Introduction/BackgroundThe laparoscopy has been found to be attractive and safe technique in gynaecological oncology. However, some recent retrospective and prospective reports on early-stage cervical cancer have shown unexpected contrary results in terms of overall and disease-free survival. In our opinion, published discussions to date do not fully address the subject and that it is worth considering important issues that were not given enough attention before.MethodologyWe conducted a systematic analysis of current knowledge about laparoscopy in early-stage cervical cancer by reviewing the relevant literature from the fields of basic and clinical research, starting with the results of the Laparoscopic Approach to Cervical Cancer (LACC) study, and including analysis of its appendix and protocol.ResultsThe preferred surgical access in cervical cancer cases was the subject of a single prospective randomized clinical trial. Other, similarly designed studies on other pelvic tumours are sparse. The biology of cancer, cancer epidemiology, as well as surgical skills and details of laparoscopic techniques underlie the observed differences in survival rates.ConclusionThere are some possibilities (such as limiting the manipulation of the uterus, closure of tubes and ligation of the parametria before using the manipulator, closure of the vaginal cuff, applying warmed and humidified CO2, and limiting intra-abdominal gas pressure) that, if considered and applied, may affect oncological results in selecting laparoscopy as the operative method for early-stage cervical cancer.DisclosureNothing to disclose.

To assess the predictive impact of ultrasound Tumor-Free Distance (uTFD) and other pathological factors in evaluation of lymph node involvement (LNI) in endometrial cancer (EC). Eighty-six patients were enrolled into the study. All patients underwent surgical treatment according to paradigm proposed by Mayo Clinic, modified by sentinel lymph node dissection (SLND) concept. Ultrasound tumor-area (TA), volume (Spe-Vol) and the minimal tumor-free distance into serosa (uTFD) were calculated. Collected data were correlated to final histopathological findings. 86 patients were identified with EC. The most common histological type was endometrioid one comprising 66 (77%) of cases. Slightly most of ECs were G1 tumors (34; 40%). Positive LN were found in 14 (16%) patients. Significant correlation between uTDF and pTDF (r = 0.3392; p = 0.0014) was found. The mean Spe-Vol were 16.26 ± 27,18 cm3,TA 7.369 ± 10,45 cm2 and uTFD 8.84 ± 6,75 mm, respectively. pTDF had greater sensitivity and specificity than uTDF. The best cut-of value in predicting metastatic lymph nodes were 5 mm for uTDF and 6 mm for pTDF. The only one ultrasound parameter was revealed to be LNI predictor (uTFD with AUC ROC of 0.738). Serous type histology (OR 27.89; CI 2.33 - 334.10; p = 0.008), pTDF (OR 0.83; CI 0.708-0.979; p = 0.024) and LVSI (OR 17.5; 4.43 - 69.11; p < 0.001) were independent risk factors for LNI. UTFD is an important ultrasound feature and predictive factor of LNI and should be considered in planning the surgical treatment. Pathological findings (pTDF and serous type of histology) were found to be independent risk factors of LNI.

We report a rare case of primary extranodal non-Hodgkin lymphoma of the uterine cervix. A 58-year old, postmenopausal multipara was admitted to the hospital with metrorrhagia and vaginal discharge. After diagnostic biopsy, the patient underwent radical abdominal hysterectomy, bilateral salpigo-oophorectomy and pelvic lymph node dissection. histologically, the lymphoma was classified as non-Hodgkin lymphoma of intermediate malignancy. Immunohistochemical studies revealed that the atypical lymphoid cells were B-cells (CD 20+), indicating that the lymphoma was of B-lineage. Postoperatively, she received adjuvant chemiotherapy. Our experience and a review of current literature are presented.

DESIGN:The authors sought to evaluate risk factors of patients with ovarian cancer treated with intraperitoneal cisplatin based chemotherapy (IPC).MATERIAL AND METHODS:From January 1996 to December 1998, 24 patients with recurrent or persistent ovarian cancer were treated. We divide them in two groups first beneath 65 year old (19 patients), second above 65 year (5 patients), and in three groups with residual microscopic diseases, residual below 0.5 cm, and between 0.5 and 2 cm in the time of the beginning of treatment with IPC. We also estimate stage (FIGO) as a risk factor.RESULTS:In the first group the study showed (CRP) among 9 patients (SD) among 2 patients PD in among patients. In the second group CRP were observed among 2 patients PD among 2 patients, and SD 1 patient.CONCLUSION:IPC is the valuable method of second line chemotherapy for ovarian cancer. Age is not a risk factor in IPC. IPC prolongs survival in ovarian cancer patients, progression free survival, and gives only slightly adverse effects.