Amandeep Mann

Trends in the incidence of serous fallopian tube, ovarian, and peritoneal cancer in the US

OBJECTIVEnTo identify the trends in incidence of serous fallopian tube, ovarian, and peritoneal epithelial cancers in the United States.nnnMETHODSnData was obtained from United States Cancer Statistics (USCS) from 2001 to 2014. All incidences are per 100,000 women. Analyses were performed using SEER*Stat and Joinpoint regression programs.nnnRESULTSnOf the 146,470 patients with serous cancers, 9381 (6.4%) were fallopian tube, 121,418 (82.9%) were ovarian, and 15,671 (10.7%) were primary peritoneal. The study period was divided from 2001 to 2005, 2006-2010, and 2011-2014, and there was an increase in fallopian tube incidence from 0.19 to 0.35 to 0.63, with a corresponding decrease in ovarian incidence from 5.31 to 5.08 to 4.86. There was no significant change in peritoneal cancers from 0.64 to 0.69 to 0.62. The age-specific peak incidence of fallopian tube cancer was younger at age 70-74, compared to ovarian and peritoneal cancer at age 75-79. Further, the incidence of serous fallopian tube cancer was highest in Whites at 0.42, compared to Blacks at 0.24, Hispanics at 0.27, and Asians at 0.28.nnnCONCLUSIONnFrom 2001 to 2014, the diagnosis of serous fallopian tube cancer increased fourfold with a corresponding decrease in ovarian cancer. The peak incidence of tubal cancer was 70-74years with an increased incidence in Whites.

Metastatic gynecologic malignancies: advances in treatment and management

Gynecologic cancers comprise of mostly uterine, ovarian, and cervical malignancies and are responsible for 95,000 new cases annually in the United States. Uterine cancer is the most common and the number of new cases and mortality has been increasing. Cervical cancer has decreased due to screening, early detection, and treatment of pre-invasive cancers. However, ovarian cancer remains the most lethal because of advanced stage at diagnosis and drug resistance. The metastatic spread pattern differs amongst these cancers, with uterine and cervical cancer found mostly in the primary organ and ovarian cancer disseminating throughout the peritoneum and upper abdomen at presentation. The primary treatment of ovarian cancer typically involves surgery followed by systemic therapy for more advanced disease. Previously, systemic chemotherapy with platinums, taxanes, doxorubicin, topotecan, and gemcitabine has been the standard in either upfront or recurrent setting. With molecular and genetic breakthroughs, we now have over eight new indications and five novel biologic therapies including antiangiogenics, poly ADP ribose polymerase inhibitors, and immunotherapies approved over the last 3xa0years. In this review, we will examine the biology of gynecologic cancer metastasis and focus on new treatment options for these cancers with a focus on ovarian cancer.

Hospital-acquired conditions after surgery for gynecologic cancer — An analysis of 82,304 patients

OBJECTIVEnTo evaluate the hospital-acquired condition (HAC) following oophorectomy and/or hysterectomy for gynecologic cancer patients based on clinical outcomes and costs.nnnMATERIALS AND METHODSnData were obtained from the Nationwide Inpatient Sample from 2005 to 2011. Chi-squared and Wilcoxon rank sum two-sample tests and multivariate logistic regression model were used for statistical analysis.nnnRESULTSnOf 82,304 women (median age: 60u202fyears, range: 1-101), 49,386 (60.0%) had endometrial, 23,510 (28.6%) had ovarian, and 9408 (11.4%) had cervical cancers. Of 135 HAC events, these involved catheter-associated urinary tract infections (nu202f=u202f47), vascular catheter-associated infection (nu202f=u202f41), foreign object retained after surgery (nu202f=u202f19), pressure ulcers (nu202f=u202f16), manifestation of poor glycemic control (nu202f=u202f10), and air embolism (nu202f=u202f2). Older patients (≥60u202fyears) experienced more HACs relative to younger (0.23% vs. 0.09%; ORu202f=u202f2.13, 95% CI: 1.30-3.50; pu202f=u202f0.003), and patients with Medicaid experienced more HACs compared to those with private insurance (0.35% vs. 0.10%; ORu202f=u202f3.09, 95% CI: 1.70-5.62; pu202f<u202f0.001). Laparoscopic surgeries were associated with less HACs compared to open surgeries (0.05% vs. 0.19%; ORu202f=u202f0.41, 95% CI: 0.19-0.90; pu202f=u202f0.03). Length of hospitalization and hospital charges were greater for those with HACs, (12u202fdays vs. 3u202fdays; pu202f<u202f0.001;

Progress in record numbers of approved therapies for gynecologic cancers: The lack of upfront approval for newly diagnosed cases.

89,324 vs.

Socioeconomic disparities in inflammatory response on cancer mortality using national health and nutrition examination survey.

31,107; pu202f<u202f0.001), respectively.nnnCONCLUSIONnThe odds of hospital-acquired conditions were higher in older patients, open surgery, Medicaid insured with higher associated hospital charges.