-
1
المؤلفون: Kay J. Park, Vance Broach, Dennis S. Chi, Irina Linkov, Frank Z. Stanczyk, Prusha Patel, Anjali Jotwani, Celeste Leigh Pearce, Malcolm C. Pike, Noah D. Kauff
المصدر: Cancer Epidemiol Biomarkers Prev
مصطلحات موضوعية: Ki-67 Antigen, Oncology, Contraceptive Agents, Epidemiology, Cysts, Intrauterine Devices, Medicated, Humans, Female, Levonorgestrel, Article, Fallopian Tubes, Menstrual Cycle, Cell Proliferation
الوصف: Background: The objectives of this study were (i) to explore whether differences in cell proliferation may help explain why most high-grade serous ovarian cancers (HGSOC) arise in the fallopian tube fimbriae (FTF) rather than in ovarian cortical inclusion cysts (CIC); (ii) to compare premenopausal and postmenopausal FTF proliferation as a reason why the age incidence of HGSOC increases at a slower rate after menopause; and (iii) to compare FTF proliferation in cycling women and women using the levonorgestrel intrauterine contraceptive system (Lng-IUS) to see whether proliferation on the Lng-IUS was lower. Methods We studied 60 women undergoing a salpingo-oophorectomy. We used Ki67, paired-box gene 8 (PAX8, Müllerian marker), and calretinin (mesothelial marker) to study FTF and CIC proliferation. Results: FTF Ki67%+ was greater in the follicular than in the luteal phase (4.9% vs. 1.5%; P = 0.003); postmenopausal Ki67%+ was 1.7%. Ki67%+ in PAX8 negative (PAX8−) CICs was extremely low. Proliferation in PAX8+ CICs did not vary by menstrual phase or menopausal status. Follicular Ki67%+ was 2.6-fold higher in FTF than PAX8+ CICs. FTF Ki67%+ from 10 women using the Lng-IUS was not lower than in cycling women. Conclusions: Overall FTF Ki67%+ is greater than overall CIC Ki67%+. Overall FTF Ki67%+ in postmenopausal women is lower than in premenopausal women. The Lng-IUS is not associated with lower FTF Ki67%+. Impact: Ki67%+ provides an explanation of the preponderance of FTF-derived HGSOCs, and of the slower increase of HGSOCs after menopause. The Lng-IUS may not be associated with a protective effect against HGSOCs.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c6dcaf0f73c196e85204c8af246eeef4
https://europepmc.org/articles/PMC9444882/ -
2
المؤلفون: Xianghui Zou, Daniel King, Baho Sidiqi, Sunita Patruni, Christopher Hollweg, Noah D. Kauff
المصدر: Journal of Clinical Oncology. 41:665-665
مصطلحات موضوعية: Cancer Research, Oncology
الوصف: 665 Background: Germline genetic testing is recommended for patients with pancreatic ductal adenocarcinoma (PDAC) and pre-diagnostic testing is offered to patients with a significant family history. However, only 36% of patients in our institution obtained genetic testing. We identified associations between patient social profiles (income, race, ethnicity, social work needs) and delays in obtaining germline genetic testing from New York’s largest healthcare system. Methods: Patients with PDAC were identified using billing records across our institution with an IRB-approved protocol. Median income was extrapolated using patient zip code. Date of diagnosis (DOD) was recorded as the date of biopsy or, if no biopsy was performed, the date of earliest lesion found on CT scan. Delays of testing was calculated as the difference between DOD and the date of germline sample collection. Results: Between Mar 2016 and Feb 2022, 305 patients with PDAC were identified, with 103 (36.3%) having reports found (F), and 202 (63.7%) not having reports found (NF). Availability of germline testing did not vary by median income (F: $95954, NF: $94368, t=0.414, p=0.68). There was no significant difference in the geographic distribution either (gender p=0.92, race p=0.92, ethnicity p=0.16). Pearson analysis between income (x) and delays of testing (y) showed a negative correlation (y=-0.0028x+316, r2=0.058, p=0.014). African American and Hispanic patients, grouped for this analysis as underserved (U), had a significant delay in obtaining germline genetic testing compared to the remainder of patients (not underserved, NU) (U: 92d, NU: 21d, u=305.5, p=0.0016). In addition, African American (AA) patients had a significant delay of testing compared to White (W) patients (AA: 92d, W: 13d, u=161.5, p=0.0002). Furthermore, all 11 patients (1 Asian, 10 White) who obtained pre-diagnostic testing were NU patients (χ2=5.005, p=0.025). Upon further analysis, patients who have social work (SW) needs have a significant delay in testing compared to patients without SW needs (SW: 109d, no SW: 23d, u=263, p=0.025). Of the 12 patients who have SW needs, the primary needs were home care, transportation, or financial assistance. In addition, there was a trend toward difference between English (E) and non-English (NE) speaking patients when comparing their delays in testing (E=26.5, NE=108.5, u=257, p=0.12). Conclusions: Analysis of germline and clinical data from our 305-patient cohort identified a striking and concerning negative correlation between patient income and delays in germline testing. In addition, underserved patients had significant delays in germline testing and did not obtain any pre-diagnostic testing. Furthermore, social needs and primary language may be barriers for germline testing. Interprofessional collaborations may be required to prompt germline testing at our institution or nationwide.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::8a0030ec5e56e6a524aa423c80bbcfe4
https://doi.org/10.1200/jco.2023.41.4_suppl.665 -
3
المؤلفون: Sarah Collins, Rebecca A. Previs, Janice Wong, Kelli Kurtovic, Kyle C. Strickland, Jennifer Mewshaw, Daniel Spinosa, Noah D. Kauff, Laura J. Havrilesky, Tatiana Acosta
المصدر: Gynecologic Oncology
مصطلحات موضوعية: Adult, Quality Control, 0301 basic medicine, medicine.medical_specialty, Quality management, Genetic testing, Referral, Psychological intervention, Hysterectomy, DNA Mismatch Repair, Article, 03 medical and health sciences, 0302 clinical medicine, Endometrial cancer, Uterine cancer, Internal medicine, Genetic screening, medicine, Humans, Quality improvement, Medical diagnosis, Early Detection of Cancer, Aged, Aged, 80 and over, medicine.diagnostic_test, business.industry, Electronic medical record, Obstetrics and Gynecology, Microsatellite instability, General Medicine, Middle Aged, medicine.disease, Colorectal Neoplasms, Hereditary Nonpolyposis, Immunohistochemistry, Lynch syndrome, 030104 developmental biology, Oncology, 030220 oncology & carcinogenesis, Uterine Neoplasms, Female, Microsatellite Instability, business
الوصف: Objective To determine the feasibility and effectiveness of a quality improvement initiative (QI) to adopt universal screening for Lynch syndrome in uterine cancer patients at an institution that previously employed age-based screening. Methods Prior to the initiative, tumors of patients with uterine cancer diagnosed at age ≤ 60 years were screened for mismatch repair deficiency (MMR) and microsatellite instability (MSI). The QI process change model adopted universal testing of all uterine cancer specimens and implemented provider training, standardized documentation, and enhanced use of the electronic medical record (EMR). We compared screening rates, results of screening, follow up of abnormal results, and final diagnoses from the pre- and post-implementation periods. Results Pre- and post-implementation screening rates for women age ≤ 60 years at the time of diagnosis were 45/78 (57.7%) and 64/68 (94.5%), respectively. The screening rate for all patients with uterine cancer increased from 73/190 (38.4%) to 172/182 (94.5%). The rate of abnormal screening results increased from 15/190 (7.9%) to 44/182 (24.0%) cases. Genetics referral rates among screen positives increased from 3/15 (20.0%) to 16/44 (36.4%). Germline diagnoses increased from 2/190 (1.1%) with two Lynch syndrome diagnoses to 4/182 (2.2%) including three Lynch syndrome diagnoses and one BRCA1 germline diagnosis. The number of patients errantly not screened decreased from at least 32 patients to 3 patients after the intervention. Conclusions Adherence to screening guidelines significantly improved after interventions involving provider education, optimal use of the EMR, and simplification of screening indications. These interventions are feasible at other institutions and translatable to other screening indications.
