Abstract:
OBJECTIVES:The aim of the study is to determine whether critical pathways can be implemented at an academic institution to limit cost, without compromising patient satisfaction and quality of care. PATIENTS AND METHODS:Patients undergoing a hysterectomy with either cervical or endometrial cancer were placed on specific critical pathways consecutively for an 18-month study period. Preoperative teaching was intensified to educate the patient regarding expectations during the postoperative period. All patients were started on early feeding and patients were also placed on separate care pathways addressing pain and deep vein thrombosis prophylaxis. Total direct costs and patient satisfaction were obtained throughout the study period. During the year prior to care pathway implementation, patient data and direct costs were obtained for the preintervention group utilized for comparison. Postintervention groups were summarized every 6 months during the study period. RESULTS:From January 1997 through June 1998, 63 patients with cervical carcinoma undergoing a radical hysterectomy (DRG 353) and 21 patients with endometrial cancer who underwent a hysterectomy and lymph node sampling (DRG 355) were utilized as the preintervention group. During the 18-month study period (July 1998-December 1999), 42 patients (DRG 353) and 25 patients (DRG 355) were accrued. The average length of stay was reduced from 5.2 (DRG 353) and 4.7 days (DRG 355) prior to implementation of pathways to 3.4 days in both groups. In addition, total direct costs were reduced by 29 (DRG 353) and 32% (DRG 355) after implementation of care pathways. Patient satisfaction data recorded during the study did not demonstrate any change throughout the study period nor were there any higher rates of readmission after implementation of the care pathways. CONCLUSIONS:Critical pathways in gynecologic oncology can be implemented in a managed care environment in order to maintain high quality of care, maintain outcomes, and help reduce costs.
journal_name
Gynecol Oncoljournal_title
Gynecologic oncologyauthors
Ghosh K,Downs LS,Padilla LA,Murray KP,Twiggs LB,Letourneau CM,Carson LFdoi
10.1006/gyno.2001.6428subject
Has Abstractpub_date
2001-11-01 00:00:00pages
378-82issue
2eissn
0090-8258issn
1095-6859pii
S0090-8258(01)96428-5journal_volume
83pub_type
杂志文章abstract:BACKGROUND:Survivorship and quality of life issues are becoming increasingly relevant in endometrial cancer as a result of the marked increase in incidence of the disease combined with excellent and improving long term survival. OBJECTIVE:The purpose of this study was to evaluate the effect of obesity on quality of li...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2013.11.018
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVE:To determine if preoperative metabolic tumor volume (MTV) measured by integrated (18)F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (FDG-PET/CT) imaging has prognostic value in patients with cervical cancer treated primarily with radical hysterectomy. METHODS:Patients with FIGO s...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2010.11.002
更新日期:2011-02-01 00:00:00
abstract::Previous herpes simplex virus type 2 (HSV-2) infections are known to predispose women for the development of cervical cancer, but causal relationship between the virus and the cancer has never been proven. Forty-six patients with cervical carcinoma (13 with preinvasive lesions and 33 with various stages of invasive di...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(84)90047-7
更新日期:1984-07-01 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::Twenty-five patients underwent adjunctive extrafascial hysterectomy 14-60 days following completion of external and intracavitary irradiation for bulky carcinoma of the uterine cervix. Review of the operative histopathology and correlation with subsequent patient outcomes suggests that morphologically persistent cance...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(87)90217-4
更新日期:1987-10-01 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:The aim of this retrospective multicenter study was to assess whether the pre-chemotherapy hemoglobin levels have any impact on the clinical outcome of patients with advanced epithelial ovarian cancer who received a first-line taxane/platinum-based regimen. METHODS:The study was conducted on 315 patients who...
journal_title:Gynecologic oncology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ygyno.2005.04.012
更新日期:2005-07-01 00:00:00
abstract:OBJECTIVE:Reduced Selenium-Binding Protein 1 (SELENBP1) expression was recently shown in multiple cancers. There is little information on the expression and function of SELENBP1 in cancer progression. In order to develop a better understanding of the role of SELENBP1 in ovarian cancer, our objective was to determine if...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2007.12.030
更新日期:2008-04-01 00:00:00
abstract::We present the largest multicenter study evaluating whether intraoperative visual estimation can accurately assess the depth of myometrial invasion in patients with endometrial cancer. The study population consisted of 403 consecutive women who underwent total hysterectomy for endometrial cancer. After the uterus was ...
journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1006/gyno.1999.5694
更新日期:2000-03-01 00:00:00
abstract:OBJECTIVE:To evaluate safety, tolerability, and antitumor activity of pembrolizumab monotherapy in patients with programmed death ligand 1 (PD-L1)-expressing advanced ovarian cancer enrolled in the multicohort, phase Ib KEYNOTE-028 trial. METHODS:Key inclusion criteria were age ≥18 years; advanced ovarian epithelial, ...
journal_title:Gynecologic oncology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ygyno.2018.11.017
更新日期:2019-02-01 00:00:00
abstract:PURPOSE:Caregiver burden, quality of life (QOL) and unmet needs are poorly understood, particularly at the end of life. We explored these issues in caregivers of women with ovarian cancer. PATIENTS AND METHODS:The Australian Ovarian Cancer Study (AOCS) is a prospective population-based study of women newly diagnosed w...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2014.01.002
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVE:To determine the incidence of parametrial involvement in a select group of patients with early cervical cancer. METHODS:We retrospectively reviewed the records of patients with cervical cancer and a maximum tumor diameter of 2 cm, infiltration depth<10 mm and negative pelvic lymph nodes who underwent a radic...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2007.01.016
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVES:We assessed neoadjuvant intraarterial chemotherapy (NAC) followed by radical hysterectomy and/or radiotherapy in patients with locally advanced cervical cancer. METHODS:Over 5 years, 48 consecutive women with International Federation of Gynecology and Obstetrics stage IIb-IVa cervical cancer were enrolled. ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1998.4976
更新日期:1998-05-01 00:00:00
abstract:OBJECTIVE:Debate continues about optimal management of patients with node-positive stage I cervical cancer. Our objective was to determine if patient outcomes are affected by radical hysterectomy in the modern era of adjuvant chemoradiation. METHODS:Cervical cancer patients diagnosed from 2000 to 2008 were identified....
