scholarly journals American Society of Clinical Oncology 2013: Summary of Scientific Advancements in Gynecologic Cancer

2014 ◽  
Vol 24 (1) ◽  
pp. 13-18 ◽  
Author(s):  
Ramez N. Eskander ◽  
Krishnansu S. Tewari
Keyword(s):  
Cervical Cancer ◽  
Clinical Oncology ◽  
Gynecologic Oncology ◽  
Gynecologic Cancer ◽  
Phase 2 ◽  
Gynecologic Malignancy ◽  
General Session ◽  
Asco Meeting ◽  
American Society ◽  
Scientific Accomplishment

AbstractThe American Society of Clinical Oncology (ASCO) meeting was held in Chicago, Ill, from May 31, 2013, to June 4, 2013, and focused on “Building Bridges to Conquer Cancer.” An estimated 25,500 oncology professionals, with a broad range of interests, attended the meeting. Cervical cancer, a gynecologic malignancy with a significant global burden, was prominently featured at this year’s meeting. In a mark of exemplary scientific accomplishment within our specialty, 2 of the 5 general session plenaries investigated advancements in cervical cancer care, extending from improved screening to treatment of metastatic disease. This was followed by the presentation of several important phase 2 and 3 clinical trials in the Gynecologic Oncology Tract, focusing on cervical, ovarian, uterine, and breast cancer, which will be discussed in this report.

Perioperative Outcomes of Combined Gynecologic Oncology and Urogynecologic Surgeries

2020 ◽  
pp. 1-5
Author(s):  
Abeer Eddib ◽  
Abeer Eddib ◽  
Ahmed Eddib ◽  
Kenneth Fan
Keyword(s):  
Urinary Incontinence ◽  
Pelvic Organ Prolapse ◽  
Operative Time ◽  
Gynecologic Oncology ◽  
Gynecologic Cancer ◽  
Pelvic Organ ◽  
Perioperative Outcomes ◽  
P Value ◽  
Gynecologic Malignancy ◽  
Improvement Program

Background: Many women diagnosed with a gynecologic malignancy may have coinciding urogynecologic complaints, such as pelvic organ prolapse (POP) and/or urinary incontinence, with approximately 35% reporting moderate to severe symptoms. Recent National Surgical Quality Improvement Program (NSQIP) database inquiries of gynecologic cancer cases found only 2.3-2.4% of women undergoing interventional surgery for gynecologic malignancy also had a procedure for pelvic organ prolapse urinary incontinence (POPUI), and those combination cases did not show significant increase in postoperative risks. The purpose of our study is to review our cases of gynecologic cancer that underwent concomitant urogynecologic procedures and compare their perioperative outcomes to gynecologic cancer cases without concomitant urogynecologic procedures. Methods: A retrospective cohort study conducted at a teaching hospital included 29 gynecologic oncology patients who underwent robot-assisted total laparoscopic hysterectomy, bilateral salpingo-oophorectomy, and lymphadenectomy. Controls underwent standard staging procedure and were compared to women with concomitant pelvic floor dysfunction that underwent additional laparoscopic uterosacral ligament suspension for apical suspension and a sling for stress urinary incontinence (SUI). The primary outcome was operative time, defined as documented total operative time and robot console time. Secondary outcomes include delta hemoglobin, hospital length of stay, readmission rate, total pain medication, urinary retention and discharge with foley. Results: The combined case group had longer total procedure time duration (301 minutes versus 210 minutes, p-value < 0.0001), with comparable mean console time (178 minutes versus 160 minutes; p = 0.1456). Blood loss estimated by mean percent difference of Hgb showed moderate conditional dependence on surgical case (22.2% cases versus 14.9% controls, p-value 0.04). Combined cases resulted in 76.9% of subjects discharged with a foley catheter compared to none in controls (p-value < 0.0001). Otherwise, there was no difference in the other perioperative outcomes between the two groups. Conclusion: With appropriate counseling and clinical judgement, combined urogynecologic and gynecologic oncologic surgeries can be performed to improve a patient’s quality of life (QOL) with minimal increase in perioperative morbidity.

Incorporation of bevacizumab in the treatment of recurrent and metastatic cervical cancer: A phase III randomized trial of the Gynecologic Oncology Group.

