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Medicina
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Emerging Topics in Female Genitourinary Oncology
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Emerging Topics in Female Genitourinary Oncology

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

Deadline for manuscript submissions: closed (28 February 2023) | Viewed by 7131

Special Issue Editor

Dr. Valentina Lancellotta

E-Mail Website
Guest Editor
IRCCS, UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli, 00168 Rome, Italy
Interests: brachytherapy; gynecological cancer

Special Issue Information

Dear Colleagues,

Primary vaginal and vulvar cancer are a rare malignancy comprising 1–8% of all gynecological cancers. There is a tendency to adopt novel treatments of other common squamous cancers, such as cervical and anal cancers. In the recent years, the management of vulvar and vaginal carcinoma have been modified according to FIGO staging changes, of the emerging role of sentinel lymph node biopsy, and of the use of concurrent chemotherapy complementary to radiation for advanced stage disease.

In this Special Issue, we would like to understand more about choosing the appropriate therapeutic strategy in patients with cervix, vaginal or vulvar cancer.

We solicit papers (original research papers, comprehensive reviews， systematic reviews, meta-analyses, etc.) on the following topics: alternatives to surgery; role of brachytherapy; role of radio-chemotherapy; role of immunotherapy; role of adjuvant radiotherapy plus/minus chemotherapy.

Dr. Valentina Lancellotta
Guest Editor

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

  • adjuvant
  • chemotherapy
  • radiation
  • cervix cancer
  • vaginal cancer
  • vulvar cancer
  • exclusive radio-chemotherapy
  • brachytherapy

Published Papers (3 papers)

