Gynecologic Oncology Reports最新文献

{"title":"Ovotesticular Disorders of sexual development (DSD): A rare case of peritoneal carcinomatosis in an elderly DSD male patient","authors":"","doi":"10.1016/j.gore.2024.101515","DOIUrl":"10.1016/j.gore.2024.101515","url":null,"abstract":"<div><div>Disorders of sexual development (DSDs) represent a spectrum of conditions characterized by atypical gonadal and/or genital development. The incidence is 1 in 5,000 live births. Patients with DSD may be at increased risk for developing gonadal and reproductive tract tumors. This report summarizes the current knowledge on the risks of gonadal tumors in patients with DSD. Specifically, we focus on ovotesticular DSD (OT-DSD), which accounts for 5% of DSD cases and is defined by the presence of both ovarian and testicular tissues in the same individual. We present a rare case of a phenotypically male XY patient with OT-DSD who was diagnosed with aggressive peritoneal cancer at the age of 71.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142319176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Invasive acantholytic anaplastic extramammary Paget disease: A previously unreported neoplasm in the vulva and review of the literature","authors":"","doi":"10.1016/j.gore.2024.101514","DOIUrl":"10.1016/j.gore.2024.101514","url":null,"abstract":"<div><div>This report describes the first documented invasive acantholytic anaplastic extramammary Paget disease (AAEMPD) of the vulva. An 87-year-old female presented with a recurrent vulvar lesion refractory to topical imiquimod and treated with multiple wide local excisions (WLE). Microscopic examination of the final WLE specimen revealed unique histologic features, primarily supra-basal intraepidermal acantholysis with epidermal papillomatosis and hyperkeratosis. The epidermis, composed of two distinct cell populations, exhibited full-thickness atypia. Paget cells with high mitotic activity were present in the basal and parabasal layers surrounding benign squamous cells in the mid-squamous mucosa. The histologic features were suspicious of the EMPD involving a warty lesion and/or invasive squamous cell carcinoma. In addition to the intraepidermal component, dermal invasion was also present with lymphovascular space invasion. Immunohistochemical studies (KRT7, HER2, and GATA3 reactivity in Paget cells, p63 negativity, and rare mucin in Paget cells) supported the diagnosis of acantholytic anaplastic EMPD. AAEMPD, a rare variant of EMPD, shares similar prognosis and behavior with the classic Paget disease. Recognition and accurate diagnosis of this subtype is crucial for optimal patient management, given distinct treatment strategies compared with other entities in the differential diagnosis.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142318866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring social determinants of health on chemotherapy-induced peripheral neuropathy severity in ovarian cancer: An integrative review","authors":"","doi":"10.1016/j.gore.2024.101509","DOIUrl":"10.1016/j.gore.2024.101509","url":null,"abstract":"<div><div>Ovarian cancer remains a significant public health concern for women despite advancements in cancer management. Despite comprising only 2.5 % of cancers in women, ovarian cancer ranks as the fifth leading cause of cancer-related deaths among women, with patients frequently receiving late diagnoses. Chemotherapy, a primary treatment, frequently causes chemotherapy-induced peripheral neuropathy (CIPN), affecting over 60 % of patients and leading to severe sensory, motor, and autonomic nerve impairments. This often necessitates dosage reduction or discontinuation of treatment, thereby increasing mortality. While CIPN’s impact on patients is well-documented, there is a paucity of knowledge of how structural and intermediary social determinants of health factors (SDOH), such as socioeconomic and political context, material circumstances such as living and walking conditions, area deprivation, and food availability, affect CIPN severity. The aim of this article was to explore the association between various SDOH and CIPN severity in ovarian cancer, identifying potential research gaps and future research directions. This article seeks to inform targeted interventions to mitigate CIPN’s impact by elucidating these associations.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352578924001887/pdfft?md5=e616d4381c4914f6b0fa029632845fe1&pid=1-s2.0-S2352578924001887-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142315006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early-career and fellow gynecologic oncologists perceive underpreparedness for the business of medicine: A Society of gynecologic oncology survey study","authors":"","doi":"10.1016/j.gore.2024.101501","DOIUrl":"10.1016/j.gore.2024.101501","url":null,"abstract":"<div><h3>Objective</h3><div>There is a research gap on the impact of payment, reimbursement, and academic productivity in career decision-making for early-career (EC) attendings in gynecologic oncology. We sought to assess gynecologic oncology fellows and EC attendings on their knowledge and perceptions regarding the business of medicine.</div></div><div><h3>Methods</h3><div>An anonymous survey was electronically disseminated to fellow and EC SGO members. Key themes were the business of medicine, productivity, and compensation/negotiation. A 5-point Likert scale was utilized; descriptive statistics were calculated using SPSS.