The IX t h Makassed Medical Congress - American University of Beirut

More documents

Recommendations

Info

T h e I X t h M a k a s e d M e d i c a l C o n g r e s s Another important change in the management of endometrial cancer is the increasing use of chemotherapy. The efficacy of chemotherapy in this disease was supported by a large prospective study that showed that systemic chemotherapy was superior to abdominal radiation therapy in patients with advanced stage disease. In addition, over half of the recurrences in early stage disease include sites outside the pelvis, a fact that support the need for a systemic treatment. References 1. World Cancer Report. International Agency for Research on Cancer Press. Edited by BW Stewart and P Kleihues 2003 2. Bokhman JV. Two pathogenetic types of endometrial carcinoma. Gynecol Oncol 1983; 15(1):10-17. 3. Creasman WT, Morrow CP, Bundy BN, et al. Surgical pathologic spread patterns of endometrial cancer. Cancer 1987; 60(8 Suppl):2035-41 4. Morrow CP, Bundy BN, Kurman RJ, et al. Relationship between surgical-pathological risk factors and outcome in clinical stage I and II carcinoma of the endometrium: a Gynecologic Oncology Group study. Gynecol Oncol 1991; 40(1):55-65 5. Scholten AN, van Putten WLJ, Beerman H, et al. Postoperative radiotherapy for Stage I endometrial cancer: long-term outcome of the randomized PORTEC trial with central pathology review. Int J Radiation Oncology Biol Phys 2005; 63(3):834-838 6. Keys HM, Roberts JA, Brunetto VL, et al. A phase III trial of surgery with or without adjunctive external pelvic radiation therapy in intermediated risk endometrial cancer: A Gynecologic Oncology Group study. Gynecol Oncol 2004; 92:744-751 7. ASTEC. Adjuvant external beam radiotherapy in the treatment of endometrial cancer (MRC ASTEC and NCIC CTG EN.5 randomized trials): pooled trial results, systematic review and meta-analysis. Lancet 2009; 373:137-146 8. Randall ME, Filiaci VL, Muss H, et al. Randomized phase III trial of whole-abdominal irradiation versus doxorubicin and cisplatin chemotherapy in advanced endometrial carcinoma: a Gynecologic Oncology Group Study. J Clin Oncol. 2006;24(1):36-44. THE ROLE OF AGGRESSIVE SURGERY IN THE MANAGEMENT OF EPITHELIAL OVARIAN CANCER (EOC) Muhieddine Seoud, MD FACOG, FACS Nearly every retrospective and prospective study has confirmed that the extent of cytoreductive surgery and the amount of residual disease are among the most important factors impacting the survival of women with advanced ovarian cancer. Role of primary surgery: Large metanalyses have clearly demonstrated that the PFS and OS are proportional to the extent of the surgical surgical effort, and so with each 10% increase in the 100
proportion of patients in each cohort undergoing maximal interval cytoreductive surgery was associated with a 1.9 month increase in median survival time (95%CI=0.23 months–3.50 months, p=0.027). However, few centers around the world have adopted a more aggressive surgical approach to patients with extensive ovarian carcinomatosis, which include extensive upper abdominal surgeries. Until recently, however, no prospective RCT confirming the widely held belief that aggressive cytoreductive surgery should be the 1st step in the treatment. Role of interval debulking: In an effort to increase the proportion of patients with advanced ovarian cancer that are ultimately left with an optimal volume of residual disease, the concept of interval cytoreduction has evolved into the treatment approach now referred to as neoadjuvant chemotherapy in which the initial attempt at cytoreduction is abandoned in favor of chemotherapy in order to reduce the extent of disease or improve patient performance A recent prospective European trial has confirmed that surgery performed following neoadjuvant chemotherapy is routinely shorter in time, associated with a better nutritional state preoperatively, less blood loss, shorter intensive care unit stays, shorter hospitalizations, reduced risk of peri-operative morbidity, and a higher rate of optimal resection. More importantly survival was not compromised. The role of surgery in recurrent disease: In properly selected patients, secondary aggressive debulking has a major impact on PFS similar, but to a lesser extent than in the primary setting. During this presentation, we will present convincing data on the role of aggressive surgery, including upper abdominal surgery, in the management of primary and recurrent ovarian cancer. TWIN PREGNANCIES FRENCH 2009 GUIDELINES Philippe Deruelle, MD Development of new technologies and dissemination of new scientific information and incorporation of research findings into practice are major challenges to health professionals. Twin pregnancies are a high risk group which needs more intensive care than singleton. However, in France, the management may be widely different between centers and countries leading to inappropriate or usefulness practices. Therefore in December 2099, the “College National des Gynécologues Obstétriciens Français” coordinated a National Consensus Conference in order to define, based upon the best evidence available, the standard care of twin gestation. The purpose of this guideline is to describe and, if possible, quantify the problems associated with twin management and to identify the best evidence to guide clinical care. Methods: fourteen questions were identified including epidemiology of twins, ultrasound diagnosis of chorionicity, screening for aneuploidies, management of monoamniotic, monochorionic diamniotic and dichorionic twin pregancies, prevention of spontaneous preterm birth, delivery and social and economic aspects of twin gestation. The MEDLINE database, the EMBASE database, the Cochrane Library, and the Guidelines published by foreign organizations or institutions such as Royal College of obstetrics and Gynaecology, American College of Obstetricians and Gynecologists, were used to conduct a literature search to locate relevant articles published. Additional studies were located by reviewing bibliographies of identified articles. The quality of evidence was evaluated and recommendations were made according to guidelines for assessing medical literature published by “Haute Autorité de la Santé”. 101
Page 1 and 2:
The IX th Makassed Medical Congress
Page 3 and 4:
CONGRESS PRESIDENT Said Sayegh, MD,
Page 5 and 6:
GENERAL INFORMATION
Page 7 and 8:
• Target Audience: Physicians, Pr
Page 9 and 10:
Durriya Sinno, MD Pediatrics Americ
Page 11 and 12:
Moderators
Page 13 and 14:
PEDIATRICS Bassem Abou Merhi, MD Pe
Page 15 and 16:
Maroun Sokhn, MD Pediatrics Saint G
Page 17 and 18:
Scientific Program
Page 19 and 20:
Session 3: Intensive Care Neonatolo
Page 21 and 22:
Session 1: Pediatric Intensive Care
Page 23 and 24:
8:00 - 8:05 08:05 - 08:10 Welcome r
Page 25 and 26:
Cardiology Session III: Interventio
Page 27 and 28:
Cardiology Session VI: Intervention
Page 29:
Cardiology Symposia (NON-CME) Frida
Page 32 and 33:
T h e I X t h M a k a s e d M e d i
Page 34 and 35:
Page 36 and 37:
Page 38 and 39:
Page 40 and 41:
Page 42 and 43:
Page 44 and 45:
Page 46 and 47:
Page 48 and 49:
Page 50 and 51: T h e I X t h M a k a s e d M e d i
show all

The IX t h Makassed Medical Congress - American University of Beirut

Create successful ePaper yourself

Delete template?

Save as template?