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10 pages, 1012 KiB  
Article
Vaginal Toxicity Management in Patients with Locally Advanced Cervical Cancer following Exclusive Chemoradiation—A Nationwide Survey on Knowledge and Attitudes by the Italian Association of Radiotherapy and Clinical Oncology (AIRO) Gynecology Study Group
by Francesca De Felice, Lisa Vicenzi, Gabriella Macchia, Andrea Vavassori, Elisabetta Perrucci, Annamaria Cerrotta, Valentina Lancellotta, Sofia Meregalli, Lorena Draghini, Antonietta Augurio and Vitaliana De Sanctis
Medicina 2023, 59(2), 385; https://doi.org/10.3390/medicina59020385 - 16 Feb 2023
Viewed by 1760
Abstract
Background and Objective: Exclusive radiotherapy, including external beam radiotherapy (EBRT) and interventional radiotherapy/brachytherapy (IRT/BT), with concurrent cisplatin-based chemotherapy, represents the standard of care in patients with locally advanced cervical cancer (LACC). The emerging topic of vaginal toxicity has become a key endpoint [...] Read more.
Background and Objective: Exclusive radiotherapy, including external beam radiotherapy (EBRT) and interventional radiotherapy/brachytherapy (IRT/BT), with concurrent cisplatin-based chemotherapy, represents the standard of care in patients with locally advanced cervical cancer (LACC). The emerging topic of vaginal toxicity has become a key endpoint in LACC management, although different approaches and non-standardized procedures were available. Our aim was to analyze a nationwide study of the attitudes of Italian gynecological radiation oncology teams in the management of LACC patients’ vaginal toxicities. Methods: A nationwide survey of radiation oncologists specializing in the treatment of gynecological malignancies was performed, using the free SurveyMonkey platform, consisting of 26 items. The questionnaire was proposed by the Italian Association of Radiation Oncologists (AIRO) gynecological working group to all 183 Italian radiation oncology institutions, as per AIRO’s website. Results: Fifty-eight questionnaires (31%) were completed and returned. The assessment of acute and late vaginal toxicities was systematic in 32 (55.2%) and 26 (44.8%) centers, respectively. In the case of EBRT, 70.7% of centers, according to the contouring and treatment plan data, did not contour the vagina as an organ at risk (OAR). Vaginal dose constraints were heterogeneous for both EBRT and IRT/BT. Local treatment to prevent vaginal toxicity was prescribed by 60.3% of radiation oncologists, mostly vaginal hyaluronic acid cream, and one center recommended vaginal estrogen preparations. During follow-up visits, vaginal toxicity was considered an issue to be investigated always (n = 31) or in sexually active women only (n = 11). Conclusions: This survey showed that wide variation exists with regard to recording and treating vaginal toxicity after exclusive chemoradiation for cervical cancer, underscoring the need to develop more comprehensive guidelines for contouring e-dose reporting of the vagina, so as to implement clinical approaches for vaginal toxicity. Full article
(This article belongs to the Special Issue Emerging Topics in Female Genitourinary Oncology)
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11 pages, 3921 KiB  
Case Report
Management of Primary Female Urethral Adenocarcinoma: Two Rare Case Reports and Literature Review
by Junjie Tian, Ting Zhu, Zhijie Xu, Xiaoyi Chen, Yunfei Wu, Guanghou Fu and Baiye Jin
Medicina 2023, 59(1), 109; https://doi.org/10.3390/medicina59010109 - 4 Jan 2023
Viewed by 2311
Abstract
Primary urethral adenocarcinoma in females is an extremely rare malignancy with unclear origin and only a few retrospective cases have been reported. The controversy continues to exist over the origin of primary urethral adenocarcinoma from periurethral glands (which include the Skene’s glands), urethritis [...] Read more.
Primary urethral adenocarcinoma in females is an extremely rare malignancy with unclear origin and only a few retrospective cases have been reported. The controversy continues to exist over the origin of primary urethral adenocarcinoma from periurethral glands (which include the Skene’s glands), urethritis glandularis or intestinal metaplasia. Herein, we report one case of a 49-year-old female with distal urethral adenocarcinoma who presented with obstructive voiding. Abdominal and pelvic CT scans and chest radiology were unremarkable. Biopsy of the mass confirmed urethral adenocarcinoma. The patient underwent partial ureterectomy and was disease-free at the 2-years follow-up period. We also present another extremely rare case of primary urethral adenocarcinoma with mucinous features in a 58-year-old female who initially complained of external urethral orifice itching with painless urethral bleeding and was treated with local excision. The patient has not received any neoadjuvant or adjuvant therapy, and experienced tumor recurrence, inguinal lymph nodes metastasis, and even local iliopsoas metastasis during over 10-years follow-up. In conclusion, our current study emphasizes the importance of imaging studies and biopsy in making an accurate preoperative diagnosis of this rare disease, and further highlights the role of multimodal therapy. A combination of radiotherapy, chemotherapy and surgery is recommended for the optimal local and distant disease control. Moreover, better medical compliance and regular follow-up are required in these patients. Full article
(This article belongs to the Special Issue Emerging Topics in Female Genitourinary Oncology)
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13 pages, 465 KiB  
Systematic Review
Assessment of Sexual Dysfunction in Cervical Cancer Patients after Different Treatment Modality: A Systematic Review
by Francesco Tramacere, Valentina Lancellotta, Calogero Casà, Bruno Fionda, Patrizia Cornacchione, Ciro Mazzarella, Rosa Pasqualina De Vincenzo, Gabriella Macchia, Martina Ferioli, Angeles Rovirosa, Maria Antonietta Gambacorta, Cesare Colosimo, Vincenzo Valentini, Roberto Iezzi and Luca Tagliaferri
Medicina 2022, 58(9), 1223; https://doi.org/10.3390/medicina58091223 - 5 Sep 2022
Cited by 14 | Viewed by 2685
Abstract
Background and Objectives: Cervical cancer is a leading cause of mortality among women. Chemo-radiation followed by interventional radiotherapy (IRT) is the standard of care for stage IB–IVA FIGO. Several studies have shown that image-guided adaptive IRT resulted in excellent local and pelvic [...] Read more.
Background and Objectives: Cervical cancer is a leading cause of mortality among women. Chemo-radiation followed by interventional radiotherapy (IRT) is the standard of care for stage IB–IVA FIGO. Several studies have shown that image-guided adaptive IRT resulted in excellent local and pelvic control, but it is associated with vaginal toxicity and intercourse problems. The purpose of this review is to evaluate the dysfunctions of the sexual sphere in patients with cervical cancer undergoing different cervix cancer treatments. Materials and Methods: We performed a comprehensive literature search using Pub med, Scopus and Cochrane to identify all the full articles evaluating the dysfunctions of the sexual sphere. ClinicalTrials.gov was searched for ongoing or recently completed trials, and PROSPERO was searched for ongoing or recently completed systematic reviews. Results: One thousand three hundred fifty-six women included in five studies published from 2016 to 2022 were analyzed. The median age was 50 years (range 46–56 years). The median follow-up was 12 months (range 0–60). Cervical cancer diagnosis and treatment (radiotherapy, chemotherapy and surgery) negatively affected sexual intercourse. Sexual symptoms such as fibrosis, strictures, decreased elasticity and depth and mucosal atrophy promote sexual dysfunction by causing frigidity, lack of lubrication, arousal, orgasm and libido and dyspareunia. Conclusions: Physical, physiological and social factors all contribute to the modification of the sexual sphere. Cervical cancer survivors who were irradiated have lower sexual and vaginal function than the normal population. Although there are cures for reducing discomfort, effective communication about sexual dysfunctions following treatment is essential. Full article
(This article belongs to the Special Issue Emerging Topics in Female Genitourinary Oncology)
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