Association of bowel preparation with surgical-site infection in gynecologic oncology surgery: Post-hoc analysis of a randomized controlled trial.

Objective: To determine the relationship between bowel preparation and surgical-site infection (SSI) incidence following colorectal resection during gynecologic oncology surgery.

Methods: This post-hoc analysis used data from a randomized controlled trial of patients enrolled from 03/01/2016-08/20/2019 with presumed gynecologic malignancy investigating negative-pressure wound therapy among those requiring laparotomy. Patients were treated preoperatively without bowel preparation, oral antibiotic bowel preparation (OABP), or OABP plus mechanical bowel preparation (MBP) per surgeon preference.

Prophylactic Negative Pressure Wound Therapy After Laparotomy for Gynecologic Surgery: A Randomized Controlled Trial.

Objective: To estimate the effectiveness of prophylactic negative pressure wound therapy in patients undergoing laparotomy for gynecologic surgery.

Methods: We conducted a randomized controlled trial. Eligible, consenting patients, regardless of body mass index (BMI), who were undergoing laparotomy for presumed gynecologic malignancy were randomly allocated to standard gauze or negative pressure wound therapy.

Trocar site hernia development in patients undergoing robotically assisted or standard laparoscopic staging surgery for endometrial cancer.

Objectives: To compare the incidence and potential risk factors of trocar site hernia formation in women undergoing robotically assisted versus standard laparoscopic staging (RBT vs. LSC, respectively) for endometrial cancer.

Methods: We retrospectively identified all patients who underwent MIS staging for endometrial cancer at our institution from 01/09-12/12.

Surgical site infection reduction bundle in patients with gynecologic cancer undergoing colon surgery.

Objective: Surgical site infections (SSIs) can lead to substantial morbidity, prolonged hospitalization, increased costs, and death in patients undergoing colorectal procedures. We sought to investigate the effect of using an SSI reduction bundle on the rate of SSIs in gynecologic cancer patients undergoing colon surgery.

Methods: We identified all gynecologic cancer patients who underwent colon resection at our institution from 2014 to 2016, during which time a service-wide SSI reduction bundle was introduced.

Survival of Patients with Serous Uterine Carcinoma Undergoing Sentinel Lymph Node Mapping.

Objective: The aim of this study was to determine progression-free survival (PFS) in patients with serous uterine carcinoma undergoing sentinel lymph node (SLN) mapping compared with patients undergoing standard lymphadenectomy.

Methods: We retrospectively reviewed all uterine cancer patients treated at our institution from 2005 to 2015. Patients were separated into two cohorts: those who underwent SLN mapping at the time of staging (SLN) and those who underwent routine lymphadenectomy (the non-SLN group).

Optimal primary management of bulky stage IIIC ovarian, fallopian tube and peritoneal carcinoma: Are the only options complete gross resection at primary debulking surgery or neoadjuvant chemotherapy?

Objective: To explore the impact of primary debulking surgery (PDS) to minimal but gross residual disease (RD) in women with bulky stage IIIC ovarian, fallopian tube, or primary peritoneal cancer.

Methods: We retrospectively reviewed all patients with the aforementioned diagnosis who underwent PDS at our institution from 01/2001-12/2010. Those with disease of non-epithelial histology or borderline tumors were excluded.

Robotically Assisted Laparoscopic Ovarian Transposition in Women with Lower Gastrointestinal Cancer Undergoing Pelvic Radiotherapy.

Background: Pelvic radiotherapy (RT) is a standard component of the management for patients with locally advanced rectal cancer or squamous cell carcinoma of the anus. Pelvic RT leads to permanent and irreversible ovarian failure in young women. This study aimed to determine the effectiveness of robotically assisted laparoscopic ovarian transposition (OT) before RT in women with rectal or anal cancer who wanted to preserve normal ovarian function.

Combined immunotherapy and radiation for treatment of mucosal melanomas of the lower genital tract.

