[Controversies on the staging of microinvasive cervix carcinoma]. / Controversie sulla stadiazione del carcinoma microinvasivo della cervice.

Controversies regarding the nosographical classification and staging of microinvasive cervical cancer are still the subject of debate largely based on two schools of thought: one privileges the morphovolumetric criterion, while the other, in an attempt to overcome one of the general aims of FIGO staging, pragmatically assigns a therapeutic orientation to it and proposes staging criteria that the opposing school finds arbitrary and not satisfactory for prognostic purposes. The key point that generates most of the dissension is the correctness of the biopsy procedures and the histological process used to examine material. The general rules for FIGO staging are rightly based on the limitation that clinical staging cannot be modified, even when subsequent histological or surgical findings show a different extension of the disease. But this is true of "clinical" carcinomas for which the diagnostic and staging criteria are still mainly clinical using procedures that have been classified by FIGO itself. However, in those cases where the diagnosis of staging is exclusively microscopic, as in IA, clear indications should be given regarding the procedures and failure to observe them should preclude staging.

Angiogenesis as a prognostic factor in cervical carcinoma.

Angiogenesis and other prognostic factors have been studied among 32 recurrences and 28 deaths of 420 patients with cervical carcinoma operated in the 1st Department of Obstetrics & Gynecology of Catania University. Prognostic factors were studied in comparison with a group of patients still alive and NED was followed for more than 60 months independently of stage and node involvement. Angiogenesis, nuclear grading 3, and lymphovascular invasion were factors common to all patients with negative prognosis. It seems that in the presence of these negative prognostic factors, we should adopt a more aggressive attitude in both our surgical strategies and adjuvant therapies, particularly preferring chemotherapy where angiogenesis is more significant.

The role of follow-up after treatment for gynecologic cancer.

The quality of life of the genital cancer patient may be considered in its many different aspects and principally from a medical, sexual and psychological point of view. In order to verify whether a substantial modification of the variable "anxiety" and of the bipolar axis male-female exists, we are conducting a research on our patients undergoing oncologic follow-up (806 patients, treated from 1975 to 1990). The result shows that the state "anxiety" decreases after follow-up examination; on the contrary to trait "anxiety" increases before and after follow-up examination. More complete information could perhaps be obtained having knowledge of the patient's personality, attitudes, feelings etc.

Nimesulide in the treatment of pelvic inflammatory diseases. A multicentre clinical trial conducted in Campania and Sicily.

400 patients aged 18 to 71 years took part in a multicentre noncomparative study designed to assess the clinical efficacy and tolerability of nimesulide in gynaecological inflammatory disease: adnexitis (72 patients), cervicitis (78 patients), endometritis (18 patients), myometritis (22 patients), and combined disorders (210 patients). All patients were treated with nimesulide 100mg twice daily in granular form for an average of 19.5 days. The treatment produced good results in all types of diseases considered, with a significant decrease in severity of symptoms being observed. The drug was well tolerated.

[A Sicilian multicenter study of the clinical effectiveness and tolerability of nimesulide in gynecologic inflammatory diseases]. / Studio policentrico siciliano sull'efficacia clinica e la tollerabilità della nimesulide nelle affezioni flogistiche ginecologiche.

Hundred-eighty patients, aged between 18 and 58 years, participated in a multicenter study, in order to assay the efficacy and tolerability of nimesulide in gynaecological inflammatory diseases. Thirty patients were affected by adnexitis, 41 patients by cervicitis, 6 by endometritis, 13 by myometritis and 90 patients presented more pathologies associated. Al the patients were treated with nimesulide 100 mg granular (sachets) bid for a mean period of 19 days. Treatment with nimesulide produced good results in all pathologies, significantly reducing the intensity of symptomatology. The tolerability of the drug was always good.

Endometrial cancer: our experience.

The Authors have referred to their experience based on 293 endometrial cancer patients operated at the II University Gynecological Clinic in Catania, between 1975 and 1989. Many prognostic indicators such as stage, histologic grade, myometrial invasion depth, lymph-node metastasis, non-neoplastic endometrium histology, tumor size and histology were studied; the Authors affirm the validity of two risk factors such as tumor size and the histology of the non-neoplastic endometrium, readily observable by hysteroscopy during the preoperative assessment and which are well correlated with the depth of myometrial invasion and lymph node methastasis.