International Federation Research Articles

Influence of COVID-19 on the clinical characteristics of patients with uterine cervical cancer in Japan: A single-center retrospective study.

This study investigated the impact of coronavirus disease 2019 (COVID-19) on the clinical characteristics and interregional movement of patients with uterine cervical cancer. This study included 1189 patients who underwent treatment for cervical cancer, including cervical intraepithelial neoplasm and adenocarcinoma in situ, at our hospital in Tokyo, Japan, in 2017-2018 and in 2021, before and after the pandemic, respectively. The patients' clinical information was compared during both periods. The clinical stage was unified using the International Federation of Gynecology and Obstetrics (FIGO) 2008 staging. The number of patients treated for cervical cancer was 355, 420, and 414 in 2017, 2018, and 2021, respectively. The percentage of invasive carcinomas significantly increased from 158 (44.5%) and 196 (46.7%) to 219 (52.9%) (p = 0.049). In all periods, no significant differences were observed in median age, histological type, and treatment. The proportions of FIGO Stage IA1 were significantly elevated from 3.9% and 3.8% to 11.4% (p < 0.001). The percentage of patients from prefectures other than Tokyo significantly increased from 34.9% to 40.8% (p = 0.049). Furthermore, the proportion of patients with invasive carcinoma in private clinics increased from 28.0% to 37.9% (p = 0.014). The number of patients with invasive carcinoma and the percentage of patients with invasive carcinoma referred from private clinics increased, indicating that the COVID-19 pandemic influenced patients to delay consultations. Furthermore, the surge in patients from other prefectures indicates that medical resources were more limited in rural areas, another impact of COVID-19.

Revisiting the Global Social Work Definition: How Social Workers Define the Profession a Decade Later?

Abstract Social work has struggled to establish a unanimous definition encompassing the full professional scope. In 2014, the International Federation of Social Workers introduced a revised global definition outlining principles, objectives, goals and theories. Now, a decade later, questions have emerged about the definition and its contemporary relevance. This qualitative study interviewed sixty-five Israeli social workers to uncover how they define the profession. Analysis revealed they define social work as a profession that fosters positive change and well-being through tailored interventions. It upholds humanistic values like equality, dignity and participation and assists diverse clients experiencing challenging transitions by utilising different means of support. Findings show continuity in how social workers in Western contexts view the purpose and tools of the profession, whilst also highlighting tensions with the global definition’s macro-orientation. This research then incorporates an inclusive ‘both/and’ perspective, including both micro and macro dimensions, using principles from rights-based social work, to propose small amendments to the global definition.

Intraoperative peritoneal cytology for cervical gastric-type adenocarcinoma: Cytopathology and clinical impact.

The objective of this study was to elucidate the frequency and cytologic features of positive peritoneal washing cytology (PWC) in cervical gastric-type adenocarcinoma (GAS) and to clarify the clinical significance of positive PWC. The authors analyzed cases from their institution between 1991 and 2023 in which patients underwent surgery and PWC. The study included 62 patients who had cervical GAS (1991-2023; including seven patients with adenocarcinoma in situ and 26, 15, nine, and five patients with International Federation of Gynecology and Obstetrics 2018 stage I, II, III, and IV disease, respectively) and 100 patients who had usual-type endocervical adenocarcinoma (2007-2023; including 65, 15, and 20 patients with stage I, II, and III disease, respectively). The frequency of positive PWC results and cytologic features was assessed, and correlations between positive PWC results and clinicopathologic factors were examined, including prognosis, in the GAS group. Positive PWC results were significantly more frequent in patients who had GAS at 24% (15 of 62 patients) compared with 7% (seven of 100 patients) in those who had usual-type endocervical adenocarcinoma. The cytologic features of GAS included distinct cellular atypia (enlarged nuclei, nuclear irregularity) and frequent formation of spherical clusters (10 of 15 cases) without the golden-yellowish mucus commonly seen in cervical smears. A positive PWC result in GAS was significantly correlated with larger tumor size, parametrium invasion, lymph node metastasis, and elevated carbohydrate antigen 19-9 levels. In patients with stage I GAS, the PWC-positive group had significantly shorter disease-free survival and overall survival compared with the PWC-negative group. Positive PWC findings are frequent in cervical GAS and are associated with pathologic factors indicative of tumor growth and progression. In patients who have stage I GAS, positive PWC results may indicate a poor prognosis, warranting further investigation.

