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Gynecologic Oncology

Barbara M Norquist
No abstract text is available yet for this article.
December 8, 2018: Gynecologic Oncology
Erica M Bednar, Charlotte C Sun, Bethsaida Camacho, John Terrell, Alyssa G Rieber, Lois M Ramondetta, Ralph S Freedman, Karen H Lu
OBJECTIVE: The universal genetic testing initiative (UGTI) is a quality improvement effort to increase rates of guideline-based genetic counseling (GC) and genetic testing (GT) of patients with potentially hereditary cancers. The UGTI was disseminated to a county hospital gynecologic oncology clinic that serves a diverse, indigent patient population. METHODS: Using the Model for Improvement quality improvement framework, interventions including integrated GC, clinic tracking, assisted GC referrals, and provider education were tested over 26 months...
December 8, 2018: Gynecologic Oncology
Katherine E Law, Emily A Hildebrand, Hunter J Hawthorne, M Susan Hallbeck, Russell J Branaghan, Sean C Dowdy, Renaldo C Blocker
OBJECTIVE: Quantifying non-routine events (NREs) assists with identify underlying sociotechnical factors that could lead to adverse events. NREs are considered any event that is unusual or atypical during surgical procedures. This study aimed to use prospective observations to characterize the occurrence of non-routine events in gynecological surgeries. METHODS: Observational data were collected prospectively within one surgical gynecology department over a five month period...
December 6, 2018: Gynecologic Oncology
Andrea Varga, Sarina Piha-Paul, Patrick A Ott, Janice M Mehnert, Dominique Berton-Rigaud, Anne Morosky, Ping Yang, Jane Ruman, Daniela Matei
OBJECTIVE: To evaluate safety, tolerability, and antitumor activity of pembrolizumab monotherapy in patients with programmed death ligand 1 (PD-L1)-expressing advanced ovarian cancer enrolled in the multicohort, phase Ib KEYNOTE-028 trial. METHODS: Key inclusion criteria were age ≥18 years; advanced ovarian epithelial, fallopian tube, or primary peritoneal carcinoma; failure of previous therapy; and tumor PD-L1 positivity. Patients received pembrolizumab (10 mg/kg every 2 weeks) for ≤24 months or until disease progression/intolerable toxicity...
December 3, 2018: Gynecologic Oncology
Thing Rinda Soong, Brooke E Howitt, Neil Horowitz, Marisa R Nucci, Christopher P Crum
Most ovarian carcinomas are high-grade serous carcinomas (HGSC) that contain TP53 mutations, present at advanced stage, and eventually become resistant to chemotherapy. The rapid evolution of this disease has been attributed to an origin in the distal fallopian tube, in the form of serous tubal intraepithelial carcinomas (STICs). This has led to a disease model where malignancy develops first in the tube and spreads to the peritoneum or regional lymph nodes. However, although most early or incidentally discovered HGSCs manifest in the tube with STICs, many advanced HGSCs are not accompanied by a malignancy in the fimbria...
November 29, 2018: Gynecologic Oncology
Weijuan Xin, Keqin Hua, Jingxin Ding
No abstract text is available yet for this article.
November 29, 2018: Gynecologic Oncology
Monica Hagan Vetter, Ambar Khan, Floor J Backes, Kristin Bixel, David E Cohn, Larry J Copeland, Jeffrey M Fowler, Ritu Salani, Quan Li, David M O'Malley
OBJECTIVES: Platinum hypersensitivity reactions (HSR) affect approximately 5% of the general oncologic population. Here we report the efficacy and safety of outpatient platinum desensitization protocol (PD) in gynecologic oncology patients with moderate (high-risk) to severe platinum HSR. METHODS: This is a retrospective report of patients with gynecologic malignancies undergoing an outpatient PD for moderate (high-risk) to severe platinum HSR from 2011 to 2017...
November 29, 2018: Gynecologic Oncology
Diogo Torres, Amanika Kumar, Jamie N Bakkum-Gamez, Amy L Weaver, Michaela E McGree, Chen Wang, Carrie L Langstraat, William A Cliby
OBJECTIVE: To evaluate the contribution of molecular subtype to 30-day postoperative complications and 90-day mortality after primary debulking surgery (PDS) in advanced stage high-grade serous ovarian cancer (HGSOC). METHODS: Patients with stages III-IV HGSOC undergoing PDS from 1994 to 2011 with available molecular subtyping were included. Residual disease (RD) status was categorized as 0, 0.1-0.5, 0.6-1.0, or >1 cm. Surgical complexity scores were calculated as high, intermediate, or low as previously published...
