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Medicina
Special Issues
Latest Findings in Diagnosis and Treatment of Gynecological Malignancies
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Special Issue "Latest Findings in Diagnosis and Treatment of Gynecological Malignancies"

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Obstetrics and Gynecology".

Deadline for manuscript submissions: closed (30 April 2023) | Viewed by 1849

Special Issue Editors

Dr. Stefano Cianci
E-Mail Website
Guest Editor
Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, 00168 Rome, Italy
Interests: gynecology; gynecological surgery
Dr. Carlo Ronsini

E-Mail Website
Guest Editor
Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
Interests: gynecology; gynecological surgery; gynecological oncology

Special Issue Information

Dear Colleagues,

Gynecological cancers still represent one of the leading causes of female death around the world. Nevertheless, the mortality and morbidity of these diseases have been on a downward trend in recent years, thanks to technological advances in surgery, oncology, and palliative care.

This Special Issue was created with the intention of collecting the latest findings in the scientific field that may refine a clinical practice or clarify the “grey areas” still present in the scientific literature. This Special Issue comes in the light of major and groundbreaking scientific discoveries that have revolutionized the approach to major gynecologic oncologic diseases, such as the LACC trial by Ramirez, which questioned the appropriateness of minimally invasive approaches in the surgical treatment of cervical carcinoma, or the SOLO-1 Trial, which introduced the use of PARP-Inhibitors for the treatment of ovarian carcinomas, opening up new scenarios still to be explored today. In addition, the increasing spread of robotic surgery, as well as the refinement of laparoscopic instruments, offer new technical horizons previously difficult to imagine. Further, the growing knowledge regarding the molecular signature of gynecological cancer and radio diagnostic advantages offers physicians the opportunity to diagnose and treat gynecological cancer early and personalize treatment. Finally, a not insignificant aspect in the management of gynecologic oncology patients is the important scientific progress that has occurred with the application of ERAS protocols and the optimization of palliative care. The scientific community is experiencing a very prosperous period that is resulting in a steady improvement in clinical care. Our Special Issue was created to collect the latest findings in these areas. We, therefore, invite our authors to contribute their most important testimonials in the form of case reports, original articles, review articles, and meta-analyses.

Dr. Stefano Cianci
Dr. Carlo Ronsini
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. Medicina is an international peer-reviewed open access monthly 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 1800 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 oncology
  • gynecological surgery
  • cancer treatment
  • cancer diagnosis

Published Papers (2 papers)

