Gynecologic Oncology Reports最新文献

{"title":"“Developing a manual clinical trials screening process in a diverse southern gynecologic oncology practice”","authors":"M. Klein ,&nbsp;H. Pirzadah ,&nbsp;Y. Magharehabed ,&nbsp;A. Chapple ,&nbsp;N. Nair ,&nbsp;A. Jernigan ,&nbsp;T. Castellano","doi":"10.1016/j.gore.2024.101549","DOIUrl":"10.1016/j.gore.2024.101549","url":null,"abstract":"<div><h3>Objective</h3><div>There is no standard clinical trial screening process in gynecologic oncology. In our low resource, highly diverse gynecologic oncology patient population, we sought to create an equitable, adaptable, manual screening process.</div></div><div><h3>Methods</h3><div>Our objective is to describe our clinical trial screening process and success in improving trial enrollment. An Institutional Review Board (IRB) approved quality improvement (QI) project was implemented in July 2022 to evaluate trial access. Screenable events were defined. Potential patients were those with a screenable event: new patients or diagnoses, regimen changes, progressions, and recurrences. Events were categorized into screen positive or screened no trial available. Screen positives were further categorized as screen positive, enrollment failure events or enrollments. Data about patients were collected via weekly research team meetings. Monthly meetings occurred to review progress. The data were compared to trials available, number of patients with trail available, and those that enrolled. Reasons for enrollment fails were tracked.</div></div><div><h3>Results</h3><div>Over time, “screen no trial available” (SNTA) rates stayed stable, but enrollment rates increased. Patient preference accounted for 32.8 % of enrollment failures (n = 42), pre-existing symptoms 23.4 % (n = 30), and location 21.1 % (n = 27). During increased employee turnover, there was a rise in enrollment fails due to staffing (n = 6, 4.7 %). We describe an effective process of clearly defining and tracking our patient population and ‘screenable events’ for which all patients are screened and offered trial participation if eligible.</div></div><div><h3>Conclusions</h3><div>We show that we improved understanding of the patient population, built a clinical trial portfolio better matched to population served, exceeded national averages for enrolling patients on trials, and are improving number eligible.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"57 ","pages":"Article 101549"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931363","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":"Digital cervicography using mobile phones with real-time consultation (DCRC) to improve performance of Visual Inspection with Acetic Acid (VIA) in cervical cancer screening of HIV-infected women. A cross-sectional study","authors":"P. Tonui ,&nbsp;P. Itsura ,&nbsp;O. Omenge ,&nbsp;N. Faiza ,&nbsp;A. Keter ,&nbsp;A. Mburu ,&nbsp;J. Oguda ,&nbsp;Amina R. Hassan ,&nbsp;S. Cu-Uvin","doi":"10.1016/j.gore.2024.101661","DOIUrl":"10.1016/j.gore.2024.101661","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Visual Inspection with Acetic Acid (VIA) has been adopted for cervical cancer screening in Kenya and other Low-Middle Income Countries despite providing suboptimal results among HIV-infected women. It is mostly performed by nurses in health centers. Innovative ways of improving the performance of VIA in HIV-infected women are desired.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To establish the feasibility of screening with VIA and Digital Cervicography with Real-time Consultation (VIA-DCRC), and compare its performance to screening with VIA alone among HIV + women.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This was a cross-sectional analytical study of two hundred HIV + women. There were two groups of women who underwent either VIA or VIA/DCRC cervical cancer screening arms. In the VIA/DCRC arm, a trained nurse did the VIA, captured an image of the cervix, uploaded it, and electronically shared it in real-time with three blinded study consultants (gynecologic oncologists) who separately assessed the digital image and classified it as VIA/DCRC positive or negative. Any two opinions of the gynecologic oncologists that concurred were considered as the final diagnosis.&lt;/div&gt;&lt;div&gt;All participants who screened positive underwent colposcopy and biopsy prior to treatment. Tissues obtained were subjected to histopathological examination. A fraction (15 %) of those who screened negative for VIA and VIA/ DCRC had random cervical biopsies taken at 12 and 6o’clock positions. We estimated the measures of accuracy using the Bayesian method.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The mean age was 39.7 +/- 10.7 years. Average CD4 + count and plasma viral load (log base 10) were 492.2 (SD: 255.3) cells per mm&lt;sup&gt;3&lt;/sup&gt;, and 2.6 (SD: 0.7) copies per ml respectively. None of the women was a smoker.