Gynecologic Oncology Reports最新文献

{"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":"Recurrence and survival in high-intermediate risk endometrial cancers with isolated tumor cell lymph node metastasis","authors":"Ahmad Awada,&nbsp;Fernando O. Recio,&nbsp;Theresa M. Kuhn,&nbsp;Sarfraz Ahmad,&nbsp;Jianbin Zhu,&nbsp;Nathalie D. McKenzie,&nbsp;James E. Kendrick,&nbsp;Robert W. Holloway","doi":"10.1016/j.gore.2025.101684","DOIUrl":"10.1016/j.gore.2025.101684","url":null,"abstract":"<div><h3>Objective</h3><div>To compare clinical outcomes of patients with early-stage, high-intermediate risk (HIR) endometrial cancer (EC) and isolated tumor cells (ITC) lymph node metastases treated with chemotherapy/radiotherapy (CRT) vs. external beam radiotherapy (EBRT)/vaginal brachytherapy (VBT).</div></div><div><h3>Methods</h3><div>We retrospectively identified all patients with early-stage HIR endometrioid EC and ITC treated with CRT or EBRT from our institutional database (January-2015 to December-2023). All patients underwent sentinel lymph node (SLN) assessments per NCCN guidelines. Progression-free survival (PFS) and cancer specific survival (CSS) were analyzed using Kaplan-Meier method. We utilized a GOG-99 scoring system in the HIR-ITC cohort to assess risk factors for recurrence.</div></div><div><h3>Results</h3><div>48 patients were identified, 32(67 %) treated with CRT, 15(31 %) with EBRT and 1(2 %) with VBT alone. Median follow-up was 63.2 and 28 months in CRT vs EBRT/VBT, respectively (<em>p</em> = 0.001). In CRT cohort, 4(12.5 %) recurred; two patients with isolated lung metastasis were salvaged and two with multiple sites of metastasis died with disease. No patient in EBRT/VBT cohort (n = 16) recurred. Estimated PFS were 84.4 % and 100 % for CRT and EBRT/VBT, respectively (<em>p</em> = 0.392), and CSS were 93.7 % vs. 100 %, respectively (<em>p</em> = 0.457). Using HIR scoring per GOG-99, 21(66 %) patients in CRT cohort had three or more HIR risk factors and 4(19 %) recurred despite adjuvant therapy.</div></div><div><h3>Conclusion</h3><div>In this retrospective study, there was no significant difference in survival for patients with HIR endometrial cancer and ITC SLNs treated with either EBRT/VBT or CRT. Patients with three or more HIR risk factors remain at risk for recurrence despite CRT. Further prospective studies should assess recurrence risk factors in HIR EC with ITC, likely incorporating standard histopathology and molecular profiles to tailor adjuvant CRT.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"57 ","pages":"Article 101684"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143180231","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":"Surgical management of endometrial cancer in patient with musculocontractural Ehlers-Danlos Syndrome harboring pathogenic variants in CHST14 (mcEDS-CHST14): A case report","authors":"Yuta Shioya ,&nbsp;Hirofumi Ando ,&nbsp;Tsutomu Miyamoto ,&nbsp;Koichi Ida ,&nbsp;Hisanori Kobara ,&nbsp;Tomomi Yamaguchi ,&nbsp;Tomoki Kosho ,&nbsp;Tanri Shiozawa","doi":"10.1016/j.gore.2024.101675","DOIUrl":"10.1016/j.gore.2024.101675","url":null,"abstract":"<div><h3>Introduction</h3><div>Musculocontractural Ehlers-Danlos syndrome (mcEDS) is a rare autosomal recessive connective tissue disorder caused by systemic depletion of dermatan sulfate. Symptoms characteristic of mcEDS include multiple contractures, fragile skin with subcutaneous bleeding, and hypermobile joints, which suggest difficulty in perioperative management. However, safe surgical techniques and perioperative management of this disorder remain unknown because of its rarity. We report a patient with mcEDS who developed endometrial cancer and underwent surgery, with emphasis on perioperative management.</div></div><div><h3>Case report</h3><div>A female patient, who had been genetically diagnosed with mcEDS-CHST14 at the age of 25, presented with symptoms characteristic of mcEDS, including: congenital contractures of fingers and clubfeet, recurrent joint dislocation, progressive foot and spinal deformities, and large subcutaneous hematomas. At age 33, she had been diagnosed with atypical endometrial hyperplasia, and scheduled to undergo total abdominal hysterectomy. To address the risk of massive hemorrhage during the surgery due to mcEDS-related tissue fragility, plasma-derived factor VIII concentrate was prophylactically administered before surgery. During the surgery, neither fragility, hyperextensibility, nor hemorrhagic tendency of the uterus or adnexa observed was observed. The surgery was uneventful, with blood loss of 180 mL and operative time of 2 h and 54 min. However, on the sixth postoperative day, a 2.5-cm dissection was noted at the site of skin incision. Subcutaneous fluid accumulation developed under the skin incision and it persisted for 1.5 months. The postoperative pathological diagnosis was endometrioid carcinoma grade 1, stage IA.