Pedro Versuti Del Cioppo Vasques , Jamie N. Bakkum-Gamez , Patrick G. Dean , Jeremy F. Molligan , Allison E. Garda
{"title":"Novel use of adjuvant proton beam therapy in patient with pelvic renal transplant diagnosed with stage IB3 cervical adenocarcinoma","authors":"Pedro Versuti Del Cioppo Vasques , Jamie N. Bakkum-Gamez , Patrick G. Dean , Jeremy F. Molligan , Allison E. Garda","doi":"10.1016/j.gore.2024.101520","DOIUrl":"10.1016/j.gore.2024.101520","url":null,"abstract":"<div><div>Cervical adenocarcinoma is the second most common histology of cervical cancer and treatment can involve surgery, radiotherapy, systemic therapy, and any combination of the three. Photon external beam radiation therapy and brachytherapy have been the mainstay of radiation treatment options for cervical cancer. Here, we report a case of a 41-year-old patient who had a prior renal transplant and was diagnosed with early-stage, intermediate-risk adenocarcinoma treated with modified radical hysterectomy plus adjuvant proton-beam therapy and vaginal brachytherapy. Treatment was well tolerated with a disease-free interval of 14-months and preserved renal function.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142421576","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}
Flora Mae G. Sta. Ines , Julia R. Salinaro , Mary Marchese , Cara A. Mathews , M. Ruhul Quddus
{"title":"Invasive acantholytic anaplastic extramammary Paget disease: A previously unreported neoplasm in the vulva and review of the literature","authors":"Flora Mae G. Sta. Ines , Julia R. Salinaro , Mary Marchese , Cara A. Mathews , M. Ruhul Quddus","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}
Anastasia Navitski , Sakshi Sehgal , Kalyani Ballur , Lawrence C. Layman , Robert V. Higgins
{"title":"Ovotesticular Disorders of sexual development (DSD): A rare case of peritoneal carcinomatosis in an elderly DSD male patient","authors":"Anastasia Navitski , Sakshi Sehgal , Kalyani Ballur , Lawrence C. Layman , Robert V. Higgins","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}
Chisom O. Odii, David E. Vance, Fiona B. A. T. Agbor, Amanda Jenkins, Ellen M. Lavoie Smith
{"title":"Exploring social determinants of health on chemotherapy-induced peripheral neuropathy severity in ovarian cancer: An integrative review","authors":"Chisom O. Odii, David E. Vance, Fiona B. A. T. Agbor, Amanda Jenkins, Ellen M. Lavoie Smith","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}
Jhalak Dholakia , Leslie R. Boyd , Rinki Agarwal , Haley Moss , Emily M. Ko , Emeline Aviki , Margaret I. Liang
{"title":"Early-career and fellow gynecologic oncologists perceive underpreparedness for the business of medicine: A Society of gynecologic oncology survey study","authors":"Jhalak Dholakia , Leslie R. Boyd , Rinki Agarwal , Haley Moss , Emily M. Ko , Emeline Aviki , Margaret I. Liang","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 < 0.01), and compensation negotiations (p < 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":"Laurence Bernard","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}
Emily G. Gleason , Daniel H. Saris , Elizabeth A. Tubridy , Colleen M. Brensinger , Emily M. Ko
{"title":"Racial disparities in receipt of radiation and brachytherapy in cervical cancer patients: Do they exist in a SEER-Medicare population?","authors":"Emily G. Gleason , Daniel H. Saris , Elizabeth A. Tubridy , Colleen M. Brensinger , Emily M. Ko","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}
Peter W. Ketch , Sean C. Dowdy , Robert D. McBane II , J. Michael Straughn Jr , Teresa K.L. Boitano
{"title":"Direct oral anticoagulants (DOACs) for postoperative venous thromboembolism prophylaxis in patients with gynecologic malignancies: A quality mini-review","authors":"Peter W. Ketch , Sean C. Dowdy , Robert D. McBane II , J. Michael Straughn Jr , Teresa K.L. Boitano","doi":"10.1016/j.gore.2024.101508","DOIUrl":"10.1016/j.gore.2024.101508","url":null,"abstract":"<div><div>Venous thromboembolism (VTE) is a common cause of morbidity and mortality in gynecologic oncology patients with an increased risk in the postoperative period. Historically, international guidelines have recommended 28 days of low molecular weight heparin (LMWH) or unfractionated heparin (UFH) for extended VTE prophylaxis after major abdominal and pelvic surgery for gynecologic malignancies. Direct oral anticoagulants (DOACs) have emerged as an attractive alternative to injectable anticoagulants. This quality mini-review evaluated the literature around the use of DOACs for postoperative VTE prophylaxis after surgery for gynecologic cancer. Overall, the reviewed literature supports the use of DOACs in select patients within this population which may lead to an improved patient experience, higher rates of treatment compliance, and increased cost savings.</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":"142326703","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":"Jhalak Dholakia, Susan C. Modesitt","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}
Jordyn Tumas , Ruben D. Alberto Hiraldo , Tara Berman
{"title":"Androgen receptor expression in recurrent granulosa cell tumor of the ovary: Clinical considerations of treatment and surveillance in a transgender male","authors":"Jordyn Tumas , Ruben D. Alberto Hiraldo , Tara Berman","doi":"10.1016/j.gore.2024.101504","DOIUrl":"10.1016/j.gore.2024.101504","url":null,"abstract":"<div><div>Granulosa cell tumors (GCT) represent a rare subtype of ovarian cancers. A majority of these tumors express androgen receptor (AR), making them hormonally sensitive. AR positivity not only suggests a potential role of anti-androgen therapy in treating these tumors but also poses a cause for concern: female to male (FTM) transgender patients undergoing exogenous testosterone therapy may be at risk for recurrence, progression, or even incidence of this type of cancer. Although treatment of GCT in transgender individuals has not been well-described, the impact of exogenous hormone use on cancer physiology and treatment should be considered, while also addressing gender dysphoria throughout treatment and in surveillance. Here, we describe a FTM transgender patient with recurrent AR-positive adult granulosa cell tumor after starting testosterone supplementation, along with a literature review to explore the current knowledge of ovarian changes observed following FTM gender transition and subsequent risk of ovarian cancer.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142445998","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}