Initial Diagnosis and Treatment of Low-Risk Gestational Trophoblastic Neoplasia.

Gestational trophoblastic neoplasia (GTN) is a rare form of cancer that is treated according to the World Health Organization (WHO) risk score, which predicts responsiveness to single-agent chemotherapy. Patients with WHO risk scores ≤6 have low-risk GTN, for which cure rates near 100%. Most women with low-risk GTN will respond to single-agent chemotherapy, which is given with either methotrexate or dactinomycin, and allows women to retain their fertility.

Timing of Colposcopy and Risk of Cervical Cancer.

Objective: To quantify the association between time to colposcopy and risk of subsequent cervical cancer.

Methods: A longitudinal analysis of patients aged 21-79 years with an abnormal cervical cancer test result from health care systems in Texas, Massachusetts, and Washington was performed. The outcome was a cervical cancer diagnosis 12 months or more after the abnormal result.

Human Papillomavirus Inpatient Postpartum Vaccination: Clinical Guideline Implementation.

Objective: The nine-valent human papillomavirus (9vHPV) vaccine is highly effective at preventing cervical cancer, yet U.S. vaccination rates remain low.

Simulation to improve trainee knowledge and comfort in managing maternal cardiac arrest.

Background: Maternal cardiac arrest is a rare outcome, and thus there are limited opportunities for specialists in obstetrics and gynecology to acquire the skills required to respond to it through routine clinical practice.

Objective: This study aimed to evaluate gaps in medical education in maternal cardiac arrest and whether a simulation-based training program improves resident knowledge and comfort in the diagnosis and treatment of maternal cardiac arrest.

Study Design: A 2-hour training for obstetrics and gynecology residents at an academic medical center was conducted, consisting of a didactic presentation, defibrillator skills station, and 2 high-fidelity simulations.

Allergic and infectious complications of Etonogestrel implant placements: A case series.

Patients rarely experience complications at the time of Etonogestrel subdermal contraceptive implant placement. Few case reports describe infection or allergy as a complication at the time of implant insertion. In this case series, we discuss three infections and one allergic reaction following Etonogestrel implant placement, review six previous case reports of eight cases of infection or allergy, and discuss management of these complications.

Black and hispanic women have less support during cancer evaluation and treatment: results from a prospective patient reported outcomes program in gynecologic malignancy.

Objective: Race remains a significant predictor of poor outcomes in women with gynecologic cancer and minority patients consistently report worse quality of life during cancer treatment. Disparities between patients in strength of social and emotional supports may contribute to these outcomes. This study's objective was to describe the racial differences in patient reported outcomes of women being evaluated or treated for a gynecologic malignancy at a large tertiary cancer hospital.

Regional Variation in Access to Oncologic Care and Racial Disparities Among Cervical Cancer Patients.

Objectives: The goal of this study was to determine whether access to gynecologic oncologists is correlated with disparate outcomes among cervical cancer patients, especially among Black women.

Materials And Methods: An ecological study was performed using the National Cancer Database among stage I-IVA cervical cancer patients from 2004 to 2014. Data from the National Cancer Institute, the Society of Gynecologic Oncology, and the United States Census were compiled to describe access to care by region.

The vaginal microbiome: A complex milieu affecting risk of human papillomavirus persistence and cervical cancer.

The purpose of this review is to describe the existing literature regarding the relationship between the vaginal microbiome, human papillomavirus persistence, and cervical cancer risk, as well as to discuss factors that mediate these relationships. Data suggest that alterations in the vaginal microbiome affect the risk of human papillomavirus infection and persistence, which has downstream effects on cervical dysplasia and cancer risk. The homeostatic Lactobillus species L.

Patient-reported outcomes and chemotherapy-related cognitive impairment in gynecologic malignancy.

Objective: Chemotherapy has multiple adverse effects, including chemotherapy-related cognitive impairment, the phenomenon colloquially referred to as 'chemobrain'. The objective of this study was to understand patient-reported experiences of this phenomenon in relation to chemotherapy administration among gynecologic oncology patients.

Methods: A prospective patient-reported outcomes program was implemented in the Gynecologic Oncology clinic of a tertiary academic institution in January 2018.

Initial findings from a prospective, large scale patient reported outcomes program in patients with gynecologic malignancy.

Introduction: Patient reported outcome measures (PROMs) are associated with improved overall survival in patients with metastatic malignancy; however, routine collection of PROMs is nascent. Little is known about PROs in women with gynecologic malignancy outside of a trial setting, limiting our understanding of how routine populations experience treatment, disease and morbidity. The goal of this study was to prospectively collect and describe disease-specific PROs in a non-trial population of women with gynecologic malignancy.

Race- and Age-Related Disparities in Cervical Cancer Mortality.

