scholarly journals “Chronic fatigue, quality of life and long-term side-effects of chemotherapy in patients treated for non-epithelial ovarian cancer: national case-control protocol study of the GINECO-Vivrovaire rare tumors INCa French network for rare malignant ovarian tumors”

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
François Gernier ◽  
Djihane Ahmed-Lecheheb ◽  
Patricia Pautier ◽  
Anne Floquet ◽  
Cédric Nadeau ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ovarian Cancer ◽  
Side Effects ◽  
Germ Cell ◽  
Germ Cell Tumors ◽  
Chronic Fatigue ◽  
Stromal Tumors ◽  
Sex Cord Stromal Tumors

Abstract Background Germ cell tumors and sex cord stromal tumors are rare cancers of the ovary. They mainly affect young women and are associated with a high survival rate. The standard treatment mainly involves conservative surgery combined with chemotherapy [bleomycin, etoposide and cisplatin (BEP)] depending on the stage and the prognostic factors, as for testicular cancers. As reported in testicular cancer survivors, chemotherapy may induce sequelae impacting quality of life, which has not yet been evaluated in survivors of germ cell tumors and sex cord stromal tumors. The GINECO-VIVROVAIRE-Rare tumor study is a two-step investigation aiming to assess i) chronic fatigue and quality of life and ii) long-term side-effects of chemotherapy with a focus on cardiovascular and pulmonary disorders. Methods Using self-reported questionnaires, chronic fatigue and quality of life are compared between 134 ovarian cancer survivors (cancer-free ≥2 years after treatment) treated with surgery and chemotherapy and 2 control groups (67 ovarian cancer survivors treated with surgery alone and 67 age-matched healthy women). Medical data are collected from patient records. In the second step evaluating the long-term side-effects of chemotherapy, a subgroup of 90 patients treated with chemotherapy and 45 controls undergo the following work-up: cardiovascular evaluation (clinical examination, non-invasive cardiovascular tests to explore heart disease, blood tests), pulmonary function testing, audiogram, metabolic and hormonal blood tests. Costs of sequelae will be also assessed. Patients are selected from the registry of the INCa French Network for Rare Malignant Ovarian Tumors, and healthy women by the ‘Seintinelles’ connected network (collaborative research platform). Discussion This study will provide important data on the potential long-term physical side-effects of chemotherapy in survivors of Germ Cell Tumors (GCT) and Sex Cord Stromal Tumors (SCST), especially cardiovascular and pulmonary disorders, and neurotoxicity. The identification of long-term side-effects can contribute to adjusting the treatment of ovarian GCT or SCST patients and to managing follow-up with adapted recommendations regarding practices and chemotherapy regimens, in order to reduce toxicity while maintaining efficacy. Based on the results, intervention strategies could be proposed to improve the management of these patients during their treatment and in the long term. Trial registration This trial was registered at clinicaltrials.gov: 03418844, on 1 February 2018. This trial was registered on 25 October 2017 under the unique European identification number (ID-RCB): 2017-A03028–45. Recruitment Status: Recruiting. Protocol version Version n° 4.2 dated from Feb 19, 2021. Trial sponsor Centre François Baclesse, 3 avenue du Général Harris, F-14076 Caen cedex 05, France.

Non-Epithelial Ovarian Cancer; NCI Study

2020 ◽  
Vol 106 (1_suppl) ◽  
pp. 7-7
Author(s):  
Ashraf Sobhy ◽  
Mohammed Gamil ◽  
Omar Youssef ◽  
Ali Hassan Mebed
Keyword(s):  
Ovarian Cancer ◽  
Germ Cell ◽  
Epithelial Ovarian Cancer ◽  
Germ Cell Tumors ◽  
Disease Stage ◽  
Early Stage Disease ◽  
Stromal Tumors ◽  
Ovarian Cancers ◽  
Malignant Germ Cell Tumors ◽  
Sex Cord Stromal Tumors