Highlights • Compliance with Lynch syndrome screening guidelines can be dramatically improved with straightforward interventions. • Universal screening for Lynch syndrome in uterine cancer patients is feasible. • Universal screening for Lynch syndrome identifies substantially more patients eligible for targeted treatments. -
4
المؤلفون: Xianghui Zou, Baho Sidiqi, Sunita Patruni, Christopher Hollweg, Noah D. Kauff, Daniel King
المصدر: Journal of Clinical Oncology. 40:e16233-e16233
مصطلحات موضوعية: Cancer Research, Oncology
الوصف: e16233 Background: Germline genetic testing is now recommended for patients with pancreatic ductal adenocarcinoma (PDAC). We explored whether attributes of testing, such as uptake fraction and rate, were associated with various clinical features. Here we examined germline mutations found in our database, identified barriers to germline testing, and explored a relationship between mutations and survival in our cohort of patients from New York’s largest healthcare system. Methods: Patients with PDAC were identified using billing records across our institution with an IRB-approved protocol. Germline mutation data were assessed through chart review. Median income was annotated using zip codes and www.census.gov. Date of diagnosis (DOD) was recorded as the date of biopsy or, if no biopsy was performed, the date of earliest lesion-found CT scan. Lag of testing was calculated as the difference between DOD and the date of germline sample collection. Overall survival (OS) was calculated by mutational status. Results: Between Mar 2016 and Feb 2022, 305 patients with PDAC were identified, with 103 (36.3%) having reports found (F), and 202 (63.7%) not having reports found (NF). Availability of germline testing did not vary by median income (F: 95954 dollars vs NF: 94368 dollars, t = 0.414, p = 0.68). The geographic distribution of patients among F and NF is listed below in Table. Pearson analysis between median income and lag of testing showed a negative correlation (y = -0.0027x+315.6, R = -0.241, p = 0.014). Level of income (cutoff: 100k) also affected the mean days in lag of testing (below: 111.8d, above: -44.0d, t = 2.190, p = 0.031). There was no difference in the median survival between F and NF (median: F: 573d, NF: 717d, HR 0.459-1.155, p = 0.17). For mutational analysis, 103 patients with PDAC were identified: 59 without germline mutations (GMs) (12 deaths), and 44 with GMs (16 deaths). We identified 7 patients with pathogenic GMs (APC, ATM, BRCA2, CHEK2, CDKN2A, and PALB2) and 41 patients with variants of unknown significance (VUS), including ATM (6), BRCA2 (4), MSH6 (3) and CHEK2 (2). OS was not statistically different between GM and no GM (Median OS: no GM 1520d; GM 573d, HR 0.394-1.871, p = 0.702). Conclusions: Analysis of germline and clinical data from our 305-patient cohort identified a striking and concerning negative correlation between patient median income and lag between DOD and germline testing. These results compel further investigation into the operational processes that prompt germline testing at our institution. [Table: see text]
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::17fb553af3c0dc4bf0e388ccd36aa1c8
https://doi.org/10.1200/jco.2022.40.16_suppl.e16233 -
5
المؤلفون: Noah D. Kauff, Ilona Stashko, Kent J. Weinhold, Terry Hyslop, S Hwang, Paul K. Marcom, Heather Ann Brauer, Gretchen Kimmick, Afshin Mashadi-Hossein, Edgardo R. Parrilla Castellar, Smita K. Nair, S Davis, Jennifer K. Plichta, Sarah Sammons, Jeremy Force, Kelly E. Westbrook
المصدر: Cancer Research. 79:P3-08
