Quantcast


CURATOR
A pinboard by
NATALIA RODRIGUEZ

Graduated in Medicine at Complutense University of Madrid, Spain.

Specialist in the field of Gynecology and Obstetrics from 2015.

I was working in public health care hospitals and private clinic in Madrid. Started my PhD program in Cancer and Pregnancy at General University Hospital Gregorio Marañon, Madrid, when I was in my second year of my residency program. Then, I was awarded with a Foundation Grant to finish it in New York City. USA.

I was working as a Clinical Research Fellow in Gynecology Oncology Department at Memorial Sloan Kettering Cancer Center, in New York City. Currently, I am working as a fellow in GYNONC at Columbia University in the city of New York.

Education: Columbia University of the City of New York. USA.2017 Weill Cornell Medicine. New York. USA. 2016 University of Texas. Houston. USA. 2014. Complutense University of Madrid. Spain. 2010

Hospital Experience: Clínical research fellowship in GYNONC, Memorial Sloan Kettering Cancer Center. New York. USA. Gynecology Oncology training, MD Anderson Cancer center, Houston, Texas. USA Obstetrics Ultrasound, University Hospital Gregorio Marañon. Madrid. Spain. Reproductive Medicine, Fundacion Jimenez Diaz, Madrid. Spain Pelvic pathology, Fuenlabrada Hospital, Madrid. Spain ] Breast Radiology, University Hospital of Mostoles, Madrid. Spain General and Digestive Surgery training, Semmelweis Klinika, Budapest, Hungary.

Research Experience: Clinical Research Fellowship in Gynecology Oncology at Columbia University, New York. USA. Clinical Research Fellowship in Gynecology Oncology at Memorial Sloan Kettering Cancer Center, New York. USA. Clinical Research Fellowship in Cancer and Pregnancy at General University Hospital Gregorio Marañon, Madrid. Spain.

Other Activities: Reviewer "The journal of minimally invasive Gynecology" JMIG

doing my Phd Program in endometrial carcinoma and sentinel lymph node mapping, trying to improve the people quality of life.

PINBOARD SUMMARY

Sentinel lymph node mapping has been proposed as an alternative to lymphadenectomy

Objective Sentinel lymph node (SLN) mapping has been proposed as an alternative to lymphadenectomy for women with uterine cancer. We performed a population-based analysis to determine the utilization and predictors of SLN mapping and, to examine whether use of SLN mapping was associated with changes in the prescription of adjuvant therapy for women with early-stage tumors.

Methods The National Cancer Data Base was used to identify women with uterine cancer who underwent hysterectomy in 2013-2014. Patients were stratified based on whether they underwent SLN mapping, lymphadenectomy or no nodal assessment. Multivariable regression models were developed to determine factors associated with performance of SLN biopsy and to examine whether SLN biopsy was associated with receipt of adjuvant radiotherapy.

Results A total of 54,039 women, including 38,453 (71.2%) who underwent lymphadenectomy, 1929 patients (3.6%) who underwent SLN and 13,657 (25.3%) who did not undergo nodal assessment were identified. In 2013, 2.8% underwent SLN biopsy, while 4.3% of those in 2014 underwent SLN biopsy (P<0.001). For those who had SLN mapping, 863 (45.4%) only underwent SLN biopsy while 1038 (54.6%) underwent concurrent lymphadenectomy. The median number of lymph nodes removed was 3 (IQR, 2-4) in those who underwent SLN biopsy alone and 14 (IQR, 9-21) in patients who had a concurrent nodal dissection. Among women who underwent nodal assessment, patients treated in 2014 were 60% more likely to undergo SLN biopsy than those in 2013 (aRR=1.60; 95% CI, 1.46-1.76), while those treated at a community cancer center were 72% more likely to undergo SLN biopsy than those treated at an academic center (aRR=1.72; 95% CI, 1.04-2.86). In contrast, women with more advanced stage disease, sarcomas or carcinosarcomas, and those with grade 3 tumors were less likely to undergo SLN biopsy (P<0.05 for all). Among women with stage I tumors who underwent nodal assessment, there was no association between SLN biopsy (compared to lymphadenectomy) and use of radiation (aRR=0.92; 95% CI, 0.82-1.05).

Conclusion Use of SLN biopsy for women with uterine cancer is increasing. A number of clinical and non-clinical factors contribute to uptake of SLN biopsy. Performance of SLN biopsy in lieu of lymphadenectomy is not associated with a higher rate of use of adjuvant radiation.

3 ITEMS PINNED

What is the incidence of isolated paraaortic nodal recurrence in grade 1 endometrial carcinoma?

