This retrospective study aimed to determine the impact of percutaneous nephrostomy (PCN) on the quality of life (QOL) and kidney function of women with advanced carcinoma of the cervix and obstructive uropathy in Kenyatta National Hospital by utilizing data from 2016 to 2019 and a follow-up patient interview in 2020. Sociodemographic data from patient records was reported as descriptive statistics. Serum urea, hemoglobin and creatinine levels before PCN and 72 hours, 1 month and 3 months after PCN were obtained. The changes were analysed using a paired t-test. Quality of life data before and after PCN tube insertion were collected using the structured Functional Assessment of Cancer Therapy and a cervix cancer-specific subscale (FACT-Cx) questionnaire, responses scored and an aggregate tallied. The QOL and kidney function data variables before and after PCN tube insertion were compared with statistical significance set at p < 0.05. Fifty eight study participants were enrolled, with an 80% power to detect a 5 fold change in kidney function. Percutaneous nephrostomy had an overall improvement in the quality of life (FACT-Cx total p = 0.041) with changes in aspects of physical well-being (p = 0.018) and additional concerns sexual function, self-esteem, appearance, urinary function, appetite and gastrointestinal function (p ≤ 0.001); but none in other aspects of the tool. Improvement was noted 72 hours after PCN tube insertion in 62% of patients’ urea (p = 0.033) and 64% of creatinine (p ≤ 0.001) levels but not sustained after 1 month and did not revert to normal levels. Hemoglobin levels did not improve. Percutaneous nephrostomy was found to have a short-term added value in management of women with obstructed uropathy in advanced carcinoma of the cervix as two aspects of their QOL improved while serum urea and creatinine levels improved slightly with no functional recovery.
本回顾性研究旨在通过2016年至2019年的数据和2020年的随访患者访谈,确定经皮肾造口术(PCN)对肯雅塔国家医院晚期宫颈癌和梗阻性尿病女性的生活质量(QOL)和肾功能的影响。来自患者记录的社会人口学数据采用描述性统计。取PCN前、PCN后72小时、1个月、3个月血清尿素、血红蛋白、肌酐水平。使用配对t检验分析这些变化。使用结构化的癌症治疗功能评估和宫颈癌特异性亚量表(FACT-Cx)问卷收集PCN管插入前后的生活质量数据,并对回答进行评分和汇总。PCN管置入前后的生活质量和肾功能数据变量比较,p <处有统计学意义;0.05. 58名研究参与者入组,检测肾功能5倍变化的准确率为80%。经皮肾造口术总体上改善了患者的生活质量(FACT-Cx total p = 0.041),在身体健康方面(p = 0.018)以及性功能、自尊、外观、泌尿功能、食欲和胃肠功能方面(p≤0.001)发生了变化,但在该工具的其他方面没有变化。在PCN管插入72小时后,62%的患者尿素(p = 0.033)和64%的患者肌酐(p≤0.001)水平有所改善,但1个月后没有持续,也没有恢复到正常水平。血红蛋白水平没有改善。经皮肾造口术对晚期宫颈癌梗阻性尿路病变的治疗具有短期的附加价值,因为其生活质量有两个方面的改善,而血清尿素和肌酐水平略有改善,但没有功能恢复。
{"title":"Impact of percutaneous nephrostomy on clinical outcomes in advanced carcinoma cervix with obstructive uropathy at Kenyatta national hospital","authors":"","doi":"10.22514/ejgo.2023.075","DOIUrl":"https://doi.org/10.22514/ejgo.2023.075","url":null,"abstract":"This retrospective study aimed to determine the impact of percutaneous nephrostomy (PCN) on the quality of life (QOL) and kidney function of women with advanced carcinoma of the cervix and obstructive uropathy in Kenyatta National Hospital by utilizing data from 2016 to 2019 and a follow-up patient interview in 2020. Sociodemographic data from patient records was reported as descriptive statistics. Serum urea, hemoglobin and creatinine levels before PCN and 72 hours, 1 month and 3 months after PCN were obtained. The changes were analysed using a paired t-test. Quality of life data before and after PCN tube insertion were collected using the structured Functional Assessment of Cancer Therapy and a cervix cancer-specific subscale (FACT-Cx) questionnaire, responses scored and an aggregate tallied. The QOL and kidney function data variables before and after PCN tube insertion were compared with statistical significance set at p < 0.05. Fifty eight study participants were enrolled, with an 80% power to detect a 5 fold change in kidney function. Percutaneous nephrostomy had an overall improvement in the quality of life (FACT-Cx total p = 0.041) with changes in aspects of physical well-being (p = 0.018) and additional concerns sexual function, self-esteem, appearance, urinary function, appetite and gastrointestinal function (p ≤ 0.001); but none in other aspects of the tool. Improvement was noted 72 hours after PCN tube insertion in 62% of patients’ urea (p = 0.033) and 64% of creatinine (p ≤ 0.001) levels but not sustained after 1 month and did not revert to normal levels. Hemoglobin levels did not improve. Percutaneous nephrostomy was found to have a short-term added value in management of women with obstructed uropathy in advanced carcinoma of the cervix as two aspects of their QOL improved while serum urea and creatinine levels improved slightly with no functional recovery.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136366306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
W. Wang, M. Gao, Xiaoting Li, Hong Zheng, Yu-nong Gao
