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- 저자 : Seracchioli (검색결과 2 건)
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Marcello Ceccaroni,Giovanni Roviglione,Mario Malzoni,Francesco Cosentino,Emanuela Spagnolo,Roberto Clarizia,Paolo Casadio,Renato Seracchioli,Fabio Ghezzi,Daniele Mautone,Francesco Bruni,Stefano Uccell 대한부인종양학회 2021 Journal of Gynecologic Oncology Vol.32 No.1
Objective: Total laparoscopic nerve-sparing radical hysterectomy (TL-NSRH) has beenconsidered a promising approach, however, surgical, clinical, oncological and functionaloutcomes have not been systematically addressed. We present a large retrospective multi center experience comparing TL-NSRH vs. open abdominal NSRH (OA-NSRH) for early andlocally-advanced cervical cancer, with particular emphasis on post-surgical pelvic function. Methods: All consecutive patients who underwent class C1-NSRH plus bilateral pelvic + para aortic lymphadenectomy for stage IA2–IIB cervical cancer at 4 Italian gynecologic oncologiccenters (Negrar, Varese, Bologna, Avellino) were enrolled. Patients were divided into TL NSRH and OA-NSRH groups and were investigated with preoperative questionnaires onurinary, rectal and sexual function. Postoperatively, patients filled a questionnaire assessingquality of life, taking into account sexual function and psychological status. Oncologicaloutcomes were analyzed using Kaplan-Meyer method. Results: 301 consecutive patients were included in this study: 170 in the TL-NSRH group and131 in the OA-NSRH group. Patients in the OA-NSRH group were more likely to experienceurinary incontinence and (after 12-months follow-up) urinary retention. No patient in theTL-NSRH group vs. 5 (5.5%) in the OA-NSRH group had complete urinary retention (at the>24-month follow-up [p=0.02]). A total of 20 (11.8%) in the TL-NSRH and 11 (8.4%) patientsin the OA-NSRH had recurrence of disease (p=0.44) and 14 (8.2%) and 9 (6.9%) died ofdisease during follow-up, respectively (p=0.83). Conclusion: Our study shows that TL-NSRH is feasible, safe and effective and conjugatesadequate radicality and improvement in post-operative functional outcomes. Oncologicaloutcomes of laparoscopic procedures deserve further investigation.
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Paolo Casadio,Francesca Guasina,Maria Rita Talamo,Roberto Paradisi,Ciro Morra,Giulia Magnarelli,Renato Seracchioli 대한부인종양학회 2019 Journal of Gynecologic Oncology Vol.30 No.4
Objective: To report hysteroscopic treatment combined with levonorgestrel-releasing intrauterine device (LNG-IUD) to treat women with early well differentiated endometrial cancer (EC) at high surgical risk. Methods: Nine women diagnosed with stage IA, grade 1 endometrioid EC which was contraindicated or refused standard treatment with external beam radiation therapy with or without brachytherapy were enrolled in our prospective study. Endo-myometrial hysteroscopic resection of the whole uterine cavity and the placement of LNG-IUD for 5 years was performed. Response rate, perioperative complications, and recurrence of disease were evaluated. Results: None had intra or post-operative complications and all were discharged no later than the third day of hospitalization. After 6 months from surgery, all the women showed a complete regression of the lesion. All the women completed the 5 years follow-up and in no case was detected sign of recurrence. Two women died for causes unrelated to the tumor or the ongoing therapy. Conclusion: The alternative treatment with endo-myometrial hysteroscopic resection and LNG-IUD in women with stage IA, grade 1 endometrioid EC showed initial encouraging outcomes in terms of effectiveness and safety.
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