Abstract: To describe the incidence of isolated paraaortic nodal recurrences in patients with a final diagnosis of grade 1 endometrial carcinoma initially treated with surgery.Records from a prospectively maintained endometrial carcinoma database were reviewed to identify sites of recurrence. Patients with any papillary serous or clear cell carcinoma, leiomyosarcoma, endometrial stromal sarcoma, squamous carcinoma, or adenosarcoma were excluded. Recurrence sites were classified into 4 main categories: 1) pelvic (including vaginal and other soft tissue pelvic sites); 2) abdominal (including peritoneum, omentum and liver); 3) distant (including lung, brain, supraclavicular, and groins); and 4) isolated paraaortic nodal recurrence (including any nodal recurrence between the midcommon iliac to renal vessels).Between 1/93 and 5/06, 1453 patients with endometrial carcinoma met the study inclusion criteria. Final grade distribution included: grade 1 endometrial adenocarcinoma, 310 (21%); grade 2, 578 (40%); grade 3, 481 (33%); and incomplete, 84 (5.8%). In all, 154 patients (11%) had documented recurrences. Recurrence sites for all patients/all grades included: pelvis, 52 (34%); abdomen, 51 (33%); distant, 41 (27%), and isolated paraaortic, 10 (6%). None of the isolated paraaortic recurrences occurred in patients with a final diagnosis of grade 1 carcinoma. Furthermore, 9/10 (90%) isolated paraaortic nodal recurrences were in grade 3 tumors. Only 8 (2.6%) of 310 patients with grade 1 tumors recurred. Sites of recurrence for grade 1 tumors included: abdomen, 3; pelvis, 3; and distant, 2.This large series of endometrial carcinoma patients initially treated with surgery confirms that isolated paraaortic nodal recurrence in women with a final diagnosis of grade 1 endometrial carcinoma is extremely rare. These rare isolated paraaortic nodal recurrences appear to be limited to high-grade endometrial carcinomas.

Pub.: 29 Jul '08, Pinned: 18 Sep '17

Detection of sentinel lymph nodes in minimally invasive surgery using indocyanine green and near-infrared fluorescence imaging for uterine and cervical malignancies.

Abstract: Our primary objective was to assess the detection rate of sentinel lymph nodes (SLNs) using indocyanine green (ICG) and near-infrared (NIR) fluorescence imaging for uterine and cervical malignancies.NIR fluorescence imaging for the robotic platform was obtained at our institution in 12/2011. We identified all cases planned for SLN mapping using fluorescence imaging from 12/2011-4/2013. Intracervical ICG was the fluorophobe in all cases. Four cc (1.25mg/mL) of ICG was injected into the cervix alone divided into the 3- and 9-o'clock positions, with 1 cc deep into the stroma and 1 cc submucosally before initiating laparoscopic entry. Blue dye was concurrently injected in some cases.Two hundred twenty-seven cases were performed. Median age was 60 years (range, 28-90 years). Median BMI was 30.2 kg/m(2) (range, 18-60 kg/m(2)). The median SLN count was 3 (range, 1-23). An SLN was identified in 216 cases (95%), with bilateral pelvic mapping in 179 (79%). An aortic SLN was identified in 21 (10%) of the 216 mapped cases. When ICG alone was used to map cases, 188/197 patients mapped, for a 95% detection rate compared to 93% (28/30) in cases in which both dyes were used (P=NS). Bilateral mapping was seen in 156/197 (79%) ICG-only cases and 23/30 (77%) ICG and blue dye cases (P=NS).NIR fluorescence imaging with intracervical ICG injection using the robotic platform has a high bilateral SLN detection rate and appears favorable to using blue dye alone and/or other modalities. Combined use of ICG and blue dye appears unnecessary.

Pub.: 04 Mar '14, Pinned: 18 Sep '17

NATALIA RODRIGUEZ

Graduated in Medicine at Complutense University of Madrid, Spain. Specialist in the field of Gynecology and Obstetrics from 2015. I was working in public health care hospitals and private clinic in Madrid. Started my PhD program in Cancer and Pregnancy at General University Hospital Gregorio Marañon, Madrid, when I was in my second year of my residency program. Then, I was awarded with a Foundation Grant to finish it in New York City. USA. I was working as a Clinical Research Fellow in Gynecology Oncology Department at Memorial Sloan Kettering Cancer Center, in New York City. Currently, I am working as a fellow in GYNONC at Columbia University in the city of New York. Education: Columbia University of the City of New York. USA.2017 Weill Cornell Medicine. New York. USA. 2016 University of Texas. Houston. USA. 2014. Complutense University of Madrid. Spain. 2010 Hospital Experience: Clínical research fellowship in GYNONC, Memorial Sloan Kettering Cancer Center. New York. USA. Gynecology Oncology training, MD Anderson Cancer center, Houston, Texas. USA Obstetrics Ultrasound, University Hospital Gregorio Marañon. Madrid. Spain. Reproductive Medicine, Fundacion Jimenez Diaz, Madrid. Spain Pelvic pathology, Fuenlabrada Hospital, Madrid. Spain ] Breast Radiology, University Hospital of Mostoles, Madrid. Spain General and Digestive Surgery training, Semmelweis Klinika, Budapest, Hungary. Research Experience: Clinical Research Fellowship in Gynecology Oncology at Columbia University, New York. USA. Clinical Research Fellowship in Gynecology Oncology at Memorial Sloan Kettering Cancer Center, New York. USA. Clinical Research Fellowship in Cancer and Pregnancy at General University Hospital Gregorio Marañon, Madrid. Spain. Other Activities: Reviewer "The journal of minimally invasive Gynecology" JMIG