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Article ; Online: Management of the sentinel lymph node in endometrial cancer: Is the role of Nuclear Medicine specialists still needed?

Paredes, Pilar / Díaz-Feijoo, Berta

Revista espanola de medicina nuclear e imagen molecular

2021 Volume 40, Issue 5, Page(s) 273–274

MeSH term(s)	Endometrial Neoplasms/pathology ; Female ; Humans ; Nuclear Medicine ; Sentinel Lymph Node/pathology ; Sentinel Lymph Node Biopsy
Language	English
Publishing date	2021-07-24
Publishing country	Spain
Document type	Editorial
ISSN	2253-8089
ISSN (online)	2253-8089
DOI	10.1016/j.remnie.2021.06.002
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Article ; Online: Para-aortic lymphadenectomy in cervical cancer deserves a new trial.

Martinez, Alejandra / Díaz-Feijoo, Berta / Querleu, Denis

International journal of gynecological cancer : official journal of the International Gynecological Cancer Society

2022

Language	English
Publishing date	2022-09-16
Publishing country	England
Document type	Letter
ZDB-ID	1070385-8
ISSN	1525-1438 ; 1048-891X
ISSN (online)	1525-1438
ISSN	1048-891X
DOI	10.1136/ijgc-2022-003910
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Article ; Online: Controversy over sentinel lymph node detection in endometrial cancer.

Paredes, P / Díaz-Feijoo, B / Aguilar Galán, E V / de Matías Martínez, M / Fuertes Cabero, S

Revista espanola de medicina nuclear e imagen molecular

2022 Volume 41, Issue 6, Page(s) 373–379

Abstract: In the last decade, the procedure of sentinel lymph node biopsy has been introduced in low-risk endometrial cancer, being optional in intermediate- and high-risk cancer. However, until the last year, there was no consensus regarding the group of patients ...

Abstract	In the last decade, the procedure of sentinel lymph node biopsy has been introduced in low-risk endometrial cancer, being optional in intermediate- and high-risk cancer. However, until the last year, there was no consensus regarding the group of patients to whom to apply it, the best tracer to use or the site of injection. In this paper, we present in a multidisciplinary view the most controversial issues about the sentinel lymph node procedure in endometrial cancer, emphasizing the pros and cons of the different tracers available: radiotracers, hybrid tracers and indocyanine green.
MeSH term(s)	Female ; Humans ; Sentinel Lymph Node/diagnostic imaging ; Sentinel Lymph Node/pathology ; Lymph Node Excision/methods ; Coloring Agents ; Sentinel Lymph Node Biopsy/methods ; Endometrial Neoplasms/diagnostic imaging ; Endometrial Neoplasms/pathology
Chemical Substances	Coloring Agents
Language	English
Publishing date	2022-09-24
Publishing country	Spain
Document type	Journal Article
ISSN	2253-8089
ISSN (online)	2253-8089
DOI	10.1016/j.remnie.2022.09.012
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Article ; Online: Laparoscopically assisted radical vaginal hysterectomy in early-stage cervical cancer.

Glickman, Ariel / Díaz-Feijoo, Berta / Agusti, Nuria / Carreras-Dieguez, Núria / Fusté, Pere / Torné, Aureli

International journal of gynecological cancer : official journal of the International Gynecological Cancer Society

2022

Language	English
Publishing date	2022-08-22
Publishing country	England
Document type	Journal Article
ZDB-ID	1070385-8
ISSN	1525-1438 ; 1048-891X
ISSN (online)	1525-1438
ISSN	1048-891X
DOI	10.1136/ijgc-2022-003670
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Article ; Online: Sentinel lymph node mapping in early-stage ovarian cancer: surgical technique in 10 steps.

Agusti, Nuria / Paredes, Pilar / Vidal-Sicart, Sergi / Glickman, Ariel / Torne, Aureli / Díaz-Feijoo, Berta

International journal of gynecological cancer : official journal of the International Gynecological Cancer Society

2022 Volume 32, Issue 8, Page(s) 1082–1083

MeSH term(s)	Female ; Humans ; Lymph Node Excision/methods ; Lymph Nodes/pathology ; Lymph Nodes/surgery ; Neoplasm Staging ; Ovarian Neoplasms/pathology ; Ovarian Neoplasms/surgery ; Sentinel Lymph Node/pathology ; Sentinel Lymph Node/surgery ; Sentinel Lymph Node Biopsy/methods
Language	English
Publishing date	2022-08-01
Publishing country	England
Document type	Journal Article
ZDB-ID	1070385-8
ISSN	1525-1438 ; 1048-891X
ISSN (online)	1525-1438
ISSN	1048-891X
DOI	10.1136/ijgc-2022-003420
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Article ; Online: Sentinel lymph node detection in early-stage ovarian cancer: a systematic review and meta-analysis.

