Aureli Torné

• MD, PhD
• Hospital Clínic de Barcelona

To evaluate and compare treatment patterns and related resource use and costs in women with abnormal cervical smears in five countries. Data from patient charts were collected for a minimum of 24 months, starting from the first recorded abnormal cervical smear. Costs, from the public health perspective, were calculated based on country-specific uni...

Background: Patients with cervical cancer treatment experience an impairment of sexual function and quality of life. This issue is usually underreported and undertreated, and evidence-based interventions are lacking. Prevention of sexual dysfunction is a crucial pillar in improving the quality of life of these patients. The primary objective of th...

Background Female recipients of allogeneic hematopoietic stem cell transplantation are at high risk of developing human papillomavirus (HPV)-associated lesions and (pre)cancer. We describe the results of a cervical cancer screening program in these women. Methods From 2010 to 2022, 70 female recipients of allogeneic hematopoietic stem cell transpl...

Objective Endocervical curettage (ECC) is the gold standard for predicting the persistence of high-grade squamous intraepithelial lesions (HSIL) after cervical conization. However, ECC has a high rate of unsatisfactory samples and may be uncomfortable for women. Endocervical sampling with brush (ECB) has been proposed as an alternative to ECC, whic...

Objective Prehabilitation, defined as the preparatory intervention to increase patient preparedness in the lead-up to surgery, has shown a decrease in post-operative complications in various types of surgery. However, there is limited evidence in advanced ovarian cancer surgery. This study aimed to evaluate the benefits of multimodal prehabilitatio...

Objectives: To assess the long-term oncological safety of laparoscopic fertility-sparing surgery (FSS) in borderline ovarian tumors and the impact of laparoscopic surgical factors on recurrences. Primary outcomes were the recurrence rate and time to recurrence after laparoscopic FSS. Secondary outcomes were to evaluate the recurrence rate after a s...

Background: This study evaluated the clinical outcomes of applying a 68 Gy EQD2(α/β=3) dose constraint to the most exposed 2 cm³ area of the vagina in post-operative endometrial cancer patients treated with vaginal-cuff brachytherapy after external beam irradiation and the impact of vaginal dilator use on late vaginal complications. Material and me...

Primary fallopian tube carcinoma (PFTC) is seldom diagnosed preoperatively and is often mistaken for epithelial ovarian carcinoma (EOC). This report details a case of primary high-grade serous carcinoma (HGSC) of the fallopian tube, highlighting radiological and clinical indicators to aid in accurate diagnosis and avoid misdiagnosis. A 46-year-old...

Introduction/Background The aim of this study was to analyse the clinical applicability of 2-[18F]FDG PET/CT volumetric parameters to anticipate surgical peritoneal cancer index (PCI), by studying their correlation in advanced high-grade serous or undifferentiated epithelial ovarian cancer (EOC) patients before primary treatment. The secondary aim...

Introduction/Background There is limited evidence regarding the improvement in functional capacity, nutritional status, and psychological well-being through prehabilitation programs prior to advanced ovarian cancer (AOC) surgery. This study aimed to evaluate the effects of a multimodal prehabilitation in AOC patients in terms of improving physical,...

Introduction/Background Patients with cervical cancer treatment experience a deterioration of sexual function, which negatively affects their quality of life. Prevention of sexual dysfunction is an essential pillar in improving the quality of life of these patients.The aim of this trial is to assess the impact on sexual function and self-perceived...

Introduction/Background Surgery is considered the mainstay of treatment in early stages of vulvar cancer and in association with radio-chemotherapy for advanced disease. Despite surgical treatment provides good local control of the disease, it often entails significant functional and anatomical impairment, affecting sexual function, body image perc...

Introduction/Background There is limited information on the mutational landscape of vulvar squamous cell carcinoma (VSCC) and the mutational patterns of its main ethio-pathogenic types: human papillomavirus-associated VSCC (HPV-associated), HPV-independent VSCC with TP53 mutation (HPV-independent/TP53mut) and HPV-independent VSCC with wild-type TP5...

