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Zhang L, Cheung AT, Chen Y, Chow KM. Effects of Cancer Rehabilitation Interventions for Women Treated for Gynaecological Cancers: A Meta-Analysis of Randomised Controlled Trials. J Clin Nurs 2025; 34:1931-1947. [PMID: 39871663 PMCID: PMC12037937 DOI: 10.1111/jocn.17673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 07/22/2024] [Accepted: 01/13/2025] [Indexed: 01/29/2025]
Abstract
AIM To analyse and synthesise current evidence on the effectiveness of cancer rehabilitation interventions in increasing physical activity, increasing healthy dietary habits, alleviating psychological distress, and increasing health-related quality of life (HRQoL) in women treated for gynaecological cancers (GCs). DESIGN A meta-analysis of randomised controlled trials (RCTs). DATA SOURCES A systematic search was conducted in 12 databases from inception to 31 May 2024. REVIEW METHODS The quantitative results from comparable RCTs were pooled and meta-analysed using Review Manager 5.4 software. The results from non-comparable (i.e., clinically heterogeneous) RCTs were narratively summarised. The methodological quality of all RCTs was assessed using Version 2 of the Cochrane risk of bias tool for randomised trials. RESULTS Nine RCTs reported in a total of 12 articles met the inclusion criteria and comprised a total of 418 patients. The interventions had significant effects on total physical activity levels at post-intervention, 6-month follow-up, and 12-month follow-up, and on self-efficacy in physical activity at post-intervention and 3-month follow-up. However, the interventions did not significantly improve overall HRQoL or healthy dietary habits and did not significantly alleviate anxiety and depression. The key intervention components were information provision on health-promoting behaviours; adoption of behavioural change techniques (goal setting, action planning, relapse prevention, problem-solving, self-monitoring, and social support); and stress and emotion management. CONCLUSION Rehabilitation interventions effectively increase physical activity in women treated for GCs, leading to sustainable effects. However, there is limited evidence on the effectiveness of such interventions in improving overall HRQoL, encouraging healthy eating, and alleviating psychological distress in women treated for GCs. RELEVANCE TO CLINICAL PRACTICE This review found that rehabilitation interventions can increase physical activity levels among women treated for GCs. It also identified the key effective components of such interventions. REPORTING METHOD This review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. PATIENT OR PUBLIC CONTRIBUTION None. TRIAL REGISTRATION International Prospective Register of Systematic Reviews registration number: CRD42023442877.
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Affiliation(s)
- Liuxin Zhang
- The Nethersole School of Nursing, Faculty of MedicineThe Chinese University of Hong KongHong KongChina
| | - Ankie Tan Cheung
- The Nethersole School of Nursing, Faculty of MedicineThe Chinese University of Hong KongHong KongChina
| | - Yongfeng Chen
- The Nethersole School of Nursing, Faculty of MedicineThe Chinese University of Hong KongHong KongChina
| | - Ka Ming Chow
- The Nethersole School of Nursing, Faculty of MedicineThe Chinese University of Hong KongHong KongChina
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Chen J, Guan S, Jiang C, Yang Z, Guo Z, Zhang H, Huang Y, Li M, Yan J. Illness Perception and Risk Management Behaviors Among Patients With Gynecologic Cancer at Risk of Lower Extremity Lymphedema. Cancer Nurs 2024:00002820-990000000-00325. [PMID: 39688391 DOI: 10.1097/ncc.0000000000001425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2024]
Abstract
BACKGROUND Patients with gynecologic cancer who undergo lymphadenectomy are at increased risk of lower extremity lymphedema (LEL). They are encouraged to be alert to the possibility of LEL and take risk-management measures throughout life. However, we know little about the perception for LEL and adherence to risk-management measures of Chinese patients with gynecologic cancer. OBJECTIVE To assess the illness perception and risk management behaviors of Chinese gynecologic cancer patients and further examine the effect of illness perception on risk management behaviors. METHODS This was a cross-sectional study. From June to December 2023, gynecologic cancer patients at risk of LEL were surveyed (n = 223). Questionnaires on illness perception and risk management behaviors specifically for LEL were utilized. Descriptive statistics, Pearson correlation analysis, univariate analysis, and multiple linear regression analysis were used for data analysis. RESULTS The participants exhibited suboptimal LEL risk management behaviors, with the physical activity dimension receiving the lowest score (3.24 ± 1.02). Patients' self-perceived understanding of LEL was relatively low (2.88 ± 0.83). Multiple linear regression analysis revealed that the identity, cause, and control dimensions of illness perception, as well as several demographic and disease variables, were significant predictors of patients' LEL risk management behaviors. CONCLUSIONS The LEL risk management behaviors of patients with gynecologic cancer need to be improved. Consideration of perceptions of identity, cause, and control is crucial for enhancing LEL risk management behaviors. IMPLICATIONS FOR PRACTICE Health professionals can implement targeted health education based on an assessment of patients' perceptions of LEL, thereby promoting lymphedema risk management.
