while the negative predictive value (NPP) reached 92.77% (95% CI: 89.56% -95.04%). In general, the diagnostic accuracy of the cytological evaluation reaches 74.93% (95% CI: 66.99% -79.43%).
Result(s)* The mean age was 50. The average tumor size was 28 mm. The tumor was bifocal in 20%. 55% of tumors were Grade II SBR.Invasive ductal carcinoma (IDC) was the most common histological subtype (74%). It was associated in 79% of cases with ductal carcinoma in situ (DCIS).For the CTCS, 60% were DCIS, and 40% of the cases were invasive ductal carcinoma.A complementary treatment consisting of mastectomy was indicated to all patients.A residual tumor was detected in the remaining mammary gland in 60.4% of cases, out of which 39% were DCIS.Chi-square test found that the presence of DCIS in CTCS, the lymphovascular invasion, and the size of tumors were not related to the presence of residual invasive or in-situ disease (p<0.05). Conclusion* CTCS can help to detect residual or multifocal diseases.Nevertheless, we need to find a way to avoid mastectomy with no residual disease in the remaining mammary gland.
Result(s)* A total of 38 out of 84 evaluable patients at 6 months included in Paloma trial were above 40yo [mean(SD) age: 47.71(5.56)], of which 30 and 13 were HR HPV and 16-18-31 HPV patients, respectively. At 6 months, normal cytology and concordant colposcopy was observed in 92%, 90% and 75% of patients treated with Papilocare ® vs 50%, 33% and 40% of patients in control group, in the total, HR and 16-18-31 populations (p=0.0066; p=0.0031; p=0.2929, Fisher test) respectively. Conclusion* Papilocare ® showed a robust and clinically significant efficacy in repairing cervical HPV lesions in women over 40 years, with a statistically significant difference vs control group in the total and HR populations.
Results 109 patients were included in the study. Primary staging was done in 62%. 88% presented at stage I. 75% had primary ovarian mucinous histology, while 25% had metastatic histology. Metastatic MOC had absent borderline areas and advanced stage. 32% underwent appendicectomy, 2 cases had positive appendices and both were grossly abnormal. 23 patients recurred -12 intraperitoneal, 8 extra-abdominal. Median follow-up of 49 months and 3year PFS and OS were 70.2% and 77.9%. Early-stage MOC median OS was not reached. Metastatic carcinomas had significantly poorer OS compared to advanced primary (10 vs 41 months p-<0.001). Fertility-sparing surgery with only ovarian cystectomy significantly reduced OS compared to adnexectomy. Conclusion Of 109 MOCs, most had primary histology and early stage. Metastatic carcinoma had absent borderline areas, smaller size, bilaterality and advanced stage. Routine appendicectomy may not have a prognostic role. Factors affecting OS were the stage of disease and extent of surgery; not chemotherapy regime. Ovarian cystectomy alone resulted in poorer survival.
See-and-treat procedure is a step towards the same. The present study was conducted to establish the two-step approach of See and treat in preference to the conventional three-step protocol In the management of Cervical intraepithelial neoplasm Methodology A Randomized controlled trial was conducted in AIIMS Rishikesh, Uttarakhand, India, from July 2018-July 2020. All women presenting to the outpatient clinic in the age group 25-60 were screened with per speculum examination and PAP smear. Colposcopy was performed on women with Abnormal PAP smear or clinically unhealthy cervix. Colposcopic guided biopsy was done when indicated. Women with CIN2/3 were randomized to a two or three-step approach. Women falling into the two-step approach(group a) underwent LEEP/Thermal Ablation/Cold knife conization in the same setting. In contrast, Group B was advised to follow up with histopathology reports for further management. The authors studied the final histopathological diagnosis to determine the adequacy of treatment. Result(s)* Overtreatment rates were 22% in See and treated approach, distributed as 3.6% in HSIL + ASC_H group and 33% in LSIL patients. 39 out of 50 women in Group B needed definitive treatment after their biopsy results, and 48% of them were lost to follow up. 72% were adequately treated in group A while only 22% could be adequately treated in Group B. Conclusion* It can thus be safely concluded that a two-step approach should be considered for preventive management, especially considering the rate of loss to follow up in a threestep approach despite the risk of overtreatment. This study thus advocates the use of the See and Treat protocol, especially in high-grade cytology lesions. In low-risk cases, too, the study proposes that see and treat protocol can be used, albeit with good clinical judgment. Offering opportunities to reduce the suffering associated with the eminently preventable cervical cancer is an ethical imperative. The SEE and TREAT approach is an attempt in that early preventive direction.
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