Gynecologic Oncology Reports最新文献

{"title":"Variables that impact HPV test accuracy during vaginal self collection workflow for cervical cancer screening","authors":"Laurence Vaughan ,&nbsp;Devin Gary ,&nbsp;Millie Shah ,&nbsp;Lyndsay Lewellen ,&nbsp;Laura Galbraith ,&nbsp;Valentin Parvu","doi":"10.1016/j.gore.2024.101421","DOIUrl":"https://doi.org/10.1016/j.gore.2024.101421","url":null,"abstract":"<div><p>Vaginal self collection (SC) is safe and effective for human papillomavirus (HPV) testing and can increase cervical cancer screening coverage for underserved women. To better understand the impact of SC methodology on HPV test outcomes, empirical testing was conducted using different swab collection workflows. Deposition of the collection swab into resuspension buffer resulted in a 2.4-cycle reduction in threshold detection of human beta-hemoglobin during PCR when compared to “swirl-and-toss”. In addition, reducing the swab resuspension volume from 10 mL to 3 mL resulted in a 2.6-cycle reduction in threshold detection of human beta-globin. A systematic literature search (01/01/2020 to 08/02/2023) of Ovid Medline and Embase, followed by data extraction and analysis, was conducted to further assess the impact of resuspension volume on performance following SC. HPV test performance for SC, relative to clinician collection (CC), was calculated for detection of cervical pre-cancer. Data were stratified by the resuspension volume ratio of SC to CC being either ≥ 1.0 or &lt; 1.0. SC with a volume ratio of ≥ 1.0 and &lt; 1.0 had a relative ≥ CIN2 sensitivity of 92.0 % (95 % CI: 88.0, 96.0) and 97.0 % (95 % CI: 94.0, 100), respectively. Taken together, these results suggest that SC conditions can be modified to optimize sample recovery and performance, as part of cervical cancer screening.</p></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352578924001000/pdfft?md5=004fc036feb7fe18a5fbee7e8fff9ae3&pid=1-s2.0-S2352578924001000-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141239270","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":"Challenges of cytoreduction in porta hepatis in surgery for advanced ovarian cancer","authors":"Kvvn Raju,&nbsp;Pavan Kumar Jonnada,&nbsp;Madhunarayana Badude,&nbsp;Siddarth Nekkanti,&nbsp;Syed Nusrath,&nbsp;Pradeep Keshri,&nbsp;Raghu Ram Reddy","doi":"10.1016/j.gore.2024.101413","DOIUrl":"10.1016/j.gore.2024.101413","url":null,"abstract":"<div><h3>Introduction</h3><p>Advanced ovarian cancer often necessitates aggressive surgical intervention, including cytoreduction of the porta hepatis, which poses significant challenges due to the intricate anatomical structures involved. This surgical video aims to illustrate these challenges and demonstrate effective techniques for clearance of critical structures such as the portal vein (PV), common bile duct (CBD), accessory left hepatic artery (Acc. LHA), obliterated umbilical vein (OUV), inferior vena cava (IVC), and foramen of Winslow.</p></div><div><h3>Methods</h3><p>The surgical procedure depicted in the video involved meticulous dissection and identification of anatomical landmarks to access the porta hepatis. Techniques for safe clearance of the PV, CBD, Acc. LHA, OUV, IVC, and foramen of Winslow were employed and are highlighted in detail. Emphasis was placed on preserving vascular integrity and minimizing intraoperative complications.</p></div><div><h3>Conclusions</h3><p>The video demonstrates the complexities associated with cytoreduction of the porta hepatis in advanced ovarian cancer surgery and offers insights into overcoming these challenges. By utilizing precise surgical techniques and careful anatomical consideration, successful clearance of critical structures can be achieved, thereby optimizing patient outcomes and minimizing postoperative complications. This educational resource provides valuable guidance for surgeons encountering similar challenges in the management of advanced ovarian cancer.