Pub Date : 2026-02-01Epub Date: 2026-01-08DOI: 10.1016/j.gore.2026.102028
Chista R. Irani , Amelia Jernigan , Amma Agyemang , Tara Castellano
Introduction
Immunocompromised patients, such as those with systemic lupus erythematosus (SLE) and solid organ transplantation (SOT) are at increased risk for persistent high-risk human papilloma viral (HPV) infection and cervical cancer due to chronic immunosuppression.
Case
A 35-year-old woman with SLE and a right pelvic renal transplant was diagnosed with HPV16-positive cervical squamous cell carcinoma. Despite history of abnormal Pap smear, inconsistent screening led to a delayed diagnosis. She underwent surgical management first followed by chemoradiation. Surgical pathology confirmed FIGO Stage IIIC1 disease. With disease progression to pulmonary, hepatic and osseous sites, the patient was started on platinum-based chemotherapy with immune checkpoint inhibitors leading to acute kidney transplant rejection. She was transitioned to dialysis and continues palliative chemotherapy.
Conclusion
This case highlights the challenges of treating cervical cancer in an immunosuppressed renal-transplant recipient and emphasizes the importance of individualized screening and multidisciplinary care. Immunotherapy use in transplant patients warrants cautious consideration with thorough risk–benefit counseling.
{"title":"Considerations on management of advanced cervical squamous cell carcinoma in a solid organ transplant and immunocompromised patient: A case report","authors":"Chista R. Irani , Amelia Jernigan , Amma Agyemang , Tara Castellano","doi":"10.1016/j.gore.2026.102028","DOIUrl":"10.1016/j.gore.2026.102028","url":null,"abstract":"<div><h3>Introduction</h3><div>Immunocompromised patients, such as those with systemic lupus erythematosus (SLE) and solid organ transplantation (SOT) are at increased risk for persistent high-risk human papilloma viral (HPV) infection and cervical cancer due to chronic immunosuppression.</div></div><div><h3>Case</h3><div>A 35-year-old woman with SLE and a right pelvic renal transplant was diagnosed with HPV16-positive cervical squamous cell carcinoma. Despite history of abnormal Pap smear, inconsistent screening led to a delayed diagnosis. She underwent surgical management first followed by chemoradiation. Surgical pathology confirmed FIGO Stage IIIC1 disease. With disease progression to pulmonary, hepatic and osseous sites, the patient was started on platinum-based chemotherapy with immune checkpoint inhibitors leading to acute kidney transplant rejection. She was transitioned to dialysis and continues palliative chemotherapy.</div></div><div><h3>Conclusion</h3><div>This case highlights the challenges of treating cervical cancer in an immunosuppressed renal-transplant recipient and emphasizes the importance of individualized screening and multidisciplinary care. Immunotherapy use in transplant patients warrants cautious consideration with thorough risk–benefit counseling.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"63 ","pages":"Article 102028"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145972988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-02-09DOI: 10.1016/j.gore.2026.102042
Sarah S. Lee , Teresa K.L. Boitano , Megan L. Hutchcraft , Susan C. Modesitt
{"title":"#DidYouKnow: Physician engagement online and offline is mission critical to promote accurate and impactful cervical cancer information dissemination","authors":"Sarah S. Lee , Teresa K.L. Boitano , Megan L. Hutchcraft , Susan C. Modesitt","doi":"10.1016/j.gore.2026.102042","DOIUrl":"10.1016/j.gore.2026.102042","url":null,"abstract":"","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"63 ","pages":"Article 102042"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147270763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2025-12-17DOI: 10.1016/j.gore.2025.102011
Victoria M. Ettorre , Luca Palmieri , Sarah Ottum , Michelle Greenman , Alessandro D. Santin
Background
Treatment of recurrent chemotherapy, aromatase (AI) and MEK Inhibitor (MEKi) resistant low grade serous ovarian cancer (LGSOC) remains a challenge. Novel treatment options for KRAS mutated MEKi resistant LGSOC are warranted.
Case
A 73-year-old with recurrent, metastatic, platinum-resistant LGSOC harboring a KRAS mutation experienced a prolonged response to the combination of Avutometinib and Defactinib after failing multiple lines of chemotherapy, aromatase inhibitor (AI), and targeted therapy with the MEK inhibitor Binimetinib (MEK-162). Following Avutometinib and Defactinib treatment, she experienced a confirmed and long-lasting (4 years) partial response as well as a return of CA-125 to baseline. The oral drug combination was well tolerated with no dose-limiting toxicity or need for dose reduction over the 4 year period.
