Patients with electrical storm and reduced LVEF best suited for early Catheter ablation strategy compared to medical therapy: Study

Researchers have demonstrated that catheter ablation (CA) significantly improves survival in patients with electrical storm (ES), particularly those with a reduced left ventricular ejection fraction (LVEF). ES is a life-threatening condition defined by recurrent ventricular arrhythmias with high early and subacute mortality rates. Even though CA is an established treatment option, the effect of the procedure on short-term and midterm survival has been unclear. A recent study was conducted by Karim B. and colleagues which was published in the journal of JACC: Clinical Electrophysiology.

The study involved 780 consecutive patients admitted with ES across four tertiary centers. The differences in baseline characteristics between the treatment groups were accounted for by propensity score matching. After matching, 288 patients underwent CA, and 288 received medical therapy alone. The demographic characteristics, ES presentation, and management strategies were comparable between the groups, thus ensuring balanced comparisons.

Key Findings

Reduction in ES Recurrence:

  • CA decreased the incidence of ES at 1 year to 5% compared with the medical therapy group (26%; p< 0.001).

  • Increased Survival:

  • Survival after discharge at 1 year was significantly higher among patients treated with CA (91%) than among those in the medical therapy group (81%; p<0.001).

  • Survival at 3 years was 78% in the CA group versus 71% in the medical therapy group (p=0.017).

Subgroup Analysis:

  • The hazard ratio was 0.39 (95% CI: 0.24–0.66) for patients above 70 years of age who benefited from CA.

  • Significant efficacy was observed in patients with LVEF <35%, with an HR of 0.39 (95% CI: 0.27–0.59).

The study concludes that survival is better and ES recurrence lesser in patients admitted for ES with CA-based management. The findings support the broader use of CA, especially in patients with low ejection fraction or other characteristics calling for high risk, and thus reinforce its role in modern cardiac care.

Reference:

Benali, K., Ninni, S., Guenancia, C., Mohammed, R., Decaudin, D., Bourdrel, O., Salaun, A., Yvorel, C., Groussin, P., Pavin, D., Vlachos, K., Jaïs, P., Bouchet, J.-B., Morel, J., Brigadeau, F., Laurent, G., Klug, D., Da Costa, A., Haissaguerre, M., & Martins, R. (2024). Impact of catheter ablation of electrical storm on survival. JACC. Clinical Electrophysiology, 10(10), 2117–2128. https://doi.org/10.1016/j.jacep.2024.05.032

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Scleral Buckling has no advantage over Pars Plana Vitrectomy in Primary Rhegmatogenous Retinal Detachment Repair: Study

A recent study published in the
journal Clinical Ophthalmology revealed that combining scleral buckling with
pars plana vitrectomy has minimal effect and limited success on anatomical
outcomes in Rhegmatogenous retinal detachment (RRD) repair.

Rhegmatogenous retinal detachment
(RRD) can cause significant and irreversible vision loss if left untreated. Recent
literature shows an increased incidence of RRD due to increased myopia and cataract
surgeries in younger individuals. Pars plana vitrectomy (PPV) is now the
preferred primary surgical technique for RRD repair, with supplemental scleral
buckling (SB) used in specific cases to address specific complications. Despite
its advantages, SB may increase discomfort, altered refractive errors, and
controversial benefits. Hence, to address this, researchers from Chiang Mai
University Hospital conducted a study to compare anatomical and visual outcomes
of PPV alone versus combined PPV/SB using propensity score analysis to reduce
bias.

Also Read: Congenital cataract with persistent fetal vasculature without anterior segment pathology associated with best postoperative visual acuity: Study

A single center retrospective observational study
was carried out y including patients who underwent PPV or PPV/SB for RRD repair
between January 2013 and December 2019 and were followed up for at least two
months. Demographic data, clinical features, surgeries, and outcome data were
collected. Th primary outcomes included the single surgery anatomic success
(SSAS) and final anatomic success, whereas the secondary outcomes included final
visual acuity changes. Categorization was done based on the retinal breaks and
surgeon experience, and visual acuity was converted to LogMAR for analysis.
Surgical techniques followed standard PPV protocols, with SB added in specific
cases.