Objectives : To investigate the effect of neoadjuvant chemotherapy combined with intraperitoneal chemotherapy after interval tumor cell reduction on the prognosis of advanced epithelial ovarian cancer. Methods : A retrospective study was performed among 210 patients with advanced ovarian cancer who were treated with neoadjuvant chemotherapy from May 1, 2007 to December 1, 2015. 121 patients with NACT-IDS (Neoadjuvant chemotherapy followed by interval debulking surgery) were enrolled. The patients were divided into observation group (NACT-IDS + IP group, n = 28) and control group (NACT-IDS + IV group, n = 93) depending on whether intraperitoneal chemotherapy was used after interval debulking surgery. The effects of intraperitoneal chemotherapy after NACT-IDS on PFS (progression-free survival) and OS (overall survival) were analyzed and the influencing factors were explored through multivariate analysis. The competitive model was used to analyze the effect of intraperitoneal chemotherapy after NACT-IDS on tumor recurrence. Toxicities associated with adjuvant chemotherapy were also analyzed between two groups. The effect of neoadjuvant chemotherapy cycles on prognosis and the correlation between postoperative CA125 decline and recurrence were evaluated. Results : Intraperitonal chemotherapy and R0 (no gross residual) were independent factors for PFS, with HRs of 0.560 (95% CI, 0.342–0.918, p = 0.022) and 0.578 (95% CI, 0.377–0.887, p = 0.012). There was no independent factor associated with OS. Significant difference in PFS was detected among the R0 + IP group, R0 + IV group, non-R0 + IP group and non-R0 + IV group. In patients with R0 tumor reduction, IP patients showed significantly better PFS, bonferronei adjusted p = 0.036. In patients without R0 tumor reduction, no significant difference was detected between IP and IV group, bonferronei adjusted p = 0.28. There were no significant differences of grade 3–4 toxicities, abdominal pain, treatment delays, dose reductions, and treatment modifications in NACT-IDS + IP group and NACT-IDS + IV group. Neoadjuvant chemotherapy cycles ( ≤ 3 and > 3) were not the influencing factors of PFS or OS and did not affect platinum-sensitive relapse or platinum-resistant relapse. The decrease in postoperative CA125 was not related to platinum-sensitive recurrence or platinum-resistant recurrence. Conclusions : Neoadjuvant chemotherapy combined with intraperitoneal chemotherapy after interval debulking surgery could improve the PFS of patients with advanced epithelial ovarian cancer compared to intravenous chemotherapy without significant differences in toxicity.
{"title":"Effect of neoadjuvant chemotherapy combined with intraperitoneal chemotherapy after interval tumor cell reduction on the prognosis of advanced epithelial ovarian cancer","authors":"W. Wang, M. Gao, Xiaoting Li, Hong Zheng, Yu-nong Gao","doi":"10.31083/j.ejgo4302030","DOIUrl":"https://doi.org/10.31083/j.ejgo4302030","url":null,"abstract":"Objectives : To investigate the effect of neoadjuvant chemotherapy combined with intraperitoneal chemotherapy after interval tumor cell reduction on the prognosis of advanced epithelial ovarian cancer. Methods : A retrospective study was performed among 210 patients with advanced ovarian cancer who were treated with neoadjuvant chemotherapy from May 1, 2007 to December 1, 2015. 121 patients with NACT-IDS (Neoadjuvant chemotherapy followed by interval debulking surgery) were enrolled. The patients were divided into observation group (NACT-IDS + IP group, n = 28) and control group (NACT-IDS + IV group, n = 93) depending on whether intraperitoneal chemotherapy was used after interval debulking surgery. The effects of intraperitoneal chemotherapy after NACT-IDS on PFS (progression-free survival) and OS (overall survival) were analyzed and the influencing factors were explored through multivariate analysis. The competitive model was used to analyze the effect of intraperitoneal chemotherapy after NACT-IDS on tumor recurrence. Toxicities associated with adjuvant chemotherapy were also analyzed between two groups. The effect of neoadjuvant chemotherapy cycles on prognosis and the correlation between postoperative CA125 decline and recurrence were evaluated. Results : Intraperitonal chemotherapy and R0 (no gross residual) were independent factors for PFS, with HRs of 0.560 (95% CI, 0.342–0.918, p = 0.022) and 0.578 (95% CI, 0.377–0.887, p = 0.012). There was no independent factor associated with OS. Significant difference in PFS was detected among the R0 + IP group, R0 + IV group, non-R0 + IP group and non-R0 + IV group. In patients with R0 tumor reduction, IP patients showed significantly better PFS, bonferronei adjusted p = 0.036. In patients without R0 tumor reduction, no significant difference was detected between IP and IV group, bonferronei adjusted p = 0.28. There were no significant differences of grade 3–4 toxicities, abdominal pain, treatment delays, dose reductions, and treatment modifications in NACT-IDS + IP group and NACT-IDS + IV group. Neoadjuvant chemotherapy cycles ( ≤ 3 and > 3) were not the influencing factors of PFS or OS and did not affect platinum-sensitive relapse or platinum-resistant relapse. The decrease in postoperative CA125 was not related to platinum-sensitive recurrence or platinum-resistant recurrence. Conclusions : Neoadjuvant chemotherapy combined with intraperitoneal chemotherapy after interval debulking surgery could improve the PFS of patients with advanced epithelial ovarian cancer compared to intravenous chemotherapy without significant differences in toxicity.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47261060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Ferioli, A. Perrone, P. Castellucci, V. Panni, A. Benini, G. Macchia, A. Galuppi, M. Buwenge, E. Lodi Rizzini, L. Strigari, L. Tagliaferri, C. Zamagni, P. De Iaco, S. Fanti, A. Morganti