&lt;/div&gt;&lt;div&gt;The median (IQR) time taken for at least one gynecologic oncologist to respond to a digital consultation was 2.0 (IQR 1.0, 4.0) minutes, range: 1.0 – 47.0.&lt;/div&gt;&lt;div&gt;Overall, 60.5 % were diagnosed with cervical pre-malignancies (VIA: 23.1 % (95 % Credible Bounds (CB): 10.1, 37.5), VIA/DCRC: 37.5 % (95 % CB: 26.6, 50.1)).&lt;/div&gt;&lt;div&gt;VIA sensitivity, specificity, positive predictive value and negative predictive value were 28.1 % (95 % CB: 11.2, 6.8), 97.8 % (95 % CB: 93.0, 99.7), 79.8 % (95 % CB: 47.3, 96.8), and 80.4 % (95 % CB: 71.0, 87.5) while that of VIA/DCRC was 69.3 % (95 % CB: 47.8, 89.7), 87.9 % (95 % CB: 76.3, 94.4), 77.6 % (95 % CB: 61.9, 89.3), and 80.3 % (95 % CB: 70.2, 88.9) respectively. Compared to the VIA/DCRC group, there was evidence of better sensitivity, comparable negative predictive value, but poor specificity, RR: 2.46 (95 % CB: 1.06, 6.26), RR: 1.65 (95 % CB: 1.00, 3.50), and RR: 0.90 (95 % CB: 0.78, 0.98) respectively.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Cervical cancer screening in HIV + women using VIA/DCRC is feasible and it significantly improves the sensitivity, and comparable negative predictive value of V","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"57 ","pages":"Article 101661"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004263","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":"BCOR abnormalities in endometrial stromal sarcoma","authors":"Abdulkareem Fayoumi","doi":"10.1016/j.gore.2024.101672","DOIUrl":"10.1016/j.gore.2024.101672","url":null,"abstract":"<div><div>Endometrial stromal tumors (ESTs) are uncommon mesenchymal tumors of the reproductive system associated with heterogeneous histomolecular features. According to the World Health Organization (WHO), ESTs are classified into benign endometrial stromal nodules (BESN) and endometrial stromal sarcomas (ESSs), which are further divided into low-grade and high-grade subtypes. High-grade ESS is frequently associated with YWHAE–NUTM2 gene fusions, while a newly recognized subtype with BCOR rearrangements, including fusions, alterations, and internal tandem duplications (ITDs), has recently been incorporated into the molecular classification of ESS. BCOR, a transcriptional corepressor of BCL-6, contributes to tumor progression through its role in polycomb repressive complex 1 (PRC1), underscoring its importance in oncogenesis and potential as a therapeutic target. Advances in molecular diagnostics, such as next-generation sequencing (NGS) and fluorescence in situ hybridization (FISH), have improved the precision of diagnosing BCOR-altered ESS, enabling better prognostic stratification. These findings also support the development of targeted therapies, including CDK4/6 inhibitors and immunotherapies targeting PD-1 and CTLA-4 pathways. Despite these advancements, barriers such as limited access to molecular diagnostics and the high cost of novel therapies remain significant challenges. This review bridges molecular and clinical insights into ESS, emphasizing the diagnostic, prognostic, and therapeutic implications of BCOR rearrangements. By integrating these advances into clinical practice, it aims to improve outcomes for patients with this rare and aggressive malignancy.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"57 ","pages":"Article 101672"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058871","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":"Step-by-step combination of 99mTc and ICG with endoscopic near infrared cameras in SLN mapping early-stage vulvar cancer","authors":"A. Rafael Guijarro-Campillo ,&nbsp;Pablo Padilla-Iserte ,&nbsp;Víctor Lago ,&nbsp;Raquel Quintana-Bertó ,&nbsp;Marta Arnáez-De La Cruz ,&nbsp;Aníbal Nieto ,&nbsp;Santiago Domingo Del Pozo","doi":"10.1016/j.gore.2025.101677","DOIUrl":"10.1016/j.gore.2025.101677","url":null,"abstract":"<div><div>Vulvar cancer guidelines recommend inguinal sentinel lymph node (SLN) biopsy as the standard of care for patients with unifocal squamous cell carcinoma tumors less than 4 cm and clinically non-suspicious nodes in the groin <span><span>[1]</span></span>. The use of radioactive tracer is mandatory, while the application of blue dye is optional <span><span>[2]</span></span>. Combination detection techniques have been established as the most accurate for early vulvar cancer, with increasing evidence supporting indocyanine green (ICG) as an alternative to blue dye <span><span>[3]</span></span>, <span><span>[4]</span></span>. However, protocols for ICG use remain heterogeneous, and the optimal protocol is yet to be defined <span><span>[5]</span></span>, <span><span>[6]</span></span>.</div><div>This video article presents a stepwise demonstration of the SLN mapping technique using a combination of radioactive 99 m-Tc and ICG with endoscopic near-infrared (NIR) cameras in two cases. A 52-year-old woman diagnosed with T1 vulvar cancer, with no extravulvar disease, was scheduled for wide local tumor excision and bilateral inguinal SLN biopsy. The procedure began with 99 m-Tc detection, followed by ICG identification. A 25 mg vial of ICG<!