Our study confirmed that pelvic posterior exenteration associated with retrograde radical hysterectomy represents the safest radical surgical approach to advanced ovarian cancer, which permits preservation of the pelvic autonomic nerve plexus and, therefore, bladder and colorectal functions.

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SUMMARY A six month, double blind, controlled study was performed in 107 asymptomatic duodenal ulcer patients who, after short term cimetidine treatment, showed complete or incomplete endoscopic healing. Patients were stratified according to the type of healing and randomly allocated to cimetidine (200 mg at lunch, 400 mg at bedtime) or placebo. Endoscopic examinations were carried out after six months or when symptoms recurred. Eighty seven patients completed the maintenance trial. Of the 56 patients admitted to the study with complete healing, 30 were placed on cimetidine and 26 on placebo. Of the 31 patients admitted with incomplete healing, 15 were placed on cimetidine, and 16 on placebo. Results showed that, regardless of maintenance treatment, patients with incompletely healed ulcers had a higher ulcer crater recurrence rate, than patients with complete healing (71% vs 34%; p<0005). A significantly higher ulcer crater recurrence was observed in incompletely healed ulcer patients, even when cimetidine or placebo treatment groups were considered separately. Irrespective of the type of healing, ulcer crater recurrence was more frequent in placebo treated patients than in those treated with cimetidine (67% vs 29%; p<0.001). We conclude that, in order to prevent a high ulcer recurrence rate, maintenance treatment should start only after the assessment of a complete endoscopic healing of duodenal ulcers.The endoscopic definition of the healing of peptic ulcers lacks uniformity and this lack of universally accepted criteria could affect the scientific and clinical results of ulcer treatment.Ippoliti et al' found that, when ulcer healing was considered as disappearance of the ulcer crater, the ulcer healing rate, after four weeks' antacid treatment, was 86%. When on the other hand ulcer healing was considered as absence of both ulcer and erosions -that is, breaks in the mucosa without a fibrous base, the rate decreased to 52% Miyake et a12 described different stages of gastric ulcer healing. The third and fourth stages were called the palisade scar stage and the cobblestone stage, respectively. These are similar to the red and white scar stages described by Sakita.3 In previous studies-7 on the effects of various

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with complete cytoreduction. In this study, we evaluated the survival impact of cardiophrenic lymph node enlargement in women with advanced stage epithelial ovarian cancer who have undergone cytoreductive surgery. Methodology The Embase, Medline, Web of science, Cochrane Library and Google scholar databases were searched for articles from the database inception to November 2020. Metaanalysis was conducted to determine the prognostic impact of surgical outcome, postoperative complication and survival using random-effects models. Result(s)* Fifteen relevant studies, involving 727 patients with CPLN adenopathy and 981 patients without CPLN adenopathy, were included in the review. The prevalence of ascites, and intra and extra abdominal metastases were highest in the CPLN adenopathy group. The mean size of pre-operative CPLN was 9.1± 3.75mm. Eighty-two percent of the patients with CPLN resection, the resected CPLN were histological confirmed pathologic nodes. Surgical outcomes and perioperative complications did not differ between both groups. The pooled median overall survival (OS) was 42.7 months (95% CI 10.8-74.6) versus 47.3 months (95% CI 23.2-71.2) in patients with and without CPLN adenopathy. The pooled median progression free survival (PFS) was 14.6 months (95% CI 4.9-24.4) versus 27.8 months (95% CI 3.2-52.5) respectively. Patients with CPLN adenopathy had a significantly increased risk of disease recurrence (OR4.56, 95% CI 1.98-10.51, P<0.001) and of dying from disease (OR 2.96, 95% CI 2.08-4.22, p<0.001) compared to those without CPLN adenopathy. Conclusion* Patients with CPLN adenopathy had a higher tumor burden in both intra and extra-abdominal sites, and lower survival compared to patients without CPLN adenopathy. The available data was not sufficient to definitively confirm a therapeutic role of CPLN resection. A randomized controlled trial is needed to demonstrate the benefit of CPLN resection in cytoreductive surgery.

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