) did not increase detection rates in either calculation. In conclusion, using maternal characteristics, biophysical parameters, and PAPP-A, an acceptable screening efficacy could be achieved for early-PE during first-trimester screening. Since PlGF did not improve efficacy in our study, we suggest setting new standard curves for PlGF in Eastern European pregnant women, and the evaluation of novel biochemical markers., (Copyright © 2019 Elsevier B.V. All rights reserved.)
- Published
- 2019
- Full Text
- View/download PDF
47. Zinc-containing Vaginal Moisturizer Gel Improves Postmenopausal Vulvovaginal Symptoms: A Pilot Study.
- Author
-
Takacs P, Kozma B, Erdodi B, Jakab A, Larson K, and Poka R
- Abstract
Objectives: Although vaginal estrogen is highly effective in alleviating genitourinary symptoms of menopause (GSM), some women are reluctant to use hormonal treatment. Our aim was to evaluate the effect of a zinc-containing vaginal moisturizer gel on GSM., Methods: Women with GSM were enrolled. Patients were asked to use the vaginal gel daily for 2 weeks. Vaginal Health Index (VHI) was calculated. Visual analogue scale (VAS) was obtained on vaginal pain, dryness, burning, itching, dyspareunia and dysuria before and 2 weeks after the completion of treatment. Vaginal cytology was obtained. Vulvovaginal symptom questionnaire (VSQ-21) was used to assess subjective symptoms., Results: Thirty-seven women with GSM participated in the study. The VHI improved significantly (mean ± standard deviation, 13 ± 4 before vs. 17 ± 4 after treatment, P < 0.01). The patient reported VAS combined score was significantly lower after the treatment (18 ± 14 before vs. 7 ± 12 after treatment, P < 0.01). The largest improvement occurred in vaginal dryness. The maturation value did not change significantly. There were no signs of inflammation on vaginal cytology. VSQ-21 combined scores also improved significantly (7.9 ± 5.5 before vs. 2.7 ± 3.6 after the intervention, P < 0.01). Side effects were rare and minor., Conclusions: Novel zinc-containing vaginal moisturizer gel significantly improves postmenopausal vulvovaginal symptoms without serious side effects., Competing Interests: Conflict of Interest: Takacs is a paid consultant for Fempharma LLC. No other authors have no potential conflict of interest relevant to this article was reported.
- Published
- 2019
- Full Text
- View/download PDF
48. Association between pelvic organ prolapse types and levator-urethra gap as measured by 3D transperineal ultrasound.
- Author
-
Kozma B, Larson K, Scott L, Cunningham TD, Abuhamad A, Poka R, and Takacs P
- Subjects
- Cohort Studies, Female, Humans, Middle Aged, Perineum diagnostic imaging, Retrospective Studies, Ultrasonography methods, Body Weights and Measures methods, Imaging, Three-Dimensional methods, Pelvic Floor diagnostic imaging, Pelvic Organ Prolapse diagnostic imaging, Urethra diagnostic imaging
- Abstract
Objectives: To evaluate the association between pelvic organ prolapse (POP) types and levator-urethra gap (LUG) as measured by 3-dimensional transperineal tomographic ultrasound., Methods: A retrospective study was carried out on 98 women with symptomatic POP. Three-dimensional transperineal tomographic ultrasound images and POP quantification coordinates were reviewed. Each vaginal compartment was staged for the degree of prolapse, and total number of involved compartments identified. LUG was measured on 3-dimensional tomographic sonograms as the distance between the center of the urethra and the levator insertion bilaterally. Based on prior studies, an abnormal LUG of 25 mm or greater indicated levator avulsion. The LUG and the presence or absence of unilateral/bilateral avulsions was analyzed with reference to the clinical diagnosis of prolapse (single versus multicompartment, and mild [stage II] versus severe [stage III-IV]). Generalized logit models were used to evaluate the association between avulsion and prolapse type and stage., Results: The LUG was substantially larger in women with multicompartment compared to single-compartment POP (28.9 ± 4.1 mm versus 22.7 ± 4.1 mm, P < .01). Similarly, LUG was substantially larger in women with severe (stage III-IV) compared to mild (stage II) POP (28.8 ± 4.7 mm versus 23.3 ± 4.5 mm, P < .01). Women with severe prolapse were 32 times more likely than women with mild prolapse to have bilateral levator avulsion. Those with POP involving all 3 vaginal compartments were 76 times more likely than single-compartment POP to have bilateral levator avulsions., Conclusions: Bilateral levator ani avulsion as diagnosed by LUG measurements of 25 mm or greater at rest is associated with multicompartment, severe prolapse., (© 2018 by the American Institute of Ultrasound in Medicine.)