Introduction/Background The removal of substantial vulvar tumors often requires radical vulvectomy, resulting in extensive defects of vulvar tissue. Flap reconstruction is performed to prevent tension in the surgical wound. Postoperative complications (20–60%) such as dehiscence, infection, necrosis and reintervention are frequent.There are expensi...

Introduction/Background Sentinel lymph node (SLN) detection in early-stage epithelial ovarian cancer (EOC) has been investigated in various trials, showing disparities in detection outcomes. Evidence suggests that using a combination of two tracers (radiotracer and indocyanine green (ICG)) yields enhanced results compared to using a single tracer....

Introduction/Background To investigate the molecular classification of endometrial carcinoma (EC) and atypical endometrial hyperplasia (AEH) treated with fertility-sparing therapy, and to determine its relationship to oncologic and reproductive outcome. Methodology Patients who received fertility-sparing therapy and molecular classification tested...

Introduction/Background Multiple studies have shown the accuracy and feasibility of sentinel lymph node (SLN) biopsy in early-stage disease. However, there is no prospective evidence on long-term oncological safety yet. We report the results from our center comparing the SLN alone with SLN and PLD. Methodology Women who underwent radical surgery f...

Purpose The recently introduced tethered DROP-IN gamma probe has revolutionized the way robotic radioguided surgery is performed, fully exploiting the nature of steerable robotic instruments. Given this success, the current first-in-human study investigates if the DROP-IN can also provide benefit in combination with steerable non-robotic instrument...

Purpose: To compare two vaginal brachytherapy (VBT) schedules in postoperative endometrial carcinoma (PEC) patients considering vaginal-cuff relapses (VCR), late toxicities, dosimetry analysis and vaginal dilator use. Material and methods:110 PEC patients were treated with exclusive high-dose-rate VBT using two schedules. Group-1:44-patients receiv...

Introduction/Background Patients with advanced ovarian cancer (AOC) diagnosis will often undergo bowel resection when primary or interval debulking surgery is performed. Properly identifying these cases is crucial to establish an accurate operative strategy and to proportionate precise information to patients, since intestinal surgery implies highe...

Introduction/Background Systematic pelvic and para-aortic lymphadenectomy is part of the staging surgery in early-stage ovarian cancer (EOC) to determine the prognosis and indicate adjuvant treatment. However, this procedure is associated with potential severe morbidity. The Mapping Sentinel Lymph Node In early-Stage Ovarian Cancer (MELISA) trial a...

Background A systematic pelvic and para-aortic lymphadenectomy remains the surgical standard management of early-stage epithelial ovarian cancer. Sentinel lymph node mapping is being investigated as an alternative procedure; however, data reporting sentinel lymph node performance are heterogeneous and limited. Objective A systematic pelvic and par...

Purpose Analyse the impact of different prognostic factors on G2-late vaginal complications after vaginal brachytherapy (VBT) ± external beam radiotherapy (EBRT) in postoperative endometrial cancer (PEC). Methods One hundred and twenty-six PEC patients treated with VBT ± EBRT were retrospectively analysed considering age, body mass index, applicato...

Introduction: Based on their etiological relationship with human papillomavirus (HPV), the 2020 WHO classification has divided vulvar squamous cell carcinomas (VSCC) into two distinct types, HPV-associated and HPV-independent, and HPV-independent tumours have recently been divided according to p53 status. Nevertheless, the clinical and prognostic...

Women with high-grade squamous intraepithelial lesions/cervical intraepithelial neoplasia (HSIL/CIN) are at high risk of anal human papillomavirus HPV infection, and it has also been suggested that self-inoculation of the virus from the anal canal to the cervix could explain HPV recurrence in the cervix after treatment of HSIL/CIN. We aimed to eval...

Aims: Each category of vulvar squamous cell carcinoma (VSCC), human papillomavirus (HPV)-associated and HPV-independent, arises on a specific intraepithelial precursor: high-grade squamous intraepithelial lesions (HSIL) and differentiated vulvar intraepithelial neoplasia (dVIN), respectively. However, a subset of HPV-independent VSCC arises on an...