Objective : Residual disease after surgery is related to an unfavorable prognosis in patients with endometrial cancer (EC). An early diagnosis and treatment of this condition could improve patients’ outcome. Aim of this study was to define the role of postoperative 18 F-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography ( 18 F-FDG-PET/CT) in patients with high risk of residual disease after EC surgery. Methods : Patients operated for EC, with one or more risk factors, who underwent 18 F-FDG-PET/CT before adjuvant treatment were included in this observational study. The primary endpoint was the rate of patients in whom 18 F-FDG-PET/CT changed the treatment strategy and/or the radiotherapy (RT) planning. Results : Our analysis included 58 patients (median age: 67.5 years, range: 48.0–86.0) with the following risk factors: lymphadenectomy not performed (26 patients; 44.8%), inadequate lymphadenectomy (23 patients; 39.7%), and high risk of residual disease due to advanced stage (nine patients; 15.5%). Postoperative 18 F-FDG-PET/CT imaging was positive in 18 patients (31%) in the following sites: pelvic extra-nodal disease (one patient), pelvic and/or paraaortic lymph nodes (12 patients), distant metastases (one patient), or combination of previous sites (four patients). Based on these results, the adjuvant therapeutic strategy was changed in five patients, three of whom were referred to chemotherapy alone due to distant metastases and two of whom were referred to nodal-directed treatment due to lymph node metastases (lymphadenectomy and pelvic chemoradiation plus boost, respectively). Furthermore, based on the 18 F-FDG-PET/CT results, the RT plan was modified in 13 patients (addition of a boost on residual pelvic/abdominal disease in 12 and target modification in one, respectively). Therefore, based on postoperative 18 F-FDG-PET/CT findings, the therapeutic strategy and the RT plan were changed in 5 patients (8.6%) and 13 patients (22.4%), respectively. Conclusion : In this analysis, the adjuvant treatment was modified after post-operative 18 F-FDG-PET/CT in about one third of patients. Further studies are needed to better define the risk factors (or their combinations) correlated with higher probability of residual disease after radical hysterectomy-adnexectomy for EC.
目的:子宫内膜癌(EC)术后残留病变与预后不良有关。这种情况的早期诊断和治疗可以改善患者的预后。本研究的目的是确定18 f -氟脱氧葡萄糖-正电子发射断层扫描/计算机断层扫描(18 F-FDG-PET/CT)在EC术后残留疾病高风险患者中的作用。方法:在辅助治疗前接受18次F-FDG-PET/CT检查的伴有一种或多种危险因素的EC手术患者纳入本观察性研究。主要终点是18f - fdg - pet /CT改变治疗策略和/或放疗(RT)计划的患者比率。结果:我们的分析纳入了58例患者(中位年龄:67.5岁,范围:48.0-86.0岁),其危险因素如下:未行淋巴结切除术(26例,44.8%),淋巴结切除术不充分(23例,39.7%),晚期残留疾病的高风险(9例,15.5%)。术后18例患者(31%)的F-FDG-PET/CT成像在以下部位呈阳性:盆腔结外疾病(1例)、盆腔和/或主动脉旁淋巴结(12例)、远处转移(1例)或先前部位的合并(4例)。基于这些结果,改变了5例患者的辅助治疗策略,其中3例因远处转移而单独化疗,2例因淋巴结转移而接受淋巴结定向治疗(分别为淋巴结切除术和盆腔放化疗加强化)。此外,根据18例F-FDG-PET/CT结果,对13例患者的RT计划进行了修改(分别增加了12例残留盆腔/腹腔疾病的增强和1例目标修改)。因此,根据术后18例F-FDG-PET/CT表现,分别有5例(8.6%)和13例(22.4%)患者改变了治疗策略和放疗计划。结论:在本分析中,约三分之一的患者在术后18 F-FDG-PET/CT后对辅助治疗进行了修改。需要进一步的研究来更好地确定与根治性子宫-附件切除术后残留疾病较高概率相关的危险因素(或其组合)。
{"title":"Adjuvant radiotherapy of endometrial cancer: role of 18F-FDG-PET/CT in treatment modulation","authors":"M. Ferioli, A. Perrone, P. Castellucci, V. Panni, A. Benini, G. Macchia, A. Galuppi, M. Buwenge, E. Lodi Rizzini, L. Strigari, L. Tagliaferri, C. Zamagni, P. De Iaco, S. Fanti, A. Morganti","doi":"10.31083/j.ejgo4302028","DOIUrl":"https://doi.org/10.31083/j.ejgo4302028","url":null,"abstract":"Objective : Residual disease after surgery is related to an unfavorable prognosis in patients with endometrial cancer (EC). An early diagnosis and treatment of this condition could improve patients’ outcome. Aim of this study was to define the role of postoperative 18 F-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography ( 18 F-FDG-PET/CT) in patients with high risk of residual disease after EC surgery. Methods : Patients operated for EC, with one or more risk factors, who underwent 18 F-FDG-PET/CT before adjuvant treatment were included in this observational study. The primary endpoint was the rate of patients in whom 18 F-FDG-PET/CT changed the treatment strategy and/or the radiotherapy (RT) planning. Results : Our analysis included 58 patients (median age: 67.5 years, range: 48.0–86.0) with the following risk factors: lymphadenectomy not performed (26 patients; 44.8%), inadequate lymphadenectomy (23 patients; 39.7%), and high risk of residual disease due to advanced stage (nine patients; 15.5%). Postoperative 18 F-FDG-PET/CT imaging was positive in 18 patients (31%) in the following sites: pelvic extra-nodal disease (one patient), pelvic and/or paraaortic lymph nodes (12 patients), distant metastases (one patient), or combination of previous sites (four patients). Based on these results, the adjuvant therapeutic strategy was changed in five patients, three of whom were referred to chemotherapy alone due to distant metastases and two of whom were referred to nodal-directed treatment due to lymph node metastases (lymphadenectomy and pelvic chemoradiation plus boost, respectively). Furthermore, based on the 18 F-FDG-PET/CT results, the RT plan was modified in 13 patients (addition of a boost on residual pelvic/abdominal disease in 12 and target modification in one, respectively). Therefore, based on postoperative 18 F-FDG-PET/CT findings, the therapeutic strategy and the RT plan were changed in 5 patients (8.6%) and 13 patients (22.4%), respectively. Conclusion : In this analysis, the adjuvant treatment was modified after post-operative 18 F-FDG-PET/CT in about one third of patients. Further studies are needed to better define the risk factors (or their combinations) correlated with higher probability of residual disease after radical hysterectomy-adnexectomy for EC.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47107659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Lin, C. Lengacher, C. Rodriguez, L. Szalacha, Jennifer R. Wolgemuth
