Feasibility of Complete Cytoreduction in Advanced Epithelial Ovarian Cancer

Objective: Complete resectability of all visualized tumor implants at debulking surgery for advanced epithelial ovarian cancer is confirmed to be the single most important prognostic factor. This study aims to develop preoperative predicting score based on clinical, biological, and radiological criteria of epithelial ovarian cancer to assess the feasibility of complete cytoreduction. Study Design: A retrospective record-based study. Patients and Methods: The study was conducted upon 50 consecutive patients managed for epithelial ovarian cancer with FIGO stage III. Patients’ data were collected from records of the Gyne-Oncology Clinic of El Shatby University Maternity Hospital affiliated to Alexandria University. Results: Many parameters were significantly associated with completeness of resectability in univariate analysis;including age, BMI, CA125, albumin, pre-albumin, PCI, mesenteric, and right copula of diaphragm affection by CT scan (p value < 0.05). A 100-point predictability score was developed, 10 for BMI ≥ 35 kg/m2, 25 points for Pre albumin < 14.5 mg/dl, 35 points for mesenteric affection, and 30 points for affection of Rt. copula of diaphragm. The overall accuracy of the score was 92%. Conclusion: In advanced ovarian cancer, pre-operative predicting score (including clinical, biological, and radiological criteria) can be used as a roadmap for prediction of feasibility of complete resectability. However, more research is needed on larger sample sizes.

Recurrent Miscarriage: Hysteroscopy-Assisted Management

Objective: To apply office hysteroscopy in assessment/management of patients with recurrent miscarriage, thus to/or not to recommend office hysteroscopy as a routine procedure in such cases. Study design: Retrospective analysis. Setting: University hospital’s outpatient abortion clinic. Subjects & Methodology: Patients’ records during the period between March 2015 and January 2017 for subjects with at least 2 previous miscarriages, who had undergone office hysteroscopy were reviewed. Results: Cases with 2 previous miscarriages (n = 95) were assessed and compared with those with 3 or more miscarriages (n = 105). Abnormal uterine findings were diagnosed in 24.1% of the former, and 43.8% of the latter group. The prevalence of uterine lesions among cases with 2 recurrent miscarriages was 42.1%;meanwhile, for subjects with 3 or more consecutive miscarriages, it was 43.8%. Conclusion: In addition to safety profile, simplicity and outpatient basis of use, outpatient hysteroscopy in recurrent miscarriages would be an added-value to practitioners as a diagnostic and therapeutic tool.