Publications by authors named "Ellen M Hartenbach"
Objectives: The incidence of venous thromboembolism (VTE) following radical surgery for vulvar carcinoma remains poorly characterized, and recommendations for postoperative chemoprophylaxis are varied. Our objective was to assess the incidence of postoperative VTE in patients undergoing surgery for vulvar carcinoma and to determine if VTE incidence differs by radical vulvectomy with or without lymph node assessment.
Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried for patients with a diagnosis of vulvar cancer undergoing radical vulvectomy with or without lymph node assessment from 2012 to 2020.
Objectives: Alterations in the tumor suppressor TP53 gene are the most common mutations in high grade serous ovarian carcinoma. The impact of TP53 mutations on clinical outcomes and platinum resistance is controversial. We sought to evaluate the genomic profile of high grade serous ovarian carcinoma and explore the association of TP53 mutations with platinum resistance.
View Article and Find Full Text PDFPhase III Trial of Carboplatin and Paclitaxel Compared With Cisplatin and Paclitaxel in Patients With Optimally Resected Stage III Ovarian Cancer: A Gynecologic Oncology Group Study.
J Clin Oncol
September 2023
In randomized trials the combination of cisplatin and paclitaxel was superior to cisplatin and cyclophosphamide in advanced-stage epithelial ovarian cancer. Although in nonrandomized trials, carboplatin and paclitaxel was a less toxic and highly active combination regimen, there remained concern regarding its efficacy in patients with small-volume, resected, stage III disease. Thus, we conducted a noninferiority trial of cisplatin and paclitaxel versus carboplatin and paclitaxel in this population.
View Article and Find Full Text PDFObjectives: Minimally invasive surgery (MIS) is increasingly utilized for gynecologic cancers. While incidence of venous thromboembolism (VTE) after MIS is low, some guidelines recommend extended chemoprophylaxis for these patients undergoing MIS. Our objectives were to determine incidence of postoperative VTE in patients undergoing MIS, evaluate differences in the incidence by MIS modality and assess the need for extended chemoprophylaxis.
View Article and Find Full Text PDFArticle Synopsis
- Cervical cancer is the most prevalent gynecologic cancer globally, primarily linked to human papillomavirus exposure.
- Treatment options vary depending on the disease stage and can include surgery, radiation, chemotherapy, and immunotherapy, but these can lead to significant side effects and complications.
- Effective supportive care, both physical and emotional, is crucial for improving the quality of life for cervical cancer patients.
Cancer treatment-induced bone loss is a known side effect of cancer therapy that increases the risk of osteoporosis and bone fracture. Women with gynecologic cancer are at increased risk of bone loss secondary to the combined effect of oophorectomy and adjuvant therapies. Data regarding bone loss in women with gynecologic cancers are overall lacking compared to other cancer populations.
View Article and Find Full Text PDFObjective: To evaluate the peripartum transfusion rates for rural women compared with urban women in the United States.
Methods: In this population-based retrospective cohort study, geocoded birth records from 2014 to 2016 from the National Center for Health Statistics were used to examine the rural-urban differences in blood transfusion among nulliparous women delivering singleton, vertex pregnancies at term. We compared transfusion rates across the counties on a continuum from urban to rural.
Background: Women with a gynecologic cancer tend to be older, obese, and postmenopausal, characteristics that are associated with an increased risk for obstructive sleep apnea. However, there is limited investigation regarding the condition's prevalence in this population or its impact on postoperative outcomes. In other surgical populations, patients with obstructive sleep apnea have been observed to be at increased risk for adverse postoperative events.
View Article and Find Full Text PDFObjectives: We sought to analyze the clinicopathologic features, recurrence patterns and survival outcomes of women with high-grade uterine cancer (UC) enrolled on The Gynecologic Oncology Group (GOG) LAP2 trial.
Methods: This is a post-hoc analysis of LAP-2 patients with grade 3 endometrioid adenocarcinoma (ENDO), uterine serous (USC), clear cell (CC) and carcinosarcoma (CS). Demographics, clinicopathologic features, and recurrence patterns, were compared by histology and surgical approach.
Article Synopsis
- Gynecologic cancer diagnoses and treatments often lead to sexual health issues and reduced quality of life for survivors.
- Research indicates that sexual dysfunction is common among these survivors, yet many feel uncomfortable discussing these problems with their doctors; effective non-hormonal treatments include lubricants, pelvic floor therapy, and cognitive behavioral therapy.
- Oncology providers play a crucial role in improving survivors' quality of life by proactively addressing sexual health concerns, implementing simple strategies, and making referrals to specialists when needed.
Article Synopsis
- The study focuses on identifying factors that can help diagnose postoperative pulmonary embolism (PE) in patients with gynecologic cancer, as their symptoms can be vague.
- Over six years, 2498 surgeries were analyzed, leading to 107 CT pulmonary angiography evaluations that revealed a 24.3% positive rate for PE.
- Key findings showed that a high platelet count and a history of venous thromboembolism were strong predictors for PE, suggesting that clinicians should consider these factors rather than relying solely on heart rate and oxygen levels.
