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Cancers of the Pelvic Organs: Contemporary Management and Actions for Improving Patients’ Quality of Life

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: closed (20 January 2023) | Viewed by 19842

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Special Issue Editors

Dr. Agnieszka Mazur-Bialy

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Guest Editor

1. Faculty of Health Science, Jagiellonian University Medical College, Skawinska 8, 31-066 Krakow, Poland
2. Department of Gynecology and Obstetrics with Gynecological Oncology, Specialized Ludwik Rydygier Hospital, ul. Zlotej Jesieni 1, 31-826 Krakow, Poland
Interests: incontinence; pelvic floor disorders; physiotherapy; obesity; physical activity; urogyneacology

Dr. Marcin Opławski

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Guest Editor

Department of Gynecology and Obstetrics with Gynecological Oncology, Specialized Ludwik Rydygier Hospital, ul. Zlotej Jesieni 1, 31-826 Krakow, Poland
Interests: gynecological oncology; urogynecology; endomerial cancer; ovarian cancer; vulvar cancer; cervical cancer; urodynamics; incontinence

Special Issue Information

Dear Colleagues,

Neoplasms affect a large population of women and men worldwide each year. The restrictions imposed during the COVID-19 pandemic have worsened access to cancer diagnosis and treatment. We hope that the pandemic will slowly fade over time. Currently, advanced diagnostic and therapeutic techniques have enabled early cancer diagnosis, frequently leading to satisfactory treatment results. However, it seems that we often neglect the quality of life of patients with cancer who live longer and experience treatment-related complications and inconvenience.

In our Special Issue of JCM, we focus on the management of neoplastic diseases of the pelvic organs (i.e., the lower urogenital system and the lower gastrointestinal tract) in both women and men. Effective treatment of these neoplasms most often involves a combination of surgery, radiotherapy, chemotherapy, hormone therapy, immunotherapy, and targeted therapy, including gene therapy. Hence, we treat this Special Issue of JCM as multidisciplinary and aim to target a wide audience, including gynecologic oncologists, oncologic urologists, urogynecologists, urologists, physiotherapists, psychologists, radiotherapists, clinical oncologists, and surgeons. We are interested in publishing prospective, retrospective, and review studies as well as interesting case reports. We would like the submitted manuscripts to address treatment complications, methods of their prevention, assessment of patients’ quality of life, supportive therapies, new technologies affecting life quality, life expectancy, and overall survival. We encourage you to share your recent experiences in these areas with us.

We are convinced that the planned Special Issue of JCM will meet the expectations of our readers who manage this group of patients. We hope that our work will have a positive impact on developing effective strategies for improving the quality of life of patients with cancers of the pelvic organs.

Dr. Agnieszka Mazur-Bialy
Dr. Marcin Opławski
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

urogynecological cancers (endometrial, cervical, ovarian, vulvar cancers)
complications of treatment
the possibility of improving patient’s quality of life
urogenital tract cancers in men (bladder, prostate, penis, testicular cancer)
gastrointestinal cancers
physiotherapy
QoL
oncology treatment (operation, chemotherapy, radiotherapy, immunotherapy, targeted therapy)

Published Papers (8 papers)

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Research

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10 pages, 953 KiB

Open AccessArticle

Effect of Muscle Loss but Not Fat Loss during Primary Debulking Surgery and Chemotherapy on Prognosis of Patients with Ovarian Cancer

by Naomi Nakayama, Kentaro Nakayama, Tomoka Ishibashi, Satoru Katayama and Satoru Kyo