Conclusion
The Avutometinib and Defactinib combination may represent a new standard treatment option for platinum-resistant and AI-resistant/recurrent LGSOC who have failed other MEKi.
{"title":"Long lasting response to the combination of Avutometinib and Defactinib after progression on Binimetinib in a patient with recurrent low grade serous ovarian carcinoma − A case report","authors":"Victoria M. Ettorre , Luca Palmieri , Sarah Ottum , Michelle Greenman , Alessandro D. Santin","doi":"10.1016/j.gore.2025.102011","DOIUrl":"10.1016/j.gore.2025.102011","url":null,"abstract":"<div><h3>Background</h3><div>Treatment of recurrent chemotherapy, aromatase (AI) and MEK Inhibitor (MEKi) resistant low grade serous ovarian cancer (LGSOC) remains a challenge. Novel treatment options for KRAS mutated MEKi resistant LGSOC are warranted.</div></div><div><h3>Case</h3><div>A 73-year-old with recurrent, metastatic, platinum-resistant LGSOC harboring a KRAS mutation experienced a prolonged response to the combination of Avutometinib and Defactinib after failing multiple lines of chemotherapy, aromatase inhibitor (AI), and targeted therapy with the MEK inhibitor Binimetinib (MEK-162). Following Avutometinib and Defactinib treatment, she experienced a confirmed and long-lasting (4 years) partial response as well as a return of CA-125 to baseline. The oral drug combination was well tolerated with no dose-limiting toxicity or need for dose reduction over the 4 year period.</div></div><div><h3>Conclusion</h3><div>The Avutometinib and Defactinib combination may represent a new standard treatment option for platinum-resistant and AI-resistant/recurrent LGSOC who have failed other MEKi.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"63 ","pages":"Article 102011"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145921636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-01-24DOI: 10.1016/j.gore.2026.102035
Haley D. Frerichs , Jenna B. Wowdzia , Allison Sivak , Sarah Chapelsky , Christa Aubrey , Sophia Pin
Objective: To evaluate self-reported adverse childhood experiences (ACEs) in patients with endometrial cancer and class 3 obesity undergoing a preoperative weight loss protocol, and summarize the existing literature surrounding ACEs, endometrial cancer, and obesity.
Methods: We performed a retrospective chart review of 92 gynecologic oncology patients enrolled in a preoperative weight loss program from 2020 to 2022. Patients included in the case series had endometrioid carcinoma or atypical endometrial hyperplasia, class 3 obesity (body mass index ≥ 40 kg/m2), and at least one self-reported ACE. The scoping review followed PRISMA guidelines and included peer-reviewed studies evaluating ACEs in individuals with endometrial cancer or obesity.
Results: Seventeen of 92 patients (18.5%) with class 3 obesity and endometrial cancer self-disclosed a history of ACEs. The most frequent ACE types were psychological abuse (7/15, 15 46.7%), sexual abuse (6/15, 40%), and physical abuse (4/15, 26.7%). Patients had a mean of 6.4 ± 2.5 comorbidities, with 13/17 (76.5%) patients having at least one mental health disorder. The scoping review identified three studies that investigated ACEs in endometrial cancer patients and found that ACEs may negatively impact gynecologic care. Various ACE types are linked to obesity, with a stronger association between ACEs and obesity in women versus men.
Conclusion: Patients with endometrial cancer, class 3 obesity, and ACEs in our study reported a high degree of abuse and medical comorbidities. ACEs appear to increase the risk of endometrial cancer via obesity and complicate patient care, but a formal association cannot be established.