Para-aortic lymph node recurrence in surgically treated early-stage cervical cancer without para-aortic lymph node surgical staging

ObjectiveThe standard treatment for early-stage cervical cancer includes radical hysterectomy with pelvic lymph node staging ± bilateral salpingo-oophorectomy. Para-aortic lymphadenectomy may be considered; however, its role remains controversial. The objective...

6848 Improvement Of Free Thyroxine Measurement Quality Through The CDC Clinical Standardization Programs

Abstract Disclosure: A. Ribera: None. N. Vazquez: None. S. Knoblock: None. O. Sugahara: None. T. Buchannan: None. L. Collins: None. D. Spector: None. L. Zhang: None. U. Danilenko: None. H.W. Vesper: None. Thyroid function tests are among the most requested tests in patient care, and reliability of these measurements are crucial for appropriate diagnosis and management of thyroid disorders. In response to concerns from the clinical and research community about the quality of thyroid function tests, the CDC Clinical Standardization Programs (CSP) has created the hormone standardization (HoSt) program for free thyroxine (FT4) in partnership with the International Federation for Clinical Chemistry and Laboratory Medicine (IFCC). As a first step, CDC CSP has completed an interlaboratory comparison study of commercial immunoassays (IA) and lab-developed tests (LDT) to determine the current agreement among assays. Participants received 40 blinded, high quality individual donor serum samples with FT4 reference values assigned by the CDC FT4 reference measurement procedure (RMP). FT4 concentrations ranged between 11-32 pmol/L. Samples were analyzed in duplicate over 2 days and results were compared to the CDC FT4 RMP. To assess the potential impact of standardizing measurements to the CDC HoSt FT4 program, reported results were normalized to the CDC RMP results (recalibrated in silico using linear regression). Mean percent bias to the reference value was evaluated pre- and post-recalibration. In addition, inter-assay agreement of classification (assignment of hypo-, eu- or hyperthyroid status according to FT4 reference intervals) were assessed pre- and post-recalibration using the assay-specific and CDC RMP reference intervals, respectively. A total of 19 methods participated, consisting of 15 IA and 4 LDT. All participants showed a negative mean bias to the RMP, with IA showing a higher magnitude of bias (average: -20.7 ± 0.9%) than LDT (average: -4.7 ± 1.1%). Of the 40 samples measured, only 53% were classified uniformly by all 19 participants. Post-recalibration, mean percent bias improved profoundly (IA average: 0.0 ± 0.8%, LDT average: 0.1 ± 1.1%), and classification agreement improved by 33% to 86% of samples with consistent classification. The CDC CSP interlaboratory comparison among FT4 assays highlights the critical need for measurement standardization to improve accuracy of FT4 measurements and increase consistency in result interpretation. This study demonstrates that it is possible to develop common FT4 reference intervals via measurement standardization, which would allow for universal evidence-based clinical guidelines to be used in patient care. Presentation: 6/3/2024

A-002 Analytical Validation of the Zybio High Sensitivity Cardiac Troponin I CLIA Assay

Abstract Background High-sensitivity cardiac troponin (hs-cTn) plays a pivotal role in the early diagnosis of Acute Coronary Syndrome (ACS). With technological advancements, the sensitivity of troponin assays has significantly improved. The International Federation of Clinical Chemistry (IFCC) criteria for hs-cTn assays include a total imprecision (Coefficient of Variation, CV) ≤10% at the gender-specific 99th percentile value and detectable levels in ≥50% of a healthy population. This study aims to evaluate the performance of Zybio's hs-cTnI assay against these high-sensitivity standards Methods This study involved 1661 individuals undergoing routine health checks at Chongqing Medical University Third Hospital. Exclusion criteria included recent medication use, abnormal NT-proBNP levels, significant cardiac silhouette changes in chest X-rays, age &amp;lt;20, incomplete data, pregnancy, or history of severe chronic diseases. Participants were classified into apparent healthy and healthy groups based on blood pressure, lipid profiles, and electrocardiogram results. Laboratory examinations included hs-cTn and NT-ProBNP concentrations using Zybio's chemiluminescence instrument EXI2400 and associated reagent kits, with other parameters measured using standard biochemical and high-performance liquid chromatography methods. Results Of the 1247 participants (556 males, 691 females) included in the final analysis, 1157 showed detectable hs-cTnI levels above the limit of detection (LOD), yielding an overall detection rate of 92.78%. Detection rates were 93.71% in males and 92.04% in females. The total imprecision (CV) of hs-cTnI at gender-specific 99th percentile values over 20 days was below 10%, meeting the high-sensitivity criteria. This finding was consistent across lower and higher concentration ranges. Conclusions The Zybio hs-cTnI assay demonstrated a high detection rate in a healthy population, with 92.78% detectability overall, 93.71% in males, and 92.04% in females. The assay met the high-sensitivity criteria of IFCC, with a total imprecision (CV) of less than 10% at the gender-specific 99th percentile levels. These results validate the utility of Zybio's hs-cTnI assay for clinical application in the early diagnosis of ACS.