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Affiliation(s)
- Jing Chen
- Author Affiliations: School of Nursing, Sun Yat-Sen University (Mss Chen, Guan, Yang, Guo, Huang, and Li and Dr Yan); Department of Gynecologic Oncology, Sun Yat-Sen University Cancer Center (Ms Jiang); and Department of Gynecology, The Third Affiliated Hospital, Sun Yat-Sen University (Ms Zhang), Guangzhou, Guangdong Province, People's Republic of China
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Taylor A, Clement K, Hillard T, Sassarini J, Ratnavelu N, Baker-Rand H, Bowen R, Davies MC, Edey K, Fernandes A, Ghaem-Maghami S, Gomes N, Gray S, Hughes E, Hudson A, Manchanda R, Manley K, Nicum S, Phillips A, Richardson A, Morrison J. British Gynaecological Cancer Society and British Menopause Society guidelines: Management of menopausal symptoms following treatment of gynaecological cancer. Post Reprod Health 2024; 30:256-279. [PMID: 39394654 DOI: 10.1177/20533691241286666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2024]
Abstract
These guidelines have been developed jointly by the British Gynaecological Cancer Society and British Menopause Society to provide information for all healthcare professionals managing women treated for gynaecological cancer. Menopausal symptoms can have a significant impact on quality of life for women. Cancer therapies, including surgery, pelvic radiotherapy, chemotherapy and endocrine therapy, can all affect ovarian function. The benefits and risks of using hormone replacement therapy are considered by cancer type with guidance on the type of HRT and optimal time of commencement after cancer treatment. Vaginal estrogens can be very effective for improving urogenital symptoms and are safe for the majority of women, including those for whom systemic HRT is contraindicated with rare exceptions. Alternative options to HRT are reviewed including pharmacological and non-pharmacological approaches.
