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E Mension

Bio: E Mension is an academic researcher from University of Barcelona. The author has contributed to research in topics: Medicine & Breast cancer. The author has an hindex of 2, co-authored 7 publications receiving 18 citations.

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Journal ArticleDOI
TL;DR: The present data suggest that these therapies are effective for VVA in BCS; however, safety remains controversial and a major concern with all of these treatments.

25 citations

Journal ArticleDOI
TL;DR: The aim of this study was to compare oncological outcomes and morbidity in patients with early‐stage vulvar cancer with negative sentinel lymph node (SLN) biopsy vs negative inguinofemoral lymphadenectomy (IFL).
Abstract: INTRODUCTION The aim of this study was to compare oncological outcomes and morbidity in patients with early-stage vulvar cancer with negative sentinel lymph node (SLN) biopsy vs negative inguinofemoral lymphadenectomy (IFL). MATERIAL AND METHODS Study with retrospectively collected data in patients with squamous cell vulvar carcinomas ≤ 4 cm without suspected inguinofemoral lymph node metastases. Only patients with negative nodes after histopathology procedure were followed. Patients who underwent only SLN were compared with patients who underwent IFL ± SLN to compare recurrences, survival rates and morbidity. RESULTS Ninety-three patients were eligible for follow up: 42 with negative SLN and 51 with negative IFL ± SLN. The median follow-up period was 60.4 months (range 6.7-160.7). The rate of isolated first groin recurrence was 4.8% in patients with negative SLN and 2.0% in patients with negative IFL ± SLN (P = 0.587) and the rates of first isolated local recurrence were 28.6% and 31.4%, respectively (P = 0.823). Only 1 patient (2.4%) in the group of negative SLN had distant recurrence. The disease-specific survival rate at 5 years was 83.3% in the negative SLN group and 92.2% in the negative IFL ± SLN group (P = 0.214). We observed a higher rate of wound breakdown and infection after IFL than SLN biopsy (17.6% vs 10.6%; P = 0.020) and lymphedema (33.3% vs 0%; P < 0.001). CONCLUSIONS We report in the same population of patients with early-stage vulvar cancer that SLN biopsy does not have significantly higher rates of groin recurrences or lower survival rates compared with IFL. Moreover, the SLN procedure has less morbidity, which should encourage gynecologists to abandon IFL.

13 citations

Journal ArticleDOI
TL;DR: In this paper, a comprehensive literature search was conducted electronically using Embase and PubMed to retrieve studies assessing evidence for the efficacy and safety of vaginal laser therapy for GSM or vulvovaginal atrophy up to June 2021.

13 citations

Journal ArticleDOI
TL;DR: In this paper , a randomized clinical trial with 84 participants in two parallel study groups, both groups received a first-line therapy based on non-hormonal moisturizers and vaginal vibrator stimulation, and participants were randomized to receive 5 weekly sessions of fractional carbon dioxide laser therapy or sham laser therapy.
Abstract: Key Points Question Is vaginal laser treatment safe and effective for genitourinary syndrome of menopause in survivors of breast cancer receiving aromatase inhibitors? Findings In this randomized clinical trial with 84 participants in 2 parallel study groups, both groups received a first-line therapy based on nonhormonal moisturizers and vaginal vibrator stimulation, and participants were randomized to receive 5 weekly sessions of fractional carbon dioxide laser therapy or sham laser therapy. No differences were observed between groups in safety or efficacy outcomes at the 6-month follow-up. Meaning These findings suggest that although vaginal laser treatment was safe, it was not more effective than first-line therapy with placebo treatment in survivors of breast cancer receiving aromatase inhibitors.

