Gynecologic Oncology Reports最新文献

英文中文

Cost of care associated with utilization of telehealth in clinical trials 与在临床试验中使用远程保健有关的护理成本

IF 1.2 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2024-10-12 DOI: 10.1016/j.gore.2024.101523

Emily Gleason , Leslie Andriani , Elizabeth A. Tubridy , Destiny Uwawuike , Simon Gunter , Nathanael C. Koelper , Heidi S. Harvie , Emily M. Ko

Objective

Due to COVID-19 pandemic restrictions, telehealth was incorporated into standard oncologic care and clinical trial operations. We sought to analyze whether telehealth changed cost of care compared to traditional clinical trial operations.

Methods

We conducted a retrospective cohort study of gynecologic oncology patients enrolled in therapeutic clinical trials at a National Cancer Institute designated center, comparing the cost of cancer care on trial pre-TELEhealth (9/30/2019 to 3/15/2020) versus during TELEhealth (3/16/2020 to 8/20/2020). Inclusion required trial participation during both study periods, ≥1 telehealth visit, and identifiable billing records. The analysis was from a healthcare sector perspective. Cost per patient per month on trial was calculated for scheduled (per protocol) and unscheduled (non-protocol) encounters using 2020 national Medicare reimbursement rates, not institution-specific prices. Pairwise t-tests between pre-TELE and TELE periods were performed.

Results

Twenty-eight patients were included in the study. The majority of patients (93 %) had ovarian cancer. One patient (4 %) had uterine and 1 (4 %) had concurrent ovarian/uterine cancer. Most patients had advanced-stage disease at diagnosis (93 %). Mean cost per patient per month was similar in pre-TELE and TELE periods ($3797 vs. $4720, p = 0.064). There were no cost differences among scheduled or unscheduled encounters, office or ED visits, admissions, outpatient procedures, nor those billed to study sponsors or patient’s insurer.

Conclusions

Incorporating telehealth in gynecologic cancer clinical trials during the COVID-19 pandemic did not increase cost of care and may be a mechanism for decentralizing clinical trials, reducing barriers to trial participation, and improving the value of cancer care.

目的由于 COVID-19 大流行的限制，远程医疗被纳入标准肿瘤治疗和临床试验操作中。我们试图分析与传统临床试验操作相比，远程医疗是否改变了护理成本。方法我们对在国家癌症研究所指定中心参加治疗性临床试验的妇科肿瘤患者进行了一项回顾性队列研究，比较了TELEhealth之前（2019 年 9 月 30 日至 2020 年 3 月 15 日）与TELEhealth期间（2020 年 3 月 16 日至 2020 年 8 月 20 日）的癌症护理成本。纳入要求在两个研究期间都参与试验，≥1 次远程医疗访问，以及可识别的账单记录。分析从医疗保健行业的角度进行。使用 2020 年全国医疗保险报销率（而非特定机构的价格）计算了试用期间计划内（按协议）和计划外（非协议）就诊的每位患者每月成本。对试验前和试验期间进行了配对 t 检验。大多数患者（93%）患有卵巢癌。一名患者（4%）患有子宫癌，一名患者（4%）同时患有卵巢癌和子宫癌。大多数患者确诊时已是晚期（93%）。TELE前和TELE期间每位患者每月的平均费用相似（3797美元对4720美元，P = 0.064）。结论在 COVID-19 大流行期间将远程医疗纳入妇科癌症临床试验并未增加医疗成本，这可能是分散临床试验、减少试验参与障碍和提高癌症医疗价值的一种机制。

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引用次数: 0

Pembrolizumab-induced cytokine release syndrome with severe encephalopathy in the setting of clear cell vaginal carcinoma: A case report 彭博利珠单抗诱导的细胞因子释放综合征伴重度脑病（透明细胞阴道癌）：病例报告

IF 1.2 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2024-10-11 DOI: 10.1016/j.gore.2024.101529