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Affiliation(s)
- Alexandra Taylor
- Department of Gynaecology Oncology, The Royal Marsden Hospital NHS Trust, London, UK
- The Institute of Cancer Research, London, UK
| | - Kathryn Clement
- Department of Gynaecology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Timothy Hillard
- Department of Gynaecology, University Hospitals Dorset NHS Foundation Trust, Poole, UK
| | - Jenifer Sassarini
- Department of Obstetrics and Gynaecology, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Nithya Ratnavelu
- Northern Gynaecological Oncology Centre, Gateshead Health NHS Foundation Trust, Gateshead, UK
| | - Holly Baker-Rand
- Department of Gynaecological Oncology, Grace Centre, Musgrove Park Hospital, Taunton, UK
| | - Rebecca Bowen
- Department of Oncology, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
- University of Bath, Bath, UK
| | - Melanie C Davies
- Reproductive Medicine Unit, University College London Hospitals NHS Foundation Trust, London, UK
| | - Katherine Edey
- Department of Gynaecological Oncology, Royal Devon University NHS Foundation Trust, Exeter, UK
| | - Andreia Fernandes
- Department of Gynaecology Oncology, The Royal Marsden Hospital NHS Trust, London, UK
| | - Sadaf Ghaem-Maghami
- Department of Surgery and Cancer, Imperial College, London University, London, UK
| | - Nana Gomes
- Department of Gynaecology Oncology, The Royal Marsden Hospital NHS Trust, London, UK
| | | | | | | | - Ranjit Manchanda
- Wolfson Institute of Population Health, Queen Mary University of London, London, UK
- Department of Gynaecological Oncology, Barts Health NHS Trust, London, UK
| | - Kristyn Manley
- Department of Gynaecology, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Shibani Nicum
- Department of Medical Oncology, University College Hospital, London, UK
- University College London, London, UK
| | - Andrew Phillips
- Derby Gynaecological Cancer Centre, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Alison Richardson
- Derby Gynaecological Cancer Centre, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Jo Morrison
- Department of Gynaecological Oncology, Grace Centre, Musgrove Park Hospital, Taunton, UK
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
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4
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Asakitogum DA, Nutor JJ, Hammer MJ, Pozzar R, Paul SM, Cooper BA, Conley YP, Levine J, Miaskowski C. Decrements in Morning and Evening Energy Are Associated With a Higher Symptom Burden in Patients With Gynecologic Cancers Receiving Chemotherapy. Cancer Nurs 2024:00002820-990000000-00299. [PMID: 39485897 DOI: 10.1097/ncc.0000000000001420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2024]
Abstract
BACKGROUND Decrements in energy are a significant problem associated with chemotherapy. To date, no study examined the variability of energy in patients with gynecologic cancers. OBJECTIVE To identify distinct morning and evening energy profiles in patients with gynecologic cancers and evaluate for differences in demographic and clinical characteristics, other common symptoms, and quality-of-life (QOL) outcomes. METHODS A sample of 232 patients with gynecologic cancers completed questionnaires 6 times over 2 cycles of chemotherapy. Latent profile analysis was used to identify distinct morning and evening energy profiles. Differences in demographic and clinical characteristics, other common symptoms, and QOL outcomes were evaluated using parametric and nonparametric tests. RESULTS Three distinct morning (ie, high [9.2%], low [63.1%], very low [27.1%]) and 2 distinct evening (moderate [30.6%], very low [69.4%]) energy classes were identified. Clinical risk factors associated with the worst morning energy profiles included lower functional status and a higher comorbidity burden. Less likely to exercise on a regular basis was the only characteristic associated with the worst evening energy profile. For both symptoms, the worst profiles were associated with higher levels of depression and sleep disturbance, lower levels of cognitive function, and poorer QOL. CONCLUSIONS Approximately 70% of patients with gynecologic cancers experienced decrements in morning and evening energy. The study identified modifiable risk factors associated with more decrements in morning and evening energy. IMPLICATIONS FOR PRACTICE Clinicians can use these findings to identify higher-risk patients and develop individualized energy conservation interventions for these vulnerable patients.