{"title":"Adverse childhood experiences, obesity, and endometrial cancer: A case series and scoping review","authors":"Haley D. Frerichs , Jenna B. Wowdzia , Allison Sivak , Sarah Chapelsky , Christa Aubrey , Sophia Pin","doi":"10.1016/j.gore.2026.102035","DOIUrl":"10.1016/j.gore.2026.102035","url":null,"abstract":"<div><div>Objective: To evaluate self-reported adverse childhood experiences (ACEs) in patients with endometrial cancer and class 3 obesity undergoing a preoperative weight loss protocol, and summarize the existing literature surrounding ACEs, endometrial cancer, and obesity.</div><div>Methods: We performed a retrospective chart review of 92 gynecologic oncology patients enrolled in a preoperative weight loss program from 2020 to 2022. Patients included in the case series had endometrioid carcinoma or atypical endometrial hyperplasia, class 3 obesity (body mass index ≥ 40 kg/m<sup>2</sup>), and at least one self-reported ACE. The scoping review followed PRISMA guidelines and included peer-reviewed studies evaluating ACEs in individuals with endometrial cancer or obesity.</div><div>Results: Seventeen of 92 patients (18.5%) with class 3 obesity and endometrial cancer self-disclosed a history of ACEs. The most frequent ACE types were psychological abuse (7/15, 15 46.7%), sexual abuse (6/15, 40%), and physical abuse (4/15, 26.7%). Patients had a mean of 6.4 ± 2.5 comorbidities, with 13/17 (76.5%) patients having at least one mental health disorder. The scoping review identified three studies that investigated ACEs in endometrial cancer patients and found that ACEs may negatively impact gynecologic care. Various ACE types are linked to obesity, with a stronger association between ACEs and obesity in women versus men.</div><div>Conclusion: Patients with endometrial cancer, class 3 obesity, and ACEs in our study reported a high degree of abuse and medical comorbidities. ACEs appear to increase the risk of endometrial cancer via obesity and complicate patient care, but a formal association cannot be established.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"63 ","pages":"Article 102035"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146170165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2025-12-26DOI: 10.1016/j.gore.2025.102019
Amrita Mukherjee , Natalie Ayoub , Lanfang Xu , Kimberly L. Cannavale , Elizabeth A. Szamreta , Matthew J. Monberg , Melissa Hodeib , Chun R. Chao
Objectives
We evaluated the impact of the COVID-19 pandemic on healthcare utilization and short-term safety outcomes in ovarian cancer patients.
Study design
Retrospective cohort study.
Methods
Epithelial ovarian cancer patients (n = 799) diagnosed between 01/01/2017–06/30/2021 at Kaiser Permanente Southern California were included. Pre-pandemic and pandemic periods were defined using 03/04/2020 (implementation of stay-at-home order in California) as the cut-off. Care utilization outcomes included the number of office and virtual visits per person-month, number of CA125, complete blood count, electrolytes, and creatinine tests done for chemotherapy monitoring. Short-term safety outcomes included the number of emergency room (ER) visits and hospitalizations per person-month. Negative binomial models were used to evaluate associations.
Results
Overall, 72.7 % and 27.3 % of the patients were diagnosed during the pre-pandemic and pandemic period, respectively. Mean (S.D.) number of office visits per person-month decreased during the pandemic period [0.4 (0.5) vs 0.6 (0.6) in pre-pandemic, p-value < 0.01]. Mean number of virtual visits increased during the pandemic [0.4 (0.7) vs 0.2 (0.3) in pre-pandemic, p-value < 0.01]. The number of virtual visits was twice during the pandemic vs the pre-pandemic period [adjusted-rate ratio (95 %CI): 2.04 (1.54–2.72)]. No differences in ER visits were observed by pandemic periods. Hospitalization rate was lower during the pandemic [adjusted-RR (95 %CI): 0.85 (0.72–1.00)]. In patients who received chemotherapy (n = 684), no differences in chemotherapy monitoring were observed.
Conclusions
Despite a shift from office visits to virtual visits during COVID-19, no differences in laboratory monitoring of chemotherapy and no increase in ER visits and hospitalizations were observed in ovarian cancer patients.
{"title":"COVID-19 pandemic and healthcare utilization in ovarian cancer patients","authors":"Amrita Mukherjee , Natalie Ayoub , Lanfang Xu , Kimberly L. Cannavale , Elizabeth A. Szamreta , Matthew J. Monberg , Melissa Hodeib , Chun R. Chao","doi":"10.1016/j.gore.2025.102019","DOIUrl":"10.1016/j.gore.2025.102019","url":null,"abstract":"<div><h3>Objectives</h3><div>We evaluated the impact of the COVID-19 pandemic on healthcare utilization and short-term safety outcomes in ovarian cancer patients.</div></div><div><h3>Study design</h3><div>Retrospective cohort study.</div></div><div><h3>Methods</h3><div>Epithelial ovarian cancer patients (n = 799) diagnosed between 01/01/2017–06/30/2021 at Kaiser Permanente Southern California were included. Pre-pandemic and pandemic periods were defined using 03/04/2020 (implementation of stay-at-home order in California) as the cut-off. Care utilization outcomes included the number of office and virtual visits per person-month, number of CA125, complete blood count, electrolytes, and creatinine tests done for chemotherapy monitoring. Short-term safety outcomes included the number of emergency room (ER) visits and hospitalizations per person-month. Negative binomial models were used to evaluate associations.