Publications by authors named "Aarthi Jayraj"

Background: The standard treatment for advanced epithelial ovarian cancer is primary cytoreductive surgery, with the goal of achieving no residual disease. Neoadjuvant chemotherapy and interval cytoreductive surgery can be viable treatment options for patients with extensive disease that precludes complete tumor removal during initial surgery, or when significant comorbidities increase the surgical risk without adversely impacting overall survival rates. However, published studies mostly included patients with high-grade serous ovarian cancer, with an underrepresentation of non-high-grade serous epithelial and non-epithelial cancers.

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Purpose: The European Society for Medical Oncology-Magnitude of Clinical Benefit Scale (ESMO-MCBS) and the ASCO Value Framework (ASCO-VF) are tools designed to assess the value of anticancer therapies. International conferences are the primary venues for sharing trial outcomes, often influencing clinical practices even before full publications are available. This analysis compares the ESMO-MCBS and ASCO-VF in evaluating the benefit of all phase III trials presented at the 2022 ASCO Annual Meeting (AM) and to examine the level of agreement between these scales.

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Background: Ovulation induction (OI) in patients with polycystic ovary syndrome (PCOS) remains challenging, and several biomarkers have been evaluated for their ability to predict ovulation. The predictive ability of candidate biomarkers, particularly with letrozole-based therapy in infertile PCOS women, remains inconclusive as it is yet to be evaluated in a prospective study.

Aim: To assess the role of anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), luteinising hormone (LH)/FSH ratio, testosterone and free androgen index (FAI) as predictors of ovarian response to letrozole-based OI therapy during OI cycles in infertile women with PCOS from North India.

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Article Synopsis
  • Granulosa cell tumors (GCTs) are common ovarian tumors associated with a good prognosis but a tendency for late recurrences, making treatment difficult.
  • A study evaluated the effects of cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC) on eight patients with recurrent adult GCTs, showing a median overall survival of 11.5 months post-treatment.
  • The procedure demonstrated acceptable levels of postoperative complications, but more research is needed to confirm its effectiveness as a treatment option for recurrent GCTs.
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Background And Objective: Serous endometrial cancers (ECs) are an aggressive histotype of ECs which are disproportionately responsible for 40% of cancer-specific mortality rates despite constituting only 5-10% of all uterine cancers in incidence. In recent times, it has become increasingly evident that about 20-40% of uterine serous cancers (USCs) have molecular alterations in pathway with human epidermal growth factor receptor 2 (HER2/neu) amplification or overexpression. We summarise the evidence on genetic and molecular alterations in HER2/neu pathway in USC with a focus on testing criteria, targeting agents and resistance mechanisms.

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Cervical cancer is a major global health issue, ranking as the fourth most common cancer in women worldwide. Depending on stage, histology, and patient factors, the standard management of cervical cancer is a combination of treatment approaches, including (fertility- or non-fertility-sparing) surgery, radiotherapy, platinum-based chemotherapy, and novel systemic therapies such as bevacizumab, immune checkpoint inhibitors, and antibody-drug conjugates. While ambitious global initiatives seek to eliminate cervical cancer as a public health problem, the management of cervical cancer continues to evolve with major advances in imaging modalities, surgical approaches, identification of histopathological risk factors, radiotherapy techniques, and biomarker-driven personalized therapies.

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Objective: To investigate the prevalence and patterns of social media use among gynecologic oncologists for professional and academic purposes.

Methods: A prospective online survey between November and December 2022 targeted gynecologic oncology practitioners (gynecologic oncologists, surgical oncologists, medical oncologists, radiation/clinical oncologists, and onco-pathologists/pathologists). The survey, distributed via various social media platforms, included 40 questions to capture qualitative and quantitative data on social media use.

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Objective: To evaluate the management and outcomes of Bartholin gland cancer at a single tertiary institution.

Study Design: A single institution retrospective review of 9 cases of BGC between 2004 and 2022 was conducted. Demographics, pathological characteristics, treatment, follow up and oncologic outcomes were extracted from clinical records.

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Article Synopsis
  • The study focuses on four cases of rare ectopic pregnancies occurring at the utero-tubal junction, highlighting the potential for severe maternal complications if these cases go undetected.
  • All four cases had different presentations, requiring distinct approaches for diagnosis, where initial 2D transvaginal scans were inadequate, and 3D transvaginal scans provided better localization of the gestational sacs.
  • The findings emphasized the importance of 3D imaging in managing these complex ectopic pregnancies and introduced a diagnostic algorithm and management strategies tailored to each case type.
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  • * A 38-year-old woman initially presented with severe pelvic pain and abnormal bleeding, and after treatment for endometriosis, she later developed a necrotic growth that was diagnosed as low-grade endometrial stromal sarcoma.
  • * Following surgical intervention to remove the tumor, the patient has remained disease-free for over 5 years, indicating a positive long-term outcome.
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  • The study analyzes 41 patients with central nervous system (CNS) metastases from epithelial ovarian cancer (EOC) between 2010 and 2020, highlighting that only 3.98% of patients developed these metastases.
  • The median age of patients was 48 years, and the majority had advanced stage EOC, with a median time of 27 months from EOC diagnosis to CNS metastasis.
  • Key findings indicate that patients with isolated CNS metastases and receiving aggressive treatment had better outcomes, with median progression-free survival of 12 months and overall survival of 33 months; lower serum CA-125 levels were associated with improved survival.
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Management of gynecological cancers has suffered during the pandemic, partly due to lockdown and partly due to directing resources to manage COVID-19 patients. Modification of gynecological cancer management during this pandemic is recommended. Cervical cancer patients who present with stage IA1 disease can have a delay of up to 8 weeks for surgical treatment, considering the slow tumor growth rate.

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Evidence from preclinical studies suggests a preventive effect of proton pump inhibitors (PPIs) in preeclampsia. Recently, several epidemiological studies have described a conflicting association between the use of PPIs during pregnancy and preeclampsia risk. This study aimed to evaluate the association between PPI use and the risk of preeclampsia.

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Introduction: Almost 80% of epithelial ovarian cancer present in advanced stage at diagnosis and despite excellent response to surgery and chemotherapy, more than 70% cancers recur. Subsequent therapies become decreasingly effective in controlling the disease, with each successful therapy being effective for a shorter duration. As a result, there is a need for novel therapeutic strategies to effectively treat recurrence.

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Article Synopsis
  • - The study examines the risks and outcomes of pregnancies in women with autoimmune disorders (AIDs) compared to low-risk pregnancies, using data from 153 AIDs cases and 1,095 control pregnancies.
  • - Results showed a significantly higher incidence of adverse perinatal outcomes in women with AIDs, particularly those with Takayasu's arteritis, antiphospholipid antibody syndrome, and systemic lupus erythematosus.
  • - The findings suggest that a multidisciplinary team approach and optimizing health before pregnancy can enhance outcomes for mothers and babies affected by autoimmune disorders.
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