2013 ◽  
Vol 31 (18_suppl) ◽  
pp. 3-3 ◽  
Author(s):  
Krishnansu Sujata Tewari ◽  
Michael Sill ◽  
Harry J. Long ◽  
Lois M. Ramondetta ◽  
Lisa Michelle Landrum ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Disease Progression ◽  
Interim Analysis ◽  
Gynecologic Oncology ◽  
Gynecologic Cancer ◽  
Single Agent ◽  
Phase Iii ◽  
Gynecologic Oncology Group ◽  
Recurrent Cervical Cancer ◽  
Anti Vegf

3 Background: Vascular endothelial growth factor (VEGF) promotes angiogenesis, a mediator of disease progression in cervical cancer. Bevacizumab (B), a humanized anti-VEGF monoclonal antibody, has shown single-agent activity in pretreated recurrent disease. We aimed to evaluate B in chemotherapy (CTX)-naive recurrent/persistent/metastatic cervical cancer. Methods: Using a 2x2 factorial design, patients were randomly assigned to CTX with or without B 15 mg/kg. The CTX regimens included cisplatin 50 mg/m2 plus paclitaxel 135-175 mg/m2 and topotecan 0.75 mg/m2 d1-3 plus paclitaxel 175 mg/m2d1. Cycles were repeated every 21 days until disease progression, unacceptable toxicity, or complete response. Overall survival (OS) was the primary endpoint with a reduction in the hazard of death by 30% using anti-VEGF therapy considered important (90% power, 1-sided alpha=2.5%). Final analysis was planned when 346 deaths were observed. Results: 452 patients were accrued from 4/6/09 to 1/3/12. The scheduled interim analysis occurred after 174 patients had died and showed that the topotecan-paclitaxel backbone was not superior to the cisplatin-paclitaxel backbone. A second interim analysis was conducted after 271 deaths. A total of 225 patients received CTX alone and 227 patients received CTX plus B. The randomized treatment groups were similar with regard to age, histology, performance status, previous platinum as a radiosensitizer, and recurrence, persistence, or advanced disease. The B-to-no-B hazard ratio (HR) of death was 0.71 (97.6% CI 0.54-0.95; 1-sided p=0.0035). Median survival was 17 m (CTX plus B) and 13.3 m (CTX alone). The RR were 48% (CTX plus B) and 36% (CTX alone) (p=0.0078). Treatment with B was associated with more grade 3-4 bleeding (5 vs 1%) thrombosis/embolism (9 vs 2%), and GI fistula (3 vs 0%). Conclusions: For the first time a targeted agent significantly improved OS in gynecologic cancer. The second interim analysis crossed the boundary for efficacy, warranting early release of this information. The nearly 4-month increase in median OS with the addition of B to CTX in women with recurrent cervical cancer is considered to be clinically significant. Clinical trial information: NCT00803062.

scholarly journals 3515 Readability of online patient education materials on gynecologic malignancies from major medical associations

2019 ◽  
Vol 3 (s1) ◽  
pp. 28-29
Author(s):  
David Samuel ◽  
Nicole Vilardo ◽  
Sara Isani ◽  
Gregory Gressel
Keyword(s):  
Medical Association ◽  
Disease Control ◽  
Gynecologic Oncology ◽  
Gynecologic Cancer ◽  
Reading Level ◽  
Educational Materials ◽  
Gynecologic Malignancy ◽  
Medical Associations ◽  
Cancer Coalition ◽  
Grade Reading Level

OBJECTIVES/SPECIFIC AIMS: Patients are increasingly using online materials to learn about gynecologic cancer. Recent studies demonstrate that 85-96% of patients with a gynecologic malignancy utilize the Internet as a health resource. Providers can refer patients to educational materials produced by major medical associations available on their websites. However, patient educational materials (PEMs) published by professional organizations from other surgical specialties have been shown to be difficult to read for the average American. The NIH and AMA recommend that PEMs be written between a sixth and eighth grade reading level. In this study, we assess the readability of online PEMs on gynecologic cancer published by major medical associations. METHODS/STUDY POPULATION: Seven national medical association websites with PEMs on gynecologic malignancy were surveyed: American College of Obstetricians and Gynecologists, Center for Disease Control, Foundation for Women’s Cancer, National Cancer Institute, National Cervical Cancer Coalition, National Ovarian Cancer Coalition, and Society of Gynecologic Oncology. Online PEMs were identified and analyzed using five validated readability indices. One-way ANOVA and Tukey’s test were performed to detect differences in readability between publishers. RESULTS/ANTICIPATED RESULTS: Two hundred and thirty PEMs were included in this analysis. Mean readability grade levels with standard deviation were: 11.3 (2.8) for Coleman-Liau index; 11.8 (3.2) for Flesch-Kincaid; 11.1 (1.2) for FORCAST formula; 12.5 (2.7) for Gunning FOG formula; 12.1 (2.6) for New Dale-Chall formula; and 13.5 (2.5) for SMOG formula. Overall, PEMs were written at a mean 12th grade reading level. Only 4.3% of articles were written at an 8th grade reading level or below. ANOVA demonstrated a significant difference in readability between publishing associations (p<0.01). PEMs from the Center for Disease Control had a mean 10th grade reading level and were significantly lower than all other organizations. PEMs from The Foundation for Women’s Cancer had a mean 13th grade reading level and were significantly higher than most other organizations. DISCUSSION/SIGNIFICANCE OF IMPACT: Gynecologic oncology PEMs available from major medical association are written well above the recommended sixth to eight grade reading level. Simplifying PEMs may improve patient understanding of their disease and facilitate physician-patient communication.