Background: Although the incidence of cervical cancer among younger Black women is now equivalent to that of White women, it is unknown whether the reduced incidence has affected survival rates among younger Black women. The goal of this study was to assess differences in survival by age and race.

Patients And Methods: A retrospective cohort study was performed using the National Cancer Database to analyze women with nonmetastatic cervical cancer diagnosed between 2004 and 2014.

Patient reported outcome measures among patients with vulvar cancer at various stages of treatment, recurrence, and survivorship.

Objective: Our goal was to pragmatically describe patient reported outcomes (PROs) in a typical clinic population of vulvar cancer patients, as prior studies of vulvar cancer PROs have examined clinical trial participants.

Methods: A prospective PRO program was implemented in the Gynecologic Oncology clinic of a tertiary academic institution in January 2018. Vulvar cancer patients through September 2019 were administered the European Organization for the Research and Treatment of Cancer Quality of life Questionnaire, the Patient Reported Outcome Measurement Information System Instrumental and Emotional Support Scales, and the Functional Assessment of Cancer Therapy-Vulvar questionnaire.

Outcomes by Race Among Women Referred to an Academic Colposcopy Clinic with a Patient Navigation Program.

Although minority women are at higher risk of cervical cancer in the United States, little is known about differences in rates of colposcopy and loop electrosurgical excision procedure (LEEP) by race once patients present for care. A prospective registry of patients presenting to an academic colposcopy clinic was queried from 2008 to 2018. Women with missing race or cytology results, prior hysterectomy, or prior history of cervical, vulvar, or vaginal cancer were excluded.

Factors associated with referral and completion of genetic counseling in women with epithelial ovarian cancer.

Objective: The National Comprehensive Cancer Network recommends that all women diagnosed with epithelial ovarian cancer undergo genetic testing, as the diagnosis of pathogenic variants may inform cancer survival and impact treatment options. The objective of this study was to assess factors associated with referral to genetic counseling in women with epithelial ovarian cancer.

Methods: A retrospective cohort study identified women with epithelial ovarian cancer from 2012 to 2017 at Massachusetts General Hospital and North Shore Medical Center, a community hospital affiliated with Massachusetts General Hospital.

Perioperative glycemic measures among non-fasting gynecologic oncology patients receiving carbohydrate loading in an enhanced recovery after surgery (ERAS) protocol.

Introduction: Preoperative carbohydrate loading is an effective method to control postoperative insulin resistance. However, data are limited concerning the effects of carbohydrate loading on preoperative hyperglycemia and possible impacts on complication rates.

Methods: A prospective cohort study was performed of patients enrolled in an enhanced recovery after surgery pathway at a single institution.

Racial disparities in brachytherapy administration and survival in women with locally advanced cervical cancer.

Objective: Black women have the highest incidence and mortality from cervical cancer in the United States. This study evaluated whether racial disparities in the receipt of brachytherapy (BT) for locally advanced cervical cancer mediate survival differences by race using the National Cancer Database.

Methods: A retrospective cohort study was performed using 16,116 women with stage IB2-IVA cervical cancer treated from 2004 to 2014.

A tumor board report of an 83-year-old woman with stage IB grade 3 endometrioid endometrial adenocarcinoma.

An 83-year-old woman presented with postmenopausal bleeding ultimately leading to surgery and a final diagnosis of stage IB grade 3 endometrioid endometrial adenocarcinoma. The tumor board reviewed current literature regarding the efficacy of sentinel lymph node dissection in appropriately allocating stage in high-grade endometrial cancer. The optimal role of adjuvant treatment in this setting is unclear.

Infection, thrombosis, and oncologic outcome after interval debulking surgery: Does perioperative blood transfusion matter?

Objectives: To determine whether perioperative red blood cell transfusion (PRBCT) affects infection, thrombosis, or survival rates in epithelial ovarian cancer (EOC) patients undergoing neoadjuvant chemotherapy (NACT) and interval debulking surgery (IDS).

Methods: Demographics, operative characteristics, and outcome data were abstracted from records of stage IIIC-IV EOC patients managed with NACT-IDS from 01/2010-07/2015. Associations of PRBCT with morbidity and oncologic outcomes were evaluated.

Utilization of Routine Primary Care Services Among Dancers.

This study examines the current utilization of primary and preventive health care services among dancers in order to assess their self-reported primary care needs. Participants were 37 dancers from a variety of dance backgrounds who presented for a free dancer health screening in a large US metropolitan area (30 females, 7 males; mean age: 27.5 ± 7.

Screening for Sexual Dysfunction by Medical Students.

Introduction: Despite the widespread effects of sexual dysfunction on health, sexual problems are not routinely addressed by physicians. Attitudes toward sexual dysfunction screening have not yet been evaluated in medical students.

Aim: To evaluate the frequency of screening for sexual dysfunction by medical students, their attitudes toward screening, and factors that influence whether medical students discuss sexual problems with patients.