Background: Salvage surgery is considered an option for isolated recurrences of retroperitoneal and pelvic tumors, in patients who have undergone previous radiotherapy. In order to increase local control intra operative electron radiation therapy (IOERT) can be used in these patients to administer additional radiation dose. We evaluated the outcom...

Background: Multimodal prehabilitation programs that combine exercise training, nutritional support, and optimize psychological status have demonstrated efficacy in reducing post-operative complications in non-gynecological abdominal surgeries; however, the benefit in advanced ovarian cancer is unclear. Primary objective: To compare the post-ope...

Objective: Fertility-sparing surgery (FSS) is the treatment of choice for patients with early cervical cancer (ECC) and fertility desire, but survival rates compared to radical hysterectomy (RH) have been scarcely reported. The aim of this study was to analyse the oncological outcomes of FSS compared to a balanced group of standard RH. Methods: A r...

Several questions regarding the role of vaccination in women treated for high-grade cervical intraepithelial lesion (HSIL) have not been clarified. One of the main queries is whether the time at which the vaccine is administered (before or after treatment) influences the protection against post-treatment HSIL. A second unanswered question is whethe...

Background: The aim of this study was to analyze the impact of tumor size > 2 cm on oncological outcomes of fertility-sparing surgery (FSS) in early cervical cancer in a Spanish cohort. Methods: A multicenter, retrospective cohort study of early cervical cancer (stage IA1 with lymphovascular space invasion -IB1 (FIGO 2009)) patients with gestati...

Background: Few studies have evaluated laparoscopic pelvic lymph node (PLN) debulking during staging aortic lymphadenectomy in locally advanced cervical cancer (LACC). It allows us to know the lymph node status and facilitates the action of chemoradiotherapy (CRT) by reducing tumor burden. We evaluated its feasibility and compared the perioperativ...

Introduction: Treatment for advanced ovarian cancer (AOC) comprises cytoreductive surgery combined with chemotherapy. Multimodal prehabilitation programmes before surgery have demonstrated efficacy in postoperative outcomes in non-gynaecological surgeries. However, the viability and effects of these programmes on patients with AOC are unknown. We...

(1) OBJECTIVE: To assess the performance of CA125, HE4, ROMA index and CPH-I index to preoperatively identify epithelial ovarian cancer (EOC) or metastatic cancer in the ovary (MCO). (2) METHODS: single center retrospective study, including women with a diagnosis of adnexal mass. We obtained the AUC, sensitivity, specificity and predictive values w...

Purpose Indocyanine green (ICG) is frequently used for the detection of the sentinel lymph node (SLN) in gynecology, but it carries the loss of the presurgical SLN mapping provided by [ 99m Tc]-based colloids. Hybrid tracers such as ICG-[ 99m Tc]Tc-albumin nanocolloid combine the benefits of both components. The aim of this study was to evaluate th...

Objectives: Accurate assessment of disease extent is required to select the best primary treatment for advanced epithelial ovarian cancer patients. Estimation of tumour burden is challenging and it is usually performed by means of a surgical procedure. Imaging techniques and tumour markers can help to estimate tumour burden non-invasively. 2-[18F]...

Objective: To evaluate whether E7 mRNA can predict the risk of progression in women with HPV16 infection. Design: A prospective observational study. Setting: A tertiary university hospital. Population: A cohort of 139 women referred to colposcopy for an abnormal screening result fulfilling the following inclusion criteria: (1) a positive test resul...

Purpose: Indocyanine green (ICG) is frequently used for the detection of the sentinel lymph node (SLN) in gynecology, but it carries the loss of the presurgical SLN mapping provided by [99mTc]-based colloids. Hybrid tracers such as ICG-[99mTc] Tc-albumin nanocolloid combine the benefits of both components. The aim of this study was to evaluate the...

Purpose The feasibility and effects of multimodal prehabilitation in patients with advanced ovarian cancer (AOC) undergoing a cytoreductive surgery are unknown. We aimed to evaluate the feasibility of a multimodal prehabilitation program in patients with AOC and its impact on postoperative outcomes. Methods We prospectively compared 15 patients wit...

