Abstract:
OBJECTIVE:To assess trends in guideline-adherent fertility-sparing surgery (GA-FSS) for early-stage cervical cancer relative to Patient Protection and Affordable Care Act (ACA) implementation. METHODS:National Cancer Database patients treated for Stage IA1-IB1 cervical cancer from 2004 to 2016 were included. Multivariable logistic regression was used to determined trends in GA-FSS relative to the ACA and identify patient factors independently associated with GA-FSS. RESULTS:Odds of GA-FSS increased in the post- compared to pre-ACA cohort (aOR = 1.65; 95%CI: 1.34-2.03). Decreasing age, Asian/Pacific Islander race, higher education and income levels, more recent treatment year, and lower clinical stage were independently associated with increased odds of receiving GA-FSS. In the pre- and post-ACA samples, decreasing age (per 1 year age increase; pre-ACA aOR = 0.87, 95%CI:0.85-0.90; post-ACA aOR = 0.85, 95%CI:0.83-0.87), higher education level (top vs. lowest education quartile; pre-ACA aOR = 2.08, 95%CI:1.19-3.65; post-ACA aOR = 2.00, 95%CI:1.43-2.80), and lower clinical stage (stages IA2 [pre-ACA aOR = 0.19, 95%CI:0.09-0.41; post-ACA aOR = 0.29, 95%CI:0.19-0.45] and IB1 [pre-ACA aOR = 0.06, 95%CI:0.06-0.16; post-ACA aOR = 0.16, 95%CI: 0.12-0.20] relative to stage IA1) were independently associated with increased odds of GA-FSS receipt. After the ACA, Asian/Pacific Islander race (aOR = 2.81, 95%CI: 1.81-4.36) and more recent treatment year (Spearman's ρ = 0.0348, p-value = 0.008) were also independently associated with increased odds of GA-FSS receipt. When adjusted for the pre- vs. post-ACA treatment periods, Medicaid patients were less likely to undergo GA-FSS than privately-insured patients (aOR = 1.65; 95%CI:1.34-2.03). CONCLUSIONS:Patients were more likely to receive GA-FSS post-ACA. Though the proportion of publicly-insured women increased after ACA implementation, women on Medicaid remained less likely to receive GA-FSS than women with private insurance.
journal_name
Gynecol Oncoljournal_title
Gynecologic oncologyauthors
Sutaria T,Sparks AD,Rao YJ,Lopez-Acevedo M,Long Bdoi
10.1016/j.ygyno.2020.05.027subject
Has Abstractpub_date
2020-08-01 00:00:00pages
424-430issue
2eissn
0090-8258issn
1095-6859pii
S0090-8258(20)31096-9journal_volume
158pub_type
杂志文章abstract:OBJECTIVES:To determine the impact of venous thromboembolism (VTE) during primary treatment of ovarian clear cell carcinoma (OCCC) on survival. METHODS:After Institutional Review Board approval, 74 cases of OCCC were retrieved from our pathology files. Clinical and pathological data were obtained by medical record and...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2013.09.005
更新日期:2013-12-01 00:00:00
abstract:INTRODUCTION:Placental site trophoblastic tumor (PSTT) is a rare variant of gestational trophoblastic disease that has been re-described during the 1970s. MATERIALS AND METHODS:The patients' age at presentation, presenting symptoms, description of last pregnancy, treatment, and outcome were analyzed in five patients d...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2004.08.049
更新日期:2005-01-01 00:00:00
abstract:OBJECTIVE:To investigate racial disparities with respect to adjuvant treatment and survival in patients presenting with malignant ovarian germ cell tumors (OGCT). METHODS:The National Cancer Database (NCDB) was used to identify women diagnosed with OGCT. Demographic data were abstracted, including stratification by ra...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2016.01.006
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVE:To help determine whether global collaborations for prospective gynecologic surgery trials should include hospitals in developing countries, we compared surgical and oncologic outcomes of patients undergoing laparoscopic radical hysterectomy at a large comprehensive cancer center in the United States and a ca...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2012.01.007
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:After The Cancer Genome Atlas (TCGA) findings, four novel prognostic groups may direct the management of endometrial cancer (EC): POLE-mutated/ultramutated (POLEmt), microsatellite-instable/hypermutated (MSI), copy-number-low/p53-wild-type (p53wt), and copy-number-high/p53-mutated (p53mt). However, data abou...