Objectives : The purpose of this systematic review was to identify the state of the scientific evidence related to educational programs for post-treatment breast cancer survivors (BCSs) during the last twenty years. Methods : A systematic search of PubMed/MEDLINE, CINAHL, EMBASE, Web of Science, and PsycINFO databases from January 2000 through May 2020 included keywords related to research on educational programs for BCSs. Inclusion criteria included: (1) focus on an educational program for post-treatment breast cancer survivors; (2) original research; (3) peer-review journals; (4) English language; and (5) published between January 2000 to May 2020. EndNote X9 (software version: X9, manufacturer: Clarivate, website location: endnote.com) was used as the reference management software package to manage citations from search results. A PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) flowchart of the selection process is presented in this paper. Results : A total of 24 educational programs/interventions research studies include one mixed-method study, three qualitative studies, and twenty quantitative studies, were identified and analyzed. Three programs focused on BCSs’ self-management and self-efficacy, two programs focused on BCSs’ cognitive problems, seven programs focused on BCSs’ psychological distress, emotional support, and information seeking. In addition, one program focused on BCSs’ body image, body function, and sexual dysfunction issues, five programs focused on BCSs’ physical activities, nutritional levels, and normal body weight maintenance, two programs focused on BCSs’ supportive care and peer advocate support. Finally, one program focused on BCSs’ palliative care and end of life care, and three programs focused on BCSs’ post-treatment symptom clusters and overall quality of life. Conclusions : After breast cancer treatment ends, BCSs continue to suffer from long-term physical and psychological symptoms and report multiple unmet needs. Research on post-treatment breast cancer educational programs showed that programs assist BCSs with post-treatment symptom management and address their concerns while promoting supportive care and peer support to improve BCS’s overall quality of life. program. Study to explore experiences of waist of the end of of the in BMI and waist circumference a healthy
目的:本系统综述的目的是确定在过去二十年中与治疗后乳腺癌幸存者(BCSs)教育计划相关的科学证据的状态。方法:系统检索2000年1月至2020年5月的PubMed/MEDLINE、CINAHL、EMBASE、Web of Science和PsycINFO数据库,包括与bcs教育项目研究相关的关键词。入选标准包括:(1)关注乳腺癌治疗后幸存者的教育项目;(2)原创性研究;(3)同行评议期刊;(4)英语语言;(5)发表于2000年1月至2020年5月之间。采用EndNote X9(软件版本:X9,制造商:Clarivate,网站位置:endnote.com)作为参考文献管理软件包,对检索结果中的引文进行管理。本文介绍了选择过程的PRISMA(系统评价和元分析的首选报告项目)流程图。结果:共识别和分析了24项教育计划/干预研究,其中包括一项混合方法研究,三项定性研究和20项定量研究。3个项目聚焦于bcs的自我管理和自我效能,2个项目聚焦于bcs的认知问题,7个项目聚焦于bcs的心理困扰、情感支持和信息寻求。此外,有一个项目侧重于bcs的身体形象、身体功能和性功能障碍问题,五个项目侧重于bcs的身体活动、营养水平和正常体重维持,两个项目侧重于bcs的支持性护理和同伴倡导支持。最后,一个项目侧重于bcs的姑息治疗和临终关怀,三个项目侧重于bcs的治疗后症状群和整体生活质量。结论:乳腺癌治疗结束后,bcs继续遭受长期的生理和心理症状,并报告多种未满足的需求。对乳腺癌治疗后教育项目的研究表明,该项目帮助BCS进行治疗后症状管理,解决他们的担忧,同时促进支持性护理和同伴支持,以提高BCS的整体生活质量。程序。本研究旨在探讨经验腰围在BMI和健康腰围之间的关系
{"title":"Educational programs for post-treatment breast cancer survivors: a systematic review","authors":"K. Lin, C. Lengacher, C. Rodriguez, L. Szalacha, Jennifer R. Wolgemuth","doi":"10.31083/j.ejgo4302036","DOIUrl":"https://doi.org/10.31083/j.ejgo4302036","url":null,"abstract":"Objectives : The purpose of this systematic review was to identify the state of the scientific evidence related to educational programs for post-treatment breast cancer survivors (BCSs) during the last twenty years. Methods : A systematic search of PubMed/MEDLINE, CINAHL, EMBASE, Web of Science, and PsycINFO databases from January 2000 through May 2020 included keywords related to research on educational programs for BCSs. Inclusion criteria included: (1) focus on an educational program for post-treatment breast cancer survivors; (2) original research; (3) peer-review journals; (4) English language; and (5) published between January 2000 to May 2020. EndNote X9 (software version: X9, manufacturer: Clarivate, website location: endnote.com) was used as the reference management software package to manage citations from search results. A PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) flowchart of the selection process is presented in this paper. Results : A total of 24 educational programs/interventions research studies include one mixed-method study, three qualitative studies, and twenty quantitative studies, were identified and analyzed. Three programs focused on BCSs’ self-management and self-efficacy, two programs focused on BCSs’ cognitive problems, seven programs focused on BCSs’ psychological distress, emotional support, and information seeking. In addition, one program focused on BCSs’ body image, body function, and sexual dysfunction issues, five programs focused on BCSs’ physical activities, nutritional levels, and normal body weight maintenance, two programs focused on BCSs’ supportive care and peer advocate support. Finally, one program focused on BCSs’ palliative care and end of life care, and three programs focused on BCSs’ post-treatment symptom clusters and overall quality of life. Conclusions : After breast cancer treatment ends, BCSs