Samantha Metzger, Keely Ulmer, Emily K. Hill

引用次数: 0

Development of diffuse cutaneous squamous cell carcinoma in situ after chemotherapy for ovarian carcinoma and remission with PD1-inhibitor 卵巢癌化疗后出现弥漫性皮肤鳞状细胞原位癌，使用PD1抑制剂后病情缓解

IF 1.2 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2024-10-11 DOI: 10.1016/j.gore.2024.101528

Jess Durbin , Taylor A. Rives , Dava Piecoro , Charles S. Dietrich

This is a 74-year-old female, initially presenting with malignant pleural effusion, and evaluation revealed programmed cell death ligand 1 (PDL1)-positive stage IV high grade serous ovarian cancer. Following initiation of standard chemotherapy agents, carboplatin and paclitaxel, the patient developed a diffuse, itchy rash over her abdomen, back, and bilateral upper and lower extremities. Biopsy of the rash revealed a diffuse non-resectable cutaneous squamous cell skin carcinoma (cSCC) in situ. Consequently, a PD1-inhibitor was added to her neoadjuvant chemotherapy regimen, which resulted in complete response to both metastatic ovarian and diffuse cSCC in situ at time of surgery.

患者是一名74岁的女性，最初出现恶性胸腔积液，评估结果显示程序性细胞死亡配体1（PDL1）阳性，为IV期高级别浆液性卵巢癌。在开始使用标准化疗药物卡铂和紫杉醇后，患者的腹部、背部和双侧上下肢出现了弥漫性瘙痒皮疹。皮疹活检显示为弥漫性不可切除的皮肤鳞状细胞原位癌（cSCC）。因此，在她的新辅助化疗方案中加入了 PD1 抑制剂，结果在手术时，转移性卵巢癌和弥漫性原位皮肤鳞状细胞癌都出现了完全反应。

引用次数: 0

Prevalence and genotype distribution of high-risk Human Papillomavirus infection among Vietnamese women in Ho Chi Minh City, Viet Nam: A population-based cross-sectional study 越南胡志明市越南妇女高危人类乳头瘤病毒感染的流行率和基因型分布：基于人口的横断面研究

IF 1.2 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2024-10-09 DOI: 10.1016/j.gore.2024.101526

Ho Minh Nguyet , Phan Thanh Tam , Quach Kim Ung , To Gia Kien , Le Hong Phuoc

Introduction

Persistent infection with high-risk Human Papillomavirus (HR-HPV) genotypes are wellknown to increase the risk of cervical cancer significantly. This study aims to determine the prevalence and distribution of high-risk HR-HPV genotypes among women in Ho Chi Minh City (HCMC), Viet Nam.

Methods

A population-based cross-sectional study was conducted between June 2020 and September 2020 in all 24 districts of HCMC, Viet Nam. Socio-demographic and behavioral data were collected from 2478 women aged 25 to 65 who had sexual intercourse using a self-administered questionnaire. Vaginal swab specimens from all participants were collected to identify HR-HPV genotypes using Polymerase Chain Reaction (PCR) protocols.

Results

The prevalence of HR-HPV infection was 3.5 % (87 women, including 20 cases infected with multi-genotypes), 3.1 % in urban and 0.4 % in rural areas. The most detected HR-HPV genotypes among positive cases were 58 (25.3 %), 52 (21.8 %), 16 (21.8 %), 68 (10.3 %), 51 (10.34 %) and 18 (9.2 %). The prevalence of multi-type HR-HPV genotypes was 0.81 %, of which the most common co-infection genotypes were 52 and 58 (20.0 %), 16 and 56 (10.0 %), and 16 and 39 (10.0 %). The percentages of one-, two-, three-, and four-genotypes of HPV among positive cases were 77.0 %, 16.1 %, 4.6 % and 2.3 %, respectively.

Conclusions

Our findings explore a low prevalence of HR-HPV infection in Vietnamese women, of which genotypes 52 and 58 are more popular than 16 and 18. Continuously updated data on the genotype distribution of HPV are helpful for vaccine development and planning preventive activities to prevent HPV-related cancers.