--> <!-->was dissolved in 10 mL of sterile water, with 2 mL injected into four intradermal quadrants around the tumor. Ten minutes post-injection, a small incision in the groin was made, assisted by lymphoscintigraphy fluorescence imaging using the NIR/ICG-IMAGE1S™ system. Images of another IB FIGO stage vulvar cancer patient undergoing SLN inguinal procedure with the NIR Da Vinci Xi camera were also included. The sentinel nodes were accurately detected in both patients, with no involvement after histological study. The informed consent for this video was obtained from both patients.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"57 ","pages":"Article 101677"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143180191","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":"Epidemiological study of HPV infection in 24,588 rural women in Luonan, China","authors":"Xin Zhao ,&nbsp;Shi Shen ,&nbsp;Cailing Su ,&nbsp;Juan Chang ,&nbsp;Yunfang Yan ,&nbsp;Jianmin Zhao","doi":"10.1016/j.gore.2024.101669","DOIUrl":"10.1016/j.gore.2024.101669","url":null,"abstract":"<div><div>Cervical cancer is a significant public health issue for women, with human papillomavirus (HPV) infection rates exhibiting regional variations throughout China. This study examined data from a cohort of 24,588 rural women who engaged in cervical cancer screening in Luonan County from 2021 to 2023, utilizing high-risk HPV (hrHPV) testing methodologies. The findings revealed an overall HPV positivity rate of 14.18 %, with hrHPV positivity rates of 13.99 % in 2021, 12.97 % in 2022, and 15.32 % in 2023. Infection rates increased with age, showing significant differences among age groups. Types 52, 16, and 58 were the most prevalent hrHPV types. Single-type infections were more common than multiple infections, with prevalent combinations such as HPV16 + HPV52, HPV52 + HPV58, and HPV51 + HPV16. The results highlight the imperative for improved screening, especially for women aged 60 to 64 residing in rural areas, and emphasize the importance of HPV vaccination and targeted screening for the prevention and eventual eradication of cervical cancer.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"57 ","pages":"Article 101669"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11743901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004351","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":"Quality of life and survival in patients with uterine carcinosarcoma: A tertiary center observational study","authors":"Eveline N.B. Pham ,&nbsp;Caroline B. van den Berg ,&nbsp;Ingrid Boere ,&nbsp;Vera de Geus ,&nbsp;Juanita A. Haagsma ,&nbsp;Marianne Maliepaard ,&nbsp;Jan Willem M. Mens ,&nbsp;Floris H. Groenendijk ,&nbsp;Heleen J. van Beekhuizen","doi":"10.1016/j.gore.2025.101679","DOIUrl":"10.1016/j.gore.2025.101679","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to assess the QoL in patients with uterine carcinosarcoma (UCS) and identify factors influencing survival.</div></div><div><h3>Methods</h3><div>A prospective cohort study was conducted of patients with UCS who were treated between 2016 and 2022 in a Dutch academic hospital. QoL was evaluated using the EORTC QLQ-C30 and QLQ-EN24 questionnaires at baseline, end of treatment, and at one, two, and five years after treatment. Outcomes were described as mean scores in functioning and symptom domains. The mean scores of the QLQ-C30 were compared to those of a matched group from the general Dutch population. Clinical data were collected. Factors influencing survival were assessed via Cox proportional hazards models.</div></div><div><h3>Results</h3><div>The study included 64 patients, 56 of them participated in the QoL questionnaires. The median progression-free survival was 13 months, and overall survival was 20 months. QoL was significantly lower in all functional domains at one year after treatment compared to members of the general population. The most affected functioning domains were physical, role, cognitive, and social functioning and symptoms like fatigue, pain, and lymphedema. Long-term QoL remained compromised, with global health and insomnia notably impaired even five years after treatment. Significant prognostic factors for better overall survival included lower FIGO stage, surgery, and chemotherapy.</div></div><div><h3>Conclusions</h3><div>Patients with UCS experience significant deterioration in QoL. Despite extensive treatment, QoL remains poor, emphasizing the need for integrating QoL considerations into treatment decisions to balance the benefits of treatment with potential QoL impairments.