Network Analysis in Global Emergency Medicine: Mapping Collaborative Structures and Enhancing Connectivity

Introduction Network analysis, which draws from fields including mathematics, sociology, and public health, is essential for interpreting complex data relationships within healthcare information systems. This approach not only highlights intricate care patterns but also enhances the navigability of systems, making complex healthcare information more accessible [1]. Our study builds on previous applications of network analysis in healthcare, specifically examining its use in structuring academic health center websites in the U.S. to improve user-oriented spaces. Our research explores the digital ecosystem of emergency medicine organizations globally, focusing on the International Federation for Emergency Medicine (IFEM). By employing a systematic, automated approach to network mapping, we aim to uncover collaborative patterns and enhance the online presence of emergency resources. This effort supports greater global collaboration and information sharing among emergency medicine organizations, leveraging the strong networks and insights provided by IFEM to ensure universal access to high-quality emergency services. Methodology We utilized a four-step process for mapping and analyzing the global network of emergency medicine organizations: Web Crawling: We collected data from the IFEM website using the Screaming Frog SEO Spider tool. The crawl depth was set to three to ensure comprehensive data capture from IFEM and its connected links. Content Filtering: BeautifulSoup was used to parse HTML content. We filtered the extracted data for relevance to emergency medicine organizations. The data was further refined using the Gemini 1.0 Pro model to isolate pertinent information about the organizations' names and locations. Geolocation Resolution: Location data extracted from the web pages was converted into geographical coordinates using the Geopy library’s Nominatim tool to accurately map of each organization's position. Network Visualization: We constructed a directed network graph using the NetworkX library, with nodes representing organizations and edges representing their interconnections. This graph was visualized with Matplotlib to illustrate the relationships and distribution patterns among the organizations. Results We identified 4,775 external links on the IFEM website and refined them to 156 unique base URLs for in-depth content analysis. Out of 55 countries listed, there were 41 functional links, 10 non-functional, and 4 missing. We effectively isolated 41 relevant multilingual URLs from the functional links, achieving a 100% accuracy rate in identifying pertinent content. Additionally, our analysis uncovered 30 URLs linked to emergency medicine organizations not listed on the IFEM member page, including the American College of Osteopathic Emergency Physicians and the Swiss Society for Emergency and Rescue Medicine. Discussion Our study highlights the utility of network analysis in understanding the digital networks of emergency medicine organizations globally, revealing essential connectivity patterns and their implications for healthcare systems. The methodology used is adaptable for other healthcare areas, enhancing collaboration and addressing language barriers. Findings indicate dynamic changes in digital connectivity, pointing to evolving collaboration and resource sharing. This research provides a foundation for exploring digital connectivity's broader impacts across various sectors.

Prenatal detection of placenta accreta spectrum using a sonographic checklist.

