Management of epithelial ovarian cancer. Short text drafted from the French joint recommendations of FRANCOGYN, CNGOF, SFOG, GINECO-ARCAGY and endorsed by INCa.
[Management of epithelial ovarian cancer. Short text drafted from the French joint recommendations of FRANCOGYN, CNGOF, SFOG, GINECO-ARCAGY and endorsed by INCa]. Bull Cancer. 2019 Mar 05;: Authors: Lavoue V, Huchon C, Akladios C, Alfonsi P, Bakrin N, Ballester M, Bendifallah S, Bolze PA, Bonnet F, Bourgin C, Chabbert-Buffet N, Collinet P, Courbiere B, De la Motte Rouge T, Devouassoux-Shisheboran M, Falandry C, Ferron G, Fournier L, Gladieff L, Golfier F, Gouy S, Guyon F, Lambaudie E, Leary A, Lecuru F, Lefrere-Belda MA, Leblanc E, Lemoine A, Narducci F, Ouldamer L, Pautier P, Planchamp F, Pouget N, Ray-Coquard I, Rousset-Jablonski C, Senechal-Davin C, Touboul C, Thomassin-Naggara I, Uzan C, You B, Daraï E Abstract Faced to an undetermined ovarian mass on ultrasound, an MRI is recommended and the ROMA score (combining CA125 and HE4) can be proposed (grade A). In case of suspected early stage ovarian or fallopian tube cancer, omentectomy (at least infracolonic), appendectomy, multiple peritoneal biopsies, peritoneal cytology (grade C) and pelvic and para-aortic lymphadenectomy are recommended (grade B) for all histological types, except for the expansive mucinous subtype where lymphadenectomy may be omitted (grade C). Minimally invasive surgery is recommended for early stage ovarian cancer, if there is no risk of tumor rupture (grade B). Adjuvant chemotherapy with carboplatin and paclitaxel is recommended for all high-grade ovarian or Fallopian tube ...
Irreversible T cell exhaustion limits the efficacy of programmed cell death 1 (PD-1) blockade. We observed that dual CD40-TLR4 stimulation within a single tumor restored PD-1 sensitivity and that this regimen triggered a systemic tumor-specific CD8+ T cell response. This approach effectively treated established tumors in diverse syngeneic cancer models, and the systemic effect was dependent on the injected tumor, indicating that treated tumors were converted into necessary components of this therapy. Strikingly, this approach was associated with the absence of exhausted PD-1hi T cells in treated and distant tumors, while s...
Active surveillance (AS) has been widely accepted as a first-line management approach in men with low-risk prostate cancer. While AS provides an avenue to reduce risk of overtreatment without compromising oncological safety, there remains a lack of consensus on the optimal approach to monitoring. An ideal surveillance strategy would be one that minimizes invasive testing such as prostate biopsy without conceding adverse oncologic outcomes. Thus, several studies have sought to identify men at higher risk of reclassification so as to more carefully select when biopsy is truly necessary.
In “National trends in the utilization of androgen deprivation therapy for very low risk prostate cancer,” the authors demonstrate a significant decline in the use of primary androgen deprivation (pADT), for very low risk prostate cancer. By 2015, only 1.7% of men in this population received pADT, representing a furthering of trends witnessed in the early 21st century, and which have been previously described.1,2
We thank the authors of this editorial for their very thoughtful comments. They are correct that the use of low dose CT (LDCT) scan can significantly reduce the radiation dose associated with kidney stone management. The sensitivity of LDCT for nephrolithiasis is well-established and comparable to that of standard dose CT scan (SDCT), especially in nonobese patients.1 Unfortunately, while the technology is available, limited evidence exists that widespread adoption of LDCT has occurred, especially in the emergency department setting where a significant percentage of imaging for nephrolithiasis is performed.
Obtaining a Post-void Residual (PVR) is one of the most common procedures performed in Urology. In a subspecialty replete with uncomfortable and potentially embarrassing tests, measuring PVR using ultrasound is arguably unique in its minimally-invasive nature, reproducibility, and ability to deliver objective data. It is a technique which has been universally adopted and employed, albeit with little data to guide the user in interpreting its results. Indeed, several guideline statements deemed obtaining a PVR a Clinical Principle, a statement for which there may or may not be evidence in the medical literature that is wide...
ConclusionReal-time indocyanine green fluorescence imaging may be particularly helpful for delineating the anatomical surgical plane and determining the appropriate division point of the hepatic duct during laparoscopic living donor hepatectomy.
ConclusionThe novel approach for transthoracic hepatectomy was safe and feasible for lesions of segment VIII in selected patients with cirrhosis,8 which was associated with reduced blood loss and a safe surgical margin.
Hi everyone I failed a course by a single question (0.2%) and as a result I have to take a Remediation Exam. The exam is on our Fundamentals Course which is all of the basics sciences. It is 2 days away and I am starting to panic. It is on all of Immuno, all of BioChem, all Anatomy, all Micro, Anti-biotics, Anti-cancers, Anti-fungals, Fundamentals of Pathology, Infectious Disease and pretty much anything you can think of. I have been studying for a month but I feel like I just cant... Remediation Exam
You've done a bowel case for a perfed DU in an otherwise young healthy guy who took too much naproxen... At the end of the case, you put in a triple lumen with ultrasound, but still manage to get a little hole in the pleura... Patient extubated and in PACU, develops shortness of breath... can anyone walk me through the physiology of how this patient could develop a tension PTX if he's spontaneously breathing and not positive pressure ventilated... ? [URL... Tension PTX
ConclusionSemi-dynamic MRI is an technique that is easy to perform to identify injuries of the A3 pulley ligament that were not seen on standard imaging.
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