Study objective: To evaluate laparoscopic pelvic lymph node debulking during extraperitoneal aortic lymphadenectomy in diagnosis, therapeutic planning and prognosis of patients with locally advanced cervical cancer and enlarged lymph nodes on imaging prior to chemoradiotherapy. Design: Retrospective, multicenter, comparative cohort study. Setti...

Vulvar squamous cell carcinoma (VSCC) is a rare malignancy with dual pathogenesis, Human papillomavirus (HPV)-associated and HPV-independent, with a poorly explored molecular landscape. We aimed to summarize the findings of the series analyzing molecular hallmarks of this neoplasm. In January 2021, we conducted a comprehensive literature search usi...

Objective To evaluate the clinical value of postreatment plasmatic levels of the squamous cell carcinoma antigen (SCC-Ag) as a survival independent prognostic factor in patients with LACC. Methods Retrospective, multicenter study including LACC patients (FIGO 2009 stages IB2, IIA2-IVA) managed at the Gynecology Oncological Units corresponding to e...

Background: To prospectively assess LLL incidence among cervical cancer patients treated by uterine surgery complemented by SLN biopsy, without PLND. Methods: A prospective study in 150 patients with stage IA1-IB2 cervical cancer treated by uterine surgery with bilateral SLN biopsy. Objective LLL assessments, based on limb volume increase (LVI)...

Objective: To evaluate whether E7 mRNA can predict the risk of progression in women with HPV16 infection. Design: prospective observational study Setting: Tertiary university hospital Population: A cohort of 139 women referred to colposcopy for an abnormal screening result fulfilling the following inclusion criteria: 1) a positive test result confi...

Objective: We aimed to evaluate the accuracy of sentinel lymph node (SLN) mapping with transvaginal ultrasound-guided myometrial injection of radiotracer (TUMIR) to detect lymph node (LN) metastases, in patients with intermediate and high-risk endometrial cancer (EC), focusing on its performance to detect paraaortic involvement. Methods: Prospec...

Malacoplakia is an uncommon chronic granulomatous inflammation that rarely affects the female genital tract. A case of a 78-year-old woman with malacoplakia involving the uterine cervix and the vagina is described. The patient complained of vaginal bleeding. Clinically, a 13-mm mass was detected in the cervix, which was confirmed by ultrasound scan...

Recently published guidelines stratify the risk of high-grade squamous intraepithelial lesion/grade 3 cervical intraepithelial neoplasia (HSIL/CIN3) based on hrHPV detection and Pap smear results. However, colposcopic impression could also provide valuable information for risk estimation. We aimed to analyze the value of adding colposcopic impressi...

Objective Despite radical surgery and chemotherapy, most patients with ovarian cancer die due to disease progression. M-Trap is an implantable medical device designed to capture peritoneal disseminated tumor cells with the aim to focalize the disease. This trial analyzed the safety and performance of the device. Methods This first-in-human prospec...

Background: Recent evidence indicates that some minimally invasive surgery approaches, such as laparoscopic and robotic-assisted radical hysterectomy, offer lower survival rates to patients with early-stage cervical cancer than open radical hysterectomy. We evaluated the oncological results of a different minimally invasive surgery approach, that...

Introduction/Background Among patients with adnexal masses, preoperative identification of epithelial ovarian cancer (EOC) or metastatic cancer in the ovary (MCO) is essential for surgical planning. Our aim was to assess the performance of CA125, HE4, and the probability models, Risk of Ovarian Malignancy Algorithm (ROMA) and Copenhagen Index (CPH-...

Introduction/Background In patients with early-stage, grade 1–2, endometrioid endometrial cancer, preoperative assessment of myometrial invasion is essential to define the need of pelvic and paraaortic lymph node dissection. Our aim was to evaluate the role of three-dimensional transvaginal ultrasound (3D-TVUS) and diffusion-weighted magnetic reson...

