Abstract:
OBJECTIVE:Timely surgery has been shown to impact outcome in endometrial cancer patients. Social determinants of health (SDH) are associated with adverse cancer outcomes. We sought to evaluate the association of SDH with surgical treatment indicators in endometrial cancer patients in a public healthcare system. METHODS:Endometrial cancer patients in Ontario, Canada, diagnosed between 2009 and 2017 were identified, and clinical, social and demographic variables were extracted from administrative databases. Validated community marginalization scores that include material deprivation, residential instability and ethnic concentration were used for stratification. Surgical treatment features were compared across marginalization quintiles using chi-square, Fischer exact or Wilcoxon rank sum tests as appropriate. Predictors of timely surgical treatment were evaluated with logistic regression. RESULTS:20228 patients were identified of whom 14,423 had primary hysterectomy for a preoperative diagnosis of endometrial cancer. Fewer patients in marginalized communities received surgery (89% vs. 93%, p < 0.001). Surgical delay was longer among marginalized patients and 78% had surgery within 12 weeks compared to 84% of those least marginalized (p < 0.0001). Other quality indicators of surgical treatment were not negatively associated with marginalization. On multivariable analysis adjusted for patient and disease factors, marginalization was independently associated with increased odds of delayed surgery (OR = 0.94/quintile, CI 0.91-0.97, p < 0.001). CONCLUSIONS:Social marginalization is associated with decreased likelihood of having surgery and with delayed surgery among endometrial cancer patients in Ontario. This may be mediated by delayed presentation and real or perceived barriers to access. Reducing surgical wait times among marginalized cancer patients is an important deliverable in public healthcare.
journal_name
Gynecol Oncoljournal_title
Gynecologic oncologyauthors
Helpman L,Pond GR,Elit L,Anderson LN,Seow Hdoi
10.1016/j.ygyno.2020.08.029subject
Has Abstractpub_date
2020-11-01 00:00:00pages
387-393issue
2eissn
0090-8258issn
1095-6859pii
S0090-8258(20)33830-0journal_volume
159pub_type
杂志文章abstract::Nineteen patients with stage III or IV epithelial ovarian cancer treated on a prospective randomized protocol with either adriamycin and cis-diamminedichloroplatinum or tamoxifen, adriamycin, and cis-diamminedichloroplatinum received a modified "CHAP II" regimen at the time of clinical progression of disease or the fi...
journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0090-8258(86)90085-5
更新日期:1986-11-01 00:00:00
abstract:OBJECTIVES:Endometriosis-associated ovarian carcinoma (EAOC) has recently received increasing attention due to its suggested biological behavior, distinctive from those of usual epithelial ovarian cancer. To elucidate some of the controversies on this intriguing entity, a series of patients with EAOC were compared to o...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.2001.6382
更新日期:2001-10-01 00:00:00
abstract::For over forty years, the Gynecologic Oncology Group drove progress in treating endometrial cancer. The first decades of investigation began with a meticulous prospective, surgicopathologic staging study that was the platform for development of all subsequent trials. The resultant statistical model of low risk, interm...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2020.01.012
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to examine the clinicopathologic correlates of T-regulatory (T(reg)) cell infiltration in serous ovarian cancers and to define gene signatures associated with high T(reg)s. METHODS:Tumor infiltrating T(reg) and cytotoxic T-cells (CTLs) were quantitated in 232 primary serous ov...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2009.11.020
更新日期:2010-03-01 00:00:00
abstract:OBJECTIVE:Ovarian cancer is most frequently diagnosed at a late stage with a poor prognosis. No markers for early diagnosis have been established. Aberrantly methylated DNA appears as a promising molecular cancer marker. The aim of this study was to analyze the methylation status of the proapoptotic cancer related gene...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2010.11.018
更新日期:2011-04-01 00:00:00
abstract::Two cases of peritonitis carcinomatosa with gynecological cancer, which did not respond to conventional treatment, were treated by intraperitoneal adoptive immunotherapy with allogeneic or autologous lymphokine-activated killer (LAK) cells plus interleukin-2. In case 1, reduction of acute ascites and disappearance of ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(89)90101-7
更新日期:1989-07-01 00:00:00
abstract:OBJECTIVES:The objectives of this study were twofold: to prospectively assess whether expressed intention to undergo prophylactic oophorectomy translated into uptake and to evaluate the psychological impact of the procedure in a sample of unaffected women with a strong family history of breast/ovarian cancer. METHODS:...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.2002.6737
更新日期:2002-08-01 00:00:00
abstract:OBJECTIVE:To investigate whether alteration of BRCA1 tumor suppressor gene occurs in sporadic endometrial carcinomas. METHODS:Genomic DNAs were prepared from 33 consecutively collected endometrial carcinoma tissues for BRCA1 mutational analysis. To screen for BRCA1 mutation, polymerase chain reaction (PCR) amplificati...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1997.4800
更新日期:1997-09-01 00:00:00
abstract::Sentinel node mapping is increasingly being utilized for endometrial cancer staging. However, only limited evidence supporting the adoption of sentinel node mapping instead of conventional lymphadenectomy is still available. Here, we aimed to review the current evidence comparing sentinel node mapping and lymphadenect...