journal_title:Gynecologic oncology
pub_type: 杂志文章,meta分析
doi:10.1016/j.ygyno.2019.08.019
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine whether para-aortic lymphadenectomy improves disease-related survival (DRS) in stage IIIc endometrial cancer. METHODS:A total of 63 patients with stage IIIc endometrial carcinoma underwent primary radical surgery in the Tohoku Gynecologic Cancer Unit from 1993 to 20...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2007.06.009
更新日期:2007-11-01 00:00:00
abstract:OBJECTIVE:To determine the overall survival and relative effect of multiple prognostic variables in cohorts of patients with advanced-stage ovarian cancer treated with platinum-based neoadjuvant chemotherapy in lieu of primary cytoreductive surgery. METHODS:Twenty-two cohorts of patients with Stage III and IV ovarian ...
journal_title:Gynecologic oncology
pub_type: 杂志文章,meta分析
doi:10.1016/j.ygyno.2006.06.025
更新日期:2006-12-01 00:00:00
abstract:OBJECTIVE:Overexpression of low-density lipoprotein (LDL) receptors occurs in several cancer cell lines and offers a unique strategy for drug targeting by using LDL as vehicle. However, the native lipoprotein is difficult to obtain and handle. Previously, we showed that a lipidic emulsion (LDE) similar to the lipid str...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.2002.6654
更新日期:2002-06-01 00:00:00
abstract:OBJECTIVES:To clarify the anatomy necessary for the nerve sparing Okabayashi's radical hysterectomy, we meticulously separated the blood vessels and connective tissues to preserve the pelvic splanchnic nerve, the hypogastric nerve, and the bladder branch of the inferior hypogastric plexus under magnification (x2.5) dur...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2007.08.076
更新日期:2007-10-01 00:00:00
abstract:OBJECTIVE:Delay in diagnosis of endometrial cancer may be associated with disease progression and impact management and outcomes. Social and cultural barriers influence recognition of symptoms and self-advocacy in seeking care. Associations between social determinants of health (SDH) and disease presentation have been ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2020.04.693
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Nongestational pure ovarian choriocarcinoma is a rare malignancy with only 29 cases described to date. CASE:We describe a case associated with mature cystic teratoma of the contralateral ovary. Details of all 30 cases including clinical features, associations, surgicopathological findings, operative procedu...
journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1006/gyno.2000.6043
更新日期:2001-02-01 00:00:00
abstract:OBJECTIVE:The purpose of this study is to evaluate the significance of the c-Met/hepatocyte growth factor receptor expression in invasive cervical carcinoma. METHODS:Ninety-Four patients with FIGO stage 1B disease, treated primarily with surgery, were studied immunohistochemically. Of the cases, 67 were squamous carci...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/s0090-8258(02)00073-2
更新日期:2003-02-01 00:00:00
abstract:OBJECTIVE:The purpose of this study is to evaluate a modified MonoPrep2 (MP) of liquid-based cytology (LBC) to search for a less expensive alternative technique usable for screening of cervical cancers. STUDY DESIGN:Cervicovaginal direct-to-vial samples from 1218 consecutive patients were processed with the modified M...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2004.05.047
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND:Low-grade endometrial stromal sarcoma is generally an indolent tumor rich in estrogen and progesterone receptors. Objective responses to hormonal therapy, most commonly with megestrol acetate, have been reported. CASE:The patient is a 51-year-old woman who presented with low-grade endometrial stromal sarcom...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.2001.6238
更新日期:2001-08-01 00:00:00
abstract:OBJECTIVE:To design and implement a standardized postoperative voiding management protocol that accurately identifies patients with urinary retention and reduces unnecessary re-catheterization. METHODS:A postoperative voiding management protocol was designed and implemented in patients undergoing major, inpatient, non...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2020.01.036
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVE:Recent scientific advances have lead to the development of a prophylactic, quadrivalent HPV vaccine conferring. We surveyed Latino and non-Latino women directly to examine what motivates them to vaccinate themselves, their daughters, and their sons. METHODS:A written survey was administered to 86 Latinas and...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2008.12.010
更新日期:2009-03-01 00:00:00
abstract:OBJECTIVES:Patients who develop recurrent ovarian of fallopian tube carcinoma involving the liver often have disease refractory to chemotherapy and carry a poor prognosis. The impact of aggressive resection in this patient population is unclear. METHODS:From 1/1988 to 9/2001, 24 patients with recurrent ovarian or fall...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2003.07.005
更新日期:2003-11-01 00:00:00