</p></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352578924000924/pdfft?md5=7950c82da7d76a4a4c63c693425fb0e1&pid=1-s2.0-S2352578924000924-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141137769","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":"A case of malignant transformation of a serous borderline ovarian tumor effectively treated with BRAF/MEK inhibitor combination","authors":"Manrose Singh ,&nbsp;Samantha Cornwell ,&nbsp;Ariel Shaddaie ,&nbsp;Leah Wachsmuth ,&nbsp;Ashwin Ragupathi ,&nbsp;Leonidas Salichos ,&nbsp;Sandra Nissel-Horowitz ,&nbsp;Rajasree Roy ,&nbsp;Maria Plummer ,&nbsp;Dong Zhang ,&nbsp;Bhoomi Mehrotra","doi":"10.1016/j.gore.2024.101417","DOIUrl":"10.1016/j.gore.2024.101417","url":null,"abstract":"<div><p>We describe a patient diagnosed with a metastatic adenocarcinoma of Müllerian origin, harboring a BRAF V600E mutation, ten years after being treated for a serous borderline tumor (SBOT). While BRAF mutations in the setting of SBOTs are common, they have been typically associated with a low chance of transformation or recurrence. The therapeutic approach, which combined hormone inhibition with receptor tyrosine kinase inhibitors (dabrafenib and trametinib), has demonstrated notable and enduring efficacy. This is clinically evidenced through serial PET-CT scans with sustained responses and extended progression-free survival, and serologically confirmed by monitoring CA-125 levels. This case demonstrates the critical role of early next-generation sequencing in detecting actionable molecular changes in rare cancers and possible metastases. It provides valuable insights into treating uncommon Müllerian adenocarcinomas and underscores the importance of targeted therapies in achieving long-lasting treatment outcomes.</p></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352578924000961/pdfft?md5=eb0b08d1ce26a25465c9fc395dc93bba&pid=1-s2.0-S2352578924000961-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141048849","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":"Application of a Malecot drain in the management of a vaginal cuff dehiscence: A case report and review of the literature","authors":"Bria Murray ,&nbsp;Caleigh E. Smith ,&nbsp;Jorge Alsina ,&nbsp;Megan Howard ,&nbsp;Charles Landen ,&nbsp;Paola A. Gehrig","doi":"10.1016/j.gore.2024.101416","DOIUrl":"10.1016/j.gore.2024.101416","url":null,"abstract":"<div><h3>Background</h3><p>Vaginal cuff dehiscence (VCD) in the setting of acute infection is an uncommon but serious complication of total hysterectomy without clear guidelines for management. There is a need for further documentation of best practices around treatment, particularly when it comes to surgical drain utilization and placement.</p></div><div><h3>Case description</h3><p>We present a case of a 68-year-old with primary peritoneal carcinoma who underwent a robot-assisted total laparoscopic hysterectomy as part of an interval debulking surgery and had a VCD. The cuff was repaired vaginally in the operating room with placement of a Malecot catheter for pelvic abscess drainage.</p></div><div><h3>Discussion</h3><p>The literature is sparse in regard to clear guidelines for management of VCD. Surgical and expectant management approaches are dependent on patient stability, surgical experience, local practice norms, and evidence of intra-abdominal injury. Interventional radiology has become a primary source of drain placement in management of VCD and vaginal cuff abscess. Malecot drains are a low cost, and effective intervention for such management and an important resource for the gynecologic surgeon.</p></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S235257892400095X/pdfft?md5=5a49cb6fc53520d06c4f17c4bb065eef&pid=1-s2.0-S235257892400095X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141024587","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":"Postoperative venous thromboembolism risk in patients with vulvar carcinoma: An analysis of the National surgical Quality Improvement Program (NSQIP) database","authors":"Quinn Kistenfeger ,&nbsp;Ashley S. Felix ,&nbsp;Caitlin E. Meade ,&nbsp;Vincent Wagner ,&nbsp;Kristin Bixel ,&nbsp;Laura M. Chambers","doi":"10.1016/j.gore.2024.101411","DOIUrl":"10.1016/j.gore.2024.101411","url":null,"abstract":"<div><h3>Objectives</h3><p>Due to low incidence of vulvar cancer (VC), incidence and predictors for development of venous thromboembolism (VTE) are poorly understood. We examined incidence and risk factors associated with VTE in patients undergoing surgery for VC.