The European Working Group for Abnormally Invasive Placenta proposed a checklist of ultrasound features for the antenatal detection of placenta accreta spectrum (PAS). This study aims to assess the performance of the checklist in identifying histopathologically confirmed PAS cases in a cohort with a high pre-test probability of PAS, and identify if particular features are associated with PAS. This is a prospective multi-site cohort study conducted between 2018 and 2023. Consecutive patients who underwent ultrasound assessment for suspicion of PAS were included, and the sonographic checklist was completed at the time of ultrasound. Cases were defined as PAS where they had intraoperative findings as described by the International Federation of Gynecology and Obstetrics (FIGO) grading, and histopathological findings for hysterectomy and myometrial resection cases. All non-PAS cases in this study had placenta previa and at least one prior cesarean delivery. Seventy-eight participants met inclusion criteria, of whom 63 (80.7%) were diagnosed with PAS. Cesarean hysterectomy was performed in 49 cases (62.8%). Overall, third-trimester ultrasound performed at a median gestational age of 32 weeks (IQR 30-34 weeks) had a sensitivity of 0.84 (95% CI 0.73 to 0.92) and specificity of 0.73 (95% CI 0.45 to 0.92) for detecting PAS, with a positive and negative likelihood ratio of 3.15 (95% CI 1.35 to 7.35) and 0.22 (95% CI 0.11 to 0.41), respectively. Features most associated with PAS were abnormal placental lacunae (Odds Ratio [OR] 5.40 [95% CI 1.61 to 18.03] and myometrial thinning OR 6.87 [95% CI 1.93 to 24.4]). While many of the ultrasound features seen in PAS were also present in cases of placenta previa with prior Cesarean section, the median (IQR) number of features present in PAS cases was significantly higher than in the non-PAS placenta previa group (six features [3-8] vs. two features [0-3] p = 0.001). No case of non-PAS placenta previa had more than five features present. The use of a standardized sonographic checklist had a high sensitivity and good specificity for the detection of PAS in this prospective cohort of well-classified PAS cases.

Safety of diagnostic hysteroscopy for the investigation of type II endometrial cancer: systematic review with meta-analysis.

The goal of this study is to evaluate the safety of diagnostic hysteroscopy (HSC) in type II endometrial cancer (EC). We searched PubMed, the Cochrane Library and the Chinese Medical Journal Full-Text Database until December 2023. Eligible trials were all cohort studies in which patients were allocated to diagnostic HSC group or dilation and curettage (D&C) group. Quality assessments of eligible studies were performed using the Newcastle-Ottawa scales. Risk ratios (RRs) with 95% CIs were calculated as a measure of effects. Three trials were included in our analysis, which were all retrospective cohort studies. 696 patients with histologically proven type II EC were allocated to HSC or D&C before surgery. 257 patients underwent preoperative HSC, and 439 patients underwent D&C. The positive peritoneal cytology rate did not statistically differ between the groups (RR, 1.9; 95% CI, 1.00 to 3.61; p=0.05). There was no significant difference in the incidence of International Federation of Gynecology and Obstetrics (FIGO) stage between the HSC and D&C groups (stage I/II: RR, 1.08; 95% CI, 0.95 to 1.24; p=0.25; stage III/IV: RR, 0.82; 95% CI, 0.62 to 1.09; p=0.18). There was no significant difference in recurrence between the HSC and D&C groups (RR, 0.92; 95% CI, 0.66 to 1.32; p=0.66); the heterogeneity of the two included studies was acceptable (p=0.54, I2=0%). Preoperative HSC in patients with type II EC does not increase the risk for cancer cell dissemination within the peritoneal cavity. Preoperative HSC does not progress the FIGO staging in patients with type II EC and does not increase the risk of tumour recurrence. There is no reason to avoid HSC for the diagnosis of type II EC currently. However, type II tumours generally are less well differentiated and have poorer prognoses than type I tumours. More prospective and adequately powered trials are required to clarify whether preoperative HSC in patients with type II EC is safe.

Impact of molecular classification on recurrence risk in endometrial cancer patients with lymph node metastasis: multicenter retrospective study

ObjectiveTo assess the distribution of molecular classes and their impact on the risk of recurrence in endometrial cancer patients with lymph node metastasis at the time of primary surgery.MethodsEndometrial cancer...

2009 International Federation of Gynecology and Obstetrics (FIGO) stage IIIA endometrial cancer: oncologic outcomes based on involvement of adnexa, serosa, or both

ObjectiveTo assess clinicopathologic features and survival outcomes of patients with endometrial carcinoma involving adnexal, full-thickness serosal, or combined involvement.MethodsThis international, multi-institutional, retrospective study examined patients with 2009 International Federation of...