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2012.03.046
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVE:To evaluate c-erbB2 gene amplification in a series of primary uterine serous carcinoma (USC) cell lines. To assess the efficacy of AZD8055, a novel dual mTORC1/2 inhibitor against primary HER2/neu amplified vs HER2/neu not amplified USC cell lines. METHODS:Twenty-two primary USC cell lines were evaluated for...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2013.08.033
更新日期:2013-12-01 00:00:00
abstract::Open biopsy of the left scalene lymph nodes has been utilized to identify distant spread of cervical carcinoma in selected groups of patients who do not have other clinical evidence of disseminated disease. Twenty-one patients with primary cervical carcinoma and histologically proven para-aortic lymph node metastases ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(87)90178-8
更新日期:1987-11-01 00:00:00
abstract:OBJECTIVE:Receptors for estrogen (ER), progesterone (PR), or androgen (AR) are predictive and prognostic markers of malignancy of multiple endocrine organs, including endometrial and breast cancer. However, the role of ERs, PRs, or ARs in the carcinogenesis of ovarian cancer, another sex hormone-dependent malignancy, i...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2004.11.010
更新日期:2005-03-01 00:00:00
abstract::Forty-two patients with malignant, mixed mesodermal tumors of the uterus were identified by retrospective chart review. Only 2 patients were premenopausal at the time of diagnosis. Six of the patients had previously received pelvic radiotherapy. Surgical/pathologic findings were inconsistent with clinical staging in 1...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/s0090-8258(89)80041-1
更新日期:1989-02-01 00:00:00
abstract::In epithelial ovarian cancer, solitary metastasis to and recurrences in the parenchyma of the spleen are rare in the absence of apparent disease in other sites. We report four patients who developed isolated, solitary splenic parenchymal recurrences of their epithelial ovarian adenocarcinomas and underwent a splenecto...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1993.1059
更新日期:1993-03-01 00:00:00
abstract::Radical vulvectomy using warm-knife and open-wound techniques was performed as the first step in a two-phase surgical approach in 274 patients with malignant vulvar tumors. Crude 5-year survival was registered in 133/223 (60%) patients. The complication rate was low and the hospitalization period was short (mean 16 da...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(84)90056-8
更新日期:1984-01-01 00:00:00
abstract:BACKGROUND:The friable and hypervascular nature of a metastatic invasive mole places the patient at risk for significant hemorrhage. Bleeding is the chief cause of morbidity and mortality in patients with a histopathological diagnosis of invasive mole. Bleeding from vaginal metastatic lesions can be controlled by packi...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1996.0171
更新日期:1996-06-01 00:00:00
abstract:OBJECTIVE:Neuropilin-1 (NRP-1) is a receptor for both semaphorin and vascular endothelial growth factor and is up-regulated in a variety of human cancers. While there are some reports of NRP-1 expression in ovarian neoplasm, those results differ in pattern of its expression and its role in ovarian cancer is still uncle...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2007.02.005
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVES:To evaluate the role of LPA in regulating E-cadherin cell surface expression, adhesion, and invasion in epithelial ovarian carcinoma (EOC) cells. METHODS:E-cadherin mRNA expression in OVCA429 and IOSE-29 cells was evaluated by real-time RT-PCR. Immunofluorescence and Western blot analysis were performed to ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2007.10.027
更新日期:2008-02-01 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:PURPOSE:The MDS1 and EVI1 complex locus (MECOM) at 3q26 gives rise to several alternatively spliced transcripts implicated in leukemic oncogenesis. Overexpression of EVI1 in ovarian cancer has led to a proposed oncogenic role. Our objective was to evaluate the therapeutic potential of EVI1 and EVI1s (also known as Delt...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2010.04.007
更新日期:2010-08-01 00:00:00
abstract::A comprehensive understanding of retroperitoneal lymphatic involvement is lacking in tumors of low malignant potential. This study was undertaken to evaluate retroperitoneal lymphatic involvement in patients with ovarian tumors of low malignant potential. One hundred seventy-one patients were diagnosed with epithelial...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(91)90331-x
更新日期:1991-08-01 00:00:00
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 datab...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.2002.6616
更新日期:2002-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the value of the combination of p16 and HPV detection in the screening for cervical cancer. METHODS:186 patients with previous abnormal cervical lesion were studied. After colposcopic examination, two conventional Pap slides were prepared: the first was Papanicolaou-stained and examined by cytolo...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2006.01.033
更新日期:2006-10-01 00:00:00
abstract::Forty-eight cases subjected to radioimmunoimaging (RII) by intraperitoneal injection with 131I-C0C183B2 monoclonal antibody (MAb) prepared in our laboratory were studied. Thirteen of 14 cases of proved primary ovarian carcinoma were positive. In 11 follow-up cases of ovarian carcinoma after initial surgery and chemoth...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(92)90109-v
更新日期:1992-11-01 00:00:00
abstract:OBJECTIVE:To identify patients with endometrial cancer at risk for hematogenous, lymphatic, or peritoneal recurrence (or combinations of them) who might potentially benefit from target-based therapies. METHODS:During a 13-year period, 915 patients had endometrial cancer managed with hysterectomy and standard adjuvant ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2004.06.042
更新日期:2004-10-01 00:00:00