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"57 ","pages":"Article 101679"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122736","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":"Factors associated with willingness to perform expedited excisional treatment for patients at high risk for cervical precancer","authors":"Rebecca B. Perkins ,&nbsp;Lindsay Fuzzell ,&nbsp;Naomi C. Brownstein ,&nbsp;Holly B. Fontenot ,&nbsp;Alexandra Michel ,&nbsp;Sidika Kajtezovic ,&nbsp;Paige Lake ,&nbsp;Susan T. Vadaparampil","doi":"10.1016/j.gore.2024.101545","DOIUrl":"10.1016/j.gore.2024.101545","url":null,"abstract":"<div><h3>Background</h3><div>The 2019 ASCCP Risk-Based Management Consensus Guidelines prefer expedited treatment, defined as proceeding to excisional treatment without first performing colposcopic biopsy, for patients with screening results indicating a high risk of cervical precancer. In this mixed methods study, we explored clinician attitudes toward expedited treatment.</div></div><div><h3>Methods</h3><div>In 2021, a national sample of 671 clinicians who performed colposcopy completed surveys; a subset (n = 41) of clinicians who performed colposcopy and/or directed patient treatment completed qualitative interviews.</div></div><div><h3>Results</h3><div>Among 671 colposcopists, 25.7 % were currently performing expedited treatment, 50.8% were not currently using expedited treatment but were willing to adopt this change, and 23.6% were not willing to perform expedited treatment. Binomial regression analyses indicated that internal medicine and family medicine clinicians (compared to Obstetrician-Gynecologists), and those practicing in academic medal centers (compared to private practice) had higher odds of currently performing expedited treatment; internal and family medicine clinicians also reported higher odds of being willing to adopt this change. Qualitative interviews highlighted benefits including improved cancer prevention among older patients, reduced loss to follow-up, reduction of time and expense for patients, and allowing shared decision-making. Concerns expressed related to future pregnancy complications, lack of available excisional treatment services (e.g., LEEP), patient preference, avoiding over- and under-treatment, and using biopsy results to plan excisional procedures.</div></div><div><h3>Conclusions</h3><div>Approximately 25 % of colposcopists are currently performing expedited treatment, and an additional 50 % would be willing to adopt this practice for high-risk patients. Improving access to expedited treatment for appropriate patients could improve cervical cancer prevention.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"57 ","pages":"Article 101545"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983315","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":"INDEPSO-ISPSM consensus on peritoneal malignancies – Enhanced recovery after surgery in cytoreductive surgery (CRS) with/without hyperthermic intraperitoneal chemotherapy (HIPEC)","authors":"Geetu Prakash Bhandoria ,&nbsp;Arvind Guru ,&nbsp;Ajinkya Pawar ,&nbsp;Aditi Bhatt ,&nbsp;Neha Kumar ,&nbsp;Rohit Kumar ,&nbsp;Swapnil Patel ,&nbsp;Sohan Lal Solanki ,&nbsp;Vivek Sukumar ,&nbsp;Ashwin K. Rajagopal ,&nbsp;S.P. Somashekhar","doi":"10.1016/j.gore.2024.101662","DOIUrl":"10.1016/j.gore.2024.101662","url":null,"abstract":"<div><h3>Background</h3><div>The role of enhanced recovery after surgery (ERAS) in cytoreductive surgery and/or Hyperthermic Intraperitoneal Chemotherapy <strong>(</strong>HIPEC) is evolving, with promising results that improve patient outcomes. This consensus exercise was carried out to address and standardize components of the ERAS protocol pertinent to the Indian context.</div></div><div><h3>Method</h3><div>The modified Delphi method was employed with two rounds of voting. All fifty invited specialists agreed to vote. There were 30 questions addressing the key elements of ERAS protocols. They were broadly distributed across four sections: Prehabilitation, Preoperative, Intraoperative, and Postoperative elements. A consensus was achieved if any one option received &gt; 70 % votes (strong consensus &gt; 90 %). If consensus was not achieved in round 1, the question was moved to round 2.</div></div><div><h3>Results</h3><div>After rounds I and II, 48/50 (95.8%) of invited panelists voted for the questions. The highest rate of ‘skipped question’ was 6% in both rounds. A consensus was obtained for 28/30 (93.33%) questions, and strong consensus was obtained for 5/30 (16.6%) questions. No consensus was obtained for two questions. Some of the panelists’ recommendations contradicted the standard ERAS guidelines, such as using intraperitoneal drains in all patients and mechanical bowel preparation for left-sided colonic or rectal resections.</div></div><div><h3>Conclusion</h3><div>Despite some limitations, this consensus exercise represents a significant step toward advancement and pioneering efforts to improve patient outcomes by implementing and standardizing ERAS protocols in CRS and/or HIPEC tailored for India.