Racial and ethnic enrollment disparities in clinical trials of poly(ADP-ribose) polymerase inhibitors for gynecologic cancers.

Objectives: Disparities persist in the enrollment of racial/ethnic groups in clinical trials for ovarian cancers. We sought to analyze the enrollment rates of patients by race/ethnicity in phase II/III clinical trials involving poly(ADP-ribose) polymerase (PARP) inhibitors for ovarian cancers and compare these to the racial/ethnic prevalence of ovarian cancers in the United States.

Methods: This study was a retrospective review of clinical trials registered with ClinicalTrials.

Discrepancies Created by Surgeon Self-Reported Operative Time and the Effects on Procedural Relative Value Units and Reimbursement.

Objective: To demonstrate discrepancies between operative times in the ACS NSQIP (American College of Surgeons National Surgical Quality Improvement Project) and self-reported operative time from the American Medical Association's Relative Value Scale Update Committee (RUC) and their effect on relative value units (RVU) determination.

Methods: This is a cross-sectional review of registry data using the ACS NSQIP 2016 Participant User File and the Centers for Medicare & Medicaid Services physician procedure time file for 2018. We analyzed total RVUs for surgeries by operative time to calculate RVU per hour and stratified by specialty.

Physician attitudes about abortion and their willingness to consult in abortion care at a Midwestern academic medical center.

Objective: To assess abortion-related attitudes, practices, and perceptions among physicians of all specialties at a Wisconsin academic medical center.

Study Design: We developed and disseminated a cross-sectional web and mail survey to physicians at our academic center using a list generated by Human Resources. We performed descriptive analyses and assessed bivariate relationships between measures of support for abortion, perceived climate of opinion, willingness to consult in abortion-related cases, and sociodemographic and professional characteristics.

A quality improvement pathway to rapidly increase telemedicine services in a gynecologic oncology clinic during the COVID-19 pandemic with patient satisfaction scores and environmental impact.

The primary goal was to convert 50% of all outpatient Gynecologic Oncology (GynOnc) encounters during the COVID-19 pandemic to telemedicine within one week. The secondary goal was to reach 100% documentation of telemedicine consent. The tertiary goal was to analyze patient satisfaction scores.

Bone health and osteoporosis screening in gynecologic cancer survivors.

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.

Increasing NIH funding for academic departments of obstetrics and gynecology: a call to action.

The National Institutes of Health funding for reproductive sciences research, specifically in academic departments of obstetrics and gynecology, is disproportionately low. Research is one of the most important pillars in advancing healthcare. Despite US Congress' vision in providing increased funding to the National Institutes of Health as a whole, underfunding for research in the departments of obstetrics and gynecology remains one of the several critical drivers in the decline in reproductive health and healthcare for women in the United States.

Universal access to contraception: women, families, and communities benefit.

Universal access to contraception benefits society: unintended pregnancies, maternal mortality, preterm birth, abortions, and obesity would be reduced by increasing access to affordable contraception. Women should be able to choose when and whether to use contraception, choose which method to use, and have ready access to their chosen method. State and national government should support unrestricted access to all contraceptives.

Age-Associated Risk of 90-Day Postoperative Mortality After Cytoreductive Surgery for Advanced Ovarian Cancer.

This study explores the association of the risk of 90-day mortality with age for US women with advanced ovarian cancer undergoing cytoreductive surgery.

Revised FIGO staging for carcinoma of the cervix uteri.

Objective: To revise FIGO staging of carcinoma of the cervix uteri, allowing incorporation of imaging and/or pathological findings, and clinical assessment of tumor size and disease extent.

Methods: Review of literature and consensus view of the FIGO Gynecologic Oncology Committee and related societies and organizations.

Results: In stage I, revision of the definition of microinvasion and lesion size as follows.

The American Gynecological and Obstetrical Society-reinvigorating for the 21st century.

The American Gynecological and Obstetrical Society (AGOS) has the potential to serve as a unifying organization to advocate for women's reproductive health care, education, and research. This report reviews a strategic plan designed to reinvigorate AGOS to address, together with our partner organizations, the ever more pressing issues and challenges in women's reproductive health.

Variation in resource utilization associated with the surgical management of ovarian cancer.

Objective: Identify the major factors that drive standardized cost in providing surgical care for women with ovarian cancer, characterize the magnitude of variation in resource utilization between centers, and to investigate the relationship between resource utilization and quality of care provided.

Methods: Retrospective cohort study of hospitals across the United States reporting to the Premier Database who cared for patients with ovarian cancer diagnosed between 2007 and 2014. The primary outcome was standardized total cost of the index hospitalization.

Trends and comparative effectiveness of inpatient radical hysterectomy for cervical cancer in the United States (2012-2015).

Objective: Report the up-to-date trends in surgical approach for cervical cancer and compare outcomes between open and minimally invasive routes.

Methods: Radical Hysterectomy (RH) cases from the National Inpatient Sample (NIS) dataset between 2012 and 2015 were grouped into abdominal (ARH) and Minimally Invasive Surgery (MIS). The MIS group was subdivided as "Laparoscopic", "Robotic", and "Converted".

Disparities in the allocation of research funding to gynecologic cancers by Funding to Lethality scores.

Purpose: To analyze National Cancer Institute (NCI) funding distributions to gynecologic cancers compared to other cancers from 2007 to 2014.