导言：众所周知，持续感染高危人乳头瘤病毒（HR-HPV）基因型会显著增加罹患宫颈癌的风险。本研究旨在确定越南胡志明市（HCMC）妇女中高风险 HR-HPV 基因型的流行率和分布情况。方法：2020 年 6 月至 2020 年 9 月期间，在越南胡志明市的所有 24 个区开展了一项基于人群的横断面研究。通过自制问卷收集了 2478 名 25 至 65 岁有过性行为的女性的社会人口和行为数据。结果HR-HPV感染率为3.5%（87名妇女，包括20例多重基因型感染者），城市地区为3.1%，农村地区为0.4%。在阳性病例中，检测到的最多的 HR-HPV 基因型分别为 58（25.3%）、52（21.8%）、16（21.8%）、68（10.3%）、51（10.34%）和 18（9.2%）。多型 HR-HPV 基因型的流行率为 0.81%，其中最常见的合并感染基因型为 52 和 58（20.0%）、16 和 56（10.0%）以及 16 和 39（10.0%）。在阳性病例中，HPV 的一种、两种、三种和四种基因型所占比例分别为 77.0%、16.1%、4.6% 和 2.3%。不断更新的人乳头瘤病毒基因型分布数据有助于疫苗开发和预防人乳头瘤病毒相关癌症的预防活动规划。

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引用次数: 0

Incidence and risk factors of silent deep venous thromboembolism before interval debulking surgery in ovarian cancer patients, a tertiary centre experience 卵巢癌患者间歇性去势手术前无声深静脉血栓栓塞症的发病率和风险因素，一家三级中心的经验

IF 1.2 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2024-10-06 DOI: 10.1016/j.gore.2024.101522

Mohamed Abdelkhalek, Basel Refky, Mohammed Zuhdy, Omar Hamdy, Mohamed Hamdy, Khaled Gaballa, Amr Elalfy

Objective

To determine the prevalence and risk factors for the development of asymptomatic venous thromboembolism (VTE) in ovarian cancer patients who underwent interval cytoreductive surgery after finishing neoadjuvant chemotherapy.

Methods

This is a prospective observational trial. Female patients with pathologically proven ovarian cancer who received neoadjuvant chemotherapy without clinical evidence of VTE were included.

Results

A total of 107 patients were enrolled in this study. The mean age was 53.37 years, and the mean body mass index (BMI) was 34.11 kg/m². Seven (6.5 %) patients suffered from silent VTE, as documented by bilateral Doppler ultrasound in the pre- and postoperative settings. The mean age of the patients in the VTE group was 56.17 years, and their mean body mass index was 31.71 Kg/m². Their median serum CA125 concentration was elevated (325.6 units/ml). On the other hand, the median D-dimer level was elevated by 678 ng/ml fibrinogen equivalent units (FEUs) in the same group of patients. In the present study, comorbidities did not influence the incidence of VTE, as the 7 patients who were diagnosed with VTE did not have any comorbidities. Most of the patients who were diagnosed with serous adenocarcinoma (71.4 %) or stage IIIc disease (57.1 %) were most likely to develop VTE.

Conclusion

Silent VTE is more prevalent in patients with advanced-stage ovarian cancer and serous carcinomas.

目的探讨卵巢癌患者在完成新辅助化疗后接受间歇性细胞减灭术时发生无症状静脉血栓栓塞（VTE）的发生率和风险因素。纳入的病理证实为卵巢癌的女性患者均接受了新辅助化疗，且无 VTE 临床证据。平均年龄为 53.37 岁，平均体重指数 (BMI) 为 34.11 kg/m2。术前和术后双侧多普勒超声检查显示，7 名患者（6.5%）患有无声 VTE。VTE 组患者的平均年龄为 56.17 岁，平均体重指数为 31.71 公斤/平方米。他们的血清 CA125 浓度中位数偏高（325.6 单位/毫升）。另一方面，同组患者的中位 D-二聚体水平升高了 678 纳克/毫升纤维蛋白原当量单位（FEUs）。在本研究中，合并症并不影响 VTE 的发病率，因为确诊为 VTE 的 7 名患者没有任何合并症。大多数确诊为浆液性腺癌（71.4%）或 IIIc 期疾病（57.1%）的患者最有可能发生 VTE。