Introduction/Background Recent evidence indicates that some minimally invasive surgery (MIS) approaches, such as laparoscopic- and robotic-assisted radical hysterectomy, offer lower survival rates to patients with early-stage cervical cancer compared with open radical hysterectomy. We evaluated the oncological results of a different MIS approach, t...

Introduction/Background The aim of this study was to analyze fertility sparing surgery (FSS) data in Spain and to evaluate its oncological results in patients with early cervical cancer (CC). Methodology Retrospective, multicenter, comparative cohort study carried out in 13 Spanish referal hospitals between 2000 and 2018, which included women with...

Introduction/Background Sentinel lymph node (SLN) detection in patients with endometrial cancer (EC) is usually performed with a [99mTc] Tc-albumin nanocolloid radiotracer (RTs). The transvaginal ultrasound-guided myometrial injection of radiotracer, unlike cervical injection, is more representative of tumor’s drainage and obtains a higher percenta...

Human papillomavirus (HPV)-independent vulvar squamous cell carcinomas (VSCC) and its precursors frequently harbour TP53 mutations. Recently, six p53 immunohistochemical (IHC) patterns have been defined, which have shown strong correlation with TP53 mutation status. However, few studies have applied this new six-pattern framework and none of them e...

Background: To evaluate whether EQD2(α/β = 3Gy) at 2 cm3 of the most exposed area of the vagina is related to late vaginal toxicity in postoperative endometrial cancer (PEC) patients (p) treated with exclusive brachytherapy (BT). Methods: From 2014 to 2017, 43p were included in this study. BT was administered: 3-fractions of 6Gy in 37p and 2-fracti...

Background Lymph node (LN) metastases are the most important prognostic factor in locally advanced cervical cancer. Paraaortic lymphadenectomy is the only method able to confirm the presence of metastasis and thereby help to determine the most adequate treatment approach. There is no standard regarding the minimal number of LNs that should be remov...

Purpose: To determine whether brachytherapy with a single hypofractionated dose of 7 Gy provides the similar vaginal-cuff relapses and safety profile in terms of complications compared to schedules of 2 or 3 fractions of lower doses in patients treated previously with external beam irradiation in postoperative endometrial carcinoma. Methods/mater...

Background: Recent studies have shown preliminary evidence that vaccination against human papillomavirus (HPV) could decrease the risk of persistent/recurrent HSIL in women treated for high-grade cervical intraepithelial lesion (HSIL). We aimed to determine the benefits of HPV vaccination in patients undergoing conization for HSIL in real-life cond...

Objective The aim of this study was to evaluate the oncological outcomes of vaginal fertility-sparing surgery plus laparoscopic sentinel lymph node biopsy in patients with early cervical cancer over a 15-years period. Patients and Methods From March 2005 to April 2018, 38 patients diagnosed with early stage cervical cancer underwent vaginal fertil...

Objective Paraaortic lymph node involvement is an important prognostic factor in locally advanced cervical cancer (LACC), but the anatomic limit of aortic lymphadenectomy is controversial. We assessed the impact of extraperitoneal paraaortic lymphadenectomy up to the left renal vein in patients with LACC undergoing pretherapeutic staging. Methods...

PurposeTo assess the impact of laparoscopic extraperitoneal paraaortic staging in therapeutic planning and prognosis of patients with locally advanced cervical cancer (LACC) as compared with imaging staging.Methods Retrospective multicenter study of stage IB2 and IIA2 to IVA (FIGO 2009) LACC patients who were candidates for primary chemoradiotherap...

Background: In endometrial cancer (EC), sentinel lymph node (SLN) mapping has emerged as an alternative to systematic lymphadenectomy. Little is known about factors that might influence SLN preoperative detection. The aim of our study is to evaluate the clinical and technical variables that may influence on the success of SLN detection in preopera...

The decision to treat a cervical squamous intraepithelial lesion (SIL) by loop electrosurgical excision procedure (LEEP) relies heavily on a colposcopy-directed biopsy showing high-grade (H)SIL. Diagnosis is often supported by p16, an immunohistochemical (IHC) biomarker of high-risk (hr)HPV E7 gene activity. Additional potential markers include met...

