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Gynecologic Oncology

Tiffany Zigras, Rachel Kupets, Lisa Barbera, Allan Covens, Ying Liu, Lilian T Gien
OBJECTIVES: To evaluate trends in uptake of sentinel lymph node (SLN) procedures over time and associated factors in women with vulvar cancer. METHODS: A retrospective population-based cohort study identified women with invasive squamous cell carcinoma (SCC) of the vulva using health administrative data for the province of Ontario, Canada, between 2008 and 2016. Patients who underwent SLN procedures were compared to those who had groin node dissection (GND). Multivariable analysis was used to identify factors associated with SLN procedures...
March 12, 2019: Gynecologic Oncology
Elena Ratner, Mohan Bala, Melinda Louie-Gao, Ebru Aydin, Sebastien Hazard, Priscilla K Brastianos
PURPOSE: To estimate the risk for brain metastases in patients with ovarian cancer using real-world data, and assess whether BRCA mutations increase that risk. METHODS: This retrospective study included 4515 patients diagnosed with ovarian cancer between January 1, 2011, and January 31, 2018, from the Flatiron Health database, a longitudinal, demographically, and geographically diverse database derived from electronic health records in the United States. RESULTS: Forty-six (1%) patients were diagnosed with brain metastases after being diagnosed with ovarian cancer...
March 12, 2019: Gynecologic Oncology
Ofer Lavie, Angela Chetrit, Ilya Novikov, Siegal Sadetzki
OBJECTIVE: Compare 5, 10 and 15 year survival in invasive epithelial ovarian cancer, between patients with and without BRCA1/2 germ line mutation in a nonselective group of patients diagnosed during 1994-99. METHODS: The analysis was based on 779 Jewish patients: 229 carriers to the Ashkenazi Jewish founder mutations in BRCA1 (185delAG; 5382insC) and BRCA2 (6174delT); and 550 non-carriers. Clinical characteristics were abstracted from the patients' medical records and vital status was updated through the National Population Registry up to 11/2015...
March 11, 2019: Gynecologic Oncology
Lauren S Prescott, Jolyn S Taylor, Ahmed Enbaya, Claire A Marten, Keith N Myers, Larissa A Meyer, Pedro T Ramirez, Charles F Levenback, Diane C Bodurka, Kathleen M Schmeler
OBJECTIVE: To evaluate the efficacy and economic impact of a transfusion reduction initiative for patients undergoing gynecologic surgery. METHODS: We conducted a prospective healthcare improvement study to align transfusion practices with the American Society of Hematology's Choosing Wisely® campaign. Baseline transfusion rates were determined retrospectively for all major gynecologic surgical cases from 3/1/14 to 6/30/14. Data for the post-intervention period from 5/15/15 to 5/16/16 were captured prospectively...
March 11, 2019: Gynecologic Oncology
I Ruengkhachorn, N Phithakwatchara, B Viriyapak, S Sangkarat, S Hanamornroongruang, J Petsuksiri
OBJECTIVES: To determine the proportion of women with undiagnosed cervical carcinoma before simple hysterectomy and its causes and to compare the oncologic outcomes of women diagnosed and treated with standard therapy to those undergoing inadvertent simple hysterectomy with subsequent treatment. METHODS: Medical records were reviewed for patients with cervical carcinoma who underwent hysterectomy between 1 January 2004 and 31 December 2014. Demographic data, chemotherapeutic agents, and response rates were analyzed using descriptive statistics...
March 11, 2019: Gynecologic Oncology
Paulo Alexandre Ribeiro Mora, Sue Yazaki Sun, Guillermo Coca Velarde, Jorge Rezende Filho, Elza H Uberti, Ana Paula Vieira Dos Santos Esteves, Kevin M Elias, Neil S Horowitz, Antonio Braga, Ross S Berkowitz
OBJECTIVE: To evaluate the impact of periodic shortage of actinomycin-d (Act-d) in the treatment of Brazilian patients with low-risk gestational trophoblastic neoplasia (GTN) after methotrexate and folinic acid rescue (MTX/FA) resistance, treated alternately with carboplatin or etoposide as a second-line regimen. METHODS: Retrospective cohort that included patients with failure of first-line MTX/FA regimen for low-risk GTN treated at Rio de Janeiro Federal University, Universidade Federal de São Paulo and Irmandade da Santa Casa de Misericórdia de Porto Alegre, from January/2010- December/2017...
March 8, 2019: Gynecologic Oncology
Ryusuke Murakami, Noriomi Matsumura, Hirofumi Michimae, Hiroshi Tanabe, Mayu Yunokawa, Haruko Iwase, Motoi Sasagawa, Toshiaki Nakamura, Osamu Tokuyama, Masashi Takano, Toru Sugiyama, Takashi Sawasaki, Seiji Isonishi, Kazuhiro Takehara, Hidekatsu Nakai, Aikou Okamoto, Masaki Mandai, Ikuo Konishi
OBJECTIVE: Recently, we established new histopathological subtypes of high-grade serous ovarian cancer (HGSOC) that include the mesenchymal transition (MT) type, the immune reactive (IR) type, the solid and proliferative (SP) type and the papillo-glandular (PG) type. Furthermore, we identified that the mesenchymal transcriptome subtype might be sensitive to taxane. We investigated whether these different histopathological subtypes of HGSOC require individualized chemotherapy for optimal treatment...
