Juliane Farthmann

Video-assisted thoracic surgery (VATS) evaluation of intrathoracic disease in patients with FIGO III and IV stage ovarian cancer

OBJECTIVES The aim of this study was to assess the influence of video-assisted thoracic surgery (VATS) on our treatment decisions in FIGO III and IV ovarian cancer patients. METHODS Patients with ovarian cancer and suspected supra-diaphragmatic involvement (pleural effusions, pleural carcinomatosis, lung metastasis, or enlarged supra-diaphragmatic lymph nodes) at chest computer tomography (CT) scan underwent VATS with or without laparoscopy (LSC) to decide for primary cytoreduction or neoadjuvant chemotherapy. Operation time, VATS complications (intrapleural hematoma, secondary hemorrhage with intervention, pneumonia and empyema) and shift in the therapeutic strategy due to VATS were evaluated. RESULTS 17 patients were included into this study (1 patient with FIGO stage IIIb, 1 with IIIc and 15 with stage IV). The median operation time for VATS only was 46.5 min (range: 20-50 min, n=3). Perioperatively, no complications occurred. After surgical staging, the tumor was confined to the abdomen in four patients in whom primary cytoreduction was attempted. All other 13 patients underwent neoadjuvant chemotherapy. VATS altered the therapeutic management in 6/17 ovarian cancer patients (3 times upstaging, 3 times downstaging). Negative predictive values (NPV) for local and diffuse pleural carcinomatosis ranged between 0.5 and 0.71. CONCLUSION In this case series, VATS in addition to LSC showed negligible morbidity related to surgery and a short operation time. We were able to improve the accuracy of the FIGO staging and assessed operability more reliably in these patients than through imaging techniques alone.

Sexual Function After Gynaecological Cancer

In gynecological cancer, sexual function plays an important role. Surgery affects female organs with consequences for sexual function beyond that of chemotherapy or radiotherapy. Premature menopause and loss of fertility may be especially important for younger patients. Also for elderly patients sexuality may be an important part of health-related quality of life. Therefore, we picture potential consequences of gynecological cancer therapy and how they may be prevented or addressed.

Sexualität und Fertilität erhalten, Lebensqualität erhöhen

Die Frage „Hat sich in Ihrer Partnerschaft etwas verändert?“ könnte der Einstieg für das Gespräch mit ihrer Krebspatientin sein, um über die Auswirkungen einer onkologischen Therapie auf die Sexualität und Fertilität zu sprechen. Die notwendige Beratung gewinnt im Rahmen der onkologischen Versorgung zunehmend an Bedeutung.

Hat sich in Ihrer Partnerschaft etwas verändert

Diese Frage könnte der Einstieg für die Krebspatientin sein, über die Auswirkungen einer onkologischen Therapie auf ihre Sexualität und Fertilität zu sprechen. Denn diese gewinnen zunehmend an Bedeutung. Die notwendige Beratung stellt behandelnde Ärzte vor eine Herausforderung.