Background: Non-epithelial cancers of the ovary are uncommon. They include malignancies of germ cell origin, sex cord-stromal cell origin, metastatic carcinomas to the ovary, and a variety of extremely rare ovarian cancers, such as sarcomas and lipoid cell tumors. Nonepithelial malignancies account for about 10% of all ovarian cancers. Objective: To review the management of Non-epithelial ovarian cancer in the NCI Cairo university during a period of 5 years (2005 till 2010). Material and Methods: Retrospective study including 114 patients who were diagnosed and treated with Non-epithelial ovarian cancer (2005 to 2010). Data were collected from the biostatistics and cancer epidemiology department. Results: Out of 114 patients; 25(21.9%) were benign and 25 (21.9%) were borderline malignant; 55 (48.2%) were malignant and 9 (7.89%) of them were unpredicted biologic behavior; the median age of the study population was 49.7 years (range 14_83years). Panhysterectomy was done in 77(67.5%) of the patients; ovariectomy and debulking were done in 22(19.3%; salpingooophorectomy was done in 10(8.8%) 0f patients and cystectomy was done in 3(2.6%) and 2 cases underwent biopsy. Conclusion: Sex cord-stromal tumors and malignant germ cell tumors are the most common nonepithelial ovarian cancers. These tumors often, but not always, present with the sequelae of overproduction of either androgens or estrogens. It is important to diagnose these masses early, as overall prognosis is typically very good for early stage disease in all histological subtypes. Both sex cord-stromal tumors and malignant germ cell tumors of the ovary are treated with initial surgical resection. Fertility sparing surgery can be considered for both sex cord-stromal and malignant germ cell tumors of the ovary. Depending on the pathological diagnosis and disease stage, postoperative management consists of either expectant management or adjuvant chemotherapy. It is recommended that all patients with nonepithelial ovarian cancer be monitored for evidence of disease recurrence on a standardized schedule.

Long-term health outcomes of germ cell tumor survivors.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 135-135
Author(s):  
Trent James Miller ◽  
Lawrence H. Einhorn ◽  
Nasser H. Hanna ◽  
Victoria Champion ◽  
Patrick Monahan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Germ Cell ◽  
General Health ◽  
Germ Cell Tumors ◽  
Total Testosterone ◽  
Patient Reported ◽  
Group 2 ◽  
Group 1

135 Background: Survivors of germ cell tumors (GCT) may face long-term health risks We have previously reported the high incidence of hypogonadism (HG) in survivors of GCT. These patients also may be at risk for other chronic health and psychosocial problems. Methods: Patients treated with chemotherapy (Group 1) or with orchiectomy and/or other surgery or radiotherapy for GCT (Group 2), were 18-50 yrs of age, and not receiving supplemental testosterone at baseline were eligible. Total testosterone was measured at baseline. For patients receiving supplemental testosterone while on study, total testosterone was also measured at 3 and 6 months. Cancer diagnosis and treatment variables were obtained from medical records. Patients completed a validated quality of life (QOL) questionnaire at baseline, 3, and 6 mos. Measures included the Aging Males’ Symptoms (AMS) scale and NIH Patient Reported Outcome Management Information Systems (PROMIS) measures. Results: The rate of HG ( < 300 testosterone) at baseline did not differ between Group 1 and Group 2 (p = 0.45). Compared to non-HG, patients with HG measured at baseline were significantly more likely to have a BMI in the obese ( > 30; 57% vs 19%) range (p < 0.001). Improvements in testosterone during treatment from baseline to follow-up were strongly correlated with improvements in AMS (r = 0.51, p = 0.001) and moderately correlated with improvements in general health (r = 0.32, p = .049). Multivariable models using baseline variables demonstrated that baseline HG was significantly associated with worse baseline quality of life in the areas of general health, sleep quality, and fatigue. BMI in the obesity range was significantly associated with worse general health. Conclusions: Patients who were treated for GCT are at higher risk of HG. This subsequently increases the risk of having a BMI in the obese range, which in turn is associated with worse QOL. Treating HG is associated with improvements in AMS scale.

scholarly journals Long-term quality of life and neuropsychologic functioning for patients with CNS germ-cell tumors: From the First International CNS Germ-Cell Tumor Study

2001 ◽  
Vol 3 (3) ◽  
pp. 174-183 ◽  
Author(s):  
Stephen A. Sands ◽  
Stewart J. Kellie ◽  
Amy L. Davidow ◽  
Blanca Diez ◽  
Judith Villablanca ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Germ Cell ◽  
Germ Cell Tumor ◽  
Germ Cell Tumors ◽  
Cell Tumor ◽  
Tumor Study ◽  
Cns Germ Cell Tumor

Sex cord stromal and germ cell ovarian cancer: Is there a racial disparity?

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e18056-e18056
Author(s):  
Fatima Reyes ◽  
Rosa Guerra ◽  
Cheng-I Liao ◽  
Chris Argueta ◽  
Amandeep Kaur Mann ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Germ Cell ◽  
Granulosa Cell ◽  
Germ Cell Tumor ◽  
Germ Cell Tumors ◽  
Immature Teratoma ◽  
Cell Tumor ◽  
Asian Women ◽  
Stromal Tumors ◽  
Sex Cord Stromal Tumors