March 7, 2019: Gynecologic Oncology
Isidre Felip, Cristian Pablo Moiola, Cristina Megino-Luque, Carlos Lopez-Gil, Silvia Cabrera, Sonia Solé-Sánchez, Pau Muñoz-Guardiola, Elisabet Megias-Roda, Héctor Pérez-Montoyo, José Alfon, Marc Yeste-Velasco, María Santacana, Xavier Dolcet, Armando Reques, Ana Oaknin, Victor Rodríguez-Freixinos, José Miguel Lizcano, Carles Domènech, Antonio Gil-Moreno, Xavier Matias-Guiu, Eva Colas, Nuria Eritja
OBJECTIVES: The PI3K/AKT/mTOR pathway is frequently overactivated in endometrial cancer (EC). We assessed the efficacy of ABTL0812, a novel first-in-class molecule presenting a unique mechanism of action inhibiting this pathway. METHODS: We investigated the effects of ABTL0812 on proliferation, cell death and modulation of intracellular signaling pathways in a wide panel of endometrioid and non-endometrioid cell lines, an inducible PTEN knock-out murine model, and two patient-derived xenograft murine models of EC...
March 7, 2019: Gynecologic Oncology
Thomas C Wright, Valentin Parvu, Mark H Stoler, Salma Kodsi, Karen Eckert, Karen Yanson, Charles K Cooper
OBJECTIVES: Countries with school-based human papillomavirus (HPV) vaccination have seen significant reductions in vaccine-targeted HPV infections, cytologic abnormalities, and high-grade cervical intraepithelial neoplasia (≥CIN2). However, the impact of HPV vaccination in the United States (where vaccination is largely opportunistic) may be less due to lower coverage rates and vaccination in patients at ages beyond the recommended routine vaccination age. METHODS: The Onclarity trial enrolled 33,858 subjects ≥21 years who were screened with cytology and the BD Onclarity HPV Assay...
March 7, 2019: Gynecologic Oncology
David W Doo, C Tyler Kirkland, Lauren H Griswold, Gerald McGwin, Warner K Huh, Charles A Leath Iii, Kenneth H Kim
OBJECTIVE: To compare the perioperative morbidity and survival between abdominal radical hysterectomy (ARH) and robotic radical hysterectomy (RRH). METHODS: A retrospective cohort of patients undergoing radical hysterectomy for cervical cancer from 2010 to 2016 was identified. Patients with stage IB1 cervical cancer were included and were grouped by ARH vs. RRH. Tumor characteristics, perioperative complications, recurrence rate, progression-free survival (PFS), and overall survival (OS) were compared between groups...
March 6, 2019: Gynecologic Oncology
Joo-Hyuk Son, Jeeyeon Kim, Jinhyung Shim, Tae-Wook Kong, Jiheum Paek, Suk-Joon Chang, Hee-Sug Ryu
OBJECTIVE: The aim of this study was to evaluate the clinical outcomes of close rectal dissection (CRD) compared with those of total mesorectal excision (TME) as the posterior rectal dissection procedure during rectosigmoid colectomy performed as part of cytoreductive surgery in patients with epithelial ovarian cancer. METHODS: We retrospectively reviewed the medical records of 163 patients who underwent posterior rectal dissection for rectosigmoid resection, including low anterior resection or subtotal colectomy, as part of ovarian cancer surgery from 2006 to 2018...
March 4, 2019: Gynecologic Oncology
Emeline M Aviki, Nadeem R Abu-Rustum
No abstract text is available yet for this article.
March 2, 2019: Gynecologic Oncology
Ismail Mert, Amanika Kumar, Diogo Torres, Yajue Huang, Michaela E McGree, Amy L Weaver, William A Cliby
OBJECTIVES: The FIGO staging consensus agreement from 2012 indicates that bowel mucosal invasion for epithelial ovarian cancer (EOC) should be assigned to stage IV disease. Finding no evidence justifying this recommendation, we examined the impact of recto-sigmoid colonic invasion on survival based on depth of invasion. METHODS: Patients having recto-sigmoid resection to achieve complete gross resection for stage IIIC/IV EOC between 2003 and 2011 were included. For this study, mucosal invasion alone was not considered as stage IV...
March 2, 2019: Gynecologic Oncology
Giorgio Bogani, Andrea Mariani, Biagio Paolini, Antonino Ditto, Francesco Raspagliesi
Nodal assessment represents an integral part of staging procedure for endometrial cancer. The widespread diffusion of sentinel node mapping determinates a phenomenon of migration from stage I to stage III disease, especially for low-risk endometrial cancer patients. The adoption of sentinel node mapping and pathological ultrastaging increase the detection of low volume disease (i.e., micrometastasis and isolated tumor cells), being low volume disease detected in >30% of patients with positive nodes. The prognostic role of low volume disease is discussed as well as the possible adjuvant strategies for patients diagnosed with micrometastasis and isolated tumor cells...