Findings:

  • About 683 patient-eyes, with a median follow-up
    duration of 13 months were included in the study.
  • Among these 211 patients (30.9%) underwent
    PPV/SB, while 472 patients (69.1%) underwent PPV as the primary
    procedure.
  • There was no significant difference between the
    two treatment groups in the risk of achieving SSAS or achieving final retinal
    anatomic attachment.
  • The two treatment groups have shown a similar occurrence
    of proliferative vitreoretinopathy.
  • However, a significantly greater mean
    improvement in VA was seen in patients who received PPV alone.
Also Read: Journal Club-Systematic review of surgical techniques for treating giant retinal tears in adults: A current assessment of approaches and interventions

Thus, the study concluded that adding
SB to PPV had little impact on anatomical results. There was minimal effect on
single surgical success rate and overall final success rate. Even though there
was an improvement in vision outcomes, the evidence was not definitive. Researchers
also suggested further research through prospective studies and using
standardized techniques to improve the reliability of the results.

Further reading: Rajsirisongsri,
P., Patikulsila, D.et al. Primary Rhegmatogenous Retinal Detachment Repair by
Pars Plana Vitrectomy with and without Scleral Buckling: A Propensity Score
Analysis. Clinical Ophthalmology, 18, 3913–3923. https://doi.org/10.2147/OPTH.S494849.

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Opioid-free treatment supplemented with TENS as effective as opioids for pain relief in bariatric surgery: Study

Obese patients undergoing bariatric surgery can manage without opioids, according to a thesis from the University of Gothenburg, Sweden. Research is paving the way for opioid-free treatment during and after surgery.

Opioid prescribing has increased, particularly in countries such as the United States, where the trend has been likened to an epidemic. Long-term use can lead to dependency and abuse. The opioid group of medicines is perhaps more commonly known as morphine and is effective in the short term against pain. However, opioids have side effects that can impair recovery after surgery. Opioids are currently the standard treatment for both treating pain impulses during surgery and relieving patients’ pain after surgical procedures, including bariatric surgery.

Non-opioid alternative

“Researchers agree that we need to reduce the use of opioids to promote recovery after bariatric surgery, but there has been a lack of knowledge about whether alternative treatment methods are really both safe and effective for the patient, especially for treating pain after surgery,” says Alexander Olausson, Nurse Anesthetist and PhD student at the Sahlgrenska Academy at the University of Gothenburg.

The thesis is based on a randomized clinical study conducted at two hospitals in Sweden. In the study, 110 people scheduled for bariatric surgery received either the usual care with opioid medicines, or an alternative form of anesthesia and pain relief without opioids. The opioid-free treatment combines three different medicines that affect pain impulses via other signaling pathways than those used by opioids.

Safe and effective

After surgery, the opioid-free treatment was supplemented with TENS (transcutaneous electrical nerve stimulation), where electrodes are attached to the skin and deliver weak electrical impulses to treat pain. If the alternative pain treatment were not effective enough, patients could get access to opioids.

“We see that the opioid-free care pathway is both safe and effective. The group of patients receiving the opioid-free treatment needed significantly less opioids during the treatment period, and in most cases they managed without them, while reporting no more pain than the group receiving the usual opioid treatment,” says Alexander Olausson. 

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Short implants as good as long implants in posterior maxilla with limited vertical bone height: Study

A study published in BMC Oral Health suggests that short implants are as good as long implants in the posterior maxilla with limited vertical bone height.

Based on the critical role of implant length and placement timing in treatment success, this study aimed to compare clinical outcomes (implant failure, marginal bone loss, biological and mechanical complications) between short implants (4–8 mm) versus long implants (≥ 8 mm) with sinus floor elevation, and between delayed versus immediate placement of long implants in the posterior maxilla. This network meta-analysis was prospectively registered in the PROSPERO database (CRD42023495027). Adhering to PRISMA-NMA guidelines, we systematically reviewed eligible studies from January 2014 to November 2024 was conducted across major databases, such as the Cochrane Library, PubMed, Embase, Scopus and Web of Science. The main focus of this NMA was to determine the rate of implant failure, as well as to assess marginal bone loss and the occurrence of biological and mechanical complications related to the implants. Results: Data from 17 studies, involving 1,076 patients and 1,751 implants, was collected and examined. Long implants have lower failure rates (OR = 1.26; 95% CI = 0.53, 3.00) and short dental implants showed a trend towards lower biological (OR = 0.47; 95% CI = 0.19, 1.18) and mechanical (OR = 0.94; 95% CI = 0.45, 1.94) complications rates, although this trend was not statistically significant. Additionally, compared to longer implants, short implants resulted in a significant reduction in marginal bone loss, regardless of whether long implants were immediately (MD=-0.17; 95%CI: -0.29, -0.05) or delayed (MD = 0.35; 95%CI: 0.05, 0.64) placed following sinus floor elevation. The analysis of cumulative ranking probabilities revealed that delayed placement of long implants with SFE demonstrated the highest efficacy in reducing implant failure (73.9%). SIs were found to excel in reducing marginal bone loss (88.7%) and biological complications (88.2%%), while short implants with SFE proved to be the most effective in preventing mechanical complications (66.0%%). Short implants achieved comparable clinical outcomes to long implants with sinus floor elevation in posterior maxilla with limited vertical bone height. Given the limitations of the network meta-analysis and included studies, treatment selection should be individualized based on specific patient conditions.