Ultrasound elastography is envisioned as an optional modality to augment standard ultrasound B-mode imaging and is a promising technique to aid in detecting uterine masses which cause abnormal uterine bleeding in both pre- and post-menopausal women. In order to determine the effectiveness of strain imaging, mechanical testing to establish the elastic contrast between normal uterine tissue and stiffer masses such as leiomyomas (fibroids) and between softer pathologies such as uterine cancer and adenomyosis has to be performed. In this paper, we evaluate the stiffness of normal uterine tissue, leiomyomas, and endometrial cancers using a EnduraTEC ElectroForce (ELF) system.
View Article and Find Full Text PDFObjective: During saline-infused sonohysterography (SIS), the distension fluid is typically discarded. If cytology analysis could identify those patients with endometrial cancer, many women would be spared from further procedures.
Methods: Thirty consecutive patients with clinical stage I or II endometrial adenocarcinoma were prospectively recruited preoperatively.
We have characterized the viscoelastic properties of human cervical tissue through a range of precompressional loads and testing frequencies. Mechanical testing is necessary to develop robust elasticity-based techniques for the diagnosis of cervical abnormalities. The storage modulus (E') and material damping (tan 6) were measured in 13 patients, 40 to 76 years old.
View Article and Find Full Text PDFObjective: To describe the surgical technique of uterine artery sparing robotic assisted radical trachelectomy (AS-RRT) for early stage cervical cancer.
Methods: We used our experience with AS-RRT performed at the University of Wisconsin-Carbone Comprehensive Cancer Center, USA, to present a detailed description of the surgical technique.
Results: The report details, step-by-step, our innovative surgical technique, supported by photos and illustrations.
Article Synopsis
- New agents are needed for uterine leiomyosarcoma patients who no longer respond to existing treatments, and sunitinib was tested for its effectiveness and toxicity in these cases.
- In a study involving 25 patients, only 2 showed a partial tumor response and 4 were progression-free for at least 6 months, indicating limited efficacy.
- The treatment had notable side effects, including various grades of neutropenia, anemia, and fatigue, while the median progression-free survival was only 1.5 months, demonstrating that sunitinib is not a viable option for this patient group.
Objective: To evaluate a quality improvement protocol for venous thromboembolism prevention in postoperative gynecologic cancer patients.
Methods: On January 1, 2006, we initiated a universal protocol of dual prophylaxis with sequential compression devices and three times daily heparin (or daily low molecular weight heparin) until discharge in gynecologic cancer patients having major surgery. Patients with both malignancy and age over 60 years (or history of prior clot) were discharged on 2 weeks of anticoagulant.
Objectives: To determine the maximum tolerated dose (MTD) and feasibility of weekly cisplatin and paclitaxel chemotherapy administered concurrently with whole abdominal radiation therapy (WART) in women with high-risk endometrial cancer.
Methods: Following surgery, patients with stage III-IV endometrial cancer (any histology) or with stage I-II serous or clear cell histology, and with largest residual disease
The effect of laparoscopic guidance on gynecologic interstitial brachytherapy.
J Minim Invasive Gynecol
January 2009
Study Objective: To compare laparoscopic-assisted interstitial brachytherapy (LAIB) with traditional interstitial brachytherapy (TrIB) in the treatment of gynecologic malignancies.
Design: Retrospective review (Canadian Task Force classification II-3).
Setting: University hospital.
Objective: The purpose of this study was to evaluate sonohysterography in patients with endometrial cancer and to determine whether (1) transtubal fluid spill occurs during routine sonohysterography, (2) a critical infusion volume for spill exists, or (3) disseminated cancer cells demonstrate viability.
Study Design: At laparotomy, sonohysterography was performed on 16 patients with endometrial adenocarcinoma. Volumes at which tubal spill occurred were recorded.
Article Synopsis
- The study aimed to create ultrasound strain imaging techniques to help doctors better diagnose and treat various uterine abnormalities, like leiomyomas, endometrial polyps, and adenomyosis, which can cause irregular bleeding.
- Researchers conducted strain imaging on 29 uteri removed during hysterectomies, finding that leiomyomas appeared stiffer compared to normal myometrium, while endometrial polyps were softer, allowing for effective differentiation between these conditions.
- Results showed that ultrasound strain imaging can effectively distinguish between endometrial polyps and leiomyomas, though further research is needed to explore its capabilities for identifying other uterine abnormalities.
Objective: To provide data from a US center on laparoscopic (LSC) approach to sentinel lymph node (SLN) detection in cervix cancer with detailed time analysis.
Methods: This prospective trial enrolled patients with stage IA2-IIA cervix cancer undergoing primary radical surgery. Tc-99 radiocolloid was injected the morning of surgery, followed by hybrid SPECT/CT lymphoscintigraphy.
Objectives: Advanced age, pelvic surgery, and the presence of malignancy place gynecologic oncology patients at high risk for venous thromboembolism (VTE). This study was designed to systematically analyze the world's literature on VTE in these patients and determine the optimal prophylaxis regimen.
Methods: Computerized searches of Pubmed, Ovid, DARE, ACP Journal Club, Cochrane Database of Systematic Reviews, and Cochrane Controlled Trials Registry 1966-2005 were performed, as well as EMBASE 1980-2005.