J. Clin. Med. 2022, 11(11), 3184; https://doi.org/10.3390/jcm11113184 - 2 Jun 2022

Cited by 4 | Viewed by 1668

Abstract

Although the negative effect of muscle loss during invasive treatment has been widely reported in patients with cancer, its value in patients with ovarian cancer is not clear. Therefore, this study was conducted to clarify whether muscle loss during cytoreductive surgery and chemotherapy affects prognosis in patients with ovarian cancer. We retrospectively recruited 58 patients with ovarian cancer who underwent site reductive surgery and chemotherapy at Shimane University Hospital from March 2006 to November 2013 and for whom pre- and postoperative computed tomography were available. Skeletal muscle changes and fat mass volume during primary debulking surgery and chemotherapy were subsequently investigated at the level of the third lumbar vertebra. Muscle and fat mass loss occurred independently in half of the patients. Muscle loss, but not fat loss, was associated with disease-free survival (p = 0.041 and p = 0.794, respectively) and poor overall survival (p = 0.033 and p = 0.61, respectively). Cancer therapy is invasive and causes compositional changes in the body, such as muscle and fat loss. During cancer therapy, muscle loss, but not fat loss, may be associated with worse prognosis in ovarian cancer. Full article

(This article belongs to the Special Issue Cancers of the Pelvic Organs: Contemporary Management and Actions for Improving Patients’ Quality of Life)

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11 pages, 1024 KiB

Open AccessArticle

Neutrophil–Lymphocyte and Platelet–Lymphocyte Ratios in Preoperative Differential Diagnosis of Benign, Borderline, and Malignant Ovarian Tumors

by Tae Hui Yun, Yoon Young Jeong, Sun Jae Lee, Youn Seok Choi and Jung Min Ryu

J. Clin. Med. 2022, 11(5), 1355; https://doi.org/10.3390/jcm11051355 - 1 Mar 2022

Cited by 10 | Viewed by 2132

Abstract

The purpose of this study was to investigate whether the neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) can be used as supplementary tools to differentiate between benign, borderline, and malignant ovarian tumors. The ratio of patients with benign to borderline to malignant tumors was planned as 3:1:2 considering the incidence of each disease. Consecutive patients were enrolled retrospectively. Preoperative complete blood counts with differentials were investigated, and calculated NLRs and PLRs were analyzed. A total of 630 patients with ovarian tumors were enrolled in this study. The final histopathological results revealed that 318 patients had benign, 108 patients had epithelial borderline, and 204 patients had epithelial malignant ovarian tumors. The NLR and PLR were significantly higher in malignant than in benign or borderline ovarian tumors, and they did not differ significantly between benign and borderline ovarian tumors. The diagnostic cut-off value of NLR for differentiating between benign or borderline and malignant tumors was 2.36, whereas that of PLR for differentiating between benign/borderline and malignancy was 150.02. High preoperative NLR and PLR indicate that the likelihood of epithelial ovarian cancer is higher than that of benign or borderline tumors. Full article

(This article belongs to the Special Issue Cancers of the Pelvic Organs: Contemporary Management and Actions for Improving Patients’ Quality of Life)

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17 pages, 575 KiB

Open AccessArticle

The Impact of Surgical Treatment with Adjuvant Chemotherapy for Ovarian Cancer on Disorders in the Urinary System and Quality of Life in Women

by Marcin Opławski, Beniamin Oskar Grabarek, Agata Średnicka, Justyna Czarniecka, Agata Panfil, Zbigniew Kojs and Dariusz Boroń