</p></div><div><h3>Methods</h3><p>We included patients who underwent surgery for VC from the National Surgical Quality Improvement Program database. VTE within the 30-day postoperative period was captured with Current Procedural Terminology codes. Baseline demographics and clinical characteristics were compared between patients with and without VTE. Univariable and multivariable-adjusted exact logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for associations between risk factors and VTE.</p></div><div><h3>Results</h3><p>We identified 1414 patients undergoing procedures for VC from the NSQIP database. Overall, 11 (0.8 %) patients developed VTE. Univariable predictors of VTE included surgery type [compared with simple vulvectomy: radical vulvectomy only (OR = 7.97, 95 % CI = 1.44, infinity) and radical vulvectomy plus unilateral IFN (OR = 15.98, 95 % CI = 2.70, infinity)], unplanned readmission (OR = 11.56, 95 % CI = 2.74, 46.38), deep surgical site infection (OR = 16.05, 95 % CI = 1.59–85.50), and preoperative thrombocytosis (OR = 6.53, 95 % CI = 0.00, 34.86). In a multivariable-adjusted model, longer operative time (≥72 min OR = 11.33, 95 % CI = 1.58–499.03) and preoperative functional status [compared with complete independence: total dependence (OR = 53.88, 95 % CI = 0.85, infinity) and partial dependence (OR = 53.88, 95 % CI = 0.85, infinity)] were associated with VTE.</p></div><div><h3>Conclusion</h3><p>In this cohort of patients with VC undergoing radical vulvectomy, VTE incidence was low. Surgery type, longer operative time, dependent functional status, and wound disruption were identified as risk factors. Our findings highlight opportunities for prophylactic intervention in certain patients.</p></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352578924000900/pdfft?md5=007379edfe7b41c71cb68540e11dd348&pid=1-s2.0-S2352578924000900-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141029961","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":"Durable response to BRAF inhibitor monotherapy in recurrent metastatic low grade serous ovarian cancer","authors":"Shashank Sama ,&nbsp;Sterling Rosqvist ,&nbsp;Talicia Savage ,&nbsp;Lesley Lomo ,&nbsp;Kiera Sibbald ,&nbsp;Alli Straubhar ,&nbsp;Theresa L. Werner","doi":"10.1016/j.gore.2024.101412","DOIUrl":"https://doi.org/10.1016/j.gore.2024.101412","url":null,"abstract":"<div><p>Low grade serous ovarian cancers (LGSOC) in an advanced setting have limited systemic treatment options. In this paper we report a case of metastatic LGSOC harboring a BRAF mutation, treated with dabrafenib. We discuss the clinical, pathologic and molecular characteristics as well as surgical considerations and ongoing investigations in LGSOC.</p></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352578924000912/pdfft?md5=9ca70b911b990f911b8092ed35f61b4a&pid=1-s2.0-S2352578924000912-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140947422","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":"When it’s not ovarian cancer: A case of a massive leiomyoma with hydropic change","authors":"Hadi Erfani ,&nbsp;Sarah Chiang ,&nbsp;Shannan Dickinson ,&nbsp;Dennis S. Chi ,&nbsp;Sarah H. Kim","doi":"10.1016/j.gore.2024.101415","DOIUrl":"https://doi.org/10.1016/j.gore.2024.101415","url":null,"abstract":"<div><h3>Background</h3><p>Uterine leiomyomas are benign tumors characterized by pelvic pain and abnormal bleeding. Their evolution can lead to degenerative changes, occasionally mimicking malignancies on imaging, presenting diagnostic challenges.</p></div><div><h3>Case presentation</h3><p>A 31-year-old nulliparous woman presented with symptoms of bloating, cramping, and abdominal distension. Imaging suggested an advanced ovarian malignancy, showing a complex adnexal mass and elevated CA-125 levels. During exploratory laparotomy, what was suspected to be ovarian cancer was instead identified as a large uterine mass on pathologic evaluation revealing a benign leiomyoma with extensive hydropic change.</p></div><div><h3>Conclusion</h3><p>This case highlights the diagnostic intricacies associated with large complex adnexal masses and illustrates how benign conditions like leiomyomas with hydropic degeneration can mimic ovarian cancer. This emphasizes the importance of comprehensive preoperative and intraoperative assessments to tailor management and avoid unindicated radical procedures.