Diagnostics, Staging and Surgical Treatment of Gynaecological Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Causes, Screening and Diagnosis".

Deadline for manuscript submissions: closed (31 March 2021) | Viewed by 21239

Special Issue Editors


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Guest Editor
Chief Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center. 1275 York Avenue, H1305, New York NY 10065.
Interests: cervical cancer; endometrial cancer; sentinel lymph node ovarian cancer; radical hysterectomy; pelvic exenteration

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Guest Editor
1. Scientific Directorate, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
2. Department of Life Sciences and Public Health, Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
Interests: personalized medicine; precision medicine; gynecologic oncology; clinical research
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Special Issue Information

Dear Colleagues,

Surgical treatment remains a cornerstone in the management of early stages of all gynaecological cancers. The two fields entailed in our topic are closely related and highly dependent on each other. The tailoring of surgical procedures requires an accurate clinical staging, and vice versa, the utilization of modern imaging modalities improves patient outcomes only if followed by a high-quality surgery.

The management of all gynaecological cancers has evolved dramatically within last 10 years thanks to systematic clinical research. Solid evidence has been gathered for new approaches (less or more radical procedures), thanks to multicentric, international and multidisciplinary collaboration.

We encourage you to submit to this Issue all articles bringing new evidence on the diagnostics and management of gynaecological cancers, precising individual steps in clinical practice algorithms, or challenging traditional recommendations.

Prof. Dr. Nadeem Abu-Rustum
Prof. Dr. Giovanni Scambia
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • ovarian cancer
  • cervical cancer
  • endometrial cancer
  • vulvar cancer
  • imaging
  • surgery
  • ultrasound
  • staging
  • radical hysterectomy
  • lymphadenectomy

Published Papers (5 papers)