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引用次数: 0

The new FIGO 2023 staging reclassification of patients with FIGO 2009 Stage IVB endometrial cancer correlates to progression-free and overall survival outcomes FIGO 2023 对 FIGO 2009 IVB 期子宫内膜癌患者的新分期重新分类与无进展生存期和总生存期结果相关联

IF 1.2 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2024-10-05 DOI: 10.1016/j.gore.2024.101527

Monal Garg , Priya Bhati , Pranidha Shree CA , Wesley M. Jose , Sheejamol V.S. , Keechilat Pavithran

Objective

This study aims to determine the oncological outcomes of Stage IVB (FIGO 2009) Endometrial cancer patients and its comparison with the new (FIGO 2023) staging.

Methods

A Retrospective analysis was conducted between May 30, 2011, and December 30, 2020 on all patients with stage IVB (FIGO 2009 Staging) endometrial cancer. Overall survival (OS) was the primary outcome. Progression-Free Survival (PFS) and comparison with new staging FIGO 2023 were the secondary outcomes. Kaplan-Meier curves and log-rank tests were used to compare the average OS time and PFS between the groups.

Results

Fifty-one patients with Stage IVB endometrial cancer (2009 FIGO Staging) were included. Median age was 68 years. Serous histology was found in 24 (47.1 %) patients. After a median follow-up period of 24 months, median OS was 36 months and median PFS was 15 months. FIGO 2023 staging criteria reclassified the stages of 23 patients (45 %). Patients were restaged into Stage IIIB2 (9.8 %), IVA (5.8 %), IVB (55 %) and IVC (29.4 %). Median OS and PFS were not reached for stages IIIB and IVA, while the median OS and median PFS for stage IVB were 36 months and 18 months, respectively. However, patients with stage IVC had lower median OS and PFS of 10 months and 4 months, respectively.

Conclusion

The clinical outcomes of patients with Stage IVB are varied depending mainly on the disease distribution. Patients with abdominal or pelvic disease had better survival outcomes and therefore, needed a different categorisation. Thus, FIGO 2023 Staging considers this varied disease distribution and appears to be a better prognostic indicator for this group.

方法在 2011 年 5 月 30 日至 2020 年 12 月 30 日期间对所有 IVB 期（FIGO 2009 分期）子宫内膜癌患者进行回顾性分析。主要结果为总生存期（OS）。无进展生存期（PFS）和与 FIGO 2023 新分期的比较是次要结果。结果51例IVB期子宫内膜癌患者（2009年FIGO分期）被纳入研究。中位年龄为 68 岁。24名患者（47.1%）发现浆液组织学。中位随访期为24个月，中位OS为36个月，中位PFS为15个月。FIGO 2023 分期标准对 23 名患者（45%）进行了重新分期。患者被重新分期为 IIIB2 期（9.8%）、IVA 期（5.8%）、IVB 期（55%）和 IVC 期（29.4%）。IIIB期和IVA期的中位OS和PFS均未达到，而IVB期的中位OS和中位PFS分别为36个月和18个月。然而，IVC 期患者的中位 OS 和 PFS 较低，分别为 10 个月和 4 个月。腹腔或盆腔疾病患者的生存预后较好，因此需要不同的分类方法。因此，FIGO 2023 分期考虑了这种不同的疾病分布情况，似乎是该组患者更好的预后指标。