9 citations

Journal ArticleDOI
TL;DR: Signs and physical examination regarding sexuality and vaginal health improved significantly, while serum estradiol remained at low levels, and prasterone seems a safe and effective option to treat GSM in BCS receiving AIs.
Abstract: Abstract Background Due to safety concerns on estrogen-based treatments for genitourinary syndrome of menopause (GSM) in breast cancer survivors (BCS), new options are appearing, such as androgen-based treatments, which according to proprieties would not be transformed systemically to estrogens in patients receiving aromatase inhibitors (AIs). Objective The aim of this pilot study is to assess the security and efficacy of vaginal prasterone (dehydroepiandrostenedione [DHEA]) in BCS treated with AIs. Methods This open, prospective, pilot study included 10 BCS treated with AIs. All participants complained of severe GSM. DHEA was administrated as a vaginal ovule. Participants were instructed to use one ovule every night during the first month, and one ovule every two nights for the entire five remaining months. The patients were requested to attend seriated visits after the beginning of the prasterone treatment to evaluate symptoms, physical improvement and serum estradiol. Results Mean serum estradiol remained low from 3.4 pg/ml to 4.3 pg/ml (p = 0.9136) after 6 months of follow-up. The visual analog scale of dyspareunia improved from 8.5 to mean values after treatment of 0.4 (p = 0.0178). The Vaginal Health Index (VHI) scale and Female Sexual Function Index improved from 9.75 to 15.8 (p = 0.0277) and from an initial score of 11.2 to 20.6 (p = 0.0277), respectively. Vaginal pH changed from basal 8.1 to final 6.5 (p = 0.0330). Conclusion Symptoms and physical examination regarding sexuality and vaginal health improved significantly, while serum estradiol remained at low levels. Prasterone seems a safe and effective option to treat GSM in BCS receiving AIs.

7 citations


Cited by
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Journal ArticleDOI
TL;DR: Treatment for early-stage vulvar cancer used to consist of wide local excision of the tumor combined with an inguinofemoral lymphadenectomy, which is effective but has a high morbidity rate.
Abstract: Obstet Gynecol Surv 2016;71(3):157-159 Treatment for early-stage vulvar cancer used to consist of wide local excision of the tumor combined with an inguinofemoral lymphadenectomy. This treatment is effective but has a high morbidity rate.

37 citations

Journal ArticleDOI
TL;DR: It is essential to standardise the acquisition protocol including SPECT/CT images, and due to the low incidence of this type of malignancy to centralise this procedure in experienced centres for personalised approach.
Abstract: This study aimed to update the clinical practice applications and technical procedures of sentinel lymph node (SLN) biopsy in vulvar cancer from European experts. A systematic data search using PubMed/MEDLINE database was performed up to May 29, 2019. Only original studies focused on SLN biopsy in vulvar cancer, published in the English language and with a minimum of nine patients were selected. Among 280 citations, 65 studies fulfilled the inclusion criteria. On the basis of the published evidences and consensus of European experts, this study provides an updated overview on clinical applications and technical procedures of SLN biopsy in vulvar cancer. SLN biopsy is nowadays the standard treatment for well-selected women with clinically negative lymph nodes. Negative SLN is associated with a low groin recurrence rate and a good 5-year disease-specific survival rate. SLN biopsy is the most cost-effective approach than lymphadenectomy in early-stage vulvar cancer. However, future trials should focus on the safe extension of the indication of SLN biopsy in vulvar cancer. Although radiotracers and optical agents are widely used in the clinical routine, there is an increasing interest for hybrid tracers like indocyanine-99mTc-nanocolloid. Finally, it is essential to standardise the acquisition protocol including SPECT/CT images, and due to the low incidence of this type of malignancy to centralise this procedure in experienced centres for personalised approach.

28 citations

Journal ArticleDOI
TL;DR: Current available menopausal hormonal therapies and novel pharmaceutical alternatives to manage menopausal symptoms are discussed, with menopausal hormone therapy (MHT), including tibolone, remains the most effective treatment for menopausal Symptoms.

23 citations

Journal ArticleDOI
TL;DR: The European Menopause and Andropause Society (EMAS) developed a care pathway for monitoring and guidance of women at midlife, focusing on those approaching the end of the reproductive life-cycle, going through the menopausal transition and beyond as mentioned in this paper .

21 citations