International Journal of Gynecological Cancer最新文献

{"title":"Racial and sociodemographic disparities in the use of targeted therapies in advanced ovarian cancer patients with Medicare.","authors":"Anne Knisely, Chi-Fang Wu, Alexa Kanbergs, Nuria Agusti, Kirsten A Jorgensen, Alexander Melamed, Sharon H Giordano, Jose Alejandro Rauh-Hain, Roni Nitecki Wilke","doi":"10.1136/ijgc-2024-005599","DOIUrl":"10.1136/ijgc-2024-005599","url":null,"abstract":"<p><strong>Objective: </strong>To describe sociodemographic and racial disparities in receipt of poly ADP-ribose polymerase inhibitors (PARPi) and bevacizumab among insured patients with ovarian cancer.</p><p><strong>Methods: </strong>This retrospective study used the Surveillance, Epidemiology, and End Results (SEER)-Medicare database to identify patients with advanced stage, high grade serous ovarian cancer diagnosed between 2010 and 2019. The primary outcome of interest was receipt of PARPi or bevacizumab at any time after diagnosis. χ² tests were used to compare categorical variables. Factors independently associated with the receipt of PARPi and/or bevacizumab were identified using a multivariable logistic regression.</p><p><strong>Results: </strong>The cohort included 6242 patients; 276 (4.4%) received PARPi, 2142 (34.3%) received bevacizumab, and 389 (6.2%) received both. Receipt of either targeted treatment increased over the study period. On univariate analysis, patients who received either targeted therapy were younger (63% vs 48% aged <75 years; p<0.001), had a lower comorbidity index (86% vs 80% Charlson Comorbidity Index 0-1; p<0.001), and higher socioeconomic status (74% vs 71% high socioeconomic status; p=0.047) compared with those who did not receive targeted therapy. In the multivariable model, non-Hispanic black patients were less likely than non-Hispanic white patients to receive either targeted therapy (odds ratio 0.77; 95% confidence interval 0.61 to 0.98; p=0.032). Older patients (aged >74 years) were also less likely to receive PARPi or bevacizumab compared with those aged 65-69 years (all p<0.001).</p><p><strong>Conclusion: </strong>Sociodemographic and racial disparities exist in receipt of PARPi and bevacizumab among patients with advanced ovarian cancer insured by Medicare. As targeted therapies become more commonly used, a widening disparity gap is likely.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"1661-1670"},"PeriodicalIF":4.1,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing minimally invasive simple hysterectomy in low risk cervical cancer: set up for the LASH trial.","authors":"Nicolò Bizzarri, Nadeem R Abu-Rustum, Marie Plante, Pedro T Ramirez, Luis Chiva, Henrik Falconer, David Cibula, Denis Querleu, Francesco Fanfani, Anna Fagotti, Giovanni Scambia","doi":"10.1136/ijgc-2024-005941","DOIUrl":"10.1136/ijgc-2024-005941","url":null,"abstract":"<p><p>After the publication of the Laparoscopic Approach to Cervical Cancer (LACC) trial, open surgery has become the standard approach for radical hysterectomy in early stage cervical cancer. Recent studies assessed the role of a non-radical approach in low risk cervical cancer and showed no survival difference compared with radical hysterectomy. However, there is a gap in knowledge regarding the oncologic outcomes of minimally invasive simple hysterectomy in low risk cervical cancer. This review offers an overview of the current evidence on the role of the minimally invasive approach in low risk cervical cancer and raises the need for a new clinical trial in this setting.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"1805-1808"},"PeriodicalIF":4.1,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anastomotic diversion rates following integration of indocyanine green fluorescence angiography in cytoreductive surgery for ovarian cancer.","authors":"Lina Salman, Liat Hogen, Manjula Maganti, Taymaa May","doi":"10.1136/ijgc-2024-005753","DOIUrl":"10.1136/ijgc-2024-005753","url":null,"abstract":"<p><strong>Objective: </strong>To compare rates of diverting ileostomy in patients with ovarian cancer, undergoing cytoreduction with bowel resection before and after the acquisition of indocyanine green fluorescence angiographic scans for anastomotic perfusion assessment.</p><p><strong>Methods: </strong>A retrospective cohort study of patients with ovarian cancer undergoing bowel resection during cytoreductive surgery between 2010 and 2021. We evaluated whether using indocyanine green fluorescence angiography impacted rates of diverting ileostomy. Baseline characteristics and rates of diversion were compared between those who had indocyanine green fluorescence assessment and those with bowel resection without anastomotic fluorescence assessment.</p><p><strong>Results: </strong>Overall, 181 patients were included. Of whom, 84 (46%) underwent anastomotic fluorescence assessment following bowel resection, and 97 (54%) had bowel resection without assessment. Mean age of the cohort was 58.2 years and 132 (73%) had stage III disease. There was no difference between groups in rates of diverting ileostomy (41% vs 41%, p=1.0). In a univariable logistic regression, the odds of having an ileostomy were 2.92 times higher in patients undergoing primary surgery than in patients undergoing interval cytoreductive surgery (95% CI 1.25 to 6.85, p=0.013). The use of fluorescence angiography did not predict performing diverting ileostomy (OR=0.97, 95% CI (0.53 to 1.76), p=0.92).