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Laparoscopy and Surgery in Gynecologic Oncology
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Laparoscopy and Surgery in Gynecologic Oncology

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Obstetrics & Gynecology".

Deadline for manuscript submissions: closed (28 December 2024) | Viewed by 5446

Special Issue Editors

Dr. Zoltan Novak

E-Mail Website
Guest Editor
Department of Gynecology, Hungarian National Institute of Oncology, 1122 Budapest, Hungary
Interests: gynecological oncology; pelvic surgery; general obstetrics; general gynecological colposcopy; gynecological tumor surgery
Special Issues, Collections and Topics in MDPI journals
Dr. Attila Bokor

E-Mail Website
Guest Editor
Department of Obstetrics and Gynaecology, Semmelweis University, 1085 Budapest, Hungary
Interests: gynaecologic oncology; cancer surgery; endometriosis; laparoscopic; minimally invasive surgery

Special Issue Information

Dear Colleagues,

Laparoscopy, a minimally invasive surgical technique, has gained significant importance in the field of gynecologic oncology. However, recent evidence proved that it may be associated with increased oncological risk in a selected patient group. These results raised many open questions that need to be investigated by the scientific community. Therefore, the place of laparoscopy in gynecologic oncology is rapidly evolving due to new scientific data. We invite you to submit your recent work on the following topics to our Special Issue:

Diagnosis: Laparoscopy is employed for the diagnosis of various gynecological cancers, including ovarian, uterine, and cervical cancers.

Staging: Laparoscopy facilitates the staging of gynecologic malignancies by enabling the confirmation of the extent of tumor spread within the abdomen and pelvis.

Surgical treatment: Laparoscopy is increasingly used for the surgical management of gynecologic cancers, including primary or secondary tumor debulking, hysterectomy, lymph node dissection, and en bloc removal of affected tissue.

Palliative care: In cases where curative treatment is not possible, laparoscopy and associated procedures can be used for palliative procedures to relieve symptoms and improve the quality of life for patients with advanced gynecologic cancers.

Fertility preservation: Laparoscopy can be utilized for fertility-sparing procedures in young women with early-stage gynecologic malignancies.

Despite its benefits, the use of laparoscopy in gynecologic oncology may be limited in certain cases. Close monitoring and specialized training are essential to ensure that laparoscopic procedures are performed effectively and with minimal risk to the patient.

We look forward to receiving your manuscripts.

Best regards,

Dr. Zoltan Novak
Dr. Attila Bokor
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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. Journal of Clinical Medicine 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 2600 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

  • gynecologic cancers
  • ovarian
  • uterine
  • cervical
  • laparoscopy
  • diagnosis
  • staging
  • treatment
  • palliative care
  • fertility preservation

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Related Special Issue

Published Papers (4 papers)