Methods: The NCI's Surveillance, Epidemiology and End Results (SEER), Cancer Trends Progress Report, and Funding Statistics were used to analyze 18 cancer sites. Site-specific mortality to incidence ratios (MIR) were normalized per 100 cases and multiplied by person-years of life lost to derive cancer-specific lethality.

Survival after Minimally Invasive Radical Hysterectomy for Early-Stage Cervical Cancer.

Background: Minimally invasive surgery was adopted as an alternative to laparotomy (open surgery) for radical hysterectomy in patients with early-stage cervical cancer before high-quality evidence regarding its effect on survival was available. We sought to determine the effect of minimally invasive surgery on all-cause mortality among women undergoing radical hysterectomy for cervical cancer.

Methods: We performed a cohort study involving women who underwent radical hysterectomy for stage IA2 or IB1 cervical cancer during the 2010-2013 period at Commission on Cancer-accredited hospitals in the United States.

Randomized phase II trial of bevacizumab plus everolimus versus bevacizumab alone for recurrent or persistent ovarian, fallopian tube or peritoneal carcinoma: An NRG oncology/gynecologic oncology group study.

Purpose: Bevacizumab (BV) monotherapy leads to compensatory upregulation of multiple signaling pathways, resulting in mTOR activation. We evaluated combining BV and everolimus (EV), an mTOR kinase inhibitor, to circumvent BV-resistance in women with recurrent or persistent ovarian, fallopian tube or primary peritoneal cancer (OC).

Patients And Methods: Eligible OC patients had measurable (RECIST1.

Isolated para-aortic lymph node metastasis in FIGO stage IA2-IB2 carcinoma of the cervix: Revisiting the role of surgical assessment.

Objectives: To investigate the utility of para-aortic lymph node dissection among women undergoing radical hysterectomy and pelvic lymph adenectomy for FIGO Stage IA2-IB2 cervical cancer using the National Cancer Database (NCDB).

Methods: We identified patients with stage IA2-IB2 squamous cell, adenosquamous, or adenocarcinoma of the cervix diagnosed 2011-2014 in the NCDB. The primary outcome was the negative predictive value of histologically assessed pelvic lymph node status for para-aortic lymph node status among women undergoing pelvic and para-aortic lymph node dissection.

Thirty-day unplanned hospital readmission in ovarian cancer patients undergoing primary or interval cytoreductive surgery: systematic literature review.

Objectives: Thirty-day readmission rate has been proposed as metric of quality and remains an ongoing clinical concern in the primary treatment of patients with advanced-stage ovarian epithelial ovarian cancer. We conducted a review of the literature to identify rates, risk factors, and predictors for 30-day readmission in this population.

Methods: A 10-year period MEDLINE (PubMed) search of English literature studies published between January 01, 2008-January 01, 2018 was performed to identify appropriate studies for review.

Hospital Readmission as a Poor Measure of Quality in Ovarian Cancer Surgery.

Objective: To evaluate the role of 30-day readmission rate as a quality of care metric in patients undergoing ovarian cancer surgery.

Methods: We performed a retrospective cohort study of women diagnosed between 2004 and 2013 with advanced-stage, high-grade, serous carcinoma who underwent primary treatment. Using the National Cancer Database, we compared the performance of hospital risk-adjusted 30-day readmission rate to other quality of care metrics (risk-adjusted 30- and 90-day mortality, rates of adherence to guideline-based care, and overall survival) within hospitals categorized by yearly case volume (10 or less, 11-20, 21-30, and 31 cases per year or more).

Preoperative obstructive sleep apnea screening in gynecologic oncology patients.

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.

Factors associated with outcomes and inpatient 90-day cost of care in endometrial cancer patients undergoing hysterectomy - implications for bundled care payments.

Objective: To investigate the association of obesity and other comorbidities as well as route of surgery with postoperative outcomes, as well as 30- and 90-day inpatient cost of care after hysterectomy for endometrial cancer.

Methods: From the 2013 National Readmission Database release, patients who underwent hysterectomy for endometrial cancer were included. Obesity was classified as non-obese (body mass index [BMI] < 35 kg/m); class I/II obesity (BMI ≥ 35 but <40 kg/m and without obesity related medical condition qualifying it as morbid obesity), class III obesity (BMI ≥ 40 kg/m OR BMI ≥ 35 kg/m with an obesity-related medical condition).

Obstructive Sleep Apnea and the Impact on Surgical Outcomes in Gynecology.

Importance: Obstructive sleep apnea syndrome (OSAS) is a common medical condition in the United States and affects gynecologic surgical outcomes.

Objective: The aim of this review was to improve perioperative diagnosis and management of OSAS in patients presenting for gynecologic surgery and ultimately improve perioperative outcomes. The role of preoperative evaluation and screening is also addressed.

Racial and ethnic disparities over time in the treatment and mortality of women with gynecological malignancies.

Objective: To examine temporal trends in treatment and survival among black, Asian, Hispanic, and white women diagnosed with endometrial, ovarian, cervical, and vulvar cancer.

Methods: Using the National Cancer Database (2004-2014), we identified women diagnosed with endometrial, ovarian, cervical, and vulvar cancer. For each disease site, we analyzed race/ethnicity-specific trends in receipt of evidence-based practices.