Agusti, Nuria / Viveros-Carreño, David / Grillo-Ardila, Carlos / Izquierdo, Nora / Paredes, Pilar / Vidal-Sicart, Sergi / Torne, Aureli / Díaz-Feijoo, Berta

International journal of gynecological cancer : official journal of the International Gynecological Cancer Society

2023 Volume 33, Issue 10, Page(s) 1493–1501

Abstract: Background: A systematic pelvic and para-aortic lymphadenectomy remains the surgical standard management of early-stage epithelial ovarian cancer. Sentinel lymph node mapping is being investigated as an alternative procedure; however, data reporting ... ...

Abstract	Background: A systematic pelvic and para-aortic lymphadenectomy remains the surgical standard management of early-stage epithelial ovarian cancer. Sentinel lymph node mapping is being investigated as an alternative procedure; however, data reporting sentinel lymph node performance are heterogeneous and limited. Objective: This study aimed to evaluate the detection rate and diagnostic accuracy of sentinel lymph node mapping in patients with early-stage ovarian cancer. Methods: A systematic search was conducted in Medline (through PubMed), Embase, Scopus, and the Cochrane Library. We included patients with clinical stage I-II ovarian cancer undergoing a sentinel lymph node biopsy and a pelvic and para-aortic lymphadenectomy as a reference standard. We conducted a meta-analysis for the detection rates and measures of diagnostic accuracy and assessed the risk of bias using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with identifying number CRD42022351497. Results: After duplicate removal, we identified 540 studies, 18 were assessed for eligibility, and nine studies including 113 patients were analyzed. The pooled detection rates were 93.3% per patient (95% CI 77.8% to 100%; I Conclusion: Sentinel lymph node biopsy in early-stage ovarian cancer showed a high detection rate and negative predictive value. The utero-ovarian and infundibulo-pelvic injection using the indocyanine green and technetium-99 combination could increase sentinel lymph node detection rates. However, given the limited quality of evidence and the small number of reports, results from ongoing trials are awaited before its implementation in routine clinical practice.
MeSH term(s)	Humans ; Female ; Sentinel Lymph Node/diagnostic imaging ; Sentinel Lymph Node/surgery ; Sentinel Lymph Node/pathology ; Indocyanine Green ; Coloring Agents ; Sentinel Lymph Node Biopsy/methods ; Lymph Node Excision/methods ; Carcinoma, Ovarian Epithelial/surgery ; Lymphadenopathy/pathology ; Ovarian Neoplasms/diagnostic imaging ; Ovarian Neoplasms/surgery ; Ovarian Neoplasms/pathology ; Lymph Nodes/pathology
Chemical Substances	Indocyanine Green (IX6J1063HV) ; Coloring Agents
Language	English
Publishing date	2023-10-02
Publishing country	England
Document type	Meta-Analysis ; Systematic Review ; Journal Article
ZDB-ID	1070385-8
ISSN	1525-1438 ; 1048-891X
ISSN (online)	1525-1438
ISSN	1048-891X
DOI	10.1136/ijgc-2023-004572
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Article ; Online: Impact of gynecological cancers on health-related quality of life: historical context, measurement instruments, and current knowledge.

Gil-Ibanez, Blanca / Davies-Oliveira, Jennifer / Lopez, Gregorio / Díaz-Feijoo, Berta / Tejerizo-Garcia, Alvaro / Sehouli, Jalid

International journal of gynecological cancer : official journal of the International Gynecological Cancer Society

2023 Volume 33, Issue 11, Page(s) 1800–1806

Abstract: Gynecologic cancers, comprising 14.4% of newly diagnosed cancer cases in women globally, are substantial causes of both mortality and morbidity, with a profound impact on the quality of life (QoL) of survivors. Over the past few decades, advancements in ... ...