Reference:

Zhang, Y., Tang, X., Zhang, Y. et al. A network meta-analysis comparing treatment modalities of short and long implants in the posterior maxilla with insufficient bone height. BMC Oral Health 24, 1574 (2024). https://doi.org/10.1186/s12903-024-05377-1

Keywords:

Short, implants, good, long, implants, posterior, maxilla, limited, vertical, bone, height, study, BMC Oral Health, Zhang, Y., Tang, X., Zhang, Y, Posterior maxilla, Short dental implants, Sinus floor elevation, Implant failure, Network meta-analysis

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Omega 3 supplementation associated with reduction in biomarker of prostate cancer progression: Study

A study published in the Journal of Clinical Oncology suggests that omega-3 supplementation is associated with a reduction in a biomarker of prostate cancer progression.

Men on active surveillance (AS) for prostate cancer are extremely interested in dietary changes or supplements to prevent progression of their disease. They sought to determine whether a high omega-3, low omega-6 fatty acid diet with fish oil capsules (D + FO) decreases proliferation (Ki-67) in prostate biopsies in men with prostate cancer on AS over a 1-year time period. In this phase II, prospective randomized trial, men (N = 100) with grade group 1 or 2 prostate cancer who elected active surveillance were randomly assigned to the D + FO or a control group. Same-site prostate biopsies were obtained at baseline and 1 year. The primary end point was the change in Ki-67 index from baseline to 1 year from same-site biopsies compared between the groups. Results: The Ki-67 index decreased in the D + FO group by approximately 15% from baseline to 1 year (1.34% at baseline, 1.14% at 1 year) and increased in the control group by approximately 24% from baseline to 1 year (1.23% at baseline, 1.52% at 1 year), resulting in a statistically significant difference in the change of Ki-67 index between the groups (95% CI, 2% to 52%, P = .043). There was no significant difference in the secondary outcomes grade group, tumor length, Decipher genomic score, or prostate-specific antigen between the two groups. Four patients in the D + fish oil group were withdrawn from the trial because of adverse events related to the fish oil . A high omega-3, low omega-6 diet with fish oil for 1 year resulted in a significant reduction in Ki-67 index, a biomarker for prostate cancer progression, metastasis, and death. These findings support future phase III trials incorporating this intervention in men on active surveillance.

Reference:

William J. Aronson et al., High Omega-3, Low Omega-6 Diet With Fish Oil for Men With Prostate Cancer on Active Surveillance: The CAPFISH-3 Randomized Clinical Trial. JCO 0, JCO.24.00608

DOI:10.1200/JCO.24.00608

Keywords:

Omega 3, supplementation, associated, reduction, biomarker, prostate, cancer, progression, Study, William J. Aronson

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AI system may help doctors identify patients at risk for suicide, states study

A new study from Vanderbilt University Medical Center shows that clinical alerts driven by artificial intelligence (AI) can help doctors identify patients at risk for suicide, potentially improving prevention efforts in routine medical settings.

A team led by Colin Walsh, MD, MA, associate professor of Biomedical Informatics, Medicine and Psychiatry, tested whether their AI system, called the Vanderbilt Suicide Attempt and Ideation Likelihood model (VSAIL), could effectively prompt doctors in three neurology clinics at VUMC to screen patients for suicide risk during regular clinic visits.

The study, reported in JAMA Network Open, compared two approaches-automatic pop-up alerts that interrupted the doctor’s workflow versus a more passive system that simply displayed risk information in the patient’s electronic chart.

The study found that the interruptive alerts were far more effective, leading doctors to conduct suicide risk assessments in connection with 42% of screening alerts, compared to just 4% with the passive system.

“Most people who die by suicide have seen a health care provider in the year before their death, often for reasons unrelated to mental health,” Walsh said. “But universal screening isn’t practical in every setting. We developed VSAIL to help identify high-risk patients and prompt focused screening conversations.”

