98%
921
2 minutes
20
Objective: To assess clinical outcomes of inguinal lymph node surgical resection compared to primary groin radiotherapy for locally advanced, surgically unresectable vulvar cancer.
Methods: All patients treated with radiation for vulvar cancer were identified between Jan 1, 2000 - Dec 31, 2020 at 2 academic centres. Inclusion criteria were those treated with curative intent primary radiotherapy +/- chemotherapy, tumors >4 cm, and surgically unresectable squamous cell vulvar carcinoma. Groin recurrence-free survival (RFS) was compared for groin surgery and primary groin radiotherapy using the Kaplan Meier method and log rank test. Groin failures are described by treatment modality, radiation dose and lymph node size.
Results: Of 476 patients treated with radiation for vulvar cancer, 112 patients (23.5%) met inclusion and exclusion criteria. The median (95% CI) follow up was 1.9 (1.4-2.5) years. Complete clinical response was significantly higher (80.0%) in patients with surgical groin resection compared to patients treated with primary groin radiotherapy (58.2%) (p = 0.04). On multivariable analysis, after adjusting for clinical and/or radiologically abnormal lymph nodes (p = 0.67), surgical groin resection was significantly associated with lower groin recurrence (HR 0.2 (95%CI 0.05-0.92), p = 0.04). The 3-year groin recurrence-free survival (RFS) was significantly higher at 94.4% (87.1-100) in patients with surgical groin resection compared to 79.2% (69.1-90.9) in patients treated with primary radiation (p = 0.02).
Conclusions: In locally advanced squamous cell vulvar cancer, surgical groin management improves groin RFS compared to radiotherapy alone.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1016/j.ygyno.2024.04.025 | DOI Listing |
Curr Opin Infect Dis
September 2025
Infectious Diseases Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna.
Purpose Of Review: Sulbactam-durlobactam (SUL-DUR) is a novel β-lactam/β-lactamase inhibitor combination recently approved for carbapenem-resistant Acinetobacter baumannii (CRAB) infections. This review summarizes current knowledge on the optimal use of SUL-DUR, whether administered alone or in combination with carbapenems, particularly imipenem.
Recent Findings: Data from registrational trial demonstrate that SUL-DUR is an effective and well tolerated treatment option for CRAB severe infections.
Clin J Am Soc Nephrol
September 2025
Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
JMIR Res Protoc
September 2025
Department of Health Services Research & Administration, College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States.
Background: With the availability of more advanced and effective treatments, life expectancy has improved among patients with metastatic breast cancer (MBC), but this makes communication with their medical oncologist more complex. Some patients struggle to learn about their therapeutic options and to understand and articulate their preferences. Mobile health (mHealth) apps can enhance patient-provider communication, playing a crucial role in the diagnosis, treatment, quality of life, and outcomes for patients living with MBC.
View Article and Find Full Text PDFJMIR Res Protoc
September 2025
Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland.
Background: In pediatric intensive care units, pain, sedation, delirium, and iatrogenic withdrawal syndrome (IWS) must be managed as interrelated conditions. Although clinical practice guidelines (CPGs) exist, new evidence needs to be incorporated, gaps in recommendations addressed, and recommendations adapted to the European context.
Objective: This protocol describes the development of the first patient- and family-informed European guideline for managing pain, sedation, delirium, and IWS by the European Society of Paediatric and Neonatal Intensive Care.
JAMA Netw Open
September 2025
School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Importance: The cost-effectiveness of adding early in-bed cycling to usual physiotherapy among adults receiving mechanical ventilation in the intensive care unit (ICU) compared with usual physiotherapy alone is unknown.
Objective: To evaluate the cost-effectiveness of in-bed cycling plus usual physiotherapy compared with usual therapy alone in the Critical Care Cycling to Improve Lower Extremity Strength (CYCLE) randomized clinical trial.
Design, Setting, And Participants: This trial-based economic evaluation with a 90-day time horizon compared early cycling plus usual physiotherapy vs usual physiotherapy alone from a societal perspective.