March 1, 2019: Gynecologic Oncology
Rebecca A Brooks, David S Tritchler, Kathleen M Darcy, Heather A Lankes, Ritu Salani, Paul Sperduto, Saketh Guntupalli, Paul DiSilvestro, Joshua Kesterson, Alexander B Olawaiye, Katherine Moxley, Steven Waggoner, Alessandro Santin, Janet S Rader, Nora T Kizer, Premal H Thaker, Matthew A Powell, David G Mutch, Michael J Birrer, Paul J Goodfellow
OBJECTIVES: The ability to stratify a patient's risk of metastasis and survival permits more refined care. A proof of principle study was undertaken to investigate the relationship between single nucleotide polymorphisms (SNPs) in literature based candidate cancer genes and the risk of nodal metastasis and clinical outcome in endometrioid endometrial cancer (EEC) patients. METHODS: Surgically-staged EEC patients from the Gynecologic Oncology Group or Washington University School of Medicine with germline DNA available were eligible...
February 28, 2019: Gynecologic Oncology
Joël Fokom Domgue, Craig Messick, Andrea Milbourne, Ming Guo, Mila P Salcedo, Kristina R Dahlstrom, Elizabeth Y Chiao, Ashish A Deshmukh, Erich M Sturgis, Kathleen M Schmeler
OBJECTIVE: To estimate the prevalence of high-grade anal dysplasia in women with high-grade dysplasia or carcinoma of the cervix, vagina or vulva. METHODS: In this cross-sectional study, participants underwent anal cytology, anal HPV testing with Cervista HPV16/18 and high-resolution anoscopy (HRA). Patients with HSIL (high-grade squamous cell intraepithelial lesion) or greater on anal cytology or anal biopsy were referred to a colorectal surgery specialist for further evaluation...
February 28, 2019: Gynecologic Oncology
M Timmermans, O van der Hel, G S Sonke, K K Van de Vijver, M A van der Aa, R F Kruitwagen
INTRODUCTION: The ability to minimize residual disease during primary cytoreductive surgery is the strongest predictor for improved overall survival in advanced ovarian cancer. But while the probability to achieve a macroscopic complete resection increases if surgery is preceded by neoadjuvant chemotherapy (NACT), survival rates after NACT are similar to those observed after primary surgery. This may suggest that the prognostic effect of residual disease is altered after NACT. More specifically, randomized data suggest that there is no difference between optimal (0...
February 27, 2019: Gynecologic Oncology
Jaclyn M Arquiette, Haley A Moss, Tracy Truong, Carl F Pieper, Laura J Havrilesky
OBJECTIVE: Accurate documentation is critical for patient care and hospital reimbursement. We sought to improve the accuracy of severity of illness (SOI) and risk of mortality (ROM) scores through implementation of documentation initiatives. METHODS: We performed a pre- versus post-implementation analysis to assess the impact of a documentation intervention bundle on calculated admission/discharge SOI/ROM scores on an inpatient gynecologic oncology service. Introduced in January 2017, the bundle included educational in-service, introduction of problem-based progress notes, a documentation tip ID badge and video, and weekly chart audits...
February 27, 2019: Gynecologic Oncology
Peter Sykes, Lois Eva, Rachael van der Griend, Orla McNally, Penelope Blomfield, Alison Brand, Amanda Tristram, Cecile Bergzoll, Simone Petrich, Diane Kenwright, Kathryn Payne, Mayada Kellow, Carrie Innes, Dianne Harker, Lewis Perrin, Paul Cohen, Ken Jaaback, Bryony Simcock
OBJECTIVES: To report the interim findings of an audit of the outcomes of sentinel node (SN) biopsy performed as a replacement for groin node dissection in women with early stage vulvar cancer in routine clinical practice in Australia and New Zealand. METHODS: A prospective multi-center study in 8 participating centers. Eligible patients had squamous cell carcinomas clinically restricted to the vulva <4 cm in diameter. SN procedures and pathological assessment were to be performed in accordance with the methods published by the GROINSS-V collaboration [1]...
February 24, 2019: Gynecologic Oncology
David A Barrington, Sarah E Dilley, Haller J Smith, J Michael Straughn
OBJECTIVE: To determine the cost-effectiveness of pembrolizumab in patients with recurrent endometrial cancer that have failed first-line chemotherapy. METHODS: We created a model to evaluate the cost-effectiveness of pembrolizumab compared to pegylated liposomal doxorubicin (PLD) or bevacizumab for the treatment of women with recurrent endometrial cancer who have failed carboplatin and paclitaxel. Microsatellite instability-high (MSI-H) and non-microsatellite instability-high (non-MSI-H) tumors were evaluated...
February 24, 2019: Gynecologic Oncology
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