Purpose: The purpose of this study was to analyze the direct economic impact of two vaginal cuff brachytherapy (VBT) schedules in postoperative endometrial carcinoma (PEC) with similar vaginal control and toxicity results. Materials and methods: From 2006 to 2015, 397 PEC patients (p) were treated with VBT: mean 40p/year, 67.5% received external...

Background: Lymph node (LN) metastases are the most important prognostic factor in locally advanced cervical cancer. Paraaortic lymphadenectomy is the only method able to confirm the presence of metastasis and thereby help to determine the most adequate treatment approach. There is no standard regarding the minimal number of LNs that should be rem...

PURPOSE: The purpose of this study was to analyze the direct economic impact of two vaginal cuff brachytherapy (VBT) schedules in postoperative endometrial carcinoma (PEC) with similar vaginal control and toxicity results. MATERIALS AND METHODS: From 2006 to 2015, 397 PEC patients (p) were treated with VBT: mean 40p/year, 67.5% received external be...

There is growing interest in anal cancer screening strategies. However, cytological/molecular evaluation of anal samples is challenging. We aimed to determine the feasibility of detecting, in anal liquid-based cytologies, the expression of biomarkers involved in the cell cycle disturbance elicited by human papillomavirus (HPV). The accuracy of this...

Introduction/Background It has been suggested that the evaluation of the expression of host-cell genes involved in cervical carcinogenesis induced by high-risk human papillomavirus (HR-HPV) may be useful to identify patients harbouring high-grade squamous intraepithelial lesions (HSIL). We aimed to evaluate the performance of mRNA detection of thre...

Antecedents Perivascular epitheliod cell tumor (PEComa) is a rare mesenchymal tumor. They are rare in the field of gynecology, which makes them difficult to consider as a possible diagnostic. We aim to contribute with our experience to ease clinical practice to others gynecologists. Patients and methods We contribute to literature with three gynec...

Background Allogenic hematopoietic stem cell transplantation (allo‐HSCT) is a common procedure in hematological disorders and is preceded by a conditioning regimen that usually includes busulfan. The immunosuppression caused by the conditioning regimen and graft‐versus‐host disease prophylaxis is associated with human papillomavirus (HPV) persisten...

Human papillomaviruses (HPV) are the causative agents of virtually all cervical carcinomas. Nevertheless, a small proportion of cervical cancer are negative for HPV, although the significance of this finding remains unclear. We aimed to provide insight into the differential clinico-pathological characteristics of this unusual subset of HPV-negative...

Introduction: Although human papillomavirus (HPV) routine vaccination programmes have been implemented around the world and recommendations have been expanded to include other high-risk individuals, current recommendations often differ between countries in Europe, as well as worldwide. Aim: To find and summarise the best available evidence of HP...

Antecedents: Perivascular epitheliod cell tumor (PEComa) is a rare mesenchymal tumor. They are rare in the field of gynecology, which makes them difficult to consider as a possible diagnostic. We aim to contribute with our experience to ease clinical practice to others gynecologists. Patients and methods: We contribute to literature with three g...

Cervical screening aims to identify women with high‐grade squamous intraepithelial lesion/cervical intraepithelial neoplasia 2‐3 (HSIL/CIN2‐3) or invasive cervical cancer (ICC). Identification of women with severe premalignant lesions or ICC (CIN3+) could ensure their rapid treatment and prevent overtreatment. We investigated high‐risk human papill...

Objective: To analyze the impact of age on radiotherapy results based on cancer-specific survival (CSS), vaginal-cuff relapses (VCR) and complications analysis in 438 patients with endometrial carcinoma (EC) receiving postoperative radiotherapy (PRT) divided into three age groups for analysis. Materials and methods: From 2003 to 2015, 438 patien...

Objectives: To assess the prognostic value of human papillomavirus (HPV) 16/18 genotyping and p16/Ki-67 dual staining cytology in high-risk HPV (hrHPV)-positive women with no lesion or minor abnormalities. Methods: We evaluated progression to high-grade squamous intraepithelial lesion/cervical intraepithelial neoplasia grades 2 to 3 or cervical...