continue to suffer from long-term physical and psychological symptoms and report multiple unmet needs. Research on post-treatment breast cancer educational programs showed that programs assist BCSs with post-treatment symptom management and address their concerns while promoting supportive care and peer support to improve BCS’s overall quality of life. program. Study to explore experiences of waist of the end of of the in BMI and waist circumference a healthy","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43014005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective : To investigate the nutritional status and health-related quality of life (HRQoL) of postoperative chemotherapy patients with ovarian cancer and to discuss the relationship between these patients’ nutritional status and HRQoL. Methods : 201 postoperative chemotherapy patients with ovarian cancer were enrolled. All of them were assessed with a general information questionnaire, the Patient Generated-Subjective Global Assessment (PG-SGA), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30). We compared the nutritional status and HRQoL among patients with different demographics and disease characteristics, as well as analyzed the correlations between nutritional status and HRQoL. Results : The mean quantitative evaluation of PG-SGA in patients receiving postoperative chemotherapy for ovarian cancer was 7.82 ± 4.58. Almost all of the study subjects in this investigation were moderately or severely malnourished and required nutritional support. We established a multivariate linear regression equation and found that the total PG-SGA score is an important predictor of HRQoL in postoperative chemotherapy patients with ovarian cancer. Conclusions : Medical staff can improve the HRQoL of this patient population by improving their nutritional status, thereby enhancing their clinical outcome.
{"title":"Relationship between nutritional status and health-related quality of life in patients receiving chemotherapy after radical ovarian cancer surgery: a cross-sectional study","authors":"Nan Qin, Di Sun, Xu Zhang, Guichun Jiang","doi":"10.31083/j.ejgo4302032","DOIUrl":"https://doi.org/10.31083/j.ejgo4302032","url":null,"abstract":"Objective : To investigate the nutritional status and health-related quality of life (HRQoL) of postoperative chemotherapy patients with ovarian cancer and to discuss the relationship between these patients’ nutritional status and HRQoL. Methods : 201 postoperative chemotherapy patients with ovarian cancer were enrolled. All of them were assessed with a general information questionnaire, the Patient Generated-Subjective Global Assessment (PG-SGA), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30). We compared the nutritional status and HRQoL among patients with different demographics and disease characteristics, as well as analyzed the correlations between nutritional status and HRQoL. Results : The mean quantitative evaluation of PG-SGA in patients receiving postoperative chemotherapy for ovarian cancer was 7.82 ± 4.58. Almost all of the study subjects in this investigation were moderately or severely malnourished and required nutritional support. We established a multivariate linear regression equation and found that the total PG-SGA score is an important predictor of HRQoL in postoperative chemotherapy patients with ovarian cancer. Conclusions : Medical staff can improve the HRQoL of this patient population by improving their nutritional status, thereby enhancing their clinical outcome.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47872233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ö. Birge, M. Bakır, Saliha Sağnıç, S. Doğan, H. Tuncer, T. Şimşek
Objective : This study aims to compare tumor diameters measured by transvaginal ultrasonography and MRI in cervical cancer. Materials and methods : The study includes 127 cervical cancer patients diagnosed and treated at Akdeniz University Faculty of Medicine between January 2002 and December 2019. Data were collected retrospectively using the electronic archive system of the hospital. Patients with pathologically unknown tumor diameters were excluded from the study. Data were tested for normal distribution, and the mean, standard deviation, median, min-max values, and frequencies were used as descriptive statistics. Categorical data were expressed as numbers and percentages (%). The Student’s t -test, one of the parametric tests, was used to compare tumor diameters. Statistical Package for the Social Sciences (SPSS) 23 software (IBM Corp., Chicago, IL, USA) was used for data analysis. A p -value less than 0.05 was considered statistically significant in all tests. Results : The mean age of patients included in the study was 49.55 ± 11.67 years. Of all patients, 79.5% had a normal delivery. 87 (68%) of the patients were not using any contraceptive method, with 0.7%, condom protection was the least. Among the complaints of patients at admission, postcoital vaginal bleeding was the most common complaint with 42.5%, and asymptomatic patients were the second most common with 22%. Human papillomavirus (HPV) status was unknown in the vast majority of patients (91.3%). Regarding the stage status, stage 1b2 was the most frequently seen stage with 29 patients. Tumor histology revealed SCC in 80.3% and adenocarcinoma in 18.1%. The mean tumor diameter measured by transvaginal ultrasonography (TVS) was 3.30 ± 1.95, by magnetic resonance imaging (MRI) was 3.37 ± 2.03, and the pathologically measured tumor diameter was 3.17 ± 1.86. There was no statistically significant difference between the mean tumor diameter measured by TVS and MRI, MRI and pathology, and TVS and pathology ( p : 0.769, p : 0.589, p : 0.891, respectively). Conclusion : When used by specialists experienced in the field of gynecological oncology, ultrasonography can be considered as effective as MRI, especially in tumor size measurement in cervical cancer, due to its ease of use, cheapness, and easy accessibility in regions with low socioeconomic status.