</div></div><div><h3>Results</h3><div>Overall, 72.7 % and 27.3 % of the patients were diagnosed during the pre-pandemic and pandemic period, respectively. Mean (S.D.) number of office visits per person-month decreased during the pandemic period [0.4 (0.5) vs 0.6 (0.6) in pre-pandemic, p-value < 0.01]. Mean number of virtual visits increased during the pandemic [0.4 (0.7) vs 0.2 (0.3) in pre-pandemic, p-value < 0.01]. The number of virtual visits was twice during the pandemic vs the pre-pandemic period [adjusted-rate ratio (95 %CI): 2.04 (1.54–2.72)]. No differences in ER visits were observed by pandemic periods. Hospitalization rate was lower during the pandemic [adjusted-RR (95 %CI): 0.85 (0.72–1.00)]. In patients who received chemotherapy (n = 684), no differences in chemotherapy monitoring were observed.</div></div><div><h3>Conclusions</h3><div>Despite a shift from office visits to virtual visits during COVID-19, no differences in laboratory monitoring of chemotherapy and no increase in ER visits and hospitalizations were observed in ovarian cancer patients.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"63 ","pages":"Article 102019"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145972990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-01-07DOI: 10.1016/j.gore.2026.102021
Emily A. Miller , Amita Kulkarni , Jeff F. Lin , Evelyn Cantillo , Melissa K. Frey , Eloise Chapman-Davis , Higinia Cardenes , Kevin Holcomb
Background: While chemotherapy has largely replaced radiation therapy in upfront treatment of ovarian cancer, radiation has shown potential in the recurrent setting where chemoresistance, toxicities, and patient preferences may limit other treatment options. Hypofractionated radiation therapy (HFRT) is a highly conformal radiation therapy in which higher doses of radiation are delivered per treatment with the goal of fewer treatments. Objectives: To evaluate treatment response and survival for patients with recurrent ovarian cancer treated with HFRT and to evaluate treatment toxicity.
Methods: This was a retrospective cohort study of patients who received HFRT for the treatment of recurrent ovarian cancer at a single, large academic institution. Patient demographics, tumor characteristics, and treatment history details of the HFRT were collected via electronic medical record chart review. Outcomes including treatment response, survival and toxicity profile were analyzed. Treatment response was defined by RECIST 1.1 criteria. Toxicities were defined using the Radiation Therapy Oncology Group Criteria.
Results: 22 patients were reviewed. 1 patient (4.55%) had a complete response, 8 patients (36%) had a partial response, 7 patients (32%) had stable disease and 3 patients (14%) had progressive disease, and 3 patients (14%) were unevaluable by RECIST 1.1 criteria after treatment with HFRT. Mean progression free survival (PFS) was 11.5 months and overall survival (OS) was 28.7 months. HFRT was well-tolerated with no Grade 3 or 4 toxicities. The majority of patient’s had one to two lesions which were targeted for treatment.
Conclusions: For well-selected patients, particularly those with oligometastatic disease, HFRT should be considered as an additional treatment option for recurrent ovarian cancer.
{"title":"Hypofractionated short course radiation therapy for recurrent ovarian cancer","authors":"Emily A. Miller , Amita Kulkarni , Jeff F. Lin , Evelyn Cantillo , Melissa K. Frey , Eloise Chapman-Davis , Higinia Cardenes , Kevin Holcomb","doi":"10.1016/j.gore.2026.102021","DOIUrl":"10.1016/j.gore.2026.102021","url":null,"abstract":"<div><div>Background: While chemotherapy has largely replaced radiation therapy in upfront treatment of ovarian cancer, radiation has shown potential in the recurrent setting where chemoresistance, toxicities, and patient preferences may limit other treatment options. Hypofractionated radiation therapy (HFRT) is a highly conformal radiation therapy in which higher doses of radiation are delivered per treatment with the goal of fewer treatments. Objectives: To evaluate treatment response and survival for patients with recurrent ovarian cancer treated with HFRT and to evaluate treatment toxicity.</div><div>Methods: This was a retrospective cohort study of patients who received HFRT for the treatment of recurrent ovarian cancer at a single, large academic institution. Patient demographics, tumor characteristics, and treatment history details of the HFRT were collected via electronic medical record chart review. Outcomes including treatment response, survival and toxicity profile were analyzed. Treatment response was defined by RECIST 1.1 criteria. Toxicities were defined using the Radiation Therapy Oncology Group Criteria.</div><div>Results: 22 patients were reviewed. 1 patient (4.55%) had a complete response, 8 patients (36%) had a partial response, 7 patients (32%) had stable disease and 3 patients (14%) had progressive disease, and 3 patients (14%) were unevaluable by RECIST 1.1 criteria after treatment with HFRT. Mean progression free survival (PFS) was 11.5 months and overall survival (OS) was 28.7 months. HFRT was well-tolerated with no Grade 3 or 4 toxicities. The majority of patient’s had one to two lesions which were targeted for treatment.</div><div>Conclusions: For well-selected patients, particularly those with oligometastatic disease, HFRT should be considered as an additional treatment option for recurrent ovarian cancer.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"63 ","pages":"Article 102021"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145972989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-02-07DOI: 10.1016/j.gore.2026.102041
John Lugata , Caleigh Smith , Fortunata Nzota , Abitalis Mayengela , Tecla Lyamuya , Albert Masenga , Eusebious Maro , Bariki Mchome , Alex Mremi
Background
Undifferentiated ovarian carcinoma (UDOC) is an exceptionally rare and highly aggressive subtype of epithelial ovarian cancer, accounting for less than 1% of cases and infrequently reported in the literature, particularly in resource-limited settings. To our knowledge, this represents the first reported case of metastatic UDOC from Sub-Saharan Africa.