</p></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352578924000948/pdfft?md5=63d3388d8ef973dcdef691aa84da1484&pid=1-s2.0-S2352578924000948-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140948662","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":"Robotic HIPEC with use of a vaginal GelPoint®","authors":"Daisy Cruz ,&nbsp;Nicole Lugo Santiago ,&nbsp;Ernest Han ,&nbsp;Jeff Lin","doi":"10.1016/j.gore.2024.101400","DOIUrl":"10.1016/j.gore.2024.101400","url":null,"abstract":"<div><p>Patients with advanced stage ovarian cancers commonly undergo hyperthermic intraperitoneal chemotherapy (HIPEC) following interval debulking via exploratory laparotomy. This video demonstrates the feasibility of HIPEC delivery via a minimally invasive approach with the use of a vaginal GelPoint® port.</p><p>This video demonstrates a 56-year-old patient with Stage 3 bilateral fallopian tube cancer who underwent 3 cycles of neoadjuvant chemotherapy with cisplatin and paclitaxel. Prior to administration of HIPEC the patient underwent an uncomplicated robotic assisted radical hysterectomy, bilateral salpingo-oopherectomy and infracolic omentectomy. Additionally, the falciform ligament was transected.</p><p>The vaginal cuff was then used for placement of the GelPoint® port. The inflow and outflow cannulas were placed at the level of the liver and pelvis robotically. To minimize risk of inadvertent spillage, robotic obturators were replaced. Prior to administration of HIPEC, 4 L of warm saline was administered. An additional safety check was performed with no areas of leak. Cisplatin was administered for 90 min followed by sodium thiosulfate and 3 L of normal saline. Confirmation of no residual fluid was noted laparoscopically.</p><p>The patient was discharged 2 days postoperatively without postoperative complications.</p><p>In this video we demonstrated the innovative technique of performing HIPEC via a minimally invasive approach, that typically requires an open procedure. With the use of a vaginal Gelpoint® we were able to safely administer intraperitoneal chemotherapy without risk to our patient. We were also able to minimize their length of hospital stay and expedite postoperative recovery. Further implementation of this technique may improve hospital resource allocation.</p></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352578924000791/pdfft?md5=18eebd5099e5529f6237b2cc06b59118&pid=1-s2.0-S2352578924000791-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141041794","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":"Endometrial cancer at recurrence: To re-sequence or not to re-sequence","authors":"Katherine Fuh,&nbsp;Beryl L. Manning-Geist","doi":"10.1016/j.gore.2024.101414","DOIUrl":"https://doi.org/10.1016/j.gore.2024.101414","url":null,"abstract":"","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352578924000936/pdfft?md5=789d63b1c524eddf4deb56bbafe07778&pid=1-s2.0-S2352578924000936-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141083638","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":"Cecal volvulus after robotic assisted laparoscopic hysterectomy in a gynecologic oncology patient: A case report","authors":"Divya Gowthaman ,&nbsp;Lauren Scanlon ,&nbsp;John C. McAuliffe ,&nbsp;Shabnam Fidvi ,&nbsp;Carly Schwartz ,&nbsp;Sara S. Isani","doi":"10.1016/j.gore.2024.101404","DOIUrl":"https://doi.org/10.1016/j.gore.2024.101404","url":null,"abstract":"<div><p>Cecal volvulus is a rare and life-threatening cause of intestinal obstruction with multiple risk factors including prior abdominal surgery and cecal hypermobility. Although its incidence has been reported after common procedures such as cholecystectomy and appendectomy, it has not been well studied after laparoscopy, especially in gynecological surgeries. If untreated, a cecal volvulus can result in serious complications such as intestinal strangulation, necrosis, or perforation. Therefore, early identification of risk factors and intervention is important in prevention of these sequelae. Here, we report a case of cecal volvulus in a patient with endometrial carcinoma after a staging robotic-assisted laparoscopic hysterectomy and the risk factors that may have led to her complication.</p></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352578924000833/pdfft?md5=24ee844e838048b679ab0d613f11bf63&pid=1-s2.0-S2352578924000833-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140893913","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}