Abstract:
OBJECTIVES:The aims of the study were to assess the clinical and histopathological characteristics of a comprehensive cohort of women with vulvovaginal melanoma (VVM) treated at our institution and to study the treatment response of checkpoint inhibitors in this patient cohort. MATERIALS AND METHODS:This is a retrospective study of women with invasive VVM treated at the Princess Margaret Cancer Centre in Toronto, Ontario, Canada, over a period of 15 years. Clinical and histopathological characteristics, treatment, as well as treatment-related outcome were analyzed in 32 women. Treatment response was evaluated retrospectively using the "response criteria for use in trials testing immunotherapeutics" (iRECIST). The objective response rate was defined as the proportion of patients with complete or partial response based on the best overall response. RESULTS:At a median follow-up of 37.8 months (5.8-110.4), 26 women (81.3%) had disease progression and 16 (50%) died. Thirteen patients with locally unresectable or metastatic melanoma were treated with immune checkpoint inhibitors. Ten additional cases were identified from previously published reports. The best objective response rate for immune checkpoint inhibitors was 30.4% (95% CI = 11.6%-49.2%) and the clinical benefit rate was 52.2% (95% CI = 31.8%-72.6%). The clinical benefit rate was significantly better for programmed cell death protein 1 inhibitors (or a combination) compared with ipilimumab alone (Fisher exact, p = .023). Grade 3/4 adverse events were observed in 3 (13.0%) of the 23 patients. CONCLUSIONS:Women with VVM constitute a high-risk group with poor overall prognosis. Immune checkpoint inhibitors are effective in the treatment of metastatic melanoma in this patient cohort.
journal_name
J Low Genit Tract Disjournal_title
Journal of lower genital tract diseaseauthors
Wohlmuth C,Wohlmuth-Wieser I,Laframboise Sdoi
10.1097/LGT.0000000000000583subject
Has Abstractpub_date
2020-11-24 00:00:00eissn
1089-2591issn
1526-0976pub_type
杂志文章abstract:OBJECTIVE:The aim of the study was to examine whether high-grade cervical intraepithelial neoplasia (CIN) was more closely associated with human papillomavirus (HPV) same-genotype persistence (SGTP) versus clearance of prior infection with a subsequent infection by a new genotype (genotype switch [GS]), clearance of HP...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0000000000000573
更新日期:2021-01-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to determine rates of cervical intraepithelial neoplasia (CIN) 2 or greater in high-risk, racially diverse, young women with low-grade cytology. MATERIALS AND METHODS:After institutional review board approval, a cross-sectional study of 21- to 24-year-old women with low-grade cytolog...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0000000000000381
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVE:Large loop excision of the transformation zone (LLETZ) is the standard surgical treatment for cervical dysplasia. The optimal way to achieve local hemostasis in women undergoing LLETZ is unknown. MATERIALS AND METHODS:In a prospective, randomized trial, we compared spray coagulation and forced coagulation in...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章,随机对照试验
doi:10.1097/LGT.0000000000000177
更新日期:2016-04-01 00:00:00
abstract:PURPOSE:To compare the collection of vaginal exudates with and without the use of a speculum to diagnose vaginal infections. MATERIAL AND METHODS:We examined 45 patients with vaginal discharge. Two vaginal swabs were taken, one with and the other without a speculum. Both were examined by wet mount microscopy to detect...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/01.lgt.0000179859.29456.ba
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVE:In this study, we investigated whether physical inactivity was associated with risk of cervical cancer in women treated at an American cancer hospital. METHODS:This case-control study included 128 patients with cervical cancer and 512 controls matched on age. Controls were women suspected of having but not u...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0000000000000210
更新日期:2016-07-01 00:00:00
abstract:OBJECTIVES:To provide management guidelines according to Pap test specimen adequacy based on literature review and expert opinion. METHODS:A task force named by the American Society for Colposcopy and Cervical Pathology conducted a literature review and discussed appropriate management. The steering committee of the A...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/00128360-200207000-00008
更新日期:2002-07-01 00:00:00
abstract:OBJECTIVES:Our objective in this study was to evaluate the clinicopathological significance of tissue eosinophilia associated with invasive cervical carcinomas. MATERIALS AND METHODS:All cases of cervical carcinoma treated at the Medical College of Georgia between October 1982 and October 1989 were reviewed. We obtain...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1046/j.1526-0976.1999.34006.x