Case presentation
We report a case of high-grade UDOC in a 63-year-old postmenopausal woman presenting to a tertiary referral center in Northern Tanzania with a one-year history of progressive abdominal pain, distension, early satiety, and weight loss. Imaging demonstrated a large heterogeneous pelvic mass with extensive exophytic hepatic metastases and omental involvement, consistent with advanced-stage disease. Exploratory laparotomy revealed a frozen pelvis with extensive adhesions and intraabdominal metastases, precluding optimal cytoreductive surgery. Histopathologic evaluation demonstrated sheets of poorly differentiated tumor cells with marked cytologic atypia and high mitotic activity, a high proliferative index, and negative staining for Wilms tumor 1 (WT1), estrogen receptor (ER), and epithelial membrane antigen (EMA), supporting the diagnosis of FIGO stage IVB UDOC. Multidisciplinary tumor board review recommended platinum-based chemotherapy; however, treatment was not initiated due to financial barriers, and the patient was subsequently lost to follow-up.
Conclusion
UDOC is a rare and aggressive malignancy that often presents at an advanced stage with nonspecific gastrointestinal symptoms and widespread metastases. This case highlights the intersection of aggressive tumor biology and structural healthcare barriers that continue to limit access to timely cancer diagnosis and treatment in resource-constrained settings, underscoring persistent disparities in global cancer care delivery.
{"title":"Metastatic high-grade undifferentiated ovarian carcinoma: A case report from Sub-Saharan Africa","authors":"John Lugata , Caleigh Smith , Fortunata Nzota , Abitalis Mayengela , Tecla Lyamuya , Albert Masenga , Eusebious Maro , Bariki Mchome , Alex Mremi","doi":"10.1016/j.gore.2026.102041","DOIUrl":"10.1016/j.gore.2026.102041","url":null,"abstract":"<div><h3>Background</h3><div>Undifferentiated ovarian carcinoma (UDOC) is an exceptionally rare and highly aggressive subtype of epithelial ovarian cancer, accounting for less than 1% of cases and infrequently reported in the literature, particularly in resource-limited settings. To our knowledge, this represents the first reported case of metastatic UDOC from Sub-Saharan Africa.</div></div><div><h3>Case presentation</h3><div>We report a case of high-grade UDOC in a 63-year-old postmenopausal woman presenting to a tertiary referral center in Northern Tanzania with a one-year history of progressive abdominal pain, distension, early satiety, and weight loss. Imaging demonstrated a large heterogeneous pelvic mass with extensive exophytic hepatic metastases and omental involvement, consistent with advanced-stage disease. Exploratory laparotomy revealed a frozen pelvis with extensive adhesions and intraabdominal metastases, precluding optimal cytoreductive surgery. Histopathologic evaluation demonstrated sheets of poorly differentiated tumor cells with marked cytologic atypia and high mitotic activity, a high proliferative index, and negative staining for Wilms tumor 1 (WT1), estrogen receptor (ER), and epithelial membrane antigen (EMA), supporting the diagnosis of FIGO stage IVB UDOC. Multidisciplinary tumor board review recommended platinum-based chemotherapy; however, treatment was not initiated due to financial barriers, and the patient was subsequently lost to follow-up.</div></div><div><h3>Conclusion</h3><div>UDOC is a rare and aggressive malignancy that often presents at an advanced stage with nonspecific gastrointestinal symptoms and widespread metastases. This case highlights the intersection of aggressive tumor biology and structural healthcare barriers that continue to limit access to timely cancer diagnosis and treatment in resource-constrained settings, underscoring persistent disparities in global cancer care delivery.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"63 ","pages":"Article 102041"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146170247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2022-12-30DOI: 10.1016/j.gore.2022.101131
Elizabeth A. Szamreta , Graceanne R. Wayser , Vimalanand S Prabhu , Emily Mulvihill , Katherine Aguinaga , Ritu Salani
Objective
Information needs for advanced cervical cancer patients have not been well studied. Our aim was to understand key drivers and barriers to seeking information, the best means of information delivery, and how this information affects the patient’s treatment experience.