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Affiliation(s)
- David Ayangba Asakitogum
- Author Affiliations: School of Nursing, University of California, San Francisco (Mr Asakitogum and Drs Nutor, Paul, Cooper, and Miaskowski); Dana Farber Cancer Institute, Boston, Massachusetts (Drs Hammer and Pozzar); School of Nursing, University of Pittsburgh, Pennsylvania (Dr Conley); School of Medicine, University of California, San Francisco (Drs Levine and Miaskowski)
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5
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Li M, Li J, Tang Q, Zhu Y. Potential antitumor activity of triptolide and its derivatives: Focused on gynecological and breast cancers. Biomed Pharmacother 2024; 180:117581. [PMID: 39427548 DOI: 10.1016/j.biopha.2024.117581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2024] [Revised: 10/01/2024] [Accepted: 10/14/2024] [Indexed: 10/22/2024] Open
Abstract
Cancer remains one of the greatest global health concerns. This is especially true for gynecological cancers, which include cervical, ovarian, and endometrial cancers, and breast cancer. Natural products used for cancer treatment offer some unique advantages. Triptolide (TPL) is a biologically active terpenoid extracted from Tripterygium wilfordii, which exhibits anti-inflammatory, immunosuppressive, antitumor, and other pharmacological activities. However, clinical applications of TPL are restricted because of poor water solubility and severe cytotoxicity; to overcome these limitations, various TPL derivatives and drug delivery systems, especially nanocarriers, have been used. Furthermore, various preclinical and clinical studies have demonstrated that TPL and its derivatives exhibit excellent antitumor effects by targeting proteins involved in multiple signaling pathways. Here, we review the progress regarding novel drug delivery systems, antitumor activities, and molecular mechanisms of action of TPL and its derivatives against gynecological and breast cancers. TPL and its derivatives inhibit tumor growth, suppress tumor metastasis, and enhance the drug sensitization of resistant cancers. In addition, TPL and its derivatives exert synergistic antitumor effects against gynecological and breast cancers when combined with existing antitumor drugs, such as carboplatin, cisplatin, and PI3K inhibitors. Moreover, we highlight the clinical potential of TPL analogs against cancer from bench to bedside and their prospects for future applications in gynecologic and breast cancers.
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Affiliation(s)
- Mengjie Li
- College of Pharmacy, Qinghai University for Nationalities, Xining, China; Department of Pharmacy, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Jiamiao Li
- Department of Pharmacy, The Affilliated Chengdu 363 Hospital of Southwest Medical University, Chengdu, China
| | - Qing Tang
- Department of Pharmacy, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Yongxia Zhu
- Department of Pharmacy, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China.
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Ray-Coquard I, Casali PG, Croce S, Fennessy FM, Fischerova D, Jones R, Sanfilippo R, Zapardiel I, Amant F, Blay JY, Martἰn-Broto J, Casado A, Chiang S, Dei Tos AP, Haas R, Hensley ML, Hohenberger P, Kim JW, Kim SI, Meydanli MM, Pautier P, Abdul Razak AR, Sehouli J, van Houdt W, Planchamp F, Friedlander M. ESGO/EURACAN/GCIG guidelines for the management of patients with uterine sarcomas. Int J Gynecol Cancer 2024; 34:1499-1521. [PMID: 39322612 DOI: 10.1136/ijgc-2024-005823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2024] Open
Affiliation(s)
- Isabelle Ray-Coquard
- Department of Medical Oncology, Centre Leon Berard, Lyon, France
- Hesper Laboratory, Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Paolo Giovanni Casali
- Medical Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
- Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - Sabrina Croce
- Department of Biopathology, Institut Bergonié, Bordeaux, France
| | - Fiona M Fennessy
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Daniela Fischerova
- Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague 2, Czech Republic
| | - Robin Jones
- Royal Marsden Hospital NHS Trust, London, UK
| | - Roberta Sanfilippo
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Ignacio Zapardiel
- Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain
| | - Frédéric Amant
- Department of Oncology, KU Leuven, Leuven, Flanders, Belgium
- Department of Gynecology, Antoni van Leeuwenhoek Nederlands Kanker Instituut afdeling Gynaecologie, Amsterdam, Netherlands
| | - Jean-Yves Blay
- Department of Medical Oncology, Centre Leon Berard, Lyon, France
| | - Javier Martἰn-Broto
- Department of Medical Oncology, Fundación Jimenez Diaz University Hospital, Madrid, Spain
- University Hospital General de Villalba, Madrid, Spain
| | - Antonio Casado
- Department of Medical Oncology, University Hospital San Carlos, Madrid, Spain
| | - Sarah Chiang
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Angelo Paolo Dei Tos
- Department of Integrated Diagnostics, Azienda Ospedale-Università Padova, Padua, Italy
- Department of Medicine, University of Padua, Padua, Italy
| | - Rick Haas
- Department of Radiotherapy, Netherlands Cancer Institute, Amsterdam, Netherlands
- Department of Radiotherapy, Leiden University Medical Center, Leiden, Netherlands
| | - Martee L Hensley
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Peter Hohenberger
- Division of Surgical Oncology and Thoracic Surgery, Mannheim University Medical Centre, University of Heidelberg, Mannheim, Germany
| | - Jae-Weon Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
| | - Se Ik Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
| | | | - Patricia Pautier
- Department of Medical Oncology, Institut Gustave-Roussy, Villejuif, Île-de-France, France
| | - Albiruni R Abdul Razak
- Division of Medical Oncology and Hematology, Princess Margaret Hospital Cancer Centre Gynecologic Site Group, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jalid Sehouli
- Department of Gynecology with Center for Oncological Surgery, Charite Universitatsmedizin Berlin, Berlin, Germany
| | - Winan van Houdt
- Department of Surgery, Netherlands Cancer Institute, Amsterdam, Netherlands
| | | | - Michael Friedlander
- Department of Medical Oncology, School of Clinical Medicine, Faculty of Medicine and Health, Sydney, New South Wales, Australia
- Department of Medical Oncology, Prince of Wales and Royal Hospital for Women, Randwick, New South Wales, Australia
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7
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Woopen H, Keller M, Zocholl D, Mittelstadt S, Barretina-Ginesta MP, Heinzelmann-Schwarz V, Lafleur J, Kocián R, Baum J, Krabisch P, Achimas-Cadariu P, Vardar MA, Vergote I, Nasser S, Link T, Gil-Martin M, Zwimpfer TA, Leitner K, Jedryka M, Boxler T, Braicu EI, Sehouli J. Side Effects from Cancer Therapies and Perspective of 1044 Long-Term Ovarian Cancer Survivors-Results of Expression VI-Carolin Meets HANNA-Holistic Analysis of Long-Term Survival with Ovarian Cancer: The International NOGGO, ENGOT, and GCIG Survey. Cancers (Basel) 2023; 15:5428. [PMID: 38001688 PMCID: PMC10670049 DOI: 10.3390/cancers15225428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
The aim of this survey was to increase the knowledge on the characteristics and health concerns of long-term survivors (LTS; survival > 5 years) after ovarian cancer in order to tailor follow-up care. This international survey was initiated by the NOGGO and was made available to members of ENGOT and GCIG. The survey is anonymous and consists of 68 questions regarding sociodemographic, medical (cancer) history, health concerns including distress, long-term side effects, and lifestyle. For this analysis, 1044 LTS from 14 countries were recruited. In total, 58% were diagnosed with FIGO stage III/IV ovarian cancer and 43.4% developed recurrent disease, while 26.0% were receiving cancer treatment at the time of filling in the survey. LTS who survived 5-10 years self-estimated their health status as being significantly worse than LTS who survived more than 10 years (p = 0.034), whereas distress also remained high 10 years after cancer diagnosis. Almost half of the cohort (46.1%) reported still having symptoms, which were mainly lymphedema (37.7%), fatigue (23.9%), pain (21.6%), polyneuropathy (16.9%), gastrointestinal problems (16.6%), and memory problems (15.5%). Almost all patients (94.2%) regularly received follow-up care. Specialized survivorship care with a focus on long-term side effects, lifestyle, and prevention should be offered beyond the typical five years of follow-up care.