{"title":"Evaluation of tumor size in cervix cancer patients treated with surgery: ultrasonography or MRI?","authors":"Ö. Birge, M. Bakır, Saliha Sağnıç, S. Doğan, H. Tuncer, T. Şimşek","doi":"10.31083/j.ejgo4302035","DOIUrl":"https://doi.org/10.31083/j.ejgo4302035","url":null,"abstract":"Objective : This study aims to compare tumor diameters measured by transvaginal ultrasonography and MRI in cervical cancer. Materials and methods : The study includes 127 cervical cancer patients diagnosed and treated at Akdeniz University Faculty of Medicine between January 2002 and December 2019. Data were collected retrospectively using the electronic archive system of the hospital. Patients with pathologically unknown tumor diameters were excluded from the study. Data were tested for normal distribution, and the mean, standard deviation, median, min-max values, and frequencies were used as descriptive statistics. Categorical data were expressed as numbers and percentages (%). The Student’s t -test, one of the parametric tests, was used to compare tumor diameters. Statistical Package for the Social Sciences (SPSS) 23 software (IBM Corp., Chicago, IL, USA) was used for data analysis. A p -value less than 0.05 was considered statistically significant in all tests. Results : The mean age of patients included in the study was 49.55 ± 11.67 years. Of all patients, 79.5% had a normal delivery. 87 (68%) of the patients were not using any contraceptive method, with 0.7%, condom protection was the least. Among the complaints of patients at admission, postcoital vaginal bleeding was the most common complaint with 42.5%, and asymptomatic patients were the second most common with 22%. Human papillomavirus (HPV) status was unknown in the vast majority of patients (91.3%). Regarding the stage status, stage 1b2 was the most frequently seen stage with 29 patients. Tumor histology revealed SCC in 80.3% and adenocarcinoma in 18.1%. The mean tumor diameter measured by transvaginal ultrasonography (TVS) was 3.30 ± 1.95, by magnetic resonance imaging (MRI) was 3.37 ± 2.03, and the pathologically measured tumor diameter was 3.17 ± 1.86. There was no statistically significant difference between the mean tumor diameter measured by TVS and MRI, MRI and pathology, and TVS and pathology ( p : 0.769, p : 0.589, p : 0.891, respectively). Conclusion : When used by specialists experienced in the field of gynecological oncology, ultrasonography can be considered as effective as MRI, especially in tumor size measurement in cervical cancer, due to its ease of use, cheapness, and easy accessibility in regions with low socioeconomic status.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47942549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Monberg, Jennifer P Hall, R. Moon, K. Khela, K. McLaurin
Objective : Although BRCA gene testing of patients diagnosed with ovarian cancer (OC) is now recommended, the level of testing undertaken in various countries is largely unknown. This study describes BRCA mutation screening patterns and results, demographics, clinical characteristics and the use of poly (ADP-ribose) polymerase inhibitors (PARPi) as maintenance treatment within a real-world sample of patients with advanced OC in the second-line (2L) treatment setting. Methods : Data were collected using the Adelphi Real World OC Disease Specific Programme (DSP)™, a point-in-time survey of physicians and their consulting patients with OC in clinical practice, undertaken across Europe (EU5: France, Germany, Italy, Spain and United Kingdom) and the United States (US) between December 2017–March 2018. Physicians completed a detailed patient record form for their next eight consecutively consulting patients, capturing data on their clinical history and treatment. All analysis was descriptive. Results : Of 1315 patients identified, 1096 (83%) were receiving 2L treatment and 219 (17%) were receiving 2L maintenance treatment; either PARPi (olaparib, rucaparib or niraparib, n = 103) or a non-PARPi (n = 116). BRCA screening rates varied between countries, increased with each line of therapy and were higher in the EU5 (55%) than the US (44%). 28% of patients receiving 2L treatment had a BRCA1/2 mutation. Patients receiving PARPi maintenance treatment had better Eastern Cooperative Oncology Group (ECOG) performance status, higher BRCA screening rates and higher proportions of serous epithelial OC than those receiving 2L treatment or non-PARPi maintenance. Common reasons for choosing 2L treatments were progression-free/overall survival benefit and improvement of quality of life. Conclusions : Despite guidelines recommending BRCA testing in patients with OC, many OC patients undergoing 2L treatment were not screened for BRCA mutations. Decisions related to PARPi use in 2L maintenance appeared to be driven by BRCA status, histology and response to first-line treatment.