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14 pages, 240 KiB  
Article
Transvaginal Ultrasound-Guided Core Biopsy—Experiences in a Comprehensive Cancer Centre
by Dániel Lengyel, Ildikó Vereczkey, Krisztina Kőhalmy, Kiarash Bahrehmand and Zoltán Novák
Cancers 2021, 13(11), 2590; https://doi.org/10.3390/cancers13112590 - 25 May 2021
Cited by 5 | Viewed by 2020
Abstract
In this paper, we report our experience of transvaginal ultrasound (TVUS)-guided core biopsies involving 303 patients referred to the gynaecological ultrasound unit of our national comprehensive cancer centre. Adequate histologic specimens were obtained in 299 patients (98.7%). The most common sites of biopsy [...] Read more.
In this paper, we report our experience of transvaginal ultrasound (TVUS)-guided core biopsies involving 303 patients referred to the gynaecological ultrasound unit of our national comprehensive cancer centre. Adequate histologic specimens were obtained in 299 patients (98.7%). The most common sites of biopsy sampling were the adnexa (29.7%), the vaginal stump or wall (13.5%), the uterus (11.6%) and the peritoneum (10.2%). Malignancy was confirmed in two-thirds of patients (201/303) and a primary malignancy was diagnosed in 111 of the 201 histologically verified malignant cases (55.2%). Interestingly, 23.9% (48/201) of malignant tumours were proven to have a non-gynaecological origin. Among them, gastrointestinal tumours occurred the most frequently (31/48 patients). Three abscesses were discovered following the biopsy procedure, resulting in a complication rate of 1%. In 94 (31%) patients, subsequent surgery allowed the comparison of the ultrasound-guided and surgically obtained histologic results. We found inaccuracy in 12 cases (12.8%), which is discussed in this paper in detail. Sensitivity, specificity, PPV and NPV to diagnose malignancy was 94.8%, 94.1%, 98.7% and 80.0%, respectively. This is the largest study reported to date about the efficacy and safety of TVUS-guided core biopsy in evaluating pelvic lesions giving rise to a suspicion of gynaecological cancer. Full article
(This article belongs to the Special Issue Diagnostics, Staging and Surgical Treatment of Gynaecological Cancer)
10 pages, 6451 KiB  
Article
Nerve-Sparing Systematic Lymph Node Dissection in Gynaecological Oncology: An Innovative Neuro-Anatomical and Surgical Protocol for Enhanced Functional Outcomes
by Mustafa Zelal Muallem, Yasser Diab, Thomas Jöns, Jalid Sehouli and Jumana Muallem
Cancers 2020, 12(11), 3473; https://doi.org/10.3390/cancers12113473 - 22 Nov 2020
Cited by 4 | Viewed by 5485
Abstract
Whilst systematic lymph node dissection has been less prevalent in gynaecological cancer cases in the last few years, there is still a good number of cases that mandate a systematic lymph node dissection for diagnostic and therapeutic purposes. In all of these cases, [...] Read more.
Whilst systematic lymph node dissection has been less prevalent in gynaecological cancer cases in the last few years, there is still a good number of cases that mandate a systematic lymph node dissection for diagnostic and therapeutic purposes. In all of these cases, it is crucial to perform the procedure as a nerve-sparing technique with utmost exactitude, which can be achieved optimally only by isolating and sparing all components of the aortic plexus and superior hypogastric plexus. To meet this purpose, it is essential to provide a comprehensive characterization of the specific anatomy of the human female aortic plexus and its variations. The anatomic dissections of two fresh and 17 formalin-fixed female cadavers were utilized to study, understand, and decipher the hitherto ambiguously annotated anatomy of the autonomic nervous system in the retroperitoneal para-aortic region. This study describes the precise anatomy of aortic and superior hypogastric plexus and provides the surgical maneuvers to dissect, highlight, and spare them during systematic lymph node dissection for gynaecological malignancies. The study also confirms the utility and feasibility of this surgery in gynaecological oncology. Full article
(This article belongs to the Special Issue Diagnostics, Staging and Surgical Treatment of Gynaecological Cancer)
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17 pages, 1227 KiB  
Article
The Prognostic Role of the Surgical Margins in Squamous Vulvar Cancer: A Retrospective Australian Study
by Ellen L. Barlow, Michael Jackson and Neville F. Hacker
Cancers 2020, 12(11), 3375; https://doi.org/10.3390/cancers12113375 - 14 Nov 2020
Cited by 8 | Viewed by 2623
Abstract
For the last 30 years at the Royal Hospital for Women, unifocal vulvar squamous cancers have been treated by radical local excision, aiming to achieve a histopathological margin of ≥8 mm, equating to a surgical margin of 1 cm. The need for a [...] Read more.