Yeni ‘Film’ veya ‘Sinema’ Tarihi: Sinema Tarihi Yazımında Yeni Gelişen İlkeler, Kuramlar ve Metodolojiler Üzerine Düşünceler

Film as an artefact has long been the subject of study by “film historians,” whether in terms of stylistic authenticity, genre specificity, or “high theory” analysis. Conversely, film history has been written as if films had no audiences (Biltereyst et al, 2012, p. 693). This kind of filmic-textual research tendency lies at the heart of the legacy of film studies discipline. In 1973, Jean Mitry proposed an ideal of film history as simultaneously, a history of its industry, its technologies, its systems of expression (or, more precisely, its systems of signification), and aesthetic structures, all bound together by the forces of the economic, psychosocial and cultural order (Maltby, 2006, p. 80). Humanities-based film studies were first re-conceptualized by the initiatives of International Federation of Film Archives (FIAF), during its 1974 and 1978 conferences. Drawing on the methodological stance of the French Annales school’s histoire totale, participants at the 1974 FIAF conference agreed on new historiographical methodologies for all rather than linear national cinema histories. In 1990, American historian Robert Sklar brought forward three types of “cinema historians” in which only second sub-type might be labeled as ‘film historian’ which has been emerged from one of the following disciplines: art history, philosophy, literary studies.

Peripartum Cesarean Hysterectomy for Placenta Percreta: A Retrospective Analysis of Cases With and Without Extrauterine Disease.

Objective The aim of this study was to compare maternal morbidity and prenatal characteristics in placenta percreta cases with extrauterine disease and those with disease confined to the uterus. Methods A retrospective analysis of prospectively collected data was done at a large tertiary referral center in Egypt from October 2018 through February 2023. A total number of 73 cases who underwent primary cesarean hysterectomy with intrapartum confirmation of placenta previa percreta where there was evidence of at least placental invasion through uterine serosa (International Federation of Gynecology and Obstetrics (FIGO) grade 3) were included. Women without extrauterine disease (FIGO grade 3a) were compared to women with extrauterine disease where there was evidence of invasion of the bladder, parametrium, or both (FIGO grades 3b and 3c). Results Of 73 women included in the study, 46 women showed no evidence of extrauterine disease (group A), while the remaining 27 women had extrauterine disease (group B). The estimated amount of blood loss (mL) was 1,972 ± 671 in group A compared with 3,544 ± 899 in group B. There were no cases requiring massive transfusion in group A compared with eight of 27 cases (29.6%) in group B. Only two cases (4.3%) in group A had bladder injuries compared with 12 cases (44.4%) in group B. All 27 cases in group B required additional measures to control ongoing pelvic bleeding after hysterectomy compared with none of the cases in group A. The operating time (minutes) was 184 ± 30 in group A compared with 254 ± 42 in group B. Only five cases (10.9 %) in group A required postoperative intensive care unit admission, compared with 13 cases (48.1%) in group B. Conclusion Placenta accreta spectrum (PAS) with extrauterine disease represents the ultimate level of PAS surgery as it is more difficult, complex, and associated with the highest maternal morbidity. Highly specialized PAS centers are advised to categorize the disease into two different entities: PAS with extrauterine disease and PAS with disease confined to the uterus, as this may aid in improving the diagnostic accuracy of the severest PAS cases.

Potential of the Arkhangelsk seismic network for European Arctic monitoring

The Arkhangelsk Seismic Network (ASN) of the N. Laverov Federal Center for Integrated Arctic Research of the Ural Branch of the Russian Academy of Sciences, founded in 2003, includes 10 permanent seismic stations located on the coasts of the White, Barents, and Kara Seas and on the Arctic archipelagos of Novaya Zemlya, Franz Josef Land, and Severnaya Zemlya. The network is registered with the International Federation of Digital Seismograph Networks and the International Seismological Center. We used not only ASN data to process earthquakes but also the waveforms of various international seismic stations. The 13,000 seismic events were registered using ASN data for 2012–2022, and for 5,500 of them, we determined the parameters of the earthquake epicenters from the European Arctic. The spatial distribution of epicenters shows that the ASN monitors not only the main seismically active zones but also weak seismicity on the shelf of the Barents and Kara Seas. The representative magnitude of ASN was ML, rep=3.5. The level of microseismic noise has seasonal variations that affect the registration capabilities of each station included in the ASN and the overall sensitivity of the network as a whole. In summer, the sensitivity of the ASN decreased owing to the increasing microseismic and ambient noises, whereas in winter, the sensitivity of the ASN increased significantly because of the decrease.