Methods
This was a qualitative study among international cohorts to assess the information needs of adult patients diagnosed with persistent, recurrent, or metastatic cervical cancer. Semi-structured interviews were held with patients of diverse demographic and socioeconomic backgrounds within two years of obtaining their cancer diagnosis. NVivo qualitative analysis software was used to identify themes that emerged from the data.
Results
In 2021, we interviewed 98 patients from Brazil (n = 25), China (n = 25), Germany (n = 20), and the United States (US) (n = 28) with a mean age ranging from 38.6 to 54.2 years. Becoming aware of treatment options and understanding prognosis were key motivators for seeking cervical cancer information. This information made patients feel more informed and confident in their care. Physicians were the preferred distributor of information due to their credibility and ability to only share information pertinent to the patient’s specific stage and type of cancer. The primary challenges for seeking information were finding trustworthy resources, feeling overwhelmed with negative information, and understanding the content and relevance to their diagnosis.
Conclusions
There is an unmet need for readily-found information on advanced cervical cancer that is credible, easy to understand, individualized, and stage-specific. Providing patients with this information could help them achieve a more satisfying treatment experience.
{"title":"Information needs during cancer care: qualitative research with advanced cervical cancer patients in Brazil, China, Germany, and the United States","authors":"Elizabeth A. Szamreta , Graceanne R. Wayser , Vimalanand S Prabhu , Emily Mulvihill , Katherine Aguinaga , Ritu Salani","doi":"10.1016/j.gore.2022.101131","DOIUrl":"10.1016/j.gore.2022.101131","url":null,"abstract":"<div><h3>Objective</h3><div>Information needs for advanced cervical cancer patients have not been well studied. Our aim was to understand key drivers and barriers to seeking information, the best means of information delivery, and how this information affects the patient’s treatment experience.</div></div><div><h3>Methods</h3><div>This was a qualitative study among international cohorts to assess the information needs of adult patients diagnosed with persistent, recurrent, or metastatic cervical cancer. Semi-structured interviews were held with patients of diverse demographic and socioeconomic backgrounds within two years of obtaining their cancer diagnosis. NVivo qualitative analysis software was used to identify themes that emerged from the data.</div></div><div><h3>Results</h3><div>In 2021, we interviewed 98 patients from Brazil (n = 25), China (n = 25), Germany (n = 20), and the United States (US) (n = 28) with a mean age ranging from 38.6 to 54.2 years. Becoming aware of treatment options and understanding prognosis were key motivators for seeking cervical cancer information. This information made patients feel more informed and confident in their care. Physicians were the preferred distributor of information due to their credibility and ability to only share information pertinent to the patient’s specific stage and type of cancer. The primary challenges for seeking information were finding trustworthy resources, feeling overwhelmed with negative information, and understanding the content and relevance to their diagnosis.</div></div><div><h3>Conclusions</h3><div>There is an unmet need for readily-found information on advanced cervical cancer that is credible, easy to understand, individualized, and stage-specific. Providing patients with this information could help them achieve a more satisfying treatment experience.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"63 ","pages":"Article 101131"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44130771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-01-24DOI: 10.1016/j.gore.2026.102036
Cecilia Rossi, Graham Chapman, Allison Reid, Lindsay Ferguson, Amy Armstrong
Objective
The objective of this needs assessment is to determine self-identified areas of strength and weakness in residents’ Gynecologic Oncology (GO) knowledge and elucidate gaps that may be addressed in future curricular initiatives.
Design
This was a cross-sectional survey designed to assess the effectiveness of current GO curricula at residency programs across the United States. Needs assessment surveys were distributed via a Program Director (PD) listserv to Obstetrics and Gynecology (OB/GYN) PDs in May 2024, with requests to distribute to OB/GYN residents and GO faculty. The primary outcome in this study was respondents’ overall satisfaction with their current GO curricula. Groups were compared in a pairwise fashion using Chi-squared testing for categorical variables and t test or Wilcoxon rank sum for continuous parametric and non-parametric variables, respectively. Multivariate logistic regression was used to control for confounders and to identify variables that were independently associated with participant satisfaction. As a secondary outcome, respondent scores assigned to ten key topics within GO were ranked.