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Affiliation(s)
- Hannah Woopen
- Department of Gynecology with Center for Oncological Surgery, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
| | - Maren Keller
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
| | - Dario Zocholl
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
- Institute of Biometry and Clinical Epidemiology, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Suzana Mittelstadt
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
- Department of Women’s Health, University Hospital Tübingen, 72076 Tübingen, Germany
| | - Maria-Pilar Barretina-Ginesta
- Institut Català d’Oncologia, Medical Oncology Department, 17007 Girona, Spain
- Precision Oncology Group, Institut d’Investigació Biomèdica de Girona, 17007 Girona, Spain
- Medical Sciences Department, Universitat de Girona, 17003 Girona, Spain
- Grupo Español de Investigación en Cáncer de Ovario (GEICO), 28003 Madrid, Spain
| | - Viola Heinzelmann-Schwarz
- Department of Gynecology and Gynecologic Oncology, University Hospital of Basel, 4056 Basel, Switzerland
- Swiss GO Trial Group (Swiss-GO), 4031 Basel, Switzerland
| | - Judith Lafleur
- Department of Gynecology and Obstetrics, Ordensklinikum Barmherzige Schwestern Linz, 4020 Linz, Austria
- Arbeitsgemeinschaft Gynaekologische Onkologie Austria (AGO Austria), 6020 Innsbruck, Austria
| | - Roman Kocián
- Department of Gynaecology, Obstetrics and Neonatology First Faculty of Medicine, Charles University and General University Hospital in Prague, 12 108 Prague, Czech Republic
- General University Hospital in Prague, 12 808 Prague, Czech Republic
- Central and Eastern European Gynecologic Oncology Group (CEEGOG), 128 51 Prague, Czech Republic
| | - Joanna Baum
- Department of Gynecology with Center for Oncological Surgery, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
| | - Petra Krabisch
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
- Department of Gynaecology and Obstetrics, Klinikum Chemnitz, 09116 Chemnitz, Germany
| | - Patriciu Achimas-Cadariu
- Institute of Oncology Prof. Dr. I. Chiricuta Cluj-Napoca, University of Medicine and Pharmacy Iuliu Hatieganu, 400015 Cluj-Napoca, Romania
| | - Mehmet Ali Vardar
- Department of Gynecologic Oncology, Cukurova University, 01250 Adana, Turkey
- Turkish Society of Gynecologic Oncology (TRSGO), Ovecler, 06450 Ankara, Turkey
| | - Ignace Vergote
- Division of Gynaecological Oncology, Leuven Cancer Institute, University Hospitals Leuven, 3000 Leuven, Belgium
- Belgium and Luxembourg Gynaecological Oncology Group (BGOG), 3000 Leuven, Belgium
| | - Sara Nasser
- Department of Gynecology with Center for Oncological Surgery, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany
- Pan-Arabian Research Society of Gynecological Oncology (PARSGO), 13353 Berlin, Germany
| | - Theresa Link
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
- Department of Gynecology and Obstetrics, Technische Universität Dresden, 01307 Dresden, Germany
| | - Marta Gil-Martin
- Grupo Español de Investigación en Cáncer de Ovario (GEICO), 28003 Madrid, Spain
- Catalan Institute of Oncology—IDIBELL, L’Hospitalet-Barcelona, 08908 Barcelona, Spain
| | - Tibor A. Zwimpfer
- Department of Gynecology and Gynecologic Oncology, University Hospital of Basel, 4056 Basel, Switzerland
- Swiss GO Trial Group (Swiss-GO), 4031 Basel, Switzerland
| | - Katharina Leitner
- Arbeitsgemeinschaft Gynaekologische Onkologie Austria (AGO Austria), 6020 Innsbruck, Austria
- Department of Obstetrics and Gynecology, Innsbruck Medical University, 6020 Innsbruck, Austria
| | - Marcin Jedryka
- Central and Eastern European Gynecologic Oncology Group (CEEGOG), 128 51 Prague, Czech Republic
- Gynecological Oncology Department, Wroclaw Medical University, 50-367 Wroclaw, Poland
- Oncological Gynecology Department, Lower Silesian Oncology, Pulmonology and Hematology Center, 53-413 Wroclaw, Poland
| | | | - Elena Ioana Braicu
- Department of Gynecology with Center for Oncological Surgery, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
| | - Jalid Sehouli
- Department of Gynecology with Center for Oncological Surgery, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
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8
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Xie N, Lin J, Liu L, Deng S, Yu H, Sun Y. Nomograms constructed for predicting diagnosis and prognosis in cervical cancer patients with second primary malignancies: a SEER database analysis. J Cancer Res Clin Oncol 2023; 149:13201-13210. [PMID: 37479758 DOI: 10.1007/s00432-023-05192-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 07/16/2023] [Indexed: 07/23/2023]