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Systematic Review
Mininvasive Cytoreduction Surgery plus HIPEC for Epithelial Ovarian Cancer: A Systematic Review
by
Carlo Ronsini
,
Francesca Pasanisi
,
Pierfrancesco Greco
,
Luigi Cobellis
,
Pasquale De Franciscis
and
Stefano Cianci
Medicina 2023, 59(3), 421; https://doi.org/10.3390/medicina59030421 - 21 Feb 2023
Viewed by 604
Abstract
Background and objectives: The Gold-Standard treatment for Advanced Epithelial Ovarian Cancer remains cytoreductive surgery followed by systemic chemotherapy. Surgery can be performed either by an open or minimally invasive approach (MIS), although the former remains the most widely used approach. Recently, Van Driel [...] Read more.
Background and objectives: The Gold-Standard treatment for Advanced Epithelial Ovarian Cancer remains cytoreductive surgery followed by systemic chemotherapy. Surgery can be performed either by an open or minimally invasive approach (MIS), although the former remains the most widely used approach. Recently, Van Driel et al. proved that adding 100 mg/m2 of Cisplatin in Hyperthermic Intraperitoneal Chemotherapy (HIPEC) at Interval Debulking Surgery (IDS) gives a disease-free survival (DFS) advantage. Similarly, Gueli-Alletti et al. demonstrated how the MIS approach is feasible and safe in IDS. Moreover, Petrillo et al. reported pharmacokinetic profiles with a higher chemotherapy concentration in patients undergoing HIPEC after MIS compared with the open approach. Therefore, the following review investigates the oncological and clinical safety consequences of the association between MIS and HIPEC. Methods: Following the recommendations in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we systematically searched the PubMed and Scopus databases in April 2022. Studies containing data about oncological and safety outcomes were included. We registered the Review to the PROSPERO site for meta-analysis with protocol number CRD42022329503. Results: Five studies fulfilled inclusion criteria. 42 patients were included in the review from three different Gynecological Oncological referral centers. The systematic review highlighted a Recurrence Rate ranging between 0 and 100%, with a 3-year Platinum-Free Survival between 10 and 70%. The most common HIPEC drug was Cisplatin, used at concentrations between 75 and 100 mg/m2 and at an average temperature of 42 °C, for 60 to 90 min. Only 1 Acute Kidney Insufficiency has been reported. Conclusions: The scarcity of clinical trials focusing on a direct comparison between MIS and the open approach followed by HIPEC in EOC treatment does not make it possible to identify an oncological advantage between these two techniques. However, the safety profiles shown are highly reassuring. Full article
(This article belongs to the Special Issue Latest Findings in Diagnosis and Treatment of Gynecological Malignancies)
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Systematic Review
The Oncological Implication of Sentinel Lymph Node in Early Cervical Cancer: A Meta-Analysis of Oncological Outcomes and Type of Recurrences
by
Carlo Ronsini
,
Pasquale De Franciscis
,
Raffaela Maria Carotenuto
,
Francesca Pasanisi
,
Luigi Cobellis
and
Nicola Colacurci
Medicina 2022, 58(11), 1539; https://doi.org/10.3390/medicina58111539 - 27 Oct 2022
Cited by 1 | Viewed by 1038
Abstract
Background and Objectives: Pelvic lymphadenectomy has been associated with radical hysterectomy for the treatment of early Cervical Cancer (ECC) since 1905. However, some complications are related to this technique, such as lymphedema and nerve damage. In addition, its clinical role is controversial. [...] Read more.
Background and Objectives: Pelvic lymphadenectomy has been associated with radical hysterectomy for the treatment of early Cervical Cancer (ECC) since 1905. However, some complications are related to this technique, such as lymphedema and nerve damage. In addition, its clinical role is controversial. For this reason, the sentinel lymph node (SLN) has found increasing use in clinical practice over time. Oncologic safety, however, is debated, and there is no clear evidence in the literature regarding this. Therefore, our meta-analysis aims to schematically analyze the current scientific evidence to investigate the non-inferiority of SLN versus PLND regarding oncologic outcomes. Materials and Methods: Following the recommendations in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we systematically searched the PubMed and Scopus databases in June 2022 since their early first publications. We made no restrictions on the country. We considered only studies entirely published in English. We included studies containing Disease-Free Survival (DFS), Overall Survival (OS), Recurrence Rate (RR), and site of recurrence data. We used comparative studies for meta-analysis. We registered this meta-analysis to the PROSPERO site for meta-analysis with protocol number CRD42022316650. Results: Twelve studies fulfilled inclusion criteria. The four comparative studies were enrolled in meta-analysis. Patients were analyzed concerning Sentinel Lymph Node Biopsy (SLN) and compared with Bilateral Pelvic Systematic Lymphadenectomy (PLND) in early-stage Cervical Cancer (ECC). Meta-analysis highlighted no differences in oncological safety between these two techniques, both in DFS and OS. Moreover, most of the sites of recurrences in the SLN group seemed not to be correlated with missed lymphadenectomy. Conclusions: Data in the literature do not seem to show clear oncologic inferiority of SLN over PLND. On the contrary, the higher detection rate of positive lymph nodes and the predominance of no lymph node recurrences give hope that this technique may equal PLND in oncologic terms, improving its morbidity profile. Full article
(This article belongs to the Special Issue Latest Findings in Diagnosis and Treatment of Gynecological Malignancies)
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