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Cibula D, Kocian R, Plaikner A, Jarkovsky J, Klat J, Zapardiel I, Pilka R, Torne A, Sehnal B, Ostojich M, Petiz A, Sanchez OA, Presl J, Buda A, Raspagliesi F, Kascak P, van Lonkhuijzen L, Barahona M, Minar L, Blecharz P, Pakiz M, Wydra D, Snyman LC, Zalewski K, Zorrero C, Havelka P, Redecha M, Vinnytska A, Vergote I, Tingulstad S, Michal M, Kipp B, Slama J, Marnitz S, Bajsova S, Hernandez A, Fischerova D, Nemejcova K, Kohler C. Sentinel lymph node mapping and intraoperative assessment in a prospective, international, multicentre, observational trial of patients with cervical cancer: The SENTIX trial. Eur J Cancer 2020; 137:69-80. [PMID: 32750501 DOI: 10.1016/j.ejca.2020.06.034] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/25/2020] [Accepted: 06/30/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND SENTIX (ENGOT-CX2/CEEGOG-CX1) is an international, multicentre, prospective observational trial evaluating sentinel lymph node (SLN) biopsy without pelvic lymph node dissection in patients with early-stage cervical cancer. We report the final preplanned analysis of the secondary end-points: SLN mapping and outcomes of intraoperative SLN pathology. METHODS Forty-seven sites (18 countries) with experience of SLN biopsy participated in SENTIX. We preregistered patients with stage IA1/lymphovascular space invasion-positive to IB2 (4 cm or smaller or 2 cm or smaller for fertility-sparing treatment) cervical cancer without suspicious lymph nodes on imaging before surgery. SLN frozen section assessment and pathological ultrastaging were mandatory. Patients were registered postoperatively if SLN were bilaterally detected in the pelvis, and frozen sections were negative. TRIAL REGISTRATION ClinicalTrials.gov (NCT02494063). RESULTS We analysed data for 395 preregistered patients. Bilateral detection was achieved in 91% (355/395), and it was unaffected by tumour size, tumour stage or body mass index, but it was lower in older patients, in patients who underwent open surgery, and in sites with fewer cases. No SLN were found outside the seven anatomical pelvic regions. Most SLN and positive SLN were localised below the common iliac artery bifurcation. Single positive SLN above the iliac bifurcation were found in 2% of cases. Frozen sections failed to detect 54% of positive lymph nodes (pN1), including 28% of cases with macrometastases and 90% with micrometastases. INTERPRETATION SLN biopsy can achieve high bilateral SLN detection in patients with tumours of 4 cm or smaller. At experienced centres, all SLN were found in the pelvis, and most were located below the iliac vessel bifurcation. SLN frozen section assessment is an unreliable tool for intraoperative triage because it only detects about half of N1 cases.
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Affiliation(s)
- David Cibula
- Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.
| | - Roman Kocian
- Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Andrea Plaikner
- Department of Special Operative and Oncologic Gynaecology, Asklepios-Clinic Hamburg, Hamburg, Germany
| | - Jiri Jarkovsky
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jaroslav Klat
- Department of Obstetrics and Gynecology, University Hospital Ostrava, Ostrava Poruba, Czech Republic
| | - Ignacio Zapardiel
- Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain
| | - Radovan Pilka
- Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry, Palacky University, University Hospital Olomouc, Olomouc, Czech Republic
| | - Aureli Torne
- Unit of Gynecological Oncology, Institute Clinic of Gynaecology, Obstetrics, and Neonatology, Hospital Clinic-Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Borek Sehnal
- Department of Obstetrics and Gynecology, Bulovka Hospital, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Marcela Ostojich
- Department of Gynecology, Institute of Oncology Angel H. Roffo, University of Buenos Aires, Buenos Aires Autonomous City, Argentina
| | - Almerinda Petiz
- Department of Gynecology, Francisco Gentil Portuguese Oncology Institute, Porto, Portugal