abstract:OBJECTIVE:Previous studies suggest that differences in molecular features of endometrial cancers between racial groups may contribute to the poorer survival in Blacks. The objective of this investigation was to determine whether gene expression among endometrial cancers is different between Blacks and Whites. METHODS:...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2013.04.017
更新日期:2013-07-01 00:00:00
abstract::Thirty-eight patients with advanced or recurrent carcinoma of the endometrium who had received no prior chemotherapy were placed on study by the Gynecologic Oncology Group. One was deemed histologically ineligible. Three patients had insufficient trials to evaluate response. Of the remaining 34 who received hexamethyl...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/s0090-8258(88)80028-3
更新日期:1988-11-01 00:00:00
abstract:INTRODUCTION:Randomized trials have demonstrated significant improvements in progression-free survival (PFS) with consolidation paclitaxel (P) and bevacizumab (B) following cytoreduction and adjuvant carboplatin/paclitaxel (CP) for advanced epithelial ovarian cancer (EOC). We sought to evaluate the cost-effectiveness (...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2011.05.014
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVE:To compare the short-term surgical outcome of patients undergoing robotic radical hysterectomy (RRH) versus open radical hysterectomy (ORH) for the treatment of early stage cervical cancer. METHODS:IRB approval was obtained for a retrospective chart review of all radical hysterectomies (RHs) for Stage I and ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2008.08.016
更新日期:2008-12-01 00:00:00
abstract:BACKGROUND:The standard therapy for invasive uterine cervical cancer causes loss of the woman's fertility. We report a successful pregnancy in a patient who desired fertility-sparing management of invasive cervical cancer and was treated with systemic chemotherapy and conization. CASE:A 28-year-old nulliparous woman w...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2005.08.018
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVE:Recent prospective data support the trend towards systematic retroperitoneal lymphadenectomy in patients with high-risk endometrial cancer. Because para-aortic node involvement in the absence of pelvic node involvement is uncommon, a reliable finding of negative pelvic lymph nodes (PLN) at intraoperative froz...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2009.07.007
更新日期:2009-10-01 00:00:00
abstract:OBJECTIVE:To determine if extra-peritoneal laparoscopic para-aortic (PA) lymphadenectomy allows a reliable assessment of PA nodes in patients with endometrial cancer (EC). METHODS:In October of 2005, a single surgeon began performing extra-peritoneal laparoscopic PA lymphadenectomy for patients with EC. A prospective ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2008.08.021
更新日期:2008-12-01 00:00:00
abstract:OBJECTIVE:To report a series of cases of hepatic resection for metastatic gynecologic carcinomas. METHODS:We reviewed the records of all patients who underwent hepatic resection for metachronous liver metastases from gynecologic carcinomas at our institution from 1986 to 1996. RESULTS:Twelve patients were identified ...
journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1006/gyno.1997.4727
更新日期:1997-07-01 00:00:00
abstract:OBJECTIVE:Preoperative identification of cervical stromal invasion in endometrial carcinoma is important to select patients for primary radical hysterectomy. The objective of this prospective implementation study was to assess if introduction of magnetic resonance imaging (MRI) in addition to the standardly applied end...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2012.05.009
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVE:To assess the role of additional biopsies performed with loop electrosurgical excisional procedure (LEEP) in predicting the likelihood of persistent high grade intraepithelial neoplasia. METHODS:Clinicopathologic data were abstracted from women who underwent excision of high grade intraepithelial lesions bet...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2017.01.007
更新日期:2017-03-01 00:00:00
abstract::Twenty-nine patients with recurrent advanced stage ovarian cancer were treated with 5-fluorouracil (5-FU) and leucovorin by intravenous bolus on 5 consecutive days, repeated every 3 weeks. Twenty-one of these patients had experienced disease progression while receiving a cisplatin- or carboplatin-based regimen. There ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(92)90226-9
更新日期:1992-09-01 00:00:00
abstract:OBJECTIVE:We demonstrate the feasibility of implementing a referral and management system for cryotherapy-ineligible women in a "screen-and-treat" cervical cancer prevention program targeting HIV-infected women in Zambia. METHODS:We established criteria for patient referral, developed a training program for loop elect...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2008.04.031
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:The serum CA-125 antigen value has proven to be useful in predicting changes that affect prognosis and management of ovarian cancer; however, interpreting variations in the tumor marker is still not well-defined. Our goal was to further understand the analytical variability of CA-125 in a conventional hospit...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2006.02.010
更新日期:2006-10-01 00:00:00