{"title":"BRCA screening, treatment patterns and response among patients with ovarian cancer in the second line treatment setting: results from a real world survey","authors":"M. Monberg, Jennifer P Hall, R. Moon, K. Khela, K. McLaurin","doi":"10.31083/j.ejgo4302026","DOIUrl":"https://doi.org/10.31083/j.ejgo4302026","url":null,"abstract":"Objective : Although BRCA gene testing of patients diagnosed with ovarian cancer (OC) is now recommended, the level of testing undertaken in various countries is largely unknown. This study describes BRCA mutation screening patterns and results, demographics, clinical characteristics and the use of poly (ADP-ribose) polymerase inhibitors (PARPi) as maintenance treatment within a real-world sample of patients with advanced OC in the second-line (2L) treatment setting. Methods : Data were collected using the Adelphi Real World OC Disease Specific Programme (DSP)™, a point-in-time survey of physicians and their consulting patients with OC in clinical practice, undertaken across Europe (EU5: France, Germany, Italy, Spain and United Kingdom) and the United States (US) between December 2017–March 2018. Physicians completed a detailed patient record form for their next eight consecutively consulting patients, capturing data on their clinical history and treatment. All analysis was descriptive. Results : Of 1315 patients identified, 1096 (83%) were receiving 2L treatment and 219 (17%) were receiving 2L maintenance treatment; either PARPi (olaparib, rucaparib or niraparib, n = 103) or a non-PARPi (n = 116). BRCA screening rates varied between countries, increased with each line of therapy and were higher in the EU5 (55%) than the US (44%). 28% of patients receiving 2L treatment had a BRCA1/2 mutation. Patients receiving PARPi maintenance treatment had better Eastern Cooperative Oncology Group (ECOG) performance status, higher BRCA screening rates and higher proportions of serous epithelial OC than those receiving 2L treatment or non-PARPi maintenance. Common reasons for choosing 2L treatments were progression-free/overall survival benefit and improvement of quality of life. Conclusions : Despite guidelines recommending BRCA testing in patients with OC, many OC patients undergoing 2L treatment were not screened for BRCA mutations. Decisions related to PARPi use in 2L maintenance appeared to be driven by BRCA status, histology and response to first-line treatment.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46911422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background : Uterine carcinosarcoma often presents with significant uterine distention. This makes it difficult to perform minimally invasive surgery, which is preferred for uterine cancer given the significant recovery benefits. Cases : We present two cases of uterine carcinosarcoma in which we performed uterine evacuation intraoperatively to decompress the uterine volume to facilitate specimen removal through the vagina. The first patient ultimately had stage IA disease. She received adjuvant chemotherapy and radiation and has remained disease-free for 2 years. The second patient had stage IVB disease on final pathology report. She received adjuvant chemotherapy but had disease recurrence 4 months after completion of treatment. Conclusion : Intraoperative uterine evacuation during surgery for uterine carcinosarcoma may make possible a minimally invasive procedure in patients with large, distended uteri.