| | - Octavio A Sanchez
- Department of Gynecologic Oncology, University Hospital of the Canary Islands, Las Palmas de Gran Canaria, Spain
| | - Jiri Presl
- Department of Gynaecology and Obstetrics, University Hospital Pilsen, Charles University, Prague, Czech Republic
| | - Alessandro Buda
- Department of Obstetrics and Gynecology, Unit of Gynecologic Oncology Surgery, San Gerardo Hospital, Monza, Italy
| | | | - Peter Kascak
- Department of Obstetrics and Gynecology, Faculty Hospital Trencin, Trencin, Slovakia
| | - Luc van Lonkhuijzen
- Center for Gynecologic Oncology, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Marc Barahona
- Department of Gynecology, University Hospital of Bellvitge, Biomedical Research Institute of Bellvitge, University of Barcelona, Barcelona, Spain
| | - Lubos Minar
- Department of Gynecology and Obstetrics, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Pawel Blecharz
- Department of Gynecologic Oncology, Centre of Oncology, M. Sklodowska-Curie Memorial Institute, Cracow Department, Cracow, Poland
| | - Maja Pakiz
- University Clinic for Gynaecology and Perinatology, University Medical Centre Maribor, Maribor, Slovenia
| | - Dariusz Wydra
- Department of Gynecology, Gynecologic Oncology and Gynecologic Endocrinology, Medical University of Gdansk, Poland
| | - Leon C Snyman
- Gynaecologic Oncology Unit, Department of Obstetrics and Gynaecology, University of Pretoria, Pretoria, South Africa
| | - Kamil Zalewski
- Department of Gynecologic Oncology, Holycross Cancer Center, Kielce, Poland
| | - Cristina Zorrero
- Gynecology Department, Instituto Valenciano de Oncologia (IVO), Valencia, Spain
| | - Pavel Havelka
- Department of Obstetrics and Gynecology, KNTB a.s Zlin, Czech Republic
| | - Mikulas Redecha
- Department of Gynaecology and Obstetrics, University Hospital, Comenius University, Bratislava, Slovakia
| | | | - Ignace Vergote
- Department of Gynecology and Obstetrics, University Hospital Leuven, Leuven Cancer Institute, Leuven, Belgium
| | | | - Martin Michal
- Department of Obstetrics and Gynaecology, Hospital Ceske Budejovice, JSC, Ceske Budejovice, Czech Republic
| | - Barbara Kipp
- Department of Obstetrics and Gynecology, Cantonal Hospital of Lucerne, Lucerne, Switzerland
| | - Jiri Slama
- Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Simone Marnitz
- Department of Radiation Oncology, CyberKnife and Radiotherapy University Hospital Cologne, Cologne, Germany
| | - Sylva Bajsova
- Department of Obstetrics and Gynecology, University Hospital Ostrava, Ostrava Poruba, Czech Republic
| | - Alicia Hernandez
- Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain
| | - Daniela Fischerova
- Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Kristyna Nemejcova
- Institute of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Christhardt Kohler
- Department of Special Operative and Oncologic Gynaecology, Asklepios-Clinic Hamburg, Hamburg, Germany
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Semaan A, Audet C, Huysmans E, Afolabi B, Assarag B, Banke-Thomas A, Blencowe H, Caluwaerts S, Campbell OMR, Cavallaro FL, Chavane L, Day LT, Delamou A, Delvaux T, Graham WJ, Gon G, Kascak P, Matsui M, Moxon S, Nakimuli A, Pembe A, Radovich E, van den Akker T, Benova L. Voices from the frontline: findings from a thematic analysis of a rapid online global survey of maternal and newborn health professionals facing the COVID-19 pandemic. BMJ Glob Health 2020; 5:e002967. [PMID: 32586891 PMCID: PMC7335688 DOI: 10.1136/bmjgh-2020-002967] [Citation(s) in RCA: 157] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/02/2020] [Accepted: 06/05/2020] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic has substantially impacted maternity care provision worldwide. Studies based on modelling estimated large indirect effects of the pandemic on services and health outcomes. The objective of this study was to prospectively document experiences of frontline maternal and newborn healthcare providers. METHODS We conducted a global, cross-sectional study