Suicide has been on the rise in the U.S. for a generation and is estimated to claim the lives of 14.2 in 100,000 Americans each year, making it the nation’s 11th leading cause of death. Studies have shown that 77% of people who die by suicide have contact with primary care providers in the year before their death.

Calls to improve risk screening have led researchers to explore ways to identify patients most in need of assessment. The VSAIL model, which Walsh’s team developed at Vanderbilt, analyzes routine information from electronic health records to calculate a patient’s 30-day risk of suicide attempt. In earlier prospective testing, where VUMC patient records were flagged but no alerts were fired, the model proved effective at identifying high-risk patients, with one in 23 individuals flagged by the system later reporting suicidal thoughts.

In the new study, when patients identified as high-risk by VSAIL came for appointments at Vanderbilt’s neurology clinics, their doctors received on a randomized basis either the interruptive or non-interruptive alerts. The research focused on neurology clinics because certain neurological conditions are associated with increased suicide risk.

The researchers suggested that similar systems could be tested in other medical settings.

“The automated system flagged only about 8% of all patient visits for screening,” Walsh said. “This selective approach makes it more feasible for busy clinics to implement suicide prevention efforts.”

The study involved 7,732 patient visits over six months, prompting 596 total screening alerts. During the 30-day follow-up period, in a review of VUMC health records, no patients in either randomized alert group were found to have experienced episodes of suicidal ideation or attempted suicide. While the interruptive alerts were more effective at prompting screenings, they could potentially contribute to “alert fatigue”-when doctors become overwhelmed by frequent automated notifications. The researchers noted that future studies should examine this concern.

“Health care systems need to balance the effectiveness of interruptive alerts against their potential downsides,” Walsh said. “But these results suggest that automated risk detection combined with well-designed alerts could help us identify more patients who need suicide prevention services.” 

Reference:

Walsh CG, Ripperger MA, Novak L, et al. Risk Model–Guided Clinical Decision Support for Suicide Screening: A Randomized Clinical Trial. JAMA Netw Open. 2025;8(1):e2452371. doi:10.1001/jamanetworkopen.2024.52371

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Elderly Cancer Survivors at increased Cardiovascular Disease Risk, Study Finds

Australia: A new analysis of the Aspirin in Reducing Events in the Elderly (ASPREE) trial has revealed that older patients diagnosed with cancer face a significantly increased cardiovascular risk, including heightened chances of myocardial infarction (MI), heart failure (HF), and ischemic stroke.

The study, published in Cancer Journal, found that aspirin did not affect the incidence of cardiovascular disease (CVD). Additionally, the risk may be greater for individuals with metastatic, hematological, and lung cancers, as well as for those undergoing chemotherapy.

In the past decade, there has been a decrease in cancer-related death rates, resulting in a growing population of cancer survivors. The researchers note that cancer survivors may face an increased risk of CVD due to their cancer or its treatment. While there are studies that explore the connection between cancer and CVD, few specifically focus on older adults, the effects of cancer treatment, or the potential role of aspirin in reducing risk within this group.

To fill this knowledge gap, Jaidyn Muhandiramge, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia, and colleagues conducted a secondary analysis of the ASPREE trial to examine how cancer and its treatment influence a composite cardiovascular disease endpoint, which includes hospitalization for heart failure (HHF), myocardial infarction (MI), and stroke.

The following were the key findings of the study:

  • Of 15,454 Australian and US ASPREE participants, 1392 had an incident cancer diagnosis.
  • Rates of CVD were greater in the cancer risk set compared to the cancer-free risk set (20.8 versus 10.3 events per 1000 person-years; incidence rate ratio, 2.03), with increased incidence seen across MI, HHF, overall stroke, and ischemic stroke.
  • Increased incidence remained after adjustment for clinically significant risk factors for CVD.
  • Incidence was greatest in metastatic, hematological, and lung cancer.
  • Chemotherapy was associated with an increased risk of CVD.
  • Rates of CVD were similar across aspirin and placebo groups.

The findings prompted researchers to conclude that older adults with cancer experience a higher incidence of cardiovascular disease, including myocardial infarction, heart failure, and ischemic stroke.

“The incidence of CVD was comparable between participants who received aspirin and those who received a placebo during the ASPREE trial. The risk may be elevated in individuals with hematological malignancies, lung cancer, metastatic disease, and those undergoing cytotoxic chemotherapy,” they wrote.