Abstract	Gynecologic cancers, comprising 14.4% of newly diagnosed cancer cases in women globally, are substantial causes of both mortality and morbidity, with a profound impact on the quality of life (QoL) of survivors. Over the past few decades, advancements in interdisciplinary and interprofessional care have contributed to an increase in the average life expectancy of gynecological cancer patients. However, the disease and its treatments have a profound impact on patients, leading to physical changes and psychological consequences, including psychosocial and psychosexual effects, which negatively affect their QoL.The primary objective of management strategies is to minimize harm while improving survival rates and enhancing QoL during the survivorship stage. QoL measures play a crucial role in enhancing our comprehension of how cancer and its treatments affect individuals. Consequently, various measurement instruments, such as the EORTC QLQ 30, PROMIS-29, FACT-G, and QOL-CS, have been developed to assess health-related quality of life (HRQoL). Pre- and post-treatment HRQoL measurements have been shown to be predictive factors for post-operative complications and prognostic factors for overall survival and progression-free survival in gynecological oncology patients. Patient-reported outcomes related to HRQoL are essential tools for measuring patient outcomes and enabling patient-centered clinical decision-making.This article focuses on HRQoL, providing a historical context, summarizing measurement instruments, and discussing the current understanding of the impact of gynecological cancers on HRQoL.
MeSH term(s)	Humans ; Female ; Quality of Life/psychology ; Genital Neoplasms, Female/psychology ; Survivors ; Progression-Free Survival ; Survival Rate
Language	English
Publishing date	2023-11-06
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1070385-8
ISSN	1525-1438 ; 1048-891X
ISSN (online)	1525-1438
ISSN	1048-891X
DOI	10.1136/ijgc-2023-004804
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Article ; Online: Simple radiologic assessment of visceral obesity and prediction of surgical morbidity in endometrial cancer patients undergoing laparoscopic aortic lymphadenectomy: A reliability and accuracy study.

Correa-Paris, Alejandro / Gorraiz Ochoa, Verónica / Hernandez Gutiérrez, Alicia / Gilabert Estellés, Juan / Díaz-Feijoo, Berta / Gil-Moreno, Antonio

The journal of obstetrics and gynaecology research

2023 Volume 49, Issue 3, Page(s) 988–997

Abstract: Aim: To evaluate the reliability of sagittal abdominal diameter (SAD)-a surrogate of visceral obesity-in magnetic resonance imaging, and its accuracy to predict the surgical morbidity of aortic lymphadenectomy.: Methods: We conducted a multicenter ... ...

Abstract	Aim: To evaluate the reliability of sagittal abdominal diameter (SAD)-a surrogate of visceral obesity-in magnetic resonance imaging, and its accuracy to predict the surgical morbidity of aortic lymphadenectomy. Methods: We conducted a multicenter reliability (phase 1) and accuracy (phase 2) cohort study in three Spanish referral hospitals. We retrospectively analyzed data from the STELLA-2 randomized controlled trial that included high-risk endometrial cancer patients undergoing minimally invasive surgical staging. Patients were classified into subgroups: conventional versus robotic-assisted laparoscopy, and transperitoneal versus extraperitoneal technique. In the first phase, we measured the agreement of three SAD measurements (at the umbilicus, renal vein, and inferior mesenteric artery) and selected the most reliable one. In phase 2, we evaluated the diagnostic accuracy of SAD to predict surgical morbidity. Surgical morbidity was the main outcome measure, it was defined by a core outcome set including variables related to blood loss, operative time, surgical complications, and para-aortic lymphadenectomy difficulty. Results: In phase 1, all measurements showed good inter-rater and intra-rater agreement. Umbilical SAD (u-SAD) was the most reliable one. In phase 2, we included 136 patients. u-SAD had a good diagnostic accuracy to predict surgical morbidity in patients undergoing transperitoneal laparoscopic lymphadenectomy (0.73 in ROC curve). It performed better than body mass index and other anthropometric measurements. We calculated a cut-off point of 246 mm (sensitivity: 0.56, specificity: 0.80). Conclusions: u-SAD is a simple, reliable, and potentially useful measurement to predict surgical morbidity in endometrial cancer patients undergoing minimally invasive surgical staging, especially when facing transperitoneal aortic lymphadenectomy.
MeSH term(s)	Female ; Humans ; Cohort Studies ; Retrospective Studies ; Obesity, Abdominal/etiology ; Obesity, Abdominal/pathology ; Obesity, Abdominal/surgery ; Reproducibility of Results ; Robotic Surgical Procedures/methods ; Lymph Node Excision/methods ; Laparoscopy/methods ; Endometrial Neoplasms/pathology ; Neoplasm Staging
Language	English
Publishing date	2023-01-02
Publishing country	Australia
Document type	Multicenter Study ; Journal Article
ZDB-ID	1327307-3
ISSN	1447-0756 ; 1341-8076
ISSN (online)	1447-0756
ISSN	1341-8076
DOI	10.1111/jog.15528
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Article ; Online: Steerable DROP-IN radioguidance during minimal-invasive non-robotic cervical and endometrial sentinel lymph node surgery.

