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The Impact of Obesity on Performing Lymphadenectomy and Its Outcome in Ovarian Cancer Patients

Journal of Cancer Therapy 2018年第7期9卷 568-575页

作者： Basel Refky mosab shetiwy Ahmed Zaki Mohamed Elmetwally Hanan Nabil Islam Abdou Ahmed Abdallah Amr Soliman Khaled Abdelwahab Anas Gamal Essam Elshiekh Khaled Gaballa Oncology Center Mansoura University Mansoura Egypt Mansoura University Hospitals Mansoura Egypt Oldenburg University Oldenburg Germany Tanta Cancer Center Tanta Egypt

Background: This study discusses the effect of obesity on the number of lymph nodes harvested during systematic LND and the LND-related complications in ovarian cancer patients. Methods: This retrospective study enrolled women with ovarian cancer who were consecutively subjected to open surgical resection that included systematic LND (pelvic and para-aortic) in the Oncology Center in Mansoura University (OCMU) during the period between January 2012 and June 2017. Patients were categorized according to the recommendations of World Health Organization by their BMI as non-obese (BMI 30.0 kg/m2) and obese (BMI ≥ 30.0 kg/m2). Results: Seventy-seven women with ovarian cancer were enrolled in the study according to our inclusion and exclusion criteria. 43 females (55.8%) were grouped as obese and 34 (44.2%) as non-obese. Lymph nodes retrieved in total and in different stations separately (pelvic and para-aortic) were all similar among patients in both groups. LND-related intraoperative complications were observed in 8 patients (18.6%) in the obese group and 3 patients in the non-obese group (8.8%) (P = 0.347). Hospital stay was the same in the two groups with a median of 4 days (IQR 3 - 5). Postoperative complications occurred in 13 patients (30.2%) in the obese group and only in one patient (3%) in the non-obese group (P = 0.004). Conclusion: Obese ovarian cancer patients may safely undergo comprehensive staging involving extensive lymph node dissection in open surgeries without significant increase in the rates of intraoperative complications. Whereas, postoperative complications (wound infection and thromboembolic events) tend to occur at higher rates with obese patients. Trial registration: This study was retrospectively registered and approved at faculty of Medicine Mansoura University, Egypt with IRB approval number R.18.02.46.

关键词： Lymphadenectomy Obesity Ovarian Cancer

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The Effectiveness of Intraoperative Frozen Section Analysis of Safety Margins in Breast Conserving Surgery and the Role of Surgeon in Decreasing the Rate of Positive Margins

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Surgical Science 2017年第12期8卷 499-509页

作者： Omar Farouk Ahmed Senbel mosab shetiwy Essam Attia Ahmed Abdallah Osama El-Damshety Ashraf Khater Sameh Roshdy Amr Abouzid Amr Hossam Islam H. Metwally Omar Hamdy Amir M. Zaid Mahmoud Abdelaziz Mohamed Elmetwally Adel Fathi Emad-Eldeen Hamed Khaled Abdel Wahab Wagdi El-Kashef Mohamed Hafez Khaled Zalata Mohamed Hegazy Adel Denewer Surgical Oncology Department Oncology Center Faculty of Medicine Mansoura University Mansoura Egypt Pathology Department Faculty of Medicine Mansoura University Mansoura Egypt

Introduction: Nowadays the more accepted surgical option for treating early breast cancer is breast conserving surgery. The main challenge in this type of surgery is to get free safety margins without need of second surgical operation, so many breast surgeons have started to depend on intraoperative frozen sections to ensure free safety margins. Aim of work: To assess our policy that we prefer to depend on intraoperative frozen section analysis to get free safety margin in breast conserving surgery from the 1st surgery, and its oncologic outcome. Patients and Methods: This is a retrospective study conducted in Oncology Center—Mansoura University (OCMU), where the data of 219 patients with breast cancer, who were managed by breast conserving surgery with intraoperative frozen section analysis of the safety margins, was analyzed. Results: The intraoperative frozen section analysis of safety margin was negative from the start in 183 (83.6%) patients, while it was positive in 36 patients (16.4%). Intraoperative decision of margin re-excision was applied for 29 patients (13.2%) in order to reach negative margin, modified radical mastectomy was offered for 4 patients (1.8%), while nipple sparing mastectomy with immediate breast reconstruction using latissimus dorsi flap was offered for 3 patients (1.4%). The postoperative paraffin results were typical with intraoperative frozen section analysis results in 216 patients (98.6%) and different results were obtained in only 3 patients (1.4%) who were managed by modified radical mastectomy in a second operation. Only 4 patients had local recurrence (1.8%) during the period of follow-up duration which was ranged from 1 to 86 months with mean ± SD (22.3 ± 14.1). Conclusion: The intraoperative frozen section analysis of safety margins in breast conserving surgery has very high-rate typical results with the paraffin section analysis and it is very helpful in decreasing the rate of second surgical operation in cases of infiltrated m

关键词： Breast Conserving Surgery Intraoperative Frozen Section Analysis Safety Margins Breast

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