Controlled decompression of large ovarian cystic tumors via mini-laparotomy using Dermabond Advanced™.

Large cystic ovarian tumors usually require surgical removal because of symptoms and the possibility of malignancy. The ideal surgical approach would minimize the risk of spillage of tumor contents while minimizing surgical morbidity. The present study aims to demonstrate a novel technique to drain large cystic ovarian tumors without spillage.

Adoption of enhanced recovery after laparotomy in gynecologic oncology.

Introduction: Enhanced recovery after surgery (ERAS) pathways combine a comprehensive set of peri-operative practices that have been demonstrated to hasten patient post-operative recovery. We aimed to evaluate the adoption of ERAS components and assess attitudes towards ERAS among gynecologic oncologists.

Methods: We developed and administered a cross-sectional survey of attending, fellow, and resident physicians who were members of the Society of Gynecologic Oncology in January 2018.

Impact of prior hysterectomy on surgical outcomes for laparoscopic adnexal surgery.

Background: Adnexal surgery is believed to be more complex in patients with prior hysterectomy; however, there is little data regarding surgical outcomes. Understanding of individualized risks improves counseling, informed consent, and preoperative planning.

Methods: We performed a retrospective cohort study with a control group; we evaluated 744 patients undergoing laparoscopic adnexal surgery at an academic tertiary care center from 2011 to 2015.

Hysterectomy Practice Patterns in the Postmorcellation Era.

Objective: To characterize long-term national trends in surgical approach for hysterectomy after the U.S. Food and Drug Administration (FDA) warning against power morcellation for laparoscopic specimen removal.

Participation in global health delivery: Survey results from the Society of Gynecologic Oncology.

•Gynecologic oncologists face multiple barriers in participating in global health.•Several barriers may be addressed at the institutional level.•Most global health experiences involved direct patient care, while only a small proportion involved research.

Durable response in a woman with recurrent low-grade endometrioid endometrial cancer and a germline BRCA2 mutation treated with a PARP inhibitor.

A 42-year-old woman with a germline BRCA2 mutation and recurrent low-grade endometrioid endometrial adenocarcinoma experienced clinical and radiographic response to the poly (ADP ribose) polymerase (PARP) inhibitor, olaparib. Molecular and treatment factors are discussed.

Urinary incontinence, depression, and economic outcomes in a cohort of women between the ages of 54 and 65 years.

Objective: To estimate the association between urinary incontinence (UI) and probable depression, work disability, and workforce exit.

Methods: The analytic sample consisted of 4,511 women enrolled in the population-based Health and Retirement Study cohort. The analysis baseline was 1996, the year that questions about UI were added to the survey instrument, and at which time study participants were 54-65 years of age.

Immunohistochemical loss of BRCA1 protein in uterine serous carcinoma.

Uterine serous carcinoma is a uncommon aggressive variant of endometrial cancer whose biologic origin is unclear. Mutations in p53 and BRCA1 genes play a key role in ovarian serous carcinogenesis. We investigated whether the loss of BRCA1 expression plays a similar role in uterine serous carcinoma.

Safety and outcome of patients treated with a modified outpatient intraperitoneal regimen for epithelial ovarian, primary peritoneal or fallopian tube cancer.

Background: Despite the survival benefit of intraperitoneal (IP) chemotherapy observed in GOG172, significant toxicity and poor treatment completion rates have prevented the widespread acceptance of this regimen. Here, we report our experience with a modified outpatient GOG172 regimen.

Methods: Eligible patients had stage III, optimally debulked epithelial ovarian, fallopian tube or primary peritoneal cancer that underwent IP port placement for administration of a modified GOG172 regimen consisting of: (i) intravenous paclitaxel 135 mg/m² on day 1 over 3 h; (ii) intraperitoneal cisplatin 75 mg/m² on day 2, and (iii) intraperitoneal paclitaxel 60 mg/m² on day 8.

Value of additional level sections in the evaluation of lymph nodes for endometrial carcinoma staging.

Objectives: To evaluate the value of deeper sections for conventional (non-sentinel) lymph node dissections in high-risk endometrial carcinoma (EC).

Methods: We conducted a retrospective review of all ECs with high-grade or serous histology, more than 50% myometrial invasion or International Federation of Gynecology and Obstetrics (FIGO) pathologic stage greater than 2, and conventional complete pelvic lymph node dissections. No sentinel lymph node (SLN) biopsies were performed.

Management of ovarian cancer: a 75-year-old woman who has completed treatment.

Ovarian cancer includes primary tumors of epithelial, sex cord-stromal, or germ cell origin as well as metastatic tumors that frequently originate in the gastrointestinal tract. Approximately 90% of ovarian cancer is epithelial in origin and constitutes a major therapeutic challenge because of its advanced stage of presentation in most patients. Epithelial ovarian cancer is the most lethal gynecologic malignancy and the fifth most common cause of female cancer death in the United States, with approximately 1 in 70 women developing this disease in their lifetime.

Assessment of long-term knowledge retention following single-day simulation training for uncommon but critical obstetrical events.

Objective: The objectives were to determine (i) whether simulation training results in short-term and long-term improvement in the management of uncommon but critical obstetrical events and (ii) to determine whether there was additional benefit from annual exposure to the workshop.

Methods: Physicians completed a pretest to measure knowledge and confidence in the management of eclampsia, shoulder dystocia, postpartum hemorrhage and vacuum-assisted vaginal delivery. They then attended a simulation workshop and immediately completed a posttest.

