From presentation to paper: Gender disparities in oncological research

Gender disparities in scientific publications have been identified in oncological research. Oral research presentations at major conferences enhance visibility of presenters. The share of women presenting at such podia is unknown. We aim to identify gender-based differences in contributions to presentations at two major oncological conferences. Abstracts presented at plenary sessions of the American Society of Clinical Oncology (ASCO) Annual Meetings and European Society for Medical Oncology (ESMO) Congresses were collected. Trend analyses were used to analyze female contribution over time. The association between presenter's sex, study outcome (positive/negative) and journals' impact factors (IFs) of subsequently published papers was assessed using Chi-square and Mann–Whitney U tests. Of 166 consecutive abstracts presented at ASCO in 2011–2018 (n = 34) and ESMO in 2008–2018 (n = 132), 21% had female presenters, all originating from Northern America (n = 17) or Europe (n = 18). The distribution of presenter's sex was similar over time (p = 0.70). Of 2,425 contributing authors to these presented abstracts, 28% were women. The proportion of female abstract authors increased over time (p < 0.05) and was higher in abstracts with female (34%) compared to male presenters (26%; p < 0.01). Presenter's sex was not associated with study outcome (p = 0.82). Median journals' IFs were lower in papers with a female first author (p < 0.05). In conclusion, there is a clear gender disparity in research presentations at two major oncological conferences, with 28% of authors and 21% of presenters of these studies being female. Lack of visibility of female presenters could impair acknowledgement for their research, opportunities in their academic career and even hamper heterogeneity in research.     

Eyes wide shut - unusual two stage repair of pectus excavatum and annuloaortic ectasia in a 37 year old marfan patient: case report

We report about a 37 year old male patient with a pectus excavatum. The patient was in NYHA functional class III. After performed computed tomography the symptoms were thought to be related to the severity of chest deformation. A Ravitch-procedure had been accomplished in a district hospital in 2009. The crack of a metal bar led to a reevaluation 2010, in which surprisingly the presence of an annuloaortic ectasia (root 73 × 74 mm) in direct neighborhood of the formerly implanted metal-bars was diagnosed. Echocardiography revealed a severe aortic valve regurgitation, the left ventricle was massively dilated presenting a reduced ejection fraction of 45%. A marfan syndrome was suspected and the patient underwent a valve sparing aortic root replacement (David procedure) in our institution with an uneventful postoperative course. A review of the literature in combination with discussion of our case suggests the application of stronger recommendations towards preoperative cardiovascular assessment in patients with pectus excavatum.     

Immunohistochemical analysis of tumour regression grade for rectal cancer after neoadjuvant chemoradiotherapy

Aim Tumour regression grade (TRG) as defined by Rödel et al. has been used as an independent prognostic factor for rectal carcinoma after preoperative treatment by chemoradiotherapy (CRT). Determination of TRG 2 and 3, semiquantitatively defined as more or less than 50% tumour regression, respectively, does not appear to correlate with prognosis. The purpose of this study was to find an immunohistochemical pattern to permit improved stratification of intermediate responders defined by disease free (DFS) and overall survival (OS). Method Immunohistochemistry of EGFR (epidermal growth factor receptor), VEGF (vascular endothelial growth factor), CD133 antibody, p53 antibody and Ki67 antibody was evaluated using tissue microarrays (TMA) on post‐treatment surgical specimens from 88 patients. CD133 expression was confirmed in the whole section when available. Results At a median follow‐up of 40 months, TRG was found to be an independent predictor of DFS (P = 0.05) and OS (P = 0.001) but no differences were found between TRG 2 and 3 in terms of DFS (P = 0.74) or OS (P = 0.41). The results of TMA showed an immunohistochemically poor prognostic profile for intermediate responders configured by negativity of CD133 expression. However, when examining CD133 expression in the whole section, there was an intermediate correlation with TMA and the prognostic significance was lost. Conclusion The results did not confirm the value of immunohistochemistry in predicting the prognosis of patients with rectal cancer following neoadjuvant chemoradiotherapy. This questions the accuracy of TMA in detecting CD133 expression in this setting.     

Surgery of female genital tract tumour lung metastases

IntroductionLung metastases originating from tumors of the female genital tract are rare. Due to this rarity and their variable histology, it has been difficult to compare different patient series.Material and methodsA retrospective study of patients who underwent resection of lung metastases of female genital tract tumors (uterine, fallopian and cervical cancer) during the period from 01/01/1989 to 12/31/2006. Epidemiological, diagnostic and treatment data were collected. Non-parametric tests and the survival analysis were performed using the Kaplan-Meier curves and the log-rank test.ResultsDuring the study period, 27 underwent resection. Mean disease-free interval (DFI) from initial diagnosis to the diagnosis of metastasis was 58 months (1–195 months). Mean survival from the diagnosis of metastasis was 94 months. The overall 5-year survival after diagnosis of metastasis was 84.1%. A second surgery for metastasis was performed on 5 patients (18.5%). Survival after second surgery of metastases was 80.5 months. Five-year survivals from diagnosis of metastasis were: endometrial carcinoma 100%; cervical cancer 62.5%; uterine sarcoma 60%. Adjuvant hormone therapy was prescribed in15 out of 16 patients with endometrial carcinoma. There was a statistically significant difference in survival depending on the histological type and disease free interval.ConclusionSurgical treatment of lung metastases originating from female genital tract tumors (mainly endometrial carcinoma) is associated with a high long-term survival.     

Coronary surgery without extracorporeal circulation and Octopus cardiac stabilizer]

Between june and july, 1998, surgical myocardial revascularization without cardiopulmonary by-pass through a conventional sternotomy with the use of the "Octopus" heart stabilizer was performed in 6 patients (mean age 63 years, range 49-74 years). All patients received an internal thoracic artery graft. Three of them had also a saphenous vein graft on the distal right coronary artery. An intracoronary shunt was used in four patients and all the anastomoses were accomplished in a completely immobilized area of epicardium. Mean postoperative hemorrhage was 200 ml (50-300 ml) and ICU and total hospital stay were 2 and 6 days respectively. At the first follow-up control, one month post-op, all six patients are free of symptoms without medication. We believe the "Octopus" tissue stabilization system outperforms other heart stabilization devices in our hands and it can be used safely in selected groups of patients.