J. Clin. Med. 2022, 11(5), 1300; https://doi.org/10.3390/jcm11051300 - 27 Feb 2022

Cited by 3 | Viewed by 2018

Abstract

Ovarian cancer is the fourth-most-common cause of death among all malignant cancers in women in Poland. This study aimed to compare the functioning of the urinary system and quality of life in women in the 12-month period following the completion of surgery or adjuvant treatment for ovarian cancer, with patients who underwent a hysterectomy for non-oncological reasons (control group). The study group consisted of 50 patients diagnosed with stage I–III ovarian cancer. Among 38 patients with type II ovarian cancer (group A), surgery followed by first-line chemotherapy was performed. Within this group of patients, 20 had stage I ovarian cancer, while 18 had stage II ovarian cancer. The study was performed at least 6 months after the final chemotherapy cycle, with no clinical, marker or radiological recurrence determined. On the other hand, in 12 patients with stage I type I ovarian cancer, oncological treatment consisted of only surgery, without the need for adjuvant chemotherapy, due to the low stage of the lesions (group B). In turn, the control group consisted of 50 women who underwent uterine removal for non-oncological reasons (group C). The assessment of quality of life was conducted using the questionnaires: Satisfaction with Life Scale (SWLS); Incontinence Impact Questionnaire, short form (IIQ-7); Urogenital Distress Inventory (UDI-6); and the Sexual Satisfaction Scale for 3, 6, 9, and 12 months after the conclusion of oncological treatment. During the follow-up, a significant reduction in the quality of everyday life and sexual life was noted among patients with ovarian cancer, more pronounced in group B, compared to the control group (p < 0.05). The risk of urinary incontinence is independent of the treatment regimen chosen for ovarian cancer. It is necessary to consider comprehensive psychological care and sexual therapy in patients with ovarian cancer and their families. Full article

(This article belongs to the Special Issue Cancers of the Pelvic Organs: Contemporary Management and Actions for Improving Patients’ Quality of Life)

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12 pages, 2225 KiB

Open AccessArticle

Results of a 2021 French National Survey on Management of Patients with Advanced Stage Epithelial Ovarian Cancer

by Leonor Drouin, Benedetta Guani, Vincent Balaya, Henri Azaïs, Sarah Betrian, Pierre-Adrien Bolze, Yohann Dabi, Yohan Kerbage, Claire Sanson, François Zaccarini, Patrice Mathevet, Fabrice Lécuru, Fréderic Guyon, Cherif Akladios, Sofiane Bendifallah, Elise Deluche and on behalf of the SFOG Campus (Young of French Society of Gynecological Oncology)

J. Clin. Med. 2021, 10(21), 4829; https://doi.org/10.3390/jcm10214829 - 21 Oct 2021

Cited by 3 | Viewed by 2067

Abstract

Background: The aim of this study was to assess current French practices in the management of patients with advanced epithelial ovarian cancer. Method: a 58-question electronic survey was distributed anonymously to the members of the SFOG (French Society of Gynaecological Oncology), GINECO-ARCAGY (National Investigators Group for Ovarian and Breast Cancer Studies in France) and FRANCOGYN (French research group in oncological and gynaecological surgery). Initial diagnostic workup and staging, pathological data, surgical data, treatments and follow-up strategies were assessed. Results: a total of 107 participants responded to emailed surveys. Most of the respondents were obstetrician-gynaecologists (37.4%), surgical oncologists (34.6%) and medical oncologists (17.8%). According to most (76.8%) participants, less than 50% of patients were eligible for primary debulking surgery (PDS). The LION study criteria were applied in 69.5% of cases during PDS and 39% after chemotherapy. The timing of BRCA testing was very heterogeneous and ranged from 1 to 6 months. The use of bevacizumab as an adjuvant schedule was lower in cases of no residual disease (for 54.5% of respondents) compared to cases of residual disease (for 63.6% of respondents). In cases of BRCA1-2 mutations, olaparib was given by 75.8–84.8% of respondents, whereas niraparib was given in cases of BRCA wild-type diseases. Conclusion: this survey provides an extensive and a unique review of current French practices in the management of patients with advanced epithelial ovarian cancer in 2021. Full article

(This article belongs to the Special Issue Cancers of the Pelvic Organs: Contemporary Management and Actions for Improving Patients’ Quality of Life)

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Review

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15 pages, 533 KiB

Open AccessReview

Combined Modality Bladder-Sparing Therapy for Muscle-Invasive Bladder Cancer: How (Should) We Do It? A Narrative Review

by Artur Lemiński, Wojciech Michalski, Bartłomiej Masojć, Krystian Kaczmarek, Bartosz Małkiewicz, Jakub Kienitz, Barbara Zawisza-Lemińska, Michał Falco and Marcin Słojewski

