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Original Research

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Robotic radical trachelectomy with sentinel lymph node mapping using ICG in early cervical cancer – a brief report

  • T. Avnon1
  • L. Gortzak-Uzan1
  • L. Ostrovsky1
  • N. Michaan1
  • Y. Raz1
  • D. Grisaru1,*,

1Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, Tel-Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel

DOI: 10.12892/ejgo4198.2018 Vol.39,Issue 6,December 2018 pp.881-883

Published: 15 December 2018

*Corresponding Author(s): D. Grisaru E-mail: grisaro@post.tau.ac.ac.il

Abstract

Diabetes and tumour diseases are serious health problems in the elderly population. Several studies have suggested that patients with diabetes are at significantly higher risk of cancer. On the other hand, epidemiologic evidence suggests that some drugs used to treat hyperglycemia are associated with reduced risk of cancer. Metformin, the drug applied in type 2 diabetes, has been shown to reduce incidence and mortality due to malignant tumours in various localities. A hypothesis is presented which seeks to explain the anticancer effects of metformin. Empirical data from the scientific literature is used to support the hypothesis that metformin restricts the growth of human cancer stem cells (CSCs). The LKB1/AMPK (liver kinase B1/AMP activated protein kinase) mechanism of the antineoplastic action is pleiotropic, involving the activation of the LKB1/AMP pathway, which inhibits mTOR signalling, inhibits STAT-3 phosphorylation, arrests cell cycle at the G1 phase, inhibits cyclin D1 activity, reduces insulin levels, as well as IGF-1, TNFα, and IL-6 levels which reduce proliferation leading to apoptosis of neoplastic cells. In various tumours, including gynaecological cancers, metformin eliminates cancer stem cells (CSCs). Repositioning metformin as a possible antineoplastic option seems promising. The present authors suggest here that metformin could be a valuable tool for clinicians to help reduce cancer risk in elderly adults with diabetes.

Keywords

Fertility preservation; ICG; Radical trachelectomy; Robotic laparoscopy; Sentinel lymph node.

Cite and Share

T. Avnon,L. Gortzak-Uzan,L. Ostrovsky,N. Michaan,Y. Raz,D. Grisaru. Robotic radical trachelectomy with sentinel lymph node mapping using ICG in early cervical cancer – a brief report. European Journal of Gynaecological Oncology. 2018. 39(6);881-883.

References

[1] Globacan 2012: “Cervical cancer incidence and mortality worldwide in 2012 summary. Cancer fact sheet. Available at: http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx.

[2] Dargent D., Burn J., Roy M.: “Pregnancies following radical trachelectomy for invasive cervical cancer”. Gynecol. Oncol., 1994, 52, 105

[3] Gizzo S., Ancona E., Saccardi C., Patrelli T.S., Berretta R., Anis O., et al.: “Radical trachelectomy: the first step of fertility preservation in young women with cervical cancer (Review)”. Oncol. Rep., 2013, 30, 2545.

[4] Burnett A.F., Stone P.J., Duckworth L.A., Roman J.J.: “Robotic radical trachelectomy for preservation of fertility in early cervical cancer: case series and description of technique”. J. Minim. Invasive Gynecol., 2009, 16, 569.

[5] Bentivegna E., Maulard A., Pautier P., Chargari C., Gouy S., Morice P.: “Fertility results and pregnancy outcomes after conservative treatment of cervical cancer: a systematic review of the literature”. Fertil. Steril., 2016, 106, 1195.e5

[6] Ma L.K., Cao D.Y., Yang J.X., Liu J.T., Shen K., Lang J.H.: “Pregnancy outcome and obstetric management after vaginal radical trachelectomy”. Eur. Rev. Med. Pharmacol Sci., 2014, 18, 3019.

[7] Johansen G., Lönnerfors C., Falconer H., Persson J.: “Reproductive and oncologic outcome following robot-assited laparoscopic radical trachelectomy for early stage cervical cancer”. Gynecol. Oncol., 2016, 141, 160.

[8] Ramirez P.T., Schmeler K.M., Malpica A., Soliman P.T.: “Safety and feasibility of robotic radical trachelectomy in patients with earlystage cervical cancer”. Gynecol. Oncol., 2010, 116, 512.

[9] Koh W.J., Greer B.E., Abu-Rustum N.R., Apte S.M., Campos S.M., Cho K.R., et al.: “Cervical Cancer, Version 2.2015”. J. Natl. Compr. Canc. Netw., 2015, 13, 395.

[10] Buda A., Papadia A., Zapardiel I., Vizza E., Ghezzi F., De Ponti E., et al.: “From Conventional Radiotracer Tc-99m with Blue Dye to Indocyanine Green Fluorescence: A Comparison of Methods Towards Optimization of Sentinel Lymph Node Mapping in Early Stage Cervical Cancer for a Laparoscopic Approach”. Ann. Surg. Oncol., 2016, 23, 2959

[11] How J., Gotlieb W.H., Press J.Z., Abitbol J., Pelmus M., Ferenczy A., et al.: “Comparing indocyanine green, technetium, and blue dye for sentinel lymph node mapping in endometrial cancer”. Gynecol. Oncol., 2015, 137, 436.

[12] Lécuru F., Mathevet P., Querleu D., Leblanc E., Morice P., Daraï E., et al.: “Bilateral negative sentinel nodes accurately predict absence of lymph node metastasis in early cervical cancer: results of the SENTICOL study”. J. Clin. Oncol., 2011, 29, 1686.

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