Objective: To report our experience using ipilimumab, a monoclonal antibody targeting CTLA-4, combined with radiation therapy in women diagnosed with mucosal melanoma of the lower genital tract.

Methods: We retrospectively identified all patients who received ipilimumab with concurrent radiation treatment of mucosal melanoma of the lower genital tract at Memorial Sloan Kettering Cancer Center from 2012 to 2015. Various clinicopathologic data and treatment response were abstracted and analyzed.

Herniation formation in women undergoing robotically assisted laparoscopy or laparotomy for endometrial cancer.

Objective: To compare the incidence of trocar site hernia in women who underwent robotically assisted laparoscopic surgery (RBT) for endometrial cancer staging with the incidence of ventral hernia formation in patients who underwent laparotomy (LAP) for the same indication. To analyze risk factors for hernia formation in women undergoing RBT for endometrial cancer.

Methods: We retrospectively identified all patients who underwent surgical staging for endometrial cancer via RBT or LAP from 2009-2012.

Survival of Patients with Uterine Carcinosarcoma Undergoing Sentinel Lymph Node Mapping.

Purpose: This study was designed to evaluate the outcome of patients with uterine carcinosarcoma undergoing sentinel lymph node (SLN) mapping.

Methods: A prospectively maintained database was reviewed for all women with uterine cancer treated at our institution from January 1, 1998 to August 31, 2014. Patients were grouped based on whether they had undergone SLN mapping or routine lymphadenectomy at the time of staging.

Prognostic significance of mucinous differentiation of endometrioid adenocarcinoma of the endometrium.

Using Surveillance, Epidemiology, and End Results database we identified 43,882 (97.0%) women with endometrioid adenocarcinomas and 1,374 (3.0%) with mucinous adenocarcinomas.

Feasibility and economic impact of same-day discharge for women who undergo laparoscopic hysterectomy.

Objective: We examined the use, safety, and economic impact of same-day discharge for women undergoing laparoscopic hysterectomy.

Study Design: We identified women in the Perspective database who underwent laparoscopic hysterectomy from 2000 through 2010. Discharge was classified as same-day, 1 day, and ≥2 days.

The commercialization of robotic surgery: unsubstantiated marketing of gynecologic surgery by hospitals.

Objective: We analyzed the content, quality, and accuracy of information provided on hospital web sites about robotic gynecologic surgery.

Study Design: An analysis of hospitals with more than 200 beds from a selection of states was performed. Hospital web sites were analyzed for the content and quality of data regarding robotic-assisted surgery.

Biologic therapies and personalized medicine in gynecologic malignancies.

Through advances in human genomic sequencing, the unique molecular biology that predisposes certain individuals to either health or disease has now been illuminated. Although many malignancies behave similarly on a phenotypic level, biologically there exist multiple layers of interconnected molecular and cellular pathways that may make each patient’s disease significantly more unique than previously appreciated. In gynecologic oncology, the most progress in developing targeted biologics has been in the treatment of ovarian cancers.

Cervical neoplasia.

Cervical intraepithelial neoplasia is common in young women, and invasive cervical cancer is one of the most common malignancies seen in pregnancy. Women with cervical cancer diagnosed at <20 to 24 weeks of gestation are typically treated immediately, whereas patients diagnosed later in pregnancy often defer treatment until after delivery. Women with early stage cervical cancer can be treated with either surgery or radiation, whereas those with advanced-stage disease are usually treated with radiation, often in combination with chemotherapy.

Natural history and outcome of mucinous carcinoma of the ovary.

Objective: We performed a population-based analysis to compare the clinical characteristics of women with mucinous tumors with women with other epithelial tumors.

Study Design: The Surveillance, Epidemiology, and End Results database was queried to identify all women with epithelial ovarian cancer diagnosed from 1988 to 2007. The natural history, clinical characteristics, and survival of women with serous tumors were compared with women with mucinous carcinomas.