of maternal and newborn health professionals via an online survey disseminated through professional networks and social media in 12 languages. Information was collected between 24 March and 10 April 2020 on respondents' background, preparedness for and response to COVID-19 and their experience during the pandemic. An optional module sought information on adaptations to 17 care processes. Descriptive statistics and qualitative thematic analysis were used to analyse responses, disaggregating by low-income and middle-income countries (LMICs) and high-income countries (HICs). RESULTS We analysed responses from 714 maternal and newborn health professionals. Only one-third received training on COVID-19 from their health facility and nearly all searched for information themselves. Half of respondents in LMICs received updated guidelines for care provision compared with 82% in HICs. Overall, 47% of participants in LMICs and 69% in HICs felt mostly or completely knowledgeable in how to care for COVID-19 maternity patients. Facility-level responses to COVID-19 (signage, screening, testing and isolation rooms) were more common in HICs than LMICs. Globally, 90% of respondents reported somewhat or substantially higher levels of stress. There was a widespread perception of reduced use of routine maternity care services, and of modification in care processes, some of which were not evidence-based practices. CONCLUSIONS Substantial knowledge gaps exist in guidance on management of maternity cases with or without COVID-19. Formal information-sharing channels for providers must be established and mental health support provided. Surveys of maternity care providers can help track the situation, capture innovations and support rapid development of effective responses.
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Affiliation(s)
- Aline Semaan
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
- Center for Research on Population and Health, American University of Beirut Faculty of Health Sciences, Beirut, Lebanon
| | - Constance Audet
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Elise Huysmans
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Bosede Afolabi
- Department of Obstetrics and Gynaecology, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Bouchra Assarag
- National School of Public Health, Ministry of Health, Rabat, Morocco
| | | | - Hannah Blencowe
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Séverine Caluwaerts
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Oona Maeve Renee Campbell
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Leonardo Chavane
- Department of Community Health, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - Louise Tina Day
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Alexandre Delamou
- Africa Centre of Excellence for Prevention and Control of Transmissible Diseases (CEA-PCMT), Universite Gamal Abdel Nasser de Conakry, Conakry, Guinea
| | - Therese Delvaux
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Wendy Jane Graham
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Giorgia Gon
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Peter Kascak
- Department of Obstetrics and Gynaecology, General Hospital Trencin, Trencin, Slovakia
| | - Mitsuaki Matsui
- Department of Global Health, Nagasaki University School of Tropical Medicine and Global Health, Nagasaki, Japan
| | - Sarah Moxon
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Annettee Nakimuli
- Department of Obstetrics & Gynaecology, Makerere University, Kampala, Uganda
- Department of Obstetrics and Gynaecology, Mulago Specialized Women and Neonatal Hospital, Kampala, Uganda
| | - Andrea Pembe
- Department of Obstetrics and Gynaecology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania
| | - Emma Radovich
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Thomas van den Akker
- Department of Obstetrics and Gynaecology, Leiden University Medical Centre, Vrije Universiteit Amsterdam, The Netherlands
- Department of Obstetrics and Gynaecology, VU Amsterdam Athena Institute, Vrije Universiteit Amsterdam, The Netherlands