J. Clin. Med. 2023, 12(4), 1560; https://doi.org/10.3390/jcm12041560 - 16 Feb 2023

Cited by 4 | Viewed by 2995

Abstract

Organ-sparing combined-modality treatment for muscle-invasive bladder cancer remains underutilized despite high-quality evidence regarding its efficacy, safety, and preservation of quality of life. It may be offered to patients unwilling to undergo radical cystectomy, as well as those unfit for neoadjuvant chemotherapy and surgery. The treatment plan should be tailored to each patient’s characteristics, with more intensive protocols offered to patients who are fit for surgery but opt for organ-sparing. After a thorough, debulking transurethral resection of the tumor and neoadjuvant chemotherapy, the response evaluation should trigger further management with either chemoradiation or early cystectomy in non-responders. A hypofractionated, continuous radiotherapy regimen of 55 Gy in 20 fractions with concurrent radiosensitizing chemotherapy with gemcitabine, cisplatin, or 5-fluorouracil and mitomycin C is currently preferred based on clinical trials. The response should be evaluated with repeated transurethral resections of the tumor bed and abdominopelvic-computed tomography after chemoradiation, with quarterly assessments during the first year. Salvage cystectomy should be offered to patients fit for surgery who failed to respond to treatment or developed a muscle-invasive recurrence. Non-muscle-invasive bladder recurrences and upper tract tumors should be treated in line with guidelines for respective primary tumors. Multiparametric magnetic resonance can be used for tumor staging and response monitoring, as it may distinguish disease recurrence from treatment-induced inflammation and fibrosis. Full article

(This article belongs to the Special Issue Cancers of the Pelvic Organs: Contemporary Management and Actions for Improving Patients’ Quality of Life)

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11 pages, 4633 KiB

Open AccessReview

Single-Port versus Multiple-Port Robot-Assisted Radical Prostatectomy: A Systematic Review and Meta-Analysis

by Omar Fahmy, Usama A. Fahmy, Nabil A. Alhakamy and Mohd Ghani Khairul-Asri

J. Clin. Med. 2021, 10(24), 5723; https://doi.org/10.3390/jcm10245723 - 7 Dec 2021

Cited by 15 | Viewed by 2698

Abstract

Background: Single-port robotic-assisted radical prostatectomy has been reported as a safe and feasible technique. However, recent studies comparing single-port versus multiple-port robotic radical prostatectomy have displayed conflicting results. Objectives: To investigate the benefit of single-port robotic radical prostatectomy and the impact on outcome compared to multiple-port robotic radical prostatectomy. Methods: Based on PRISMA and AMSTAR criteria, a systematic review and meta-analysis were carried out. Finally, we considered the controlled studies with two cohorts (one cohort for single-port RARP and the other cohort for multiple-port RARP). For statistical analysis, Review Manager (RevMan) software version 5.4 was used. The Newcastle-Ottawa Scale was employed to assess the risk of bias. Results: Five non-randomized controlled studies with 666 patients were included. Single-port robotic radical prostatectomy was associated with shorter hospital stays. Only 60.6% of single-port patients (109/180) required analgesia compared to 90% (224/249) of multiple-port patients (Z = 3.50; p = 0.0005; 95% CI 0.07:0.47). Opioid administration was also significantly lower in single-port patients, 26.2% (34/130) vs. 56.6% (77/136) (Z = 4.90; p < 0.00001; 95% CI 0.15:–0.44) There was no significant difference in operative time, blood loss, complication rate, positive surgical margin rate, or continence at day 90. Conclusion: The available data on single-port robotic radical prostatectomy is very limited. However, it seems comparable to the multiple-port platform in terms of short-term outcomes when performed with expert surgeons. Single-port prostatectomies might provide a shorter hospital stay and a lower requirement for opioids; however, randomized trials with long-term follow-up are mandatory for valid comparisons. Full article

