Robotic Surgery in Patients With Locally Advanced Cervical Cancer After Neoadjuvant Chemotherapy: Survival Outcomes.

AIM: To evaluate the survival outcomes of consecutive patients with locally advanced cervical cancer (LACC) who underwent comprehensive robotic surgery after neoadjuvant chemotherapy (NACT). MATERIALS AND METHODS: Since 2009, patients with LACC (FIGO [International Federation of Gynecology and Obstetrics] stages IB2-IIB) were submitted to robotic surgical staging after 3 cycles of NACT. Clinical objective tumor response was assessed according to the Response Evaluation Criteria in Solid Tumors, whereas pathologic responses were defined according to the criteria of the European study SNAP01. Univariable and multivariable analyses were performed to assess potential clinicopathologic prognostic factors affecting progression-free survival and overall survival (OS). RESULTS: During the study period, 32 patients meeting the inclusion criteria were managed. The median (range) age and body mass index were 47.3 (8.6-75.5) years and 22.7 (17.5-37.1) kg/m(2), respectively. Overall, 28.0 (range, 12-58) lymph nodes were retrieved. According to the final pathologic examination, 6 (18.8%) women had positive pelvic lymph nodes, whereas 16 (50.0%) patients achieved an optimal pathological response. After a median follow-up of 36.3 (range, 5.2-71.1) months, 6 (18.8%) patients had a recurrence and subsequently died of disease.Positive nodal status was the only independent predictor of both progression-free survival (12.5 [2.3-69.1]; P < 0.0001) and OS (12.0 [2.0-60.4]; P < 0.0001) at multivariable analysis. CONCLUSIONS: Nodal status represents the strongest predictor of survival in women with LACC. Similarly, NACT including 3 agents (TIP [paclitaxel 175 mg/m(2) + ifosfamide 5 g/m(2) + cisplatin 75 mg/m(2)] and TEP [paclitaxel 175 mg/m(2) + epirubicin 80 mg/m(2) + cisplatin 75 mg/m(2)] regimens) warranted better OS than those achieved by other schedules.

Rotationally adiabatic pair interactions of para- and ortho-hydrogen with the halogen molecules F2, Cl2, and Br2.

The present work is concerned with the weak interactions between hydrogen and halogen molecules, i.e., the interactions of pairs H2-X2 with X = F, Cl, Br, which are dominated by dispersion and quadrupole-quadrupole forces. The global minimum of the four-dimensional (4D) coupled cluster with singles and doubles and perturbative triples (CCSD(T)) pair potentials is always a T shaped structure where H2 acts as the hat of the T, with well depths (De) of 1.3, 2.4, and 3.1 kJ/mol for F2, Cl2, and Br2, respectively. MP2/AVQZ results, in reasonable agreement with CCSD(T) results extrapolated to the basis set limit, are used for detailed scans of the potentials. Due to the large difference in the rotational constants of the monomers, in the adiabatic approximation, one can solve the rotational Schrödinger equation for H2 in the potential of the X2 molecule. This yields effective two-dimensional rotationally adiabatic potential energy surfaces where pH2 and oH2 are point-like particles. These potentials for the H2-X2 complexes have global and local minima for effective linear and T-shaped complexes, respectively, which are separated by 0.4-1.0 kJ/mol, where oH2 binds stronger than pH2 to X2, due to higher alignment to minima structures of the 4D-pair potential. Further, we provide fits of an analytical function to the rotationally adiabatic potentials.

From synchronous to sequential double proton transfer: quantum dynamics simulations for the model porphine.

Quantum dynamics simulations of double proton transfer (DPT) in the model porphine, starting from a nonequilibrium initial state, demonstrate that a switch from synchronous (or concerted) to sequential (or stepwise or successive) breaking and making of two bonds is possible. For this proof of principle, we employ the simple model of Smedarchina, Z.; Siebrand, W.; Fernández-Ramos, A. J. Chem. Phys. 2007, 127, 174513, with reasonable definition for the domains D for the reactant R, the product P, the saddle point SP2 which is crossed during synchronous DPT, and two intermediates I = I(1) + I(2) for two alternative routes of sequential DPT. The wavepacket dynamics is analyzed in terms of various properties, from qualitative conclusions based on the patterns of the densities and flux densities, until quantitative results for the time evolutions of the populations or probabilities P(D)(t) of the domains D = R, P, SP2, and I, and the associated net fluxes F(D)(t) as well as the domain-to-domain (DTD) fluxes F(D1,D2) between neighboring domains D1 and D2. Accordingly, the initial synchronous mechanism of the first forward reaction is due to the directions of various momenta, which are imposed on the wavepacket by the L-shaped part of the steep repulsive wall of the potential energy surface (PES), close to the minimum for the reactant. At the same time, these momenta cause initial squeezing followed by rapid dispersion of the representative wavepacket. The switch from the synchronous to sequential mechanism is called indirect, because it is mediated by two effects: First, the wavepacket dispersion; second, relief reflections of the broadened wavepacket from wide regions of the inverse L-shaped steep repulsive wall of the PES close to the minimum for the product, preferably to the domains I = I(1) + I(2) for the sequential DPT during the first back reaction, and also during the second forward reaction, etc. Our analysis also discovers a variety of minor effects, such as direct switch of the mechanisms, as well as damped oscillations in the net fluxes and populations due to compensations of partially overlapping DTD fluxes.