مصطلحات موضوعية: Cancer Research, education.field_of_study, animal structures, endocrine system diseases, business.industry, Population, Wild type, Cancer, medicine.disease, female genital diseases and pregnancy complications, Germline, Breast cancer, Oncology, Hormone receptor, Cancer research, medicine, Stage (cooking), skin and connective tissue diseases, business, education, Hormone
الوصف: Background: BRCA mutated (BRCA+) breast cancers are expected to have increased activation of Homologous Recombination Deficiency (HRD) and altered DNA damage repair pathways when compared to BRCA wildtype (BRCA-). To better understand differences in these populations, biological patterns and immune responses to BRCA+ breast cancers were evaluated. The primary aim of our study was to use novel gene expression tools to assess early stage breast cancers with and without germline BRCA mutations, and within distinct BRCA+ subgroups. Methods: We identified 124 early stage untreated breast cancers with and without BRCA mutations (n = 62 and 62, respectively). Our BRCA- group was matched by hormone receptor (HR) status, age, and stage to the BRCA+ group. The NanoString Breast Cancer 360 panel was applied to RNA isolated from 80 breast tumors (BRCA+ = 39; BRCA- = 41). The BRCA+ group had a BRCA1+ subgroup (n=17) and a BRCA2+ subgroup (n=22). Results: There was a significant increase in two BC360 signatures in both the BRCA1+ and BRCA2+ tumors compared with the BRCA- population: Prosigna™Risk of Recurrence (ROR) score [BRCA1+: HR: 1.142 (95% CI 1.019, 1.279), p=0.02; BRCA2+: HR: 1.321 (95% CI 1.190, 1.466), p Conclusions: In early stage BRCA+ breast cancer, tumors have higher ROR and increased HRD signature scores compared to BRCA- tumors. Furthermore, BRCA1+ and BRCA2+ tumors have both signature and single gene expression differences when compared to BRCA- tumors, indicating distinct subgroup-related biology. The greater correlation of BRCA1+ tumors with basal-like biology and BRCA2+ tumors with aggressive hormonal biology confirms these trends. Distinctions in hormone receptor signaling, DNA-damage pathways, and microenvironment/inflammatory features between BRCA1 and BRCA2 associated cancers suggest a need for different prevention and therapeutic strategies for each of these breast cancer subtypes. The unique biological patterns identified here should be further evaluated as predictive or prognostic tools that could be translated into clinical care for early stage BRCA+ patients. Citation Format: Force J, Plichta J, Stashko I, Kimmick G, Westbrook K, Sammons S, Hwang S, Hyslop T, Kauff N, Castellar E, Nair S, Weinhold K, Davis S, Mashadi-Hossein A, Brauer HA, Marcom PK. Distinct biological signatures describe differences in BRCA mutated subgroups [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-08-07.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::3aa64f4e5ba2300308543dc2e589100a
https://doi.org/10.1158/1538-7445.sabcs18-p3-08-07 -
6
المؤلفون: Catherine H. Watson, Lindsay Soo, Paula S. Lee, Angeles Alvarez Secord, Rebecca A. Previs, Laura J. Havrilesky, Leah McNally, Noah D. Kauff, Andrew Berchuck, Brittany A. Davidson
المصدر: International journal of gynecological cancer : official journal of the International Gynecological Cancer Society. 30(10)
مصطلحات موضوعية: Adult, medicine.medical_specialty, Ubiquitin-Protein Ligases, Salpingo-oophorectomy, Gynecologic oncology, Ataxia Telangiectasia Mutated Proteins, Carcinoma, Ovarian Epithelial, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, Surveys and Questionnaires, medicine, Mutation type, Humans, 030212 general & internal medicine, Practice Patterns, Physicians', Germ-Line Mutation, Ovarian Neoplasms, business.industry, Age Factors, Obstetrics and Gynecology, Middle Aged, medicine.disease, Penetrance, Menopause, DNA-Binding Proteins, Oncology, Gynecology, 030220 oncology & carcinogenesis, Relative risk, Mutation (genetic algorithm), RAD51C, Female, business, Ovarian cancer