- Published
- 2018
- Full Text
- View/download PDF
49. Cell adhesion molecule profiles, proliferation activity and p53 expression in advanced epithelial ovarian cancer induced malignant ascites-Correlation of tissue microarray and cytology microarray.
- Author
-
Toth L, Nagy B, Mehes G, Laszlo E, Molnar PP, Poka R, and Hernadi Z
- Subjects
- Adult, Aged, Aged, 80 and over, Biomarkers, Tumor metabolism, Carcinoma, Ovarian Epithelial, Cell Line, Tumor, Epithelial-Mesenchymal Transition genetics, Female, Humans, Microarray Analysis methods, Middle Aged, Young Adult, Cadherins metabolism, Cell Adhesion Molecules metabolism, Cell Proliferation physiology, Neoplasms, Glandular and Epithelial metabolism, Ovarian Neoplasms metabolism, Peritoneal Neoplasms metabolism, Tumor Suppressor Protein p53 metabolism
- Abstract
Introduction: Peritoneal dissemination accompanied by ascites formation is common in epithelial ovarian cancer (EOC). Adhesion molecules are crucial in metastatic spread and the latter involves epithelial-mesenchymal transition (EMT). This study aimed at: (1) clarifying whether E-cadherin and β-catenin expression and proliferative activity in metastatic ovarian cancer are inter-related; (2) Identifying possible correlations between cell adhesion molecular expression profiles, the proliferative activity and p53 expression of tumor cells and tumor grade and stage; (3) testing the cytology microarray (CMA) technique in analyzing metastasis formation., Material and Methods: Both tumorous and ascitic samples from 27 EOC patients were examined by using tissue microarray (TMA) and cytology microarray (CMA), respectively. CMA blocks were constructed using cores from each cell block of the ascitic specimens. Expression of E-cadherin, β-catenin, Ki-67 and p53 was immunohistochemically detected both in TMA and CMA blocks., Results: E-cadherin expression was higher in ascitic cells than in primary tumor cells (p = .294). β-catenin expression was significantly lower in ascitic cells than in primary tumor cells (p = .006). Expression of Ki-67 was lower and expression of p53 was higher in primary tumors than in ascitic cells, for p53 the difference was significant (p = .001). Both Ki-67 and p53 expression elevated significantly in high-grade primary tumor cells and in ascites cells (p = .039, and p = .004, respectively)., Conclusion: Epithelial-mesenchymal transition- mesenchymal-epithelial transition is suggested as the best descriptive term for our IHC observations which accompany increased proliferative activity of ascitic cells. The CMA method is an adequate and reliable method for the analysis of ascitic tumor cells disseminating from ovarian malignancies., (Copyright © 2018 Elsevier GmbH. All rights reserved.)
- Published
- 2018
- Full Text
- View/download PDF
50. Age-specific prevalence of high-risk human papillomavirus infection in a Hungarian female population with positive cytology.
- Author
-
Sapy T, Poka R, Szarka K, Konya J, Huga S, and Hernadi Z
- Subjects
- Adolescent, Adult, Age Factors, Aged, Female, Humans, Hungary epidemiology, Middle Aged, Prevalence, Vaginal Smears, Papillomavirus Infections epidemiology
- Abstract
Objective: Patients with positive screening results and persistence of high-risk human papillomavirus (HPV) infection represent the population at the highest risk for developing cervical cancer. To describe the epidemiology in this high-risk population, data were collected and analysed at the referral centre for patients with positive cytology., Study Design: Between January 1997 and December 2002 the authors performed 3480 virus identifications using the Digene Hybrid Capture system in a female population with positive cytology at cervical cancer screening. Age-specific prevalence data were evaluated and compared between the age groups by running the chi(2) and Pearson chi(2) tests. Subgroup analysis was performed to estimate monthly clearance rates among eligible women with positive HR-HPV results., Results: Low-risk (LR), high-risk (HR) and double infections were detected in 91 cases (2.6%), 1072 cases (30.8%) and 59 cases (1.7%), respectively. A significantly higher incidence of high-, rather than low-risk HPV infections was found in all age groups (p<0.001). Also, in this high-risk population with positive screening a significant decrease was detected in the prevalence of both high- and low-risk infections beyond 35 years of age (p<0.001). However, the decline in the HR-HPV types occurred later than in the case of LR infections, and HR-HPV was of remarkable frequency in the older age groups, which might represent both incidental and prevalent cases. Subgroup analysis for estimating monthly clearance rates revealed no significant differences between the various age groups and between women with various cytology results., Conclusions: In a population with positive cytology the prevalence of HPV drops with age while the relative frequency of high-risk HPV infection remains at the same level as that of the youngest age group.
- Published
- 2008
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.