</div></div><div><h3>Conclusion</h3><div>The present case suggested that the prophylactic use of factor VIII was effective for the prevention of hemorrhage during surgery. However, delayed wound healing of the skin and subcutaneous tissues was considered a subject for future improvement.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"57 ","pages":"Article 101675"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046372","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}

{"title":"Views on cervical cancer screening among female caregivers at the Uganda cancer Institute","authors":"Martin Origa ,&nbsp;Anthony Kayiira ,&nbsp;Rahel Ghebre ,&nbsp;Lauren Bollinger ,&nbsp;Sheila Irene Kisakye ,&nbsp;Deanna Teoh","doi":"10.1016/j.gore.2024.101654","DOIUrl":"10.1016/j.gore.2024.101654","url":null,"abstract":"<div><div>Patients admitted to Uganda Cancer Institute (UCI) have their non-medical needs provided by caregivers called “attendants” who are predominantly female family members. This provides a unique opportunity to provide free screening among attendants during their free time at the hospital. The objective of this qualitative focus group study was to understand knowledge of and facilitators and barriers to cervical cancer screening among attendants at the UCI. The goal is to use these data to inform a future opportunistic intervention. Female attendants 25 years of age or older were included in this focus group study. The focus group discussions explored knowledge of cervical cancer and screening modalities, health information sources, barriers and facilitators for cervical cancer screening, and potential use of mobile phone technology to share cervical cancer screening information among one’s social community. Data were analyzed using an inductive approach and thematic analysis. Results showed moderate understanding of risk factors for cervical cancer, supplemented by misinformation. Knowledge of symptoms of advanced cervical cancer was high. Most participants were aware that cervical cancer screening exists but knew little about screening modalities. Responses were mixed regarding preferred information sources, and included healthcare workers and facilities, radio and family members. Participants were enthusiastic about mobile phone messaging to provide information about screening but emphasized a need to catch their attention and incentivize screening with promise of good such as sugar, demonstrating prioritization of immediate needs over future cancer risk. These results will inform an intervention which aims to connect female caregivers with free screening available at the adjacent cancer prevention clinic.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"57 ","pages":"Article 101654"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894041","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":"Pulsed electric field (PEF) treatment of refractory vulvar melanoma concurrently treated with immune checkpoint blockade demonstrating an abscopal response: A case report","authors":"Daniel B. Knight ,&nbsp;Hannah Hillard ,&nbsp;Chauncy Handran ,&nbsp;Patrick Kuhlman","doi":"10.1016/j.gore.2024.101671","DOIUrl":"10.1016/j.gore.2024.101671","url":null,"abstract":"","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"57 ","pages":"Article 101671"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004353","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":"Transforming clinical trial enrollment: Leveraging technology and innovation to reach patients where they are","authors":"Sahana Somasegar,&nbsp;Jamie N. Bakkum-Gamez","doi":"10.1016/j.gore.2025.101691","DOIUrl":"10.1016/j.gore.2025.101691","url":null,"abstract":"","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"57 ","pages":"Article 101691"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143428927","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":"Neovaginal squamous cell carcinoma in a transgender woman: Case report, treatment insights, and literature review","authors":"Manengue Arsene ,&nbsp;Nantier Émilie Marie-Christine ,&nbsp;Pelland Marie-Ève ,&nbsp;Beauchemin Marie-Claude ,&nbsp;Bourque Jean-Marc","doi":"10.1016/j.gore.2025.101686","DOIUrl":"10.1016/j.gore.2025.101686","url":null,"abstract":"","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"57 ","pages":"Article 101686"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143127834","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}