| | - Lenka Benova
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
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Nemejcova K, Kocian R, Kohler C, Jarkovsky J, Klat J, Berjon A, Pilka R, Sehnal B, Gil-Ibanez B, Lupo E, Petiz A, Arencibia Sanchez O, Kascak P, Martinelli F, Buda A, Presl J, Barahona M, van Lonkhuijzen L, Szatkowski W, Minar L, Pakiz M, Havelka P, Zorrero C, Misiek M, Snyman LC, Wydra D, Vergote I, Vinnytska A, Redecha M, Michal M, Tingulstad S, Kipp B, Szewczyk G, Toth R, de Santiago Garcia FJ, Coronado Martin PJ, Poka R, Tamussino K, Luyckx M, Fastrez M, Staringer JC, Germanova A, Plaikner A, Bajsova S, Dundr P, Mallmann-Gottschalk N, Cibula D. Central Pathology Review in SENTIX, A Prospective Observational International Study on Sentinel Lymph Node Biopsy in Patients with Early-Stage Cervical Cancer (ENGOT-CX2). Cancers (Basel) 2020; 12:cancers12051115. [PMID: 32365651 PMCID: PMC7281480 DOI: 10.3390/cancers12051115] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 04/23/2020] [Accepted: 04/25/2020] [Indexed: 02/07/2023] Open
Abstract
The quality of pathological assessment is crucial for the safety of patients with cervical cancer if pelvic lymph node dissection is to be replaced by sentinel lymph node (SLN) biopsy. Central pathology review of SLN pathological ultrastaging was conducted in the prospective SENTIX/European Network of Gynaecological Oncological Trial (ENGOT)-CX2 study. All specimens from at least two patients per site were submitted for the central review. For cases with major or critical deviations, the sites were requested to submit all samples from all additional patients for second-round assessment. From the group of 300 patients, samples from 83 cases from 37 sites were reviewed in the first round. Minor, major, critical, and no deviations were identified in 28%, 19%, 14%, and 39% of cases, respectively. Samples from 26 patients were submitted for the second-round review, with only two major deviations found. In conclusion, a high rate of major or critical deviations was identified in the first round of the central pathology review (28% of samples). This reflects a substantial heterogeneity in current practice, despite trial protocol requirements. The importance of the central review conducted prospectively at the early phase of the trial is demonstrated by a substantial improvement of SLN ultrastaging quality in the second-round review.
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Affiliation(s)
- Kristyna Nemejcova
- Institute of Pathology, First Faculty of Medicine, Charles University and General University Hospital, 12000 Prague, Czech Republic; (K.N.); (P.D.)
| | - Roman Kocian
- Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital, 12000 Prague, Czech Republic; (R.K.); (A.G.)
| | - Christhardt Kohler
- Department of Special Operative and Oncologic Gynaecology, Asklepios-Clinic Hamburg, 22763 Hamburg, Germany; (C.K.); (A.P.)
| | - Jiri Jarkovsky
- Institute for Biostatistics and Analyses, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic;
| | - Jaroslav Klat
- Department of Obstetrics and Gynecology, University Hospital Ostrava, 708 52 Ostrava Poruba, Czech Republic; (J.K.); (S.B.)
| | - Alberto Berjon
- Department of Pathology, La Paz University Hospital, 28046 Madrid, Spain;
- Molecular Pathology and Therapeutic Targets Group, IdiPAZ, 28046 Madrid, Spain
| | - Radovan Pilka
- Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry, Palacky University, University Hospital Olomouc, 77520 Olomouc, Czech Republic;
| | - Borek Sehnal
- Department of Obstetrics and Gynecology, Bulovka Hospital, First Faculty of Medicine, Charles University, 18081 Prague, Czech Republic;
| | - Blanca Gil-Ibanez
- Unit of Gynecological Oncology, Institute Clinic of Gynecology, Obstetrics and Neonatology (ICGON), Hospital Clinic of Barcelona, 08036 Barcelona, Spain;
| | - Ezequiel Lupo
- Department of Pathology, Institute of Oncology Angel H. Roffo, University of Buenos Aires, Buenos Aires Autonomous City 1214, Argentina;
| | - Almerinda Petiz
