Gynecologic oncology
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Gynecologic oncology · Dec 2006
Evaluation of predictive formulae for glomerular filtration rate for carboplatin dosing in gynecological malignancies.
Carboplatin dosing is usually based on glomerular filtration rate (GFR). The Cockcroft-Gault and the Modified Diet in Renal Disease (MDRD) Study formulae are based on serum creatinine to estimate GFR when measured GFR is impractical. The MDRD formula has been shown to be more accurate in non-cancer patients with chronic renal disease. We compared the accuracy of these formulae for dosing carboplatin in patients with gynecological cancers. ⋯ The MDRD formula seems to be more accurate than the Cockcroft-Gault formula in this population. However, both have limited precision and measured GFR should be preferred for carboplatin dosing.
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Gynecologic oncology · Dec 2006
The benefits of low anterior en bloc resection as part of cytoreductive surgery for advanced primary and recurrent epithelial ovarian cancer patients outweigh morbidity concerns.
The aim of this study was to assess the safety, efficacy and impact on survival of low anterior resection and primary anastomosis at the time of en bloc resection for primary and recurrent epithelial ovarian carcinoma. ⋯ En bloc resection of primary and recurrent epithelial ovarian carcinomas with low anterior resection permits a high rate of complete debulking with acceptable morbidity and mortality rates. Patients with no visible RT after surgery had a survival advantage over patients with visible RT.
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Gynecologic oncology · Dec 2006
Incidence and management of pleural effusions after diaphragm peritonectomy or resection for advanced mullerian cancer.
Diaphragm peritonectomy or resection is an effective way to cytoreduce diaphragm disease but frequently results in sympathetic pleural effusions. Our objective was to determine the incidence and management of effusions that developed after diaphragm surgery in patients with advanced mullerian cancer. ⋯ More than half of patients developed ipsilateral pleural effusions after diaphragm peritonectomy for cytoreduction. Most were managed conservatively without requiring a chest tube or thoracentesis. The incidence of symptomatic effusions was not high enough to recommend routine chest tube placement at the time of diaphragm peritonectomy or resection.
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Gynecologic oncology · Dec 2006
Participation of the general gynecologist in surgical staging of endometrial cancer: analysis of cost and perioperative outcomes.
To compare the cost and perioperative outcomes of endometrial cancer staging when the procedure is performed by a gynecologic oncologist alone or when a general gynecologist participates in the procedure. ⋯ Operative time and costs increase when general gynecologists participate in the surgical procedure of patients with clinical stage I endometrial cancer. Although perioperative outcomes are similar, the involvement of two surgeons increases the length of the procedure as well as the cost of operating room time and physician reimbursement. The efficient use of limited health care resources must be considered as we plan the surgical approach to endometrial cancer.
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Gynecologic oncology · Nov 2006
Evaluation of the incidence of carboplatin hypersensitivity reactions in cancer patients.
Although the reported incidence of carboplatin hypersensitivity is low, its occurrence is important to characterize because of potential fatal complications. The purpose of this study was to determine the current incidence of carboplatin hypersensitivity in the ovarian cancer patients compared to other oncology patients and identify potential risk factors that may contribute to development of carboplatin hypersensitivity reactions. ⋯ This study confirmed a similar incidence of carboplatin hypersensitivity reactions to previous reports. However, we found that the higher incidence associated with ovarian cancer patients can be attributed to the prolonged carboplatin exposure or history of drug allergies. This is the first study to observe that the administration of H1 and H2 antagonists is associated with a decrease risk of carboplatin hypersensitivity reaction.