Gynecologic oncology
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Gynecologic oncology · May 2016
ReviewA call for new standard of care in perioperative gynecologic oncology practice: Impact of enhanced recovery after surgery (ERAS) programs.
Enhanced recovery after surgery (ERAS) programs aim to hasten functional recovery and improve postoperative outcomes. However, there is a paucity of data on ERAS programs in gynecologic surgery. We reviewed the published literature on ERAS programs in colorectal surgery, general gynecologic surgery, and gynecologic oncology surgery to evaluate the impact of such programs on outcomes, and to identify key elements in establishing a successful ERAS program. ⋯ Postoperatively, it is important to encourage early feeding, early mobilization, timely removal of tubes and drains, if present, and function oriented multimodal analgesia regimens. Successful implementation of an ERAS program requires a multidisciplinary team effort and active participation of the patient in their goal-oriented functional recovery program. However, future outcome studies should evaluate the efficacy of an intervention within the pathway, include objective measures of symptom burden and control, study measures of functional recovery, and quantify outcomes of the program in relation to the rates of adherence to the key elements of care in gynecologic oncology such as oncologic outcomes and return to intended oncologic therapy (RIOT).
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Gynecologic oncology · May 2016
Postmolar choriocarcinoma: An independent risk factor for chemotherapy resistance in low-risk gestational trophoblastic neoplasia.
To evaluate the effect of a clinicopathologic diagnosis of choriocarcinoma (CCA) on clinical characteristics, extent of disease, and response to chemotherapy in low-risk gestational trophoblastic neoplasia (GTN). ⋯ Clinicopathologic diagnosis of postmolar CCA in patients with low-risk GTN is associated with higher pretreatment hCG levels, higher FIGO scores, and increased resistance to first-line single-agent methotrexate chemotherapy.
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Gynecologic oncology · Mar 2016
Sequential combination therapy of ovarian cancer with cisplatin and γ-secretase inhibitor MK-0752.
Ovarian cancer is one of the most lethal of women cancers and lack potent therapeutic options. There have many evidences demonstrate the Notch signaling has deregulation in variety of human malignancies.MK-0752 is a novel potent γ-secretase inhibitor and now assessed in clinical trial for treatment of several types of cancer, our objective was to investigate the anticancer effects and mechanisms of MK-0752 alone or combined with cisplatin in ovarian cancer. ⋯ Our data supports the sequential combination of cisplatin prior to MK-0752 is a highly promising novel experimental therapeutic strategy against ovarian cancer.
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Gynecologic oncology · Mar 2016
Comparative StudyComparison of MRI and 18F-FDG PET/CT in the preoperative evaluation of uterine carcinosarcoma.
To compare the validities of magnetic resonance imaging (MRI) and (18)F-fluoro-deoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) in preoperative evaluation of uterine carcinosarcoma. ⋯ In patients with uterine carcinosarcoma, (18)F-FDG PET/CT is comparable to MRI in detecting primary uterine lesions. For predicting LN metastases, though (18)F-FDG PET/CT might be insufficient for replacing lymphadenectomy or MRI, it might allow lymphadenectomy to be omitted in poor surgical candidates. For detecting extrauterine metastases, it could also be useful to identify unsuspected disease.