For the last 30 years at the Royal Hospital for Women, unifocal vulvar squamous cancers have been treated by radical local excision, aiming to achieve a histopathological margin of ≥8 mm, equating to a surgical margin of 1 cm. The need for a margin of this width has recently been challenged. We aimed to determine the long-term outcome following this conservative approach, and the relationship between vulvar recurrences and surgical margins. Data were obtained retrospectively on 345 patients treated primarily with surgery for squamous vulvar cancer between 1987 and 2017. Median follow-up was 93 months. Five-year disease-specific survival was 86%. Of 78 vulvar recurrences, 33 (42.3%) were at the primary site and 45 (57.7%) at a remote site. In multivariable analysis, a margin < 5 mm showed a higher risk of all vulvar (Hazard ratio (HR), 2.29; CI, 1.12−4.70), and primary site recurrences (subdistribution hazard ratio (SHR), 15.20; CI, 5.21−44.26), while those with a margin of 5 to <8 mm had a higher risk of a primary site recurrence (SHR, 8.92; CI, 3.26−24.43), and a lower risk of remote site recurrence. Excision margins < 8 mm treated by re-excision or radiation therapy had a significantly decreased risk of recurrence. Guidelines should continue to recommend a surgical margin of 1 cm. Full article
(This article belongs to the Special Issue Diagnostics, Staging and Surgical Treatment of Gynaecological Cancer)
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13 pages, 1299 KiB  
Article
Detection of Ovarian Cancer through Exhaled Breath by Electronic Nose: A Prospective Study
by Francesco Raspagliesi, Giorgio Bogani, Simona Benedetti, Silvia Grassi, Stefano Ferla and Susanna Buratti
Cancers 2020, 12(9), 2408; https://doi.org/10.3390/cancers12092408 - 25 Aug 2020
Cited by 25 | Viewed by 3774
Abstract
Background: Diagnostic methods for the early identification of ovarian cancer (OC) represent an unmet clinical need, as no reliable diagnostic tools are available. Here, we tested the feasibility of electronic nose (e-nose), composed of ten metal oxide semiconductor (MOS) sensors, as a diagnostic [...] Read more.
Background: Diagnostic methods for the early identification of ovarian cancer (OC) represent an unmet clinical need, as no reliable diagnostic tools are available. Here, we tested the feasibility of electronic nose (e-nose), composed of ten metal oxide semiconductor (MOS) sensors, as a diagnostic tool for OC detection. Methods: Women with suspected ovarian masses and healthy subjects had volatile organic compounds analysis of the exhaled breath using e-nose. Results: E-nose analysis was performed on breath samples collected from 251 women divided into three groups: 86 OC cases, 51 benign masses, and 114 controls. Data collected were analyzed by Principal Component Analysis (PCA) and K-Nearest Neighbors’ algorithm (K-NN). A first 1-K-NN (cases vs. controls) model has been developed to discriminate between OC cases and controls; the model performance tested in the prediction gave 98% of sensitivity and 95% of specificity, when the strict class prediction was applied; a second 1-K-NN (cases vs. controls + benign) model was built by grouping the non-cancer groups (controls + benign), thus considering two classes, cases and controls + benign; the model performance in the prediction was of 89% for sensitivity and 86% for specificity when the strict class prediction was applied. Conclusions: Our preliminary results suggested the potential role of e-nose for the detection of OC. Further studies aiming to test the potential adoption of e-nose in the early diagnosis of OC are needed. Full article
(This article belongs to the Special Issue Diagnostics, Staging and Surgical Treatment of Gynaecological Cancer)
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15 pages, 753 KiB  
Systematic Review
The Role of Bitter Taste Receptors in Cancer: A Systematic Review
by Sofie Zehentner, Agnes T. Reiner, Christoph Grimm and Veronika Somoza
Cancers 2021, 13(23), 5891; https://doi.org/10.3390/cancers13235891 - 23 Nov 2021
Cited by 15 | Viewed by 6703
Abstract
Background: Since it is known that bitter taste receptors (TAS2Rs) are expressed and functionally active in various extra-oral cells, their genetic variability and functional response initiated by their activation have become of broader interest, including in the context of cancer. Methods: A systematic [...] Read more.
Background: Since it is known that bitter taste receptors (TAS2Rs) are expressed and functionally active in various extra-oral cells, their genetic variability and functional response initiated by their activation have become of broader interest, including in the context of cancer. Methods: A systematic research was performed in PubMed and Google Scholar to identify relevant publications concerning the role of TAS2Rs in cancer. Results: While the findings on variations of TAS2R genotypes and phenotypes and their association to the risk of developing cancer are still inconclusive, gene expression analyses revealed that TAS2Rs are expressed and some of them are predominately downregulated in cancerous compared to non-cancerous cell lines and tissue samples. Additionally, receptor-specific, agonist-mediated activation induced various anti-cancer effects, such as decreased cell proliferation, migration, and invasion, as well as increased apoptosis. Furthermore, the overexpression of TAS2Rs resulted in a decreased tumour incidence in an in vivo study and TAS2R activation could even enhance the therapeutic effect of chemotherapeutics in vitro. Finally, higher expression levels of TAS2Rs in primary cancerous cells and tissues were associated with an improved prognosis in humans. Conclusion: Since current evidence demonstrates a functional role of TAS2Rs in carcinogenesis, further studies should exploit their potential as (co-)targets of chemotherapeutics. Full article
(This article belongs to the Special Issue Diagnostics, Staging and Surgical Treatment of Gynaecological Cancer)
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