- Department of Gynecology, Francisco Gentil Portuguese Oncology Institute, 4200-072 Porto, Portugal;
| | - Octavio Arencibia Sanchez
- Departments of Gynecologic Oncology, University Hospital of the Canary Islands, 35016 Las Palmas de Gran Canaria, Spain;
| | - Peter Kascak
- Department of Obstetrics and Gynecology, Faculty Hospital Trencin, 91171 Trencin, Slovakia;
| | - Fabio Martinelli
- IRCCS Foundation National Cancer Institute in Milan, 20133 Milan, Italy;
| | - Alessandro Buda
- Department of Obstetrics and Gynecology, Unit of Gynecologic Oncology Surgery, San Gerardo Hospital, 20900 Monza, Italy;
| | - Jiri Presl
- Department of Gynaecology and Obstetrics, University Hospital Pilsen, Charles University, 30460 Prague, Czech Republic;
| | - Marc Barahona
- Department of Gynecology, University Hospital of Bellvitge, Biomedical Research Institute of Bellvitge, University of Barcelona, 08907 Barcelona, Spain;
| | - Luc van Lonkhuijzen
- Center for Gynecologic Oncology, Academic Medical Centre, 1100DD Amsterdam, The Netherlands;
| | - Wiktor Szatkowski
- Department of Gynecologic Oncology, Centre of Oncology, M. Sklodowska-Curie Memorial Institute, Cracow Department, 31-115 Cracow, Poland;
| | - Lubos Minar
- Department of Gynecology and Obstetrics, Faculty of Medicine, Masaryk University, 60200 Brno, Czech Republic;
| | - Maja Pakiz
- University Clinic for Gynaecology and Perinatology, University Medical Centre Maribor, 2000 Maribor, Slovenia;
| | | | - Cristina Zorrero
- Gynecology Department, Instituto Valenciano de Oncología (IVO), 46009 Valencia, Spain;
| | - Marcin Misiek
- Department of Gynecologic Oncology, Holycross Cancer Center, 25-734 Kielce, Poland;
| | - Leon Cornelius Snyman
- Gynaecologic Oncology Unit, Department of Obstetrics and Gynaecology, University of Pretoria, Pretoria 0001, South Africa;
| | - Dariusz Wydra
- Department of Gynecology, Gynecologic Oncology and Gynecologic Endocrinology, Medical University of Gdansk, 80-402 Gdansk, Poland;
| | - Ignace Vergote
- Department of Gynecology and Obstetrics, University Hospital Leuven, Leuven Cancer Institute, 3000 Leuven, Belgium;
| | - Alla Vinnytska
- LISOD-Israeli Oncological Hospital, 08720 Plyuty, Ukraine;
| | - Mikulas Redecha
- Department of Gynaecology and Obstetrics, University Hospital, Comenius University, 82101 Bratislava, Slovakia;
| | - Martin Michal
- Department of Obstetrics and Gynaecology, Hospital Ceske Budejovice, JSC, 37001 Ceske Budejovice, Czech Republic;
| | | | - Barbara Kipp
- Department of Obstetrics and Gynecology, Cantonal Hospital of Lucerne, 6000 Lucerne, Switzerland;
| | - Grzegorz Szewczyk
- Department of Obstetrics and Gynecology, Institute of Mother and Child, 01-211 Warsaw, Poland;
| | - Robert Toth
- Oncology Institute of East Slovakia, 04191 Košice, Slovakia;
| | | | | | - Robert Poka
- Institute of Obstetrics and Gynaecology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary;
| | | | - Mathieu Luyckx
- Department of Gynecology, Universite catholique de Louvain, Cliniques Universitaires St Luc, 1200 Brussels, Belgium;
| | - Maxime Fastrez
- Department of Obstetrics and Gynaecology, St Pierre University Hospital, Universite Libre de Bruxelles, 1000 Brussels, Belgium;
| | - Juan Carlos Staringer
- Department of Gynecology and Obstetrics, Hospital Español de Buenos Aires, Buenos Aires 2975, Argentina;
| | - Anna Germanova
- Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital, 12000 Prague, Czech Republic; (R.K.); (A.G.)
| | - Andrea Plaikner
- Department of Special Operative and Oncologic Gynaecology, Asklepios-Clinic Hamburg, 22763 Hamburg, Germany; (C.K.); (A.P.)
| | - Sylva Bajsova
- Department of Obstetrics and Gynecology, University Hospital Ostrava, 708 52 Ostrava Poruba, Czech Republic; (J.K.); (S.B.)
| | - Pavel Dundr
- Institute of Pathology, First Faculty of Medicine, Charles University and General University Hospital, 12000 Prague, Czech Republic; (K.N.); (P.D.)
| | | | - David Cibula
- Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital, 12000 Prague, Czech Republic; (R.K.); (A.G.)