scholarly journals Neoadjuvant Chemotherapy for Newly Diagnosed, Advanced Ovarian Cancer: Society of Gynecologic Oncology and American Society of Clinical Oncology Clinical Practice Guideline

2016 ◽  
Vol 34 (28) ◽  
pp. 3460-3473 ◽  
Author(s):  
Alexi A. Wright ◽  
Kari Bohlke ◽  
Deborah K. Armstrong ◽  
Michael A. Bookman ◽  
William A. Cliby ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Epithelial Ovarian Cancer ◽  
Clinical Oncology ◽  
Cytoreductive Surgery ◽  
Gynecologic Oncology ◽  
Phase Iii ◽  
Stage Iiic ◽  
American Society ◽  
Interval Cytoreduction

Purpose To provide guidance to clinicians regarding the use of neoadjuvant chemotherapy and interval cytoreduction among women with stage IIIC or IV epithelial ovarian cancer. Methods The Society of Gynecologic Oncology and the American Society of Clinical Oncology convened an Expert Panel and conducted a systematic review of the literature. Results Four phase III clinical trials form the primary evidence base for the recommendations. The published studies suggest that for selected women with stage IIIC or IV epithelial ovarian cancer, neoadjuvant chemotherapy and interval cytoreduction are noninferior to primary cytoreduction and adjuvant chemotherapy with respect to overall and progression-free survival and are associated with less perioperative morbidity and mortality. Recommendations All women with suspected stage IIIC or IV invasive epithelial ovarian cancer should be evaluated by a gynecologic oncologist prior to initiation of therapy. The primary clinical evaluation should include a CT of the abdomen and pelvis, and chest imaging (CT preferred). Women with a high perioperative risk profile or a low likelihood of achieving cytoreduction to < 1 cm of residual disease (ideally to no visible disease) should receive neoadjuvant chemotherapy. Women who are fit for primary cytoreductive surgery, and with potentially resectable disease, may receive either neoadjuvant chemotherapy or primary cytoreductive surgery. However, primary cytoreductive surgery is preferred if there is a high likelihood of achieving cytoreduction to < 1 cm (ideally to no visible disease) with acceptable morbidity. Before neoadjuvant chemotherapy is delivered, all patients should have confirmation of an invasive ovarian, fallopian tube, or peritoneal cancer. Additional information is available at www.asco.org/NACT-ovarian-guideline and www.asco.org/guidelineswiki .

International Perspective on the Global Advances in Gynecologic Oncology

2012 ◽  
pp. 330-334
Author(s):  
Lynette Denny
Keyword(s):  
Cervical Cancer ◽  
Gynecologic Oncology ◽  
Gynecologic Cancer ◽  
Developed Countries ◽  
International Perspective ◽  
Chemotherapeutic Agents ◽  
Concurrent Chemotherapy ◽  
Adjuvant Radiation ◽  
Genetic Profiling ◽  
Risk Factors For Recurrence

Overview: The treatment of gynecologic cancer has evolved over the years, with greater emphasis on tailored surgery and reducing morbidity and mortality related to surgery, particularly in the management of vulvar and cervical cancer. The addition of concurrent chemotherapy to radiation regimens has improved survival of patients with cervical cancer in developed countries; however, most women with cancer in developing countries have advanced, untreatable disease and minimal access to anticancer therapies. In the past 15 years there has been intense research into alternatives to cervical cytologic testing, particularly in low resourced regions but also in an attempt to improve on cytologic testing in developed countries. Surgical staging in endometrial cancer has enabled the use of adjuvant radiation to be individualized to the patient's particular risk factors for recurrence. The management of ovarian cancer, long stagnant since the introduction of platinum and paclitaxel as chemotherapeutic agents, is set to change with the onset of molecular and genetic profiling and the introduction of novel therapies.

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