Gynecologic Cancers: Clinical Research Progress of Resection

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Clinical Research of Cancer".

Deadline for manuscript submissions: closed (30 September 2024) | Viewed by 5321

Special Issue Editor


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Guest Editor
School of Public Health, Center of Postgraduate Medical Education, 01-809 Warsaw, Poland
Interests: pelvic exenteration; gynecological surgery; operative morbidity; gynecological malignancy; palliative indications; curative intent
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Special Issue Information

Dear Colleagues,

Both primary cancer nests and cancer relapse nests localized in the pelvis can be removed using the en bloc resection technique. Indeed, a recent analysis shows the mortality rate following pelvic exenteration to be somewhere between 0.7% and 6.4% when an acceptable level of exenteration is achieved.

Unsurprisingly, extensive surgery of this kind requires support at the organization level. While just such an organizing trend has been observed in renowned oncological centers, it needs to be more widely promoted and connected with the centralization of patients in referring hospitals. The success of the plan is more closely related to the surgical skill of the team, as achieving R0 resection (which is the only type of surgery with a curative intent) requires considerable surgical experience. Even pelvic exenteration due to palliative indications may prolong overall patient survival and have reliable functional results when R0 resection is achieved. Moreover, should the primary intent of the surgery change from palliative to curative, patient benefit will likely increase if a well-trained multidisciplinary team performs the procedure. Such a team not only understands pelvic anatomy but also has the knowledge and surgical skills to be able to imagine the sequelae of the resection procedure and to perform reconstructive procedures later. In summary, knowledge and information need to be widely disseminated. The resulting discussions will increase awareness among gynecological oncologists and so help to promote training programs aimed at expanding the surgical skills of qualified physicians.

Prof. Dr. Lukasz Wicherek
Guest Editor

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Published Papers (3 papers)

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Review

17 pages, 1049 KiB  
Review
Oncofertility as an Essential Part of Comprehensive Cancer Treatment in Patients of Reproductive Age, Adolescents and Children
by Dominika Łubik-Lejawka, Iwona Gabriel, Adrianna Marzec and Anita Olejek
Cancers 2024, 16(10), 1858; https://doi.org/10.3390/cancers16101858 - 13 May 2024
Viewed by 1290
Abstract
The number of children, adolescents and young adults diagnosed with cancer has been rising recently. Various oncological treatments have a detrimental effect on female fertility, and childbearing becomes a major issue during surveillance after recovery. This review discusses the impact of oncological treatments [...] Read more.
The number of children, adolescents and young adults diagnosed with cancer has been rising recently. Various oncological treatments have a detrimental effect on female fertility, and childbearing becomes a major issue during surveillance after recovery. This review discusses the impact of oncological treatments on the ovarian reserve with a thorough explanation of oncologic treatments’ effects and modes of oncofertility procedures. The aim of this review is to help clinicians in making an informed decision about post-treatment fertility in their patients. Ultimately, it may lead to improved overall long-term outcomes among young populations suffering from cancer. Full article
(This article belongs to the Special Issue Gynecologic Cancers: Clinical Research Progress of Resection)
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25 pages, 404 KiB  
Review
Range of Resection in Endometrial Cancer—Clinical Issues of Made-to-Measure Surgery
by Agnieszka Horala, Sebastian Szubert and Ewa Nowak-Markwitz
Cancers 2024, 16(10), 1848; https://doi.org/10.3390/cancers16101848 - 11 May 2024
Viewed by 1470
Abstract
Endometrial cancer (EC) poses a significant health issue among women, and its incidence has been rising for a couple of decades. Surgery remains its principal treatment method and may have a curative, staging, or palliative aim. The type and extent of surgery depends [...] Read more.
Endometrial cancer (EC) poses a significant health issue among women, and its incidence has been rising for a couple of decades. Surgery remains its principal treatment method and may have a curative, staging, or palliative aim. The type and extent of surgery depends on many factors, and the risks and benefits should be carefully weighed. While simple hysterectomy might be sufficient in early stage EC, modified-radical hysterectomy is sometimes indicated. In advanced disease, the evidence suggests that, similarly to ovarian cancer, optimal cytoreduction improves survival rate. The role of lymphadenectomy in EC patients has long been a controversial issue. The rationale for systematic lymphadenectomy and the procedure of the sentinel lymph node biopsy are thoroughly discussed. Finally, the impact of the molecular classification and new International Federation of Gynecology and Obstetrics (FIGO) staging system on EC treatment is outlined. Due to the increasing knowledge on the pathology and molecular features of EC, as well as the new advances in the adjuvant therapies, the surgical management of EC has become more complex. In the modern approach, it is essential to adjust the extent of the surgery to a specific patient, ensuring an optimal, made-to-measure personalized surgery. This narrative review focuses on the intricacies of surgical management of EC and aims at summarizing the available literature on the subject, providing an up-to-date clinical guide. Full article
(This article belongs to the Special Issue Gynecologic Cancers: Clinical Research Progress of Resection)
21 pages, 1131 KiB  
Review
The Potential Influence of Residual or Recurrent Disease on Bevacizumab Treatment Efficacy in Ovarian Cancer: Current Evidence and Future Perspectives
by Klaudia Żak, Małgorzata Satora, Ilona Skrabalak, Rafał Tarkowski, Marta Ostrowska-Leśko and Marcin Bobiński
Cancers 2024, 16(5), 1063; https://doi.org/10.3390/cancers16051063 - 5 Mar 2024
Cited by 1 | Viewed by 1956
Abstract
There were high hopes for the new antiangiogenic medicament, bevacizumab, which could inhibit the creation of new blood vessels through binding to isoform A of vascular endothelial growth factor (VEGF). However, it is not only blood vessels that are responsible for tumor cell [...] Read more.
There were high hopes for the new antiangiogenic medicament, bevacizumab, which could inhibit the creation of new blood vessels through binding to isoform A of vascular endothelial growth factor (VEGF). However, it is not only blood vessels that are responsible for tumor cell spread. During the process of tumor growth, lymphangiogenesis is mediated by other members of the VEGF family, specifically VEGF-C and VEGF-D, which act independent to bevacizumab. Therefore, based on the mechanism of bevacizumab action and the processes of angio- and lymphangiogenesis, we formed three hypotheses: (1) if the lymph nodes in primary ovarian cancers are metastatic, the outcome of bevacizumab treatment is worsened; (2) concerning the second-line treatment, bevacizumab will act in a weakened manner if recurrence occurs in lymph nodes as opposed to a local recurrence; (3) patients treated by bevacizumab are more likely to have recurrences in lymph nodes. These hypotheses raise the issue of the existing knowledge gap, which concerns the effect of bevacizumab on metastatic lymph nodes. Full article
(This article belongs to the Special Issue Gynecologic Cancers: Clinical Research Progress of Resection)
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