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13 pages, 968 KiB  
Article
Sentinel Lymph Node Detection in Cervical Cancer: Challenges in Resource-Limited Settings with High Prevalence of Large Tumours
by Szilárd Leó Kiss, Mihai Stanca, Dan Mihai Căpîlna, Tudor Emil Căpîlna, Maria Pop-Suciu, Botond Istvan Kiss, Szilárd Leó Kiss, Sr. and Mihai Emil Căpîlna
J. Clin. Med. 2025, 14(4), 1381; https://doi.org/10.3390/jcm14041381 - 19 Feb 2025
Viewed by 528
Abstract
Background/Objectives: Cervical cancer primarily disseminates through the lymphatic system, with the metastatic involvement of pelvic and para-aortic lymph nodes significantly impacting prognosis and treatment decisions. Sentinel lymph node (SLN) mapping is critical in guiding surgical management. However, resource-limited settings often lack advanced [...] Read more.
Background/Objectives: Cervical cancer primarily disseminates through the lymphatic system, with the metastatic involvement of pelvic and para-aortic lymph nodes significantly impacting prognosis and treatment decisions. Sentinel lymph node (SLN) mapping is critical in guiding surgical management. However, resource-limited settings often lack advanced detection tools like indocyanine green (ICG). This study evaluated the feasibility and effectiveness of SLN biopsy using alternative techniques in a high-risk population with a high prevalence of large tumours. Methods: This prospective, observational study included 42 patients with FIGO 2018 stage IA1–IIA1 cervical cancer treated between November 2019 and April 2024. SLN mapping was performed using methylene blue alone or combined with a technetium-99m radiotracer. Detection rates, sensitivity, and false-negative rates were analysed. Additional endpoints included tracer technique comparisons, SLN localization patterns, and factors influencing detection success. Results: SLNs were identified in 78.6% of cases, with bilateral detection in 57.1%. The combined technique yielded higher detection rates (93.3% overall, 80% bilateral) compared to methylene blue alone (70.4% overall, 40.7% bilateral, p < 0.05). The sensitivity and negative predictive values were 70% and 93.87%, respectively. Larger tumours (>4 cm), deep stromal invasion, and prior conization negatively impacted detection rates. False-negative SLNs were associated with larger tumours and positive lymphovascular space invasion. Conclusions: SLN biopsy is feasible in resource-limited settings, with improved detection rates using combined tracer techniques. However, sensitivity remains suboptimal due to a steep learning curve and challenges in high-risk patients. Until a high detection accuracy is achieved, SLN mapping should complement, rather than replace, pelvic lymphadenectomy in high-risk cases. Full article
(This article belongs to the Special Issue Laparoscopy and Surgery in Gynecologic Oncology)
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15 pages, 2190 KiB  
Article
Overall Survival Following Interval Complete Gross Resection of Advanced Ovarian Cancer via Laparoscopy Versus Open Surgery: An Analysis of the National Cancer Database
by Judy Hayek, Anjile An, Jennifer Wolf, Kelly Lamiman, Michael Kim, Hope Knochenhauer, Nicole Goncalves and Ioannis Alagkiozidis
J. Clin. Med. 2025, 14(4), 1164; https://doi.org/10.3390/jcm14041164 - 11 Feb 2025
Viewed by 661
Abstract
Background: Advanced epithelial ovarian cancer (EOC) has traditionally been treated with primary debulking surgery; however, recent phase III trials have demonstrated similar survival outcomes for patients who were randomized to neoadjuvant chemotherapy followed by interval debulking (IDS) when compared to patients who underwent [...] Read more.
Background: Advanced epithelial ovarian cancer (EOC) has traditionally been treated with primary debulking surgery; however, recent phase III trials have demonstrated similar survival outcomes for patients who were randomized to neoadjuvant chemotherapy followed by interval debulking (IDS) when compared to patients who underwent PDS. Methods: We sought to evaluate a cohort of patients with EOC diagnosed between 2010 and 2019 who underwent complete cytoreduction (R0—no gross residual disease) during IDS. We compared the outcomes after R0 resection via MIS versus laparotomy in IDS. The primary endpoint was overall survival (OS). Kaplan-Meier analysis and inverse probability of treatment weighting (IPTW) were used. Cases were stratified by surgical extent and within the MIS cohort by robotic assistance. Surgical outcomes (LOS, readmission rate, 30- and 90-day mortality) were also assessed. Results: In total, 2412 patients were eligible. 624 (25.8%) underwent R0 resection via MIS. Over the study period, the MIS utilization rate increased from 12% to 36%. There was no significant difference in OS between the MIS and open cohorts (51 vs. 46 months, HR 1.1; 95% CI 0.96–1.24). 30-day and 90-day postoperative mortality rates were higher in the open group (1.6% vs. 0.8%, p = 0.006) and (1.9% vs. 3.5%, p = 0.003), respectively. Patients in the MIS group were less likely to undergo extensive surgery (41% vs. 53%, p < 0.001). When stratified by surgical extent, no significant difference in OS was observed between MIS and laparotomy (49 vs. 44 months in the extensive surgery group and 53 vs. 50 months in the non-extensive surgery group). Within the MIS cohort, 49% of cases were performed robotically. OS did not differ significantly between robotic and conventional laparoscopic cases (52 vs. 50 months). From 2010 to 2019, there was an increase in the use of robot-assisted laparoscopy (from 6.2% to 25.5%), coinciding with a decline in the laparotomy rate (from 88.1% to 63.5%) (p = 0.008). Conclusions: R0 resection via MIS during IDS showed similar OS and decreased postoperative mortality compared to laparotomy. The increasing utilization of robotic assistance is associated with a decrease in the laparotomy rate. Full article