e18056 Background: We proposed to determine the incidence and presentation of sex cord stromal and germ cell ovarian cancers in various racial groups. Methods: Data was obtained from the United States Cancer Statistics (USCS) and National Cancer Database (NCDB) databases between 2004 and 2016. Chi-squared tests were used for statistical analyses. Results: Of 8,917 women, 48.2% were diagnosed with sex cord stromal ovarian cancer, and 52.5% had germ cell ovarian cancer. White, Black, and Asian individuals comprised 72.5%, 19.8%, and 4.16% of the population, respectively. Of the sex cord stromal tumors, 84.1% were granulosa cell, 7.9% sertoli leydig, 1.8% steroid cell, and 6.2% "other" tumors. Of the germ cell tumors, 23.3% were immature teratoma, 19.6% dysgerminoma, 10.3% yolk sac, 8.3% mixed germ cell tumor, 0.1% embryonal carcinoma, and 38.3% "other" germ cell tumor histologies. Using the UCSC database, the age-adjusted incidence of sex cord stromal was 0.50 per 100,000 for Blacks compared to 0.23 for Whites and 0.14 for Asians. The incidence for germ cell tumors was 0.40 per 100,000 in Whites, 0.46 in Blacks, and 0.44 in Asians. Using NCDB data, the proportion of sex cord stromal tumor was 5.6% in Blacks compared to 1.5% in Whites and 1.55% in Asians, and the most common histology of sex cord stromal tumors was granulosa cell tumors in every racial group. The proportion of germ cell tumors was also higher in Blacks at 4.4% compared to 2.0% in Whites and 3.9% in Asians. Of germ cell tumors, the most common histology was dysgerminoma for Whites at 22.3% and immature teratoma in Blacks and Asians at 28.0% and 26.9%, respectively. Conclusions: Our data suggest that Black women are more likely to be diagnosed with sex cord stromal tumors compared to White and Asian women. Black and Asian women also had more germ cell cancer than White women.

scholarly journals Quality of life in long-term survivors of ovarian germ cell tumors: A Gynecologic Oncology Group Study

2007 ◽  
Vol 105 (3) ◽  
pp. 687-694 ◽  
Author(s):  
Victoria Champion ◽  
Stephen D. Williams ◽  
Anna Miller ◽  
Kristina M. Reuille ◽  
Kim Wagler-Ziner ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Germ Cell ◽  
Gynecologic Oncology ◽  
Germ Cell Tumors ◽  
Gynecologic Oncology Group ◽  
Oncology Group ◽  
Oncology Group Study ◽  
Long Term Survivors

scholarly journals Quality of life among long-term survivors of advanced stage ovarian cancer: A cross-sectional approach

2017 ◽  
Vol 146 (1) ◽  
pp. 101-108 ◽  
Author(s):  
Susan K. Lutgendorf ◽  
Eileen Shinn ◽  
Jeanne Carter ◽  
Susan Leighton ◽  
Keith Baggerly ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ovarian Cancer ◽  
Advanced Stage ◽  
Cross Sectional ◽  
Long Term Survivors

scholarly journals Opioid Analgesia: Perspectives on Right Use and Utility

2007 ◽  
Vol 3;10 (5;3) ◽  
pp. 479-491 ◽  
Author(s):  
Jane C. Ballantyne
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Side Effects ◽  
Clinical Decision Making ◽  
Analgesic Efficacy ◽  
Clinical Decision ◽  
Opioid Analgesia ◽  
Opioid Treatment

The ability of opioids to effectively and safely control acute and cancer pain has been one of several arguments used to support extending opioid treatment to patients with chronic pain, against a backdrop of considerable caution that has been based upon fears of addiction. Of course, opioids may cause addiction, but the “principle of balance” may justify that “…efforts to address abuse should not interfere with legitimate medical practice and patient care.” Yet, situations are increasingly encountered in which opioid-maintained patients are refractory to analgesia during periods of pain, or even during the course of chronic treatment. The real question is whether analgesic efficacy of opioids can be maintained over time. Overall, the evidence supporting long-term analgesic efficacy is weak. The putative mechanisms for failed opioid analgesia may be related to tolerance or opioid-induced hyperalgesia. Advances in basic sciences may help in understanding these phenomena, but the question of whether long-term opioid treatment can improve patients’ function or quality of life remains a broader issue. Opioid side effects are well known, but with chronic use, most (except constipation) subside. Still, side effects can negatively affect the outcomes and continuity of therapy. This paper addresses 1) what evidence supports the long-term utility of opioids for chronic pain; 2) how side effects may alter quality of life; 3) the nature of addiction and why it is different in pain patients, and 4) on what grounds could pain medication be denied? These questions are discussed in light of patients’ rights, and warrant balancing particular responsibilities with risks. These are framed within the Hippocratic tradition of “producing good for the patient and protecting from harm,” so as to enable 1) more informed clinical decision making, and 2) progress towards right use and utility of opioid treatment for chronic pain. Key Words: Opioids, chronic pain, addiction, side effects, utility, ethics

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