Robotic versus open hysterectomy for very large uterus (more than 1000 g): A bicentric retrospective study of 150 patients.

Objective: To compare robotic (RAL) and open abdominal (OA) hysterectomy for very large uteri in terms of perioperative outcomes, complications, and costs.

Methods: Data from patients undergoing total hysterectomy between 2015 and 2021 for benign indications with a uterus weighing 1000 g or more according to the pathology report in two French Academic hospitals were retrospectively collected. All patients with a malignant pathology were excluded.

Diagnostic performances of hysteroscopy in post-remission surveillance of patients treated conservatively for endometrial cancer and atypical hyperplasia: a cohort study.

Objective: Hysteroscopy is commonly used for diagnosing benign endometrial conditions, but its diagnostic performance in malignancies post-treatment surveillance has not been evaluated. This study evaluated the correlation between hysteroscopic appearance and histological outcomes in patients in remission after conservative treatment for atypical hyperplasia (AH) or early-stage endometrial cancer (EC).

Study Design: Multicenter retrospective cohort study utilizing data from the French national register of fertility-sparing management for AH/EC (PREFERE database) from May 2015 to December 2020.

Vaginal versus laparoscopic suture for vaginal cuff closure in total robot-assisted laparoscopic hysterectomy: A multicentric comparative study.

Background: Vaginal cuff closure is an important step in hysterectomy. To date, the literature and data on this procedure are inconsistent, and the optimal approach (i.e.

Pregnancy and obstetric outcomes after fertility-sparing management of endometrial cancer and atypical hyperplasia: a multicentre cohort study.

Study Question: What are the pregnancy and obstetric outcomes in women with atypical hyperplasia (AH) or early-stage endometrial cancer (EC) managed conservatively for fertility preservation?

Summary Answer: The study found a live birth rate of 62% in patients with AH or EC after conservative treatment, with higher level of labour induction, caesarean section, and post-partum haemorrhage.

What Is Known Already: Fertility-sparing treatment is a viable option for women with AH or EC during childbearing years, but the outcomes of such treatments, especially regarding pregnancy and obstetrics, need further exploration.

Study Design, Size, Duration: This retrospective cohort study analysed data from January 2010 to October 2022, involving 269 patients from the French national register of patients with fertility-sparing management of AH/EC.

Impact of sentinel lymph node mapping on survival in patients with high-risk endometrial cancer in the early stage: A matched cohort study.

Objective: The aim of this study was to compare patient survival using sentinel lymph node (SLN) procedure and pelvic lymphadenectomy for stating early-stage high risk endometrial cancer.

Methods: Patients who underwent surgery for early-stage high risk endometrial cancer between 2010 and 2017 were extracted from the incidence registry of the SEER program. We identified patients who underwent SLN mapping.

[Conservative treatments for endometrial cancer].

CONSERVATIVE TREATMENTS FOR ENDOMETRIAL CANCER Treatment for early endometrial cancer remains based on hysterectomy. However, in patients of reproductive age with a pregnancy desire, conservative alternative may be considered in case of atypical hyperplasia or endometrial endometrial adenocarcinoma without myometrial invasion. The conservative treatment consists in proposing a protocol preserving the uterus, based on an antigonadotropic treatment (oral or intrauterine progestin, GnRH agonist) allowing a regression of the endometrial lesion.

Residual Microscopic Peritoneal Metastases after Macroscopic Complete Cytoreductive Surgery for Advanced High-Grade Serous Ovarian Carcinoma: A Target for Folate Receptor Targeted Photodynamic Therapy?

Despite conventional treatment combining complete macroscopic cytoreductive surgery (CRS) and systemic chemotherapy, residual microscopic peritoneal metastases (mPM) may persist as the cause of peritoneal recurrence in 60% of patients. Therefore, there is a real need to specifically target these mPM to definitively eradicate any traces of the disease and improve patient survival. Therapeutic targeting method, such as photodynamic therapy, would be a promising method for such a purpose.

Microscopic Peritoneal Residual Disease after Complete Macroscopic Cytoreductive Surgery for Advanced High Grade Serous Ovarian Cancer.

Background: Epithelial ovarian cancers (EOC) are usually diagnosed at an advanced stage and managed by complete macroscopic cytoreductive surgery (CRS) and systemic chemotherapy. Peritoneal recurrence occurs in 60% of patients and may be due to microscopic peritoneal metastases (mPM) which are neither eradicated by surgery nor controlled by systemic chemotherapy. The aim of this study was to assess and quantify the prevalence of residual mPM after complete macroscopic CRS in patients with advanced high-grade serous ovarian cancer (HGSOC).

[First results of a breast cancer risk assessment and management consultation].

Introduction: In France, participation in the organized breast cancer screening program remains insufficient. A personalized approach adapted to the risk factors for breast cancer (RBC) should make screening more efficient. A RBC evaluation consultation would therefore make it possible to personalize this screening.

Anti-NMDA receptor encephalitis associated with ovarian tumor: the gynecologist point of view.