(This article belongs to the Special Issue Cancers of the Pelvic Organs: Contemporary Management and Actions for Improving Patients’ Quality of Life)

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25 pages, 1133 KiB

Open AccessReview

Functional Changes of the Genitourinary and Gastrointestinal Systems before and after the Treatment of Endometrial Cancer—A Systematic Review

by Marcin Oplawski, Agata Średnicka, Aleksandra Dutka, Sabina Tim and Agnieszka Mazur-Bialy

J. Clin. Med. 2021, 10(23), 5579; https://doi.org/10.3390/jcm10235579 - 27 Nov 2021

Cited by 5 | Viewed by 2186

Abstract

The incidence of endometrial cancer (EC), which coexists with such civilization diseases as diabetes, obesity or hypertension, is constantly increasing. Treatment includes surgery as well as brachytherapy, teletherapy, rarely chemotherapy or hormone therapy. Due to the good results of the treatment, the occurrence of side effects of therapy becomes a problem for the patients. One of the large groups of side effects includes the pelvic organ prolapse, urinary and fecal incontinence. The aim of this study was to present current knowledge on the occurrence of pelvic floor dysfunction in women treated for EC. A literature review was conducted in the PubMED and WoS databases, including articles on pelvic floor dysfunction in women with EC. PRISMA principles were followed in the research methodology. A total of 1361 publications were retrieved. Based on the inclusion and exclusion criteria, 24 papers were eligible for the review. Mostly retrospective studies based on different questionnaires were evaluated. No prospective studies were found in which, in addition to subjective assessment, clinical examination and objective assessment of urinary incontinence were used. Studies show a significant increase in the incidence of pelvic floor disorders, including urinary incontinence, after various forms of EC treatment. We believe that assessment of complications after endometrial cancer treatment is clinically relevant. The review emphasizes the importance of programming prospective studies to prevent and address these disorders at each stage of oncologic treatment. Full article

(This article belongs to the Special Issue Cancers of the Pelvic Organs: Contemporary Management and Actions for Improving Patients’ Quality of Life)

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Other

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27 pages, 3556 KiB

Open AccessSystematic Review

Physiotherapy as an Effective Method to Support the Treatment of Male Urinary Incontinence: A Systematic Review

by Agnieszka Mazur-Bialy, Sabina Tim, Daria Kołomańska-Bogucka, Bartłomiej Burzyński, Tomasz Jurys and Natalia Pławiak

J. Clin. Med. 2023, 12(7), 2536; https://doi.org/10.3390/jcm12072536 - 27 Mar 2023

Cited by 2 | Viewed by 3035

Abstract

Urinary incontinence (UI) is a serious health issue that affects both women and men. The risk of UI increases in men with age and after treatment for prostate cancer and affects up to 32% of men. Furthermore, UI may affect up to 69% of men after prostatectomy. Considering such a high incidence, it is critical to search for effective methods to mitigate this issue. Hence, the present review aims to provide an overview of physiotherapeutic methods and evaluate their effectiveness in treating UI in men. This systematic review was performed using articles included in PubMed, Embase, WoS, and PEDro databases. A total of 6965 relevant articles were found. However, after a risk of bias assessment, 39 studies met the inclusion criteria and were included in the review. The research showed that the available physiotherapeutic methods for treating men with UI, including those after prostatectomy, involve pelvic floor muscle training (PFMT) alone or in combination with biofeedback (BF) and/or electrostimulation (ES), vibrations, and traditional activity. In conclusion, PFMT is the gold standard of UI therapy, but it may be complemented by other techniques to provide a personalized treatment plan for patients. The effectiveness of the physiotherapeutic methods varies from study to study, and large methodological differences make it difficult to accurately compare individual results and draw unequivocal conclusions. Full article

(This article belongs to the Special Issue Cancers of the Pelvic Organs: Contemporary Management and Actions for Improving Patients’ Quality of Life)

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