- Correspondence: ; Tel.: +420-224967451
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Zahumensky J, Psenkova P, Nemethova B, Halasova D, Kascak P, Korbel M. Evaluation of cesarean delivery rates at three university hospital labor units using the Robson classification system. Int J Gynaecol Obstet 2019; 146:118-125. [PMID: 31058314 DOI: 10.1002/ijgo.12842] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 04/05/2019] [Accepted: 05/03/2019] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To analyze the frequency of cesarean delivery using the Robson 10-group classification. METHODS A multicenter retrospective cohort study was conducted at three university hospital labor units in the Slovak Republic. The medical records of all women who gave birth at these centers from January 1 to December 31, 2017, were assessed. RESULTS In all, 1437 of 3361 (42.8%), 729 of 2795 (26.1%), and 303 of 2080 (14.6%) births recorded at the three centers during the current study period were by cesarean delivery. Among the nulliparous term singleton vertex deliveries (Robson group 1 and 2), the frequency of cesarean delivery at the three centers was 613 of 1653 (37.1%), 278 of 1389 (20.0%), and 91 of 898 (10.1%). Among term multiparas with one fetus in a cephalic position and at least one previous cesarean delivery (Robson group 5), the frequency of cesarean delivery at the three centers was 405 of 418 (96.9%), 261 of 343 (76.1%), and 55 of 115 (47.8%). CONCLUSION Analysis of the frequency of cesarean delivery by Robson classification could help to identify possibilities for safely decreasing cesarean delivery rates in the clinic. Robson groups 1, 2, and 5 were the most modifiable groups.
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Affiliation(s)
- Jozef Zahumensky
- 2nd Department of Obstetrics and Gynecology, University Hospital Bratislava and Comenius University, Bratislava, Slovak Republic
| | - Petra Psenkova
- 2nd Department of Obstetrics and Gynecology, University Hospital Bratislava and Comenius University, Bratislava, Slovak Republic
| | - Bianka Nemethova
- 1st Department of Obstetrics and Gynecology, University Hospital Bratislava and Comenius University, Bratislava, Slovak Republic
| | - Dominika Halasova
- Department of Obstetrics and Gynecology, Trencin University Hospital, Trencin, Slovak Republic
| | - Peter Kascak
- Department of Obstetrics and Gynecology, Trencin University Hospital, Trencin, Slovak Republic
| | - Miroslav Korbel
- 1st Department of Obstetrics and Gynecology, University Hospital Bratislava and Comenius University, Bratislava, Slovak Republic
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Kascak P, Zamecnik M, Bystricky B. Small Cell Carcinoma of the Ovary (Hypercalcemic Type): Malignant Rhabdoid Tumor. Case Rep Oncol 2016; 9:305-11. [PMID: 27462229 PMCID: PMC4939673 DOI: 10.1159/000446694] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 05/09/2016] [Indexed: 01/09/2023] Open
Abstract
We present a rare case of malignant rhabdoid tumor (ovarian small cell carcinoma of hypercalcemic type) in a 24-year-old female with fulminant course. Clinically, hypercalcemia was not found at the time of primary diagnosis. However, it appeared later during the course of tumor progression. Histologically, the tumor showed classical features of small cell carcinoma of hypercalcemic type. Therapy included radical surgery with adjuvant chemotherapy. Despite this intensive therapy, the disease recurred and the patient died 10 months after the diagnosis. We discuss the diagnosis and therapy of this tumor, as well as its recent classification as malignant rhabdoid tumor.
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Affiliation(s)
- Peter Kascak
- Department of Obstetrics and Gynecology, Faculty Hospital, Trenčîn, Slovakia; Faculty of Health, Alexander Dubcek University, Trenčîn, Slovakia
| | - Michal Zamecnik
- Medirex Group Academy n.o., Bratislava, Slovakia; Department of Pathology, Agel Laboratories, Nový Jičîn, Czech Republic
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Kascak P, Chovanec M, Limner R. Herpes gestationis - A case report. Int J Gynaecol Obstet 2000. [DOI: 10.1016/s0020-7292(00)83172-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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