van Oosterom, Matthias N / Diaz-Feijóo, Berta / Santisteban, Maria Isabel / Sánchez-Izquierdo, Núria / Perissinotti, Andrés / Glickman, Ariel / Marina, Tiermes / Torné, Aureli / van Leeuwen, Fijs W B / Vidal-Sicart, Sergi

European journal of nuclear medicine and molecular imaging

2024

Abstract: Purpose: The recently introduced tethered DROP-IN gamma probe has revolutionized the way robotic radioguided surgery is performed, fully exploiting the nature of steerable robotic instruments. Given this success, the current first-in-human study ... ...

Abstract	Purpose: The recently introduced tethered DROP-IN gamma probe has revolutionized the way robotic radioguided surgery is performed, fully exploiting the nature of steerable robotic instruments. Given this success, the current first-in-human study investigates if the DROP-IN can also provide benefit in combination with steerable non-robotic instruments during conventional laparoscopic surgery, showing equivalence or even benefit over a traditional rigid gamma probe. Methods: The evaluation was performed in ten patients during laparoscopic cervical (n = 4) and endometrial (n = 6) cancer sentinel lymph node (SLN) procedures. Surgical guidance was provided using the hybrid, or bi-modal, SLN tracer ICG- Results: The gynecologists experienced an enlarged freedom of movement when using the DROP-IN + LaproFlex combination compared to the rigid laparoscopic probe, making it possible to better isolate the SLN signal from background signals. This did not translate into a change in the SLN find rate yet. In both cervical and endometrial cancer combined, the rigid probe and DROP-IN + LaproFlex combination provided an equivalent detection rate of 96%, while fluorescence provided 85%. Conclusion: We have successfully demonstrated the in-human use of steerable DROP-IN radioguidance during laparoscopic cervical and endometrial cancer SLN procedures, expanding the utility beyond robotic procedures. Indicating an improved surgical experience, these findings encourage further investigation and consideration on a path towards routine clinical practice and improved patient outcome. Trial registration: HCB/2021/0777 and NCT04492995; https://clinicaltrials.gov/study/NCT04492995.
Language	English
Publishing date	2024-01-18
Publishing country	Germany
Document type	Journal Article
ZDB-ID	8236-3
ISSN	1619-7089 ; 0340-6997 ; 1619-7070
ISSN (online)	1619-7089
ISSN	0340-6997 ; 1619-7070
DOI	10.1007/s00259-023-06589-3
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Article: Patterns of First Recurrence and Oncological Outcomes in Locally Advanced Cervical Cancer Patients: Does Surgical Staging Play a Role?

Bebia, Vicente / Díaz-Feijoo, Berta / Tejerizo, Álvaro / Torne, Aureli / Benito, Virginia / Hernández, Alicia / Gorostidi, Mikel / Domingo, Santiago / Bradbury, Melissa / Luna-Guibourg, Rocío / Gil-Moreno, Antonio

Cancers

2024 Volume 16, Issue 7

Abstract: Background: We aimed to determine whether surgical aortic staging by minimally invasive paraaortic lymphadenectomy (PALND) affects the pattern of first recurrence and survival in treated locally advanced cervical cancer (LACC) patients when compared to ... ...

Abstract	Background: We aimed to determine whether surgical aortic staging by minimally invasive paraaortic lymphadenectomy (PALND) affects the pattern of first recurrence and survival in treated locally advanced cervical cancer (LACC) patients when compared to patients staged by imaging (noPALND). Methods: This study was a multicenter observational retrospective cohort study of patients with LACC treated at tertiary care hospitals throughout Spain. The inclusion criteria were histological diagnosis of squamous carcinoma, adenosquamous carcinoma, and/or adenocarcinoma; FIGO stages IB2, IIA2-IVA (FIGO 2009); and planned treatment with primary chemoradiotherapy between 2000 and 2016. Propensity score matching (PSM) was performed before the analysis. Results: After PSM and sample replacement, 1092 patients were included for analysis (noPALND n = 546, PALND n = 546). Twenty-one percent of patients recurred during follow-up, with the PALND group having almost double the recurrences of the noPALND group (noPALND: 15.0%, PALND: 28.0%, Conclusion: After treatment, surgically staged patients with LACC recurred more frequently and showed worse survival rates.
Language	English
Publishing date	2024-04-06
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers16071423
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