</p><p><strong>Conclusion: </strong>In this cohort, the simple introduction of indocyanine green fluorescence angiography had no impact on the rates of anastomotic diversion. Developing a systematic, reproducible diversion protocol with selection criteria that include fluorescence angiography is needed to assess the impact of this surgically innovative tool on the rates of anastomotic diversion in patients with advanced ovarian cancer.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"1775-1779"},"PeriodicalIF":4.1,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to: Correspondence on 'An international worldwide retrospective cohort observational study comparing primary cytoreductive surgery with neoadjuvant chemotherapy and interval cytoreductive surgery in patients with carcinoma of the ovary, fallopian tubes, and peritoneum (SUROVA trial)' by Chiva et al.","authors":"Luis Chiva, Pilar Ordás","doi":"10.1136/ijgc-2024-006139","DOIUrl":"10.1136/ijgc-2024-006139","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"1841"},"PeriodicalIF":4.1,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diaphragmatic and pericardiac ovarian cancer recurrence removal and mesh reconstruction.","authors":"Agnieszka Rychlik, Maria Bedyńska, Piotr Hevelke","doi":"10.1136/ijgc-2024-005375","DOIUrl":"10.1136/ijgc-2024-005375","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"1822-1823"},"PeriodicalIF":4.1,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141184008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oncologic outcomes of incidental serous tubal intraepithelial carcinoma and associated high-grade serous carcinoma in high-risk patients undergoing risk-reducing surgery.","authors":"Eliane Aoun, Barrett Lawson, Chika Awujo, Denise Nebgen, Beth R Soletsky, Gary B Chisholm, Karen H Lu, Roni Nitecki Wilke","doi":"10.1136/ijgc-2024-005964","DOIUrl":"10.1136/ijgc-2024-005964","url":null,"abstract":"<p><strong>Objective: </strong>We sought to describe the oncologic outcomes of isolated serous tubal intraepithelial carcinomas compared to an intraepithelial carcinoma found concurrently with microscopic high-grade serous carcinoma among patients with hereditary predisposition to ovarian cancer who underwent risk-reducing surgery.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 32 high-risk patients with <i>BRCA1, BRCA2, RAD51C/D, BRIP1,</i> or <i>PALB2</i> pathogenic variants who were diagnosed with either isolated serous tubal intraepithelial carcinoma or concurrent serous tubal intraepithelial carcinoma and microscopic high-grade serous carcinoma following risk-reducing surgery between January 2006 and December 2023. Our population included patients who underwent surgery at our institution as well as those who had surgery elsewhere, but sought second opinions, follow-up care, or treatment at our institution. Data were gathered from medical and pathologic records, and pathologic specimens were re-reviewed by a gynecologic pathologist. Standard statistical methods were used to describe oncologic outcomes per group.</p><p><strong>Results: </strong>Among 32 patients in the cohort, we found that 68.7% had a pathologic diagnosis of an incidental serous tubal intraepithelial carcinoma, while 31.3% had a pathologic diagnosis of microscopic high-grade serous carcinoma with associated serous tubal intraepithelial carcinoma. Notably, two patients (9%) with isolated serous tubal intraepithelial carcinoma developed primary peritoneal carcinoma within a median of 29 months after surgery. One-third of patients with microscopic cancer experienced recurrence despite receiving standard staging surgery and chemotherapy for early-stage disease. Most of the patients in the cohort were older at the time of risk-reducing surgery than recommended for their pathologic variant.</p><p><strong>Conclusions: </strong>The study supports the critical need for timely risk-reducing surgery in high-risk populations, as well as a comprehensive pathologic examination along with vigilant post-operative surveillance. Consensus guidelines for management of serous tubal intraepithelial carcinoma are necessary to identify a group of patients at higher risk of progression to primary peritoneal carcinoma and optimize patient care.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of an oral combination therapy of niraparib and etoposide in platinum resistant/refractory ovarian cancer: a single arm, prospective, phase II study.","authors":"Huimei Zhou, Qian Liu, Depu Zhang, Qingshui Li, Dongyan Cao, Ninghai Cheng, Xirun Wan, Ying Zhang, Fengzhi Feng, Yang Xiang, Jiaxin Yang","doi":"10.1136/ijgc-2024-005386","DOIUrl":"10.1136/ijgc-2024-005386","url":null,"abstract":"<p><strong>Objective: </strong>Non-platinum chemotherapy is used in platinum resistant/refractory ovarian cancer patients but offers limited efficacy, especially in those who develop platinum resistance after ≤2 lines of platinum based chemotherapy. This phase II study aimed to evaluate the efficacy and safety of oral niraparib plus etoposide in platinum resistant/refractory ovarian cancer.