الوصف: ObjectiveLimited information exists regarding risk reduction strategies for women with moderate and low penetrance ovarian cancer susceptibility mutations. We sought to assess current risk reduction practice patterns for carriers of these mutations through a survey of members of the Society of Gynecologic Oncology.MethodsSociety of Gynecologic Oncology members were emailed a survey consisting of two vignettes: (1) a 35-year-old premenopausal woman; (2) a 55-year-old postmenopausal woman with comorbidities. Each vignette contained sub-scenarios in which the patient had either a BRCA1 (relative risk (RR)=30–60), RAD51C (RR=5.0), or ATM (RR=1.5–2.0) mutation. Respondents were queried about their preferred management approach. Summary statistics were performed to describe results of the survey. We used χ2 testing for statistical analyses, comparing results according to mutation type and demographic information.ResultsA total of 193 (15%) of 1284 Society of Gynecologic Oncology members responded. For the premenopausal woman, 99%, 80%, and 40% would perform a risk reducing salpingo-oophorectomy prior to menopause in the setting of a BRCA1, RAD51C, and ATM mutation, respectively. For the postmenopausal woman, 98%, 85%, and 42% would proceed with risk reducing salpingo-oophorectomy in the setting of a BRCA1, RAD51C, and ATM mutation, respectively. Response distribution for carriers of RAD51C and ATM mutations were different from BRCA1 in both vignettes (pConclusionsRespondents were more likely to perform risk reducing salpingo-oophorectomy, in the setting of a BRCA1, RAD51C, and ATM mutation, earlier and more frequently in the setting of a BRCA1 mutation. However, there was a lack of consensus about management of the moderate and low penetrance mutations, suggesting that more data regarding age specific risks and appropriate risk reduction strategies for these alterations are needed.
-
7
المؤلفون: Veena S. John, Hector Chavarria, Noah D. Kauff, Seema Khutti, Marina Frimer
المصدر: Journal of Clinical Oncology. 39:e17557-e17557
مصطلحات موضوعية: Cancer Research, Atypical small acinar proliferation, Pathology, medicine.medical_specialty, medicine.diagnostic_test, business.industry, Ovary, Epithelium, Stromal Invasion, medicine.anatomical_structure, Oncology, medicine, Immunohistochemistry, DNA mismatch repair, Borderline ovarian tumors, business
الوصف: e17557 Background: Borderline tumors (BT) are atypical proliferation of epithelium in the ovary in the absence of destructive stromal invasion, representing for 15% of all epithelial ovarian cancers. [1] Around 10% of the ovarian tumors are hereditary, and approximately 10% of all the hereditary forms of epithelial ovarian tumors are result of a loss of DNA mismatch repair (MMR). [2] Endometrioid borderline tumor (EBT) and Seromucinous borderline tumors (SMBT) are rare tumors in ovary and there is limited literature available on immunohistochemical (IHC) expression of Mismatch repair proteins(MMRP)in these tumors.[3, 4] The aim of this study is to evaluate IHC expression of MMRP in EBT and SMBT of ovary. Methods: Pathology database was searched for ovarian Endometrioid borderline tumor (EBT) and Seromucinous borderline tumor (SMBT) for a 10-year period (2010-2020). The cohort consisted of 10 EBT (6 of which had focal microinvasion or carcinoma) and 12 SMBT(2 of which had focal carcinoma ). For comparison, 1 borderline Brenner. 