November 28, 2018: Gynecologic Oncology
Casey M Hay, Heidi S Donovan, Grace B Campbell, Sarah E Taylor, Li Wang, Madeleine Courtney-Brooks
OBJECTIVE: Evaluate the ability of an office-administered phenotypic frailty assessment to predict chemotherapy tolerance in older adult gynecologic oncology patients, and describe practice patterns for chemotherapy administration in this population. METHODS: Prospective, single-institution cohort study of gynecologic oncology patients 65 or older initiating chemotherapy. Phenotypic frailty testing at an office visit encompassed components of two validated frailty assessments: Fried Score (physical testing and patient response) and FRAIL Scale (patient response only)...
November 28, 2018: Gynecologic Oncology
Barbara Stanley, Robert L Hollis, Hugo Nunes, Jonathan D Towler, Xiangfei Yan, Tzyvia Rye, Carol Dawson, Melanie J Mackean, Fiona Nussey, Michael Churchman, C Simon Herrington, Charlie Gourley
OBJECTIVES: The role of endocrine therapy (ET) in high grade serous ovarian carcinoma (HGSOC) is poorly defined due to the lack of phase III data and significant heterogeneity of clinical trials performed. In this study, we sought to identify predictive factors of endocrine sensitivity in HGSOC. METHODS: HGSOC patients who received at least four weeks of ET for relapsed disease following one line of chemotherapy at the Edinburgh Cancer Centre were identified. Exclusion criteria were use of endocrine therapy as maintenance therapy or of unknown duration...
November 27, 2018: Gynecologic Oncology
Courtney A Penn, Neil S Kamdar, Daniel M Morgan, Ryan J Spencer, Shitanshu Uppal
OBJECTIVE: Returning home after surgery is a desirable patient-centered outcome associated with decreased costs compared to non-home discharge. Our objective was to develop a preoperative risk-scoring model predicting non-home discharge after surgery for gynecologic malignancy. METHODS: Women who underwent surgery involving hysterectomy for gynecologic malignancy from 2013 to 2015 were identified from the Michigan Surgical Quality Collaborative database. Patients were divided by discharge destination, and a multivariable logistic regression model was developed to create a nomogram to assign case-specific risk scores...
November 26, 2018: Gynecologic Oncology
Akila Subramaniam, Brett D Einerson, Christina T Blanchard, Britt K Erickson, Jeff Szychowski, Charles A Leath, Joseph R Biggio, Warner K Huh
OBJECTIVES: Opportunistic salpingectomy is a cost-effective strategy recommended for ovarian cancer (OvCa) risk reduction at the time of gynecologic surgery in women who have completed childbearing. We aimed to evaluate the cost-effectiveness of opportunistic salpingectomy compared to standard tubal ligation (TL) during cesarean delivery. STUDY DESIGN: A cost-effectiveness analysis using decision modeling to compare opportunistic salpingectomy to TL at the time of cesarean using probabilities of procedure completion derived from a trial...
November 23, 2018: Gynecologic Oncology
Reem Albeesh, Guy-Anne Turgeon, Joanne Alfieri, José João Mansure, Lili Fu, Jocelyne Arseneau, Xing Zeng, Kris Jardon, Lucy Gilbert, Luis Souhami
OBJECTIVE: To review outcomes of patients with stage III endometrial cancer confined to the pelvis treated with adjuvant pelvic radiotherapy (RT) or sequential chemoradiotherapy (CRT). METHODS: Between 1990 and 2012, 144 patients diagnosed with stage IIIA, B or C1 endometrial cancer were treated in our institution. All were treated with total hysterectomy, bilateral salpingo-oophorectomy ± lymph node dissection. Post-operatively, 67 patients received adjuvant RT alone, 37 CRT, 21 chemotherapy alone and 19 had no adjuvant therapy...
November 22, 2018: Gynecologic Oncology
M M Frijstein, C A R Lok, N E van Trommel, M J Ten Kate-Booij, L F A G Massuger, E van Werkhoven, B Kaur, J A Tidy, N Sarwar, F Golfier, M C Winter, B W Hancock, M J Seckl
OBJECTIVE: Epithelioid Trophoblastic Tumor (ETT) is an extremely rare form of Gestational Trophoblastic Neoplasia (GTN). Knowledge on prognostic factors and optimal management is limited. We identified prognostic factors, optimal treatment, and outcome from the world's largest case series of patients with ETT. METHODS: Patients were selected from the international Placental Site Trophoblastic Tumor (PSTT) and ETT database. Fifty-four patients diagnosed with ETT or mixed PSTT/ETT between 2001 and 2016 were included...