However, the researchers noted some limitations, including a shorter follow-up period for the cancer risk set, which may miss late cardiotoxicities. The study lacked ethnic diversity and had a healthy survivor bias, potentially underestimating CVD rates. The cancer cohort was small, leading to underpowered subgroup analyses, and data on treatment modality specifics were not captured.

Reference:

Muhandiramge, J., Zalcberg, J. R., Warner, E. T., Polekhina, G., Gibbs, P., Bernstein, W. B., Macrae, F., Haydon, A., Tie, J., Millar, J. L., Mar, V. J., Gately, L., Tonkin, A., Ford, L., Umar, A., Chan, A. T., Woods, R. L., & Orchard, S. G. Cardiovascular disease and stroke following cancer and cancer treatment in older adults. Cancer. https://doi.org/10.1002/cncr.35503

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Clinical pregnancy rates affected when serum progesterone levels on day of hcg > 3.5 ng/ ml in patients undergoing IVF, finds research

In vitro fertilization, also called IVF, is a complex series of procedures that can lead to a pregnancy.

Researchers have found in a new study that Clinical pregnancy rates are affected when serum progesterone levels on day of hcg > 3.5 ng/ ml in patients undergoing In vitro fertilization.

The Researchers conducted the research to explore if serum progesterone (P) level on the hCG day
has a negative impact on the pregnancy rate in patients undergoing In vitro fertilization with
GnRH agonist long protocol. Authors Urman et AL carried out a
non-interventional, retrospective study the findings of the which were published in Fertility and Sterility.

In all 2845 In vitro fertilization cycles were performed between 2008-2010 with a GnRH agonist long protocol were included in
the study. Pituitary down-regulation was induced with leuprolide acetate. Rec
FSH was started on cycle day 3. Ovulation was triggered with rec hCG. E2 and P
levels were measured on the hCG day. Decision to proceed with oocyte retrieval
was not based on P levels.

Progesterone was significantly correlated with E2 level on
the day of hCG, and the number of oocytes collected (p<0.01). Patients with
P level up to 3.4 ng/mL had comparable whereas the levels ≥
3.5ng/mL were associated with significantly reduced clinical pregnancy rates.

These results show that elevated P levels on the hCG day may
reduce the success rate of In vitro fertilization in patients undergoing IVF with long protocol.
However, study findings indicated that this reduction occurred only after serum
P levels exceeded 3.5 ng/mL challenging the previous findings indicating an
adverse effect with lower levels.

For further reference log on to: Urman,a,b O. Oktem,a,b E. Alper,b K. Yakin,b S.
Aksoy,b R. Mercan.b a Obstetrics and Gynecology, Koc University School of
Medicine, Istanbul, Turkey; b Women’s Health Center Assisted Reproduction Unit,
American Hospital, Istanbul, Turkey.

FertilitySterilty

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New imaging technique offers insight into Achilles tendon injury recovery

Achilles tendon injuries are common but challenging to monitor during recovery due to the limitations of current imaging techniques. Researchers, led by Associate Professor Zeng Nan from the International Graduate School at Shenzhen, Tsinghua University, have applied Mueller matrix polarimetry, a non-invasive imaging method, to more accurately observe and evaluate the healing of Achilles tendon injuries. This technique offers unique insights by capturing the subtle changes in tendon tissue without needing labels or dyes, allowing for more natural tissue characterization.

The study used Mueller matrix polarimetry to assess various Achilles tendon samples, comparing injured tissues with those undergoing treatment. The findings revealed specific patterns in injured tendons, such as decreased phase retardance and increased diattenuation, as well as irregular fiber orientation. Healthy tendons, by contrast, showed higher phase retardance and a more consistent fiber arrangement, markers indicative of strong, undamaged tissue.

By combining experimental results with Monte Carlo simulations, the study highlighted three key recovery indicators: fiber diameter growth, improved alignment, and increased birefringence due to collagen production. A new parameter, called PFP, was developed based on these observations, offering a practical tool for visualizing and quantifying tendon healing progress. This breakthrough, spearheaded by Professor Zeng Nan’s team, could have significant implications for clinical practice, as it allows for precise, real-time assessment of treatment efficacy for Achilles tendon injuries. 