Results
There were 85 survey respondents including 51 residents and 34 faculty. The primary composite outcome of satisfaction with the current curriculum was met in 30 participants (35.3%). Those who were satisfied were more likely to be part of a large residency program (43.3% vs 20.0%, p = 0.02), and reported greater numbers of annual gynecologic oncology lectures (5 + lectures, 70.0% vs 30.9%, p=<0.001). No difference was noted between groups in regard to region or setting of residency program, gender, or rate of additional graduate degrees. Satisfaction was reported in 27.4% of residents vs 47.1% of faculty (p = 0.06).On multivariate logistic regression, having 5 or more lectures per year was the only independent predictor of higher satisfaction (aOR 4.8, 95%CI 1.7–13.4, p = 0.003). Both residents and faculty reported the strongest resident knowledge was in the following 3 key domains: preoperative and postoperative care, critical care and inpatient management, and surgical principles. Residents identified lectures as their preferred educational format, and a preference for supplemental education to be offered during protected resident education time at the workplace.
Conclusions
In this survey study we aimed to assess the overall levels of satisfaction with GO educational curricula, to identify specific areas of strengths and weaknesses within curricula, and to propose strategies for improvement. Satisfaction rates with GO curricula amongst current OBGYN residents and faculty were relatively low. Our findings suggest that investing in GO-focused lectures may improve resident education curricula.
{"title":"Gynecologic oncology education for obstetrics and gynecology residents: a needs assessment","authors":"Cecilia Rossi, Graham Chapman, Allison Reid, Lindsay Ferguson, Amy Armstrong","doi":"10.1016/j.gore.2026.102036","DOIUrl":"10.1016/j.gore.2026.102036","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this needs assessment is to determine self-identified areas of strength and weakness in residents’ Gynecologic Oncology (GO) knowledge and elucidate gaps that may be addressed in future curricular initiatives.</div></div><div><h3>Design</h3><div>This was a cross-sectional survey designed to assess the effectiveness of current GO curricula at residency programs across the United States. Needs assessment surveys were distributed via a Program Director (PD) listserv to Obstetrics and Gynecology (OB/GYN) PDs in May 2024, with requests to distribute to OB/GYN residents and GO faculty. The primary outcome in this study was respondents’ overall satisfaction with their current GO curricula. Groups were compared in a pairwise fashion using Chi-squared testing for categorical variables and <em>t</em> test or Wilcoxon rank sum for continuous parametric and non-parametric variables, respectively. Multivariate logistic regression was used to control for confounders and to identify variables that were independently associated with participant satisfaction. As a secondary outcome, respondent scores assigned to ten key topics within GO were ranked.</div></div><div><h3>Results</h3><div>There were 85 survey respondents including 51 residents and 34 faculty. The primary composite outcome of satisfaction with the current curriculum was met in 30 participants (35.3%). Those who were satisfied were more likely to be part of a large residency program (43.3% vs 20.0%, p = 0.02), and reported greater numbers of annual gynecologic oncology lectures (5 + lectures, 70.0% vs 30.9%, p=<0.001). No difference was noted between groups in regard to region or setting of residency program, gender, or rate of additional graduate degrees. Satisfaction was reported in 27.4% of residents vs 47.1% of faculty (p = 0.06).On multivariate logistic regression, having 5 or more lectures per year was the only independent predictor of higher satisfaction (aOR 4.8, 95%CI 1.7–13.4, p = 0.003). Both residents and faculty reported the strongest resident knowledge was in the following 3 key domains: preoperative and postoperative care, critical care and inpatient management, and surgical principles. Residents identified lectures as their preferred educational format, and a preference for supplemental education to be offered during protected resident education time at the workplace.</div></div><div><h3>Conclusions</h3><div>In this survey study we aimed to assess the overall levels of satisfaction with GO educational curricula, to identify specific areas of strengths and weaknesses within curricula, and to propose strategies for improvement. Satisfaction rates with GO curricula amongst current OBGYN residents and faculty were relatively low. Our findings suggest that investing in GO-focused lectures may improve resident education curricula.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"63 ","pages":"Article 102036"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146073634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2025-12-26DOI: 10.1016/j.gore.2025.102015
Susie Cho , Kenneth Pike , Seth Wolpin , Mihkai Wickline , Holly Tomashek , Donna L Berry , Barbara A Goff
Background
In the advanced ovarian cancer setting (AOC), palliative care (PC) is appropriate for virtually every patient. The objectives of this study were 1) to compare referral and visit rates to PC services, pre and post implementation of the electronic Self-Assessment and Care (eSAC) application, in both a prospective study sample and for the institutional population of patients with advanced ovarian cancer; and 2) explore patients’ experiences integrating PC into their medical care.