{"title":"The new FIGO 2023 staging reclassification of patients with FIGO 2009 Stage IVB endometrial cancer correlates to progression-free and overall survival outcomes","authors":"Monal Garg , Priya Bhati , Pranidha Shree CA , Wesley M. Jose , Sheejamol V.S. , Keechilat Pavithran","doi":"10.1016/j.gore.2024.101527","DOIUrl":"10.1016/j.gore.2024.101527","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to determine the oncological outcomes of Stage IVB (FIGO 2009) Endometrial cancer patients and its comparison with the new (FIGO 2023) staging.</div></div><div><h3>Methods</h3><div>A Retrospective analysis was conducted between May 30, 2011, and December 30, 2020 on all patients with stage IVB (FIGO 2009 Staging) endometrial cancer. Overall survival (OS) was the primary outcome. Progression-Free Survival (PFS) and comparison with new staging FIGO 2023 were the secondary outcomes. Kaplan-Meier curves and log-rank tests were used to compare the average OS time and PFS between the groups.</div></div><div><h3>Results</h3><div>Fifty-one patients with Stage IVB endometrial cancer (2009 FIGO Staging) were included. Median age was 68 years. Serous histology was found in 24 (47.1 %) patients. After a median follow-up period of 24 months, median OS was 36 months and median PFS was 15 months. FIGO 2023 staging criteria reclassified the stages of 23 patients (45 %). Patients were restaged into Stage IIIB2 (9.8 %), IVA (5.8 %), IVB (55 %) and IVC (29.4 %). Median OS and PFS were not reached for stages IIIB and IVA, while the median OS and median PFS for stage IVB were 36 months and 18 months, respectively. However, patients with stage IVC had lower median OS and PFS of 10 months and 4 months, respectively.</div></div><div><h3>Conclusion</h3><div>The clinical outcomes of patients with Stage IVB are varied depending mainly on the disease distribution. Patients with abdominal or pelvic disease had better survival outcomes and therefore, needed a different categorisation. Thus, FIGO 2023 Staging considers this varied disease distribution and appears to be a better prognostic indicator for this group.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142421492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tisotumab vedotin extravasation injury in a patient with recurrent cervical cancer 一名复发性宫颈癌患者的替妥单抗维多汀外渗损伤

IF 1.2 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2024-10-02 DOI: 10.1016/j.gore.2024.101525

Ji Son , Katherine E. Cain , Claire A. Marten , Kaitlin W Dwyer , Travis T. Sims , Jolyn S. Taylor

引用次数: 0

Utility of next generation sequencing to unequivocally establish clonality in synchronous vs metastatic endometrial and ovarian carcinomas 利用新一代测序技术明确确定同步性与转移性子宫内膜癌和卵巢癌的克隆性

IF 1.2 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2024-10-02 DOI: 10.1016/j.gore.2024.101524

Michelle Greenman , Stefania Bellone , Tobias Hartwich , Natalia Buza , Alessandro D. Santin

Background

Synchronous endometrial and ovarian carcinomas represent up to 10% of all endometrial and ovarian tumors. These are diagnostically challenging cases to determine if they represent dual primary tumors or related metastatic tumors.

Case

A 48-year-old was diagnosed with synchronous primary ovarian and endometrial malignancies on pathology based on traditional morphological parameters. However, following next generation sequencing (NGS) of tumors from both the uterus and ovary, the malignancies were unequivocally recognized as primary uterine tumor metastatic to the ovary using mismatch repair protein expression profile and tumor clonality.

Conclusion

NGS using FDA-approved commercially available platforms is becoming increasingly utilized to understand the genetic landscape of tumors and select the appropriate targeted therapies for improved outcomes. Simultaneous sequencing of synchronous endometrial and ovarian carcinomas may represent the new gold standard to unequivocally demonstrate tumor clonal relationships, properly classify disease as well as guide the most appropriate adjuvant treatment in these challenging cases.