15 serous borderline tumors (SBT) and 15 mucinous borderline tumors (MBT) were also included. After reviewing slides, a block with adequate borderline tumor was selected for IHC stains. For the cases with carcinoma, two different blocks with each component were selected. In all selected blocks, IHC stains for four MMRP (MLH1, PMS2, MSH2, MSH6) were performed. The complete absence of nuclear staining in tumor cells was considered as “loss” of the MMRP expression. Any “weak” or “focal” nuclear staining was considered intact. Results: Total 53 cases were evaluated for MMRP IHC. All cases had intact MMRP expression. In cases with carcinoma, both components (BT and carcinoma) have intact MMR IHC expression. See table. Conclusions: Our study did not show loss of MMRP IHC expression in EMT or SMBT. However, our study consisted of a small number of cases. Multi Institutional study with a large number of cases can be helpful in future to further evaluate the role of MMRP IHC in EMT and SMBT. [Table: see text]
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::9af9d9bbbd963bfdabcc65eb8023c0d1
https://doi.org/10.1200/jco.2021.39.15_suppl.e17557 -
8
المؤلفون: Evan R. Myers, Haley A. Moss, Junzo Chino, Laura J. Havrilesky, Noah D. Kauff
المصدر: Gynecologic Oncology. 145:549-554
مصطلحات موضوعية: Adult, medicine.medical_specialty, endocrine system diseases, Cost effectiveness, Cost-Benefit Analysis, Ovariectomy, medicine.medical_treatment, Genes, BRCA1, Hysterectomy, 03 medical and health sciences, 0302 clinical medicine, Uterine cancer, medicine, Humans, Prospective cohort study, Germ-Line Mutation, Aged, Gynecology, Models, Statistical, 030219 obstetrics & reproductive medicine, business.industry, Obstetrics, Incidence (epidemiology), Obstetrics and Gynecology, Prophylactic Surgical Procedures, Middle Aged, medicine.disease, Markov Chains, United States, Cystadenocarcinoma, Serous, Serous fluid, Oncology, 030220 oncology & carcinogenesis, Uterine Neoplasms, Female, Ovarian cancer, business, Mastectomy
الوصف: Objective To estimate the survival benefit and cost-effectiveness of performing hysterectomy during risk-reducing salpingo-oophorectomy (RRSO) for BRCA1 mutation carriers. Methods Based on a recent prospective cohort study indicating an elevated incidence of serous/serous-like uterine cancers among BRCA1 mutation carriers, we constructed a modified Markov decision model from a payer perspective to inform decisions about performance of hysterectomy during RRSO at age 40. We assumed patients had previously undergone a risk-reducing mastectomy and had a residual risk of death from breast or ovarian cancer. Disease-specific survival, age-adjusted competing hysterectomy rates, and deaths from other causes were incorporated. Costs of risk-reducing surgery, competing hysterectomy, and care for serous/serous-like uterine cancer were included. Results A 40year old woman who undergoes RRSO+Hysterectomy gains 4.9 additional months of overall survival (40.38 versus 39.97 undiscounted years) compared to RRSO alone. The lifetime probabilities of developing or dying from serous/serous-like uterine cancer in the RRSO group are 3.5% and 2%, respectively. The RRSO alone strategy has an average cost of $9013 compared to $8803 for RRSO+Hysterectomy, and is dominated (less effective and more costly) when compared to RRSO+Hysterectomy. In an alternative analysis, delayed hysterectomy remains a cost-effective prevention strategy with an ICER of less than $100,000/year for up to 25years following RRSO at age 40. Conclusions The addition of hysterectomy to RRSO in a 40year old BRCA1 mutation carrier results in a mean gain of 4.9 additional months of life and is cost-effective.