(This article belongs to the Special Issue Laparoscopy and Surgery in Gynecologic Oncology)
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12 pages, 5680 KiB  
Article
Prognostic Factors After the First Recurrence of Ovarian Cancer
by Patricia Salas Bolívar, Cristina Gonzalez-Benitez, María Carbonell López, Jesús Díez Sebastian, Alicia Hernández Gutiérrez and Ignacio Zapardiel
J. Clin. Med. 2025, 14(2), 470; https://doi.org/10.3390/jcm14020470 - 13 Jan 2025
Viewed by 1128
Abstract
Objective: Ovarian cancer is the fifth most frequent tumor in women and the second most common gynecological cancer. Recurrence of ovarian cancer develops in up to 50–90% of patients within the first five years after diagnosis. Approximately 70% of patients with advanced disease [...] Read more.
Objective: Ovarian cancer is the fifth most frequent tumor in women and the second most common gynecological cancer. Recurrence of ovarian cancer develops in up to 50–90% of patients within the first five years after diagnosis. Approximately 70% of patients with advanced disease will experience a relapse. The aim of this study was to assess prognostic factors that may predict a higher probability of additional recurrences, as well as their treatment and impact on disease-free and overall survival. Method: A retrospective observational study was conducted on patients diagnosed with recurrent ovarian cancer at the Gynecologic Oncology Unit of Hospital Universitario La Paz (Madrid, Spain) from January 2000 to December 2020. All variables related to the initial treatment, diagnosis, and management of the recurrence were collected and analyzed. Results: Data from 144 patients with recurrent ovarian cancer were analyzed. Statistically significant differences were found in disease-free survival between patients depending on initial tumor staging and primary treatment. Better outcomes were observed in patients with FIGO (International Federation of Gynecology and Obstetrics) stages I–II compared to those with FIGO stages III–IV at diagnosis (p = 0.021), as well as in patients who underwent primary cytoreduction compared to those who received neoadjuvant chemotherapy followed by interval surgery (p < 0.001). The disease-free interval was categorized into three periods, <6 months, 6–12 months, and ≥12 months, with greater survival observed in those with a longer disease-free interval (p < 0.001). After the first recurrence, two factors significantly influenced patient survival: the type of treatment received after the first recurrence (p < 0.001) and the type of chemotherapy regimen (p = 0.001). Complete cytoreduction during primary treatment was an independent prognostic factor and was related to better overall survival in patients where it was achieved (p = 0.004), regardless of the number of recurrences. Conclusions: The prognostic factors with impact on the survival of patients with a first recurrence of ovarian cancer are the following: treatment modality of the primary tumor, treatment modality of the recurrence, type of chemotherapy regimen, and disease-free interval from initial diagnosis to the first recurrence. Full article
(This article belongs to the Special Issue Laparoscopy and Surgery in Gynecologic Oncology)
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25 pages, 1639 KiB  
Systematic Review
Management of Malignant Bowel Obstruction in Patients with Gynaecological Cancer: A Systematic Review
by Richárd Tóth, Zsófia Tóth, Lotti Lőczi, Marianna Török, Nándor Ács, Szabolcs Várbíró, Márton Keszthelyi and Balázs Lintner
J. Clin. Med. 2024, 13(14), 4213; https://doi.org/10.3390/jcm13144213 - 19 Jul 2024
Cited by 1 | Viewed by 2509
Abstract
Objectives: This systematic review aimed to evaluate current surgical and non-surgical management strategies for malignant bowel obstruction (MBO) in patients with gynaecological cancer. Methods: Comprehensive literature searches were conducted across MEDLINE, Embase, CENTRAL, and Scopus, without restrictions on language or publication date. Following [...] Read more.
Objectives: This systematic review aimed to evaluate current surgical and non-surgical management strategies for malignant bowel obstruction (MBO) in patients with gynaecological cancer. Methods: Comprehensive literature searches were conducted across MEDLINE, Embase, CENTRAL, and Scopus, without restrictions on language or publication date. Following the removal of duplicates, 4866 articles were screened, with 34 meeting the inclusion criteria. Results: Surgical intervention remains the definitive treatment for MBO, offering longer symptom-free periods and improved survival, particularly when conservative methods fail. However, the selection of surgical candidates is crucial due to the high risk of morbidity and the potential for significant complications. Non-surgical treatments, such as the use of Gastrografin, Octreotide, and Dexamethasone, along with invasive procedures like nasogastric tubing, percutaneous gastrostomy, and stent placement, offer varying degrees of symptom relief and are often considered when surgery is not feasible. Conclusions: In this article we provide a potential therapeutic algorithm for the management of patients with MBO. This review underscores the urgent need for high-quality research to develop clear, evidence-based guidelines for MBO management in patients with gynaecologic cancer. Establishing standardised protocols will improve patient outcomes by aiding clinicians in making informed, individualised treatment decisions. Full article
(This article belongs to the Special Issue Laparoscopy and Surgery in Gynecologic Oncology)
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