</div></div><div><h3>Results</h3><div>There was a 29 % response rate: 82 fellows and 102 EC attendings. Most were white (n = 143, 78 %) and female (n = 138, 75 %.) Most fellows (n = 67, 82 %) were interested in, and most EC (n = 82, 82 %) were employed in, academic/non-private practice. Fellows and EC attendings reported insufficient education on RVUs (relative value units) and reimbursement (80 %, n = 66; 81 %, n = 83) and did not feel prepared for the business aspect of practice (80 %, n = 66; 73 %, n = 75). Over 40 % of fellows did not understand how RVUs relate to practice. Thirty-three percent of EC attendings did not understand RVU assignments; 29 % were satisfied with methods used to determine productivity, and 17 % did not understand their compensation. Over 60 % of fellows felt unprepared to negotiate clinical productivity expectations. For EC attendings, 47 % were uncomfortable negotiating clinical expectations, 32 % negotiating academic expectations, and 52 % negotiating compensation changes. Female EC felt less prepared than male EC regarding the business of medicine (p = 0.02), RVU assignments (p &lt; 0.01), and compensation negotiations (p &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>Most gynecologic oncology fellows and early-career attendings do not feel prepared for the business of medicine. Women were less comfortable with these concepts than men. Formal education should be incorporated into career development curricula.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352578924001802/pdfft?md5=2c29b6f9701b12c1c7cd207fcf409b7d&pid=1-s2.0-S2352578924001802-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142314919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of recurrent ovarian germ cell tumours: Is there a role for immune checkpoint inhibitors?","authors":"","doi":"10.1016/j.gore.2024.101502","DOIUrl":"10.1016/j.gore.2024.101502","url":null,"abstract":"<div><div>Ovarian germ cell tumours predominantly affect young women and have an excellent prognosis. While most contemporary papers concentrate on reducing treatment morbidity and preserving fertility, some women still succumb to refractory or recurrent OGCTs. Despite the significant impact of immune checkpoint inhibitors (ICIs) on many tumors, no case of a chemo-resistant ovarian germ cell tumour successfully treated with immunotherapy has been reported. In testicular cancer, only a few cases of partial response or stable disease to ICIs have been described. PD-L1 expression does not predict response, but microsatellite instability status may serve as a potential biomarker. MSI testing should be performed on a recurrent tumour sample as MSI status may evolve during treatment.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142319177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial disparities in receipt of radiation and brachytherapy in cervical cancer patients: Do they exist in a SEER-Medicare population?","authors":"","doi":"10.1016/j.gore.2024.101505","DOIUrl":"10.1016/j.gore.2024.101505","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate if race is associated with disparities in receipt of radiation (RT) and outcomes for Medicare patients with cervical cancer who are candidates for primary radiation-chemotherapy.</div></div><div><h3>Methods</h3><div>This SEER-Medicare retrospective study included White and Black patients with stage IB1 through IVA squamous cell carcinoma or adenocarcinoma diagnosed 2000–2017 who were candidates for primary radiation-chemotherapy. Receipt of treatment by race and associated cancer specific (CSS) and overall survival (OS) outcomes were analyzed using frequency distributions, chi squared, log rank, multivariable Cox proportional-hazards models, and multivariable logistic models.</div></div><div><h3>Results</h3><div>1038 patients (84.9 % White and 15.1 % Black) were included. 825 (79.5 %) received RT, and 601 (57.9 %) received brachytherapy (BT). Blacks were more likely to undergo RT than Whites (86.0 % vs. 78.3 %, <em>p</em> = 0.028) and had similar rates of BT (58.0 % vs. 57.9 %, <em>p</em> = 0.986). Median RT duration was 64.0 days (IQR 52.0, 75.0), and 276 (33.5 %) completed treatment in ≤ 56 days, with no differences by race (<em>p</em> = 0.488, 0.303, respectively). BT was more frequently provided at larger hospitals, National Cancer Institute-designated cancer centers, and teaching hospitals. When adjusted for covariates, no significant differences in RT, BT, or RT duration by race were identified. Median unadjusted OS was 3.58 years (95 % CI 2.92, 4.42) for White patients and 2.50 years (95 % CI 2.0, 5.25) for Black patients, with no differences in OS (HR 0.93, 95 % CI 0.75, 1.13) or CSS (HR 1.13, 95 %CI 0.86, 1.43).</div></div><div><h3>Conclusions</h3><div>Black Medicare patients with cervical cancer had greater receipt of RT than White patients, similar rates of BT, and no difference in survival.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S235257892400184X/pdfft?md5=96b9942cdafaebc45b5e7932d08f6147&pid=1-s2.0-S235257892400184X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142315005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The time is now: Concrete actions are needed to improve diversity and representation in clinical trials participation","authors":"","doi":"10.1016/j.gore.2024.101513","DOIUrl":"10.1016/j.gore.2024.101513","url":null,"abstract":"","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142319540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global distribution and career outcomes of international fellows trained in Canadian gynecologic oncology programs","authors":"","doi":"10.1016/j.gore.2024.101512","DOIUrl":"10.1016/j.gore.2024.101512","url":null,"abstract":"<div><h3>Objective</h3><div>We assessed the global distribution and academic, administrative and research outcomes of international fellows (IFs) trained in Canadian gynecologic oncology (GO) programs.