Abstract
PURPOSE Cervical cancer (CC) patients are more likely to develop second primary malignancies (SPMs) than general population. With the advancement in cancer therapy, CC patients are achieving long-term survival, leading SPMs to our attention. Our study aims to establish diagnostic and prognostic nomograms for CC patients with second primary malignancies (CCSPMs) to help make personalized follow-up plans and treatments. METHODS Data of CCSPMs between 2000 and 2019 was extracted from SEER. The proportions and the median interval time of CCSPM onset were calculated. 11 related clinical characteristics, including age, race, marital status, grade, FIGO stage, radiotherapy, chemotherapy, and surgery, were further explore. Logistic and Cox regressions were employed to predict risk factors for CCSPMs diagnosis. Finally, two nomograms were developed to predict the probability occurrence and prognosis of CCSPMs, respectively. RESULTS For diagnostic nomogram construction, 59,178 CC patients were randomly divided into training (n = 41,426) and validation cohorts (n = 17,752). For prognostic nomogram construction, 3527 CCSPMs patients were randomly divided into training (n = 2469) and validation cohorts (n = 1058). The diagnostic nomogram consisting of above 11 independent risk factors (all P < 0.05), had high accuracy (AUCtraining = 0.851 and AUCvalidating = 0.845). The prognostic nomogram integrated with eight independent prognostic factors such as treatments, FIGO stage and TNM stage performed well in predicting 5-year OS (AUCtraining = 0.835 and AUCvalidating = 0.837). CONCLUSION Our diagnostic and prognostic nomograms could facilitate clinicians to quantify individual SPMs risk and survival probabilities and optimize the surveillance recommendations and personalized clinical decision-making.
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Affiliation(s)
- Ning Xie
- Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Jie Lin
- Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Linying Liu
- Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Sufang Deng
- Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Haijuan Yu
- Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Yang Sun
- Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China.
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Brummel B, van Heumen C, Smits A, van den Berg M, Ezendam NPM, Pijnenborg JMA, de van der Schueren MAE, Wilkinson SA, van der Meij BS. Barriers to and facilitators of a healthy lifestyle for patients with gynecological cancer: a systematic review of qualitative and quantitative research with healthcare providers and patients. Maturitas 2023; 177:107801. [PMID: 37541112 DOI: 10.1016/j.maturitas.2023.107801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/12/2023] [Accepted: 07/16/2023] [Indexed: 08/06/2023]
Abstract
The prevalence of an unhealthy lifestyle among patients with gynecological cancer is high and associated with increased risk of all-cause mortality. Although lifestyle changes have the potential to improve outcomes, lifestyle counseling is not routinely integrated into standard care. This review explores research on the barriers to and facilitators of both the promotion of healthy lifestyles by healthcare providers (HCPs) and healthy lifestyle changes by patients with gynecological cancer. The Theoretical Domains Framework (TDF) was used to deductively code the identified factors for a comprehensive understanding of the barriers and facilitators. A search across five databases yielded a total of 12,687 unique studies, of which 43 were included in the review. Of these 43, 39 included gynecological cancer patients and only 6 included HCPs. Among the barriers identified for HCPs, most studies evaluated barriers regarding weight loss counseling. Limited knowledge, reluctance to address weight loss, skepticism about the benefits, and workload concerns were commonly reported barriers for HCPs. HCPs will benefit from education and training in lifestyle counseling, including effective communication skills like motivational interviewing. Gynecological cancer patients lacked tools, support, knowledge, and faced mental health issues, environmental constraints, and physical limitations. The review emphasizes the importance of addressing these barriers and utilizing identified facilitators, such as social support, to promote and support healthy lifestyle behaviors on the part of patients and their promotion by HCPs. Future research should focus not only on patients but also on supporting HCPs and implementing necessary changes in current practices.