Artificial Intelligence Algorithms in Predictive Factors for Hematologic Toxicities During Concurrent Chemoradiation for Cervical Cancer.

The most recent research conducted for the International Federation of Gynecology and Obstetrics indicates that, depending on the stage of cervical cancer (CC), several therapies can provide similar overall survival and progression-free survival rates. To determine the hematologic toxicities during concurrent chemotherapy for cervical cancer, we evaluated these two therapies (cisplatin or carboplatin). Hematologic markers have been studied using statistical models and descriptive statistics. Artificial intelligence models were built using the treatment data and all the information gathered from each patient after one or more administrations to forecast the CC stage. The information was gathered from stage III cervical cancer patients and provided by Oncohelp Hospital from the West Region of Romania. Many traditional machine learning techniques, such as naïve Bayes (NB), random forest (RF), decision trees (DTs), and a trained transformer called TabPFN, were used in the current study to obtain the tabular data. The algorithms NB, RF, and DTs yielded the greatest classification score of 100% when it came to cervical cancer prediction. On the other hand, TabPFN demonstrated an accuracy of 88%. The effectiveness of the models was evaluated by computing the computational complexity of traditional machine learning methods. Early detection increases the likelihood of a good prognosis during the precancerous and malignant stages. Being aware of any indications and symptoms of cervical cancer can also help to prevent delays in diagnosis. These hematologic toxicities, which have been demonstrated to grow linearly with lowering hematologic markers below their normal expectations, would significantly impair patients' quality of life.

Oncologic outcomes based on lymphovascular space invasion in node-negative FIGO 2009 stage I endometrioid endometrial adenocarcinoma: a multicenter retrospective cohort study

BackgroundThe 2023 International Federation of Gynecology and Obstetrics (FIGO) staging system includes lymphovascular invasion quantification as a staging criterion for endometrioid endometrial carcinomas; no lymphovascular invasion and focal invasion (≤4...

International sports federations as de facto lawmakers: Queer-feminist explorations of the gendered power of sports law

Abstract This article analyses the law-making power of international sports federations, with a specific focus on their authority of shaping global norms on gender. It explores a variety of international sporting rules from feminist and queer perspectives. These include the ban of rainbow armbands at the 2022 FIFA (Men’s) World Cup, rules on the participation of transgender persons in rugby, gendered and racialized uniform regulations in sports, and the Semenya case concerning the sports participation of women with variations in sex characteristics The analysis asserts that despite being non-state actors, international sports federations are de facto international lawmakers that disseminate hegemonic gender norms reflecting cis-hetero-sexism and white body norms. However, analysing the Semenya case and the decision of the Chamber of the European Court of Human Rights in the case shows that the law-making power of international sports federations in shaping gender norms is not absolute but embedded in a transnational network of norms. The article concludes that subjecting international sports federations to a feminist, queer, and anti-racist legal analysis assists in understanding how hegemonic norms on gender circulate transnationally and enhances knowledge on how international law works in practice.

Factors Limiting Ostomy Reversal After Cytoreductive Surgery for Ovarian Cancer: A Retrospective Study.