journal_title:Gynecologic oncology
pub_type: 杂志文章,meta分析
doi:10.1016/j.ygyno.2019.03.254
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate the 5-year survival probability (SP) of patients treated for ovarian clear cell adenocarcinoma (OCCA) at a single tertiary institution and to compare it to the 5-year SP of patients with other histologic subtypes of epithelial ovarian cancer. METHODS:Sixty-four patients ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1999.5445
更新日期:1999-07-01 00:00:00
abstract:OBJECTIVE:To develop a nomogram to predict overall survival (OS) in women with recurrent ovarian cancer treated with bevacizumab and chemotherapy. METHODS:A multicenter retrospective study was conducted. Potential prognostic variables included age; stage; grade; histology; performance status; residual disease; presenc...
journal_title:Gynecologic oncology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ygyno.2014.01.036
更新日期:2014-03-01 00:00:00
abstract:UNLABELLED:Misconceptions about cancer may increase the level of fear in the general public and render coping more difficult in cancer patients. The aim of this survey was to study the level of knowledge and misconceptions. MATERIALS AND METHODS:A questionnaire comprising 27 questions related to cancer etiology, treat...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1997.4626
更新日期:1997-04-01 00:00:00
abstract:OBJECTIVE:The present study aimed to identify differentially expressed proteins employing a high resolution mass spectrometry (MS)-based proteomic analysis of endometrial cancer cells harvested using laser microdissection. METHODS:A differential MS-based proteomic analysis was conducted from discrete epithelial cell p...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2011.02.031
更新日期:2011-06-01 00:00:00
abstract:OBJECTIVES:We have previously shown that high activity of lactate dehydrogenase (LD) isoenzymes 4 and 5 in terine aspirates is a marker for endometrial carcinoma. The purpose of this study was to identify an abnormal activity profile of LD2-5 using LD1 as an internal standard, thereby being able to dispense with measur...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2004.02.014
更新日期:2004-05-01 00:00:00
abstract:OBJECTIVE:The objective was to determine the frequency with which regression or progression of disease without treatment occurred in women diagnosed with squamous cell cervical carcinoma in situ (CIS) during pregnancy. METHODS:. A retrospective chart review of all women evaluated at the University of Iowa Colposcopy C...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1997.4856
更新日期:1997-11-01 00:00:00
abstract:OBJECTIVE:Approximately 2 million women worldwide are infected with high-risk human papillomaviruses (HPV), resulting in a substantial risk for the development of invasive lower genital malignancies. This study was undertaken to determine the effects of vaccination with a protein encoding a bacterial heat shock protein...
journal_title:Gynecologic oncology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ygyno.2007.05.038
更新日期:2007-09-01 00:00:00
abstract::Twenty-eight patients with advanced, persistent or recurrent leiomyosarcoma of the uterus not previously exposed to cytotoxic drugs were entered into a study of single-agent intravenous etoposide 100 mg/m2 daily for 3 days every 3 weeks. No complete or partial responses were observed. Thirteen patients demonstrated st...
journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章
doi:10.1006/gyno.1996.0289
更新日期:1996-10-01 00:00:00
abstract:OBJECTIVE:Human papillomavirus (HPV) infection is the primary cause of cervical cancer. HPV-mediated immune alterations are known to play crucial roles in determining viral persistence and host cell transformation. We sought to thoroughly understand HPV-directed immune alterations in cervical cancer by exploring public...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2018.01.031
更新日期:2018-05-01 00:00:00
abstract:OBJECTIVE:PTEN, a tumor suppressor gene shown to be frequently mutated in endometrial cancers, has been suggested to be a target of microsatellite instability (MSI)-driven mutagenesis. We set out to investigate the relationship between MSI and PTEN mutation in a large series of primary endometrial carcinomas. METHODS:...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.2000.5900
更新日期:2000-10-01 00:00:00
abstract::Mixed Müllerian tumors (MMT) of the uterus are aggressive entities that result in a very poor prognosis even for patients in whom the disease is limited to the uterus. This phase II trial was undertaken in an attempt to improve overall survival as well as progression-free survival of these patients. Forty-two consecut...
journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章
doi:10.1006/gyno.1995.1065
更新日期:1995-03-01 00:00:00
abstract:OBJECTIVE:BRCA-associated and sporadic ovarian cancers have different pathologic and clinical features. Our goal was to determine if BRCA mutation status is an independent predictor of residual tumor volume following primary surgical cytoreduction. METHODS:We conducted a retrospective analysis of patients with FIGO st...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2012.05.001
更新日期:2012-08-01 00:00:00
abstract:OBJECTIVES:This trial was conducted to evaluate the safety and efficacy of cisplatin plus gemcitabine in previously treated squamous cell carcinoma of the cervix. SUBJECTS AND METHODS:All women had measurable histologically confirmed squamous cell cervical cancer and a GOG performance status less than or equal to 2. T...
journal_title:Gynecologic oncology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ygyno.2005.09.009
更新日期:2006-02-01 00:00:00
abstract:OBJECTIVE:Ovarian cancer is the leading cause of death from gynecologic malignancies in the Western world. Fibroblast growth factor receptor (FGFR) signaling has been implicated to play a role in ovarian tumorigenesis. Mutational activation of one member of this receptor family, FGFR2, is a frequent event in endometrio...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2009.12.002
更新日期:2010-04-01 00:00:00
abstract:OBJECTIVE:The goals of this study were to evaluate the feasibility of pelvic intensity-modulated radiotherapy (IMRT) in the adjuvant treatment of gynecologic malignancies and to compare the dose-volume histograms (DVHs) and determine the potential impact on acute and long-term toxicity based on the dose to target and n...
journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章
doi:10.1016/s0090-8258(03)00461-x
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVE:Over 90% of all cervical adenocarcinoma are caused by a transforming infection with a high-risk type human papillomavirus (hrHPV). Previous studies demonstrated that the association between hrHPV positivity and cervical clear-cell adenocarcinoma (CCAC) varies between 0% and 100%. As approximately 60% of all C...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2011.05.002
更新日期:2011-08-01 00:00:00
abstract::In a prospective, randomized, double-blind trial the combination betamethasone-dixyrazine was compared with high-dose metoclopramide as antiemetic treatment during combination chemotherapy (melphalan-doxorubicin and cisplatin) of ovarian carcinoma. Of 40 evaluable patients, 15 (38%) had previous experience with chemot...
journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0090-8258(89)90129-7
更新日期:1989-08-01 00:00:00
abstract:OBJECTIVES:To prospectively evaluate the diagnostic value of combined PET/CT in detecting a malignant tumor in patients with no previous cancer history, presenting with a pelvic mass. METHODS:From September 2004 to March 2006, 101 patients (median age=60 years, range=24-85 years) with a Risk of Malignancy Index (RMI)>...
journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章
doi:10.1016/j.ygyno.2006.11.022
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:Malignant acanthosis nigricans is a mucocutaneous eruption associated with internal malignancies. Tripe palms refers to a characteristic velvety thickening of the palms, with exaggeration of normal skin markings. The sign of Leser-Tre'lat is the presence of multiple seborrheic keratoses and scattered skin ta...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2005.12.024
更新日期:2006-05-01 00:00:00
abstract::Twenty-one patients with squamous carcinoma of the genital tract were treated with bleomycin, Oncovin, mitomycin-C, and cisplatin (BOMP). Six patients received BOMP as primary therapy. Five of six responded with one patient having an autopsy-proven complete response after treatment for a disseminated adenosquamous car...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(85)90220-3
更新日期:1985-03-01 00:00:00
abstract::Clear cell carcinoma of the ovary accounts for 2 to 3% of all epithelial ovarian neoplasms. Patient profiles, pathological characteristics, and results of treatment are reviewed for 59 patients. The median age was 51. Disease extent at diagnosis was as follows: stage I, 18 patients (31%); stage II, 20 patients (34%); ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(89)90043-7
更新日期:1989-11-01 00:00:00