Background: Anti-NMDA receptor antibody (anti-NMDAr) encephalitis, although still a rare condition, is well known to neurologists as it is the leading cause of non-infectious acute encephalitis in young women. However, this is less well known to gynecologists, who may have a decisive role in etiological management. Indeed, in 30-60% of cases in women of childbearing age, it is associated with the presence of an ovarian teratoma, whose removal is crucial in the resolution of symptomatology.

Lymph node metastasis probability in young patients eligible for conservative management of endometrial cancer.

Objective: Endometrial cancer (EC) is a rare condition in young women. The objective of this study was to evaluate the risk of pelvic lymph node (LN) metastasis in young women with EC who are candidates for conservative management.

Methods: Using the SEER database, a population-based analysis was conducted to identify women <45 years with grade 1, 2, or 3 endometrioid adenocarcinoma stage IA (FIGO 2009) who underwent pelvic lymphadenectomy with at least ten LNs removed.

[Are there still indications of lymph node dissection in epithelial ovarian cancers after the LION trial?].

In March 2019, Harter et al. published the results of the LION study (Lymphadenectomy in patients with advanced ovarian neoplasms) which raises the question of pelvic and para-aortic lymphadenectomy for patients with advanced-stage epithelial ovarian cancer (EOC). These results influenced the new French recommendations published in December 2018 by the French National Cancer Institute (INCa).

[Update regarding the management of vulvar cancer: The guidelines of the Assistance Publique-Hôpitaux de Paris].

Vulvar cancer is a rare disease, which represents 4% of gynecological tumors with an incidence of 0.5 to 1.5 per 100,000 women per year in France.

Association between maternal social deprivation and prenatal care utilization: the PreCARE cohort study.

Background: Maternal social deprivation is associated with an increased risk of adverse maternal and perinatal outcomes. Inadequate prenatal care utilization (PCU) is likely to be an important intermediate factor. The health care system in France provides essential health services to all pregnant women irrespective of their socioeconomic status.

Impact of Conservative Managements in Young Women With Grade 2 or 3 Endometrial Adenocarcinoma Confined to the Endometrium.

Objectives: The aim of this study was to evaluate the impact of ovarian and/or uterine preservation in young patients with grade 2 or 3 endometrial adenocarcinoma confined to the endometrium.

Methods/materials: A population-based analysis was conducted. The SEER'17 Database was used to identify women younger than 45 years with grade 2 or 3 endometrial adenocarcinoma confined to the endometrium from 1983 to 2012.

Cancer Incidence in Patients with Atypical Endometrial Hyperplasia Managed by Primary Hysterectomy or Fertility-sparing Treatment.

Aim: To compare the risk of developing endometrial carcinoma (EC) in young women with atypical endometrial hyperplasia (AEH) undergoing fertility-sparing management compared to women treated by primary hysterectomy.

Patients And Methods: In this multicentric retrospective study, 111 patients with a diagnosis of AEH by endometrial biopsy were included. EC incidence was compared in two groups: 32 patients treated with fertility-sparing management and 79 older patients treated with primary hysterectomy.

Surgical Outcomes After Debulking Surgery for Intraabdominal Ovarian Growing Teratoma Syndrome: Analysis of 38 Cases.

Background: The goal, methods, and results of surgery for growing teratoma syndrome (GTS) in men after testicular cancer have been well described. The main surgical challenge relates to the need for vascular or thoracic procedures. But little is known about GTS in women, particularly regarding the optimal management of intraabdominal disease.

Gliomatosis peritonei: a particular entity with specific outcomes within the growing teratoma syndrome.

Objectives: Ovarian immature teratoma may be associated with peritoneal spread that could, after adjuvant chemotherapy, develop into disease exclusively composed of mature implants (growing teratoma syndrome) and/or gliomatosis peritonei (GP), defined as the presence of pure mature glial tissue. However, very few specific series are devoted to the outcomes of pure GP. This was the aim of the present study.

Factors predictive of endometrial carcinoma in patients with atypical endometrial hyperplasia on preoperative histology.

Aim: To identify predictive factors of endometrial cancer in patients with atypical endometrial hyperplasia (AEH).

Patients And Methods: This was a retrospective cohort study of 79 patients diagnosed with AEH. Clinicopathological characteristics of patients and final histology on hysterectomy were reviewed and univariate and multivariate analyses were performed.

Impact of obesity on the results of fertility-sparing management for atypical hyperplasia and grade 1 endometrial cancer.

Objectives: The aim of the present study was to evaluate the impact of obesity on reproductive and oncologic outcomes on the success of fertility-sparing management.

Methods: This retrospective multicenter cohort study included women treated conservatively for atypical hyperplasia (AH) and endometrial cancer (EC) to preserve fertility. Five inclusion criteria were defined: (i) the presence of AH or grade 1 EC confirmed by two pathologists; (ii) adequate radiological examination before conservative management; (iii) available body mass index (BMI) at the beginning of treatment; and (iv) a minimum follow-up time of six months.