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"57 ","pages":"Article 101662"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983324","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":"Provider perspectives on caring for patients with limited English proficiency-a national survey of the Society of Gynecologic Oncology","authors":"S.M. Folsom ,&nbsp;A.B. Olawaiye ,&nbsp;S.E. Taylor","doi":"10.1016/j.gore.2024.101655","DOIUrl":"10.1016/j.gore.2024.101655","url":null,"abstract":"<div><h3>Background</h3><div>In diversity, equity and inclusion research, overcoming barriers in language discordant patient care is one of the largest and most challenging gaps. It is well established that patients with limited English proficiency (LEP) have higher rates of misdiagnosis, medical errors, and serious adverse events, and recommended best practices for LEP patient care are often not followed.</div></div><div><h3>Objective</h3><div>Our team sought to elicit provider perspectives regarding the barriers they face in caring for LEP patients—especially the unique challenges faced when caring for patients with complex and sensitive diagnoses such as gynecologic cancer.</div></div><div><h3>Methods</h3><div>A national survey was conducted through the Society of Gynecologic Oncology survey database during November and December of 2023. The survey included questions regarding the landscape of LEP patient care in varied geographic settings and practice types. It queried providers regarding available support and resources, as well as tools practitioners would recommend to improve care for LEP patients with gynecologic cancer. The results were assessed using descriptive statistics and Likert Scales and analyzed using t-tests, Fisher’s Exact test, Chi-square analysis and ANOVA.</div></div><div><h3>Results</h3><div>188 respondents completed the survey. Spanish was the most spoken non-English language in providers’ patient populations; however, 39 different languages were reported as commonly spoken. Providers reported increases in stress and a lack of time in caring for LEP patients. When asked what interventions providers would recommend to improve LEP patient care, providers asked for more in-person interpreters (40%), more written patient instructions in needed languages (32%), and more time (17%).</div></div><div><h3>Conclusions</h3><div>Understanding barriers to best practices in LEP patient care is vital to planning future interventions. While this survey was limited by the small percentage of respondents, it provides foundational information for future interventions intended to relieve over-burdened practitioners and systems and achieve the ultimate goal of improved outcomes for LEP patients.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"57 ","pages":"Article 101655"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970425","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":"Hydronephrosis and survival in cervical cancer patients: The role of urinary diversion","authors":"María Esther Garza-Montúfar ,&nbsp;Gibrán Domingo Carballo-Rosario ,&nbsp;Carlos Marcel García-Pérez","doi":"10.1016/j.gore.2024.101660","DOIUrl":"10.1016/j.gore.2024.101660","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to assess the impact of urinary diversion on survival in patients with advanced cervical cancer (CC) and hydronephrosis. Additionally, we examined the influence of other patient factors and urinary diversion type on survival.</div></div><div><h3>Methods</h3><div>A retrospective study analyzed survival in cervical cancer (CC) patients with hydronephrosis treated at two Mexican hospitals from 2011 to 2023. Patient data, including demographics, clinical, and pathological characteristics, were collected. Urinary diversion details and complications were recorded. Survival analysis was performed using Kaplan-Meier method and Cox regression model to identify predictors of survival.</div></div><div><h3>Results</h3><div>A total of 228 cervical cancer patients presenting with hydronephrosis were analyzed. Median follow-up was 9 months. The majority of patients were in stage IVA (44.3 %), with 66.7 % exhibiting bilateral renal involvement. Urinary diversion was performed in 192 patients (84.2 %). Median overall survival (OS) was 15.5 months. Multivariate analysis identified stage, disease course, oncologic treatment, laterality, performance status, and urinary diversion as independent prognostic factors for survival. In patients undergoing urinary diversion, bilateral renal involvement (HR 2.0) and deteriorated performance status (HR 3.6) were risk factors for mortality. Neither the laterality (unilateral or bilateral) nor the type of diversion significantly affected overall survival.</div></div><div><h3>Conclusions</h3><div>Survival in CC patients with hydronephrosis is influenced by factors such as: bilateral involvement, performance status, clinical stage, course and treatment of the underlying malignancy and urinary diversion. Urinary diversion improves survival, regardless of the specific diversion type or whether the diversion is unilateral or bilateral.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"57 ","pages":"Article 101660"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983320","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}