更新日期:1999-10-01 00:00:00
abstract:OBJECTIVES:The objective of this multicenter trial was to determine the incidence of human papillomavirus (HPV) in the amniotic fluid of pregnant patients. METHODS:Fifty-three pregnant patients undergoing genetic counseling or amniocentesis for preterm labor were entered into the study. Cervical swabs and amniotic flu...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/00128360-199807000-00008
更新日期:1998-07-01 00:00:00
abstract:OBJECTIVE:For the 2019 ASCCP Risk-Based Management Consensus Guidelines, we conducted a systematic review of diagnostic assays for postcolposcopy and posttreatment management. MATERIALS AND METHODS:A literature search was conducted to identify articles reporting on tests/assays for cervical cancer screening, triage, p...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章,meta分析
doi:10.1097/LGT.0000000000000526
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:This cross-sectional study was intended to assess the association between immunohistochemical analysis of p16 and fragile histidine triad (FHIT) and the presence of precancerous cervical lesions. MATERIALS AND METHODS:Women seen at Pérola Byington Hospital, São Paulo, Brazil, with histologically confirmed ce...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e31802efb9e
更新日期:2007-07-01 00:00:00
abstract:OBJECTIVES:Our aim was to evaluate the feasibility and performance of smartphone digital images for the detection of cervical intraepithelial neoplasia of grade 2 or worse (CIN2+) as an adjunct to a conventional visual inspection approach with acetic acid (VIA) and Lugol's iodine (VILI), in comparison with detection by...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0000000000000136
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:The authors' objective was to determine retrospectively the methods used to follow up atypical glandular cells of undetermined significance (AGUS) on Papanicolaou smears and to evaluate the effectiveness of those methods. MATERIAL AND METHODS:The charts of all patients with AGUS smears obtained between Febr...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/00128360-199704000-00007
更新日期:1997-04-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to assess whether HIV-positive (HIV+) women aged 30 years and older with concurrent normal cervical cytology and undetectable cervical HPV have a low 3-year risk of developing cervical intraepithelial neoplasia grade 2 or higher (CIN 2+) in a clinical setting. MATERIALS AND METHODS:W...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0000000000000304
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to evaluate the rate of patient adherence to provider recommendations for biopsy proven cervical intraepithelial neoplasia (CIN) 2 or 3 in an academic safety-net hospital. MATERIALS AND METHODS:This is a case series of patients with biopsy-proven CIN 2 or 3 identified via pathology r...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0000000000000148
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVE:This study explores the prevalence and provider- and practice-related correlates of physician recommendation and administration of the quadrivalent human papillomavirus (HPV) vaccine, Gardasil, to 11- to 12-year-old girls and the intention to recommend the HPV vaccine to 11- to 12-year-old boys in Georgia. Th...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0000000000000011
更新日期:2014-10-01 00:00:00
abstract::This review highlights recent advances in our understanding of preneoplastic squamous lesions of the vulva, from a pathologist's perspective. Vulvar intraepithelial neoplasia (VIN) is the preferred nomenclature for these lesions. VIN lesions may or may not be symptomatic and have a variable clinical appearance. Three ...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/00128360-199801000-00007
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVES:Low physician density, undercapacitated laboratory infrastructures, and limited resources are major limitations to the development and implementation of widely accessible cervical cancer prevention programs in sub-Saharan Africa. MATERIALS AND METHODS:We developed a system operated by nonphysician health pr...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e3181cd6d5e
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVE:The natural evolution of atypical glandular cells of undetermined significance (AGUS) within a dysplasia clinic population has not yet been studied. The purpose of this study was to determine the outcome of cervico-vaginal smears with the diagnosis of AGUS from dysplasia clinic patients. MATERIAL AND METHODS...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/00128360-199810000-00001