Laparoscopic intraperitoneal port placement for optimally cytoreduced advanced ovarian cancer.

Study Objective: To evaluate complications of intraperitoneal ports placed laparoscopically as a separate procedure after initial debulking surgery for ovarian, fallopian tube, or primary peritoneal cancer.

Design: A retrospective case series (Canadian Task Force Classification III).

Setting: Inpatient, academic teaching institution.

Description and validation of the Pelv-Sim: a training model designed to improve gynecologic minimally invasive suturing skills.

Study Objective: To describe and validate the Pelv-Sim trainer, an innovative training model for gynecologic laparoscopic suturing with 4 laparoscopic exercises: closing an open vaginal cuff, transposing an ovary to the pelvic sidewall, ligating an infundibulopelvic ligament, and closing a port-site fascial incision.

Design: Randomized controlled trial (Canadian Task Force classification I).

Setting: Academic medical center.

Nomogram for survival after primary surgery for bulky stage IIIC ovarian carcinoma.

Objective: Nomograms have been developed for numerous malignancies to predict a specific individual's probability of long-term survival based on known prognostic factors. To date, only one prediction model has been reported for patients with epithelial ovarian carcinoma (EOC). The objective of this study was to develop a more accurate survival nomogram for patients with bulky stage IIIC EOC.

The outcomes of patients with positive margins after excision for intraepithelial Paget's disease of the vulva.

Objectives: Vulvar Paget's disease is a rare neoplasm that usually occurs in postmenopausal women. Treatment with surgical excision can be complicated by extension of microscopic disease in an irregular manner well beyond the visible margins of the lesion. The objective or our study was to analyze the outcomes of patients with primary vulvar intraepithelial Paget's disease who had positive microscopic margins after primary excision.

Surgical resection of recurrent endometrial carcinoma.

Objective: Chances of survival after the diagnosis of recurrent endometrial cancer are poor. Although total pelvic exenteration has been described as a treatment for a select subset of patients with recurrent endometrial cancer, the use of other surgical procedures in this setting has not been well described. The objective of this study was to review our experience with non-exenterative surgery for recurrent endometrial cancer.

Laparoscopic bilateral salpingo-oophorectomy in breast cancer patients after transverse rectus abdominus myocutaneous flap reconstructive surgery.

Objective: The aim of this study was to describe the feasibility and outcome of laparoscopic risk-reducing salpingo-oophorectomy (RRSO) in patients with a history of breast cancer who previously had undergone a transverse rectus abdominus myocutaneous (TRAM) flap reconstruction.

Methods: We performed a retrospective review of patients with a history of breast cancer who had undergone laparoscopic RRSO between February 1995 and April 2002. Patients who had undergone TRAM flap reconstructive surgery were compared with patients who had undergone laparoscopic RRSO without prior reconstructive surgery.

Gene expression profiles of serous, endometrioid, and clear cell subtypes of ovarian and endometrial cancer.

Purpose: The presence of similar histologic subtypes of epithelial ovarian and endometrial cancers has long been noted, although the relevance of this finding to pathogenesis and clinical management is unclear. Despite similar clinical characteristics, histologic subtypes of cancers of the ovary and endometrium are treated according to organ of origin. This study compares the gene expression profiles of analogous histologic subtypes of cancers of the ovary and endometrium using the same genomic platform to determine the similarities and differences between these tumors.

Gene expression profiles associated with response to chemotherapy in epithelial ovarian cancers.

Purpose: The goal of this study was to determine whether distinct gene expression profiles are associated with intrinsic and/or acquired chemoresistance in epithelial ovarian carcinoma.

Experimental Design: Gene expression profiles were generated from 21 primary chemosensitive tumors and 24 primary chemo-resistant tumors using cDNA-based microarrays. Gene expression profiles of both groups of primary tumors were then compared with those of 15 ovarian carcinomas obtained following platinum-based chemotherapy ("post-chemotherapy" tumors).

Gene expression profiling of tamoxifen-associated uterine cancers: evidence for two molecular classes of endometrial carcinoma.

Objective: Endometrial cancers associated with tamoxifen exposure potentially represent a unique resource for investigating the molecular mechanisms of estrogen-induced tumorigenesis. The purpose of this study was to test the hypothesis that tamoxifen-associated endometrial carcinomas have a distinct gene expression profile compared to matched cases not associated with this exposure.

Methods: Microarray-based expression profiling was performed on a series of tamoxifen-associated (N = 10) and matched sporadic cases (N = 29) of endometrial carcinoma.

Choice of normal ovarian control influences determination of differentially expressed genes in ovarian cancer expression profiling studies.

Purpose: As with many cancers thought to be of epithelial origin, expression profiling studies of ovarian cancer have relied on a variety of sources of normal cells for comparison with tumors, including whole ovary samples (WO), ovarian surface epithelium (OSE) exposed to short-term culture, and immortalized OSE cell lines (IOSE). Our purpose was to assess the impact of the use of different types of normal controls on the determination of gene expression alterations in ovarian cancer studies.

Experimental Design: We compared the gene expression profiles generated on an 11,000-element cDNA microarray of OSE brushings, whole ovary samples, short-term cultures of normal OSE, SV40 large T antigen-immortalized OSE cell lines, and telomerase-immortalized OSE cell lines.