To investigate the factors related to non-reversal of ostomy after cytoreductive surgery in ovarian cancer. In many women with ovarian cancer, transitory ostomies are performed to limit the consequences of anastomotic leak. Although intended to be temporary, a proportion of these ostomies might never be reversed. This was a retrospective study of patients with 2014 International Federation of Obstetrics and Gynecology stage IIB-IVB ovarian cancer requiring a transitory ostomy during primary or secondary cytoreductive surgery at the Bergonie Institute, France, and the University Hospital of Las Palmas, Spain, between January 2012 and December 2022. Rate of ostomy reversal, its timing (weeks) and postoperative complications were assessed. Multivariate logistic regression analysis was performed to identify limiting factors for ostomy reversal. During the study period, we reviewed data on 181 consecutive patients with ovarian cancer with transitory ostomy creation; 89 (49.2%) patients were not candidates for an ostomy reversal surgery because of disease progression (n=65), death (n=16), and patient's refusal of surgery (n=8). A total of 92 patients were candidates for reversal surgery and were therefore included in the final analysis. In total, 57 (62%) patients had their ostomy reversed. The mean time from ostomy creation to ostomy closure was 47.7 (standard deviation=33.1) weeks. Hartmann's procedure (leaving a rectal stump of 5-6 cm) was identified as an independent predictive factor for non-reversal of ostomy (odds ratio=6.42, 95% confidence interval=1.61-25.53; p=0.008). Complications after ostomy reversal occurred in 32 patients (34.8%). Hartmann's procedure is a limiting factor for ostomy reversal in patients with ovarian cancer. We recommend avoiding Hartmann's procedure during cytoreductive surgery, even after colorectal anastomotic leak.

Is infracolic omentectomy necessary for early-stage (FIGO I–II) borderline ovarian tumors? A protocol for systematic review and meta-analysis

Background: Borderline ovarian tumors (BOTs) are reported to account for 10%–20% of all ovarian tumors. Guidelines for the surgical management of BOTs include hysterectomy with bilateral salpingo-oophorectomy, peritoneal washings, omentectomy, and multiple peritoneal biopsies. However, when omentectomy is recommended, it is unclear whether removal of a normal-appearing omentum has a therapeutic benefit. Methods: We will search the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL), the latest issue in the Cochrane Library, PubMed, EMBASE, LILACS, SCOPUS, Web of Science and Grey literature. Randomized controlled trials (RCTs) and non-randomized studies will be included if the patients are adults (≥18 years) with BOTs in stages I–II according to International Federation of Gynaecology and Obstetrics (FIGO). The methodological assessment will be carried out by two reviewers independently of each other using Cochrane risk-of-bias tool for randomized controlled trials (RoB 2), and the risk of bias in non-randomized studies (ROBINS-I) tool for non-randomized. The search strategy is constructed using the Boolean operators “OR” and “AND,” thorough search, a combination of medical subject heading and free-text terms will be employed. The Review Manager 5.4 will be used for the meta-analysis. For time‐to‐event data, we will use the hazard ratio with a 95% confidence interval (CI). For dichotomous outcomes, we will be used to calculate the risk ratio with a 95% CI. Continuous outcomes will be presented as the weighted mean difference or standardized mean difference with 95% CI. Results: This review will evaluate the effects of non-infracolic omentectomy on overall survival, progression-free survival, quality of life, recurrence index and adverse events in patients with BOTs. Conclusion: Our results will provide clear evidence to determine whether non-infracolic omentectomy is an effective and safe intervention for early stage (FIGO I–II) BOTs, thus benefiting patients, practitioners, and policy makers.

The Predictive Value of the Fibrinogen-Albumin-Ratio Index on Surgical Outcomes in Patients with Advanced High-Grade Serous Ovarian Cancer.

The present study evaluates predictive implications of the pretherapeutic Fibrinogen-Albumin-Ratio Index (FARI) in high-grade serous ovarian cancer (HGSOC) patients undergoing primary cytoreductive surgery. This retrospective study included 161 patients with HGSOC International Federation of Gynecology and Obstetrics (FIGO) stage ≥ IIb, who underwent primary cytoreductive surgery followed by platinum-based chemotherapy. Associations between the FARI and complete tumor resection status were described by receiver operating characteristics, and binary logistic regression models were fitted. Higher preoperative FARI values correlated with higher ascites volumes (r = 0.371, p < 0.001), and higher CA125 levels (r = 0.271, p = 0.001). A high FARI cut at its median (≥11.06) was associated with lower rates of complete tumor resection (OR 3.13, 95% CI [1.63-6.05], p = 0.001), and retrained its predictive value in a multivariable model independent of ascites volumes, CA125 levels, FIGO stage, and Charlson Comorbidity Index (CCI). The FARI appears to act as a surrogate for higher intra-abdominal tumor load. After clinical validation, FARI could serve as a readily available serologic biomarker to complement preoperative patient assessment, helping to identify patients who are likely to achieve complete tumor resection during primary cytoreductive surgery.