-
9
المؤلفون: Noah D. Kauff, John F. Boggess, Mark H. Greene, Martee L. Hensley, Thomas J. Rutherford, Joan L. Walker, Paul K. J. Han, Kelly Jeanes Wilkinson, David E. Cohn, Helen Q. Huang, Lari Wenzel, Phuong L. Mai, Kelly-Anne Phillips, Gustavo C. Rodriguez, Chad A. Hamilton, Robert M. Wenham, Matthew A. Powell, Richard P. Moser
المصدر: Gynecol Oncol
Gynecologic oncology, vol 156, iss 1مصطلحات موضوعية: 0301 basic medicine, Adult, medicine.medical_specialty, Clinical Trials and Supportive Activities, Oncology and Carcinogenesis, Salpingo-oophorectomy, Article, Paediatrics and Reproductive Medicine, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Rare Diseases, Quality of life, Clinical Research, Internal medicine, Epidemiology, Behavioral and Social Science, Medicine, Humans, Oncology & Carcinogenesis, Prospective Studies, Family history, Prospective cohort study, Early Detection of Cancer, Cancer, Aged, Ovarian Neoplasms, business.industry, Depression, Prevention, Obstetrics and Gynecology, Middle Aged, medicine.disease, Ovarian Cancer, 030104 developmental biology, Mental Health, Oncology, 030220 oncology & carcinogenesis, Cohort, Quality of Life, Anxiety, Female, Patient Safety, medicine.symptom, business, Cohort study, Follow-Up Studies
الوصف: Background Risk-reducing salpingo-oophorectomy (RRSO) and ovarian cancer screening (OCS) are management options for women at increased risk of ovarian cancer. Long-term effects of these interventions on quality of life (QOL) are not well understood. Methods GOG-0199 is a prospective cohort study of women at increased ovarian cancer risk who chose either RRSO or OCS as their risk management intervention. At study entry, 6, 12, 24 and 60 months of follow-up, participants completed the QOL questionnaire, which included the Medical Outcome Study Short Form-36, the Impact of Events Scales, the Center for Epidemiological Studies Depression Scale, the State-Trait Anxiety Inventory, the Functional Assessment of Cancer Therapy – Endocrine Subscale, and the Sexual Activity Questionnaire. QOL measures were compared between the RRSO and OCS cohort at baseline and over time. Results Five-hundred-sixty-two participants in the RRSO cohort and 1,010 in the OCS completed the baseline and at least one follow-up questionnaire. At baseline, participants selecting RRSO reported lower health-related QOL (HRQOL), greater ovarian cancer-related stress, greater anxiety, and more depressive symptomatology, which improved during follow-up, especially for ovarian cancer-related stress. Screening was not found to adversely impact HRQOL. Hormone-related menopausal symptoms worsened and sexual functioning declined during follow-up in both cohorts, but more so among participants who underwent RRSO. Conclusions HRQOL improved after surgery among women who chose RRSO and remained stable among participants undergoing screening. The adverse effects of RRSO and screening on short-term and long-term sexual activity and sexual functioning warrant consideration in the decision-making process for high-risk women.
وصف الملف: application/pdf
-
10
المؤلفون: Emma J. Crosbie, Neil A.J. Ryan, Mark J. Arends, Tjalling Bosse, John Burn, Joanna M. Cornes, Robin Crawford, Diana Eccles, Ian M. Frayling, Sadaf Ghaem-Maghami, Heather Hampel, Noah D. Kauff, Henry C. Kitchener, Sarah J. Kitson, Ranjit Manchanda, Raymond F.T. McMahon, Kevin J. Monahan, Usha Menon, Pål Møller, Gabriela Möslein, Adam Rosenthal, Peter Sasieni, Mourad W. Seif, Naveena Singh, Pauline Skarrott, Tristan M. Snowsill, Robert Steele, Marc Tischkowitz, Angel Alonso Sanchez, James Bolton, David Church, Karen Donnelly, Richard J. Edmondson, D. Gareth Evans, Paula Gollop, Selina Goodman, Shirley Hodgson, Fiona Lalloo, Anne Lowry, Rhona J. McVey, Tracie Miles, Gabriela Moeslein, Pal Moller, Astrid Stormoken, Helen Stringfellow, Andrew Wallace, Luciya Whyte, Nafisa Wilkinson, Godfrey Wilson, Jo Wilson, Nick Wood