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Affiliation(s)
- Bo Brummel
- Department of Human Nutrition and Health, Wageningen University & Research, 6708 WE Wageningen, the Netherlands; Center of Research on Psychological and Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, 5037 AB Tilburg, the Netherlands
| | - Cindy van Heumen
- Department of Human Nutrition and Health, Wageningen University & Research, 6708 WE Wageningen, the Netherlands
| | - Anke Smits
- Department of Obstetrics & Gynecology, Radboudumc, 6525 GA Nijmegen, the Netherlands
| | - Manon van den Berg
- Department of Gastroenterology and Hepatology- Dietetics, Radboudumc, 6525 GA Nijmegen, the Netherlands
| | - Nicole P M Ezendam
- Center of Research on Psychological and Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, 5037 AB Tilburg, the Netherlands; Netherlands Comprehensive Cancer Organisation, 5612 HZ Eindhoven, the Netherlands
| | | | - Marian A E de van der Schueren
- Department of Human Nutrition and Health, Wageningen University & Research, 6708 WE Wageningen, the Netherlands; Department of Nutrition, Dietetics and Lifestyle, HAN University of Applied Sciences, 6525 EN Nijmegen, the Netherlands
| | - Shelley A Wilkinson
- Department of Obstetric Medicine, Mater Mothers Hospital, South Brisbane 4101, Australia; Lifestyle Maternity, Brisbane, QLD 4069, Australia
| | - Barbara S van der Meij
- Department of Human Nutrition and Health, Wageningen University & Research, 6708 WE Wageningen, the Netherlands; Department of Nutrition, Dietetics and Lifestyle, HAN University of Applied Sciences, 6525 EN Nijmegen, the Netherlands; Bond University Nutrition and Dietetics Research Group, Bond University, Gold Coast, QLD 4226, Australia.
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Quantification of Women Who Could Benefit from Hormone Therapy after Endometrial Cancer Treatment: An Analysis of SEER Data. Curr Oncol 2022; 29:9215-9223. [PMID: 36547135 PMCID: PMC9777495 DOI: 10.3390/curroncol29120721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 11/18/2022] [Accepted: 11/23/2022] [Indexed: 11/29/2022] Open
Abstract
Our primary aim was to estimate the magnitude of stage I endometrial cancer (EC) survivors that could benefit from hormonal therapy (HT). Our secondary aims were to assess EC incidence in women below 50 and below 60 over the years, and analyze the overall survival and any influencing factors. We analyzed the endometrioid EC data from the Surveillance, Epidemiology, and End Results (SEER) program according to women's age, tumor stage, and grade. We analyzed the proportions of EC survivors below 50 and below 60 years of age and stratified those age groups by race. For age distribution and survival analysis SEER, 18 registries' research data (2000-2018) were analyzed. We analyzed the SEER 12 registries' research data (1992-2019) for incidence time trends. Our investigation found a 14% and 40% cumulative prevalence of stage I EC that occurs in women below 50 or 60 years, respectively. EC's prevalence has progressively risen in recent decades, but cancer-specific mortality remains low. The increasing number of women affected by EC in premenopause or early postmenopause face an 18 years-survival rate of 96.86% and 95.73%, respectively. A significant proportion of low-grade EC survivors can potentially benefit from HT treatment, and this requires awareness of other aspects of their health or quality of life, in addition to cancer treatments.
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Affiliation(s)
- Angelo Cagnacci
- Academic Unit of Obstetrics and Gynecology, IRCCS- San Martino Hospital of Genova, Genova, Italy
- Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Infant Health (DiNOGMI), University of Genova, Genova, Italy
| | - Ambrogio P Londero
- Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Infant Health (DiNOGMI), University of Genova, Genova, Italy
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