</div></div><div><h3>Methods</h3><div>A web-based survey was sent to IFs who completed GO training in Canada. Using the Web of science database, we identified the publication list, citation record and H-index of IFs and classified them according to their region of practice: high-income countries (HIC), middle income countries (MIC), and low-income countries (LIC).</div></div><div><h3>Results</h3><div>From 1996 to 2020, 81 IFs from 23 countries were trained in English-speaking (62,9%) and French-speaking Canadian universities (37,1%). Most IFs came from HIC (87,6%) and none from LIC. Only 12 IFs (14,8%) are now practicing in Canada. Of the 55 IFs who completed the survey (response rate: 67,9%), the majority (58,2%) reported working in an academic hospital and 29,1% were holding an executive position in a national scholar organization. IFs participated in mentoring residents (96.4 %) and medical students (83,6%) and 36,3% initiated a GO fellowship program in their home country. 67,3% of IFs were involved in international research collaboration and 52,7% participated in international clinical trials. The mean number of publications (22,36 vs 7,75, p = 0.007), citations (369,15 vs 45,12 p = 0.0006) and H-Index (6,88 vs 2,37 p = 0.0001) were significantly higher among IFs working in HIC compared to those in MIC. Most IFs (98,2%) recommended their Canadian GO fellowship program to a colleague from their home country.</div></div><div><h3>Conclusion</h3><div>Most IFs trained in Canadian GO fellowship programs returned to their home countries and achieved important milestones in terms of academic, clinical and research accomplishments.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352578924001917/pdfft?md5=1c1c977aacbd2f277660e05bb1f26654&pid=1-s2.0-S2352578924001917-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142314221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced recovery after surgery (ERAS) guided gynecologic/oncology surgery – The patient’s perspective","authors":"","doi":"10.1016/j.gore.2024.101510","DOIUrl":"10.1016/j.gore.2024.101510","url":null,"abstract":"<div><h3>Objective</h3><p>Enhanced recovery after surgery (ERAS) pathways have demonstrated improvements in outcomes following benign gynecologic and gynecologic oncology surgery. However, there is limited data reporting the benefit of ERAS from the patient’s perspective. This study aimed to explore patient knowledge of and experience with ERAS-guided surgery.</p></div><div><h3>Methods</h3><p>This interpretive descriptive study included participants who had undergone ERAS-guided gynecologic and gynecologic oncology surgery in Alberta, Canada using convenience sampling. Semi-structured interviews explored patient knowledge of ERAS, overall experience with surgery and recommended changes for surgical care. An inductive thematic analysis was conducted.</p></div><div><h3>Results</h3><p>Eight females aged 26–76 years old participated in the study who had gynecologic (n = 4) and gynecologic oncology (n = 4) surgery. Six themes central to participant experience of ERAS-guided surgery were identified: patient expectations, individual motivation, values and support, healthcare provider communication, trust in healthcare providers, COVID-19 and care co-ordination. Overall, specific knowledge of ERAS was low. Expectations were set by previous experience of healthcare (previous surgery or occupation), as well as information provided by healthcare professionals. Participants whose expectations aligned with physical experience of ERAS provided favourable perspectives. Participants recommended improving the quality, relevance and availability of information and establishing accessible follow up strategies.</p></div><div><h3>Conclusion</h3><p>Based on the finding that knowledge about ERAS was minimal, we advocate for improved education pertaining to ERAS recommendations. Acknowledging patients’ expertise and motivation to engage in their care maybe one strategy to improve compliance with ERAS guidelines and improve outcomes for both patients and the healthcare system.</p></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352578924001899/pdfft?md5=655ef4a370d0cef4c47086a86caa04ac&pid=1-s2.0-S2352578924001899-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142242424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-surgical management of recurrent Paget’s disease of the vulva: A case report","authors":"","doi":"10.1016/j.gore.2024.101511","DOIUrl":"10.1016/j.gore.2024.101511","url":null,"abstract":"<div><div>Paget’s Disease of the Vulva is a relatively rare condition with a high rate of recurrence. Extensive work-up and treatment is warranted as lesions have the capacity to become invasive and can be associated with underlying malignancy. First line therapy includes surgical resection. For those that are not surgical candidates or who do not desire surgical intervention, non-surgical management options include topical therapy with imiquimod. Unfortunately, irritating side effects often results in poor treatment compliance and premature discontinuation limiting efficacy. Here we present a unique case of extensive, recurrent vulvar Paget’s disease with excellent response to a combination therapy of imiquimod and Silver Sulfadiazine. To the best of our knowledge, this is the first documented case illustrating the utility of non-surgical management with combination therapy with topical imiquimod and Silver Sulfadiazine for treatment in patients who do not desire surgical intervention.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352578924001905/pdfft?md5=e5a0a4fe9b762c192658e0ecaf236e36&pid=1-s2.0-S2352578924001905-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142314920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}