背景同步性子宫内膜癌和卵巢癌占所有子宫内膜和卵巢肿瘤的 10%。病例一名 48 岁的患者根据传统的形态学参数被病理诊断为同步原发性卵巢和子宫内膜恶性肿瘤。然而，在对来自子宫和卵巢的肿瘤进行新一代测序（NGS）后，利用错配修复蛋白表达谱和肿瘤克隆性，这些恶性肿瘤被明确认定为转移至卵巢的原发性子宫肿瘤。同步子宫内膜癌和卵巢癌的同步测序可能代表着新的黄金标准，可明确显示肿瘤克隆关系、对疾病进行正确分类，并指导这些具有挑战性的病例进行最合适的辅助治疗。

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引用次数: 0

Malignant STK11 adnexal tumor harboring a somatic mutation in a woman previously diagnosed with mesothelioma, a case report 曾被诊断为间皮瘤的一名女性体内携带体细胞突变的恶性 STK11 附件肿瘤病例报告

IF 1.2 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2024-10-01 DOI: 10.1016/j.gore.2024.101521

Christina R. Rutherford , Taylor A. Rives , Dava W. Piecoro , Charles S. Dietrich

STK11 germline pathogenic variants are typically associated with Peutz-Jeghers syndrome, an autosomal dominant disease characterized by hamartomatous polyps in the gastrointestinal tract, hyperpigmented patches, and increased risk of stomach, colorectal, small bowel, and breast cancers (Beggs et al., 2010). Mutations in this gene have also been identified in skin, pancreatic, testicular, and stromal ovarian cancer (Fagerberg et al., 2014). To date, there have been less than 30 cases of ovarian cancer reported associated with mutated STK11 (Bennett et al., 2021). In this report, we discuss a rare case of a STK11 adnexal tumor in a 39-year-old woman previously diagnosed with malignant mesothelioma. After 33 months with no evidence of disease following cytoreductive surgery with HIPEC and adjuvant chemotherapy, a new retroperitoneal lesion was noted on imaging. After resection, molecular testing indicated an STK11 mutation, and histology was consistent with an STK11 adnexal tumor. A high index of suspicion is required to make the diagnosis of STK11 adnexal tumor due to its non-distinct pathology and IHC staining. Due to the rarity of this neoplasm, analysis of current and future cases of the STK11 adnexal tumor is necessary to understand its pathogenesis, genetic mutational analysis, clinical course, and best treatment options.

STK11种系致病变体通常与Peutz-Jeghers综合征有关，这是一种常染色体显性遗传病，其特征是胃肠道的瘤状息肉、色素沉着斑块以及胃癌、结肠直肠癌、小肠癌和乳腺癌风险增加（Beggs等人，2010年）。在皮肤癌、胰腺癌、睾丸癌和间质卵巢癌中也发现了该基因的突变（Fagerberg 等人，2014 年）。迄今为止，与 STK11 基因突变相关的卵巢癌病例不足 30 例（Bennett 等人，2021 年）。在本报告中，我们讨论了一例罕见的 STK11 附件肿瘤病例，患者是一名 39 岁女性，之前被诊断为恶性间皮瘤。在接受 HIPEC 细胞减灭术和辅助化疗 33 个月后，无任何疾病迹象，但在影像学检查中发现新的腹膜后病变。切除术后，分子检测显示该患者存在 STK11 基因突变，组织学检查结果与 STK11 附件肿瘤一致。由于 STK11 附件肿瘤的病理和 IHC 染色不明显，因此诊断时需要高度怀疑。由于这种肿瘤的罕见性，有必要对目前和未来的 STK11 附件肿瘤病例进行分析，以了解其发病机制、基因突变分析、临床过程和最佳治疗方案。

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引用次数: 0

Docetaxel induced myositis in the treatment of uterine Leiomyosarcoma: A case report and review of literature 多西他赛在治疗子宫线粒体肉瘤过程中诱发肌炎：病例报告和文献综述

IF 1.2 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2024-09-30 DOI: 10.1016/j.gore.2024.101519

Nourah Ibrahim , Alon D. Altman

引用次数: 0

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