Authors: Fagotti A; Fanfani F; Vizzielli G; Gallotta V; Ercoli A; Paglia A; Costantini B; Vigliotta M; Scambia G; Ferrandina G
OBJECTIVES: Primary: To investigate whether S-LPS could contribute to a better identification of patients to submit to IDS. Secondary: To identify the most appropriate level of laparoscopic index value (PIV) to identify inoperable patients in this subset of patients. METHODS: A prospective single-institutional study including patients with advanced ovarian/peritoneal cancer (FIGO stage IIIC-IV) to be submitted to IDS after NACT. Patients have been considered eligible for surgical exploration in case of complete/partial radiological or serological response; stable disease if primary surgery had been performed in a different hospital; progressive radiological disease in the presence of serological response, young age, and good performance status (ECOG <1); and progressive serological disease with stable clinical and radiological disease. A laparoscopic assessment for each patient has been performed. RESULTS: Ninety-eight consecutive AOC patients submitted to NACT have been eligible for the study. With the addition of S-LPS to the RECIST criteria, a surgical exploration is performed in all patients and the percentage of explorative laparotomies drops to about 10%. The use of S-LPS after the GCIG criteria can reduce the risk of both explorative laparotomies from 30% to 13%, and inappropriate unexplorations from 18% to 0%. Moreover, at a PIV >4 the probability of optimally resecting the disease at laparotomy is equal to 0. CONCLUSIONS: Present data suggest that S-LPS can play a relevant role to discriminate patients with partially/stable disease or referred from other Institutions after NACT, which can be susceptible of successful IDS.
PARIGI 4/5 DICEMBRE 2010
Université Paris-Descartes
Laboratoire d’Anatomie
45, rue des Saints-Pères - 75006 Paris
DIRETTORE DEL CORSO
Prof. Giovanni Scambia
TUTORS
Dr. Alfredo Ercoli
Dr.ssa Anna Fagotti
Dr. Francesco Fanfani
McCuskey RS, Carmichael SW, Kirch DG.
Department of Cell Biology and Anatomy, College of Medicine, P.O. Box 245044, University of Arizona, Tucson, AZ 85724-5044, USA. mccuskey@email.arizona.edu
The current shortage of faculty qualified to teach anatomy in U.S. medical schools is reversible. Sufficient numbers of individuals are in the pipeline to provide a future cadre of well-trained faculty members educating students in gross anatomy. The challenge is to realign departmental, institutional, and federal training grant priorities and resources, creating incentives for graduate students, postdoctoral fellows, and faculty members to stay the course and become the teachers needed to educate the next generation of health professionals. These strategies include (but are not limited to) team-teaching gross anatomy, thereby distributing the time commitments of a laboratory-based course more widely within a department; funds made available from the administration of medical schools to allow postdoctoral fellows to participate in teaching and providing compensation for the research activities; using "mission-based budgeting" to specifically compensate for faculty teaching time; and, finally, re-instituting federally funded training grants that solved this same teaching crisis in the not-too-distant past.
Ercoli Alfredo; Delmas Vincent; Fanfani Francesco; Gadonneix Pierre; Ceccaroni Marcello; Fagotti Anna; Mancuso Salvatore; Scambia Giovanni
American journal of obstetrics and gynecology 2005;193(4):1565-73
Department of Gynecology, Catholic University, Rome, Italy.
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