Reference:

Yang, H., Xu, M., He, H. et al. Mueller matrix polarimetry for quantitative evaluation of the Achilles tendon injury recovery. Front. Optoelectron. 17, 39 (2024). https://doi.org/10.1007/s12200-024-00142-2

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Minimally Invasive Surgery in Advanced epithelial ovarian cancer: Study evaluates Outcomes in Face of Complications

Cytoreductive surgery, whether performed as the initial treatment or following neoadjuvant chemotherapy (NACT) for advanced epithelial ovarian cancer (EOC), fallopian tube carcinoma, and primary peritoneal cancer, poses significant risks of complications. These complications can delay the timely delivery of chemotherapy, extend hospital stays and lead to readmissions, ultimately affecting survival rates negatively. Recent study evaluates the feasibility of conducting a randomized clinical trial (RCT) to compare the efficacy of minimally invasive surgery (MIS) against traditional laparotomy for patients with advanced-stage epithelial ovarian cancer (EOC) who have responded to neoadjuvant chemotherapy (NACT). The research is part of the Laparoscopic Cytoreduction After Neoadjuvant Chemotherapy (LANCE) trial, which focuses on patients with stage IIIC or IV EOC, specifically those showing a complete or partial response to NACT.

Pilot Phase Details

The pilot phase, initiated in September 2020 and concluding with the enrollment of the 100th patient in February 2023, included participants from 11 academic cancer centers across North America and Europe. Inclusion criteria encompassed adult patients exhibiting elevated cancer antigen 125 (CA-125) levels and a partial or complete radiologic response after 3-4 cycles of NACT. Patients were randomly assigned to either an MIS arm, involving laparoscopic or robotic surgery, or a laparotomy control arm. Outcomes were assessed primarily on feasibility metrics such as patient accrual rates, conversion rates from MIS to laparotomy, and rates of complete gross resection. The study successfully enrolled 100 patients (median age 63 years), with 49 in the MIS group and 51 in the laparotomy group. The results indicated a patient accrual rate of 5.9 patients per month, surpassing the predefined threshold. Conversion from MIS to laparotomy occurred in 12.5% of the MIS group, which met the pre-established criterion of being below 25%. Overall, complete gross resection was achieved in 88% of the MIS group and 83% of the laparotomy group, reflecting a small absolute difference that was well within acceptable limits.

Secondary Outcomes

Secondary outcomes reported that patients in the MIS arm experienced significantly shorter postoperative hospital stays (median of 1 day vs. 4 days for laparotomy) and lower estimated blood loss. However, there were more postoperative complications in the laparotomy group (26% compared to 8% in the MIS group), suggesting a possible advantage of MIS in reducing complications. No substantial differences in overall health-related quality of life were noted, aside from marginally higher social functioning in the MIS group. These findings provide preliminary evidence supporting the feasibility of the LANCE trial and suggest that MIS may be associated with fewer complications and shorter recovery times compared to laparotomy in the surgical management of advanced EOC. Further research in the form of a full-scale RCT is warranted to establish the oncological effectiveness of MIS.

Key Points

– The study assesses the feasibility of a randomized clinical trial comparing minimally invasive surgery (MIS) with traditional laparotomy for patients with advanced-stage epithelial ovarian cancer (EOC) who responded to neoadjuvant chemotherapy (NACT), as part of the LANCE trial.

– The pilot phase, running from September 2020 to February 2023, included 100 patients from 11 academic cancer centers in North America and Europe, with a median age of 63 years. Patients met specific inclusion criteria, including elevated CA-125 levels and radiologic responses to NACT.

– Participants were randomly allocated to either the MIS group, which involved laparoscopic or robotic surgery, or the laparotomy control group. Key feasibility metrics assessed were patient accrual rates, conversion rates from MIS to laparotomy, and rates of complete gross resection.

– The trial successfully enrolled 100 patients, achieving a patient accrual rate of 5.9 per month and maintaining a conversion rate from MIS to laparotomy at 12.5%, below the threshold of 25%. Complete gross resection was accomplished in 88% of the MIS cohort and 83% of the laparotomy cohort.

– Secondary outcomes indicated that the MIS arm had significantly shorter postoperative hospital stays (median 1 day) and lower estimated blood loss compared to the laparotomy group (median 4 days), along with fewer postoperative complications (8% in MIS vs. 26% in laparotomy).

– Overall health-related quality of life did not show substantial differences between groups, though the MIS group reported marginally better social functioning. These preliminary findings support the feasibility of the LANCE trial and suggest potential advantages of MIS in terms of lower complications and quicker recovery, warranting further investigation in a full-scale RCT.

Reference –

J. Rauh-Hain et al. (2024). Laparoscopic Cytoreduction After Neoadjuvant Chemotherapy In High-Grade Epithelial Ovarian Cancer. *JAMA Network Open*, 7. https://doi.org/10.1001/jamanetworkopen.2024.46325

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