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 (C/E) of these consolidation strategies. METHODS:A decision model was developed based on Gynecologic Oncology Group (GOG) protocols #178 and #218. Arm 1 is 6 cycles of CP. Arm 2 is 6 cycles of CP followed by 12 cycles of P (CP+P). Arm 3 is 1 cycle of CP, 5 cycles of CPB, and 16 cycles of B (CPB+B). Parameters include PFS, overall survival (OS), cost, complications (neuropathy for P and bowel perforation for B), and quality-of-life utility values. Sensitivity analyses were performed. RESULTS:The incremental cost-effectiveness ratio (ICER) for CT+T is $13,402/quality adjusted life year (QALY) gained compared to CP. For CPB+B compared to CP, the ICER is $326,530/QALY. When compared simultaneously, CPB+B is dominated, i.e. is more costly and less effective than CP+P. Results were robust to parameter variation. At a willingness to pay threshold of $100,000/QALY, CP+P was the preferred option throughout most of the decision space. Sensitivity analyses suggest that CPB+B would become the preferred option if it were to improve OS by 6.1 years over CP+P. CONCLUSIONS:In this model, B consolidation for advanced EOC was associated with a modest improvement in effectiveness that is less than that with P consolidation and more costly. A statistically significant improvement in survival may improve the value of B consolidation.
journal_name
Gynecol Oncoljournal_title
Gynecologic oncologyauthors
Lesnock JL,Farris C,Krivak TC,Smith KJ,Markman Mdoi
10.1016/j.ygyno.2011.05.014subject
Has Abstractpub_date
2011-09-01 00:00:00pages
473-8issue
3eissn
0090-8258issn
1095-6859pii
S0090-8258(11)00402-1journal_volume
122pub_type
杂志文章abstract::One of the most prevalent potential therapeutic targets for women with endometrioid endometrial cancer (EC) is the estrogen receptor (ER)/progesterone receptor (PR) pathway. Despite a high proportion of endometrioid ECs being ER and/or PR positive, endocrine therapy is only effective in a minority of women with EC and...
journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1016/j.ygyno.2018.12.018
更新日期:2019-04-01 00:00:00
abstract::The records of 125 patients with nonmucinous invasive ovarian adenocarcinoma who underwent cytoreductive surgery, cisplatin-based combination chemotherapy, and second-look laparotomy were analyzed to correlate pre-second-look serum CA-125 levels with the size of residual ovarian cancer. The majority of patients with n...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(90)90359-s
更新日期:1990-06-01 00:00:00
abstract::From June 1, 1984, to May 31, 1985, 98 cases of epithelial ovarian carcinomas were assessed and followed prospectively using a new murine monoclonal antibody OC 125 which detects the antigen CA 125. Serous tumors comprised 43.7% of cases, mucinous tumors 20.4%, endometrioid tumors 16%, and other epithelial tumors 19.4...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(88)90042-x
更新日期:1988-05-01 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::By serendipity we have had the opportunity to evaluate cis-platin-based chemotherapy in ovarian tumors of low malignant potential (LMP). Optimal (less than 1 cm residual disease) FIGO stage III ovarian carcinomas were randomly assigned to treatment with cisplatin plus cyclophosphamide with or without doxorubicin on a ...
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(91)90314-u
更新日期:1991-06-01 00:00:00
abstract:OBJECTIVE:To determine whether single agent chemotherapy with intramuscular methotrexate 50mg administered on days 1, 3, 5, and 7 and oral folinic acid 15mg administered on days 2, 4, 6, and 8 in 2 weekly cycles (IM MTX/FA) is an effective treatment regimen for patients with low risk gestational choriocarcinoma. METHO...
journal_title:Gynecologic oncology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ygyno.2014.12.024
更新日期:2015-02-01 00:00:00
abstract::To determine how patients with invasive cervical cancer present and whether presentation affects disease-free survival (DFS), a review of 81 patients treated for cervical cancer by the Division of Gynecologic Oncology and Pelvic Surgery at the Southern California Permanente Medical Group between January 1, 1986, and D...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(91)90229-x
更新日期:1991-07-01 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:OBJECTIVE:The objective of this study was to determine whether there is a link between integrins and components of the plasminogen system, regarding tumor cell invasion to the artificial extracellular matrix. METHODS:Immunocytochemistry was performed with antibodies directed against integrins alpha2beta1, alpha4beta1,...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.2001.6410
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVES:To examine the impact of treatment- and disease-related factors on the quality of life of patients with ovarian cancers undergoing chemotherapy. PATIENTS AND METHODS:Over 18 months period, all patients with ovarian cancer receiving chemotherapy at the Saskatoon Cancer Center were recruited. The Functional A...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2003.11.034
更新日期:2004-03-01 00:00:00
abstract::Between 1972 and 1977, 141 patients with benign gynecologic disease and 149 patients with carcinoma of the cervix were evaluated with peritoneal fluid cytology at time of celiotomy. There was no positive cytology (malignant cells) in the benign disease group. The overall incidence of positive peritoneal cytology in th...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(84)90069-6
更新日期:1984-02-01 00:00:00
abstract:OBJECTIVE:To compare the incidence of postoperative complications and opioid pain medication usage in gynecologic oncology patients who did and did not receive an epidural prior to undergoing exploratory laparotomy. METHODS:Retrospective cohort study of all patients undergoing exploratory laparotomy with the gynecolog...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2019.02.017
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVE:To determine the antitumor activity and toxicity profile of gemcitabine as second-line chemotherapy in patients with recurrent or persistent uterine leiomyosarcoma (LMS). METHODS:Intravenous gemcitabine was administered over 30 min at a dose of 1000 mg/m(2) on days 1, 8, 15, with cycles repeated every 28 day...
journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.ygyno.2003.11.023
更新日期:2004-02-01 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:OBJECTIVE:To evaluate the effect of orally administered medroxyprogesterone acetate upon angiogenesis in the myometrium of patients with complex endometrial hyperplasia. METHODS:Microvessel counts in the myometrium of consecutive patients with complex endometrial hyperplasia, treated with oral medroxyprogesterone acet...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1998.5106
更新日期:1999-02-01 00:00:00
abstract:INTRODUCTION:Focused ultrasound under real-time MR guidance and control (MRgFUS) can be used for the thermal ablation of tissue. Currently this technique is used clinically for the noninvasive treatment of uterine leiomyomas and is in clinical evaluation for breast cancer, adenomyosis and other indications. MRgFUS is b...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2007.08.079
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVE:To compare the surgical and histological outcomes of diaphragmatic peritonectomy vs. full thickness resection with pleurectomy during Visceral-Peritoneal Debulking. METHODS:Service evaluation protocol (Trust number 3265). All patients with stage IIIC-IV ovarian cancer who had diaphragmatic surgery between Ap...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2015.12.004
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVES:Intraperitoneal (IP) chemotherapy following neoadjuvant chemotherapy (NACT) and interval tumor reductive surgery (TRS) for advanced ovarian cancer is feasible, however, the impact on disease outcomes remains unclear. We compare outcomes of patients treated with IP chemotherapy versus intravenous (IV) chemoth...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2019.12.016
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVE:To evaluate efficacy and safety of WF10 (TCDO iv solution) therapy in patients with late hemorrhagic radiation cystitis and proctitis in a long-term follow up. MATERIAL AND METHODS:From February 1999 to July 2001, 30 symptomatic patients with endoscopically confirmed grade 2 and 3 late hemorrhagic cystitis (...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2005.08.014
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVE:To determine the effectiveness of chemotherapy alone as postoperative adjuvant therapy for intermediate- and high-risk cervical cancer. METHODS:The study group comprised of 65 consecutive patients with stage IB or IIA squamous cell or adenosquamous cervical cancer who were initially treated with radical hyst...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2006.04.019
更新日期:2006-11-01 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:PURPOSE:To evaluate the efficacy and toxicity of interferon-alpha-2b (IFN-alpha) and cisplatin given concomitantly with radiation therapy (RT) in the treatment of locally advanced cervical carcinoma. MATERIALS AND METHODS:Twenty-one patients with stage bulky Ib-IIIb (Ib, 2; IIa, 2; IIb, 8; IIIb, 9) cervical carcinoma ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1997.4879
更新日期:1997-12-01 00:00:00
abstract::An oncocytoma of the right ovary in a 22-year-old Japanese woman was examined by light and electron microscopy. The tumor was composed of oxyphilic cells with a granular cytoplasm. Electron microscopic studies revealed mitochondrial hyperplasia, a characteristic feature of the oncocyte . This may be the first report o...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(84)90013-1
更新日期:1984-05-01 00:00:00
abstract::Surgical assessment of aortocaval lymph nodes in patients with unresectable primary cervical cancer helps in planning radiation treatment ports. Removal of enlarged lymph nodes may also serve a therapeutic purpose in reducing the tumor load to be sterilized by radiation. An extraperitoneal dissection is considered to ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1995.1036
更新日期:1995-02-01 00:00:00
abstract:OBJECTIVE:Human papillomavirus (HPV) infection play a significant role in cervical carcinogenesis, and HPV oncoprotein E7 has important functions in the formation and maintenance of cervical cancers. Interleukin-12 (IL-12) has been reported to induce cellular immune responses, and has also been demonstrated to suppress...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2005.01.046
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVE/BACKGROUND:Laparoscopic splenectomy is a potential surgical option for the treatment of isolated gynecologic cancer recurrence to the spleen [1-7]. The purpose of this video is to demonstrate a step-by-step approach for laparoscopic splenectomy in the setting of recurrent, oligometastatic ovarian cancer. MET...
journal_title:Gynecologic oncology
pub_type:
doi:10.1016/j.ygyno.2019.12.021
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVES:The role of adjuvant therapy in patients with early stage ovarian carcinoma has not been clearly defined. Most randomized trials examining this issue have not used the vigorous staging exploration accepted as today's standard. This report examines the natural history of patients after surgically documented s...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1999.5440
更新日期:1999-08-01 00:00:00
abstract::In a series of 38 nonmetastasizing and 29 metastasizing endometrial cancers, histologic subtype, aneuploidy, nuclear grade, and depth of myometrial invasion were the features most distinctly separating these two groups of patients. The most important factor was histologic type: papillary, papillary serous, adenosquamo...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(90)90251-f
更新日期:1990-12-01 00:00:00
abstract:PURPOSE:Racial genetic admixture (RGA), a measure to account for ancestral genetic background that correlates with individual's racial classification, could provide insights on causation of racial disparity in endometrial cancer (EC). Our objective is to evaluate the association of RGA with EC outcomes. METHODS:EC pat...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2015.11.018
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Although overall cervical cancer incidence rates have decreased in both black and white women in the U.S. since the mid 1950s due to widespread screening, rates continue to be higher among blacks than among whites. However, whether this pattern differs by age is unknown. METHODS:Cervical cancer cases (1975-...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2012.08.021
更新日期:2012-12-01 00:00:00