</p><p><strong>Methods: </strong>Platinum resistant/refractory ovarian cancer patients after ≤2 lines of platinum based chemotherapy, histologically confirmed as non-mucinous epithelial ovarian cancer, regardless of biomarker status, were eligible. Patients received niraparib with a starting dose of 200 mg/100 mg alternate once a day, and oral etoposide of 50 mg once a day, on days 1-20 of 30 days per cycle for a maximum of 6-8 cycles, followed by niraparib until disease progression or intolerable toxicity. The primary endpoint was investigator assessed progression free survival.</p><p><strong>Results: </strong>29 patients were enrolled from 22 May 2020 to 3 February 2023; 26 patients were included in the efficacy analysis set as per protocol. Median progression free survival was 4.2 months (95% confidence interval (CI) 3.9 to 4.4). Overall response rate was 26.9% (95% CI 8.7 to 45.2). Disease control rate was 57.7% (95% CI 37.3 to 78.0). Overall response rate in patients with a BRCA mutation and homologous recombination deficiency was 50% and 41.7%, respectively. Median progression free survival in patients with primary platinum resistance was 4.5 months (95% CI 3.6 to 5.3). 29 patients were included in the safety analysis set, and 8 (28%) patients experienced treatment related adverse events of grade ≥3. There was no treatment related discontinuation.</p><p><strong>Conclusions: </strong>Niraparib combined with etoposide showed evidence of antitumor activity in platinum resistant/refractory ovarian cancer after ≤2 lines of platinum based chemotherapy, particularly in patients with a BRCA mutation, homologous recombination deficiency, or primary platinum resistance. This once-a-day oral combination was a convenient option.</p><p><strong>Trial registration number: </strong>NCT04217798.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"1761-1767"},"PeriodicalIF":4.1,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total pelvic exenteration with radical vulvectomy and anorectal resection in 10 steps.","authors":"Elodie Gauroy, Jessa Suhner, Thomas Meresse, Gwenael Ferron, Elodie Chantalat, Alejandra Martinez","doi":"10.1136/ijgc-2024-005556","DOIUrl":"10.1136/ijgc-2024-005556","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"1826-1827"},"PeriodicalIF":4.1,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intercultural dialogues and multilevel strategies for cervical cancer prevention for the Arhuacos indigenous community in Colombia.","authors":"Angela Regina Zambrano Harvey, Lina M Galvis-Cataño, Francisco Javier Bonilla-Escobar, Maria Alejandra Zapata Izquierdo","doi":"10.1136/ijgc-2024-005871","DOIUrl":"10.1136/ijgc-2024-005871","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"1820-1821"},"PeriodicalIF":4.1,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Premature adoption of adjuvant chemotherapy for locally advanced cervical carcinoma before the OUTBACK trial: cautionary tale on outcomes.","authors":"Dimitrios Nasioudis, Nawar A Latif, Stefan Gysler, Robert L Giuntoli, Sarah H Kim, Emily M Ko","doi":"10.1136/ijgc-2024-005560","DOIUrl":"https://doi.org/10.1136/ijgc-2024-005560","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to investigate the use and outcomes of adjuvant chemotherapy for patients with locally advanced cervical carcinoma receiving definitive chemoradiation.</p><p><strong>Methods: </strong>The National Cancer Database was accessed, and patients diagnosed between 2004 and 2015 with International Federation of Gynecology and Obstetrics (FIGO) 2009 stage IB2-IVA disease who underwent definitive chemoradiation were selected. Patients who received radio-sensitizing single agent chemotherapy and those who received adjuvant multi-agent chemotherapy were identified. Overall survival was evaluated following generation of Kaplan-Meier curves while a Cox model was constructed to control for confounders.</p><p><strong>Results: </strong>A total of 9895 patients were identified; 1003 (10.1%) received multi-agent adjuvant chemotherapy. Patients who received adjuvant chemotherapy were less likely to receive brachytherapy (60.9% vs 68.4%, p<0.001). Rate of adjuvant chemotherapy was higher among patients with stage IVA (18.1%) and stage III (11.9%) disease compared with those with stage II (8.4%) and stage IB2 (7.2%) disease (p<0.001). After controlling for confounders, administration of adjuvant chemotherapy was not associated with a survival benefit (hazard ratio 1.09, 95% confidence interval 0.98 to 1.20). Following stratification by disease stage, there was no survival benefit of patients who received adjuvant chemotherapy compared with those who did not; stage IB (p=0.002; 5 year overall survival 59.2% vs 74.9% favoring chemoradiation alone), stage II (p=0.41; 5 year overall survival 63.8% vs 67.6%, respectively), stage III (p=0.52; 5 year overall survival 48% vs 47.8%, respectively), or stage IVA disease (p=0.27; 5 year overall survival 29.5% vs 34.3%, respectively).</p><p><strong>Conclusions: </strong>In the US, approximately 1 in 10 patients with locally advanced cervical carcinoma who underwent definitive chemoradiation also received adjuvant chemotherapy that was not associated with improvement in overall survival.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}