更新日期:1998-10-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to summarize and review the evidence for the efficacy and safety of adipose-derived stem cells (ADSCs) and platelet-rich plasma (PRP) for the treatment of vulvar lichen sclerosus (LS). MATERIALS AND METHODS:PubMed/MEDLINE, Ovid, Web of Science, and clinicaltrials.gov were searched fr...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章,评审
doi:10.1097/LGT.0000000000000440
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:It was hypothesized that music or guided imagery versus usual care would result in less anxiety and perceived pain for colposcopy patients. MATERIALS AND METHODS:Patients were randomized to music, guided imagery, or usual care after completing a baseline questionnaire. All patients completed a postprocedure ...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.lgt.0000230206.50495.4c
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVE:Determine the extent of endocervical canal extension of the transformation zone on fresh hysterectomy specimens. MATERIALS AND METHODS:After removal for standard gynecologic indications, 201 uteri were evaluated in the pathology accessioning area of a community hospital before formalin fixation. Uteri were o...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/00128360-200310000-00005
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVE:This study aimed to assess the risk of progression/persistence of squamous intraepithelial lesions (SILs) during pregnancy according to the age of the woman, the grade of the lesion, the type of human papillomavirus (HPV) infection, and the mode of delivery. MATERIALS AND METHODS:Eighty pregnant women with a...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e31822e83cf
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVES:Vulvar vestibule is a common term in the medical nomenclature. In our view, this term is inaccurate. MATERIALS AND METHODS:Herein, we provide evidence from embryologic, anatomic, and architectonic textbooks that shows the links between the vestibule and vagina. RESULTS:Our research proves that the term vul...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/00128360-200401000-00014
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVE:This study aimed to assess the incidence of cervical intraepithelial neoplasia (CIN) by grade (CIN 1, CIN 2, CIN 3) and age in Estonia (a country with less developed cervical cancer screening program and high cervical cancer incidence). MATERIALS AND METHODS:This descriptive study uses data from a health ins...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e3182652213
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to assess clinical and histopathologic characteristics of symptomatic women who underwent a nondiagnostic biopsy of the inner vulva. MATERIALS AND METHODS:Consecutive nondiagnostic biopsies from medial labia minora, posterior fourchette, and vestibule obtained from symptomatic women ...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0000000000000366
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:The objective of the current study was to describe outcomes among women with low-grade abnormalities on cervical cytology screening in the setting of previous excisional or ablative treatment for cervical intraepithelial neoplasia (CIN). METHODS:Study participants were recruited into the Study to Understand ...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e3181ed3d6d
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to compare the effectiveness of mindfulness-based group cognitive behavior therapy (M-gCBT) versus education support group therapy for the pain and distress associated with provoked localized vulvodynia. MATERIALS AND METHODS:Participants were randomized to M-gCBT or education suppor...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章,随机对照试验
doi:10.1097/LGT.0000000000000456
更新日期:2019-04-01 00:00:00
abstract:OBJECTIVE:This study aimed to highlight that colposcopic vaginal patterns are not specific, unlike cervical colposcopic patterns, and to provide a simpler classification of vaginal colposcopic patterns. MATERIALS AND METHODS:A total of 223 patients who underwent colposcopy with Schiller test were assessed (hierarchica...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e318237ec82
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVE:: This study aimed to explore the role of hormone replacement therapy (HRT) in susceptibility to vulvovaginal candidiasis (VVC) in a private vulval disease referral practice. METHODS:: Between January 2009 and December 2010, 149 healthy, nondiabetic patients with vulvar conditions were compared for significa...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e3182241f1a
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVE:To determine the validity of the Papanicolaou smear in the diagnosis of bacterial vaginosis, Trichomonas vaginalis, and Candida spp. MATERIALS AND METHODS:We determined the sensitivity, specificity, positive predictive value, and negative predictive value of Pap smears we performed in 824 symptomatic patient...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:
更新日期:2001-10-01 00:00:00