Abstract:
OBJECTIVE:The objective was to describe trends over time in key factors surrounding end-of-life care on a gynecologic oncology service at a tertiary cancer center. METHODS:Patients with gynecologic cancers who were hospitalized and died at our institution between 1992 and 1997 were identified using institutional databases. The study group consisted of 176 patients. For analysis, patients were divided into two groups: those who died between 1992 and 1994 and those who died between 1995 and 1997. Data were abstracted from medical records regarding the interval between placement of do-not-resuscitate (DNR) orders and death; the interval between the patient's being informed of her terminal-stage disease and death; the types of interventions performed near the end-of-life; and other factors related to end-of-life care. RESULTS:The average patient age on last admission to the hospital was 56 years, and the most common disease sites were ovary (47%), cervix (30%), and uterus (17%). Most deaths (82%) occurred on medical or surgical units, with the remainder occurring in the intensive care unit (12%) or emergency room (6%). The average interval between placement of DNR orders and death was longer among patients who died in 1995-1997 than among patients who died in 1992-1994 (49.6 days vs 19.2 days, P = 0.027). The average annual number of deaths (42.0 vs 16.7, P = 0.061) and the average length of hospital stay (13.3 vs 8.8 days; P = 0.079) decreased between 1992-1994 and 1995-1997, but the differences did not reach statistical significance. Changes between patients who died in 1992-1994 and those who died in 1995-1997 in the interval between the last cycle of chemotherapy and death (87 days and 49 days, respectively; P = 0.29), the proportion of patients with a DNR order on admission (39 and 45%, respectively; P = 0.59), the proportion of patients admitted for terminal care only (22 and 19%, respectively; P = 0.47), and the proportion of patients who died awaiting transfer to hospice (32 and 22%, respectively; P = 0.24) likewise did not reach statistical significance. CONCLUSIONS:Our data indicate that discussions about DNR orders are occurring earlier in relation to terminal events. However, we could not detect significant changes in the other outcome measures we studied. Major opportunities remain for further enhancements in the realm of advance planning for end-of-life care. Educational opportunities should be offered to physicians regarding communicating with patients about disease progression and end-of-life decision-making.
journal_name
Gynecol Oncoljournal_title
Gynecologic oncologyauthors
Dalrymple JL,Levenback C,Wolf JK,Bodurka DC,Garcia M,Gershenson DMdoi
10.1006/gyno.2002.6616subject
Has Abstractpub_date
2002-05-01 00:00:00pages
356-61issue
2eissn
0090-8258issn
1095-6859pii
S0090825802966163journal_volume
85pub_type
杂志文章abstract:OBJECTIVES:The objectives of this study were twofold: (1) to estimate the anti-tumor efficacy of CI-958 in patients with measurable platinum-resistant ovarian cancer; (2) to determine the nature and degree of toxicity of CI-958 in these patients. METHODS:Patients received CI-958 560 mg/m(2) intravenously every 3 weeks...
journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1006/gyno.2000.5984
更新日期:2000-12-01 00:00:00
abstract::Young women diagnosed with breast cancer typically face systemic treatments that may delay childbearing or permanently impair their fertility. These concerns add to the stress experienced by young cancer survivors. Timely counseling and providing fertility preservation through cryopreservation of eggs or embryos have ...
journal_title:Gynecologic oncology
pub_type: 社论
doi:10.1016/j.ygyno.2011.11.028
更新日期:2012-03-01 00:00:00
abstract::The usefulness of percutaneous endoscopic gastrostomy (PEG) for decompression in patients with unresolving intestinal obstruction by gynecological malignancy is examined. Between April 1993 and August 1995, 34 consecutive patients with small-bowel obstruction by gynecological cancer, heavily pretreated with surgery an...
journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章
doi:10.1006/gyno.1996.0197
更新日期:1996-07-01 00:00:00
abstract::In situ hybridization (ISH) and polymerase chain reaction (PCR) for several common HPV types were performed on 41 cases of vulvar dystrophy, 19 of which were associated with previous or simultaneous invasive squamous cell carcinoma of the vulva. Three of the 19 cases (16%) of dystrophy associated with cancer were foun...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1996.0151
更新日期:1996-06-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to analyze our experience with colorectal function preservation at the time of pelvic exenteration. METHODS:Between January 1980 and December 2001, 201 pelvic exenterations for gynecologic malignancies were performed in our hospital. Ninety-eight were supralevator exenteration...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/s0090-8258(03)00069-6
更新日期:2003-04-01 00:00:00
abstract:OBJECTIVES:To describe our experience with extraperitoneal lymph node staging in gynecologic oncology. MATERIALS AND METHODS:The extraperitoneal approach was performed to assess the lymph node histology in patients with gynecologic malignancies. The nodes are approached from a lateral approach after dissecting open th...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2004.07.007
更新日期:2004-10-01 00:00:00
abstract:OBJECTIVE:Different Human Papilloma Virus (HPV) tests are currently used. An integrated comparison of the Amplicor, Cobas4800, PreTect HPV-Proofer and APTIMA HPV tests has not been done. METHODS:We compared the high-risk HPV detection power of these HPV tests in 528 consecutive population-based follow-up Liquid-Based ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2011.07.024
更新日期:2011-11-01 00:00:00
abstract::In approximately ten months' time, the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has infected over 34 million people and caused over one million deaths worldwide. The impact of this virus on our health, relationships, and careers is difficult to overstate. As the economic realiti...
journal_title:Gynecologic oncology
pub_type: 指南,杂志文章,评审
doi:10.1016/j.ygyno.2020.10.009
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:The simultaneous occurrence of advanced cervical cancer and a pelvic kidney is uncommonly reported. It is an interesting clinical problem because the pelvic kidney lies within the radiation field. CASE:A patient found to have bilateral pelvic kidneys and stage II-B cervical cancer underwent an anterior exen...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2003.09.033
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:We attempted to determine the prevalence of genital human papillomavirus (HPV) infection in women attending gynecologic practitioners in South Taiwan. METHODS:The population included 4383 women aged 16-78 seeking HPV testing at primary gynecologic practitioners regardless of their cervical cytology results....
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2005.09.028
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:Granulosa cell tumors of the ovary are rare, primarily treated surgically. In advanced or recurrent disease, data are inconclusive regarding the benefit of either primary or adjuvant chemotherapy. Hormonal therapy has been suggested as an alternative treatment. CASE:Our patient had three recurrences of estr...
journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1016/j.ygyno.2004.10.042
更新日期:2005-03-01 00:00:00
abstract::There have been nine cases reported in the English literature in which the finding of malignant cells on cervical/vaginal cytology led to the diagnosis of primary gastric cancer. We report on a patient with gastric carcinoma, metastatic to the cervix, in which the diagnosis was suspected by the finding of signet ring ...
journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1016/0090-8258(90)90117-4
更新日期:1990-01-01 00:00:00
abstract:OBJECTIVES:The PI3K/AKT/mTOR pathway is frequently overactivated in endometrial cancer (EC). We assessed the efficacy of ABTL0812, a novel first-in-class molecule presenting a unique mechanism of action inhibiting this pathway. METHODS:We investigated the effects of ABTL0812 on proliferation, cell death and modulation...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2019.03.002
更新日期:2019-05-01 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:OBJECTIVE:To evaluate the effect of margin status and radiation dose in patients treated with radiation therapy (RT) for vulvar cancer. Clinical outcomes included vulvar recurrence (VR), relapse-free survival (RFS) and overall survival (OS). METHODS:We retrospectively reviewed the records of 300 patients with Stage I-...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2013.05.036
更新日期:2013-09-01 00:00:00
abstract::A 75-year-old Japanese woman, who had an enlarged uterus and two nodules on the anterior vaginal wall, underwent wide excision of the anterior vaginal wall, bilateral inguinal lymphadenectomy, modified radical hysterectomy, and pelvic lymph node dissection. Her serum level of 5-S-cysteinyldopa (5-S-CD) was elevated, b...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1998.5176
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:Epithelioid sarcoma is a soft tissue tumor rarely found centrally and even less commonly on the vulva. Vulvar sarcoma in pregnancy is also exceedingly rare with only five cases reported to date, none of which have been an epithelioid sarcoma. CASE:We report a case of a 29-year-old woman presenting with a vu...
journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1006/gyno.2002.6610
更新日期:2002-04-01 00:00:00
abstract::In a prospective study, the serum levels of CA 125 were estimated at regular intervals in 139 patients with ovarian carcinoma. Seventy-two of 78 patients with a second-look laparotomy had elevated CA 125 levels initially. The main aim of our investigation was the correlation of CA 125 levels with the histological find...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(89)90008-5
更新日期:1989-10-01 00:00:00
abstract:OBJECTIVES:The objectives of this phase II trial were to assess the activity and tolerability of the combination of bevacizumab and erlotinib in patients with recurrent ovarian, primary peritoneal or fallopian tube cancer. METHODS:This was a single arm, multicenter phase II trial with overall objective response as the...
journal_title:Gynecologic oncology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ygyno.2008.02.009
更新日期:2008-07-01 00:00:00
abstract::Myometrial invasion greater than 33% negatively affects the prognosis of endometrial carcinoma. Since the endometrium is readily differentiated from myometrium via high-resolution transvaginal sonography (TVS), this prospective study was undertaken to evaluate the efficacy of TVS in determining the depth of myometrial...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(91)90023-x
更新日期:1991-12-01 00:00:00
abstract:OBJECTIVE:Although there have been studies that focused on the correlation between the HPV presence of pelvic lymph nodes and pathological metastasis in patients with cervical cancer, the biologic role of HPV DNA in lymph nodes still remains uncertain. We performed this study to investigate the correlation between the ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2006.12.016
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVE:Patients with advanced epithelial ovarian cancer treated with salvage therapy using new combinations of systemic chemotherapy, radiation therapy, and systemic immunotherapy have had limited success. Since the most common site of relapse or failure to conventional systemic chemotherapy has been the peritoneal ...
journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章
doi:10.1006/gyno.1998.5206
更新日期:1998-12-01 00:00:00
abstract:OBJECTIVE:The present study was undertaken to analyze the impact of epigenetic alterations with a main focus on nuclear area, aneuploidy, hyperploidy, and proliferation in 70 ovarian cancer specimens. METHODS:Morphometric changes and somatic chromosomal ploidy status were assessed by Feulgen spectrophotometry. DNA-hyp...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2010.12.332
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:According to current treatment guidelines, comprehensive surgical staging procedures in endometrial cancer confined to the uterus depend on uterine risk factors: a systematic lymph node dissection (LND) is recommended in high risk patients and should be omitted in low risk patients. Its role in intermediate ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2019.04.002
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVE:Our aim was to evaluate the feasibility of a novel technique using single-port laparoscopy for the complete surgical staging of endometrial cancer. METHODS:Total hysterectomy, bilateral salpingo-oophorectomy, pelvic lymphadenectomy and para-aortic lymphadenectomy was performed using a single-port device in t...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2015.12.014
更新日期:2016-02-01 00:00:00
abstract::This study evaluated the effect ovarian weight has on the accuracy of frozen sections in serous and mucinous ovarian tumors. The study group included 294 patients who had an initial frozen section (189 serous and 105 mucinous tumors) at surgery. The pathology reports were separated into subgroups (benign, borderline, ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1997.4836
更新日期:1997-10-01 00:00:00
abstract::A study was undertaken to determine the potential value of involucrin immunostaining, a protein synthesized by mature squamous epithelial cells, in distinguishing benign from neoplastic lesions in cervical pathology. A total of 146 cervical biopsies were analyzed using an indirect immunoperoxidase method and polyclona...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(90)90105-t
更新日期:1990-01-01 00:00:00
abstract:OBJECTIVE:Cisplatin-based combination therapy produces higher response rates and improved survival, in comparison to single-agent cisplatin in the treatment of cervical cancer. Cisplatin and paclitaxel (PT) requires a prolonged infusion and is less convenient and more toxic than the combination of carboplatin and pacli...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2006.12.031
更新日期:2007-05-01 00:00:00
abstract::The role of adjuvant chemotherapy in surgically staged stage I clear cell ovarian cancer (OCCC) is unclear. Here, we performed a systematic review and meta-analysis in order to evaluate the role of chemotherapy vs. observation in stage I OCCC. This systematic review was registered in the International Prospective Regi...
journal_title:Gynecologic oncology
pub_type: 杂志文章,meta分析
doi:10.1016/j.ygyno.2019.12.045
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVES:While there are many psychosocial interventions for cancer patients, few are brief in nature. The aim of this study was to investigate the usefulness of a single-visit psychosocial intervention for gynecologic cancer patients. METHODS:One hundred women attending a gynecologic cancer clinic as new patients w...
journal_title:Gynecologic oncology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ygyno.2008.06.024
更新日期:2008-10-01 00:00:00