November 22, 2018: Gynecologic Oncology
Sara Wiswell, Jeffrey G Bell, Jennifer McHale, John O Elliott, Kellie Rath, Aine Clements
OBJECTIVES: Most art therapy research has involved patients with malignancies other than gynecologic cancer. The current study aimed to assess the impact of an art therapy intervention on the quality of life (QOL) in patients with gynecologic cancer who were receiving chemotherapy. METHODS: This was a prospective, non-randomized, pilot study. Eligible patients had a primary or recurrent gynecologic malignancy scheduled to be treated with at least 6 cycles of chemotherapy over 18 weeks...
November 22, 2018: Gynecologic Oncology
Beth E Wagner, Carrie L Langstraat, Michaela E McGree, Amy L Weaver, Shikha Sarangi, Bahareh Mokri, Sean C Dowdy, William A Cliby, Amanika Kumar, Jamie N Bakkum-Gamez
OBJECTIVE: To determine the incidence and risk factors for venous thromboembolism (VTE) within six months after primary debulking surgery (PDS) for epithelial ovarian cancer (EOC). METHODS: In a historical cohort, we estimated the cumulative incidence of clinically diagnosed VTE within 6 months among consecutive women who underwent PDS for EOC at a single institution from 1/1/2003 to 12/31/2011. We evaluated perioperative variables as potential risk factors of VTE within 6 months during the postoperative period using univariate and multivariable Cox proportional hazards models...
November 21, 2018: Gynecologic Oncology
Melissa Javellana, Claire Hoppenot, Ernst Lengyel
OBJECTIVE: It is unclear if the types of surgical procedures performed on long-term survivors (LTS) of high-grade serous ovarian carcinoma (HGSOC) contribute to prolonged survival. In this case-control study we review the surgical procedures performed on LTS and describe their individual longitudinal disease courses. METHODS: Women with FIGO stage III-IV high-grade serous cancer of the ovary, fallopian tube or peritoneum were selected from the University of Chicago ovarian cancer database...
November 21, 2018: Gynecologic Oncology
Julia L Boland, Qin Zhou, Madhuri Martin, Margaret K Callahan, Jason Konner, Roisin E O'Cearbhaill, Claire F Friedman, William Tew, Vicky Makker, Rachel N Grisham, Martee L Hensley, Nicholas Zecca, Alexia E Iasonos, Alexandra Snyder, David M Hyman, Paul Sabbatini, Carol Aghajanian, Karen A Cadoo, Dmitriy Zamarin
OBJECTIVE: Delayed responses observed with immune checkpoint blockade (ICB) present a challenge for patients with peritoneal malignancies, who risk early symptomatic disease progression requiring treatment discontinuation. While efforts are ongoing to define the biomarkers of response, it is equally important to identify patients at risk for early discontinuation. We sought to investigate the timing of disease progression in epithelial ovarian cancer (EOC) patients treated with ICB and to identify pre-treatment clinical parameters associated with early discontinuation...
November 20, 2018: Gynecologic Oncology
Saira Sanjida, Monika Janda, Steven M McPhail, David Kissane, Jeremy Couper, James Scott, Andreas Obermair
OBJECTIVE: Psychotropic medications including antidepressants and anxiolytics are used to treat anxiety and depression in cancer patients; however, little is known about the prescription practices in endometrial cancer. This study aimed to determine the prevalence, type, dose, frequency and timing of psychotropic medications prescribed to endometrial cancer patients. A secondary aim was to study sociodemographic and clinical characteristics associated with receiving a psychotropic medication prescription...
November 19, 2018: Gynecologic Oncology
Judith A Smith, Tran Le, Grace A Martin, Anjali Gaikwad, Chenchen H Sun, Elizabeth K Nugent, Joseph A Lucci
OBJECTIVE: Niraparib is a poly (ADP-ribose) polymerase inhibitor (PARP) approved for use in maintenance therapy for ovarian cancer that is associated with the unpredictable grade 3/4 thrombocytopenia. This study was conducted to refine patient dosing recommendations for niraparib based upon clinical practice observations of grade 3/4 thrombocytopenia. METHODS AND MATERIALS: Six patient cases were reviewed to identify similarities in patient factors. An in vitro study was conducted using healthy volunteer blood spiked with Niraparib concentrations ranging from 0 ng/mL to 5000 ng/mL...
November 19, 2018: Gynecologic Oncology
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