Methods
Participants remotely submitted symptom and quality of life (QOL) reports about 5 days prior to clinic visits. Moderate-severe symptoms or QOL reports triggered teaching modules, including PC, and clinicians received summary reports with a PC prompt. PC rates were calculated for the prospective sample participants. Pre- and post-study rates for PC were compared using two-sample tests of proportions in the institutional population. A purposive sample of participants who triggered PC referral recommendations were recruited for semi-structured, telephone interviews to explore their experiences with PC integration. Reflexive thematic analysis was conducted to analyze interview data.
Results
In the prospective sample, 145/165 (88 %) patients enrolled; 120 submitted ≥1 report. 78/120 (65 %) participants triggered the PC referral recommendation on ≥1 report; 46 of 78 (59 %) were referred to PC and 49 (63 %) had an initial PC visit by six weeks after the end of the enrollment period. From pre-to-post implementation, institutional PC referral rates increased from 8.6 % to 12.8 % (p = 0.014). Rates of having a PC visit were not significant between pre- and post-implementation. Thirteen participants completed qualitative interviews. Two primary domains emerged: cancer care narratives, and perceptions of PC integration. Key barriers to PC engagement included limited understanding of PC scope, perception of adequate current care, and concerns about care burden and appointment fatigue.
Conclusions
Implementation of eSAC may have impacted the institutional referral rates for PC but did not result in a significant increase in visits. In study participants who triggered a referral, 63 % attended at least one PC visit. Qualitative findings revealed significant barriers to PC engagement including limited understanding of PC services and perceived care burden.
{"title":"A web-based application to promote palliative care in advanced ovarian cancer: A pre-post design","authors":"Susie Cho , Kenneth Pike , Seth Wolpin , Mihkai Wickline , Holly Tomashek , Donna L Berry , Barbara A Goff","doi":"10.1016/j.gore.2025.102015","DOIUrl":"10.1016/j.gore.2025.102015","url":null,"abstract":"<div><h3>Background</h3><div>In the advanced ovarian cancer setting (AOC), palliative care (PC) is appropriate for virtually every patient. The objectives of this study were 1) to compare referral and visit rates to PC services, pre and post implementation of the electronic Self-Assessment and Care (eSAC) application, in both a prospective study sample and for the institutional population of patients with advanced ovarian cancer; and 2) explore patients’ experiences integrating PC into their medical care.</div></div><div><h3>Methods</h3><div>Participants remotely submitted symptom and quality of life (QOL) reports about 5 days prior to clinic visits. Moderate-severe symptoms or QOL reports triggered teaching modules, including PC, and clinicians received summary reports with a PC prompt. PC rates were calculated for the prospective sample participants. Pre- and post-study rates for PC were compared using two-sample tests of proportions in the institutional population. A purposive sample of participants who triggered PC referral recommendations were recruited for semi-structured, telephone interviews to explore their experiences with PC integration. Reflexive thematic analysis was conducted to analyze interview data.</div></div><div><h3>Results</h3><div>In the prospective sample, 145/165 (88 %) patients enrolled; 120 submitted ≥1 report. 78/120 (65 %) participants triggered the PC referral recommendation on ≥1 report; 46 of 78 (59 %) were referred to PC and 49 (63 %) had an initial PC visit by six weeks after the end of the enrollment period. From pre-to-post implementation, institutional PC referral rates increased from 8.6 % to 12.8 % (p = 0.014). Rates of having a PC visit were not significant between pre- and post-implementation. Thirteen participants completed qualitative interviews. Two primary domains emerged: cancer care narratives, and perceptions of PC integration. Key barriers to PC engagement included limited understanding of PC scope, perception of adequate current care, and concerns about care burden and appointment fatigue.</div></div><div><h3>Conclusions</h3><div>Implementation of eSAC may have impacted the institutional referral rates for PC but did not result in a significant increase in visits. In study participants who triggered a referral, 63 % attended at least one PC visit. Qualitative findings revealed significant barriers to PC engagement including limited understanding of PC services and perceived care burden.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"63 ","pages":"Article 102015"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145921588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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