المصدر: Crosbie, E J, Ryan, N A J, Arends, M, Bosse, T, Burn, J, Cornes, J M, Crawford, R A F, Eccles, D, Frayling, I M, Ghaem-Maghami, S, Hampel, H, Kauff, N, Kitchener, H C, Kitson, S J, Manchanda, R, McMahon, R F T, Monahan, K J, Menon, U, Moller, P, Moeslein, G, Rosenthal, A N, Sasieni, P, Seif, M W, Singh, N, Skarrott, P, Snowsill, T M, Steele, R J, Tischkowitz, M D & Evans, D G R 2019, ' The Manchester International Consensus Group Recommendations for the Management of Gynecological Cancers in Lynch Syndrome ', Genetics in Medicine . https://doi.org/10.1038/s41436-019-0489-y
2019, ' The Manchester International Consensus Group recommendations for the management of gynecological cancers in Lynch syndrome ', Genetics in Medicine, vol. 21, no. 10, pp. 2390-2400 . https://doi.org/10.1038/s41436-019-0489-y
Genetics in Medicine, 21(10), 2390-2400
Crosbie, E, Ryan, N, Evans, D G, Edmondson, R & et al. 2019, ' The Manchester International Consensus Group Recommendations for the Management of Gynecological Cancers in Lynch Syndrome ', Genetics in Medicine . https://doi.org/10.1038/s41436-019-0489-y, https://doi.org/10.1038/s41436-019-0489-y
Genetics in Medicineمصطلحات موضوعية: MICROSATELLITE INSTABILITY, 0302 clinical medicine, Colorectal Neoplasms, Hereditary Nonpolyposis/epidemiology, Endometrial Neoplasms/epidemiology, Mass Screening, MUTATION, Genetics (clinical), Early Detection of Cancer, Ovarian Neoplasms, Genetics & Heredity, RISK, 0303 health sciences, Manchester Cancer Research Centre, CLINICAL-CRITERIA, WOMEN, NONPOLYPOSIS COLORECTAL-CANCER, TUMORS, Lynch syndrome, 3. Good health, Europe, 030220 oncology & carcinogenesis, endometrial cancer, surveillance, Female, Ovarian Neoplasms/epidemiology, Life Sciences & Biomedicine, guidance, medicine.medical_specialty, congenital, hereditary, and neonatal diseases and abnormalities, Consensus, Genital Neoplasms, Female, QUALITY-ASSURANCE, Best practice, OVARIAN-CANCER, Unmet needs, 03 medical and health sciences, Special Article, medicine, Humans, 030304 developmental biology, 0604 Genetics, Science & Technology, business.industry, Endometrial cancer, ResearchInstitutes_Networks_Beacons/mcrc, screening, nutritional and metabolic diseases, 1103 Clinical Sciences, medicine.disease, Gynecological cancer, Colorectal Neoplasms, Hereditary Nonpolyposis, digestive system diseases, Endometrial Neoplasms, Family medicine, Expert opinion, Manchester International Consensus Group, North America, Genital Neoplasms, Female/epidemiology, business
الوصف: Purpose\ud \ud There are no internationally agreed upon clinical guidelines as to which women with gynecological cancer would benefit from Lynch syndrome screening or how best to manage the risk of gynecological cancer in women with Lynch syndrome. The Manchester International Consensus Group was convened in April 2017 to address this unmet need. The aim of the Group was to develop clear and comprehensive clinical guidance regarding the management of the gynecological sequelae of Lynch syndrome based on existing evidence and expert opinion from medical professionals and patients.\ud \ud Methods\ud \ud Stakeholders from Europe and North America worked together over a two-day workshop to achieve consensus on best practice.\ud \ud Results\ud \ud Guidance was developed in four key areas: (1) whether women with gynecological cancer should be screened for Lynch syndrome and (2) how this should be done, (3) whether there was a role for gynecological surveillance in women at risk of Lynch syndrome, and (4) what preventive measures should be recommended for women with Lynch syndrome to reduce their risk of gynecological cancer.\ud \ud Conclusion\ud \ud This document provides comprehensive clinical guidance that can be referenced by both patients and clinicians so that women with Lynch syndrome can expect and receive appropriate standards of care.
وصف الملف: application/pdf; text
Full Text via ClinicalKey 
Find this article in full text from Springer Verlag.