{"title":"Uterine cavity evacuation as a novel approach for uterine size reduction during minimal invasive surgery for uterine carcinosarcoma: a report of two cases","authors":"A. Chen, L. Turker, J. Divito, D. Kuo","doi":"10.31083/j.ejgo4302044","DOIUrl":"https://doi.org/10.31083/j.ejgo4302044","url":null,"abstract":"Background : Uterine carcinosarcoma often presents with significant uterine distention. This makes it difficult to perform minimally invasive surgery, which is preferred for uterine cancer given the significant recovery benefits. Cases : We present two cases of uterine carcinosarcoma in which we performed uterine evacuation intraoperatively to decompress the uterine volume to facilitate specimen removal through the vagina. The first patient ultimately had stage IA disease. She received adjuvant chemotherapy and radiation and has remained disease-free for 2 years. The second patient had stage IVB disease on final pathology report. She received adjuvant chemotherapy but had disease recurrence 4 months after completion of treatment. Conclusion : Intraoperative uterine evacuation during surgery for uterine carcinosarcoma may make possible a minimally invasive procedure in patients with large, distended uteri.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44778645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. K. Gomez, J. Thomson, G. Grimes, A. Wang, M. Churchman, M. O’Connor, C. Gourley, D. Melton
Objective : As a result of TP53 gene mutation high grade serous ovarian cancer (HGSOC) is dependent on the G2 checkpoint for the repair of DNA damage and survival. The key role of WEE1 kinase at this checkpoint makes inhibition of WEE1 kinase in combination with DNA damaging agents an attractive therapeutic strategy for HGSOC. Our aim was to characterise resistance mechanisms to WEE1 inhibitor AZD1775 and identify ways to overcome resistance ready for use in the clinic. Methods : AZD1775-resistant HGSOC cell clones were isolated and western blotting, cell cycle analysis, growth assays, RNA-Seq and gene expression analysis were used to characterise resistance mechanisms and investigate a way to overcome resistance. Results : A resistance mechanism previously reported in small cell lung cancer did not operate in HGSOC. Instead, resistance resulted from different cell cycle control pathway changes that slow AZD1775-induced cell cycle progression and reduce accumulation of replication associated DNA damage. One major change was reduced levels of CDK1, the substrate for WEE1 kinase inhibition; another was increased levels of PKMYT1, which can also inhibit CDK1. Increased expression of TGF β signalling to slow cell cycle progression occurred in resistant clones. A TGF β R1 inhibitor overcame resistance in a clone with the highest TGF β R1 receptor expression. Conclusions : Although overexpression of the membrane glycoprotein MDR1 is a common mechanism of drug resistance, it was not involved in our HGSOC cells. Instead AZD1775 resistance resulted from cell cycle control pathway changes that combine to slow AZD1775-induced cell cycle progression and so reduce accumulation of replication-associated DNA damage.
{"title":"Identifying and overcoming a mechanism of resistance to WEE1 kinase inhibitor AZD1775 in high grade serous ovarian cancer cells","authors":"M. K. Gomez, J. Thomson, G. Grimes, A. Wang, M. Churchman, M. O’Connor, C. Gourley, D. Melton","doi":"10.31083/j.ejgo4302024","DOIUrl":"https://doi.org/10.31083/j.ejgo4302024","url":null,"abstract":"Objective : As a result of TP53 gene mutation high grade serous ovarian cancer (HGSOC) is dependent on the G2 checkpoint for the repair of DNA damage and survival. The key role of WEE1 kinase at this checkpoint makes inhibition of WEE1 kinase in combination with DNA damaging agents an attractive therapeutic strategy for HGSOC. Our aim was to characterise resistance mechanisms to WEE1 inhibitor AZD1775 and identify ways to overcome resistance ready for use in the clinic. Methods : AZD1775-resistant HGSOC cell clones were isolated and western blotting, cell cycle analysis, growth assays, RNA-Seq and gene expression analysis were used to characterise resistance mechanisms and investigate a way to overcome resistance. Results : A resistance mechanism previously reported in small cell lung cancer did not operate in HGSOC. Instead, resistance resulted from different cell cycle control pathway changes that slow AZD1775-induced cell cycle progression and reduce accumulation of replication associated DNA damage. One major change was reduced levels of CDK1, the substrate for WEE1 kinase inhibition; another was increased levels of PKMYT1, which can also inhibit CDK1. Increased expression of TGF β signalling to slow cell cycle progression occurred in resistant clones. A TGF β R1 inhibitor overcame resistance in a clone with the highest TGF β R1 receptor expression. Conclusions : Although overexpression of the membrane glycoprotein MDR1 is a common mechanism of drug resistance, it was not involved in our HGSOC cells. Instead AZD1775 resistance resulted from cell cycle control pathway changes that combine to slow AZD1775-induced cell cycle progression and so reduce accumulation of replication-associated DNA damage.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44865387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yunzhe Wan, X. Zhang, Yue Sun, Linping Wang, Guoyan Liu
Background: Uterine lipoleiomyoma is a rare lipomatous variant of uterine leiomyoma composed of a variable mixture of mature smooth muscle cells and adipocytes, typically found in peri or postmenopausal women. Malignancies arising from the tumor have rarely been reported though it is considered benign. Cases : We present three cases of uterine lipoleiomyoma and review literature to explore its etiology, characteristics, diagnosis and malignant transformation potential. Conclusion : Imaging examinations especially magnetic resonance imaging (MRI) play an important role in preoperative diagnosis. For large size and rapid growth of lipoleiomyoma, malignant transformation potential should be considered and surgery is required. Follow-up is still necessary.
{"title":"Uterine lipoleiomyoma: a benign entity with malignant transformation potential?","authors":"Yunzhe Wan, X. Zhang, Yue Sun, Linping Wang, Guoyan Liu","doi":"10.31083/j.ejgo4302042","DOIUrl":"https://doi.org/10.31083/j.ejgo4302042","url":null,"abstract":"Background: Uterine lipoleiomyoma is a rare lipomatous variant of uterine leiomyoma composed of a variable mixture of mature smooth muscle cells and adipocytes, typically found in peri or postmenopausal women. Malignancies arising from the tumor have rarely been reported though it is considered benign. Cases : We present three cases of uterine lipoleiomyoma and review literature to explore its etiology, characteristics, diagnosis and malignant transformation potential. Conclusion : Imaging examinations especially magnetic resonance imaging (MRI) play an important role in preoperative diagnosis. For large size and rapid growth of lipoleiomyoma, malignant transformation potential should be considered and surgery is required. Follow-up is still necessary.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45834082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}